Science.gov

Sample records for gas management options

  1. Evaluating greenhouse gas impacts of organic waste management options using life cycle assessment.

    PubMed

    Kong, Dung; Shan, Jilei; Iacoboni, Mario; Maguin, Stephen R

    2012-08-01

    Efforts to divert organics away from landfills are viewed by many as an important measure to significantly reduce the climate change impacts of municipal solid waste management. However, the actual greenhouse gas (GHG) impacts of organics diversion from landfills have yet to be thoroughly evaluated and whether such a diversion provides significant environmental benefits in terms of GHG impacts must be answered. This study, using California-specific information, aimed to analyse the GHG impacts of organics diversion through a life-cycle assessment (LCA). This LCA considered all aspects of organics management including transportation, materials handling, GHG emissions, landfill gas capture/utilization, energy impacts, and carbon sequestration. The LCA study evaluated overall GHG impacts of landfilling, and alternative management options such as composting and anaerobic digestion for diverted organic waste. The LCA analysis resulted in net GHG reductions of 0.093, 0.048, 0.065 and 0.073 tonnes carbon equivalent per tonne organic waste for landfilling, windrow composting, aerated static pile composting, and anaerobic digestion, respectively. This study confirms that all three options for organics management result in net reductions of GHG emissions, but it also shows that organics landfilling, when well-managed, generates greater GHG reductions. The LCA provides scientific insight with regards to the environmental impacts of organics management options, which should be considered in decision and policy-making. The study also highlights the importance of how site and case-specific conditions influence project outcomes when considering organic waste management options.

  2. Supply chain management and economic valuation of real options in the natural gas and liquefied natural gas industry

    NASA Astrophysics Data System (ADS)

    Wang, Mulan Xiaofeng

    My dissertation concentrates on several aspects of supply chain management and economic valuation of real options in the natural gas and liquefied natural gas (LNG) industry, including gas pipeline transportations, ocean LNG shipping logistics, and downstream storage. Chapter 1 briefly introduces the natural gas and LNG industries, and the topics studied in this thesis. Chapter 2 studies how to value U.S. natural gas pipeline network transport contracts as real options. It is common for natural gas shippers to value and manage contracts by simple adaptations of financial spread option formulas that do not fully account for the implications of the capacity limits and the network structure that distinguish these contracts. In contrast, we show that these operational features can be fully captured and integrated with financial considerations in a fairly easy and managerially significant manner by a model that combines linear programming and simulation. We derive pathwise estimators for the so called deltas and structurally characterize them. We interpret them in a novel fashion as discounted expectations, under a specific weighing distribution, of the amounts of natural gas to be procured/marketed when optimally using pipeline capacity. Based on the actual prices of traded natural gas futures and basis swaps, we show that an enhanced version of the common approach employed in practice can significantly underestimate the true value of natural gas pipeline network capacity. Our model also exhibits promising financial (delta) hedging performance. Thus, this model emerges as an easy to use and useful tool that natural gas shippers can employ to support their valuation and delta hedging decisions concerning natural gas pipeline network transport capacity contracts. Moreover, the insights that follow from our data analysis have broader significance and implications in terms of the management of real options beyond our specific application. Motivated by current developments

  3. Greenhouse gas emissions of waste management processes and options: A case study.

    PubMed

    de la Barrera, Belen; Hooda, Peter S

    2016-07-01

    Increasing concern about climate change is prompting organisations to mitigate their greenhouse gas emissions. Waste management activities also contribute to greenhouse gas emissions. In the waste management sector, there has been an increasing diversion of waste sent to landfill, with much emphasis on recycling and reuse to prevent emissions. This study evaluates the carbon footprint of the different processes involved in waste management systems, considering the entire waste management stream. Waste management data from the Royal Borough of Kingston upon Thames, London (UK), was used to estimate the carbon footprint for its (Royal Borough of Kingston upon Thames) current source segregation system. Second, modelled full and partial co-mingling scenarios were used to estimate carbon emissions from these proposed waste management approaches. The greenhouse gas emissions from the entire waste management system at Royal Borough of Kingston upon Thames were 12,347 t CO2e for the source-segregated scenario, and 11,907 t CO2e for the partial co-mingled model. These emissions amount to 203.26 kg CO2e t(-1) and 196.02 kg CO2e t(-1) municipal solid waste for source-segregated and partial co-mingled, respectively. The change from a source segregation fleet to a partial co-mingling fleet reduced the emissions, at least partly owing to a change in the number and type of vehicles.

  4. Options for fuel management

    SciTech Connect

    Reardon, L.D. Jr.; Chance, R.C.

    1996-12-31

    The key to cofiring wood or other biomass with coal in existing power stations is fuel management. Fuel management includes the procurement, receiving, processing, storage, and blending of the biomass with coal. Procurement options may include the purchase of lower cost biomass fuels, receipt of subsidies to make capital modifications to cofire biomass {open_quotes}waste{close_quotes} fuels or receive tipping fees where biomass waste disposal options for a particular area are expensive. Biomass receiving options include delivery methods, unloading, measurement, and inspection. Processing options are associated with screen types, drying systems, final particle size required, and associated questions of fuel supply reliability. Issues include the ability of the coal yard to accept this processing operation, handling convenience, traffic patterns, staffing requirements, and ultimately the cost of fuel at the burner. Issues associated with storage include locating the facility, managing dust, managing moisture pick-up, and managing runoff. Blending options include pre-blending or designing a system to blend the fuels as they are transported from the coal yard to the bunkers. This paper reviews the major decisions that have to be made, and discusses some of the options available. It draws upon existing experience in cofiring systems to achieve a low cost, high reliability system to use biomass at coal-fired electricity generating stations.

  5. Economic outcomes of greenhouse gas mitigation options

    USDA-ARS?s Scientific Manuscript database

    Economic outcomes of greenhouse gas (GHG) mitigation options are reviewed including reductions in tillage intensity, diversifying crop rotation, and N fertilizer management. The review indicates that, while reducing tillage can be a cost effective GHG mitigation practice, results vary by region and ...

  6. Mixed waste management options

    SciTech Connect

    Owens, C.B.; Kirner, N.P.

    1991-12-31

    Disposal fees for mixed waste at proposed commercial disposal sites have been estimated to be $15,000 to $40,000 per cubit foot. If such high disposal fees are imposed, generators may be willing to apply extraordinary treatment or regulatory approaches to properly dispose of their mixed waste. This paper explores the feasibility of several waste management scenarios and attempts to answer the question: Can mixed waste be managed out of existence? Existing data on commercially generated mixed waste streams are used to identify the realm of mixed waste known to be generated. Each waste stream is evaluated from both a regulatory and technical perspective in order to convert the waste into a strictly low-level radioactive or a hazardous waste. Alternative regulatory approaches evaluated in this paper include a delisting petition, no migration petition, and a treatability variance. For each waste stream, potentially available treatment options are identified that could lead to these variances. Waste minimization methodology and storage for decay are also considered. Economic feasibility of each option is discussed broadly.

  7. Environmental assessment of gas management options at the Old Ammässuo landfill (Finland) by means of LCA-modeling (EASEWASTE).

    PubMed

    Manfredi, Simone; Niskanen, Antti; Christensen, Thomas H

    2009-05-01

    The current landfill gas (LFG) management (based on flaring and utilization for heat generation of the collected gas) and three potential future gas management options (LFG flaring, heat generation and combined heat and power generation) for the Old Ammässuo landfill (Espoo, Finland) were evaluated by life-cycle assessment modeling. The evaluation accounts for all resource utilization and emissions to the environment related to the gas generation and management for a life-cycle time horizon of 100 yr. The assessment criteria comprise standard impact categories (global warming, photo-chemical ozone formation, stratospheric ozone depletion, acidification and nutrient enrichment) and toxicity-related impact categories (human toxicity via soil, via water and via air, eco-toxicity in soil and in water chronic). The results of the life-cycle impact assessment show that disperse emissions of LFG from the landfill surface determine the highest potential impacts in terms of global warming, stratospheric ozone depletion, and human toxicity via soil. Conversely, the impact potentials estimated for other categories are numerically-negative when the collected LFG is utilized for energy generation, demonstrating that net environmental savings can be obtained. Such savings are proportional to the amount of gas utilized for energy generation and the gas energy recovery efficiency achieved, which thus have to be regarded as key parameters. As a result, the overall best performance is found for the heat generation option - as it has the highest LFG utilization/energy recovery rates - whereas the worst performance is estimated for the LFG flaring option, as no LFG is here utilized for energy generation. Therefore, to reduce the environmental burdens caused by the current gas management strategy, more LFG should be used for energy generation. This inherently requires a superior LFG capture rate that, in addition, would reduce fugitive emissions of LFG from the landfill surface

  8. Peak load management: Potential options

    SciTech Connect

    Englin, J.E.; De Steese, J.G.; Schultz, R.W.; Kellogg, M.A.

    1989-10-01

    This report reviews options that may be alternatives to transmission construction (ATT) applicable both generally and at specific locations in the service area of the Bonneville Power Administration (BPA). Some of these options have potential as specific alternatives to the Shelton-Fairmount 230-kV Reinforcement Project, which is the focus of this study. A listing of 31 peak load management (PLM) options is included. Estimated costs and normalized hourly load shapes, corresponding to the respective base load and controlled load cases, are considered for 15 of the above options. A summary page is presented for each of these options, grouped with respect to its applicability in the residential, commercial, industrial, and agricultural sectors. The report contains comments on PLM measures for which load shape management characteristics are not yet available. These comments address the potential relevance of the options and the possible difficulty that may be encountered in characterizing their value should be of interest in this investigation. The report also identifies options that could improve the efficiency of the three customer utility distribution systems supplied by the Shelton-Fairmount Reinforcement Project. Potential cogeneration options in the Olympic Peninsula are also discussed. These discussions focus on the options that appear to be most promising on the Olympic Peninsula. Finally, a short list of options is recommended for investigation in the next phase of this study. 9 refs., 24 tabs.

  9. Newer Management Options in Leprosy

    PubMed Central

    Rao, P Narasimha; Jain, Suman

    2013-01-01

    Newer management options are needed for leprosy control even at present, as it is predicted that new cases of leprosy will continue to appear for many more years in future. This article detail newer methods of clinical grading of peripheral nerve involvement (thickening, tenderness and nerve pain which are subjective in nature) and the advances made in the use of Ultrasonography and Colour Doppler as an objective imaging tool for nerves in leprosy. It also briefly discusses the newer drugs and alternative regimens as therapeutic management options which hold promise for leprosy in future. PMID:23372204

  10. Managing Nuclear Waste: Options Considered

    SciTech Connect

    DOE

    2002-05-02

    Starting in the 1950s, U.S. scientists began to research ways to manage highly radioactive materials accumulating at power plants and other sites nationwide. Long-term surface storage of these materials poses significant potential health, safety, and environmental risks. Scientists studied a broad range of options for managing spent nuclear fuel and high-level radioactive waste. The options included leaving it where it is, disposing of it in various ways, and making it safer through advanced technologies. International scientific consensus holds that these materials should eventually be disposed of deep underground in what is called a geologic repository. In a recent special report, the National Academy of Sciences summarized the various studies and emphasized that geologic disposal is ultimately necessary.

  11. Greenhouse gas mitigation options for Washington State

    SciTech Connect

    Garcia, N.

    1996-04-01

    President Clinton, in 1993, established a goal for the United States to return emissions of greenhouse gases to 1990 levels by the year 2000. One effort established to help meet this goal was a three part Environmental Protection Agency state grant program. Washington State completed part one of this program with the release of the 1990 greenhouse gas emissions inventory and 2010 projected inventory. This document completes part two by detailing alternative greenhouse gas mitigation options. In part three of the program EPA, working in partnership with the States, may help fund innovative greenhouse gas reduction strategies. The greenhouse gas control options analyzed in this report have a wide range of greenhouse gas reductions, costs, and implementation requirements. In order to select and implement a prudent mix of control strategies, policy makers need to have some notion of the potential change in climate, the consequences of that change and the uncertainties contained therein. By understanding the risks of climate change, policy makers can better balance the use of scarce public resources for concerns that are immediate and present against those that affect future generations. Therefore, prior to analyzing alternative greenhouse gas control measures, this report briefly describes the phenomenon and uncertainties of global climate change, and then projects the likely consequences for Washington state.

  12. Managing financial risk with options on futures.

    PubMed

    Bond, M T; Marshall, B S

    1995-05-01

    With the rise of managed care and capitation, more providers will be sharing in the financial risk of providing care. To help protect their organizations from the risk of unexpectedly high utilization under such a fixed-payment system, healthcare financial managers soon will be able to use options on futures contracts. These contracts provide wide profit potential but limited loss potential. Before investing in options on futures, however, healthcare financial managers should consider issues such as basis risk and trading costs.

  13. Bt: One Option for Gypsy Moth Management

    Treesearch

    Deborah C. Mccullough; Leah S. Bauer

    2000-01-01

    Though the gypsy moth will never go away, you have a variety of options to help manage this pest during outbreaks. One option involves the use of Bt to protect tree foliage and reduce the annoyance caused by gypsy moth caterpillars during an outbreak. Bt or Btk refers to a microorganism called Bacillus Thuringeniesis var. kurstaki. Bt has been widely adopted for...

  14. Osteoarthritis - management options in general practice.

    PubMed

    McKenzie, Suzanne; Torkington, Amanda

    2010-09-01

    Osteoarthritis, characterised by joint pain and stiffness, is a common and significant chronic disease, reducing mobility and causing considerable impact on quality of life. Multiple evidence based management options are available. The aim of this article is to summarise the main management options suggested in The Royal Australian College of General Practitioners Guideline for the nonsurgical management of hip and knee osteoarthritis and to also highlight those that are not recommended. Following diagnosis based primarily on history and examination, management focuses on optimising quality of life by providing self management advice combined with appropriate pharmacological and nonpharmacological strategies, aiming to reduce acute exacerbations, prevent complications and delay progression.

  15. Greenhouse gas emission reduction options and strategies

    SciTech Connect

    Kane, R.L.; Klein, D.E.

    1994-12-31

    This paper describes the energy-related components of the Clinton Administration`s Climate Change Action Plan. The Action Plan was formulated to meet the Administration`s commitment of returning US emissions of greenhouse gases to 1990 levels by the year 2000. The paper discusses what the energy industry and energy consumers will be requested to do in order to meet this commitment. Several themes addressed in this paper include: (1) the largely voluntary nature of the actions identified in the Action Plan; (2) consideration of diverse opportunities to reduce emissions; (3) the outlook for US greenhouse gas emissions after 2000; and (4) actions involved for speeding the utilization of new, energy efficient technologies both domestically and abroad. The value of employing a diverse set of activities and the important role of technology improvements will be explored further in section 10 of this volume: ``Greenhouse Gas Emission Mitigation Strategies.`` Papers presented there include the utilization of more efficient fossil energy technologies, energy conservation and demand-side management programs, renewable energy and reforestation, and carbon dioxide capture and disposal.

  16. Options in dairy data management.

    PubMed

    Etherington, W G; Kinsel, M L; Marsh, W E

    1995-01-01

    A great deal of progress has been made in the development of dairy herd management software in the last few years. At the same time, the speed, capacity, and portability of computer hardware have increased, while costs have decreased, thus encouraging use by veterinarians,dairy herd managers, and other industry support groups. A review of the literature indicates that an increasing number of producers, veterinarians, and other dairy industry service personnel are using computers and dairy herd management software in the delivery of their services (1-3,5,9-11,26-30,38,39). Wider adoption will occur if information generated through the use of these systems is directed towards the improvement of the profitability of dairy production. The quality of a decision is only as good as the information used to make it. In the past, the limited availability of reliable herd data has restricted our understanding of factors that influence herd performance. In essence, we must define what is normal before we can determine what is abnormal. More importantly, we must define what management practices are profitable and to what extent they increase revenue (3 1,32). Improved record keeping will benefit the dairy industry by allowing producers and dairy consultants to make profitable decisions based on more accurate and complete information. The ability to merge biological, management,and economic data may prove valuable in the evaluation of intervention at the herd and individual animal level. The impact of interventions is often as much a function of the unique combination of management factors on a dairy, as the biological effect that can be evaluated in a clinical trial. For example, the use of gonadotrophin-releasing hormone therapy at the time of service has been shown to be more successful in herds with better than average conception rates than in herds with poor conception rates. This difference in efficacy may be due to nutritional and other herd level management factors

  17. Options in dairy data management.

    PubMed Central

    Etherington, W G; Kinsel, M L; Marsh, W E

    1995-01-01

    A great deal of progress has been made in the development of dairy herd management software in the last few years. At the same time, the speed, capacity, and portability of computer hardware have increased, while costs have decreased, thus encouraging use by veterinarians, dairy herd managers, and other industry support groups. A review of the literature indicates that an increasing number of producers, veterinarians, and other dairy industry service personnel are using computers and dairy herd management software in the delivery of their services (1-3,5,9-11,26-30,38,39). Wider adoption will occur if information generated through the use of these systems is directed towards the improvement of the profitability of dairy production. The quality of a decision is only as good as the information used to make it. In the past, the limited availability of reliable herd data has restricted our understanding of factors that influence herd performance. In essence, we must define what is normal before we can determine what is abnormal. More importantly, we must define what management practices are profitable and to what extent they increase revenue (31,32). Improved record keeping will benefit the dairy industry by allowing producers and dairy consultants to make profitable decisions based on more accurate and complete information. The ability to merge biological, management, and economic data may prove valuable in the evaluation of intervention at the herd and individual animal level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7859210

  18. School Management Options for American Indians.

    ERIC Educational Resources Information Center

    Streiff, Paul R.

    In response to the Presidential/Secretarial Educational Objective of 1975 which called for a statement from American Indian communities relative to their educational management preferences, the Office of Indian Education Programs (OIEP) established a program for gathering and disseminating educational management options to Indian people. A seven…

  19. Herbicide options for hardwood management

    Treesearch

    Andrew W. Ezell; A. Brady Self

    2016-01-01

    The use of herbicides in hardwood management presents special problems in that many of the most effective herbicides are either designed to control hardwoods or the product is not labeled for such applications. Numerous studies involving herbicide application in hardwoods have been completed at Mississippi State University. This paper is a compilation of results from...

  20. Management options in decompensated cirrhosis.

    PubMed

    Shah, Neeral L; Banaei, Yasmin Pourkazemi; Hojnowski, Kristen L; Cornella, Scott L

    2015-01-01

    Chronic injury to the liver from a variety of different sources can result in irreversible scarring of the liver, known as cirrhosis. Cirrhosis is a major cause of morbidity and mortality in the USA, and according to the Centers for Disease Control and Prevention was responsible for 31,903 deaths in 2010 alone. It is thus of the utmost importance to appropriately manage these patients in the inpatient and outpatient setting to improve morbidity and mortality. In this review, we address four major areas of cirrhosis management: outpatient management of portal hypertension with decompensation, hepatic encephalopathy, hepatorenal syndrome, and bleeding/coagulation issues. Outpatient management covers recommendations for health care maintenance and screening. Hepatic encephalopathy encompasses a brief review of pathophysiology, treatment in the acute setting, and long-term prevention. Hepatorenal syndrome is discussed in regards to pathophysiology and treatment in the hospital setting. Finally, a discussion of the assessment of coagulation profiles in cirrhosis and recommendations for bleeding and thrombosis complications is included. These topics are not all encompassing with regard to this complicated population, but rather an overview of a few medical problems that are commonly encountered in their care.

  1. Managing diseases in seed garlic: What are the options?

    USDA-ARS?s Scientific Manuscript database

    Organisms (fungi, bacteria, viruses and nematodes) causing diseases of seed garlic are discussed in terms of their pathogenic abilities, aggressiveness, management constraints and management options. Management options for vectors (for viral diseases) are placed in context. Concise and general manag...

  2. Technological options for the management of biosolids.

    PubMed

    Wang, Hailong; Brown, Sally L; Magesan, Guna N; Slade, Alison H; Quintern, Michael; Clinton, Peter W; Payn, Tim W

    2008-06-01

    Large quantities of biosolids (sewage sludge), which are produced from municipal wastewater treatment, are ever-increasing because of the commissioning of new treatment plants and continuous upgrades of the existing facilities. A large proportion of biosolids are currently landfilled. With increasing pressure from regulators and the general public, landfilling of biosolids is being phased out in many countries because of potential secondary pollution caused by leachate and the emission of methane, a potent greenhouse gas. Biosolids contain nutrients and energy that can be used beneficially. Significant efforts have been made recently to develop new technologies to manage biosolids and make useful products from them. In this paper, we provide a review of the technologies in biosolids management. A survey of literature was conducted. At present, the most common beneficial use of biosolids is agricultural land application because of inherent fertilizer values found in biosolids. Expansion of land application, however, may be limited in the future because of more stringent regulatory requirements and public concern about food chain contamination in some countries. Perceived as a green energy source, the combustion of biosolids has received renewed interest. Anaerobic digestion is generally a more effective method than incineration for energy recovery, and digested biosolids are suitable for further beneficial use through land application. Although conventional incineration systems for biosolid management generally consume more energy than they produce because of the high moisture content in the biosolids, it is expected that more combustion systems, either monocombustion or cocombustion, will be built to cope with the increasing quantity of biosolids. Under the increasingly popular low-carbon economy policy, biosolids may be recognized as a renewable fuel and be eligible for 'carbon credits'. Because ash can be used to manufacture construction materials, combustion can

  3. Greenhouse Gas Mitigation Options Database(GMOD)and Tool

    EPA Science Inventory

    Greenhouse Gas Mitigation Options Database (GMOD) is a decision support database and tool that provides cost and performance information for GHG mitigation options for the power, cement, refinery, landfill and pulp and paper sectors. The GMOD includes approximately 450 studies fo...

  4. Greenhouse Gas Mitigation Options Database(GMOD)and Tool

    EPA Science Inventory

    Greenhouse Gas Mitigation Options Database (GMOD) is a decision support database and tool that provides cost and performance information for GHG mitigation options for the power, cement, refinery, landfill and pulp and paper sectors. The GMOD includes approximately 450 studies fo...

  5. Economics of Alaska North Slope gas utilization options

    SciTech Connect

    Thomas, C.P.; Doughty, T.C.; Hackworth, J.H.; North, W.B.; Robertson, E.P.

    1996-08-01

    The recoverable natural gas available for sale in the developed and known undeveloped fields on the Alaskan North Slope (ANS) total about 26 trillion cubic feet (TCF), including 22 TCF in the Prudhoe Bay Unit (PBU) and 3 TCF in the undeveloped Point Thomson Unit (PTU). No significant commercial use has been made of this large natural gas resource because there are no facilities in place to transport this gas to current markets. To date the economics have not been favorable to support development of a gas transportation system. However, with the declining trend in ANS oil production, interest in development of this huge gas resource is rising, making it important for the U.S. Department of Energy, industry, and the State of Alaska to evaluate and assess the options for development of this vast gas resource. The purpose of this study was to assess whether gas-to-liquids (GTL) conversion technology would be an economic alternative for the development and sale of the large, remote, and currently unmarketable ANS natural gas resource, and to compare the long term economic impact of a GTL conversion option to that of the more frequently discussed natural gas pipeline/liquefied natural gas (LNG) option. The major components of the study are: an assessment of the ANS oil and gas resources; an analysis of conversion and transportation options; a review of natural gas, LNG, and selected oil product markets; and an economic analysis of the LNG and GTL gas sales options based on publicly available input needed for assumptions of the economic variables. Uncertainties in assumptions are evaluated by determining the sensitivity of project economics to changes in baseline economic variables.

  6. Landfill-gas utilization: Options, benefits, and barriers

    SciTech Connect

    Thorneloe, S.A.

    1992-01-01

    Of the more than 6,000 active municipal solid waste landfills in the United States (U.S.), there are 114 landfill gas (LFG) to energy projects. The paper describes the different options for LFG to energy projects and provides statistics on the U.S. LFG industry. The paper also provides an overview of the benefits associated with LFG utilization and identifies some of the current barriers in the U.S. that affect LFG utilization. The support for the research is from the U.S. Environmental Protection Agency's (EPA's) Global Climate Change Program on emissions and mitigation from landfills and other waste management facilities that produce greenhouse gases. EPA's Air and Energy Engineering Research Laboratory (AEERL) has responsibility for EPA's research on emissions and mitigation for the major sources contributing to global climate change.

  7. Domestic Options to Offshore Oil and Gas.

    ERIC Educational Resources Information Center

    Kash, Don E.

    1983-01-01

    The continuing controversey over offshore oil/gas has given impetus to searching for domestic energy alternatives. The need for and types of several alternative sources are discussed. Indicates that the United States needs to pursue both offshore and other domestic liquid-fuel sources if it is to avoid becoming increasingly dependent on imports.…

  8. Domestic Options to Offshore Oil and Gas.

    ERIC Educational Resources Information Center

    Kash, Don E.

    1983-01-01

    The continuing controversey over offshore oil/gas has given impetus to searching for domestic energy alternatives. The need for and types of several alternative sources are discussed. Indicates that the United States needs to pursue both offshore and other domestic liquid-fuel sources if it is to avoid becoming increasingly dependent on imports.…

  9. Sediment Management Options for Galveston Island, Texas

    DTIC Science & Technology

    2015-06-15

    the potential for long-term sustainability are presented. Galveston Island is a 47 km long sand barrier island along the upper Texas coast (Figure...1 SEDIMENT MANAGEMENT OPTIONS FOR GALVESTON ISLAND , TEXAS ASHLEY E. FREY1, ANDREW MORANG1, DAVID B. KING1, ROBERT C. THOMAS2 1. U.S. Army...Galveston Island is a major tourist and commercial center on the Gulf of Mexico at the mouth of Galveston Bay, Texas, USA. The shoreline along the

  10. NSPS monitoring options for landfill gas

    SciTech Connect

    Stollings, W.A.

    1998-12-31

    The analytical methods prescribed in the New Source Performance Standards (NSPS) for Municipal Solid Waste (MSW) landfills are USEPA Method 18 and USEPA Method 25-C/3-C. There have been considerable confusion and problems in the implementation of monitoring programs using these methods. The requirements for these methods are reviewed and compared. Many of the positive and negative aspects for each of these methods are detailed and possible options are examined. Results of several field samples comparing Non-Methane Organic Compounds (NMOC) to a modified TO-14 and TO-15 analysis are reviewed. Results of an inter-laboratory analyses of USEPA audits and field samples are also compared. The modifications to the methods and their effects upon the reported results are explored. This information will be useful in planning and implementing defendable sampling programs for NSPS

  11. Erectile dysfunction management options in Nigeria.

    PubMed

    Afolayan, Anthony Jide; Yakubu, Musa Toyin

    2009-04-01

    In Nigeria, the prevalence of erectile dysfunction (ED) among patients attending primary care clinics, age-standardized to the U.S. population in 2000 is 57.4%. This is considered high enough to warrant the attention of scientist for critical studies and analysis. The high ED prevalence is associated with etiologies such as psychosexual factors, chronic medical conditions, and some lifestyles. ED constitutes a major public health problem, influencing the patient's well-being and quality of life. It also leads to broken homes and marriages, psychological, social, and physical morbidity. To give an account of various ED management options in Nigeria. Review of peer-reviewed literature, questionnaire, and ethnobotanical survey to some indigenous herb sellers and herbalists. Cross cultural perspectives of ED management in Nigeria. The review suggests that traditional (phytotherapy, zootherapy, and occultism) and nontraditional, orthodox practice (drug therapy, psychological, and behavioral counseling) are applicable to ED management in Nigeria. This review should help in creating awareness into various options available for managing ED in the country, but does not recommend self medication of any form, be it the use of orthodox or herbal remedy.

  12. Selected Energy Management Options for Small Business and Local Government.

    ERIC Educational Resources Information Center

    Wert, Jonathan M.; Worthington, Barry K.

    This document is a checklist of 257 energy management options for small business and local government. The energy management options are categorized under: (1) Energy management strategies; (2) Buildings; (3) Lighting; (4) Water; (5) Waste operations; (6) Equipment; (7) Transportation; and (8) Food preparation. To select options for…

  13. Therapeutic options for management of endometrial hyperplasia.

    PubMed

    Chandra, Vishal; Kim, Jong Joo; Benbrook, Doris Mangiaracina; Dwivedi, Anila; Rai, Rajani

    2016-01-01

    Endometrial hyperplasia (EH) comprises a spectrum of changes in the endometrium ranging from a slightly disordered pattern that exaggerates the alterations seen in the late proliferative phase of the menstrual cycle to irregular, hyperchromatic lesions that are similar to endometrioid adenocarcinoma. Generally, EH is caused by continuous exposure of estrogen unopposed by progesterone, polycystic ovary syndrome, tamoxifen, or hormone replacement therapy. Since it can progress, or often occur coincidentally with endometrial carcinoma, EH is of clinical importance, and the reversion of hyperplasia to normal endometrium represents the key conservative treatment for prevention of the development of adenocarcinoma. Presently, cyclic progestin or hysterectomy constitutes the major treatment option for EH without or with atypia, respectively. However, clinical trials of hormonal therapies and definitive standard treatments remain to be established for the management of EH. Moreover, therapeutic options for EH patients who wish to preserve fertility are challenging and require nonsurgical management. Therefore, future studies should focus on evaluation of new treatment strategies and novel compounds that could simultaneously target pathways involved in the pathogenesis of estradiol-induced EH. Novel therapeutic agents precisely targeting the inhibition of estrogen receptor, growth factor receptors, and signal transduction pathways are likely to constitute an optimal approach for treatment of EH.

  14. Therapeutic options for management of endometrial hyperplasia

    PubMed Central

    2016-01-01

    Endometrial hyperplasia (EH) comprises a spectrum of changes in the endometrium ranging from a slightly disordered pattern that exaggerates the alterations seen in the late proliferative phase of the menstrual cycle to irregular, hyperchromatic lesions that are similar to endometrioid adenocarcinoma. Generally, EH is caused by continuous exposure of estrogen unopposed by progesterone, polycystic ovary syndrome, tamoxifen, or hormone replacement therapy. Since it can progress, or often occur coincidentally with endometrial carcinoma, EH is of clinical importance, and the reversion of hyperplasia to normal endometrium represents the key conservative treatment for prevention of the development of adenocarcinoma. Presently, cyclic progestin or hysterectomy constitutes the major treatment option for EH without or with atypia, respectively. However, clinical trials of hormonal therapies and definitive standard treatments remain to be established for the management of EH. Moreover, therapeutic options for EH patients who wish to preserve fertility are challenging and require nonsurgical management. Therefore, future studies should focus on evaluation of new treatment strategies and novel compounds that could simultaneously target pathways involved in the pathogenesis of estradiol-induced EH. Novel therapeutic agents precisely targeting the inhibition of estrogen receptor, growth factor receptors, and signal transduction pathways are likely to constitute an optimal approach for treatment of EH. PMID:26463434

  15. New options in the management of tendinopathy

    PubMed Central

    Maffulli, Nicola; Longo, Umile Giuseppe; Loppini, Mattia; Spiezia, Filippo; Denaro, Vincenzo

    2010-01-01

    Tendon injuries can be acute or chronic, and caused by intrinsic or extrinsic factors, either alone or in combination. Tendinopathies are a common cause of disability in occupational medicine and account for a substantial proportion of overuse injuries in sports. Tendinopathy is essentially a failed healing response, with haphazard proliferation of tenocytes, abnormalities in tenocytes, with disruption of collagen fibres and subsequent increase in noncollagenous matrix. The scientific evidence base for managing tendinopathies is limited. What may appear clinically as an “acute tendinopathy” is actually a well advanced failure of a chronic healing response in which there is neither histologic nor biochemical evidence of inflammation. In this review we report the new options for the management of tendinopathy, including eccentric exercises, extracorporeal shockwave therapy, injections (intratendinous injections of corticosteroids, aprotinin, polidocanol platelet-rich plasma, autologous blood injection, high-volume injections) and surgery. Open surgery aims to excise fibrotic adhesions, remove areas of failed healing and make multiple longitudinal incisions in the tendon to detect intratendinous lesions, and to restore vascularity and possibly stimulate the remaining viable cells to initiate cell matrix response and healing. New surgical techniques aim to disrupt the abnormal neoinnervation to interfere with the pain sensation caused by tendinopathy. These procedures are intrinsically different from the classical ones in present use, because they do not attempt to address directly the pathologic lesion, but act only to denervate them. They include endoscopy, electrocoagulation, and minimally invasive stripping. Further randomized controlled trials are necessary to clarify better the best therapeutic options for the management of tendinopathy. PMID:24198540

  16. Greenhouse Gas Mitigation Options Database and Tool - Data ...

    EPA Pesticide Factsheets

    Industry and electricity production facilities generate over 50 percent of greenhouse gas (GHG) emissions in the United States. There is a growing consensus among scientists that the primary cause of climate change is anthropogenic greenhouse gas (GHG) emissions. Reducing GHG emissions from these sources is a key part of the United States’ strategy to reduce the impacts of these global-warming emissions. As a result of the recent focus on GHG emissions, the U.S. Environmental Protection Agency (EPA) and state agencies are implementing policies and programs to quantify and regulate GHG emissions from key emitting sources in the United States. These policies and programs have generated a need for a reliable source of information regarding GHG mitigation options for both industry and regulators. In response to this need, EPA developed a comprehensive GHG mitigation options database (GMOD) that was compiled based on information from industry, government research agencies, and academia. The GMOD and Tool (GMODT) is a comprehensive data repository and analytical tool being developed by EPA to evaluate alternative GHG mitigation options for several high-emitting industry sectors, including electric power plants, cement plants, refineries, landfills and other industrial sources of GHGs. The data is collected from credible sources including peer-reviewed journals, reports, and others government and academia data sources which include performance, applicability, develop

  17. Cornual heterotopic pregnancy: contemporary management options.

    PubMed

    Habana, A; Dokras, A; Giraldo, J L; Jones, E E

    2000-05-01

    This review covers the clinical presentations, treatments, and outcomes of cornual heterotopic pregnancies reported in the literature. Infertile women with a history of ectopic pregnancy, tubal surgery, or disease are at increased risk for cornual heterotopic pregnancy when they undergo in vitro fertilization. Women who have undergone bilateral salpingectomy also seem to be predisposed to this condition when they undergo in vitro fertilization. We recommend that these patients be followed up closely after a successful in vitro fertilization cycle with monitoring of serum beta-human chorionic gonadotropin levels and serial transvaginal ultrasonography because of the high associated morbidity. Laparotomy remains the treatment of choice for rupture of a cornual heterotopic pregnancy. In the absence of cornual rupture, however, medical management is an option that eliminates the risk of surgery and anesthesia and results in outcomes similar to those associated with surgical treatment. Currently there is insufficient evidence to recommend any single treatment modality, and the decision should be based on such factors as clinical presentation, surgeon's expertise, side effects, overall cost, and the patient's preference.

  18. Development of Greenhouse Gas Mitigation Options for Alberta's Energy Sector

    NASA Astrophysics Data System (ADS)

    Subramanyam, Veena

    Alberta is the third largest economy in Canada and is expected to grow significantly in the coming decade. The energy sector plays a major role in Alberta's economy. The objective of this research is to develop various greenhouse gas (GHG) mitigations scenarios in the energy demand and supply sectors for the Province of Alberta. This is done through an energy-environment planning and forecasting tool called Long Range Energy Alternative Planning system model (LEAP). By using LEAP, a sankey diagram for energy and emission flows for the Province of Alberta has been developed. A reference case also called as business-as-usual scenario was developed for a study period of 25 years (2005-2030). The GHG mitigation scenarios encompassed various demand and supply side scenarios. In the energy conversion sector, mitigation scenarios for renewable power generation and inclusion of supercritical, ultra-supercritical and integrated gasification combined cycle (IGCC) plants were investigated. In the oil and gas sector, GHG mitigation scenarios with carbon capture and sequestration (CCS) option were considered. In Alberta's residential and commercial sector 4-6 MT of CO2 equivalents per year of GHG mitigation could be achieved with efficiency improvement. In the industrial sector up to 40 MT of CO2 equivalents per year of GHG reduction could be achieved with efficiency improvement. In the energy conversion sector large GHG mitigation potential lies in the oil and gas sector and also in power plants with carbon capture and storage (CCS) option. The total GHG mitigation possible in the supply side option is between 20--70 MT CO2 equivalents per year.

  19. Life cycle assessment of bagasse waste management options

    SciTech Connect

    Kiatkittipong, Worapon; Wongsuchoto, Porntip; Pavasant, Prasert

    2009-05-15

    Bagasse is mostly utilized for steam and power production for domestic sugar mills. There have been a number of alternatives that could well be applied to manage bagasse, such as pulp production, conversion to biogas and electricity production. The selection of proper alternatives depends significantly on the appropriateness of the technology both from the technical and the environmental points of view. This work proposes a simple model based on the application of life cycle assessment (LCA) to evaluate the environmental impacts of various alternatives for dealing with bagasse waste. The environmental aspects of concern included global warming potential, acidification potential, eutrophication potential and photochemical oxidant creation. Four waste management scenarios for bagasse were evaluated: landfilling with utilization of landfill gas, anaerobic digestion with biogas production, incineration for power generation, and pulp production. In landfills, environmental impacts depended significantly on the biogas collection efficiency, whereas incineration of bagasse to electricity in the power plant showed better environmental performance than that of conventional low biogas collection efficiency landfills. Anaerobic digestion of bagasse in a control biogas reactor was superior to the other two energy generation options in all environmental aspects. Although the use of bagasse in pulp mills created relatively high environmental burdens, the results from the LCA revealed that other stages of the life cycle produced relatively small impacts and that this option might be the most environmentally benign alternative.

  20. Life cycle assessment of bagasse waste management options.

    PubMed

    Kiatkittipong, Worapon; Wongsuchoto, Porntip; Pavasant, Prasert

    2009-05-01

    Bagasse is mostly utilized for steam and power production for domestic sugar mills. There have been a number of alternatives that could well be applied to manage bagasse, such as pulp production, conversion to biogas and electricity production. The selection of proper alternatives depends significantly on the appropriateness of the technology both from the technical and the environmental points of view. This work proposes a simple model based on the application of life cycle assessment (LCA) to evaluate the environmental impacts of various alternatives for dealing with bagasse waste. The environmental aspects of concern included global warming potential, acidification potential, eutrophication potential and photochemical oxidant creation. Four waste management scenarios for bagasse were evaluated: landfilling with utilization of landfill gas, anaerobic digestion with biogas production, incineration for power generation, and pulp production. In landfills, environmental impacts depended significantly on the biogas collection efficiency, whereas incineration of bagasse to electricity in the power plant showed better environmental performance than that of conventional low biogas collection efficiency landfills. Anaerobic digestion of bagasse in a control biogas reactor was superior to the other two energy generation options in all environmental aspects. Although the use of bagasse in pulp mills created relatively high environmental burdens, the results from the LCA revealed that other stages of the life cycle produced relatively small impacts and that this option might be the most environmentally benign alternative.

  1. Management options for recycling radioactive scrap metals

    SciTech Connect

    Dehmel, J.C.; MacKinney, J.; Bartlett, J.

    1997-02-01

    The feasibility and advantages of recycling radioactive scrap metals (RSM) have yet to be assessed, given the unique technical, regulatory, safety, and cost-benefit issues that have already been raised by a concerned recycling industry. As is known, this industry has been repeatedly involved with the accidental recycling of radioactive sources and, in some cases, with costly consequences. If recycling were deemed to be a viable option, it might have to be implemented with regulatory monitoring and controls. Its implementation may have to consider various and complex issues and address the requirements and concerns of distinctly different industries. There are three basic options for the recycling of such scraps. They are: (1) recycling through the existing network of metal-scrap dealers and brokers, (2) recycling directly and only with specific steelmills, or (3) recycling through regional processing centers. Under the first option, scrap dealers and brokers would receive material from RSM generators and determine at which steelmills such scraps would be recycled. For the second option, RSM generators would deal directly with selected steelmills under specific agreements. For the third option, generators would ship scraps only to regional centers for processing and shipment to participating steelmills. This paper addresses the potential advantages of each option, identifies the types of arrangements that would need to be secured among all parties, and attempts to assess the receptivity of the recycling industry to each option.

  2. Options for gas-to-liquids technology in Alaska

    SciTech Connect

    Robertson, E.P.

    1999-12-01

    The purpose of this work was to assess the effect of applying new technology to the economics of a proposed natural gas-to-liquids (GTL) plant, to evaluate the potential of a slower-paced, staged deployment of GTL technology, and to evaluate the effect of GTL placement of economics. Five scenarios were economically evaluated and compared: a no-major-gas-sales scenario, a gas-pipeline/LNG scenario, a fast-paced GTL development scenario, a slow-paced GTL development scenario, and a scenario which places the GTL plant in lower Alaska, instead of on the North Slope. Evaluations were completed using an after-tax discounted cash flow analysis. Results indicate that the slow-paced GTL scenario is the only one with a rate of return greater than 10%. The slow-paced GTL development would allow cost saving on subsequent expansions. These assumed savings, along with the lowering of the transportation tariff, combine to distinguish this option for marketing the North Slope gas from the other scenarios. Critical variables that need further consideration include the GTL plant cost, the GTL product premium, and operating and maintenance costs.

  3. Options for Gas-to-Liquids Technology in Alaska

    SciTech Connect

    Robertson, Eric Partridge

    1999-10-01

    The purposes of this work was to assess the effect of applying new technology to the economics of a proposed natural gas-to-liquids (GTL) plant, to evaluate the potential of a slower-paced, staged deployment of GTL technology, and to evaluate the effect of GTL placement of economics. Five scenarios were economically evaluated and compared: a no-major-gas-sales scenario, a gas-pipeline/LNG scenario, a fast-paced GTL development scenario, a slow-paced GTL development scenario, and a scenario which places the GTL plant in lower Alaska, instead of on the North Slope. Evaluations were completed using an after-tax discounted cash flow analysis. Results indicate that the slow-paced GTL scenario is the only one with a rate of return greater than 10 percent. The slow-paced GTL development would allow cost saving on subsequent expansions. These assumed savings, along with the lowering of the transportation tariff, combine to distinquish this option for marketing the North Slope gas from the other scenarios. Critical variables that need further consideration include the GTL plant cost, the GTL product premium, and operating and maintenance costs.

  4. Melasma: clinical diagnosis and management options.

    PubMed

    Rodrigues, Michelle; Pandya, Amit G

    2015-08-01

    Melasma is a common acquired disorder of pigmentation most commonly seen in those with skin of colour. It has long been a condition that is frustrating for both the dermatologist and patient to treat. This article provides a review of the literature on melasma and examines, in detail, various treatment options currently available to treat it.

  5. Shale gas wastewater management under uncertainty.

    PubMed

    Zhang, Xiaodong; Sun, Alexander Y; Duncan, Ian J

    2016-01-01

    This work presents an optimization framework for evaluating different wastewater treatment/disposal options for water management during hydraulic fracturing (HF) operations. This framework takes into account both cost-effectiveness and system uncertainty. HF has enabled rapid development of shale gas resources. However, wastewater management has been one of the most contentious and widely publicized issues in shale gas production. The flowback and produced water (known as FP water) generated by HF may pose a serious risk to the surrounding environment and public health because this wastewater usually contains many toxic chemicals and high levels of total dissolved solids (TDS). Various treatment/disposal options are available for FP water management, such as underground injection, hazardous wastewater treatment plants, and/or reuse. In order to cost-effectively plan FP water management practices, including allocating FP water to different options and planning treatment facility capacity expansion, an optimization model named UO-FPW is developed in this study. The UO-FPW model can handle the uncertain information expressed in the form of fuzzy membership functions and probability density functions in the modeling parameters. The UO-FPW model is applied to a representative hypothetical case study to demonstrate its applicability in practice. The modeling results reflect the tradeoffs between economic objective (i.e., minimizing total-system cost) and system reliability (i.e., risk of violating fuzzy and/or random constraints, and meeting FP water treatment/disposal requirements). Using the developed optimization model, decision makers can make and adjust appropriate FP water management strategies through refining the values of feasibility degrees for fuzzy constraints and the probability levels for random constraints if the solutions are not satisfactory. The optimization model can be easily integrated into decision support systems for shale oil/gas lifecycle

  6. A real-world way to manage real options.

    PubMed

    Copeland, Tom; Tufano, Peter

    2004-03-01

    Each corporate growth project is an option, in the sense that managers face choices--push ahead or pull back--along the way. Yet many companies hesitate to apply options theory to initiatives such as R&D and geographic expansion, partly because these "real" options are highly complex. In this article, the authors make the case that the complexity of real options can be eased through the use of a binomial valuation model. Many of the problems with real-options analysis stem from the use of the Black-Scholes-Merton model, which isn't suited to real options. Binomial models, by contrast, are simpler mathematically, and you can tinker with a binomial model until it closely reflects the project you wish to value. Suppose your company is considering investing in a new plant. To use the binomial model, you must create an "event tree" to figure out the full range of possible values for the plant during the project's lifetime--next year, at the end of the design phase, upon completion. Then you work backward from the value at completion, factoring in the various investments, to determine the value of the project today. These calculations provide you with numbers for all the possible future values of the option at the various points where a decision needs to be made on whether to continue with the project. The authors also address another criticism of real options: that gaps often arise between theoretical and realized values of options of all types. Such gaps may be largely the result of managers exercising options at the wrong time. To improve the way it manages its real options, a company can look out for the decision trigger points that correspond to the nodes on a binomial decision tree. The trigger points should not only tell managers when they need to decide on exercise but also specify rules governing the exercise decisions.

  7. Economic analysis of emerald ash borer (Coleoptera: Buprestidae) management options.

    PubMed

    Vannatta, A R; Hauer, R H; Schuettpelz, N M

    2012-02-01

    Emerald ash borer, Agrilus planipennis (Fairmaire) (Coleoptera: Buprestidae), plays a significant role in the health and extent of management of native North American ash species in urban forests. An economic analysis of management options was performed to aid decision makers in preparing for likely future infestations. Separate ash tree population valuations were derived from the i-Tree Streets program and the Council of Tree and Landscape Appraisers (CTLA) methodology. A relative economic analysis was used to compare a control option (do-nothing approach, only removing ash trees as they die) to three distinct management options: 1) preemptive removal of all ash trees over a 5 yr period, 2) preemptive removal of all ash trees and replacement with comparable nonash trees, or 3) treating the entire population of ash trees with insecticides to minimize mortality. For each valuation and management option, an annual analysis was performed for both the remaining ash tree population and those lost to emerald ash borer. Retention of ash trees using insecticide treatments typically retained greater urban forest value, followed by doing nothing (control), which was better than preemptive removal and replacement. Preemptive removal without tree replacement, which was the least expensive management option, also provided the lowest net urban forest value over the 20-yr simulation. A "no emerald ash borer" scenario was modeled to further serve as a benchmark for each management option and provide a level of economic justification for regulatory programs aimed at slowing the movement of emerald ash borer.

  8. Meadow management and treatment options [chapter 8

    Treesearch

    Jeanne C. Chambers; Jerry R. Miller

    2011-01-01

    Restoration and management objectives and approaches are most effective when based on an understanding of ecosystem processes and the long- and short-term causes of disturbance (Wohl and others 2005). As detailed in previous chapters, several factors are critical in developing effective management strategies for streams and their associated meadow ecosystems in the...

  9. The best MSW treatment option by considering greenhouse gas emissions reduction: a case study in Georgia.

    PubMed

    Tayyeba, Omid; Olsson, Monika; Brandt, Nils

    2011-08-01

    The grave concern over climate change and new economic incentives such as the clean development mechanism (CDM) have given more weight to the potential of projects for reducing greenhouse gas (GHG) emissions. In the Adjara solid waste management project, even though the need for reductions in GHG emissions is acknowledged, it is not one of the key factors for selecting the most appropriate treatment method. This study addresses the benefit of various solid waste treatment methods that could be used in the Adjara project in terms of reducing GHG emissions. Seven different options for solid waste treatment are examined: open dumping as the baseline case, four options for landfill technology (no provision of landfill gas capture, landfill gas capture with open flare system, with enclosed flare system and with electricity generation), composting and anaerobic digestion with electricity production. CDM methodologies were used to quantify the amount of reductions for the scenarios. The study concludes sanitary landfill with capture and burning of landfill gas by an enclosed flare system could satisfy the requirements, including GHG reduction potential. The findings were tested for uncertainty and sensitivity by varying the data on composition and amount of waste and were found to be robust.

  10. [Options for stress management in obesity treatment].

    PubMed

    Czeglédi, Edit

    2016-02-14

    Overeating and physical inactivity are of great importance in the etiology of obesity. Psychological factors are often found in the background of life style. Chronic stress can contribute to physical inactivity and behaviors that hinder the keeping of a diet (e.g., irregular eating pattern, emotional eating). Results of randomized controlled trials show that relaxation can reduce emotional eating, improve cognitive restraint, and thereby reduce weight. However, stress management is more than relaxation. It consists of adaptive emotion-focused and problem-focused coping strategies and skills to improve relationships. Deflection skills may help in replacing emotional eating with other behaviors. Cognitive restructuring, saying no, and problem solving help to prevent or manage conflicts and difficulties otherwise would result in overeating due to distress. Developing stress management skills may result in greater compliance with the treatment. The techniques presented in the study can be easily applied by general practitioners or specialists, and provide tools for optimizing obesity treatment.

  11. The infected total knee: management options.

    PubMed

    Cuckler, John M

    2005-06-01

    The management of infection after total knee arthroplasty depends on the chronicity of the infection, host factors, and sensitivity of the infecting bacteria. Two-stage salvage consisting of removal of implants and cement, placement of an antibiotic spacer, and appropriate intravenous antibiotic therapy followed by reimplantation with an antibiotic-impregnated cement appears to be the predominant approach to managing this complication. The use of articulated spacers consisting of the sterilized femoral and polyethylene components with antibiotic cement allows maintenance of motion and bone stock. This report details the author's experience with 44 infected knee arthroplasties.

  12. Geothermal Produced Fluids: Characteristics, Treatment Technologies, and Management Options

    SciTech Connect

    Finster, Molly; Clark, Corrie; Schroeder, Jenna; Martino, Louis

    2015-10-01

    Geothermal power plants use geothermal fluids as a resource and create waste residuals as part of the power generation process. Both the geofluid resource and the waste stream are considered produced fluids. The chemical and physical nature of produced fluids can have a major impact on the geothermal power industry and can influence the feasibility of geothermal power development, exploration approaches, power plant design, operating practices, and the reuse or disposal of residuals. In general, produced fluids include anything that comes out of a geothermal field and that subsequently must be managed on the surface. These fluids vary greatly depending on the geothermal reservoir being harnessed, power plant design, and the life cycle stage in which the fluid exists, but generally include water and fluids used to drill geothermal wells, fluids used to stimulate wells in enhanced geothermal systems, and makeup and/or cooling water used during operation of a geothermal power plant. Additional geothermal-related produced fluids include many substances that are similar to waste streams from the oil and gas industry, such as scale, flash tank solids, precipitated solids from brine treatment, hydrogen sulfide, and cooling-tower-related waste. This review paper aims to provide baseline knowledge on specific technologies and technology areas associated with geothermal power production. Specifically, this research focused on the management techniques related to fluids produced and used during the operational stage of a geothermal power plant; the vast majority of which are employed in the generation of electricity. The general characteristics of produced fluids are discussed. Constituents of interest that tend to drive the selection of treatment technologies are described, including total dissolved solids, noncondensable gases, scale and corrosion, silicon dioxide, metal sulfides, calcium carbonate, corrosion, metals, and naturally occurring radioactive material. Management

  13. Urinary Incontinence: Management and Treatment Options

    ERIC Educational Resources Information Center

    Griebling, Tomas L.

    2009-01-01

    Urinary incontinence, defined as the involuntary leakage of urine, is a common health problem in both women and men. Children may also suffer from this condition. Management and treatment of urinary incontinence depends primarily on the specific type of incontinence and the underlying problem causing the leakage for a given patient. Because…

  14. Reducing greenhouse gas emissions for climate stabilization: framing regional options

    SciTech Connect

    Laura Schmitt Olabisi; Peter B. Reich; Kris A. Johnson; Anne R. Kapuscinski; Sangwon Suh; Elizabeth J. Wilson

    2009-03-15

    The Intergovernmental Panel on Climate Change (IPCC) has stated that stabilizing atmospheric CO{sub 2} concentrations will require reduction of global greenhouse gas (GHG) emissions by as much as 80% by 2050. Subnational efforts to cut emissions will inform policy development nationally and globally. We projected GHG mitigation strategies for Minnesota, which has adopted a strategic goal of 80% emissions reduction by 2050. A portfolio of conservation strategies, including electricity conservation, increased vehicle fleet fuel efficiency, and reduced vehicle miles traveled, is likely the most cost-effective option for Minnesota and could reduce emissions by 18% below 2005 levels. An 80% GHG reduction would require complete decarbonization of the electricity and transportation sectors, combined with carbon capture and sequestration at power plants, or deep cuts in other relatively more intransigent GHG-emitting sectors. In order to achieve ambitious GHG reduction goals, policymakers should promote aggressive conservation efforts, which would probably have negative net costs, while phasing in alternative fuels to replace coal and motor gasoline over the long-term. 31 refs., 3 figs., 1 tab.

  15. Reducing greenhouse gas emissions for climate stabilization: framing regional options.

    PubMed

    Olabisi, Laura Schmitt; Reich, Peter B; Johnson, Kris A; Kapuscinski, Anne R; Su, Sangwon H; Wilson, Elizabeth J

    2009-03-15

    The Intergovernmental Panel on Climate Change (IPCC) has stated that stabilizing atmospheric CO2 concentrations will require reduction of global greenhouse gas (GHG) emissions by as much as 80% by 2050. Subnational efforts to cut emissions will inform policy development nationally and globally. We projected GHG mitigation strategies for Minnesota, which has adopted a strategic goal of 80% emissions reduction by 2050. A portfolio of conservation strategies, including electricity conservation, increased vehicle fleet fuel efficiency, and reduced vehicle miles traveled, is likely the most cost-effective option for Minnesota and could reduce emissions by 18% below 2005 levels. An 80% GHG reduction would require complete decarbonization of the electricity and transportation sectors, combined with carbon capture and sequestration at power plants, or deep cuts in other relatively more intransigent GHG-emitting sectors. In order to achieve ambitious GHG reduction goals, policymakers should promote aggressive conservation efforts, which would probably have negative net costs, while phasing in alternative fuels to replace coal and motor gasoline over the long-term.

  16. Pressurized fluidized bed combustion ash management options

    SciTech Connect

    Bland, A.E.; Brown, T.H.; Young, L.J.; Wheeldon, J.M.

    1995-12-31

    Pressurized fluidized bed combustion (PFBC) of coal is undergoing demonstration and commercial deployment in the United States, as well as throughout the world. American Electric Power`s (AEP) bubbling PFBC 70 MW{sub e} Tidd demonstration program in Ohio and pilot-scale work at Ahlstrom Pyropower`s 10 MW{sub e} circulating PFBC at Karhula, Finland have demonstrated the advantages of PFBC technology. Development of uses for solid wastes from PFBC coal conversion systems is being actively pursued as part of the commercial demonstration of PFBC technologies. Ash collected from the low-sulfur subbituminous coal-fired Ahlstrom pilot circulating PFBC tests in Karhula, Finland and ash from the AEP`s high-sulfur bituminous coal-fired bubbling PFBC in Brilliant, Ohio were evaluated in laboratory and pilot-scale ash use testing at Western Research Institute (WRI). Ash use options evaluated for these PFBC ashes were construction-related applications, such as (1) cement production, (2) fills and embankment, (3) soil stabilization, (4) synthetic aggregate production, as well as an amendment for acidic and sodic soil and mine spoil.

  17. Gestational diabetes: risks, management, and treatment options

    PubMed Central

    Kim, Catherine

    2010-01-01

    Gestational diabetes mellitus (GDM) is commonly defined as glucose intolerance first recognized during pregnancy. Diagnostic criteria for GDM have changed over the decades, and several definitions are currently used; recent recommendations may increase the prevalence of GDM to as high as one of five pregnancies. Perinatal complications associated with GDM include hypertensive disorders, preterm delivery, shoulder dystocia, stillbirths, clinical neonatal hypoglycemia, hyperbilirubinemia, and cesarean deliveries. Postpartum complications include obesity and impaired glucose tolerance in the offspring and diabetes and cardiovascular disease in the mothers. Management strategies increasingly emphasize optimal management of fetal growth and weight. Monitoring of glucose, fetal stress, and fetal weight through ultrasound combined with maternal weight management, medical nutritional therapy, physical activity, and pharmacotherapy can decrease comorbidities associated with GDM. Consensus is lacking on ideal glucose targets, degree of caloric restriction and content, algorithms for pharmacotherapy, and in particular, the use of oral medications and insulin analogs in lieu of human insulin. Postpartum glucose screening and initiation of healthy lifestyle behaviors, including exercise, adequate fruit and vegetable intake, breastfeeding, and contraception, are encouraged to decrease rates of future glucose intolerance in mothers and offspring. PMID:21151681

  18. Global plutonium management: A security option

    SciTech Connect

    Sylvester, K.W.B.

    1998-12-31

    The US surplus plutonium disposition program was created to reduce the proliferation risk posed by the fissile material from thousands of retired nuclear weapons. The Department of Energy has decided to process its Put into a form as secure as Pu in civilian spent fuel. While implementation issues have been considered, a major one (Russian reciprocity) remains unresolved. Russia has made disposition action conditional on extracting the fuel value of its Pu but lacks the infrastructure to do so. Assistance in the construction of the required facilities would conflict with official US policy opposing the development of a Pu fuel cycle. The resulting stagnation provides impetus for a reevaluation of US nonproliferation objectives and Pu disposition options. A strategy for satisfying Russian fuel value concerns and reducing the proliferation risk posed by surplus weapons-grade plutonium (WGPu) is proposed. The effectiveness of material alteration (e.g., isotopic, chemical, etc.{hor_ellipsis}) at reducing the desire, ability and opportunity for proliferation is assessed. Virtually all the security benefits attainable by material processing can be obtained by immobilizing Pu in large unit size/mass monoliths without a radiation barrier. Russia would be allowed to extract the Pu at a future date for use as fuel in a verifiable manner. Remote tracking capability, if proven feasible, would further improve safeguarding capability. As an alternate approach, the US could compensate Russia for its Pu, allowing it to be disposed of or processed elsewhere. A market based method for pricing Pu is proposed. Surplus Pu could represent access to nuclear fuel at a fixed price at a future date. This position can be replicated in the uranium market and priced using derivative theory. The proposed strategy attempts to meet nonproliferation objectives by recognizing technical limitations and satisfying political constraints.

  19. Options for perioperative pain management in neurosurgery

    PubMed Central

    Vadivelu, Nalini; Kai, Alice M; Tran, Daniel; Kodumudi, Gopal; Legler, Aron; Ayrian, Eugenia

    2016-01-01

    Moderate-to-severe pain following neurosurgery is common but often does not get attention and is therefore underdiagnosed and undertreated. Compounding this problem is the traditional belief that neurosurgical pain is inconsequential and even dangerous to treat. Concerns about problematic effects associated with opioid analgesics such as nausea, vomiting, oversedation, and increased intracranial pressure secondary to elevated carbon dioxide tension from respiratory depression have often led to suboptimal postoperative analgesic strategies in caring for neurosurgical patients. Neurosurgical patients may have difficulty or be incapable of communicating their need for analgesics due to neurologic deficits, which poses an additional challenge. Postoperative pain control should be a priority, because pain adversely affects recovery and patient outcomes. Inconsistent practices and the quality of current analgesic strategies for neurosurgical patients still leave room for improvement. Given the complexity of postoperative pain management for these patients, multimodal strategies are often required to optimize pain control and at the same time limit undesired side effects. PMID:26929661

  20. Whooping crane egg management: options and consequences

    USGS Publications Warehouse

    Ellis, D.H.; Gee, G.F.

    2001-01-01

    Eggs to build captive whooping crane (Grus americana) flocks and most eggs for reintroduction experiments have come from second viable eggs in 2-egg clutches in Canada. Four years ago, egg removal ceased. Based on reproductive rates for years when second eggs were removed and for years when eggs were not removed, we project numbers of young fledging in the wild and in captivity for the 2 most likely egg-management strategies. From existing data sets, we find that reproductive performance was, on average, better during the era of routine removal of the second viable eggs than when no manipulation occurred. Further, the number of young produced in captivity from the removed eggs, on average, resulted in a doubling of the number of young birds (wild and captive) alive each autumn.

  1. [Conservative management option in elderly patients].

    PubMed

    Guienne, Véronique; Parahy, Sophie; Testa, Angelo

    2016-04-01

    "Conservative management" is as an alternative care pathway offered to patients who elect not to start dialysis often because of a heavy burden of comorbid illness and advanced ages. Our research, characterized by a transdisciplinary medical and social investigation and based on a case by case analysis, intends to understand the reasons and the context in which this choice has to be made. On the first hand, the results show that all the studied cases can be explained by two variables, the latter can be combined: when the patient is suffering from important clinical pathologies; when the patient lives with this renal failure as a trouble linked to the age. On the second hand, two important questions are raised: the first one is about the medical practices and stems from the influence of criteria always present in the decisions to take (the paramedical exams and the clinical information from the interview, the patient's examination and the discussion with his/her close family member). The second one is about the patient's autonomy and can be analyzed regarding to his/her capacity to express his/her choices and share it with his close family. But also, to live in according to his age, that is to say the relation he/she has with his/her edged body and to the limits of his/her existence. The key notion of shared decision-making renewed is to refer in the consultation and the choices to take to the question of the advantages/drawbacks for the patient's life and not only to the question of the connection between the results and the medical risks, in order to exchange view with the patient on his/her future life and not only on the condition of his failed organ.

  2. Evaluation of Dairy Effluent Management Options Using Multiple Criteria Analysis

    NASA Astrophysics Data System (ADS)

    Hajkowicz, Stefan A.; Wheeler, Sarah A.

    2008-04-01

    This article describes how options for managing dairy effluent on the Lower Murray River in South Australia were evaluated using multiple criteria analysis (MCA). Multiple criteria analysis is a framework for combining multiple environmental, social, and economic objectives in policy decisions. At the time of the study, dairy irrigation in the region was based on flood irrigation which involved returning effluent to the river. The returned water contained nutrients, salts, and microbial contaminants leading to environmental, human health, and tourism impacts. In this study MCA was used to evaluate 11 options against 6 criteria for managing dairy effluent problems. Of the 11 options, the MCA model selected partial rehabilitation of dairy paddocks with the conversion of remaining land to other agriculture. Soon after, the South Australian Government adopted this course of action and is now providing incentives for dairy farmers in the region to upgrade irrigation infrastructure and/or enter alternative industries.

  3. Evaluation of dairy effluent management options using multiple criteria analysis.

    PubMed

    Hajkowicz, Stefan A; Wheeler, Sarah A

    2008-04-01

    This article describes how options for managing dairy effluent on the Lower Murray River in South Australia were evaluated using multiple criteria analysis (MCA). Multiple criteria analysis is a framework for combining multiple environmental, social, and economic objectives in policy decisions. At the time of the study, dairy irrigation in the region was based on flood irrigation which involved returning effluent to the river. The returned water contained nutrients, salts, and microbial contaminants leading to environmental, human health, and tourism impacts. In this study MCA was used to evaluate 11 options against 6 criteria for managing dairy effluent problems. Of the 11 options, the MCA model selected partial rehabilitation of dairy paddocks with the conversion of remaining land to other agriculture. Soon after, the South Australian Government adopted this course of action and is now providing incentives for dairy farmers in the region to upgrade irrigation infrastructure and/or enter alternative industries.

  4. Calcific tendinitis of the rotator cuff: management options.

    PubMed

    Suzuki, Kentaro; Potts, Aaron; Anakwenze, Oke; Singh, Anshu

    2014-11-01

    Calcific tendinitis of the rotator cuff tendons is a common cause of shoulder pain in adults and typically presents as activity-related shoulder pain. It is thought to be an active, cell-mediated process, although the exact pathophysiology remains unclear. Nonsurgical management continues to be the mainstay of treatment; most patients improve with modalities such as oral anti-inflammatory medication, physical therapy, and corticosteroid injections. Several options are available for patients who fail nonsurgical treatment, including extracorporeal shock wave therapy, ultrasound-guided needle lavage, and surgical débridement. These modalities alleviate pain by eliminating the calcific deposit, and several recent studies have demonstrated success with the use of these treatment options. Surgical management options include arthroscopic procedures to remove calcific deposits and subacromial decompression; however, the role of subacromial decompression and repair of rotator cuff defects created by removing these deposits remains controversial. Copyright 2014 by the American Academy of Orthopaedic Surgeons.

  5. National Forest management options in response to climate change

    Treesearch

    Forest Service U.S. Department of Agriculture

    2009-01-01

    The effect of climate change on ecosystem structure, function, and services will depend on the ecosystem's degree of sensitivity to climate change, the natural ability of plants and animals to adapt, and the availability of effective management options. Sensitivity to climate change is a function of ecosystem health and environmental stresses such as air pollution...

  6. Fuel cell gas management system

    DOEpatents

    DuBose, Ronald Arthur

    2000-01-11

    A fuel cell gas management system including a cathode humidification system for transferring latent and sensible heat from an exhaust stream to the cathode inlet stream of the fuel cell; an anode humidity retention system for maintaining the total enthalpy of the anode stream exiting the fuel cell equal to the total enthalpy of the anode inlet stream; and a cooling water management system having segregated deionized water and cooling water loops interconnected by means of a brazed plate heat exchanger.

  7. Thermal management system options for high power space platforms

    NASA Technical Reports Server (NTRS)

    Sadunas, J. A.; Lehtinen, A.; Parish, R.

    1985-01-01

    Thermal Management System (TMS) design options for a high power (75kWe), low earth orbit, multimodule space platform were investigated. The approach taken was to establish a baseline TMS representative of current technology, and to make incremental improvements through successive subsystem trades that lead to a candidate TMS. The TMS trades included centralized and decentralized transport, single-phase and two-phase transport, alternate working fluids, liquid loop and heat pipe radiators, deployed fixed, body mounted and steerable radiators, and thermal storage. The subsystem options were evaluated against criteria such as weight, TMS power requirement, reliability, system isothermality penalty, and growth potential.

  8. Thermal management system options for high power space platforms

    NASA Technical Reports Server (NTRS)

    Sadunas, J. A.; Lehtinen, A.; Parish, R.

    1985-01-01

    Thermal Management System (TMS) design options for a high power (75kWe), low earth orbit, multimodule space platform were investigated. The approach taken was to establish a baseline TMS representative of current technology, and to make incremental improvements through successive subsystem trades that lead to a candidate TMS. The TMS trades included centralized and decentralized transport, single-phase and two-phase transport, alternate working fluids, liquid loop and heat pipe radiators, deployed fixed, body mounted and steerable radiators, and thermal storage. The subsystem options were evaluated against criteria such as weight, TMS power requirement, reliability, system isothermality penalty, and growth potential.

  9. Avoiding the unmanageable and managing the unavoidable: Options for water managers (Invited)

    NASA Astrophysics Data System (ADS)

    Gleick, P. H.; Cooley, H.

    2009-12-01

    The need to both adapt to, and mitigate climate change is now increasingly compelling. Any effort to characterize the climate problem as one or the other is incomplete. Accepting this will lead to a different set of options for water managers than traditionally described because of the potential advantages of strategies that simultaneously enhance both mitigation and adaptation. Yet expensive new water or energy proposals continue to be put forward that have the potential to help with one of these needs while worsening the other, including massive desalination options, extensive desert solar thermal systems, or long-distance interbasin transfers of water. Examples from the in the areas of water and energy will be described, with a focus on new priorities for simultaneously improving the efficiency of water use, reducing pressures on limited supplies, and reducing greenhouse gas emissions. In particular, the importance of including water in decisions about new energy sources and including energy in decisions about water management will be shown. Some initial estimates of the water requirements of different configurations of solar thermal energy systems will be presented as will some of the cost advantages of water-efficiency improvements of fixtures that use hot, as opposed to cold water, or that save water with high “embedded” energy costs.

  10. Landfill gas management in Canada

    SciTech Connect

    David, A.

    1997-12-31

    Landfill gas produced from solid waste landfills is one of the most significant sources of anthropogenic methane in Canada. Methane, a potent greenhouse gas, is 24.5 times more powerful than carbon dioxide by weight in terms of global climate change. Landfill gas recovery plays an important role in Canada`s commitment to stabilize greenhouse gas emissions at 1990 levels by the year 2000 under the United Nations Framework Convention on Climate Change. Landfill gas is a potentially harmful emission that can be converted into a reliable environmentally-sustainable energy source used to generate electricity, fuel industries and heat buildings. The recovery and utilization of landfill gas is a win-win situation which makes good sense from local, regional and global perspectives. It provides the benefits of (1) reducing the release of greenhouse gases that contribute to global warming; (2) limiting odors; (3) controlling damage to vegetation; (4) reducing risks from explosions, fires and asphyxiation; (5) converting a harmful emission into a reliable energy source; and (6) creating a potential source of revenue and profit. Canadian landfills generate about 1 million tons of methane every year; the equivalent energy of 9 million barrels of oil (eight oil super tankers), or enough energy to meet the annual heating needs of more than half a million Canadian homes. Currently, twenty-seven facilities recover and combust roughly 25% of the methane generated by Canadian landfills producing about 3.2 PJ (10{sup 15} Joules) of energy including 80 MW of electricity and direct fuel for nearby facilities (e.g., cement plants, gypsum board manufacturers, recycling facilities, greenhouses). This paper reviews landfill gas characteristics; environmental, health and safety impacts; landfill gas management in Canada; the costs of landfill gas recovery and utilization systems; and on-going projects on landfill gas utilization and flaring.

  11. Strategic environmental assessment of greenhouse gas mitigation options in the Canadian agricultural sector.

    PubMed

    Noble, Bram F; Christmas, Lisa M

    2008-01-01

    This article presents a methodological framework for strategic environmental assessment (SEA) application. The overall objective is to demonstrate SEA as a systematic and structured policy, plan, and program (PPP) decision support tool. In order to accomplish this objective, a stakeholder-based SEA application to greenhouse gas (GHG) mitigation policy options in Canadian agriculture is presented. Using a mail-out impact assessment exercise, agricultural producers and nonproducers from across the Canadian prairie region were asked to evaluate five competing GHG mitigation options against 13 valued environmental components (VECs). Data were analyzed using multi-criteria and exploratory analytical techniques. The results suggest considerable variation in perceived impacts and GHG mitigation policy preferences, suggesting that a blanket policy approach to GHG mitigation will create gainers and losers based on soil type and associate cropping and on-farm management practices. It is possible to identify a series of regional greenhouse gas mitigation programs that are robust, socially meaningful, and operationally relevant to both agricultural producers and policy decision makers. The assessment demonstrates the ability of SEA to address, in an operational sense, environmental problems that are characterized by conflicting interests and competing objectives and alternatives. A structured and systematic SEA methodology provides the necessary decision support framework for the consideration of impacts, and allows for PPPs to be assessed based on a much broader set of properties, objectives, criteria, and constraints whereas maintaining rigor and accountability in the assessment process.

  12. The Oil and Natural Gas Knowledge Management Database from NETL

    DOE Data Explorer

    The Knowledge Management Database (KMD) Portal provides four options for searching the documents and data that NETL-managed oil and gas research has produced over the years for DOE’s Office of Fossil Energy. Information includes R&D carried out under both historical and ongoing DOE oil and gas research and development (R&D). The Document Repository, the CD/DVD Library, the Project Summaries from 1990 to the present, and the Oil and Natural Gas Program Reference Shelf provide a wide range of flexibility and coverage.

  13. Using real options analysis to support strategic management decisions

    NASA Astrophysics Data System (ADS)

    Kabaivanov, Stanimir; Markovska, Veneta; Milev, Mariyan

    2013-12-01

    Decision making is a complex process that requires taking into consideration multiple heterogeneous sources of uncertainty. Standard valuation and financial analysis techniques often fail to properly account for all these sources of risk as well as for all sources of additional flexibility. In this paper we explore applications of a modified binomial tree method for real options analysis (ROA) in an effort to improve decision making process. Usual cases of use of real options are analyzed with elaborate study on the applications and advantages that company management can derive from their application. A numeric results based on extending simple binomial tree approach for multiple sources of uncertainty are provided to demonstrate the improvement effects on management decisions.

  14. Perioperative pain management in hip arthroscopy; what options are there?

    PubMed Central

    Bech, N. H.; Hulst, A. H.; Spuijbroek, J. A.; van Leuken, L. L. A.; Haverkamp, D.

    2016-01-01

    Hip arthroscopy is a fast growing orthopedic field of expertise. As in any field of surgery adequate postoperative pain management regimes are of utmost importance. The purpose of this review is to provide an overview of current knowledge on anesthetic options for perioperative pain management for hip arthroscopy. We searched the Pubmed/Medline and Embase database for literature and included 10 studies for our analysis. Because of the variety of pain scales and different ways of measured pain no meta-analysis could be performed and a descriptive review is performed. There are several types of pain regimens that can mostly be divided in two groups: local anesthetics and nerve blocks. Included studies show a rather large variation in reported visual analogue scale scores, post anesthesia care unit admission time and opioid usage. There are several anesthetic options available for hip arthroscopy. Different studies use different dosages, anesthetic regimens and different protocols; this partly explains the differences between studies with similar techniques. Peripheral nerve blocks seems promising but regarding current literature no clear recommendation can be made about what the best perioperative pain management option is, an overview of all reported techniques is given. PMID:27583156

  15. Integrated Analysis of Greenhouse Gas Mitigation Options and Related Impacts

    EPA Science Inventory

    Increased concerns over air pollution (combined with detrimental health effects) and climate change have called for more stringent emission reduction strategies for criteria air pollutants and greenhouse gas emissions. However, stringent regulatory policies can possibly have a...

  16. Integrated Analysis of Greenhouse Gas Mitigation Options and Related Impacts

    EPA Science Inventory

    Increased concerns over air pollution (combined with detrimental health effects) and climate change have called for more stringent emission reduction strategies for criteria air pollutants and greenhouse gas emissions. However, stringent regulatory policies can possibly have a...

  17. Sickle cell disease: management options and challenges in developing countries.

    PubMed

    Ansong, Daniel; Akoto, Alex Osei; Ocloo, Delaena; Ohene-Frempong, Kwaku

    2013-01-01

    Sickle Cell Disease (SCD) is the most common genetic disorder of haemoglobin in sub-Saharan Africa. This commentary focuses on the management options available and the challenges that health care professionals in developing countries face in caring for patients with SCD. In a developing countries like Ghana, new-born screening is now about to be implemented on a national scale. Common and important morbidities associated with SCD are vaso-occlusive episodes, infections, Acute Chest Syndrome (ACS), Stroke and hip necrosis. Approaches to the management of these morbidities are far advanced in the developed countries. The differences in setting and resource limitations in developing countries bring challenges that have a major influence in management options in developing countries. Obviously clinicians in developing countries face challenges in managing SCD patients. However understanding the disease, its progression, and instituting the appropriate preventive methods are paramount in its management. Emphasis should be placed on early counselling, new-born screening, anti-microbial prophylaxis, vaccination against infections, and training of healthcare workers, patients and caregivers. These interventions are affordable in developing countries.

  18. Gastrointestinal chronic graft-versus-host disease: management options.

    PubMed

    Awan, Farrukh; Hamadani, Mehdi

    2007-03-01

    Chronic graft-versus-host disease (GVHD) is a common and debilitating condition afflicting a number of allogeneic stem cell recipients more than 100 days after their transplant. Limited options are available for the acute management of patients with severe gastrointestinal (GI) symptoms including gastric bleeding. Along with increased immunosuppression and aggressive supportive care, we report here the use of aminocaproic acid in the management of patients with GI bleeding resulting from severe GVHD. The use of aminocaproic acid enabled us to reduce the frequency and number of blood product transfusions required to manage our patient. Anti-fibrinolytic agents may therefore serve as useful adjunctive but underutilized therapy in the management of patients with severe GI chronic GVHD.

  19. Low Carbon Technology Options for the Natural Gas ...

    EPA Pesticide Factsheets

    The ultimate goal of this task is to perform environmental and economic analysis of natural gas based power production technologies (different routes) to investigate and evaluate strategies for reducing emissions from the power sector. It is a broad research area. Initially, the research will be focused on the preliminary analyses of hydrogen fuel based power production technologies utilizing hydrogen fuel in a large size, heavy-duty gas turbines in integrated reformer combined cycle (IRCC) and integrated gasification combined cycle (IGCC) for electric power generation. The research will be expanded step-by-step to include other advanced (e.g., Net Power, a potentially transformative technology utilizing a high efficiency CO2 conversion cycle (Allam cycle), and chemical looping etc.) pre-combustion and post-combustion technologies applied to natural gas, other fossil fuels (coal and heavy oil) and biomass/biofuel based on findings. Screening analysis is already under development and data for the analysis is being processed. The immediate action on this task include preliminary economic and environmental analysis of power production technologies applied to natural gas. Data for catalytic reforming technology to produce hydrogen from natural gas is being collected and compiled on Microsoft Excel. The model will be expanded for exploring and comparing various technologies scenarios to meet our goal. The primary focus of this study is to: 1) understand the chemic

  20. Low Carbon Technology Options for the Natural Gas Electricity Production

    EPA Science Inventory

    The ultimate goal of this task is to perform environmental and economic analysis of natural gas based power production technologies (different routes) to investigate and evaluate strategies for reducing emissions from the power sector. It is a broad research area. Initially, the...

  1. Low Carbon Technology Options for the Natural Gas Electricity Production

    EPA Science Inventory

    The ultimate goal of this task is to perform environmental and economic analysis of natural gas based power production technologies (different routes) to investigate and evaluate strategies for reducing emissions from the power sector. It is a broad research area. Initially, the...

  2. High Temperature Gas-Cooled Test Reactor Options Status Report

    SciTech Connect

    Sterbentz, James William; Bayless, Paul David

    2015-08-01

    Preliminary scoping calculations are being performed for a 100 MWt gas-cooled test reactor. The initial design uses standard prismatic blocks and 15.5% enriched UCO fuel. Reactor physics and thermal-hydraulics simulations have been performed to identify some reactor design features to investigate further. Current status of the effort is described.

  3. Natural Gas Propulsion Options for Short Sea Shipping Routes

    DTIC Science & Technology

    2010-08-01

    to a safe zone. In addition to the engine room ventilation systems, the crankcase for each engine is individually vented. The gas from the...12 Ventilation ............................................................................................................. 13...5 kg capacity should be placed near the bunkering station. More details of the bunkering control systems, ventilation requirements, and fire safety

  4. Environmental review of options for managing radioactively contaminated carbon steel

    SciTech Connect

    1996-10-01

    The U.S. Department of Energy (DOE) is proposing to develop a strategy for the management of radioactively contaminated carbon steel (RCCS). Currently, most of this material either is placed in special containers and disposed of by shallow land burial in facilities designed for low-level radioactive waste (LLW) or is stored indefinitely pending sufficient funding to support alternative disposition. The growing amount of RCCS with which DOE will have to deal in the foreseeable future, coupled with the continued need to protect the human and natural environment, has led the Department to evaluate other approaches for managing this material. This environmental review (ER) describes the options that could be used for RCCS management and examines the potential environmental consequences of implementing each. Because much of the analysis underlying this document is available from previous studies, wherever possible the ER relies on incorporating the conclusions of those studies as summaries or by reference.

  5. A review on technological options of waste to energy for effective management of municipal solid waste.

    PubMed

    Kumar, Atul; Samadder, S R

    2017-09-05

    Approximately one-fourth population across the world rely on traditional fuels (kerosene, natural gas, biomass residue, firewood, coal, animal dung, etc.) for domestic use despite significant socioeconomic and technological development. Fossil fuel reserves are being exploited at a very fast rate to meet the increasing energy demands, so there is a need to find alternative sources of energy before all the fossil fuel reserves are depleted. Waste to energy (WTE) can be considered as a potential alternative source of energy, which is economically viable and environmentally sustainable. The present study reviewed the current global scenario of WTE technological options (incineration, pyrolysis, gasification, anaerobic digestion, and landfilling with gas recovery) for effective energy recovery and the challenges faced by developed and developing countries. This review will provide a framework for evaluating WTE technological options based on case studies of developed and developing countries. Unsanitary landfilling is the most commonly practiced waste disposal option in the developing countries. However, developed countries have realised the potential of WTE technologies for effective municipal solid waste management (MSWM). This review will help the policy makers and the implementing authorities involved in MSWM to understand the current status, challenges and barriers for effective management of municipal solid waste. This review concluded WTE as a potential renewable source of energy, which will partly meet the energy demand and ensure effective MSWM. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Review of pharmacotherapy options for the management of obesity.

    PubMed

    Bragg, Rebecca; Crannage, Erica

    2016-02-01

    To highlight the prevalence and impact of obesity in the United States and provide nurse practitioners (NPs) with an overview of pharmacotherapy options for treatment of overweight and obese individuals. A comprehensive review of the literature was conducted using multiple databases, including PubMed, MEDLINE, and Ovid. Keywords used to obtain relevant articles included obesity and drug, or orlistat, topiramate/phentermine, lorcaserin, bupropion/naltrexone, and liraglutide. Obesity is a prevalent disease with more than two thirds of Americans being considered overweight and one third being obese. Obesity places patients at an increased risk for many comorbidities that impact patient health as well as public health. There are currently five approved medications for the chronic management of obesity, two of which were approved in 2014. These pharmacological therapies are options to aid weight loss in patients that are obese or those who are overweight with additional risk factors. NPs can assist patients struggling with their weight. With new pharmacotherapy options, there is an opportunity to add to diet and exercise in order to achieve increased weight loss. A decrease in obesity would potentially alleviate the burden on the healthcare system, both socially and economically, and improve patient quality of life. ©2015 American Association of Nurse Practitioners.

  7. Greenhouse Gas Management Program Overview (Fact Sheet)

    SciTech Connect

    Not Available

    2011-11-01

    Program fact sheet highlighting federal requirements for GHG emissions management, FEMP services to help agencies reduce emissions, and additional resources. The U.S. Department of Energy (DOE) Federal Energy Management Program (FEMP) assists Federal agencies with managing their greenhouse gas (GHG) emissions. GHG management entails measuring emissions and understanding their sources, setting a goal for reducing emissions, developing a plan to meet this goal, and implementing the plan to achieve reductions in emissions. FEMP provides the following services to help Federal agencies meet the requirements of inventorying and reducing their GHG emissions: (1) FEMP offers one-on-one technical assistance to help agencies understand and implement the Federal Greenhouse Gas Accounting and Reporting Guidance and fulfill their inventory reporting requirements. (2) FEMP provides training, tools, and resources on FedCenter to help agencies complete their annual inventories. (3) FEMP serves a leadership role in the interagency Federal Working Group on Greenhouse Gas Accounting and Reporting that develops recommendations to the Council on Environmental Quality (CEQ) for the Federal Greenhouse Gas Accounting and Reporting Guidance. (4) As the focus continues to shift from measuring emissions (completing inventories) to mitigating emissions (achieving reductions), FEMP is developing a strategic planning framework and resources for agencies to prioritize among a variety of options for mitigating their GHG emissions, so that they achieve their reduction goals in the most cost-effective manner. These resources will help agencies analyze their high-quality inventories to make strategic decisions about where to use limited resources to have the greatest impact on reducing emissions. Greenhouse gases trap heat in the lower atmosphere, warming the earth's surface temperature in a natural process known as the 'greenhouse effect.' GHGs include carbon dioxide (CO{sub 2}), methane (CH{sub 4

  8. Management options of non-syndromic sagittal craniosynostosis.

    PubMed

    Lee, Bryan S; Hwang, Lee S; Doumit, Gaby D; Wooley, Joseph; Papay, Francis A; Luciano, Mark G; Recinos, Violette M

    2017-05-01

    There have been various effective surgical procedures for the treatment of non-syndromic sagittal craniosynostosis, but no definitive guidelines for management have been established. We conducted a study to elucidate the current state of practice and establish a warranted standard of care. An Internet-based study was sent to 180 pediatric neurosurgeons across the country and 102 craniofacial plastic surgeons in fourteen different countries, to collect data for primary indication for surgical management, preference for timing and choice of surgery, and pre-, peri-, and post-operative management options. The overall response rate from both groups was 32% (n=90/284). Skull deformity was the primary indication for surgical treatment in patients without signs of hydrocephalus for both neurosurgeons and craniofacial surgeons (80% and 63%, respectively). Open surgical management was most commonly performed at six months of age by neurosurgeons (46%) and also by craniofacial surgeons (35%). Open surgical approach was favored for patients younger than four months of age by neurosurgeons (50%), but endoscopic approach was favored by craniofacial surgeons (35%). When performing an open surgical intervention, most neurosurgeons preferred pi or reversed pi procedure (27%), whereas total cranial vault remodeling was the most commonly performed procedure by craniofacial surgeons (37%). The data demonstrated a discrepancy in the treatment options for non-syndromic sagittal craniosynostosis. By conducting/comparing a wide survey to collect consolidative data from both groups of pediatric neurosurgeons and craniofacial plastic surgeons, we can attempt to facilitate the establishment of standard of care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. An environmental analysis for comparing waste management options and strategies.

    PubMed

    Marchettini, N; Ridolfi, R; Rustici, M

    2007-01-01

    The debate on different waste management practices has become an issue of utmost importance as human activities have overloaded the assimilative capacity of the biosphere. Recent Italian law on solid waste management recommends an increase in material recycling and energy recovery, and only foresees landfill disposal for inert materials and residues from recovery and recycling. A correct waste management policy should be based on the principles of sustainable development, according to which our refuse is not simply regarded as something to eliminate but rather as a potential resource. This requires the creation of an integrated waste management plan that makes full use of all available technologies. In this context, eMergy analysis is applied to evaluate three different forms of waste treatment and construct an approach capable of assessing the whole strategy of waste management. The evaluation included how much investment is needed for each type of waste management and how much "utility" is extracted from wastes, through the use of two indicators: Environmental yield ratio (EYR) and Net eMergy. Our results show that landfill is the worst system in terms of eMergy costs and eMergy benefits. Composting is the most efficient system in recovering eMergy (highest EYR) from municipal solid waste (MSW) while incineration is capable of saving the greatest quantity of eMergy per gram of MSW (highest net eMergy). This analysis has made it possible to assess the sustainability and the efficiency of individual options but could also be used to assess a greater environmental strategy for waste management, considering a system that might include landfills, incineration, composting, etc.

  10. Identifying and Managing Gas Leakage from Subsurface Sources

    NASA Astrophysics Data System (ADS)

    Benson, S. M.

    2015-12-01

    Subsurface gas accumulations exist from both natural sources such as hydrocarbon reservoirs, as well as, man-made sources such as natural gas storage, gas pipelines, CO2 storage, or even H2 storage. Both natural and manmade sources of subsurface gases have the potential to leak to the surface. Leakage can cause safety hazards and detrimental impacts associated with the release of greenhouse gases into the atmosphere. Leak management, which involves identifying, characterizing, assessing, and remediating leakage requires a coordinated and systematic approach to effectively deal with these occurrences. Here an overall workflow for leak management is presented, along with technological options and challenges for successful implementation. Many tools and approaches for leak management are available and in use today. However, the increased attention to leakage from a larger variety of sources, particularly associated with legacy facilities and infrastructure, raises new issues and challenges that are highlighted here.

  11. RealGasBrine v1.0 option of TOUGH+ v1.5

    SciTech Connect

    Moridis, George

    2015-02-27

    RealGasBrine v1.0 is a numerical code that for the simulation of the behavior of gas-bearing porous and/fractured geologic media. It is an option of TOUGH+ v1.5 [Moridis, 2014], a successor to the TOUGH2 [Pruess et al., 1999; 2012] family of codes for multi-component, multiphase ?uid and heat ?ow developed at the Lawrence Berkeley National Laboratory. RealGasBrine v1.0 needs the TOUGH+ v1.5 core code in order to compile and execute. It is written in standard FORTRAN 95/2003, and can be run on any computational platform (workstation, PC, Macintosh) for which such compilers are available. RealGasBrine v1.0 describes the non-isothermal two- (for pure water) or three-phase (for brine) flow of an aqueous phase and a real gas mixture in a gas-bearing medium, with a particular focus in ultra-tight (such as tight-sand and shale gas) systems. Up to 12 individual real gases can be tracked, and salt can precipitate as solid halite. The capabilities of the code include coupled flow and thermal effects, real gas behavior, Darcy and non-Darcy flow, several isotherm options of gas sorption onto the grains of the porous media, complex fracture descriptions, gas solubility into water, and geomechanical effects on flow properties. RealGasBrine v1.0 allows the study of flow and transport of fluids and heat over a wide range of time frames and spatial scales not only in gas reservoirs, but also in any problem involving the flow of gases in geologic media, including the geologic storage of greenhouse gas mixtures, the behavior of geothermal reservoirs with multi-component condensable (H2O and CO2) and non-condensable gas mixtures, the transport of water and released H2 in nuclear waste storage applications, etc.

  12. 13 CFR 107.250 - Exclusion of stock options issued by Licensee from Management Expenses.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Sbic § 107.250 Exclusion of stock options issued by Licensee from Management Expenses. Stock options... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Exclusion of stock options issued by Licensee from Management Expenses. 107.250 Section 107.250 Business Credit and Assistance...

  13. Caesarean scar pregnancy: a review of management options.

    PubMed

    Litwicka, Katarzyna; Greco, Ermanno

    2011-12-01

    The current review aims to provide an overview of the already available and emerging treatment modalities for caesarean scar pregnancy (CSP). CSP is a type of ectopic gestation associated with a high risk of serious complications. The cause of this condition and the best management are still unclear. However, some medical and surgical treatment modalities have been suggested. The main objectives in the clinical management of CSP should be the prevention of massive blood loss and the conservation of the uterus to maintain further fertility, women's health and quality of life. Current data suggest that expectant management should not be recommended, whereas there are accumulating data suggesting that early diagnosis offers single or combined medical and surgical treatment options avoiding uterine rupture and haemorrhage, thus preserving the uterus and fertility. No universal treatment guidelines for the management of CSP have been published up to now. The lack of data on the best evidence should encourage any individual case report and further multicentre studies for recommendations establishment.

  14. Caesarean scar pregnancy: a review of management options.

    PubMed

    Litwicka, Katarzyna; Greco, Ermanno

    2013-12-01

    The current review aims to provide an overview of the already available and emerging treatment modalities for caesarean scar pregnancy (CSP). CSP is a type of ectopic gestation associated with a high risk of serious complications. The cause of this condition and the best management are still unclear. However, some medical and surgical treatment modalities have been suggested. The main objectives in the clinical management of CSP should be the prevention of massive blood loss and the conservation of the uterus to maintain further fertility, women's health and quality of life. Current data suggest that expectant management should not be recommended, whereas there are accumulating data suggesting that early diagnosis offers single or combined medical and surgical treatment options avoiding uterine rupture and haemorrhage, thus preserving the uterus and fertility. No universal treatment guidelines for management of CSP have been published up to now. The lack of data on the best evidence should encourage any individual case report and further multicentre studies for recommendation establishment.

  15. Mixed Waste Management Options: 1995 Update. National Low-Level Waste Management Program

    SciTech Connect

    Kirner, N.; Kelly, J.; Faison, G.; Johnson, D.

    1995-05-01

    In the original mixed Waste Management Options (DOE/LLW-134) issued in December 1991, the question was posed, ``Can mixed waste be managed out of existence?`` That study found that most, but not all, of the Nation`s mixed waste can theoretically be managed out of existence. Four years later, the Nation is still faced with a lack of disposal options for commercially generated mixed waste. However, since publication of the original Mixed Waste Management Options report in 1991, limited disposal capacity and new technologies to treat mixed waste have become available. A more detailed estimate of the Nation`s mixed waste also became available when the US Environmental Protection Agency (EPA) and the US Nuclear Regulatory Commission (NRC) published their comprehensive assessment, titled National Profile on Commercially Generated Low-Level Radioactive Mixed Waste (National Profile). These advancements in our knowledge about mixed waste inventories and generation, coupled with greater treatment and disposal options, lead to a more applied question posed for this updated report: ``Which mixed waste has no treatment option?`` Beyond estimating the volume of mixed waste requiring jointly regulated disposal, this report also provides a general background on the Atomic Energy Act (AEA) and the Resource Conservation and Recovery Act (RCRA). It also presents a methodical approach for generators to use when deciding how to manage their mixed waste. The volume of mixed waste that may require land disposal in a jointly regulated facility each year was estimated through the application of this methodology.

  16. Quantitative option analysis for implementation and management of landfills.

    PubMed

    Kerestecioğlu, Merih

    2016-09-01

    The selection of the most feasible strategy for implementation of landfills is a challenging step. Potential implementation options of landfills cover a wide range, from conventional construction contracts to the concessions. Montenegro, seeking to improve the efficiency of the public services while maintaining affordability, was considering privatisation as a way to reduce public spending on service provision. In this study, to determine the most feasible model for construction and operation of a regional landfill, a quantitative risk analysis was implemented with four steps: (i) development of a global risk matrix; (ii) assignment of qualitative probabilities of occurrences and magnitude of impacts; (iii) determination of the risks to be mitigated, monitored, controlled or ignored; (iv) reduction of the main risk elements; and (v) incorporation of quantitative estimates of probability of occurrence and expected impact for each risk element in the reduced risk matrix. The evaluated scenarios were: (i) construction and operation of the regional landfill by the public sector; (ii) construction and operation of the landfill by private sector and transfer of the ownership to the public sector after a pre-defined period; and (iii) operation of the landfill by the private sector, without ownership. The quantitative risk assessment concluded that introduction of a public private partnership is not the most feasible option, unlike the common belief in several public institutions in developing countries. A management contract for the first years of operation was advised to be implemented, after which, a long term operating contract may follow. © The Author(s) 2016.

  17. Impact assessment of waste management options in Singapore.

    PubMed

    Tan, Reginald B H; Khoo, Hsien H

    2006-03-01

    This paper describes the application of life cycle assessment for evaluating various waste management options in Singapore, a small-island city state. The impact assessment method by SimaPro is carried out for comparing the potential environmental impacts of waste treatment options including landfilling, incineration, recycling, and composting. The inventory data include gases and leachate from landfills, air emissions and energy recovery from incinerators, energy (and emission) savings from recycling, composting gases, and transport pollution. The impact assessment results for climate change, acidification, and ecotoxicity show that the incineration of materials imposes considerable harm to both human health and the environment, especially for the burning of plastics, paper/cardboard, and ferrous metals. The results also show that, although some amount of energy can be derived from the incineration of wastes, these benefits are outweighed by the air pollution (heavy metals and dioxins/furans) that incinerators produce. For Singapore, landfill gases and leachate generate minimal environmental damage because of the nation's policy to landfill only 10% of the total disposed wastes. Land transportation and separation of waste materials also pose minimal environmental damage. However, sea transportation to the landfill could contribute significantly to acidification because of the emissions of sulfur oxides and nitrogen oxides from barges. The composting of horticultural wastes hardly imposes any environmental damage. Out of all the waste strategies, the recycling of wastes offers the best solution for environmental protection and improved human health for the nation. Significant emission savings can be realized through recycling.

  18. Rosacea Management: Update on general measures and topical treatment options.

    PubMed

    Schaller, M; Schöfer, H; Homey, B; Hofmann, M; Gieler, U; Lehmann, P; Luger, T A; Ruzicka, T; Steinhoff, M

    2016-12-01

    Although there is presently no cure for rosacea, there are several recommended treatment options available to control many of the symptoms and to prevent them from getting worse. In addition to self-help measures like avoidance of trigger factors and proper skin care, rosacea management should include topical medications as one of the first-line choices for patients with erythematous and mild to severe papulopustular rosacea. Since mixed forms of characteristic rosacea symptoms are more common, medical treatment must be symptom-tailored for each individual case and will often involve a combination therapy. Approved topical agents for the major symptoms of rosacea encompass brimonidine for erythema and ivermectin, metronidazole or azelaic acid for inflammatory lesions, all of which have shown their efficacy in numerous valid, well-controlled trials. In addition, there are several other, not approved topical treatments which are possible options that require further validation in larger well-controlled studies. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  19. Review of Management Options for Patients With Atypical Peyronie's Disease.

    PubMed

    Yafi, Faysal A; Hatzichristodoulou, Georgios; DeLay, Kenneth J; Hellstrom, Wayne J G

    2017-04-01

    Peyronie's disease (PD) is a wound-healing disorder of the tunica albuginea often associated with penile deformity. Less commonly, patients with PD might display atypical presentations such as ventral curvature, hourglass deformity, significantly shortened penis, and/or multiplanar curvature. To review the available literature on the prevalence of and management options for atypical PD. A literature review was performed through PubMed from 1982 through 2016 regarding atypical PD. Keywords used for the search were Peyronie's disease, atypical Peyronie's disease, ventral Peyronie's disease, ventral plaque, hourglass deformity, penile indentation, penile notching, short penis, shortened penis, shrunken penis, biplanar curvature, and multiplanar curvature. To assess the various surgical and non-surgical techniques used for the management of atypical PD. Collagenase Clostridium histolyticum is contraindicated for patients with ventral plaques and/or hourglass deformities. Patients with maintained erectile function and ventral PD plaques are best treated with intralesional injections of interferon alpha-2b or tunica plication. Patients with maintained erectile function with PD associated with hourglass deformity and/or multiplanar curvature are best treated with plaque incision or partial excision and grafting. Patients with a shortened penis could attempt conservative measures such as penile traction therapy and medical management. When erectile function is compromised, insertion of an inflatable penile prosthesis with or without ancillary straightening procedures should be recommended. Lengthening procedures can be attempted in very special circumstances by expert surgeons. There is a paucity of data regarding atypical PD. Ventral plaques can be treated with intralesional injections or surgery, hourglass deformity and multiplanar curvatures are best managed surgically, and a shortened penis should be treated with non-invasive approaches. When concomitant erectile

  20. Carbon footprint and energy use of food waste management options for fresh fruit and vegetables from supermarkets.

    PubMed

    Eriksson, Mattias; Spångberg, Johanna

    2017-02-01

    Food waste is a problem with economic, environmental and social implications, making it both important and complex. Previous studies have addressed food waste management options at the less prioritised end of the waste hierarchy, but information on more prioritised levels is also needed when selecting the best available waste management options. Investigating the global warming potential and primary energy use of different waste management options offers a limited perspective, but is still important for validating impacts from the waste hierarchy in a local context. This study compared the effect on greenhouse gas emissions and primary energy use of different food waste management scenarios in the city of Växjö, Sweden. A life cycle assessment was performed for four waste management scenarios (incineration, anaerobic digestion, conversion and donation), using five food products (bananas, tomatoes, apples, oranges and sweet peppers) from the fresh fruit and vegetables department in two supermarkets as examples when treated as individual waste streams. For all five waste streams, the established waste hierarchy was a useful tool for prioritising the various options, since the re-use options (conversion and donation) reduced the greenhouse gas emissions and the primary energy use to a significantly higher degree than the energy recovery options (incineration and anaerobic digestion). The substitution of other products and services had a major impact on the results in all scenarios. Re-use scenarios where food was replaced therefore had much higher potential to reduce environmental impact than the energy recovery scenarios where fossil fuel was replaced. This is due to the high level of resources needed to produce food compared with production of fossil fuels, but also to fresh fruit and vegetables having a high water content, making them inefficient as energy carriers. Waste valorisation measures should therefore focus on directing each type of food to the waste

  1. Natural gas applications in waste management

    SciTech Connect

    Tarman, P.B.

    1991-01-01

    The Institute of Gas Technology (IGT) is engaged in several projects related to the use of natural gas for waste management. These projects can be classified into four categories: cyclonic incineration of gaseous, liquid, and solid wastes; fluidized-bed reclamation of solid wastes; two-stage incineration of liquid and solid wastes; natural gas injection for emissions control. 5 refs., 8 figs.

  2. Participatory groundwater management in Jordan: Development and analysis of options

    NASA Astrophysics Data System (ADS)

    Chebaane, Mohamed; El-Naser, Hazim; Fitch, Jim; Hijazi, Amal; Jabbarin, Amer

    Groundwater over-exploitation has been on the rise in Jordan. Competing demands have grown in the face of perennial water shortages, a situation which has been exacerbated by drought conditions in the past decade. This paper reports findings of a project in which management options to address over-exploitation were developed for one of Jordan's principal aquifer systems, the Amman-Zarqa Basin. Options for addressing the situation were developed through a participatory approach that involved government officials and various public and private sector interest groups. Particular efforts were made to involve well irrigators, who are likely to be heavily impacted by the changes required to reduce groundwater pumping to a sustainable level. With information obtained from a rapid appraisal survey as well as from interviews with farmers, community groups, government officials, and technical experts, an extensive set of options was identified for evaluation. Based on integrated hydrogeologic, social, and economic analysis, five complementary management options were recommended for implementation. These included the establishment of an Irrigation Advisory Service, buying out farm wells, placing firm limits on well ion and irrigated crop areas, exchanging treated wastewater for groundwater, and measures to increase the efficiency of municipal and industrial water use. Various combinations and levels of these options were grouped in scenarios, representing possible implementation strategies. The scenarios were designed to assist decision makers, well owners and other stakeholders in moving gradually towards a sustainable ion regime. Social and economic aspects of each option and scenario were analyzed and presented to stakeholders, together with a of legal, institutional and environmental ramifications. Combining scientific analysis with a participatory approach in the Amman Zarqa Basin groundwater management was devised as a prototype to be used in the management of other

  3. Management options for cholestatic liver disease in children.

    PubMed

    Catzola, Andrea; Vajro, Pietro

    2017-07-28

    Due to a peculiar age-dependent increased susceptibility, neonatal cholestasis affects the liver of approximately 1 in every 2500 term infants. A high index of suspicion is the key to an early diagnosis, and to implement timely, often life-saving treatments. Even when specific treatment is not available or curative, prompt medical management and optimization of nutrition are of paramount importance to survival and avoidance of complications. Areas covered: The present article will prominently focus on a series of newer diagnostic and therapeutic options of cholestasis in neonates and infants blended with consolidated established paradigms. The overview of strategies for the management reported here is based on a systematic literature search published in English using accessible databases (PubMed, MEDLINE) with the keywords biliary atresia, choleretics and neonatal cholestasis. References lists from retrieved articles were also reviewed. Expert commentary: A large number of uncommon and rare hepatobiliary disorders may present with cholestasis during the neonatal and infantile period. Potentially life-saving disease-specific pharmacological and surgical therapeutic approaches are currently available. Advances in hepatobiliary transport mechanisms have started clarifying fundamental aspects of inherited and acquired cholestasis, laying the foundation for the development of possibly more effective specific therapies.

  4. New treatment options for the management of restless leg syndrome.

    PubMed

    Toro, Beatriz Elizabeth Carmona

    2014-08-01

    Restless leg syndrome (RLS), also known as Willis-Ekbom disease, is a condition that includes sensations such as crawling, tingling, or aching in the limbs and creates an urge to move. The prevalence is estimated at 3% to 15% of the population and may present as primary RLS or secondary RLS. Secondary RLS may be a result of some medications, iron deficiency, or conditions such as neuropathies, or it may be related to pregnancy. The guidelines for diagnosis, which is usually made on clinical presentation, are discussed in the article. Medication use is not always necessary in the management of RLS. Multiple options are available and are reviewed within the article. Since 2011, two medications have been approved for the treatment of RLS, and these are discussed in detail. Neupro (rotigotine) is a dopamine agonist available as a patch that has been approved for the treatment of RLS as well as Parkinson disease. One of the major issues in treating RLS with dopamine agonists is augmentation, meaning symptoms occur earlier in the day due to medication use. This rate of augmentation with use of rotigotine is significantly lower than other dopamine agonists. Horizant (gabapentin enacarbil) is the only nondopaminergic medication approved for the treatment of RLS. Bioavailability is greater in gabapentin enacarbil as compared to gabapentin. Augmentation has not been associated with gabapentin or gabapentin enacarbil. Neupro (rotigotine) and Horizant (gabapentin enacarbil) provide additional treatment options for patients with RLS who are in need of medications. Consideration of each individual patient is necessary when determining if medication is needed and in choosing the appropriate agent.

  5. Ranula: Current Concept of Pathophysiologic Basis and Surgical Management Options.

    PubMed

    Kokong, Daniel; Iduh, Augustine; Chukwu, Ikechukwu; Mugu, Joyce; Nuhu, Samuel; Augustine, Sule

    2017-06-01

    There is no consensus opinion on a definitive surgical management option for ranulas to curtail recurrence, largely from the existing gap in knowledge on the pathophysiologic basis. To highlight the current scientific basis of ranula development that informed the preferred surgical approach. Retrospective cohort study. Public Tertiary Academic Health Institution. A 7-year 7-month study of ranulas surgically managed at our tertiary health institution was undertaken-June 1, 2008-December 31, 2015-from case files retrieved utilising the ICD-10 version 10 standard codes. Twelve cases, representing 0.4 and 1.2% of all institutional and ENT operations, respectively, were managed for ranulas with a M:F = 1:1. The ages ranged from 5/12 to 39 years, mean = 18.5 years, and the disease was prevalent in the third decade of life. Main presentation in the under-fives was related to airway and feeding compromise, while in adults, cosmetic facial appearance. Ranulas in adults were plunging (n = 8, 58.3%), left-sided save one with M:F = 2:1. All were unilateral with R:L = 1:2. Treatment included aspiration (n = 2, 16.7%) with 100% recurrence, intra-/extraoral excision of ranula only (n = 4, 33.3%) with recurrence rate of 50% (n = 2, 16.7%), while marsupialisation in children (n = 1, 8.3%) had no recurrence. Similarly, transcervical approach (n = 5, 41.7%) with excision of both the ranula/sublingual salivary gland recorded zero recurrence. Recurrence was the main complication (n = 4, 33.3%). With the current knowledge on the pathophysiologic basis, extirpation of both the sublingual salivary gland and the ranula by a specialist surgeon is key for a successful outcome.

  6. Macro material flow modeling for analyzing solid waste management options

    SciTech Connect

    Holter, G.M.; Pennock, K.A.; Shaver, S.R.

    1993-06-01

    A Macro Material Flow Modeling (MMFM) concept and approach are being adopted to develop a predictive modeling capability. This capability is intended to provide part of the basis for evaluating potential impacts from various solid waste management system configurations and operating scenarios, as well as evaluating the impacts of various policies on solid waste quantities and compositions. The MMFM capability, as part of a broader Solid Waste Initiative at Pacific Northwest Laboratory, is intended to provide an increased understanding of solid waste as a disposal, energy, and resource problem on a national and global scale, particularly over the long term. This model is a macro-level simulation of the flows of the various materials through the solid waste management system, and also through the associated materials production and use system. Inclusion of materials production and use within the modeling context allows a systems approach to be used, providing a much more complete understanding of the origins of the solid waste materials and also of possible options for materials recovery and reuse than if a more traditional ``end-of-pipe`` view of solid waste is adopted. The MMFM is expected to be useful in evaluating longer-term, broader-ranging solid waste impacts than are traditionally evaluated by decision-makers involved in implementing solutions to local or regional solid waste management problems. This paper discusses the types of questions of interest in evaluating long-term, broad-range impacts from solid waste. It then identifies the basic needs for predictive modeling capabilities like the MMFM, and provides a basic description of the conceptual framework for the model and the associated data. Status of the MMFM implementation is also discussed.

  7. Macro material flow modeling for analyzing solid waste management options

    SciTech Connect

    Holter, G.M.; Pennock, K.A.; Shaver, S.R.

    1993-06-01

    A Macro Material Flow Modeling (MMFM) concept and approach are being adopted to develop a predictive modeling capability. This capability is intended to provide part of the basis for evaluating potential impacts from various solid waste management system configurations and operating scenarios, as well as evaluating the impacts of various policies on solid waste quantities and compositions. The MMFM capability, as part of a broader Solid Waste Initiative at Pacific Northwest Laboratory, is intended to provide an increased understanding of solid waste as a disposal, energy, and resource problem on a national and global scale, particularly over the long term. This model is a macro-level simulation of the flows of the various materials through the solid waste management system, and also through the associated materials production and use system. Inclusion of materials production and use within the modeling context allows a systems approach to be used, providing a much more complete understanding of the origins of the solid waste materials and also of possible options for materials recovery and reuse than if a more traditional end-of-pipe'' view of solid waste is adopted. The MMFM is expected to be useful in evaluating longer-term, broader-ranging solid waste impacts than are traditionally evaluated by decision-makers involved in implementing solutions to local or regional solid waste management problems. This paper discusses the types of questions of interest in evaluating long-term, broad-range impacts from solid waste. It then identifies the basic needs for predictive modeling capabilities like the MMFM, and provides a basic description of the conceptual framework for the model and the associated data. Status of the MMFM implementation is also discussed.

  8. A Review of Management Options for Proximal Humeral Fractures

    PubMed Central

    Jordan, Robert W; Modi, Chetan S

    2014-01-01

    Proximal humeral fractures are common and although the majority can be managed non-operatively, the optimal treatment of displaced or complex fractures remains controversial. Non-operative treatment is typically selected for minimally displaced fractures where union rates are high and good or excellent outcomes can be expected in approximately 80% of cases. The aims of surgical fixation are to restore articular surface congruency, alignment and the relationship between the tuberosities and the humeral head. Hemiarthroplasty provides patients with reliable pain relief and its indications include fracture dislocations, humeral head splitting fractures and some three- and four- part fractures. The key areas of surgical technique that influence functional outcome include correctly restoring the humeral height, humeral version and tuberosity position. Function, however, is poor if the tuberosities either fail to unite or mal-unite. The interest in reverse shoulder arthroplasty as an alternative option has therefore recently increased, particularly in older patients with poor bone quality and tuberosity comminution. The evidence supporting this, however, is currently limited to multiple case series with higher level studies currently underway. PMID:25067968

  9. Thermal management technology for hydrogen storage: Fullerene option

    SciTech Connect

    Wang, J.C.; Chen, F.C.; Murphy, R.W.

    1996-05-28

    Fullerenes were picked as first option for H storage because of potentially high volumetric and gravimetric densities. Results indicate that about 6 wt% H (corresponding to C{sub 60}H{sub 48}) can be added to and taken out of fullerenes. A model with thermally activated hydrogenation/dehydrogenation was developed. Activation energies were estimated to be 100 and 160 kJ/mole (1.0 and 1.6 eV/H{sub 2}) for hydrogenation and dehydrogenation, respectively; difference is interpreted as heat release during hydrogenation. The activation energies and hydrogenation heat may be modifiable by catalysts. Preliminary H storage simulations for a conceptually simple device were performed (a 1-m long hollow metal cylinder with inner dia 0.02 m filled with fullerene powders). Results indicate that the thermal diffusivity of the fullerenes controls the hydrogenation and dehydrogenation rates. Rates can be significantly modified by changing the thermal diffusivity, eg, by incorporating a metal mesh. The simulation suggest that thermal management is essential for efficient H storage devices using fullerenes. More controlled experiments, model development, and physical property determinations are needed; catalyst use also needs to be pursued. Future ORNL/MER cooperative work is planned.

  10. Thermal management technology for hydrogen storage: Fullerene option

    SciTech Connect

    Wang, J.C.; Chen, F.C.; Murphy, R.W.

    1996-10-01

    Fullerenes are selected as the first option for investigating advanced thermal management technologies for hydrogen storage because of their potentially high volumetric and gravimetric densities. Experimental results indicate that about 6 wt% of hydrogen (corresponding to C{sub 60}H{sub 48}) can be added to and taken out of fullerenes. A model assuming thermally activated hydrogenation and dehydrogenation processes was developed to explain the experimental findings. The activation energies were estimated to be 100 and 160 kJ/mole (1.0 and 1.6 eV/H{sub 2}) for the hydrogenation and dehydrogenation processes, respectively. The difference is interpreted as the heat released during hydrogenation. There are indications that the activation energies and the heat of hydrogenation can be modified by the use of catalysts. Preliminary hydrogen storage simulations for a conceptually simple device were performed. A 1-m long hollow metal cylinder with an inner diameter of 0.02 m was assumed to be filled with fullerene powders. The results indicate that the thermal diffusivity of the fullerenes controls the hydrogenation and dehydrogenation rates. The rates can be significantly modified by changing the thermal diffusivity of the material inside the cylinder, e.g., by incorporating a metal mesh. Results from the simulation suggest that thermal management is essential for efficient hydrogen storage devices using fullerenes. While the preliminary models developed in this study explain some of the observation, more controlled experiments, rigorous model development, and physical property determinations are needed for the development of practical hydrogen storage devices. The use of catalysts to optimize the hydrogen storage characteristics of fullerenes also needs to be pursued. Future cooperative work between Oak Ridge National Laboratory (ORNL) and Material & Electrochemical Research Corporation (MER) is planned to address these needs.

  11. Membrane Distillation Bioreactor (MDBR) - A lower Green-House-Gas (GHG) option for industrial wastewater reclamation.

    PubMed

    Goh, Shuwen; Zhang, Jinsong; Liu, Yu; Fane, Anthony G

    2015-12-01

    A high-retention membrane bioreactor system, the Membrane Distillation Bioreactor (MDBR) is a wastewater reclamation process which has the potential to tap on waste heat generated in industries to produce high quality product water. There are a few key factors which could make MDBR an attractive advanced treatment option, namely tightening legal requirements due to increasing concerns on the micropollutants in industrial wastewater effluents as well as concerns over the electrical requirement of pressurized advanced treatment processes and greenhouse gas emissions associated with wastewater reclamation. This paper aims to provide a consolidated review on the current state of research for the MDBR system and to evaluate the system as a possible lower Green House Gas (GHG) emission option for wastewater reclamation using the membrane bioreactor-reverse osmosis (MBR-RO) system as a baseline for comparison. The areas for potential applications and possible configurations for MDBR applications are discussed.

  12. Options analysis of managed care contracting and regulation: theory and evidence.

    PubMed

    McLean, R A; Magiera, F T

    2000-08-01

    Managed care contracts can be represented as bundles of options. In particular, the managed care provider is short a call option. To hedge the risk involved in such contracts, managed care contractors can construct several types of virtual put options, among them the ownership of facilities. Agency theory and options theory suggest that for-profit managed care plans, in the presence of debt, will engage in less hedging activity than will other managed care plans. Here, the authors test that hypothesis, using data for Florida HMOs in 1995, and they reject the null hypothesis. That managed care organizations act as if they are short a call option raises interesting regulatory issues, including the possibility of using a hedge-based regulatory scheme in place of a net-worth-based scheme.

  13. Greenhouse gas emissions from a managed grassland

    NASA Astrophysics Data System (ADS)

    Jones, S. K.; Rees, R. M.; Skiba, U. M.; Ball, B. C.

    2005-07-01

    Managed grasslands contribute to global warming by the exchange of the greenhouse gases carbon dioxide, nitrous oxide and methane. To reduce uncertainties of the global warming potential of European grasslands and to assess potential mitigation options, an integrated approach quantifying fluxes from all three gases is needed. Greenhouse gas emissions from a grassland site in the SE of Scotland were measured in 2002 and 2003. Closed static chambers were used for N 2O and CH 4 flux measurements, and samples were analysed by gas chromatography. Closed dynamic chambers were used for soil respiration measurements, using infrared gas analysis. Three organic manures and two inorganic fertilizers were applied at a rate of 300 kg N ha -1 a -1 (available N) and compared with a zero-N control on grassland plots in a replicated experimental design. Soil respiration from plots receiving manure was up to 1.6 times larger than CO 2 release from control plots and up to 1.7 times larger compared to inorganic treatments ( p<0.05). A highly significant ( p<0.001) effect of fertilizer and manure treatments on N 2O release was observed. Release of N 2O from plots receiving inorganic fertilizers resulted in short term peaks of up to 388 g N 2O-N ha -1 day -1. However losses from plots receiving organic manures were both longer lasting and greater in magnitude, with an emission of up to 3488 g N 2O-N ha -1 day -1 from the sewage sludge treatments. During the 2002 growing season the cumulative total N 2O flux from manure treatments was 25 times larger than that from mineral fertilizers. CH 4 emissions were only significantly increased ( p<0.001) for a short period following applications of cattle slurry. Although soil respiration in manure plots was high, model predictions and micrometeorological flux measurements at an adjacent site suggest that all plots receiving fertilizer or manure acted as a sink for CO 2. Therefore in terms of global warming potentials the contribution of N 2O from

  14. Creative Approaches to Health Education in Higher Education: Wellness Management Option.

    ERIC Educational Resources Information Center

    Burckes-Miller, Mardie E.

    Wellness Management has been designed as an option in the health education bachelors program at Plymouth State College of the University System of New Hampshire. The Wellness Management option was created because alumni and employers stated that graduates needed business skills in order to be more marketable and effective as health educators. The…

  15. Clinically undetected retinal breaks causing retinal detachment: options for management.

    PubMed

    Gupta, Deepak; Ching, Jared; Tornambe, Paul E

    2017-08-11

    The successful detection of retinal breaks is a critical step in rhegmatogenous retinal detachment (RRD) surgery in order to prevent persistent/recurrent RRDs. Not all retinal breaks causing retinal detachments are obvious. Retinal breaks may be obscured due to opacities that are either anterior-segment related, lens related or posterior-segment related. Rules to identify breaks based on sub-retinal fluid (SRF) configuration are more difficult to apply in pseudophakic, aphakic, encircled eyes, and eyes with repeat detachments and those with proliferative vitreoretinopathy (PVR). Exudative detachments exhibit characteristic features and must be ruled out. A thorough clinical examination pre-operatively is important even if a vitrectomy is planned. This paper reviews the incidence and causes of undetected breaks along with pre-operative/clinical issues that may hinder break detection. We review the literature with respect to investigative approaches and techniques that are available to the vitreo-retinal surgeon when primary breaks remains clinically undetected during the pre-operative examination. We broadly divide the surgical approaches into ones where the surgeon utilises techniques to actively pursue a search for breaks versus adopting a purely speculative approach. Advantages and disadvantages of various techniques are appraised. Intuitively one might argue that an encircling scleral buckle combined with vitrectomy would give higher single operation success than PPV alone because 'undetected' retinal breaks would be addressed by a 360° plombage. We could not confirm this concept. Newer techniques, such as PPV augmented with dye extrusion or endoscopic-assisted PPV show encouraging results. Technological advances such as intraoperative OCT will also help to broaden the VR surgeon's armamentarium. At this time there is no gold standard in terms of the recommended approach and this is reflected in the many options that are available for management in this

  16. Rice management interventions to mitigate greenhouse gas emissions: a review.

    PubMed

    Hussain, Saddam; Peng, Shaobing; Fahad, Shah; Khaliq, Abdul; Huang, Jianliang; Cui, Kehui; Nie, Lixiao

    2015-03-01

    Global warming is one of the gravest threats to crop production and environmental sustainability. Rice, the staple food of more than half of the world's population, is the most prominent cause of greenhouse gas (GHG) emissions in agriculture and gives way to global warming. The increasing demand for rice in the future has deployed tremendous concerns to reduce GHG emissions for minimizing the negative environmental impacts of rice cultivation. In this review, we presented a contemporary synthesis of existing data on how crop management practices influence emissions of GHGs in rice fields. We realized that modifications in traditional crop management regimes possess a huge potential to overcome GHG emissions. We examined and evaluated the different possible options and found that modifying tillage permutations and irrigation patterns, managing organic and fertilizer inputs, selecting suitable cultivar, and cropping regime can mitigate GHG emissions. Previously, many authors have discussed the feasibility principle and the influence of these practices on a single gas or, in particular, in the whole agricultural sector. Nonetheless, changes in management practices may influence more than one gas at the same time by different mechanisms or sometimes their effects may be antagonistic. Therefore, in the present attempt, we estimated the overall global warming potential of each approach to consider the magnitude of its effects on all gases and provided a comprehensive assessment of suitable crop management practices for reducing GHG emissions in rice culture.

  17. Surgical options for the management of visceral artery aneurysms.

    PubMed

    Van Petersen, A; Meerwaldt, R; Geelkerken, R; Zeebregts, C

    2011-06-01

    Visceral artery aneurysm (VAA) is a rare entity but increased use of abdominal imaging has led to an increased prevalence. Rupture is related to a high mortality rate. Open repair, endovascular treatment and laparoscopic techniques have been described as treatment options. In this systematic review we describe the surgical options for treating VAA. A literature search identified articles focussing on the key issues of visceral artery aneurysms and surgical options using the Pubmed and Cochrane databases. Case reports dominate the literature about VAA. Twenty-seven small case series and ten review articles have been published in the last 20 years concerning the surgical options for VAA. The evidence does not exceed level 3. Surgical treatment is dictated by both patient and aneurysm characteristics. Whether VAA should be treated largely depends upon age, gender, presence of hypertension (e.g. in renal aneurysm), aneurysm size and presentation. Aneurysm size and characteristics, anatomical location and presence of collateral circulation dictate the surgical option to be chosen. The mortality and morbidity rates after elective open repair are low. Literature about surgical options for treating VAA remains scarce. Only a few clinical trials have shown the possibilities and results of open surgical repair. In general, there is no consensus on the surgical treatment of VAA and the highest level of evidence is based upon expert opinions.

  18. Options for treating high-temperature gas-cooled reactor fuel for repository disposal

    SciTech Connect

    Lotts, A.L.; Bond, W.D.; Forsberg, C.W.; Glass, R.W.; Harrington, F.E.; Micheals, G.E.; Notz, K.J.; Wymer, R.G.

    1992-02-01

    This report describes the options that can reasonably be considered for disposal of high-temperature gas-cooled reactor (HTGR) fuel in a repository. The options include whole-block disposal, disposal with removal of graphite (either mechanically or by burning), and reprocessing of spent fuel to separate the fuel and fission products. The report summarizes what is known about the options without extensively projecting or analyzing actual performance of waste forms in a repository. The report also summarizes the processes involved in convert spent HTGR fuel into the various waste forms and projects relative schedules and costs for deployment of the various options. Fort St. Vrain Reactor fuel, which utilizes highly-enriched {sup 235}U (plus thorium) and is contained in a prismatic graphite block geometry, was used as the baseline for evaluation, but the major conclusions would not be significantly different for low- or medium-enriched {sup 235}U (without thorium) or for the German pebble-bed fuel. Future US HTGRs will be based on the Fort St. Vrain (FSV) fuel form. The whole block appears to be a satisfactory waste form for disposal in a repository and may perform better than light-water reactor (LWR) spent fuel. From the standpoint of process cost and schedule (not considering repository cost or value of fuel that might be recycled), the options are ranked as follows in order of increased cost and longer schedule to perform the option: (1) whole block, (2a) physical separation, (2b) chemical separation, and (3) complete chemical processing.

  19. Water management practices used by Fayetteville shale gas producers.

    SciTech Connect

    Veil, J. A.

    2011-06-03

    Water issues continue to play an important role in producing natural gas from shale formations. This report examines water issues relating to shale gas production in the Fayetteville Shale. In particular, the report focuses on how gas producers obtain water supplies used for drilling and hydraulically fracturing wells, how that water is transported to the well sites and stored, and how the wastewater from the wells (flowback and produced water) is managed. Last year, Argonne National Laboratory made a similar evaluation of water issues in the Marcellus Shale (Veil 2010). Gas production in the Marcellus Shale involves at least three states, many oil and gas operators, and multiple wastewater management options. Consequently, Veil (2010) provided extensive information on water. This current study is less complicated for several reasons: (1) gas production in the Fayetteville Shale is somewhat more mature and stable than production in the Marcellus Shale; (2) the Fayetteville Shale underlies a single state (Arkansas); (3) there are only a few gas producers that operate the large majority of the wells in the Fayetteville Shale; (4) much of the water management information relating to the Marcellus Shale also applies to the Fayetteville Shale, therefore, it can be referenced from Veil (2010) rather than being recreated here; and (5) the author has previously published a report on the Fayetteville Shale (Veil 2007) and has helped to develop an informational website on the Fayetteville Shale (Argonne and University of Arkansas 2008), both of these sources, which are relevant to the subject of this report, are cited as references.

  20. A multi-criteria decision analysis assessment of waste paper management options.

    PubMed

    Hanan, Deirdre; Burnley, Stephen; Cooke, David

    2013-03-01

    The use of Multi-criteria Decision Analysis (MCDA) was investigated in an exercise using a panel of local residents and stakeholders to assess the options for managing waste paper on the Isle of Wight. Seven recycling, recovery and disposal options were considered by the panel who evaluated each option against seven environmental, financial and social criteria. The panel preferred options where the waste was managed on the island with gasification and recycling achieving the highest scores. Exporting the waste to the English mainland for incineration or landfill proved to be the least preferred options. This research has demonstrated that MCDA is an effective way of involving community groups in waste management decision making. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. A multi-criteria decision analysis assessment of waste paper management options

    SciTech Connect

    Hanan, Deirdre; Burnley, Stephen; Cooke, David

    2013-03-15

    Highlights: ► Isolated communities have particular problems in terms of waste management. ► An MCDA tool allowed a group of non-experts to evaluate waste management options. ► The group preferred local waste management solutions to export to the mainland. ► Gasification of paper was the preferred option followed by recycling. ► The group concluded that they could be involved in the decision making process. - Abstract: The use of Multi-criteria Decision Analysis (MCDA) was investigated in an exercise using a panel of local residents and stakeholders to assess the options for managing waste paper on the Isle of Wight. Seven recycling, recovery and disposal options were considered by the panel who evaluated each option against seven environmental, financial and social criteria. The panel preferred options where the waste was managed on the island with gasification and recycling achieving the highest scores. Exporting the waste to the English mainland for incineration or landfill proved to be the least preferred options. This research has demonstrated that MCDA is an effective way of involving community groups in waste management decision making.

  2. Temporary stream and wetland crossing options for forest management

    Treesearch

    Charles R. Blinn; Rick. Dahlman; Lola. Hislop; Michael A. Thompson

    1998-01-01

    Discusses temporary options for crossing streams and wetland soils with forest harvesting and transportation equipment. Reviews the available literature on the environmental effects of temporary crossings. Provides an overview of regulations pertaining to temporary crossings for several jurisdictions in the Great Lakes Region.

  3. Temporary stream and wetland crossing options for forest management.

    Treesearch

    Charles R. Blinn; Rick Dahlman; Lola Hislop; Michael A. Thompson

    1998-01-01

    Discusses temporary options for crossing streams and wetland soils with forest harvesting and transportation equipment. Reviews the available literature on the environmental effects of temporary crossings. Provides an overview of regulations pertaining to temporary crossings for several jurisdictions in the Great Lakes Region.

  4. Management Options for Control of a Stunt and Needle Nematode in Southern Forest Nurseries

    Treesearch

    Michelle M. Cram; Stephen W. Fraedrich

    2005-01-01

    Crop rotation and fallow are management options that can be used to control plant parasitic nematodes in forest tree nurseries. Before these options can be put into practice, it is important to determine the host range and survivability under fallow of the parasitic nematode to be controlled. The results of host range tests on a needle nematode (Longidorus...

  5. Management Options For Reducing The Release Of Antibiotics And Antibiotic Resistance Genes To The Environment

    EPA Science Inventory

    Background: There is growing concern worldwide about the role of polluted soil and water - 77 environments in the development and dissemination of antibiotic resistance. 78 Objective: To identify management options for reducing the spread of antibiotics and 79 antibiotic resist...

  6. Management Options For Reducing The Release Of Antibiotics And Antibiotic Resistance Genes To The Environment

    EPA Science Inventory

    Background: There is growing concern worldwide about the role of polluted soil and water - 77 environments in the development and dissemination of antibiotic resistance. 78 Objective: To identify management options for reducing the spread of antibiotics and 79 antibiotic resist...

  7. Assessment and management options for women with vulvodynia.

    PubMed

    Cox, Kim J; Neville, Cynthia E

    2012-01-01

    Vulvodynia is a chronic pain disorder that affects sexual function in adult women. The etiology of vulvodynia is poorly understood, making the condition difficult to diagnose and treat. Women with vulvodynia often suffer significant psychological distress and have difficulty finding a compassionate and supportive health care provider. This article reviews the etiology, diagnosis, educational strategies, and treatment options for vulvodynia with the aim of increasing primary care providers' knowledge and assessment skills. Physical therapy and other nonsurgical treatment modalities are explored in depth.

  8. Template for assessing climate change impacts and management options: TACCIMO user guide version 2.2

    Treesearch

    Emrys Treasure; Steven McNulty; Jennifer Moore Myers; Lisa Nicole Jennings

    2014-01-01

    The Template for Assessing Climate Change Impacts and Management Options (TACCIMO) is a Web-based tool developed by the Forest Service, U.S. Department of Agriculture to assist Federal, State, and private land managers and planners with evaluation of climate change science implications for sustainable natural resource management. TACCIMO is a dynamic information...

  9. Coalbed methane-produced water quality and its management options in Raniganj Basin, West Bengal, India

    NASA Astrophysics Data System (ADS)

    Mendhe, Vinod Atmaram; Mishra, Subhashree; Varma, Atul Kumar; Singh, Awanindra Pratap

    2017-06-01

    Coalbed methane (CBM) recovery is associated with production of large quantity of groundwater. The coal seams are depressurized by pumping of water for regular and consistent gas production. Usually, CBM operators need to pump >10 m3 of water per day from one well, which depends on the aquifer characteristics, drainage and recharge pattern. In India, 32 CBM blocks have been awarded for exploration and production, out of which six blocks are commercially producing methane gas at 0.5 million metric standard cubic feet per day. Large amount of water is being produced from CBM producing blocks, but no specific information or data are available for geochemical properties of CBM-produced water and its suitable disposal or utilization options for better management. CBM operators are in infancy and searching for the suitable solutions for optimal management of produced water. CBM- and mine-produced water needs to be handled considering its physical and geochemical assessment, because it may have environmental as well as long-term impact on aquifer. Investigations were carried out to evaluate geochemical and hydrogeological conditions of CBM blocks in Raniganj Basin. Totally, 15 water samples from CBM well head and nine water samples from mine disposal head were collected from Raniganj Basin. The chemical signature of produced water reveals high sodium and bicarbonate concentrations with low calcium and magnesium, and very low sulphate in CBM water. It is comprehend that CBM water is mainly of Na-HCO3 type and coal mine water is of Ca-Mg-SO4 and HCO3-Cl-SO4 type. The comparative studies are also carried out for CBM- and mine-produced water considering the geochemical properties, aquifer type, depth of occurrence and lithological formations. Suitable options like impounding, reverse osmosis, irrigation and industrial use after prerequisite treatments are suggested. However, use of this huge volume of CBM- and mine-produced water for irrigation or other beneficial purposes

  10. Coalbed methane-produced water quality and its management options in Raniganj Basin, West Bengal, India

    NASA Astrophysics Data System (ADS)

    Mendhe, Vinod Atmaram; Mishra, Subhashree; Varma, Atul Kumar; Singh, Awanindra Pratap

    2015-09-01

    Coalbed methane (CBM) recovery is associated with production of large quantity of groundwater. The coal seams are depressurized by pumping of water for regular and consistent gas production. Usually, CBM operators need to pump >10 m3 of water per day from one well, which depends on the aquifer characteristics, drainage and recharge pattern. In India, 32 CBM blocks have been awarded for exploration and production, out of which six blocks are commercially producing methane gas at 0.5 million metric standard cubic feet per day. Large amount of water is being produced from CBM producing blocks, but no specific information or data are available for geochemical properties of CBM-produced water and its suitable disposal or utilization options for better management. CBM operators are in infancy and searching for the suitable solutions for optimal management of produced water. CBM- and mine-produced water needs to be handled considering its physical and geochemical assessment, because it may have environmental as well as long-term impact on aquifer. Investigations were carried out to evaluate geochemical and hydrogeological conditions of CBM blocks in Raniganj Basin. Totally, 15 water samples from CBM well head and nine water samples from mine disposal head were collected from Raniganj Basin. The chemical signature of produced water reveals high sodium and bicarbonate concentrations with low calcium and magnesium, and very low sulphate in CBM water. It is comprehend that CBM water is mainly of Na-HCO3 type and coal mine water is of Ca-Mg-SO4 and HCO3-Cl-SO4 type. The comparative studies are also carried out for CBM- and mine-produced water considering the geochemical properties, aquifer type, depth of occurrence and lithological formations. Suitable options like impounding, reverse osmosis, irrigation and industrial use after prerequisite treatments are suggested. However, use of this huge volume of CBM- and mine-produced water for irrigation or other beneficial purposes

  11. An integrated assessment of options for rural wastewater management in Austria.

    PubMed

    Starkl, M; Ornetzeder, M; Binner, E; Holubar, P; Pollak, M; Dorninger, M; Mascher, F; Fuerhacker, M; Haberl, R

    2007-01-01

    This paper reports a recently finished, interdisciplinary project on rural wastewater management in Austria. The objective of the project was to study alternative wastewater management options based on separation of the wastewater into its constituent parts, and to compare them with conventional ones. Thereby, a feasibility study of both conventional and alternative options for wastewater management in six model regions was carried out. Life cycle costs and social acceptance were analysed by using a case study-based assessment approach. However, hygienic and environmental risks were evaluated on a more general level. In order to complement the findings, a survey on urine separation system users in the Solar City of Linz was conducted. Based on these assessments and empirical findings, the paper concludes that options using a full separation of all wastewater fractions should be considered with care. Options based on a separation of only grey water and black water or in the liquid/solid phase can offer ecological and financial advantages over conventional options. Further, options combining wastewater management and regional biogas plants were identified as an interesting solution. However, legal constraints restrict this option currently.

  12. A treatment algorithm for managing Achilles tendinopathy: new treatment options

    PubMed Central

    Alfredson, Håkan; Cook, J

    2007-01-01

    Achilles tendinopathy affects athletes, recreational exercisers and even inactive people. The pathology is not inflammatory; it is a failed healing response. The source of pain in tendinopathy could be related to the neurovascular ingrowth seen in the tendon's response to injury. The treatment of Achilles tendinopathy is primarily conservative with an array of effective treatment options now available to the primary care practitioner. If conservative treatment is not successful, then surgery relieves pain in the majority of cases. Directing a patient through the algorithm presented here will maximise positive treatment outcomes. PMID:17311806

  13. Science-management collaborations: Developing adaptation options for National Forests

    Treesearch

    Forest Service U.S. Department of Agriculture

    2010-01-01

    Climate is constantly changing, prompting natural and managed ecosystems to adjust. As a natural process, adaptation refers to the reactive changes that species and ecosystems make in response to environmental changes. With human intervention, adaptation refers to management actions and decisions that help ecological, social, and economic systems accommodate challenges...

  14. Proceedings of the 1999 Oil and Gas Conference: Technology Options for Producer Survival

    SciTech Connect

    None available

    2000-04-12

    The 1999 Oil & Gas Conference was cosponsored by the U.S. Department of Energy (DOE), Office of Fossil Energy, Federal Energy Technology Center (FETC) and National Petroleum Technology Office (NPTO) on June 28 to 30 in Dallas, Texas. The Oil & Gas Conference theme, Technology Options for Producer Survival, reflects the need for development and implementation of new technologies to ensure an affordable, reliable energy future. The conference was attended by nearly 250 representatives from industry, academia, national laboratories, DOE, and other Government agencies. Three preconference workshops (Downhole Separation Technologies: Is it Applicable for Your Operations, Exploring and developing Naturally Fractured Low-Permeability Gas Reservoirs from the Rocky Mountains to the Austin Chalk, and Software Program Applications) were held. The conference agenda included an opening plenary session, three platform sessions (Sessions 2 and 3 were split into 2 concurrent topics), and a poster presentation reception. The platform session topics were Converting Your Resources Into Reserves (Sessions 1 and 2A), Clarifying Your Subsurface Vision (Session 2B), and High Performance, Cost Effective Drilling, Completion, Stimulation Technologies (Session 3B). In total, there were 5 opening speakers, 30 presenters, and 16 poster presentations.

  15. Disposal/recovery options for brine waters from oil and gas production in New York State. Final report

    SciTech Connect

    Matsumoto, M.R.; Atkinson, J.F.; Bunn, M.D.; Hodge, D.S.

    1996-03-01

    Produced water from oil and gas operations, or brine as it is typically referred, may be characterized as being highly saline, with total dissolved solids greater than 100 g/L. If these bribes are disposed improperly there may be severe adverse environmental effects. Thus, it is important that brine be disposed using environmentally sound methods. Unfortunately, costs for the disposal of brine water are a significant burden to oil and gas producers in New York State. These costs and the relatively low market price of oil and natural gas have contributed to the decline in gas and oil production in New York State during the past 10 years. The objectives of this study were to evaluate new and existing options for brine disposal in New York State, examine the technical and economic merits of these options, and assess environmental impacts associated with each option. Two new disposal options investigated for New York State oil and gas producers included construction of a regional brine treatment facility to treat brine prior to discharge into a receiving water and a salt production facility that utilizes produced water as a feed stock. Both options are technically feasible; however, their economic viability depends on facility size and volume of brine treated.

  16. Kasabach-Merritt Phenomenon: Classic Presentation and Management Options.

    PubMed

    Mahajan, Priya; Margolin, Judith; Iacobas, Ionela

    2017-01-01

    Kasabach-Merritt phenomenon (KMP) is a rare consumptive coagulopathy associated with specific vascular tumors, kaposiform hemangioendothelioma, and tufted angioma. Kasabach-Merritt phenomenon, characterized by profound thrombocytopenia, hypofibrinogenemia, elevated fibrin split products, and rapid tumor growth, can be life-threatening. Severe symptomatic anemia may also be present. With prompt diagnosis and management, KMP can resolve and vascular tumors have been shown to regress. This review highlights the clinical presentation, histopathology, management, and treatment of KMP associated with kaposiform hemangioendothelioma, and less frequently tufted angioma. A classic clinical case is described to illustrate the presentation and our management of a patient with KMP.

  17. Greenhouse gas balances in low-productive drained boreal peatlands - is climate-friendly management possible?

    NASA Astrophysics Data System (ADS)

    Ojanen, Paavo; Minkkinen, Kari; Heikkinen, Tiina; Penttilä, Timo

    2016-04-01

    Five million hectares of peatland has been drained for forestry in Finland. About 20% of that, i.e. one million hectares, has been estimated to be so low-productive that the profitability of keeping them in forestry is questionable. At the same time, drainage has introduced changes in the ecosystem functions of these peatlands, including fluxes of greenhouse gases. Options to manage such peatlands include for example 1) no measures, i.e. leaving the drained peatlands as they are 2) increasing intensity by e.g. repetitive fertilisations and 3) restoration back to functional peatlands. Here we estimate the greenhouse gas impacts of these three management options. We collected GHG and organic carbon flux data from 50 low-productive peatlands under these management options over two years 2014-2015. Gas fluxes (CO2, CH4, N2O) were measured with closed chambers. Litter production rates of different plants above and below ground were estimated using litter traps (trees), biomass sampling (roots), through-grow nets (mosses), allometric biomass models (other vasculars) and published turnover rates (roots, other vasculars). Characteristics for estimating tree stand biomass increment were measured at each site from circular sample plots. In this presentation we will estimate the GHG impacts for the different management options, and aim to find the most climate-friendly options for the management of low-productive peatlands in the short and long term. This work was funded by Life+ LIFE12/ENV/FI/150.

  18. Workshop 3 (synthesis): climate variability, water systems and management options.

    PubMed

    Connor, R; Kuylenstierna, J

    2004-01-01

    Addressing climate variability now will better prepare us for future impacts of climate change. Sustained, multi-stakeholder dialogue at local through national levels is an approach that will reach the widest audience, helped by tools that illustrate vulnerability such as the Climate Vulnerability Index. Integrated water resources management deals with managing for variability and change and is therefore highly appropriate for dealing with climate impacts.

  19. Current Federal Identity Management and the Dynamic Signature Biometrics Option

    DTIC Science & Technology

    2009-03-01

    systems (Council, Identity Management Task Force Report 2008, 15). There would no longer be a need to continuously remember or write - down PIN’s or...Reader: James Ehlert THIS PAGE INTENTIONALLY LEFT BLANK i REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting burden for this...Directorate for Information Operations and Reports , 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and

  20. CAD/CAM data management needs, requirements and options

    NASA Technical Reports Server (NTRS)

    Lopatka, R. S.; Johnson, T. G.

    1978-01-01

    The requirements for a data management system in support of technical or scientific applications and possible courses of action were reviewed. Specific requirements were evolved while working towards higher level integration impacting all phases of the current design process and through examination of commercially marketed systems and related data base research. Arguments are proposed for varied approaches in implementing data base systems ranging from no action necessary to immediate procurement of an existing data base management system.

  1. CAD/CAM data management needs, requirements and options

    NASA Technical Reports Server (NTRS)

    Lopatka, R. S.; Johnson, T. G.

    1978-01-01

    The requirements for a data management system in support of technical or scientific applications and possible courses of action were reviewed. Specific requirements were evolved while working towards higher level integration impacting all phases of the current design process and through examination of commercially marketed systems and related data base research. Arguments are proposed for varied approaches in implementing data base systems ranging from no action necessary to immediate procurement of an existing data base management system.

  2. Current options for nonsurgical management of carpal tunnel syndrome

    PubMed Central

    Carlson, Hans; Colbert, Agatha; Frydl, Jennifer; Arnall, Elizabeth; Elliot, Molly; Carlson, Nels

    2010-01-01

    Carpal tunnel syndrome (CTS) is the most common of the entrapment neuropathies. Surgical decompression is commonly performed and has traditionally been considered the defnitive treatment for CTS. Conservative treatment options include physical therapy, bracing, steroid injections and alternative medicine. While CTS is often progressive, patients may get better without formal treatment. The resolution of symptoms is not necessarily related to the severity of the clinical findings and self-limited activity is common. The current literature suggests that bracing and corticosteroid injections may be useful in the nonsurgical treatment of CTS, although the benefits may be short term. There is limited evidence regarding the efficacy of other treatments, such as therapy, exercise, yoga, acupuncture, lasers and magnets, and further studies are needed. Surgery is recommended for progressive functional deficits and significant pain. PMID:20490348

  3. Managing oil disruptions: issues and policy options. [Monograph

    SciTech Connect

    Webre, P.

    1981-01-01

    The Congressional Budget Office (CBO) prepared the analysis of policy options to help Congress decide whether to extend or expand the Emergency Petroleum Allocation Act of 1973, or whether to let it lapse on September 30, 1981. The central theme is that large disruptions of imported oil can deal the economy a severe blow that reduces output and increases unemployment and inflation. Alternative policies might allow this blow to be offset in different ways, but they cannot eliminate an impact. Some policies better contain the inflationary effects of a disruption, but are less effective in mitigating losses in aggregate production and higher unemployment. For others, the converse is true. Further, the appropriateness of each policy varies with the size and anticipated duration of the import disruption. Congress may wish to consider a portfolio of standby policies as well as the selection of just one. Two appendices offer further policy analyses. 10 references, 3 tables.

  4. Internalizing production externalities: A structural estimation of real options in the upstream oil and gas industry

    NASA Astrophysics Data System (ADS)

    Muehlenbachs, Lucija

    implies that typically wells are left inactive not because of the option to reactivate, but rather because the cost of environmental cleanup is too high. Should there be externalities from idling the wells (such as continued contamination of groundwater) that are not accounted for in the decision, then this behavior may not be socially optimal. The model predicts that a Pigouvian tax on inactive wells would have the added benefit of inciting the reactivation of oil and gas wells, however in the case of oil, a tax would incite more wells to be decommissioned than reactivated.

  5. Air quality management in China: issues, challenges, and options.

    PubMed

    Wang, Shuxiao; Hao, Jiming

    2012-01-01

    This article analyzed the control progress and current status of air quality, identified the major air pollution issues and challenges in future, proposed the long-term air pollution control targets, and suggested the options for better air quality in China. With the continuing growth of economy in the next 10-15 years, China will face a more severe situation of energy consumption, electricity generation and vehicle population leading to increase in multiple pollutant emissions. Controlling regional air pollution especially fine particles and ozone, as well as lowering carbon emissions from fossil fuel consumption will be a big challenge for the country. To protect public health and the eco-system, the ambient air quality in all Chinese cities shall attain the national ambient air quality standards (NAAQS) and ambient air quality guideline values set by the World Health Organization (WHO). To achieve the air quality targets, the emissions of SO2, NOx, PM10, and volatile organic compounds (VOC) should decrease by 60%, 40%, 50%, and 40%, respectively, on the basis of that in 2005. A comprehensive control policy focusing on multiple pollutants and emission sources at both the local and regional levels was proposed to mitigate the regional air pollution issue in China. The options include development of clean energy resources, promotion of clean and efficient coal use, enhancement of vehicle pollution control, implementation of synchronous control of multiple pollutants including SO2, NOx, VOC, and PM emissions, joint prevention and control of regional air pollution, and application of climate friendly air pollution control measures.

  6. Energy-saving options for the mitigation of greenhouse gas emissions from the Mongolian energy sector

    SciTech Connect

    Dorjpurev, J.; Purevjal, O.; Erdenechimeg, Ch.

    1996-12-31

    The Energy sector is the largest contributor to GHG emission in Mongolia. The Energy sector emits 54 percent of CO2 and 4 percent of methane. All emissions of other greenhouse gases are accounted from energy related activities. The activities in this sector include coal production, fuel combustion, and biomass combustion at the thermal power stations and in private houses (stoves) for heating purposes. This paper presents some important Demand-side options considered for mitigation of CO2 emissions from energy sector such as Energy Conservation in Industrial Sector and in Buildings. Changes in energy policies and programmes in the Mongolian situation that promote more efficient and sustainable practices are presented in the paper. These energy saving measures will not only help reduce greenhouse gas emissions, but will also promote economic development and alleviate other environmental problems.

  7. Greenhouse gas mitigation options in the forest sector of Russia: National and project level assessments

    SciTech Connect

    Vinson, T.S.; Kolchugina, T.P.; Andrasko, K.A.

    1996-09-01

    Greenhouse gas (GHG) mitigation options in the Russian forest sector include: afforestation and reforestation of unforested/degraded land area; enhanced forest productivity; incorporation of nondestructive methods of wood harvesting in the forest industry; establishment of land protective forest stands; increase in stand age of final harvest in the European part of Russia; increased fire control; increased disease and pest control; and preservation of old growth forests in the Russian Far-East, which are presently threatened. Considering the implementation of all of the options presented, the GHG mitigation potential within the forest and agroforestry sectors of Russia is approximately 0.6-0.7 Pg C/yr or one half of the industrial carbon emissions of the United States. The difference between the GHG mitigation potential and the actual level of GHGs mitigated in the Russian forest sector will depend to a great degree on external financing that may be available. One possibility for external financing is through joint implementation (JI). However, under the JI process, each project will be evaluated by considering a number of criteria including also the difference between the carbon emissions or sequestration for the baseline (or reference) and the project case, the permanence of the project, and leakage. Consequently, a project level assessment must appreciate the near-term constraints that will face practitioners who attempt to realize the GHG mitigation potential in the forest and agroforestry sectors of their countries. 25 refs.

  8. Middle ear capillary haemangioma: Review of literature and appraisal of management options.

    PubMed

    Salamat, Ali A; Casselden, Elizabeth; Theaker, Jeffrey; Batty, Vincent; Thomas, Sebastian

    2016-12-01

    Infantile middle ear capillary haemangiomas (MECH) are a rare entity with only five reported cases in the literature. At present there is no consensus regarding the management of such lesions. Extra-cutaneous haemangiomas have been successfully managed with oral propranolol but not yet reported in MECH. We present a further case and appraise the management options. At present oral propranolol has not been used in the treatment of MECH. The literature suggests that infantile MECH have a higher propensity to spontaneously involute and a greater likelihood of response to propranolol. Surgical excision is the best option in older children and adults.

  9. PHILADELPHIA AIR TOXICS STUDY: EVALUATION OF RISK MANAGEMENT OPTIONS USING MIRA

    EPA Science Inventory

    Evaluation of risk management options usually takes place within single programs at the U.S. EPA. This can produce inadvertent tradeoffs among important criteria by risk managers and other decision makers; resulting in decision surprises. This study is a demonstration of a diff...

  10. Climate change adaptation and mitigation options a guide for natural resource managers in southern forest ecosystems

    Treesearch

    James M. Vose; Kier D. Klepzig

    2014-01-01

    The rapid pace of climate change and its direct and indirect effects on forest ecosystems present a pressing need for better scientific understanding and the development of new science-management partnerships. Understanding the effects of stressors and disturbances (including climatic variability), and developing and testing science-based management options to deal...

  11. PHILADELPHIA AIR TOXICS STUDY: EVALUATION OF RISK MANAGEMENT OPTIONS USING MIRA

    EPA Science Inventory

    Evaluation of risk management options usually takes place within single programs at the U.S. EPA. This can produce inadvertent tradeoffs among important criteria by risk managers and other decision makers; resulting in decision surprises. This study is a demonstration of a diff...

  12. How to manage fatigue in fibromyalgia: nonpharmacological options.

    PubMed

    Ericsson, Anna; Mannerkorpi, Kaisa

    2016-05-01

    The aim of this article is to suggest recommendations for the management of fatigue in fibromyalgia (FM) by reviewing and compiling findings of nonpharmacological treatment for fatigue in patients with FM. The management of fatigue in FM should incorporate regular physical exercise maintained for a longer period of time, which contributes to improved general health and facilitates coping with fatigue and other symptoms. The evidence is still low and the effect of exercise on fatigue in FM needs to be further studied. Patients with FM appear to benefit from general sleep hygiene advice and also need to develop individual strategies to manage the complex factors in everyday life that may be related to fatigue.

  13. Previous iodinated contrast anaphylaxis in blunt abdominal trauma: management options.

    PubMed

    Zaman, Shahriar Raj

    2012-06-01

    A 34-year-old man presented with significant intra-abdominal and orthopaedic injuries following a high-speed motorbike crash. The man had a history of an anaphylactic reaction to iodine. As a result, the gold standard CT of the abdomen with contrast was unable to be performed to ascertain the exact nature of the intra-abdominal injuries. After stabilisation, an MRI of the abdomen was performed which localised the injuries. The previous contrast anaphylaxis delayed full assessment of the patient and subsequent management. This case discusses the current literature and the management guidelines in a patient with previous anaphylaxis to contrast.

  14. ANALYSIS OF INSECT RESISTANCE MANAGEMENT OPTIONS FOR TRANSGENIC BT CORN,

    EPA Science Inventory

    Increasing interest in the responsible management of technology in the industrial and agricultural sectors of the economy has been met through the development of broadly applicable tools to assess the "sustainability" of new technologies. An arena ripe for application of such ana...

  15. ANALYSIS OF INSECT RESISTANCE MANAGEMENT OPTIONS FOR TRANSGENIC BT CORN,

    EPA Science Inventory

    Increasing interest in the responsible management of technology in the industrial and agricultural sectors of the economy has been met through the development of broadly applicable tools to assess the "sustainability" of new technologies. An arena ripe for application of such ana...

  16. Models to compare management options for a protogynous fish.

    PubMed

    Heppell, Selina S; Heppell, Scott A; Coleman, Felicia C; Koenig, Christopher C

    2006-02-01

    Populations of gag (Mycteroperca microlepis), a hermaphroditic grouper, have experienced a dramatic shift in sex ratio over the past 25 years due to a decline in older age classes. The highly female-skewed sex ratio can be predicted as a consequence of increased fishing mortality that truncates the age distribution, and raises some concern about the overall fitness of the population. Management efforts may need to be directed toward maintenance of sex ratio as well as stock size, with evaluations of recruitment based on sex ratio or male stock size in addition to the traditional female-based stock-recruitment relationship. We used two stochastic, age-structured models to heuristically compare the effects of reducing fishing mortality on different life history stages and the relative impact of reductions in fertilization rates that may occur with highly skewed sex ratios. Our response variables included population size, sex ratio, lost egg fertility, and female spawning stock biomass. Population growth rates were highest for scenarios that reduced mortality for female gag (nearshore closure), while improved sex ratios were obtained most quickly with spawning reserves. The effect of reduced fertility through sex ratio bias was generally low but depended on the management scenario employed. Our results demonstrate the utility of evaluation of fishery management scenarios through model analysis and simulation, the synergistic interaction of life history and response to changes in mortality rates, and the importance of defining management goals.

  17. Options in the local management of invasive breast cancer.

    PubMed

    Nixon, A J; Troyan, S L; Harris, J R

    1996-08-01

    Newly diagnosed, early-stage breast cancer confronts the patient and her clinician with multiple treatment decisions. This review examines some of these local treatment options including the choice between breast-conserving treatment (BCT) and mastectomy, how best to treat the axilla, and the optimal sequencing of local and systemic therapy. Key elements in the selection of patients for BCT or mastectomy include preoperative mammography, careful pathological evaluation, and an assessment of patient desires in order to balance the risk of local recurrence against preservation of a cosmetically acceptable breast. Although some absolute contraindications to BCT exist, most patients are candidates for BCT. The role of axillary dissection is currently being redefined, and in the future, more limited procedures may be able to identify patients who can avoid axillary dissection. The relationship between timing of breast surgery with regard to the menstrual cycle and outcome is intriguing but not yet established. As well, the appropriate sequencing of chemotherapy and radiotherapy (RT) after conservative surgery (CS) is uncertain, although randomized trials are beginning to shed some light on this issue. Whether all patients treated with CS require treatment with RT is another question that is currently under investigation. This article addresses these issues, focusing on the specifics of treatment implementation.

  18. Current Diagnostic and Management Options in Perihilar Cholangiocarcinoma

    PubMed Central

    Rizvi, Sumera; Gores, Gregory J.

    2014-01-01

    Cholangiocarcinomas (CCA) are heterogeneous biliary tract tumors with dismal prognosis. Perihilar cholangiocarcinoma (pCCA) involves the large bile ducts of the hepatic hilum, and is the most common type of CCA. Primary sclerosing cholangitis (PSC) is an established risk factor for pCCA. Although the diagnosis of pCCA is challenging, recent advances have been made including cytologic techniques such as fluorescence in situ hybridization. Endoscopic ultrasound with sampling of regional lymph nodes is emerging as a valuable diagnostic modality in the diagnosis and staging of pCCA. Curative treatment options are limited to early stage disease, and include surgical resection and liver transplantation after neoadjuvant therapy. This underscores the importance of early detection, and the need for development of innovative diagnostic tools such as biomarkers. A dense desmoplastic tumor stroma plays an integral role in pCCA progression. The tumor stroma represents an additional target for development of new therapies. Herein, we discuss these advances in the diagnosis and treatment of pCCA. PMID:24860985

  19. Management Options for a High Elevation Forest in the Alps

    NASA Astrophysics Data System (ADS)

    Jandl, R.; Jandl, N.; Schindlbacher, A.

    2013-12-01

    We explored different management strategies for a Cembran pine forest close to the timber line with respect to maintenance of the stand structure, the sequestration of carbon in the biomass and the soil, and the economical relevance of timber production. We used the forest growth simulation model Caldis for the implementation of three management intensities (zero managment, thinning every 30 years, thinning every 50 years) under two climate scenarios (IPCC A1B and B1). The soil carbon dynamics were analyzed with the simulation model Yasso07. The ecological evaluation of our simulation data showed that the extensive management with cutting interventions every 50 years allows the maintenance of the ecosystem carbon pool. Zero managment leads to the build-up of the carbon pool because the forest stand is rather unvulnerable to disturbances (bark beetle, storm). The more intensive mangement causes a decline in the ecosystem carbon pool. The economical evaluation showed the marginal relevance of the income generated by timber production. The main challenge is the compensation for the high harvesting costs (long-distance cable logging system). Even at extremely favorable market prices for timber from Cembran pine it is impossible to extract an appropriate amount of timber to justify the temporary instalment of the harvesting system and to maintain a stand density expected for a protection forest. We conclude that timber production is not a feasible object for mountain forests close to the timber line. Even in a warmer climate the productivity situation of forests close to the timberline will not change sufficiently. Therefore it will require public subsidies and personal efforts to maintain the silvicultural intensity at a level that is required for the sustainable maintenance of protection forests.

  20. Waste heat recovery options in a large gas-turbine combined power plant

    NASA Astrophysics Data System (ADS)

    Upathumchard, Ularee

    This study focuses on power plant heat loss and how to utilize the waste heat in energy recovery systems in order to increase the overall power plant efficiency. The case study of this research is a 700-MW natural gas combined cycle power plant, located in a suburban area of Thailand. An analysis of the heat loss of the combustion process, power generation process, lubrication system, and cooling system has been conducted to evaluate waste heat recovery options. The design of the waste heat recovery options depends to the amount of heat loss from each system and its temperature. Feasible waste heat sources are combustion turbine (CT) room ventilation air and lubrication oil return from the power plant. The following options are being considered in this research: absorption chillers for cooling with working fluids Ammonia-Water and Water-Lithium Bromide (in comparison) and Organic Rankine Cycle (ORC) with working fluids R134a and R245fa. The absorption cycles are modeled in three different stages; single-effect, double-effect and half-effect. ORC models used are simple ORC as a baseline, ORC with internal regenerator, ORC two-phase flash expansion ORC and ORC with multiple heat sources. Thermodynamic models are generated and each system is simulated using Engineering Equation Solver (EES) to define the most suitable waste heat recovery options for the power plant. The result will be synthesized and evaluated with respect to exergy utilization efficiency referred as the Second Law effectiveness and net output capacity. Results of the models give recommendation to install a baseline ORC of R134a and a double-effect water-lithium bromide absorption chiller, driven by ventilation air from combustion turbine compartment. The two technologies yield reasonable economic payback periods of 4.6 years and 0.7 years, respectively. The fact that this selected power plant is in its early stage of operation allows both models to economically and effectively perform waste heat

  1. Greenhouse gas mitigation options in the forestry sector of The Gambia: Analysis based on COMAP model

    SciTech Connect

    Jallow, B.P.

    1996-12-31

    Results of the 1993 Greenhouse Gas Emissions Inventory of The Gambia showed net CO{sub 2} emissions of over (1.66 x 10{sup 6} tons) and 1% was due to uptake by plantations (0.01 x 10{sup 6} tons). This is a clear indication that there is need to identify changes in the land-use policy, law and tenure that discourages forest clearing at the same time significantly influencing the sustainable distribution of land among forestry, rangeland and livestock, and agriculture. About 11% of the total area of The Gambia is either fallow or barren flats that once supported vegetation and hence is still capable of supporting vegetation. The US Country Study Programme has provided the Government of The Gambia through the National Climate Committee funds to conduct Assessment of Mitigation Options to Reduce Greenhouse Gas Emissions. The Forestry Sector is one area for which assessment is being conducted. The assessment is expected to end in September 1996. The Comprehensive Mitigation Analysis Process (COMAP) is one of the Models supplied to the National Climate Committee by the Lawrence Berkeley Laboratory, on behalf of the US Country Study Programme, and is being used to conduct the analysis in The Gambia.

  2. Integration of the Brayton and Rankine cycle to maximize gas turbine performance--A cogeneration option

    SciTech Connect

    Meserlie, R.L.; Strother, J.R.

    1984-06-01

    The Brayton and Rankine cycles are well known and widely used in their own way to generate power. A combining of the fluids of the two cycles has been proposed by International Power Technology and tested by Allison Gas Turbine Operations. Steam generated by the exhaust heat is mixed with the fuel and air in the gas turbine combustion chamber prior to expansion through the turbine. The thermal efficiency of an existing engine can be increased by 40% and power output by 60% at constant turbine temperature. This concept is identified as the Dual Fluid Cycle (DFC). In addition to the basic improvement in cycle performance, the DFC provides an added degree of flexibility to the power plant engineer in his effort to satisfy plant needs for power, heat, and steam. Allison test results of this concept on a Model 501-KB engine have been correlated with a computer model of the engine and show good agreement. This paper shows how the DFC can be used to maximize thermal efficiency while meeting the requirement for power and steam in selected cases. Comparisons are made to other options for power and steam generation.

  3. Manure management for greenhouse gas mitigation.

    PubMed

    Petersen, S O; Blanchard, M; Chadwick, D; Del Prado, A; Edouard, N; Mosquera, J; Sommer, S G

    2013-06-01

    Ongoing intensification and specialisation of livestock production lead to increasing volumes of manure to be managed, which are a source of the greenhouse gases (GHGs) methane (CH4) and nitrous oxide (N2O). Net emissions of CH4 and N2O result from a multitude of microbial activities in the manure environment. Their relative importance depends not only on manure composition and local management practices with respect to treatment, storage and field application, but also on ambient climatic conditions. The diversity of livestock production systems, and their associated manure management, is discussed on the basis of four regional cases (Sub-Saharan Africa, Southeast Asia, China and Europe) with increasing levels of intensification and priorities with respect to nutrient management and environmental regulation. GHG mitigation options for production systems based on solid and liquid manure management are then presented, and potentials for positive and negative interactions between pollutants, and between management practices, are discussed. The diversity of manure properties and environmental conditions necessitate a modelling approach for improving estimates of GHG emissions, and for predicting effects of management changes for GHG mitigation, and requirements for such a model are discussed. Finally, we briefly discuss drivers for, and barriers against, introduction of GHG mitigation measures for livestock production. There is no conflict between efforts to improve food and feed production, and efforts to reduce GHG emissions from manure management. Growth in livestock populations are projected to occur mainly in intensive production systems where, for this and other reasons, the largest potentials for GHG mitigation may be found.

  4. Coastal resource complexes of South India: options for sustainable management.

    PubMed

    Damodaran, A

    2006-04-01

    India's coastal resource complexes were traditionally characterized by a continuum of 'common property resources' or 'commons' that stretched from the shores to the seas. The continuum aided the existence of sustainable livelihood systems for local communities. Today, fragmented policy approaches and economic welfare schemes have caused the disintegration of community control over the continuum. As a consequence, livelihood systems of local communities have declined. The introduction of coastal management guidelines in the 1990s has exacerbated the situation. With reference to a coastal village located in the State of Kerala in South West India, the paper describes the trajectory of unsustainable change that has taken place in the coastal area resource complexes of the country. The paper argues for restoring the continuum of commons in the study area through community driven systems of natural resource management that are based on networks of nested institutions.

  5. Options for the destruction of chemical weapons and management of the associated risks.

    PubMed

    Manley, Ron G

    2006-09-01

    The destruction of chemical weapons is a hazardous operation. The degree of hazard posed, however, is not uniform and is dependent on the specific chemical agent and the configuration of the weapon or bulk storage vessel in which it is contained. For example, a highly volatile nerve agent in an explosively configured munition, such as a rocket, poses a very different hazard from that of a bulk storage container of viscous mustard gas. Equally the handling of recovered, often highly corroded, World War (WW)I or WWII chemical munitions will pose a very different hazard from that associated with dealing with modern chemical weapons stored under the appropriate conditions. Over the years, a number of technologies have been developed for the destruction of chemical weapons. Each has its advantages and disadvantages. None of them provide a universal solution to the problem. When assessing options for the destruction of these weapons and the management of the associated risks, therefore, it is important to give due consideration and weight to these differences. To ensure that the destruction technology selected takes due account of them and that the resulting overall risk assessment accurately reflects the actual risks involved.

  6. Review of Options for Ammonia/Ammonium Management

    SciTech Connect

    Nash, C. A.

    2016-05-06

    This report is a review of literature supporting practical ammonia/ammonium destruction processes. Melter research supporting Hanford Low Activity Waste (LAW) glass production has shown that significant amounts of ammonia will be in the melter offgas condensate. Further work with secondary waste forms indicates the potential need to remove the ammonia, perhaps by an oxidative process. This review finds likely practical chemical methods to oxidize ammonia in aqueous solution at moderate temperatures and atmospheric pressure, using easily obtained reagents. Leading candidates include nitrite oxidation to produce nitrogen gas, various peroxide oxidative processes, and air stripping. This work reviews many other processes and provides reasoning to not consider those processes further for this application.

  7. The conversion of grassland to acacia forest as an effective option for net reduction in greenhouse gas emissions.

    PubMed

    de Godoi, Stefânia Guedes; Neufeld, Ângela Denise Hubert; Ibarr, Mariana Alves; Ferreto, Décio Oscar Cardoso; Bayer, Cimélio; Lorentz, Leandro Homrich; Vieira, Frederico Costa Beber

    2016-03-15

    This study aimed to evaluate the effect of forestation with leguminous Acacia mearnsii De Wild in native grasslands on the soil greenhouse (GHG) fluxes and their main driving factors. The experiment was conducted in the Brazilian Pampa over the period of one year in a six-year-old Acacia plantation, evaluating four treatments: Acacia (AM), Acacia with litter periodically removed (A-l), Acacia after harvest (AH) and native grassland (NG) (reference treatment). Air samples were obtained by the static chamber method, and gas concentrations were evaluated by gas chromatography. Soil and climate factors were monitored. The accumulated fluxes of methane (CH4) and nitrous oxide (N2O) were statistically similar between the soils in the AM and NG treatments, which tended to oxidize CH4 (-1445 and -1752 g C-CH4 ha(-1) yr(-1), respectively) and had low emission of N2O (242 and 316 g N-N2O ha(-1) yr(-1)), most likely influenced by the low water-filled pore space and the low content of mineral N in the soil. However, the soil in the AH treatment presented higher emissions of both gases, totaling 1889 g C-CH4 ha(-1) yr(-1) and 1250 g N-N2O ha(-1) yr(-1). Afforestation neither significantly affected the total organic C stocks nor their lability, keeping the C management index for the forested area similar to that in the NG treatment. The conversion from grassland to Acacia forest represents an effective option for mitigating the net reduction in greenhouse gas emissions, which is basically determined by C accumulation in biomass and wood products. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Tube thoracostomy: primary management option for empyema thoracis in children.

    PubMed

    Ghritlaharey, Rajendra K; Budhwani, Keshav S; Shrivastava, Dhirendra K; Srivastava, Jyoti

    2012-01-01

    The aim of this study was to review our experience with tube thoracostomy in the management of empyema thoracis in children. This retrospective study included 46 children (26 boys and 20 girls) who were admitted and managed for empyema thoracis, between January 1, 2010 and December 31, 2010 at the author's department of paediatric surgery. During the last 12 months, 46 children aged below 12 years were treated for empyema thoracis: Five (10.86%) were infants, 22 (47.82%) were 1 to 5 years and 19 (41.30%) were 6 to 12 years of age. All the patients presented with complaints of cough, fever and breathlessness of variable durations. Twenty three (50%) children had history of pneumonia and treatment prior to development of empyema. Thirty five (76.08%) children had right-sided and 11 (23.91%) had left-sided empyema. Thirty nine (84.78%) children were successfully treated with tube thoracostomy, systemic antibiotics and other supportive measures. Seven (15.21%) children failed to respond with above and needed decortications. Most commonly isolated bacteria were Pseudomonas (n = 12) and Staphylococcus aureus (n = 7). The average length of hospital stay in patients with tube thoracostomy was 15.35 days, and in patients who needed decortications was 16.28 days following thoracotomy. There was no mortality amongst above treated children. Majority of children with empyema thoracis are manageable with tube thoracostomy, antibiotics, physiotherapy and other supportive treatment. Few of them who fail to above measures need more aggressive management.

  9. Allergic rhinitis: selective comparisons of the pharmaceutical options for management.

    PubMed

    Lanier, Bob

    2007-01-01

    The depth and variety of pharmaceuticals available to manage the syndrome of allergic rhinitis is unparalleled. To arrive at a personal formulary, a physician would be well advised to understand what patients want and what they are willing to accept in terms of expense and adverse events. Patients want medications that are nonsteroidal, non habituating, produce no drowsiness, and could be used intermittently on demand only. This review is intended as an aid in comparing classes and formats of medications affecting nasal allergy.

  10. Textile industry: Profile and DSM (demand-side management) options

    SciTech Connect

    Not Available

    1990-07-01

    The Textile Industry Guidebook provides electric utility planning, marketing, and customer service staff with a practical tool to better understand the textile industry and the challenges it faces; its manufacturing processes, technologies, and energy use; and its opportunities for demand-site management (DSM). The Guidebook concludes with guidance and summary data for developing and evaluating DSM plans to realize such opportunities. 5 refs., 37 figs., 52 tabs.

  11. Short bowel syndrome: a review of management options.

    PubMed

    Seetharam, Prasad; Rodrigues, Gabriel

    2011-01-01

    Extensive resection of the intestinal tract frequently results in inadequate digestion and/or absorption of nutrients, a condition known as short bowel syndrome (SBS). This challenging condition demands a dedicated multidisciplinary team effort to overcome the morbidity and mortality in these patients. With advances in critical care management, more and more patients survive the immediate morbidity of massive intestinal resection to present with SBS. Several therapies, including parenteral nutrition (PN), bowel rehabilitation and surgical procedures to reconstruct bowel have been used in these patients. Novel dietary approaches, pharmacotherapy and timely surgical interventions have all added to the improved outcome in these patients. However, these treatments only partially correct the underlying problem of reduced bowel function and have limited success resulting in 30% to 50% mortality rates. However, increasing experience and encouraging results of intestinal transplantation has added a new dimension to the management of SBS. Literature available on SBS is exhaustive but inconclusive. We conducted a review of scientific literature and electronic media with search terms 'short bowel syndrome, advances in SBS and SBS' and attempted to give a comprehensive account on this topic with emphasis on the recent advances in its management.

  12. Management and recovery options for Ural river beluga sturgeon.

    PubMed

    Doukakis, Phaedra; Babcock, Elizabeth A; Pikitch, Ellen K; Sharov, Alexei R; Baimukhanov, Mirgaly; Erbulekov, Sagiden; Bokova, Yelena; Nimatov, Akhat

    2010-06-01

    Management of declining fisheries of anadromous species sometimes relies heavily on supplementation of populations with captive breeding, despite evidence that captive breeding can have negative consequences and may not address the root cause of decline. The beluga sturgeon (Huso huso), a species threatened by the market for black caviar and reductions in habitat quality, is managed through harvest control and hatchery supplementation, with an emphasis on the latter. We used yield per recruit and elasticity analyses to evaluate the population status and current levels of fishing and to identify the life-history stages that are the best targets for conservation of beluga of the Ural River. Harvest rates in recent years were four to five times higher than rates that would sustain population abundance. Sustainable rates of fishing mortality are similar to those for other long-lived marine species such as sharks and mammals. Yield per recruit, which is maximized if fish are first harvested at age 31 years, would be greatly enhanced by raising minimum size limits or reducing illegal take of subadults. Improving the survival of subadult and adult females would increase population productivity by 10 times that achieved by improving fecundity and survival from egg to age 1 year (i.e., hatchery supplementation). These results suggest that reducing mortality of subadults and adult wild fish is a more effective conservation strategy than hatchery supplementation. Because genetics is not factored into hatchery management practices, supplementation may even reduce the viability of the beluga sturgeon.

  13. Diagnosis and management options in malignant pleural effusions

    PubMed Central

    Dixit, Ramakant; Agarwal, KC; Gokhroo, Archana; Patil, Chetan B; Meena, Manoj; Shah, Narender S; Arora, Piyush

    2017-01-01

    Malignant pleural effusion (MPE) denotes an advanced malignant disease process. Most of the MPE are metastatic involvement of the pleura from primary malignancy at lung, breast, and other body sites apart from lymphomas. The diagnosis of MPE has been traditionally made on cytological examination of pleural fluid and/or histological examination of pleural biopsy tissue that still remains the initial approach in these cases. There has been tremendous advancement in the diagnosis of MPE now a day with techniques i.e. characteristic Ultrasound and computed tomography features, image guided biopsies, fluorodeoxyglucose-positron emission tomography imaging, thoracoscopy with direct biopsy under vision, tumor marker studies and immunocytochemical analysis etc., that have made possible an early diagnosis of MPE. The management of MPE still remains a challenge to pulmonologist and oncologist. Despite having various modalities with better tolerance such as pleurodesis and indwelling pleural catheters etc., for long-term control, all the management approaches remain palliative to improve the quality of life and reduce symptoms. While choosing an appropriate management intervention, one should consider the clinical status of the patient, life expectancy, overall cost, availability and comparative institutional outcomes, etc. PMID:28360465

  14. New options for the management of hyperparathyroidism after renal transplantation

    PubMed Central

    Douthat, Walter Guillermo; Chiurchiu, Carlos Raul; Massari, Pablo Ulises

    2012-01-01

    The persistence and severity of hyperparathyroidism (HPT) post-renal transplantation is relatively frequent and primarily associated with the timing and its magnitude in the pre-transplant period and with the presence of parathyroid adenomas. HPT after renal transplantation is clinically manifested with hypercalcemia, hypophosphatemia, bone pain, fractures, and in more serious cases with cardiovascular calcifications that affect the survival. The primary clinical objective for patients with secondary HPT after renal transplantation is to obtain a level of parathyroid hormone (PTH) adequate to the renal transplanted function and to normalize levels of calcium, phosphorus and vitamin D. In many cases during this period, the development of hypercalcemia and/or hypophosphatemia makes it necessary to take different therapeutic measures. The use of vitamin D or its analogues has been extrapolated from the management of pre-transplant HPT obtaining variable outcomes, although its use is limited by its capacity to produce hypercalcemia. Calcimimetics are drugs that have proven be effective in reducing PTH levels in patients with HPT on dialysis and has been effective in reducing up to 50% PTH levels in moderate to severe HPT in post-renal transplantation.When HPT persists after renal transplantation and does not respond to medical treatment, invasive management by percutaneous ethanol injection therapy of parathyroid glands or parathyroidectomy should be considered. The emergence of new methods for the management of HPT expands the availability of therapeutic tools for transplant patients. PMID:24175195

  15. Management of hepatitis delta: Need for novel therapeutic options

    PubMed Central

    Abbas, Zaigham; Abbas, Minaam

    2015-01-01

    Hepatitis D virus (HDV) is the smallest single stranded RNA virus infecting humans. The hepatitis B surface antigen envelope protein protects the HDV nucleocapsid antigen and provides a means for the virus to enter and exit the hepatocyte. Hepatitis B and D viruses exploit the human sodium taurocholate co-transporting polypeptide (NTCP), a receptor, for their entry into hepatocytes. Prenylation of the large delta antigen is a critical determinant of HDV particle assembly. Treatment with pegylated interferon results in sustained virological response six months post-treatment in one fourth of the patients. Nucleos(t)ide analogs (NAs) have been widely tested in hepatitis delta, but they appear to be ineffective. Combination treatment of NAs with interferon also proved to be disappointing so there is a need for novel therapeutic options. The receptor function of NTCP is blocked by Myrcludex B, a synthetic N-acylated preS1 lipopeptide that competes with infectious virions for receptor binding. There are already some approved drugs available, including irbesartan, ezetimibe, and ritonavir and cyclosporin A, with documented inhibitory effects on NTCP’s metabolic function. These drugs may have a role in HDV treatment. Interference with host-mediated post-translational changes of proteins that are crucial to the HDV life cycle, such as prenylation may become an important tool to control HDV infection and prevent replication. Lonafarnib, a prenylation inhibitor significantly reduces virus levels in hepatitis delta patients. Antisense oligodeoxynucleotides which are complementary to genomic HDV ribozyme self-cleavage site and stem I regions can inhibit genomic HDV ribozyme activity. PMID:26327754

  16. Management of hepatitis delta: Need for novel therapeutic options.

    PubMed

    Abbas, Zaigham; Abbas, Minaam

    2015-08-28

    Hepatitis D virus (HDV) is the smallest single stranded RNA virus infecting humans. The hepatitis B surface antigen envelope protein protects the HDV nucleocapsid antigen and provides a means for the virus to enter and exit the hepatocyte. Hepatitis B and D viruses exploit the human sodium taurocholate co-transporting polypeptide (NTCP), a receptor, for their entry into hepatocytes. Prenylation of the large delta antigen is a critical determinant of HDV particle assembly. Treatment with pegylated interferon results in sustained virological response six months post-treatment in one fourth of the patients. Nucleos(t)ide analogs (NAs) have been widely tested in hepatitis delta, but they appear to be ineffective. Combination treatment of NAs with interferon also proved to be disappointing so there is a need for novel therapeutic options. The receptor function of NTCP is blocked by Myrcludex B, a synthetic N-acylated preS1 lipopeptide that competes with infectious virions for receptor binding. There are already some approved drugs available, including irbesartan, ezetimibe, and ritonavir and cyclosporin A, with documented inhibitory effects on NTCP's metabolic function. These drugs may have a role in HDV treatment. Interference with host-mediated post-translational changes of proteins that are crucial to the HDV life cycle, such as prenylation may become an important tool to control HDV infection and prevent replication. Lonafarnib, a prenylation inhibitor significantly reduces virus levels in hepatitis delta patients. Antisense oligodeoxynucleotides which are complementary to genomic HDV ribozyme self-cleavage site and stem I regions can inhibit genomic HDV ribozyme activity.

  17. NORM Management in the Oil & Gas Industry

    NASA Astrophysics Data System (ADS)

    Cowie, Michael; Mously, Khalid; Fageeha, Osama; Nassar, Rafat

    2008-08-01

    It has been established that Naturally Occurring Radioactive Materials (NORM) accumulates at various locations along the oil/gas production process. Components such as wellheads, separation vessels, pumps, and other processing equipment can become NORM contaminated, and NORM can accumulate in sludge and other waste media. Improper handling and disposal of NORM contaminated equipment and waste can create a potential radiation hazard to workers and the environment. Saudi Aramco Environmental Protection Department initiated a program to identify the extent, form and level of NORM contamination associated with the company operations. Once identified the challenge of managing operations which had a NORM hazard was addressed in a manner that gave due consideration to workers and environmental protection as well as operations' efficiency and productivity. The benefits of shared knowledge, practice and experience across the oil & gas industry are seen as key to the establishment of common guidance on NORM management. This paper outlines Saudi Aramco's experience in the development of a NORM management strategy and its goals of establishing common guidance throughout the oil and gas industry.

  18. The RealGas and RealGasH2O options of the TOUGH+ code for the simulation of coupled fluid and heat flow in tight/shale gas systems

    EPA Science Inventory

    We developed two new EOS additions to the TOUGH+ family of codes, the RealGasH2O and RealGas. The RealGasH2O EOS option describes the non-isothermal two-phase flow of water and a real gas mixture in gas reservoirs, with a particular focus in ultra-tight (such as tight-sand and sh...

  19. The RealGas and RealGasH2O options of the TOUGH+ code for the simulation of coupled fluid and heat flow in tight/shale gas systems

    EPA Science Inventory

    We developed two new EOS additions to the TOUGH+ family of codes, the RealGasH2O and RealGas. The RealGasH2O EOS option describes the non-isothermal two-phase flow of water and a real gas mixture in gas reservoirs, with a particular focus in ultra-tight (such as tight-sand and sh...

  20. Wildlife habitats in managed rangelands—the Great Basin of southeastern Oregon: management practices and options.

    Treesearch

    Frederick C. Hall

    1985-01-01

    Management practices and options to provide habitat for wildlife in the Great Basin of southeastern Oregon deal with both vegetation treatment and protection, livestock management, maintenance or distribution of water developments, protection of wildlife areas through road closures or fencing, and direct manipulation of wildlife through hunting, trapping, or other...

  1. Effect of allelopathic rice varieties combined with cultural management options on paddy field weeds.

    PubMed

    Kong, Chui-Hua; Hu, Fei; Wang, Peng; Wu, Jing-Lun

    2008-03-01

    A number of techniques, including cultural management, allelopathy and bioherbicide, have been considered as alternatives for synthetic herbicides, but successful weed control will require the careful integration of these multiple techniques. This study was conducted to assess the use of allelopathic rice varieties in combination with cultural management options on paddy weeds, in order to develop an allelopathy-based technique to reduce herbicide use in paddies. The weed-suppressive effects of the rice varieties tested varied highly with allelopathic trait, planting pattern and cultural management including planting density, flooding depth and duration and supply of nitrogen. Allelopathic rice varieties PI312777 and Huagan-1 demonstrated much stronger weed suppression than the non-allelopathic variety Huajianxian under the same planting pattern and cultural management. Their weed-suppressive effect was increased with cultural management options. In particular, if integrated cultural management options of allelopathic rice varieties included a low-dose (bensulfuron-methyl, 25 g AI ha(-1), a third of the recommended dose) herbicide application, the emergence and growth of most weeds found in paddy fields was completely controlled. No grain yield reduction for allelopathic varieties occurred under integrated cultural management options, whereas with the non-allelopathic variety a reduction of up to 45-60% was measurable even with the low-dose herbicide application. The allelopathic potential of rice varieties will likely have a great impact on paddy weed control if integrated with cultural management options and application of low doses of herbicides. Therefore, it is feasible to reduce herbicide input in paddies if allelopathic rice is grown under integrated cultural management practices. (c) 2008 Society of Chemical Industry.

  2. Irritable bowel syndrome: modern concepts and management options.

    PubMed

    Sayuk, Gregory S; Gyawali, C Prakash

    2015-08-01

    Irritable bowel syndrome is the most common functional gastrointestinal disorder, manifesting as abdominal pain/discomfort and altered bowel function. Despite affecting as many as 20% of adults, a lack of understanding of etiopathogenesis and evaluation strategies results in diagnostic uncertainty, and in turn frustration of both the physician and the patient. This review summarizes the current literature on the diagnosis and management of irritable bowel syndrome, with attention to evidence-based approaches. A 4-step treatment strategy that has been used successfully in our tertiary referral practice is presented and should lead to successful therapeutic outcomes in the majority of patients with irritable bowel syndrome.

  3. Alternative management and funding options for aeronautics programs, Task 1

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Research and technology will be at lower program levels with basic military research for aviation decreasing as fewer aircraft programs are initiated and the present new aircraft programs move into the prototype and production status. The key question is can industry take on the management and financing role and meet the criteria and characteristics considered essential for a viable research and technology program. The criteria for evaluating alternative approaches include an examination of the nature of the product to be provided, responsiveness to changing needs, efficiency in terms of costs, ability to provide leadership, and to provide impartial and independent evaluation of approaches, and to provide technological inputs for regulating functions.

  4. Pharmacologic options for the management of multiple sclerosis symptoms.

    PubMed

    Schapiro, Randall T

    2002-09-01

    Multiple sclerosis (MS) is a disease with a wide-ranging impact on physical functioning. Although pharmacotherapy plays an indispensable role in the management of MS symptoms, optimal disease management requires a multidisciplinary approach that combines medication, rehabilitation, and patient education. Successful control of symptoms is critical to quality of life for MS patients. Immunomodulating drugs provide a means of controlling the underlying disease process, but they are not a cure. This places responsibility on health care providers to control a patient's MS-related symptoms to limit disability and delay impairment in the activities of daily living. Owing to the importance of symptom control, comprehensive patient evaluations should be performed at regular intervals to determine the extent of neurological damage and disease progression and to address changing patient needs. The goal of interventions should be not only to treat the primary and secondary symptoms of MS but also to provide access to the psychosocial support that will help MS patients and their families continue to cope as disease status changes.

  5. Current and emerging treatment options in the management of lupus

    PubMed Central

    Jordan, Natasha; D’Cruz, David

    2016-01-01

    Systemic lupus erythematosus (SLE) is a complex autoimmune disease with variable clinical manifestations. While the clearest guidelines for the treatment of SLE exist in the context of lupus nephritis, patients with other lupus manifestations such as neuropsychiatric, hematologic, musculoskeletal, and severe cutaneous lupus frequently require immunosuppression and/or biologic therapy. Conventional immunosuppressive agents such as mycophenolate mofetil, azathioprine, and cyclophosphamide are widely used in the management of SLE with current more rationalized treatment regimens optimizing the use of these agents while minimizing potential toxicity. The advent of biologic therapies has advanced the treatment of SLE particularly in patients with refractory disease. The CD20 monoclonal antibody rituximab and the anti-BLyS agent belimumab are now widely in use in clinical practice. Several other biologic agents are in ongoing clinical trials. While immunosuppressive and biologic agents are the foundation of inflammatory disease control in SLE, the importance of managing comorbidities such as cardiovascular risk factors, bone health, and minimizing susceptibility to infection should not be neglected. PMID:27529058

  6. Current and emerging treatment options in the management of lupus.

    PubMed

    Jordan, Natasha; D'Cruz, David

    2016-01-01

    Systemic lupus erythematosus (SLE) is a complex autoimmune disease with variable clinical manifestations. While the clearest guidelines for the treatment of SLE exist in the context of lupus nephritis, patients with other lupus manifestations such as neuropsychiatric, hematologic, musculoskeletal, and severe cutaneous lupus frequently require immunosuppression and/or biologic therapy. Conventional immunosuppressive agents such as mycophenolate mofetil, azathioprine, and cyclophosphamide are widely used in the management of SLE with current more rationalized treatment regimens optimizing the use of these agents while minimizing potential toxicity. The advent of biologic therapies has advanced the treatment of SLE particularly in patients with refractory disease. The CD20 monoclonal antibody rituximab and the anti-BLyS agent belimumab are now widely in use in clinical practice. Several other biologic agents are in ongoing clinical trials. While immunosuppressive and biologic agents are the foundation of inflammatory disease control in SLE, the importance of managing comorbidities such as cardiovascular risk factors, bone health, and minimizing susceptibility to infection should not be neglected.

  7. Financial incentives: Possible options for sustainable rangeland management?

    PubMed

    Louhaichi, Mounir; Yigezu, Yigezu A; Werner, Jutta; Dashtseren, Lojoo; El-Shater, Tamer; Ahmed, Mohamed

    2016-09-15

    Large-scale mismanagement of natural resources emanating from lack of appropriate policies and regulatory framework is arguably one of the reasons that led to resource degradation and poor livelihoods in many countries in the Middle East and North Africa (MENA) region. Sustainable rangeland management practices (SRMPs) are considered to be a solution to feed shortages and rangeland degradation. However, the scope for SRMP adoption, has been a subject of debate. Using a case study from Syria and the application of the Minimum Data Analysis method (TOA-MD), this paper provides empirical evidence for ensuring wider adoption of SRMP. The paper argues that the introduction of financial incentives in the form of payments for agricultural-environmental services can increase the economic viability and enhance the adoption of SRMPs and is a better alternative to the unsustainable state subsidies for fodder purchases and barley cultivation on rangelands. Model results indicate that further investment in reasearch toward generating low cost technologies and tailored governance strategies including a financial incentive system would lead to better management of rangelands and improve livelihoods in the Syrian Badia. These findings are valuable for policy makers, donors as well as development and extension practitioners in the MENA region as they can better inform future courses of actions.

  8. Management of Haemophilia in Developing Countries: Challenges and Options.

    PubMed

    Ghosh, Kanjaksha; Ghosh, Kinjalka

    2016-09-01

    There are significant challenges in managing haemophilia patients in developing countries. These challenges are (i) Lack of proper health care infrastructure and human resources suitable for haemophilia care (ii) Competing health care priorities of the government. (iii) Lack of penetrance of medical insurance in the population. (iv) Lesser visibility of the haemophilia patients in health care system (v) Low awareness across the medical profession, population and the policy makers about the condition (vi) Non availability of factor concentrates (vii) Inadequate utilization of knowledge for reducing factor concentrate use. (viii) Inadequate pain relief (ix) Challenges due to inhibitor developing (x) Viral hepatitis & (xi) Lack of research publications relevant to the country are some of the challenges faced by PWH for their management in developing country. The solutions are not easy but development of a strong patient organization with linkages with World Federation of Haemophilia is an important initial step. Following that internal and international twinning, use of internal sources, strong advocacy programme targeting government, doctors, opinion makers will solve many of the challenges in the time to come.

  9. Lupus: An Overview of the Disease And Management Options

    PubMed Central

    Maidhof, William; Hilas, Olga

    2012-01-01

    Lupus is a chronic inflammatory autoimmune disease with a wide range of clinical presentations resulting from its effect on multiple organ systems. There are four main types of lupus: neonatal, discoid, drug-induced, and systemic lupus erythematosus (SLE), the type that affects the majority of patients. Patients with lupus experience a loss of self-tolerance as a result of abnormal immunological function and the production of autoantibodies, which lead to the formation of immune complexes that may adversely affect healthy tissue. Although the precise etiologic mechanism is unknown, genetic, hormonal, and environmental factors, as well as immune abnormalities, have been identified. Associations between lupus onset and age, sex, geography, and race have also been established. Management of this disease should be individualized and should include both pharmacological and nonpharmacological modalities for symptom relief and resolution as well as improved quality of life. PMID:22593636

  10. Global Change Drought in the Southwest: New Management Options

    NASA Astrophysics Data System (ADS)

    Udall, B. H.; Overpeck, J. T.

    2015-12-01

    Long held worries about future runoff declines in the Colorado River under climate change are proving to be more than just theory. Fifteen years into this century flows of the Colorado are already declining due mostly to unprecedented temperatures, and as warming proceeds, declines in river flow will grow larger. Temperature-driven droughts, some lasting decades and much more severe than the current 15-year drought, will also become more commonplace if climate change continues unabated. Current projections of future water availability almost universally understate the risk of large Colorado flow reductions under business-as-usual warming. Betting on highly uncertain projections of increased precipitation to overcome even part of the flow reductions due to virtually certain warming is a poor risk management strategy. Many of the existing water policy arrangements in the Colorado River Basin will fail in the 21st century unless innovative new solutions are developed under leadership from the federal government and its basin state partners.

  11. Multilocular disseminated Tarlov cysts: Importance of imaging and management options

    PubMed Central

    Padma, Subramanyam; Palaniswamy, Shanmuga Sundaram

    2012-01-01

    With technological advancements and wider availability of multimodality imaging, incidental lesions are frequently identified in patients undergoing various imaging studies. We report here a case of multiloculated disseminated perineural or Tarlov cysts (TCs). The primary aim of this case study was to (1) provide a comprehensive review of the clinical, imaging, and histopathological features of TCs (2) to draw attention to the fact that multiple lumbosacral and dorsal TCs can produce nerve injuries and serious movement disturbances, and (3) to document the usefulness of the magnetic resonance imaging and bone scan in non-invasive diagnosis and guiding management in such cases. These cysts are clearly identified by magnetic resonance imaging (MRI) and computerized tomography imaging of the lumbosacral spine. However, there are no reports on the scintigraphic findings of multilocular disseminated TC in literature. TCs are typically benign, asymptomatic lesions that can simply be monitored. To date, no consensus exists about the best surgical strategy to use when indicated. PMID:23723584

  12. Multilocular disseminated Tarlov cysts: Importance of imaging and management options.

    PubMed

    Padma, Subramanyam; Palaniswamy, Shanmuga Sundaram

    2012-04-01

    With technological advancements and wider availability of multimodality imaging, incidental lesions are frequently identified in patients undergoing various imaging studies. We report here a case of multiloculated disseminated perineural or Tarlov cysts (TCs). The primary aim of this case study was to (1) provide a comprehensive review of the clinical, imaging, and histopathological features of TCs (2) to draw attention to the fact that multiple lumbosacral and dorsal TCs can produce nerve injuries and serious movement disturbances, and (3) to document the usefulness of the magnetic resonance imaging and bone scan in non-invasive diagnosis and guiding management in such cases. These cysts are clearly identified by magnetic resonance imaging (MRI) and computerized tomography imaging of the lumbosacral spine. However, there are no reports on the scintigraphic findings of multilocular disseminated TC in literature. TCs are typically benign, asymptomatic lesions that can simply be monitored. To date, no consensus exists about the best surgical strategy to use when indicated.

  13. Toxic epidermal necrolysis - management issues and treatment options.

    PubMed

    Widgerow, Alan D

    2011-01-01

    Toxic epidermal necrolysis (TEN) and Steven-Johnson syndrome (SJS) are characterized by extensive necrosis and cleavage of the epidermis from the dermis akin to a superficial or partial thickness burn. Sepsis is the usual cause of mortality but much of the pathophysiologic process results from an outpouring of cytokines and matrixmetalloproteinases (MMPs) which have a destructive effect on the extracellular matrix and may play a part in the epidermal/dermal cleavage seen with this disease. Recent attention has been focused on the modulation of proteases in an attempt to decrease the MMP-mediated destruction. Nanocrystalline silver (NCS) is one such agent that has good anti-microbial efficacy, but is also effective in modulating MMP levels. Twelve cases of confirmed TEN that were treated with NCS were analyzed with a view to assessing efficacy and setting logical guidelines for managing this condition, particularly in relation to immunosupressed patients. From this study important issues have been highlighted for discussion.

  14. Pediatric and adolescent obesity: management, options for surgery, and outcomes.

    PubMed

    Zitsman, Jeffrey L; Inge, Thomas H; Reichard, Kirk W; Browne, Allen F; Harmon, Carroll M; Michalsky, Marc P

    2014-03-01

    The past four decades have witnessed a marked rise in the number of children and adolescents with obesity. Severe obesity has also become increasingly prevalent. More young patients who have obesity are being referred for weight management and weight loss surgery, thus posing new challenges to both the medical personnel who care for them as well as the institutions in which that care is provided. This manuscript is generated from the material presented at the Education Day symposium entitled "Surgical Care of the Obese Child" held at the 42nd Annual Meeting of the American Pediatric Surgical Association in Palm Desert, CA, on May 22, 2011. Herein the presenters at the symposium update the material addressing evaluation of a young person for weight loss surgery (including the team approach to patient evaluation and institutional infrastructure and responsibilities). The procedures most frequently available to young patients with obesity are identified, and current outcomes, trends, and future direction are also discussed.

  15. Management options to limit nitrate leaching from grassland

    NASA Astrophysics Data System (ADS)

    Cuttle, S. P.; Scholefield, D.

    1995-12-01

    Nitrate leaching can be reduced by the adoption of less intensive grassland systems which, though requiring a greater land area to achieve the same agricultural output, result in less nitrate leaching per unit of production than do intensively managed grasslands. The economic penalties associated with reductions in output can be partly offset by greater reliance on symbiotic nitrogen fixation and the use of clover-based swards in place of synthetic N fertilisers. Alternatively, specific measures can be adopted to improve the efficiency of nitrogen use in intensively managed systems in order to maintain high outputs but with reduced losses. Controls should take account of other forms of loss and flows of nitrogen between grassland and other components of the whole-farm system and, in most instances, should result in an overall reduction in nitrogen inputs. Removing stock from the fields earlier in the grazing season will reduce the accumulation of high concentrations of potentially leachable nitrate in the soil of grazed pastures but will increase the quantity of manure produced by housed animals and the need to recycle this effectively. Supplementing grass diets with low-nitrogen forages such as maize silage will reduce the quantity of nitrogen excreted by livestock but may increase the potential for nitrate leaching elsewhere on the farm if changes to cropping patterns involve more frequent cultivation of grassland. Improved utilisation by the sward of nitrogen in animal excreta and manures and released by mineralisation of soil organic matter will permit equivalent reductions to be made in fertiliser inputs, provided that adequate information is available about the supply of nitrogen from these non-fertiliser sources.

  16. Management of post dermato- oncological defects: a case series and discussion of treatment options.

    PubMed

    Roodbergen, Sofie Louise; van der Geer, Simone; Krekels, Gertruud A

    2012-02-01

    Managing poorly healing wounds and large defects of the scalp after treatment of skin cancer in elderly men is a common and challenging problem. The increasing incidence of scalp pathology, and the often concomitant morbidity in these patients, often restricts invasive treatment options. Subsequently, this requires the dermatologist to look at alternative treatment options. Attention has been focused on well-tolerable treatments with good long-term outcomes. This report describes four patients who received treatment by either the use of a purse-string suture, pulsed dye laser (PDL) treatment, and/or healing by secondary intention. Additionally, recent literature concerning these management strategies is discussed.

  17. New Pain Management Options for the Surgical Patient on Methadone and Buprenorphine.

    PubMed

    Sen, Sudipta; Arulkumar, Sailesh; Cornett, Elyse M; Gayle, Julie A; Flower, Ronda R; Fox, Charles J; Kaye, Alan D

    2016-03-01

    Perioperative management of patients receiving opioid addiction therapy presents a unique challenge for the anesthesiologist. The goal of pain management in this patient population is to effectively manage postoperative pain, to improve patient satisfaction and outcomes, and to reduce the cost of health care. Multimodal analgesics, including nonsteroid anti-inflammatory drugs, intravenous acetaminophen, gabapentanoid agents, and low-dose ketamine infusions, have been used to improve postoperative pain and to reduce postoperative opioid use. Patients on long-term opioid management therapy with methadone and buprenorphine require special considerations. Recommendations and options for treating postoperative pain in patients on methadone and buprenorphine are outlined below. Other postoperative pain management options include patient-controlled analgesia, intravenous, and transdermal, in addition to neuraxial and regional anesthesia techniques. Special patient populations include the parturient on long-term opioid therapy. Recommendations for use of opioids in these patients during labor and delivery and in the postpartum period are discussed.

  18. New options and perspectives for proteinuria management after kidney transplantation.

    PubMed

    Soler, María José; Riera, Marta; Gutierrez, Alex; Pascual, Julio

    2012-01-01

    Proteinuria has been strongly correlated with reduced function and graft survival in kidney-transplanted patients. Data regarding new strategies in proteinuria treatment and subsequent allograft survival are lacking. Similarities between chronic graft injury and chronic kidney disease (CKD) suggest that the same therapeutic antiproteinuric tools should be effective in kidney-transplanted patients. The classic strategies to decrease proteinuria such as blood pressure control, nicotine cessation, low-salt diet, and maintaining an ideal body weight seem to be not enough to achieve proteinuria control. Improvements in our understanding of the pathogenesis of CKD have led to the identification of several novel targets for proteinuria management. In this review, we discuss novel pharmacological approaches that aim to decrease proteinuria in CKD patients, including the use of direct renin inhibitors, vitamin D analogs, pentoxifylline, and endothelin receptor antagonists. We also discuss the promise of using antifibrotic agents to treat proteinuria. The identification of new biomarkers of CKD and its progression can help in the selection of the most effective treatment for decreasing proteinuria and maintaining kidney function. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Hot asphalt burns: a review of injuries and management options.

    PubMed

    Bosse, George M; Wadia, Shernaz A; Padmanabhan, Pradeep

    2014-07-01

    Hot asphalt burns to human tissue can increase the likelihood of infection and potential conversion of partial thickness to full-thickness injuries. Successful intervention for hot asphalt burns requires immediate and effective cooling of the asphalt on the tissue followed by subsequent gradual removal of the cooled asphalt. A review of the literature reveals that multiple substances have been used to remove asphalt, including topical antibiotics, petroleum jelly, a commercial product known as De-Solv-It (ORANGE-SOL, Chandler, AZ), sunflower oil, baby oil, liquid paraffin, butter, mayonnaise, and moist-exposed burn ointment (MEBO). Although many of these products may be effective in the removal of asphalt, they may not be readily available in an emergency department setting. Topical antibiotics are readily available, are more commonly described in the medical literature, and would be expected to be effective in the removal of asphalt. We developed guidelines for on scene (first-aid) management and the initial care of such patients upon presentation to a health care facility. These guidelines emphasize the principles of early cooling, gradual removal of adherent asphalt using topical antibiotics, and avoidance of the use of topical agents, which are likely to result in tissue toxicity.

  20. Management options for reducing the release of antibiotics and antibiotic resistance genes to the environment.

    PubMed

    Pruden, Amy; Larsson, D G Joakim; Amézquita, Alejandro; Collignon, Peter; Brandt, Kristian K; Graham, David W; Lazorchak, James M; Suzuki, Satoru; Silley, Peter; Snape, Jason R; Topp, Edward; Zhang, Tong; Zhu, Yong-Guan

    2013-08-01

    There is growing concern worldwide about the role of polluted soil and water environments in the development and dissemination of antibiotic resistance. Our aim in this study was to identify management options for reducing the spread of antibiotics and antibiotic-resistance determinants via environmental pathways, with the ultimate goal of extending the useful life span of antibiotics. We also examined incentives and disincentives for action. We focused on management options with respect to limiting agricultural sources; treatment of domestic, hospital, and industrial wastewater; and aquaculture. We identified several options, such as nutrient management, runoff control, and infrastructure upgrades. Where appropriate, a cross-section of examples from various regions of the world is provided. The importance of monitoring and validating effectiveness of management strategies is also highlighted. Finally, we describe a case study in Sweden that illustrates the critical role of communication to engage stakeholders and promote action. Environmental releases of antibiotics and antibiotic-resistant bacteria can in many cases be reduced at little or no cost. Some management options are synergistic with existing policies and goals. The anticipated benefit is an extended useful life span for current and future antibiotics. Although risk reductions are often difficult to quantify, the severity of accelerating worldwide morbidity and mortality rates associated with antibiotic resistance strongly indicate the need for action.

  1. Management Options for Reducing the Release of Antibiotics and Antibiotic Resistance Genes to the Environment

    PubMed Central

    Pruden, Amy; Amézquita, Alejandro; Collignon, Peter; Brandt, Kristian K.; Graham, David W.; Lazorchak, James M.; Suzuki, Satoru; Silley, Peter; Snape, Jason R.; Topp, Edward; Zhang, Tong; Zhu, Yong-Guan

    2013-01-01

    Background: There is growing concern worldwide about the role of polluted soil and water environments in the development and dissemination of antibiotic resistance. Objective: Our aim in this study was to identify management options for reducing the spread of antibiotics and antibiotic-resistance determinants via environmental pathways, with the ultimate goal of extending the useful life span of antibiotics. We also examined incentives and disincentives for action. Methods: We focused on management options with respect to limiting agricultural sources; treatment of domestic, hospital, and industrial wastewater; and aquaculture. Discussion: We identified several options, such as nutrient management, runoff control, and infrastructure upgrades. Where appropriate, a cross-section of examples from various regions of the world is provided. The importance of monitoring and validating effectiveness of management strategies is also highlighted. Finally, we describe a case study in Sweden that illustrates the critical role of communication to engage stakeholders and promote action. Conclusions: Environmental releases of antibiotics and antibiotic-resistant bacteria can in many cases be reduced at little or no cost. Some management options are synergistic with existing policies and goals. The anticipated benefit is an extended useful life span for current and future antibiotics. Although risk reductions are often difficult to quantify, the severity of accelerating worldwide morbidity and mortality rates associated with antibiotic resistance strongly indicate the need for action. PMID:23735422

  2. Real options analysis for land use management: Methods, application, and implications for policy.

    PubMed

    Regan, Courtney M; Bryan, Brett A; Connor, Jeffery D; Meyer, Wayne S; Ostendorf, Bertram; Zhu, Zili; Bao, Chenming

    2015-09-15

    Discounted cash flow analysis, including net present value is an established way to value land use and management investments which accounts for the time-value of money. However, it provides a static view and assumes passive commitment to an investment strategy when real world land use and management investment decisions are characterised by uncertainty, irreversibility, change, and adaptation. Real options analysis has been proposed as a better valuation method under uncertainty and where the opportunity exists to delay investment decisions, pending more information. We briefly review the use of discounted cash flow methods in land use and management and discuss their benefits and limitations. We then provide an overview of real options analysis, describe the main analytical methods, and summarize its application to land use investment decisions. Real options analysis is largely underutilized in evaluating land use decisions, despite uncertainty in policy and economic drivers, the irreversibility and sunk costs involved. New simulation methods offer the potential for overcoming current technical challenges to implementation as demonstrated with a real options simulation model used to evaluate an agricultural land use decision in South Australia. We conclude that considering option values in future policy design will provide a more realistic assessment of landholder investment decision making and provide insights for improved policy performance.

  3. Failed endoscopic third ventriculostomy in children: management options.

    PubMed

    Mohanty, Aaron; Vasudev, M K; Sampath, S; Radhesh, S; Sastry Kolluri, V R

    2002-12-01

    Endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus has a failure rate of 20-50% in various series. The present study analyzes ETV failures in 72 patients over a 2-year period and attempts to outline a management plan. Of the 72 patients who underwent ETV, it failed in 13. Seven of these failures occurred within 1 month, and in 5 others, ETV failed after 1-2 months. Another patient had a delayed failure 2 years after the initial surgery. Upon clinical failure, MRI scans were performed in all patients using either T2 fast spin echo or two-dimensional phase contrast MRI techniques. Of these, no flow could be demonstrated in 12 patients, whereas in 1 patient, good flow was observed. Endoscopic exploration was undertaken in the 12 patients in whom flow could not be demonstrated. Of the 12 who underwent endoscopic exploration, a patent stoma was observed in 7, necessitating insertion of a ventriculoperitoneal shunt (VPS). In the other 5, the stoma had closed by gliosis and a repeat ETV was performed. In 3 of these patients, in addition to the ETV, a VPS was also inserted in accordance with the family's wishes. VPS insertion was carried out in the patient with suggestion of good flow through the stoma. In failed ETV, MRI with flow studies is essential to identify the possible cause of failure. Endoscopic exploration is indicated for patients with no evidence of flow. A repeat ETV is indicated in patients with a closed stoma. Patients with a patent stoma could require insertion of a cerebrospinal fluid shunt. Copyright 2002 S. Karger AG, Basel

  4. Is orthodontics an option in the management of bimaxillary protrusion?

    PubMed

    Dawjee, S M; Becker, P J; Hlongwa, P

    2010-10-01

    Successful orthodontic treatment is based on a clear perception by the clinician of a patient's facial preference and treatment needs. Bimaxillary protrusion is a normal facial trait seen in the Black population and the most acceptable bimaxillary facial profile in a sample of Black subjects was determined by Beukes et al in 2007. Variations from this ideal profile may require extractions as part of orthodontic treatment in order to attain the ideal. The objective of this study was to determine whether Black subjects with bimaxillary protrusion would want to change their facial profile to the ideal and at what financial cost. A sample of 586 school learners and 321 university students were presented with four silhouetted profiles of varying degrees of bimaxillary protrusion. One of the silhouette profiles represented the ideal and treatment procedures required to achieve this ideal were explained to the sample. They were then requested to answer a questionnaire that would assist in identifying their perception of their own profile and their desire to change their appearance. The ideal silhouette was confirmed to be the most attractive (91.51%) and the sample felt that any severe deviations from this ideal profile should be treated. The financial cost of treatment was found to be a concern, as more subjects (62.84%) would undergo the required treatment if it were free. Many subjects (43.55%) would be prepared to pay for the necessary treatment to achieve the ideal profile. Females were found to be more definite in their decision making, reflecting a greater awareness about their aesthetic appearance than their male counterparts. Findings from this study can serve as an essential tool to assist both orthodontists and maxillofacial surgeons in the treatment planning and management of Black patients with bimaxillary protrusion.

  5. Options and problems in environmental management and evaluation

    NASA Astrophysics Data System (ADS)

    Lewis, J. R.

    1980-03-01

    Although logical compromise agreement between all the conflicting users of the sea seems the most obvious way to protect marine life, we have in practice mainly ad-hoc restrictions aimed at protecting habitats or species, or at trying to prevent chemical/physical deterioration of the environment. The establishment of reserves on biological rather than touristic grounds necessitates consideration of the criteria, appropriate to marine life, that should be used. Successful reserve management or species protection measures depend upon distinguishing between natural and man-made changes, an ability that can be enhanced in part by appropriate disturbance experiments. Anti-pollution measures have centred upon effluent input rather than biological effect in the field, with “acceptable discharge levels” being based upon lethal and sub-lethal experimental effects. But the ultimate criteria of environmental well-being are ecological responses at the population and community levels where, unfortunately, many natural and man-made influences produce similar changes. Knowledge of community dynamics and a resulting ability to discount natural events require long-term studies and are slow to accumulate. Thus while short-term sublethal studies proliferate many ecological data remain uninterpretable except in localities of gross and obvious pollution (including tanker accidents). The scarcity of sub-lethal and ecological effects in the field is even supplemented by ecological changes that are contrary to expectations based on pollution loadings. Is this because ecological expertise is still inadequate, or because experimental and environmental loading data grossly overstate the risks and are largely irrelevant at the community level? Can we assume that fears of chronic pollution are unfounded or must we intensify our efforts? If the latter, in which direction?

  6. Analysis of options for coal combustion waste management in the Pacific Basin

    SciTech Connect

    Elcock, D.; Gasper, J.

    1993-10-01

    Many Pacific Basin countries rely on oil for electricity production. Alternative fuel sources such as coal, which is available in the Pacific Basin, can help mitigate adverse impacts of sudden price increases or supply disruptions. Coal combustion produces solid and potentially hazardous wastes of concern to environmental regulators and utility managers. This paper identifies issues associated with managing coal combustion wastes in the Pacific Basin, using the state of Hawaii as a case study. Hawaii is typical of many Pacific Basin locations in that it depends on oil, has limited sites, for waste management operations, and is subject to domestic and international waste management regulations. The paper discusses coal-fired utility wastes, environmental impacts of coal combustion waste disposal, and regulatory requirements that impact coal waste management. From this baseline, potential on- and off-island options for coal waste management are identified. Waste management costs are estimated and non-quantifiable issues are addressed for each option. Many options are applicable across the Pacific Rim and may serve as a basis for future fuel-use decisions.

  7. Managing Cancer Care: a psycho-educational intervention to improve knowledge of care options and breast cancer self-management.

    PubMed

    Schulman-Green, Dena; Jeon, Sangchoon

    2017-02-01

    We tested the feasibility and acceptability of a psycho-educational self-management intervention, Managing Cancer Care: A Personal Guide (MCC), to improve knowledge of care options (curative, palliative, and hospice care) among a range of breast cancer self-management skills. We conducted a one-group, pre-post-test study among women with non-metastatic breast cancer (n = 105). We gave participants the printed, self-guided, seven-module intervention following enrollment. At baseline and 2  months, we measured knowledge of care options, desired and actual role in self-management, medical communication skills, experience and management of transitions, anxiety, depression, uncertainty, and self-efficacy. We conducted interviews to obtain module ratings and qualitative data on strengths and limitations of MCC. Knowledge of care options (δ = 0.40 (1.11), p = 0.0005) and desired role in self-management (δ = -0.28 (1.08), p = 0.0177) significantly improved. Less skilled medical communicators significantly improved their communication (δ = 3.47, standard deviation = 6.58, p = 0.0449). Multivariate modeling showed that changes in our primary outcomes of medical communication and management of transitions seemed to drive positive changes in our secondary outcomes of anxiety, depression, uncertainty, and self-efficacy. Participants highly rated MCC and reported the importance of understanding care options despite non-metastatic disease. MCC is a feasible and acceptable means of improving knowledge of care options and other aspects of breast cancer self-management. The combination of modules offered in MCC appears to have beneficial interactive effects. We are currently testing MCC more rigorously in a randomized controlled trial to explore mediating and moderating relationships. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  8. Risk management of liquefied natural gas installations

    NASA Technical Reports Server (NTRS)

    Fedor, O. H.; Parsons, W. N.; Coutinho, J. De C.

    1976-01-01

    In connection with the construction of four major liquefied natural gas (LNG) facilities in New York City, the New York City Fire Commissioner has asked NASA for assistance. It was decided that the Kennedy Space Center should develop a risk management system (RMS) for the use of the New York Fire Department (NYFD). The RMS provides for a published set of safety regulations by the NYFD. A description of the RMS is presented as an example of an application of aerospace technology to a civilian sector, namely LNG facilities.

  9. Risk management of liquefied natural gas installations

    NASA Technical Reports Server (NTRS)

    Fedor, O. H.; Parsons, W. N.; Coutinho, J. De C.

    1976-01-01

    In connection with the construction of four major liquefied natural gas (LNG) facilities in New York City, the New York City Fire Commissioner has asked NASA for assistance. It was decided that the Kennedy Space Center should develop a risk management system (RMS) for the use of the New York Fire Department (NYFD). The RMS provides for a published set of safety regulations by the NYFD. A description of the RMS is presented as an example of an application of aerospace technology to a civilian sector, namely LNG facilities.

  10. Lethal trap trees: a potential option for emerald ash borer (Agrilus planipennis Fairmaire) management

    Treesearch

    Deborah G McCullough; Therese M. Poland; Phillip A. Lewis

    2015-01-01

    BACKGROUND: Economic and ecological impacts of ash (Fraxinus spp.) mortality resulting from emerald ash borer (EAB) (Agrilus planipennis Fairmaire) invasion are severe in forested, residential and urban areas. Management options include girdling ash trees to attract ovipositing adult beetles and then destroying infested trees...

  11. Identifying wood utilization options for ecosystem management : summary of a national research project

    Treesearch

    K. E. Skog; R. J. Barbour; J. E. Baumgras; A. Clark

    1997-01-01

    Using an ecosystem approach to forest management will change silvicultural practices, thus requiring utilization options to provide revenue and to help offset the costs of the silviculture treatments. The Forest Service, university cooperators, and several industry mills in the southern, western, and northeastern United States have been involved in a national...

  12. 13 CFR 107.250 - Exclusion of stock options issued by Licensee from Management Expenses.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Exclusion of stock options issued by Licensee from Management Expenses. 107.250 Section 107.250 Business Credit and Assistance SMALL... issued by any Licensee, including a 1940 or 1980 Act Company, are not considered compensation and...

  13. Developing management options for longleaf communities of the gulf coastal plain

    Treesearch

    Kenneth W. Outcalt

    2003-01-01

    Choosing treatments to reduce fuel loads and readjust structure and composition in longleaf communities of the Gulf Coastal Plains region is difficult because benefits and costs of possible treatment combinations are not fully known. The objective of this research project is to develop management options to reduce fuels and restore the ecosystem that are economically...

  14. Evaluating options for balancing the water-electricity nexus in California: Part 2--greenhouse gas and renewable energy utilization impacts.

    PubMed

    Tarroja, Brian; AghaKouchak, Amir; Sobhani, Reza; Feldman, David; Jiang, Sunny; Samuelsen, Scott

    2014-11-01

    A study was conducted to compare the technical potential and effectiveness of different water supply options for securing water availability in a large-scale, interconnected water supply system under historical and climate-change augmented inflow and demand conditions. Part 2 of the study focused on determining the greenhouse gas and renewable energy utilization impacts of different pathways to stabilize major surface reservoir levels. Using a detailed electric grid model and taking into account impacts on the operation of the water supply infrastructure, the greenhouse gas emissions and effect on overall grid renewable penetration level was calculated for each water supply option portfolio that successfully secured water availability from Part 1. The effects on the energy signature of water supply infrastructure were found to be just as important as that of the fundamental processes for each option. Under historical (baseline) conditions, many option portfolios were capable of securing surface reservoir levels with a net neutral or negative effect on emissions and a benefit for renewable energy utilization. Under climate change augmented conditions, however, careful selection of the water supply option portfolio was required to prevent imposing major emissions increases for the system. Overall, this analysis provided quantitative insight into the tradeoffs associated with choosing different pathways for securing California's water supply. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. A Many-Objective Analysis of Supply and Demand Management Options for the Thames Basin

    NASA Astrophysics Data System (ADS)

    Huskova, I.; Matrosov, E.; Kasprzyk, J. R.; Harou, J. J.; Reed, P. M.

    2012-12-01

    In this study we link water basin simulation and many-objective evolutionary optimization to evaluate tradeoffs for the water stressed Thames water supply system in South East England which includes the city of London. We consider both infrastructure additions and demand management options to satisfy the future supply/demand balance, in order to develop management alternatives that can meet a range of fiscal and performance constraints under future supply and demand trajectories. The suite of new infrastructure options includes a new reservoir, water transfers, conjunctive use of groundwater, wastewater reuse and brackish groundwater desalination. Additionally, demand management options include leakage reduction, compulsory metering and the introduction of seasonal tariffs. Infrastructure options are evaluated using quantitative performance measures that minimize costs and energy use while maximizing engineering, social and environmental performance, subject to supply reliability constraints set by the local water utility and the Environment Agency regulator. Pareto approximate trade-off curves show the tradeoffs between engineering, cost, social and environmental performance measures. We use interactive visual analytics to show the performance of solutions across a broad range of performance measures and interrogate the impact of the infrastructure portfolios on the performance measures. Using an optimization—simulation framework enables the consideration of non-linear and rule-based phenomena, which are frequently useful or necessary to accurately describe how real water systems are managed. Results suggest that a diverse portfolio of supply-side and demand side options can aid water management in the UK. The Thames basin is modeled using a generalized computationally efficient open-source water resource simulator, Interactive River-Aquifer Simulation-2010 (IRAS-2010). The IRAS-2010 Thames system model is linked via a C++ wrapper to the Epsilon Dominance

  16. GRAFEC: A New Spanish Program to Investigate Waste Management Options for Radioactive Graphite - 12399

    SciTech Connect

    Marquez, Eva; Pina, Gabriel; Rodriguez, Marina; Fachinger, Johannes; Grosse, Karl-Heinz; Leganes Nieto, Jose Luis; Quiros Gracian, Maria

    2012-07-01

    graphite in a long term stable glass matrix. The principal applicability has been already proved by FNAG. Crushed graphite mixed with a suitable glass powder has been pressed at elevated temperature under vacuum. The vacuum is required to avoid gas enclosures in the obtained product. The obtained products, named IGM for 'Impermeable Graphite Matrix', have densities above 99% of theoretical density. The amount of glass has been chosen with respect to the pore volume of the former graphite parts. The method allows the production of encapsulated graphite without increasing the disposal volume. This paper will give a short overview of characterisation results of different irradiated graphite materials obtained at CIEMAT and in the Carbowaste project as well as the proposed methods and the actual status of the program including first results about leaching of non-radioactive IGM samples and hopefully first tendencies concerning the C-14 separation from graphite of Vandellos I by thermal treatment. Both processes, the thermal treatment as well as the IGM, have the potential to solve problems related to the management of irradiated graphite in Spain. However the methods have only been tested with different types of i-graphite and virgin graphite, respectively. Only investigations with real i-graphite from Spain will reveal whether the described methods are applicable to graphite from Vandellos I. However all partners are convinced that one of these new methods or a combination of them will lead to a feasible option to manage i-graphite in Spain on an industrial scale. (authors)

  17. Options to reduce greenhouse gas emissions during wastewater treatment for agricultural use.

    PubMed

    Fine, Pinchas; Hadas, Efrat

    2012-02-01

    Treatment of primarily-domestic sewage wastewater involves on-site greenhouse gas (GHG) emissions due to energy inputs, organic matter degradation and biological nutrient removal (BNR). BNR causes both direct emissions and loss of fertilizer value, thus eliminating possible reduction of emissions caused by fertilizer manufacture. In this study, we estimated on-site GHG emissions under different treatment scenarios, and present options for emission reduction by changing treatment methods, avoiding BNR and by recovering energy from biogas. Given a typical Israeli wastewater strength (1050mg CODl(-1)), the direct on-site GHG emissions due to energy use were estimated at 1618 and 2102g CO(2)-eq m(-3), respectively, at intermediate and tertiary treatment levels. A potential reduction of approximately 23-55% in GHG emissions could be achieved by fertilizer preservation and VS conversion to biogas. Wastewater fertilizers constituted a GHG abatement potential of 342g CO(2)-eq m(-3). The residual component that remained in the wastewater effluent following intermediate (oxidation ponds) and enhanced (mechanical-biological) treatments was 304-254g CO(2)-eq m(-3) and 65-34g CO(2)-eq m(-3), respectively. Raw sludge constituted approximately 47% of the overall wastewater fertilizers load with an abatement potential of 150g CO(2)-eq m(-3) (385kg CO(2)-eq dry tonne(-1)). Inasmuch as anaerobic digestion reduced it to 63g CO(2)-eq m(-3) (261kg CO(2)-eq dry tonne(-1)), the GHG abatement gained through renewable biogas energy (approx. 428g CO(2)-eq m(-3)) favored digestion. However, sludge composting reduced the fertilizer value to 17g CO(2)-eq m(-3) (121kg CO(2)-eq dry tonne(-1)) or less (if emissions, off-site inputs and actual phytoavailability were considered). Taking Israel as an example, fully exploiting the wastewater derived GHG abatement potential could reduce the State overall GHG emissions by almost 1%. This demonstrates the possibility of optional carbon credits which

  18. Greenhouse gas accounting and waste management.

    PubMed

    Gentil, Emmanuel; Christensen, Thomas H; Aoustin, Emmanuelle

    2009-11-01

    Accounting of emissions of greenhouse gas (GHG) is a major focus within waste management. This paper analyses and compares the four main types of GHG accounting in waste management including their special features and approaches: the national accounting, with reference to the Intergovernmental Panel on Climate Change (IPCC), the corporate level, as part of the annual reporting on environmental issues and social responsibility, life-cycle assessment (LCA), as an environmental basis for assessing waste management systems and technologies, and finally, the carbon trading methodology, and more specifically, the clean development mechanism (CDM) methodology, introduced to support cost-effective reduction in GHG emissions. These types of GHG accounting, in principle, have a common starting point in technical data on GHG emissions from specific waste technologies and plants, but the limited availability of data and, moreover, the different scopes of the accounting lead to many ways of quantifying emissions and producing the accounts. The importance of transparency in GHG accounting is emphasised regarding waste type, waste composition, time period considered, GHGs included, global warming potential (GWP) assigned to the GHGs, counting of biogenic carbon dioxide, choice of system boundaries, interactions with the energy system, and generic emissions factors. In order to enhance transparency and consistency, a format called the upstream-operating-downstream framework (UOD) is proposed for reporting basic technology-related data regarding GHG issues including a clear distinction between direct emissions from waste management technologies, indirect upstream (use of energy and materials) and indirect downstream (production of energy, delivery of secondary materials) activities.

  19. Technological options for management of hazardous wastes from US Department of Energy facilities

    SciTech Connect

    Chiu, S.; Newsom, D.; Barisas, S.; Humphrey, J.; Fradkin, L.; Surles, T.

    1982-08-01

    This report provides comprehensive information on the technological options for management of hazardous wastes generated at facilities owned or operated by the US Department of Energy (DOE). These facilities annually generate a large quantity of wastes that could be deemed hazardous under the Resource Conservation and Recovery Act (RCRA). Included in these wastes are liquids or solids containing polychlorinated biphenyls, pesticides, heavy metals, waste oils, spent solvents, acids, bases, carcinogens, and numerous other pollutants. Some of these wastes consist of nonnuclear hazardous chemicals; others are mixed wastes containing radioactive materials and hazardous chemicals. Nearly 20 unit processes and disposal methods are presented in this report. They were selected on the basis of their proven utility in waste management and potential applicability at DOE sites. These technological options fall into five categories: physical processes, chemical processes, waste exchange, fixation, and ultimate disposal. The options can be employed for either resource recovery, waste detoxification, volume reduction, or perpetual storage. Detailed descriptions of each technological option are presented, including information on process performance, cost, energy and environmental considerations, waste management of applications, and potential applications at DOE sites. 131 references, 25 figures, 23 tables.

  20. The Template for Assessing Climate Change Impacts and Management Options (TACCIMO): Science at Your Fingertips

    NASA Astrophysics Data System (ADS)

    Jennings, L. N.; Treasure, E.; Moore Myers, J.; McNulty, S.

    2012-12-01

    There is an ever-increasing volume of useful scientific knowledge about climate change effects and management options for natural ecosystems. Agencies such as the USDA Forest Service have been charged with the need to evaluate this body of knowledge and if necessary adapt to the impacts of climate change in their forest planning and management. However, the combined volume of existing information and rate of development of new information, lack of climate change specialists, and limited technology transfer mechanisms make efficient access and use difficult. The Template for Assessing Climate Change Impacts and Management Options (TACCIMO) addresses this difficulty through its publically accessible web-based tool that puts current and concise climate change science at the fingertips of forest planners and managers. A collaborative product of the USDA Forest Service Research Stations and the National Forest System, TACCIMO integrates peer-reviewed research with management and planning options through search and reporting tools that connect land managers with information they can trust. TACCIMO highlights elements from the wealth of climate change science with attention to what natural resource planners and managers need through a searchable repository of over 4,000 effects of climate change and close to 1,000 adaptive management options, all excerpted from a growing body of peer-reviewed scientific literature. A geospatial mapping application provides downscaled climate data for the nation and other spatially explicit models relevant to evaluating climate change impacts on forests. Report generators assist users in capturing outputs specific to a given location and resource area in a consistent and organized manner. For USDA Forest Service users, science findings can be readily linked with management conditions and capabilities from national forest management plans. The development of TACCIMO was guided by interactions with natural resource professionals, resulting

  1. Evaluating ecosystem-based management options: Effects of trawling in Torres Strait, Australia

    NASA Astrophysics Data System (ADS)

    Ellis, Nick; Pantus, Francis; Welna, Andrzej; Butler, Alan

    2008-09-01

    A suite of management options for a prawn trawl fishery in Torres Strait, Australia was assessed for impacts on the benthic fauna using a dynamic management strategy evaluation approach. The specification of the management options was gained through consultation with stakeholders. Data for the model was drawn from several sources: the fleet data from fishery logbooks and satellite vessel monitoring systems, benthic depletion rates from trawl-down experiments, benthic recovery rates from post-experiment recovery monitoring studies, and benthic distribution from large-scale benthic surveys. Although there were large uncertainties in the resulting indicators, robust measures relevant to management were obtained by taking ratios relative to the status quo. The management control with the biggest effect was total effort; reducing trawl effort always led to increases in benthic faunal density of up to 10%. Spatial closures had a smaller benefit of up to 2%. The effect of closing a set of buffer zones around reefs to trawling was indistinguishable from the status quo option. Closing a larger area, however, was largely beneficial especially for sea cucumbers. When the spatial distributions of fauna prior to fishing were accounted for, fauna with distributions positively correlated with effort improved relative to those negatively correlated. The reduction in prawn catch under effort reduction scenarios could be ameliorated by introducing temporal closures over the full-moon period.

  2. Options for managing hypoxic blackwater events in river systems: a review.

    PubMed

    Kerr, Janice L; Baldwin, Darren S; Whitworth, Kerry L

    2013-01-15

    Blackwater events are characterised by a high concentration of dissolved organic carbon in the water column. They occur naturally in lowland rivers with forested floodplains and bring a variety of benefits to both aquatic and floodplain biota. However, particularly when accompanied by high temperatures, respiration of the organic carbon may cause blackwater to become hypoxic. This may lead to a range of lethal and sub-lethal effects on the aquatic biota. We review the current scientific knowledge concerning the management of blackwater and hypoxia, and examine how this knowledge may be applied to the management of hypoxic blackwater events in lowland river systems. A range of management options, which aim to either prevent the development of hypoxic blackwater or to reintroduce oxygen into deoxygenated waters, are reported. Mitigation options that may be applicable to lowland river systems include manipulating the season and magnitude of floods in regulated rivers, increasing roughness in flow paths, establishing oxygenated refugia for aquatic biota and introducing hydraulic structures that promote turbulence and re-aeration. With climatic changes trending towards a scenario where extreme events leading to the development of hypoxic blackwater are more probable, it is now vital to validate and optimise management options on local and regional scales and work towards closing knowledge gaps. With judicious management of regulated rivers, it is possible to minimise the impacts of hypoxic flows while preserving the benefits brought to floodplain and river ecosystems by seasonal flooding and carbon exchange.

  3. 41 CFR 102-194.30 - What role does my agency play in the Standard and Optional Forms Management Program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What role does my agency... What role does my agency play in the Standard and Optional Forms Management Program? Your agency head or designee's role is to: (a) Designate an agency-level Standard and Optional Forms Liaison...

  4. 41 CFR 102-194.30 - What role does my agency play in the Standard and Optional Forms Management Program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What role does my agency... What role does my agency play in the Standard and Optional Forms Management Program? Your agency head or designee's role is to: (a) Designate an agency-level Standard and Optional Forms Liaison...

  5. 41 CFR 102-194.30 - What role does my agency play in the Standard and Optional Forms Management Program?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What role does my agency... What role does my agency play in the Standard and Optional Forms Management Program? Your agency head or designee's role is to: (a) Designate an agency-level Standard and Optional Forms Liaison...

  6. 41 CFR 102-194.30 - What role does my agency play in the Standard and Optional Forms Management Program?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false What role does my agency... What role does my agency play in the Standard and Optional Forms Management Program? Your agency head or designee's role is to: (a) Designate an agency-level Standard and Optional Forms Liaison...

  7. Decision analysis and drug development portfolio management: uncovering the real options value of your projects.

    PubMed

    Rosati, Nicoletta

    2002-04-01

    Project selection and portfolio management are particularly challenging in the pharmaceutical industry due to the high risk - high stake nature of the drug development process. In the recent years, scholars and industry experts have agreed that traditional Net-Present-Value evaluation of the projects fails to capture the value of managerial flexibility, and encouraged adopting a real options approach to recover the missed value. In this paper, we take a closer look at the drug development process and at the indices currently used to rank projects. We discuss the economic value of information and of real options arising in drug development and present decision analysis as an ideal framework for the implementation of real options valuation.

  8. Taking action against ocean acidification: a review of management and policy options.

    PubMed

    Billé, Raphaël; Kelly, Ryan; Biastoch, Arne; Harrould-Kolieb, Ellycia; Herr, Dorothée; Joos, Fortunat; Kroeker, Kristy; Laffoley, Dan; Oschlies, Andreas; Gattuso, Jean-Pierre

    2013-10-01

    Ocean acidification has emerged over the last two decades as one of the largest threats to marine organisms and ecosystems. However, most research efforts on ocean acidification have so far neglected management and related policy issues to focus instead on understanding its ecological and biogeochemical implications. This shortfall is addressed here with a systematic, international and critical review of management and policy options. In particular, we investigate the assumption that fighting acidification is mainly, but not only, about reducing CO2 emissions, and explore the leeway that this emerging problem may open in old environmental issues. We review nine types of management responses, initially grouped under four categories: preventing ocean acidification; strengthening ecosystem resilience; adapting human activities; and repairing damages. Connecting and comparing options leads to classifying them, in a qualitative way, according to their potential and feasibility. While reducing CO2 emissions is confirmed as the key action that must be taken against acidification, some of the other options appear to have the potential to buy time, e.g. by relieving the pressure of other stressors, and help marine life face unavoidable acidification. Although the existing legal basis to take action shows few gaps, policy challenges are significant: tackling them will mean succeeding in various areas of environmental management where we failed to a large extent so far.

  9. Sustainability and Energy Development: Influences of Greenhouse Gas Emissions Reduction Options on Water Use in Energy Production

    SciTech Connect

    D. Craig Cooper; Gerald Sehlke

    2012-01-01

    Climate change mitigation strategies cannot be evaluated solely in terms of energy cost and greenhouse gas (GHG) mitigation potential. Maintaining GHGs at a 'safe' level will require fundamental change in the way we approach energy production, and a number of environmental, economic, and societal factors will come into play. Water is an essential component of energy production, and water resource constraints (e.g., insufficient supplies and competing ecological and anthropogenic needs) will limit our options for producing energy and for reducing GHG emissions. This study evaluates these potential constraints from a global perspective by revisiting the 'climate wedges' proposal of Pacala and Sokolow [1], and evaluating the potential water impacts of the 'wedges' associated with energy production. Results indicate that there is a range of water impacts, with some options reducing water demand while others increase water demand. Mitigation options that improve energy conversion and end-use efficiency have the greatest potential for reducing water resources impacts. These options provide 'win-win-win' scenarios for reducing GHG emissions, lowering energy costs and reducing water demand. Thet may merit higher priority than alternative options that emphasize deploying new low-carbon energy facilities or modifying existing facilities with energy intensive GHG mitigation technologies to reduce GHG emissions. While the latter can reduce GHG emissions, they will typically increase energy costs and water impacts.

  10. Herbal Medicine Offered as an Initiative Therapeutic Option for the Management of Hepatocellular Carcinoma.

    PubMed

    Chen, Shao-Ru; Qiu, Hong-Cong; Hu, Yang; Wang, Ying; Wang, Yi-Tao

    2016-06-01

    Hepatocellular carcinoma (HCC) is a common malignant cancer and is the third leading cause of death worldwide. Effective treatment of this disease is limited by the complicated molecular mechanism underlying HCC pathogenesis. Thus, therapeutic options for HCC management are urgently needed. Targeting the Wnt/β-catenin, Hedgehog, Notch, and Hippo-YAP signaling pathways in cancer stem cell development has been extensively investigated as an alternative treatment. Herbal medicine has emerged as an initiative therapeutic option for HCC management because of its multi-level, multi-target, and coordinated intervention effects. In this article, we summarized the recent progress and clinical benefits of targeting the above mentioned signaling pathways and using natural products such as herbal medicine formulas to treat HCC. Proving the clinical success of herbal medicine is expected to deepen the knowledge on herbal medicine efficiency and hasten the adoption of new therapies. Copyright © 2016 John Wiley & Sons, Ltd.

  11. Cost-effectiveness of Management Options for Small Renal Mass: A Systematic Review.

    PubMed

    Wang, Ye; Chen, Yu-Wei; Leow, Jeffrey J; Levy, Alison C; Chang, Steven L; Gelpi, Francisco-Hammerschmidt

    2016-10-01

    Costs of surgery for small renal masses (SRMs) are high. This study aimed to systematically review and evaluate the cost-effectiveness analyses of management options for SRMs. Six databases were searched from inception to August 2015. Inclusion criteria were full original research, full economic evaluation of management options for SRM, and written in English. Among 776 studies screened, 6 met the inclusion criteria. Ablation was cost-effective versus nephron-sparing surgery. Laparoscopic partial nephrectomy was cost-effective versus the open approach. Renal mass biopsy dominated immediate treatment in the United States, but not in Canada. According to the Consolidated Health Economic Evaluation Reporting Standards, all the studies had relatively good quality. Despite the observed evidence, future research is needed to fill in the knowledge gap. A few suggestions should be kept in mind such as conducting the cost-effectiveness analysis in a variety of countries.

  12. Intramedullary Spinal Cord Tumors: Part II—Management Options and Outcomes

    PubMed Central

    Samartzis, Dino; Gillis, Christopher C.; Shih, Patrick; O'Toole, John E.; Fessler, Richard G.

    2015-01-01

    Study Design Broad narrative review. Objectives Intramedullary spinal cord tumors (IMSCT) are uncommon lesions that can affect any age group or sex. However, numerous IMSCT exist and the clinical course of each tumor varies. The following article addresses the various management options and outcomes in patients with IMSCT. Methods An extensive review of the peer-reviewed literature was performed, addressing management options and clinical outcomes of patients with IMSCT. Results Early diagnosis and intervention are essential to obtain optimal functional outcome. Each IMSCT have specific imaging characteristics, which help in the clinical decision-making and prognostication. A comprehension of the tumor pathology and the clinical course associated with each tumor can allow for the proper surgical and nonsurgical management of these tumors, and reduce any associated morbidity and mortality. Recent advances in the operative management of such lesions have increased the success rate of tumor removal while minimizing iatrogenic-related trauma to the patient and, in tandem, improving patient outcomes. Conclusions Awareness and understanding of IMSCT is imperative to design proper management and obtain optimal patient outcomes. Meticulous operative technique and the use of surgical adjuncts are essential to accomplish proper tumor removal, diminish the risk of recurrence, and preserve neurologic function. Operative management of IMSCT should be individualized and based on tumor type, location, and dimensional extensions. To assist with preoperative and intraoperative decision-making, a general algorithm is provided. PMID:26933620

  13. Innovation and Change Management in Public and Private Organizations: Case Studies and Options for EPA

    DTIC Science & Technology

    2003-04-01

    change management that helped the selected organizations become more innovative; and (3) use the findings from the cases to suggest options for innovation within the U.S. Environmental Protection Agency (EPA). RAND selected three public organizations (Food and Drug Administration, the Veterans Health Administration, and the U.S. Customs Service) and three private organizations (DuPont, Marriott, and Procter and Gamble) that had implemented and sustained innovative practices. Beyond meeting this threshold criterion, these organizations also had operational and structural

  14. Agricultural land management options following large-scale environmental contamination - evaluation for Fukushima affected agricultural land

    SciTech Connect

    Vandenhove, Hildegarde

    2013-07-01

    The accident at the Fukushima Daiichi Nuclear Power Plant has raised questions about the accumulation of radionuclides in soils, the transfer in the food chain and the possibility of continued restricted future land use. This paper summarizes what is generally understood about the application of agricultural countermeasures as a land management option to reduce the radionuclides transfer in the food chain and to facilitate the return of potentially affected soils to agricultural practices in areas impacted by a nuclear accident. (authors)

  15. Toward Improved Management of Officer Retention: A New Capability for Assessing Policy Options

    DTIC Science & Technology

    2014-01-01

    reports undergo rigorous peer review to ensure high standards for research quality and objectivity. Michael G. Mattock, Beth J. Asch , James Hosek...Toward Improved Management of Officer Retention A New Capability for Assessing Policy Options Michael G. Mattock, Beth J. Asch , James Hosek...model is based on the pioneering work of Gotz and McCall (1984). Additional studies include Asch and Warner (1994), Daula and Moffitt (1995), Hosek et

  16. Greenhouse gas budgets of managed European grasslands

    NASA Astrophysics Data System (ADS)

    Ammann, C.; Horváth, L.; Jones, S. K.

    2012-04-01

    Greenhouse gas exchange of grasslands are directly and indirectly related to the respective carbon (C) and nitrogen (N) budget. Within the framework of the NitroEurope project we investigated the greenhouse gas, carbon, and nitrogen budgets of four European grassland systems over several years: Easter Bush (UK), Oensingen intensive and extensive (CH), and Bugac (HU). They span contrasting climatic conditions, management types (grazing, cutting) and intensity. While Easter Bush (pasture) and Oensingen int. (meadow) were intensively managed and received a considerable amount of fertiliser, the unfertilised sites Bugac (pasture) and Oensingen ext. (meadow) depended on atmospheric N input (wet and dry deposition) and biological N fixation. The experimental results of the four sites were also compared to published GHG fluxes of other European grasslands. While the ecosystem CO2 exchange was measured on the field scale with the eddy covariance method, the soil fluxes of the other greenhouse gases CH4 and N2O have been detected generally by means of static chambers (only occasional application of eddy covariance). The emission of CH4 by grazing ruminant resulting from enteric fermentation was estimated by animal type specific emission factors. For characterizing the total GHG effect of the grassland sites, the contributions of the different GHGs were normalised to CO2-equivalents. Except for Oensingen ext., all sites showed positive C budgets (sequestration). The observed positive correlation between C and N sequestration (with a ratio between 10 and 20) agrees with studies reported in the literature. The magnitude of N2O emission depended mainly on management intensity (fertiliser input) and on the soil moisture conditions. Whereas for the Oensingen and the Bugac sites, the total GHG budget was dominated by the carbon budget, for Easter Bush the combined effect of N2O and CH4 emission (including animal enteric fermentation) was in the same order of magnitude as the

  17. Greenhouse gas emission impacts of alternative-fueled vehicles: Near-term vs. long-term technology options

    SciTech Connect

    Wang, M.Q.

    1997-05-20

    Alternative-fueled vehicle technologies have been promoted and used for reducing petroleum use, urban air pollution, and greenhouse gas emissions. In this paper, greenhouse gas emission impacts of near-term and long-term light-duty alternative-fueled vehicle technologies are evaluated. Near-term technologies, available now, include vehicles fueled with M85 (85% methanol and 15% gasoline by volume), E85 (85% ethanol that is produced from corn and 15% gasoline by volume), compressed natural gas, and liquefied petroleum gas. Long-term technologies, assumed to be available around the year 2010, include battery-powered electric vehicles, hybrid electric vehicles, vehicles fueled with E85 (ethanol produced from biomass), and fuel-cell vehicles fueled with hydrogen or methanol. The near-term technologies are found to have small to moderate effects on vehicle greenhouse gas emissions. On the other hand, the long-term technologies, especially those using renewable energy (such as biomass and solar energy), have great potential for reducing vehicle greenhouse gas emissions. In order to realize this greenhouse gas emission reduction potential, R and D efforts must continue on the long-term technology options so that they can compete successfully with conventional vehicle technology.

  18. Life-cycle assessment of selected management options for air pollution control residues from waste incineration.

    PubMed

    Fruergaard, Thilde; Hyks, Jiri; Astrup, Thomas

    2010-09-15

    Based on available technology and emission data seven selected management options for air-pollution-control (APC) residues from waste incineration were evaluated by life-cycle assessment (LCA) using the EASEWASTE model. Scenarios were evaluated with respect to both non-toxicity impact categories (e.g. global warming) and toxicity related impact categories (e.g. ecotoxicity and human toxicity). The assessment addressed treatment and final placement of 1 tonne of APC residue in seven scenarios: 1) direct landfilling without treatment (baseline), 2) backfilling in salt mines, 3) neutralization of waste acid, 4) filler material in asphalt, 5) Ferrox stabilization, 6) vitrification, and 7) melting with automobile shredder residues (ASR). The management scenarios were selected as examples of the wide range of different technologies available worldwide while at the same time using realistic technology data. Results from the LCA were discussed with respect to importance of: energy consumption/substitution, material substitution, leaching, air emissions, time horizon aspects for the assessment, and transportation distances. The LCA modeling showed that thermal processes were associated with the highest loads in the non-toxicity categories (energy consumption), while differences between the remaining alternatives were small and generally considered insignificant. In the toxicity categories, all treatment/utilization options were significantly better than direct landfilling without treatment (lower leaching), although the thermal processes had somewhat higher impacts than the others options (air emissions). Transportation distances did not affect the overall ranking of the management alternatives.

  19. Referral and management options for patients with chronic kidney disease: perspectives of patients, generalists and specialists.

    PubMed

    Wilson, Charlotte; Campbell, Stephen M; Luker, Karen A; Caress, Ann-Louise

    2015-06-01

    Chronic Kidney Disease (CKD) is increasing in prevalence and significance as a global public health issue. Appropriate management of CKD stages 3-4 in either generalist or specialist care is essential in order to slow disease progression. As various consulting options between services may be used, it is important to understand how patients and practitioners view these options. To elicit patient and practitioner views and preferences on the acceptability and appropriateness of referral practices and consulting options for CKD stage 3-4. A mixed methods approach involving a semi-structured interview and structured rating exercise administered by telephone. Adult (18+) patients with CKD stage 3-4 were recruited via their General Practitioner (GP). Practitioners were recruited from both general and specialist services. Sixteen patients and twenty-two practitioners participated in the study between July and September, 2011. Both patients and practitioners preferred 'GP with access to a specialist' and least preferred 'Specialist Review'. Computer review and telephone review were acceptable to participants under certain conditions. Practitioners favoured generalist management of patients with CKD 3. Specialists recommended active discharge of patients with stabilised stage 4 back to generalist care. Both generalists and specialists strongly supported sharing patients' medical records via electronic consultation systems. Participants tended to prefer the current model of CKD management. Suggested improvements included; increasing the involvement of patients in referral and discharge decisions; improving the adequacy of information given to specialists on referral and encouraging further use of clinical guidelines in practice. © 2012 Blackwell Publishing Ltd.

  20. Elective preterm delivery as a management option in cryptogenic organizing pneumonia

    PubMed Central

    Holder, Kelly L; Scardo, James A; Laye, M Ryan

    2011-01-01

    Bronchiolitis obliterans organizing pneumonia, now termed as cryptogenic organizing pneumonia (COP), is a fibrotic lung disease of the small airways with the potential to progress to end-stage lung disease. COP in pregnancy carries a high risk of maternal and neonatal complications and only two prior cases have been reported. This is the first case of pre-existing COP in pregnancy. We report a 16-year-old primigravid with COP who elected inpatient management and preterm delivery as a successful management option. PMID:27582859

  1. Papillon–Lefèvre syndrome: clinical presentation and management options

    PubMed Central

    Sreeramulu, Basapogu; Shyam, Naragani DVN; Ajay, Pilla; Suman, Pathipaka

    2015-01-01

    Papillon–Lefèvre syndrome (PLS) is a rare autosomal recessive disorder, characterized by diffuse palmoplantar keratoderma and precocious aggressive periodontitis, leading to premature loss of deciduous and permanent dentition at a very young age. Various etiopathogenic factors are associated with the syndrome, like immunologic alterations, genetic mutations, and the role of bacteria. Dentists play a significant role in the diagnosis and management of PLS as there are characteristic manifestations like periodontal destruction at an early age and an early eruption of permanent teeth. Here, we are presenting an elaborate review of PLS, its etiopathogenesis, clinical presentation, and management options. PMID:26203280

  2. Elective preterm delivery as a management option in cryptogenic organizing pneumonia.

    PubMed

    Holder, Kelly L; Scardo, James A; Laye, M Ryan

    2011-06-01

    Bronchiolitis obliterans organizing pneumonia, now termed as cryptogenic organizing pneumonia (COP), is a fibrotic lung disease of the small airways with the potential to progress to end-stage lung disease. COP in pregnancy carries a high risk of maternal and neonatal complications and only two prior cases have been reported. This is the first case of pre-existing COP in pregnancy. We report a 16-year-old primigravid with COP who elected inpatient management and preterm delivery as a successful management option.

  3. Tubo-ovarian abscess management options for women who desire fertility.

    PubMed

    Rosen, Mitchell; Breitkopf, Dan; Waud, Kay

    2009-10-01

    Tubo-ovarian abscess (TOA), a serious sequela of pelvic inflammatory disease, occurs usually in women of ages 20 to 40. Up to 59% of these women are nulliparous. Traditionally, pregnancy rates after TOA are estimated to be 15% or less. Current proposed management algorithms for TOA do not include a separate pathway for women of reproductive age who may desire future pregnancies. A MEDLINE search and extensive review of published literature was undertaken to study management options for patients with TOA, and to compare rates of responders, pregnancies and complications associated with each management option. If intra-abdominal rupture is suspected, and patients are treated with fertility-preserving, conservative surgery, reported pregnancy rate is 25%. If no rupture is suspected and patients are treated with medical management alone, reported pregnancy rates vary between 4% and 15%. If no rupture is suspected, and the treatment is medical management with immediate laparoscopic drainage within 24 hours, reported pregnancy rates vary between 32% and 63%. Laparoscopy should be considered to all patients with TOA who desire future conception. Overall, the advantages of immediate laparoscopy allow for an accurate diagnosis, effective treatment under magnification with minimal complications, possibly faster response rates with shorter hospitalization times and decreased infertility.

  4. The RealGas and RealGasH2O Options of the TOUGH+ Code for the Simulation of Coupled Fluid and Heat Flow in Tight/Shale Gas Systems

    SciTech Connect

    Moridis, George; Freeman, Craig

    2013-09-30

    We developed two new EOS additions to the TOUGH+ family of codes, the RealGasH2O and RealGas . The RealGasH2O EOS option describes the non-isothermal two-phase flow of water and a real gas mixture in gas reservoirs, with a particular focus in ultra-tight (such as tight-sand and shale gas) reservoirs. The gas mixture is treated as either a single-pseudo-component having a fixed composition, or as a multicomponent system composed of up to 9 individual real gases. The RealGas option has the same general capabilities, but does not include water, thus describing a single-phase, dry-gas system. In addition to the standard capabilities of all members of the TOUGH+ family of codes (fully-implicit, compositional simulators using both structured and unstructured grids), the capabilities of the two codes include: coupled flow and thermal effects in porous and/or fractured media, real gas behavior, inertial (Klinkenberg) effects, full micro-flow treatment, Darcy and non-Darcy flow through the matrix and fractures of fractured media, single- and multi-component gas sorption onto the grains of the porous media following several isotherm options, discrete and fracture representation, complex matrix-fracture relationships, and porosity-permeability dependence on pressure changes. The two options allow the study of flow and transport of fluids and heat over a wide range of time frames and spatial scales not only in gas reservoirs, but also in problems of geologic storage of greenhouse gas mixtures, and of geothermal reservoirs with multi-component condensable (H2O and CH4) and non-condensable gas mixtures. The codes are verified against available analytical and semi-analytical solutions. Their capabilities are demonstrated in a series of problems of increasing complexity, ranging from isothermal flow in simpler 1D and 2D conventional gas reservoirs, to non-isothermal gas flow in 3D fractured shale gas reservoirs involving 4 types of fractures, micro-flow, non-Darcy flow and gas

  5. The RealGas and RealGasH2O options of the TOUGH+ code for the simulation of coupled fluid and heat flow in tight/shale gas systems

    NASA Astrophysics Data System (ADS)

    Moridis, George J.; Freeman, Craig M.

    2014-04-01

    We developed two new EOS additions to the TOUGH+ family of codes, the RealGasH2O and RealGas. The RealGasH2O EOS option describes the non-isothermal two-phase flow of water and a real gas mixture in gas reservoirs, with a particular focus in ultra-tight (such as tight-sand and shale gas) reservoirs. The gas mixture is treated as either a single-pseudo-component having a fixed composition, or as a multicomponent system composed of up to 9 individual real gases. The RealGas option has the same general capabilities, but does not include water, thus describing a single-phase, dry-gas system. In addition to the standard capabilities of all members of the TOUGH+ family of codes (fully-implicit, compositional simulators using both structured and unstructured grids), the capabilities of the two codes include coupled flow and thermal effects in porous and/or fractured media, real gas behavior, inertial (Klinkenberg) effects, full micro-flow treatment, Darcy and non-Darcy flow through the matrix and fractures of fractured media, single- and multi-component gas sorption onto the grains of the porous media following several isotherm options, discrete and fracture representation, complex matrix-fracture relationships, and porosity-permeability dependence on pressure changes. The two options allow the study of flow and transport of fluids and heat over a wide range of time frames and spatial scales not only in gas reservoirs, but also in problems of geologic storage of greenhouse gas mixtures, and of geothermal reservoirs with multi-component condensable (H2O and CH4) and non-condensable gas mixtures. The codes are verified against available analytical and semi-analytical solutions. Their capabilities are demonstrated in a series of problems of increasing complexity, ranging from isothermal flow in simpler 1D and 2D conventional gas reservoirs, to non-isothermal gas flow in 3D fractured shale gas reservoirs involving 4 types of fractures, micro-flow, non-Darcy flow and gas

  6. Toward a protocol for quantifying the greenhouse gas balance and identifying mitigation options in smallholder farming systems

    NASA Astrophysics Data System (ADS)

    Rosenstock, T. S.; Rufino, M. C.; Butterbach-Bahl, K.; Wollenberg, E.

    2013-06-01

    ). In that way, the research captures the balance of benefits between the private landholder and the global public good. Joint assessment of food production and emissions may produce optimal management strategies that balance the competing demands of food production and climate stabilization. For example, nitrous oxide emissions per unit of product are lowest at intermediate (not the lowest) fertilization rates (Van Groenigen et al 2010) which differs from the optimal strategy for reducing emissions per unit area. Costs associated with collecting the additional data are likely to be small relative to the operational budget for GHG field research and could viably become standard practice. Cost-differentiated measurements . Potential end users of the protocol are diverse in their purpose, resources available, and capacity to carry out research. For example, development organizations may want to determine the relative difference in emission impacts between mitigation options while governments may be interested in quantification of impacts across landscapes to develop Nationally Appropriate Mitigation Actions. The most useful approach to quantification therefore lies at the nexus among key constraints: objectives, resources, and capacity. The protocol develops a system of 'tiered' entry points for greenhouse gas accounting, with explicit attention directed toward the uncertainty induced from the various measurement selections. The protocol will include decision pathways to help users quickly determine the quantification options suitable for their goals and constraints to optimize the relationship among accuracy, costs, and scale. The CCAFS-CGIAR protocol is being developed and field-tested in mixed crop-livestock systems of Kenya and intensive rice production in the Philippines, with plans to expand to other sites and agroecosystems in the next year. These initial pilot projects provide a trial of the approach and methods, highlighting technical gaps and promising

  7. Conceptual approaches for incorporating climatic change into the development of forest management options for sequestering carbon

    SciTech Connect

    King, G.A.

    1993-01-01

    The potential for significant enviromental change over the next 100 years has resulted in efforts to develop mitigation options for reducing the rate of increase of carbon dioxide concentrations in the atmosphere. One of the more promising options is management of forest and agroforestry systems. However, most of the assessments of the potential of forest management options to sequester carbon have not factored in future environmental change (climate and CO2 concentration) into their analyses. Climate and ecological models that could be used to incorporate environmental change into forest mitigation planning efforts are reviewed in the paper in terms of their relative strengths and limitations for this particular application. Recommendations are then made as to how to use the available models to estimate the global and regional potential for sequestering carbon in the terrestrial biosphere, incorporating future environmental change into the analyses. Recommendations are also made as to how to target the most promising regions for reforestation efforts given the likelihood of future environmental change. (Copyright (c) Inter-Research 1993.)

  8. Fecal incontinence in acutely and critically ill patients: options in management.

    PubMed

    Beitz, Janice M

    2006-12-01

    Fecal incontinence presents a major challenge in the comprehensive nursing care of acutely and critically ill patients. When manifested as diarrhea, the effects of fecal incontinence can range from mild (superficial skin irritation) to profound (severe perineal dermatitis, dehydration, electrolyte imbalance, and sepsis). Fecal incontinence has many etiologies and risk factors. These include damage to the anal sphincter or pelvic floor, liquid stool consistency, abnormal colonic transport, and decreased intestinal capacity. To avoid or minimize complications, the cause of diarrhea should be addressed, fecal leakage prevented, stool contained, and skin integrity preserved. Management options addressing these goals include diet, pharmacological therapy, and the use of containment products. Management options and their respective advantages and disadvantages are presented with a special focus on safety issues. Diverse approaches are safe only if they are knowledgeably selected, carefully instituted, and constantly monitored for their effects on patient outcomes. Research to identify which options work best in selected clinical situations and which combinations of therapies are most effective is needed.

  9. Waste Management Options for Long-Duration Space Missions: When to Reject, Reuse, or Recycle

    NASA Technical Reports Server (NTRS)

    Linne, Diane L.; Palaszewski, Bryan A.; Gokoglu, Suleyman; Gallo, Christopher A.; Balasubramaniam, Ramaswamy; Hegde, Uday G.

    2014-01-01

    The amount of waste generated on long-duration space missions away from Earth orbit creates the daunting challenge of how to manage the waste through reuse, rejection, or recycle. The option to merely dispose of the solid waste through an airlock to space was studied for both Earth-moon libration point missions and crewed Mars missions. Although the unique dynamic characteristics of an orbit around L2 might allow some discarded waste to intersect the lunar surface before re-impacting the spacecraft, the large amount of waste needed to be managed and potential hazards associated with volatiles recondensing on the spacecraft surfaces make this option problematic. A second option evaluated is to process the waste into useful gases to be either vented to space or used in various propulsion systems. These propellants could then be used to provide the yearly station-keeping needs at an L2 orbit, or if processed into oxygen and methane propellants, could be used to augment science exploration by enabling lunar mini landers to the far side of the moon.

  10. Underground natural gas storage reservoir management

    SciTech Connect

    Ortiz, I.; Anthony, R.

    1995-06-01

    The objective of this study is to research technologies and methodologies that will reduce the costs associated with the operation and maintenance of underground natural gas storage. This effort will include a survey of public information to determine the amount of natural gas lost from underground storage fields, determine the causes of this lost gas, and develop strategies and remedial designs to reduce or stop the gas loss from selected fields. Phase I includes a detailed survey of US natural gas storage reservoirs to determine the actual amount of natural gas annually lost from underground storage fields. These reservoirs will be ranked, the resultant will include the amount of gas and revenue annually lost. The results will be analyzed in conjunction with the type (geologic) of storage reservoirs to determine the significance and impact of the gas loss. A report of the work accomplished will be prepared. The report will include: (1) a summary list by geologic type of US gas storage reservoirs and their annual underground gas storage losses in ft{sup 3}; (2) a rank by geologic classifications as to the amount of gas lost and the resultant lost revenue; and (3) show the level of significance and impact of the losses by geologic type. Concurrently, the amount of storage activity has increased in conjunction with the net increase of natural gas imports as shown on Figure No. 3. Storage is playing an ever increasing importance in supplying the domestic energy requirements.

  11. Manage fuel gas with an expert system

    SciTech Connect

    Giacone, G.; Toben, S.; Bergeron, G.; Ayral, T.

    1996-09-01

    The Star Louisiana refinery has fuel gas header systems throughout the plant that are utilized by fuel gas producers and consumers. The refinery simultaneously exports surplus fuel gas from the export gas header, and maintains a minimum natural gas makeup rates from multiple external suppliers for fuel gas header pressure control. Successfully implementing a fuel gas expert system has facilitated communication of accurate, timely information to all unit control board operators in the refinery when any change or sub-optimal situation occurs in either of these systems. Information provided from the expert system rule knowledge base results in: proper unit operating actions taken when a flaring situation approaches, thus minimizing the negative impact of flaring on the environment and minimizing product loses to the flare; minimizing purchase of makeup natural gas used for fuel gas system pressure control; maximizing export gas capacity to prevent surplus fuel gas production from limiting refinery operation; immediately recognizing an upset in any fuel gas header system and advising the best corrective action for all affected refinery units; and minimizing voice communication required between units in an upset, since the expert system provides the communication immediately in expert advice messages.

  12. Climate change, coral reef ecosystems, and management options for marine protected areas.

    PubMed

    Keller, Brian D; Gleason, Daniel F; McLeod, Elizabeth; Woodley, Christa M; Airamé, Satie; Causey, Billy D; Friedlander, Alan M; Grober-Dunsmore, Rikki; Johnson, Johanna E; Miller, Steven L; Steneck, Robert S

    2009-12-01

    Marine protected areas (MPAs) provide place-based management of marine ecosystems through various degrees and types of protective actions. Habitats such as coral reefs are especially susceptible to degradation resulting from climate change, as evidenced by mass bleaching events over the past two decades. Marine ecosystems are being altered by direct effects of climate change including ocean warming, ocean acidification, rising sea level, changing circulation patterns, increasing severity of storms, and changing freshwater influxes. As impacts of climate change strengthen they may exacerbate effects of existing stressors and require new or modified management approaches; MPA networks are generally accepted as an improvement over individual MPAs to address multiple threats to the marine environment. While MPA networks are considered a potentially effective management approach for conserving marine biodiversity, they should be established in conjunction with other management strategies, such as fisheries regulations and reductions of nutrients and other forms of land-based pollution. Information about interactions between climate change and more "traditional" stressors is limited. MPA managers are faced with high levels of uncertainty about likely outcomes of management actions because climate change impacts have strong interactions with existing stressors, such as land-based sources of pollution, overfishing and destructive fishing practices, invasive species, and diseases. Management options include ameliorating existing stressors, protecting potentially resilient areas, developing networks of MPAs, and integrating climate change into MPA planning, management, and evaluation.

  13. Climate Change, Coral Reef Ecosystems, and Management Options for Marine Protected Areas

    NASA Astrophysics Data System (ADS)

    Keller, Brian D.; Gleason, Daniel F.; McLeod, Elizabeth; Woodley, Christa M.; Airamé, Satie; Causey, Billy D.; Friedlander, Alan M.; Grober-Dunsmore, Rikki; Johnson, Johanna E.; Miller, Steven L.; Steneck, Robert S.

    2009-12-01

    Marine protected areas (MPAs) provide place-based management of marine ecosystems through various degrees and types of protective actions. Habitats such as coral reefs are especially susceptible to degradation resulting from climate change, as evidenced by mass bleaching events over the past two decades. Marine ecosystems are being altered by direct effects of climate change including ocean warming, ocean acidification, rising sea level, changing circulation patterns, increasing severity of storms, and changing freshwater influxes. As impacts of climate change strengthen they may exacerbate effects of existing stressors and require new or modified management approaches; MPA networks are generally accepted as an improvement over individual MPAs to address multiple threats to the marine environment. While MPA networks are considered a potentially effective management approach for conserving marine biodiversity, they should be established in conjunction with other management strategies, such as fisheries regulations and reductions of nutrients and other forms of land-based pollution. Information about interactions between climate change and more “traditional” stressors is limited. MPA managers are faced with high levels of uncertainty about likely outcomes of management actions because climate change impacts have strong interactions with existing stressors, such as land-based sources of pollution, overfishing and destructive fishing practices, invasive species, and diseases. Management options include ameliorating existing stressors, protecting potentially resilient areas, developing networks of MPAs, and integrating climate change into MPA planning, management, and evaluation.

  14. Land management restrictions and options for change in perpetual conservation easements.

    PubMed

    Rissman, Adena; Bihari, Menka; Hamilton, Christopher; Locke, Christina; Lowenstein, David; Motew, Melissa; Price, Jessica; Smail, Robert

    2013-07-01

    Conservation organizations rely on conservation easements for diverse purposes, including protection of species and natural communities, working forests, and open space. This research investigated how perpetual conservation easements incorporated property rights, responsibilities, and options for change over time in land management. We compared 34 conservation easements held by one federal, three state, and four nonprofit organizations in Wisconsin. They incorporated six mechanisms for ongoing land management decision-making: management plans (74 %), modifications to permitted landowner uses with discretionary consent (65 %), amendment clauses (53 %), easement holder rights to conduct land management (50 %), reference to laws or policies as compliance terms (47 %), and conditional use permits (12 %). Easements with purposes to protect species and natural communities had more ecological monitoring rights, organizational control over land management, and mechanisms for change than easements with general open space purposes. Forestry purposes were associated with mechanisms for change but not necessarily with ecological monitoring rights or organizational control over land management. The Natural Resources Conservation Service-Wetland Reserve Program had a particularly consistent approach with high control over land use and some discretion to modify uses through permits. Conservation staff perceived a need to respond to changing social and ecological conditions but were divided on whether climate change was likely to negatively impact their conservation easements. Many conservation easements involved significant constraints on easement holders' options for altering land management to achieve conservation purposes over time. This study suggests the need for greater attention to easement drafting, monitoring, and ongoing decision processes to ensure the public benefits of land conservation in changing landscapes.

  15. Land Management Restrictions and Options for Change in Perpetual Conservation Easements

    NASA Astrophysics Data System (ADS)

    Rissman, Adena; Bihari, Menka; Hamilton, Christopher; Locke, Christina; Lowenstein, David; Motew, Melissa; Price, Jessica; Smail, Robert

    2013-07-01

    Conservation organizations rely on conservation easements for diverse purposes, including protection of species and natural communities, working forests, and open space. This research investigated how perpetual conservation easements incorporated property rights, responsibilities, and options for change over time in land management. We compared 34 conservation easements held by one federal, three state, and four nonprofit organizations in Wisconsin. They incorporated six mechanisms for ongoing land management decision-making: management plans (74 %), modifications to permitted landowner uses with discretionary consent (65 %), amendment clauses (53 %), easement holder rights to conduct land management (50 %), reference to laws or policies as compliance terms (47 %), and conditional use permits (12 %). Easements with purposes to protect species and natural communities had more ecological monitoring rights, organizational control over land management, and mechanisms for change than easements with general open space purposes. Forestry purposes were associated with mechanisms for change but not necessarily with ecological monitoring rights or organizational control over land management. The Natural Resources Conservation Service-Wetland Reserve Program had a particularly consistent approach with high control over land use and some discretion to modify uses through permits. Conservation staff perceived a need to respond to changing social and ecological conditions but were divided on whether climate change was likely to negatively impact their conservation easements. Many conservation easements involved significant constraints on easement holders' options for altering land management to achieve conservation purposes over time. This study suggests the need for greater attention to easement drafting, monitoring, and ongoing decision processes to ensure the public benefits of land conservation in changing landscapes.

  16. Factors that influence patient preferences for prostate cancer management options: A systematic review

    PubMed Central

    Showalter, Timothy N; Mishra, Mark V; Bridges, John FP

    2015-01-01

    Purpose We performed a systematic review to evaluate evidence regarding factors that influence patient preferences for management options for localized prostate cancer. Methods We followed a prespecified search protocol (PROSPERO identifier CRD42014009173) to identify studies that evaluated patient preferences for prostate cancer management options for localized prostate cancer. We queried PubMed, the Cochrane Database of Systematic Reviews, Embase, Cumulative Index to Nursing & Allied Health Literature (CINAHL) Plus, and Econ-Lit databases. Two separate reviewers completed the article selection process and review, including coding of study characteristics. Study quality was scored according to the PREFS checklist, which consists of five criteria: Purpose, Respondents, Explanation, Findings, and Significance. Reviewers summarized the primary findings of each article included in the analysis. Results Of the 606 citations identified in the literature search, there were a total of 21 articles that met all selection criteria, reporting results for a total of 4,131 subjects. Themes identified in the studies included: the importance of patient perceptions of treatment efficacy and side effects; the influence of physician recommendations on patient decision-making; and the prioritization of concerns regarding treatment side effects among those men who prefer radiation therapy or active surveillance. The articles had an average PREFS score of 3.4 (standard deviation [SD] 1.0), which is similar to a recent study for breast cancer treatment preferences. Conclusion This systematic review of factors that influence patient preferences for prostate cancer management options identified a small, but high quality, group of articles that satisfied the selection criteria. The available evidence suggests that interventions aimed at informing patients regarding the comparative effectiveness of prostate cancer management alternatives should include the influence of physician

  17. Options for managing impacts of climate change on a deep-sea community

    NASA Astrophysics Data System (ADS)

    Thresher, Ronald E.; Guinotte, John M.; Matear, Richard J.; Hobday, Alistair J.

    2015-07-01

    The deep sea hosts some of the world's largest, oldest, and most sensitive ecosystems. Climate change and ocean acidification are likely to have severe implications for many deep-sea ecosystems and communities, but what, if anything, can be done to mitigate these threats is poorly understood. To begin to bridge this gap, we convened a stakeholder workshop to assess and prioritize options for conserving legislatively protected deep-sea coral reefs off southeast Australia that, without management intervention, are likely to be severely degraded within decades as a result of climate change. Seventeen possible options were explored that span biological, engineering and regulatory domains and that differed widely in their perceived costs, benefits, time to implementation, and risks. In the short term, the highest priority identified is the need to urgently locate and protect sites globally that are, or will become, refugia areas for the coral and its associated community as climate change progresses.

  18. Current and emerging management options for patients with Morquio A syndrome.

    PubMed

    Algahim, Mohamed F; Almassi, G Hossein

    2013-01-01

    Morquio A syndrome is a lysosomal storage disease associated with mucopolysaccharidosis. It is caused by a deficiency of the lysosomal enzyme, N-acetylgalactosamine-6-sulfate sulfatase, which leads to accumulation of keratan sulfate and condroitin-6 sulfate in multiple organs. Patients present with multisystemic complications involving the musculoskeletal, respiratory, cardiovascular, and digestive systems. Presently, there is no definitive cure, and current management options are palliative. Enzyme replacement therapy and hematopoietic stem cell therapy have been proven effective in certain lysosomal storage diseases, and current investigations are underway to evaluate the effectiveness of these therapies and others for the treatment of Morquio A syndrome. This review discusses the current and emerging treatment options for Morquio A syndrome, citing examples of the treatment of other mucopolysaccharidoses.

  19. Update of the management of chronic psoriasis: new approaches and emerging treatment options

    PubMed Central

    Laws, Philip M; Young, Helen S

    2010-01-01

    Psoriasis is a common, chronic inflammatory skin disease which is associated with a number of significant co-morbidities including: impairment of quality of life; cardiovascular disease; and a seronegative arthritis known as psoriatic arthritis. Our understanding of the pathogenesis of psoriasis has developed at a remarkable rate in recent years. These new insights have significantly changed our perception of the condition and have led to the development of several new treatment strategies. Biological agents have proved a major step forward in therapeutic options for psoriasis. The ability to clear, or almost clear, cutaneous disease has changed the outcomes and expectations of many patients with this disease. The impact on both physical and psychological health may be great. This review covers the clinical features and management of psoriasis with specific reference to new therapeutic options. PMID:21437057

  20. Estimating option values of solar radiation management assuming that climate sensitivity is uncertain.

    PubMed

    Arino, Yosuke; Akimoto, Keigo; Sano, Fuminori; Homma, Takashi; Oda, Junichiro; Tomoda, Toshimasa

    2016-05-24

    Although solar radiation management (SRM) might play a role as an emergency geoengineering measure, its potential risks remain uncertain, and hence there are ethical and governance issues in the face of SRM's actual deployment. By using an integrated assessment model, we first present one possible methodology for evaluating the value arising from retaining an SRM option given the uncertainty of climate sensitivity, and also examine sensitivities of the option value to SRM's side effects (damages). Reflecting the governance challenges on immediate SRM deployment, we assume scenarios in which SRM could only be deployed with a limited degree of cooling (0.5 °C) only after 2050, when climate sensitivity uncertainty is assumed to be resolved and only when the sensitivity is found to be high (T2x = 4 °C). We conduct a cost-effectiveness analysis with constraining temperature rise as the objective. The SRM option value is originated from its rapid cooling capability that would alleviate the mitigation requirement under climate sensitivity uncertainty and thereby reduce mitigation costs. According to our estimates, the option value during 1990-2049 for a +2.4 °C target (the lowest temperature target level for which there were feasible solutions in this model study) relative to preindustrial levels were in the range between $2.5 and $5.9 trillion, taking into account the maximum level of side effects shown in the existing literature. The result indicates that lower limits of the option values for temperature targets below +2.4 °C would be greater than $2.5 trillion.

  1. Estimating option values of solar radiation management assuming that climate sensitivity is uncertain

    PubMed Central

    Arino, Yosuke; Akimoto, Keigo; Sano, Fuminori; Homma, Takashi; Oda, Junichiro; Tomoda, Toshimasa

    2016-01-01

    Although solar radiation management (SRM) might play a role as an emergency geoengineering measure, its potential risks remain uncertain, and hence there are ethical and governance issues in the face of SRM’s actual deployment. By using an integrated assessment model, we first present one possible methodology for evaluating the value arising from retaining an SRM option given the uncertainty of climate sensitivity, and also examine sensitivities of the option value to SRM’s side effects (damages). Reflecting the governance challenges on immediate SRM deployment, we assume scenarios in which SRM could only be deployed with a limited degree of cooling (0.5 °C) only after 2050, when climate sensitivity uncertainty is assumed to be resolved and only when the sensitivity is found to be high (T2x = 4 °C). We conduct a cost-effectiveness analysis with constraining temperature rise as the objective. The SRM option value is originated from its rapid cooling capability that would alleviate the mitigation requirement under climate sensitivity uncertainty and thereby reduce mitigation costs. According to our estimates, the option value during 1990–2049 for a +2.4 °C target (the lowest temperature target level for which there were feasible solutions in this model study) relative to preindustrial levels were in the range between $2.5 and $5.9 trillion, taking into account the maximum level of side effects shown in the existing literature. The result indicates that lower limits of the option values for temperature targets below +2.4 °C would be greater than $2.5 trillion. PMID:27162346

  2. Cost-effectiveness analysis of nephron sparing options for the management of small renal masses.

    PubMed

    Chang, Steven L; Cipriano, Lauren E; Harshman, Lauren C; Garber, Alan M; Chung, Benjamin I

    2011-05-01

    A recent increase in the detection of contrast enhancing renal masses 4 cm or smaller suspicious for malignancy has led to the widespread use of nephron sparing options. Limited data exist to help clinicians decide which of these competing nephron sparing therapies is most appropriate. We performed a cost-effectiveness analysis to evaluate the relative clinical and economic merits of commonly available nephron sparing strategies for small renal masses. We developed a decision analytic Markov model estimating the costs and health outcomes of treating a healthy 65-year-old patient with an asymptomatic unilateral small renal mass using competing nephron sparing options of immediate intervention (ie open and laparoscopic partial nephrectomy as well as laparoscopic and percutaneous ablation), active surveillance with possible delayed intervention and nonsurgical management with observation. Benefits were measured in quality adjusted life-years. We used a societal perspective, lifetime horizon and willingness to pay threshold of $50,000 per quality adjusted life-year gained. Model results were assessed with sensitivity analyses. In the base case scenario the least costly option was observation and the optimal option was immediate laparoscopic partial nephrectomy, which had an incremental cost-effectiveness ratio of $36,645 per quality adjusted life-year gained compared to surveillance with possible delayed percutaneous ablation. Results were sensitive to age at diagnosis, health status and tumor size. Immediate laparoscopic partial nephrectomy is the preferred nephron sparing option for healthy patients younger than 74 years old with a small renal mass. Surveillance with possible delayed percutaneous ablation is a cost-effective alternative for patients with advanced age or significant comorbidities. Observation maximizes quality adjusted life-years in patients who are poor surgical candidates or with limited life expectancy (less than 3 years). Copyright © 2011

  3. 75 FR 41790 - Address Management Services-Elimination of the Manual Card Option for Address Sequencing Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-19

    ... 111 Address Management Services--Elimination of the Manual Card Option for Address Sequencing Services... Standards of the United States Postal Service, Domestic Mail Manual (DMM ) 507.8 to eliminate the manual... pricing, which requires address sequencing. For the manual option of Address Sequencing service, customers...

  4. Integrated dissolved gas management for contaminated aquifer in situ bioremediation

    SciTech Connect

    Gantzer, C.J.

    1995-12-31

    Integrated management is the simultaneous management of a target gas concentration and the total gas pressure in an aqueous stream. A membrane-based integrated gas management system is presented that allows the aqueous delivery of elevated dissolved concentrations of gaseous microbial substrates to an aquifer with no potential for bubble formation. The delivery of gaseous microbial substrates can enhance the in situ bioremediation of a contaminated aquifer. Bubble information in an aquifer is undesirable for three reasons: substrate is wasted, gases migrate off site, and the aquifer clogs with bubbles. Integrated gas management is a two-step process. The first step consists of the nonselective removal of dissolved gases to reduce the total gas pressure of the injection water. The second step consists of dissolving the desired gaseous substrate. The resulting water has an elevated concentration of the gaseous substrate and a total gas pressure less than the absolute hydrostatic pressure at the delivery point for the aquifer. A membrane-based integrated gas management system has operated for 9 months at a former manufactured gas plant site and delivers 5 gpm of oxygenated water (25 mg O{sub 2}/L) to a silt-clay aquifer at a total gas pressure of 1 atmosphere.

  5. Managing gas plant margins through the financial commodities market

    SciTech Connect

    Peters, D.; Lafferty, L.

    1995-12-31

    Gas processors invest capital in gas plants to condition raw natural gas for market. They also attempt to upgrade the value of natural gas streams by removing gas liquids contained in these streams and selling them for a profit. Unfortunately, this is not always possible. Gas processing profit margins swing up and down in line with the volatility of the natural gas and gas liquids markets. Consequently the return on gas processors invested capital also swings up and down through ``good years`` and ``bad years``. Until recently, gas processors have had to bear the risk associated with these swings in margins. While an efficient market exists for products like crude oil on the New York Mercantile Exchange, no similar market has been available for gas liquids. The NYMEX propane contract has not developed sufficient liquidity for year round hedging of propane, much less the other gas liquids. Processors in regions without access to the Belvieu market encounter an even more difficult task attempting to use the NYMEX contract to hedge. Today this inability to manage risk is beginning to change. The natural gas markets have led the way since their deregulation with an actively traded over-the-counter forwards market firmly established. An over-the-counter forwards market for gas liquids has also started to emerge. It is through these new and emerging markets that a gas plant`s profitability can be hedged.

  6. Greenhouse Gas Mitigation Options Database and Tool - Data repository of GHG mitigation technologies.

    EPA Science Inventory

    Industry and electricity production facilities generate over 50 percent of greenhouse gas (GHG) emissions in the United States. There is a growing consensus among scientists that the primary cause of climate change is anthropogenic greenhouse gas (GHG) emissions. Reducing GHG emi...

  7. Sustainable approaches for minimizing biosolids production and maximizing reuse options in sludge management: A review.

    PubMed

    Joo, Sung Hee; Dello Monaco, Francesca; Antmann, Eric; Chorath, Philip

    2015-08-01

    Sludge generation during wastewater treatment is inevitable even with proper management and treatment. Yet proper handling and disposal of sludge are still challenging in terms of treatment cost, presence of recalcitrant contaminants of concern, sanitary issues, and public acceptance. Conventional disposal methods (i.e. landfilling, incineration) have created concerns in terms of legislative restrictions and community perception, incentivizing consideration of substitute sludge management options. Furthermore, with proper treatment, biosolids from sludge, rich in organic materials and nutrients, could be utilizable as fertilizer. Despite the challenges of dealing with sludge, no review has dealt with integrated source reduction and reuse as the best sustainable management practices for sludge treatment. In this review, we present two main approaches as potentially sustainable controls: (i) pretreatment for minimizing extensive sludge treatment, and (ii) recycling and reuse of residual sludge. Drawing on these approaches, we also suggest strategies for efficient pretreatment mechanisms and residual reuse, presenting ideas for prospective future research.

  8. The Gas Turbine - Modular Helium Reactor: A Promising Option for Near Term Deployment

    SciTech Connect

    LaBar, Malcolm P.

    2002-07-01

    The Gas Turbine - Modular Helium Reactor (GT-MHR) is an advanced nuclear power system that offers unparalleled safety, high thermal efficiency, environmental advantages, and competitive electricity generation costs. The GT-MHR module couples a gas-cooled modular helium reactor (MHR) with a high efficiency modular Brayton cycle gas turbine (GT) energy conversion system. The reactor and power conversion systems are located in a below grade concrete silo that provides protection against sabotage. The GT-MHR safety is achieved through a combination of inherent safety characteristics and design selections that take maximum advantage of the gas-cooled reactor coated particle fuel, helium coolant and graphite moderator. The GT-MHR is projected to be economically competitive with alternative electricity generation technologies due to the high operating temperature of the gas-cooled reactor, high thermal efficiency of the Brayton cycle power conversion system, high fuel burnup (>100,000 MWd/MT), and low operation and maintenance requirements. (author)

  9. Framework for managing wastes from oil and gas exploration and production (E&P) sites.

    SciTech Connect

    Veil, J. A.; Puder, M. G.; Environmental Science Division

    2007-09-15

    Oil and gas companies operate in many countries around the world. Their exploration and production (E&P) operations generate many kinds of waste that must be carefully and appropriately managed. Some of these wastes are inherently part of the E&P process; examples are drilling wastes and produced water. Other wastes are generic industrial wastes that are not unique to E&P activities, such as painting wastes and scrap metal. Still other wastes are associated with the presence of workers at the site; these include trash, food waste, and laundry wash water. In some host countries, mature environmental regulatory programs are in place that provide for various waste management options on the basis of the characteristics of the wastes and the environmental settings of the sites. In other countries, the waste management requirements and authorized options are stringent, even though the infrastructure to meet the requirements may not be available yet. In some cases, regulations and/or waste management infrastructure do not exist at all. Companies operating in these countries can be confronted with limited and expensive waste management options.

  10. Women's experiences of three early miscarriage management options a qualitative study

    PubMed Central

    Smith, Lindsay F; Frost, Julia; Levitas, Ruth; Bradley, Harriet; Garcia, Jo

    2006-01-01

    Background Miscarriage affects around one in six pregnancies. Much research has taken place identifying the consequences of this for parents but is mainly quantitative. Of the limited qualitative studies, none have explored women's experiences of the methods of miscarriage management received. Aim To assess the social and personal impact of different management methods (expectant, medical and surgical) on women's experience of first trimester miscarriage. Design of study Qualitative interviews using a topic guide with a purposive cohort of four categories of women (each management method plus non-participants) 6 months to 1 year after first trimester miscarriage. Focus groups with both research participants and health workers. Setting Women from three hospitals in the South West of England that participated in the Miscarriage Treatment (MIST) trial. Method Seventy-two interviews were undertaken between September 1999 and June 2000. There were also five focus groups (47 participants) and two feedback sessions (8 participants) with written feedback from 12 women. Interviews lasted 0.5–2.5 hours generating over 2000 A4 pages of transcripts. The transcripts were analysed for common themes, using standard proformas, which were filled in by individual team members and then discussed by the whole research team. Iterative readings in the light of new emerging issues ensured that new themes could be identified throughout the analytical process. All transcripts were then encoded for the identified themes using NUDIST. Results Common themes emerged across all management options although some were specific to just one or two management options. The five major themes arising out of the data analysis were: intervention; experiences of care; finality; the ‘baby’; and pain and bleeding. Conclusions Women's experiences and beliefs vary widely and their preferences need to be considered in their early miscarriage management. The three methods have different benefits and

  11. Sustainable water use and management options in a water-stressed river basin in Kenya

    NASA Astrophysics Data System (ADS)

    Hirpa, Feyera; Dadson, Simon; Dyer, Ellen; Barbour, Emily; Charles, Katrina; Hope, Robert

    2017-04-01

    Sustainable water resource is critical for maintaining healthy ecosystems and supporting socio-economic sectors. Hydro-climatic change and variability, population growth as well as new infrastructure developments create water security risks. Therefore, evidence-based management decisions are necessary to improve water security and meet the future water demands of multiple competing sectors. In this work we perform water resource modelling in order to investigate the impact of increasing water demand (expanding agriculture, booming industry, growing population) on the sustainable water use in Turkwel river basin, located in arid north-western Kenya. We test different management options to determine those that meet the water demands of the concerned sectors whilst minimising environmental impact. We perform scenario analysis using Water Evaluation And Planning (WEAP) model to explore different ranges of climate conditions, population growth rates, irrigation scale, reservoir operations, and economic development. The results can be used as a scientific guideline for the policy makers who decide the alternative management options that ensure the sustainable water use in the basin. The work is part of the REACH - improving water security for the poor program (http://reachwater.org.uk/), aiming to support a pathway to sustainable growth and poverty reduction

  12. Which cropland greenhouse gas mitigation options give the greatest benefits in different world regions? Climate and soil specific predictions from integrated empirical models

    NASA Astrophysics Data System (ADS)

    Hillier, J.; Brentrup, F.; Wattenbach, M.; Walter, C.; Garcia-Suarez, T.; Mila-i-Canals, L.; Smith, P.

    2012-04-01

    Major sources of greenhouse gas (GHG) emissions from agricultural crop production are nitrous oxide (N2O) emissions resulting from the application of mineral and organic fertiliser, and carbon dioxide (CO2) emissions from soil carbon losses. Consequently, choice of fertiliser type, optimising fertiliser application rates and timing, reducing microbial denitrification and improving soil carbon management are focus areas for mitigation. We have integrated separate models derived from global data on fertiliser induced soil N2O emissions, soil nitrification inhibitors, and the effects of tillage and soil inputs of soil C stocks into a single model in order to determine optimal mitigation options as a function of soil type, climate, and fertilisation rates. After Monte Carlo sampling of input variables we aggregated the outputs according to climate, soil and fertiliser factors to consider the benefits of several possible emissions mitigation strategies, and identified the most beneficial option for each factor class on a per hectare basis. The optimal mitigation for each soil-climate-region was then mapped to propose geographically specific optimal GHG mitigation strategies for crops with varying N requirements. The use of empirical models reduces the requirements for validation (since they are calibrated on globally or continentally observed phenomena). However, since they are relatively simple in structure, they may not be applicable for accurate site specific prediction of GHG emissions. The value of this modelling approach is for initial screening and ranking of potential agricultural mitigation options and to explore the potential impact of regional agricultural GHG abatement policies. Given the clear association between management practice and crop productivity, it is essential to incorporate characterisation of the yield effect on a given crop before recommending any mitigation practice.

  13. Medication therapy management: why it no longer should be considered optional.

    PubMed

    Molokwu, Ogochukwu Chidozie; Nkansah, Nancy Twum

    2009-08-01

    Medications are the primary therapeutic intervention in many health care settings. As prescription drug use continues to grow, and medication therapies become more complex, our health care systems have become more prone to medication errors and adverse drug events. Medication Therapy Management services provided by pharmacists have been shown to help reduce medication errors, adverse drug events, and costs. Such services need to be integrated into the health care system and not be regarded as optional. This article is intended to provide pharmacists, pharmacy leaders, and health care policymakers the information needed to broach this topic at the health care policy level.

  14. NOBLAST and JAMBLAST: New Options for BLAST and a Java Application Manager for BLAST results.

    PubMed

    Lagnel, Jacques; Tsigenopoulos, Costas S; Iliopoulos, Ioannis

    2009-03-15

    NOBLAST (New Options for BLAST) is an open source program that provides a new user-friendly tabular output format for various NCBI BLAST programs (Blastn, Blastp, Blastx, Tblastn, Tblastx, Mega BLAST and Psi BLAST) without any use of a parser and provides E-value correction in case of use of segmented BLAST database. JAMBLAST using the NOBLAST output allows the user to manage, view and filter the BLAST hits using a number of selection criteria. A distribution package of NOBLAST and JAMBLAST including detailed installation procedure is freely available from http://sourceforge.net/projects/JAMBLAST/ and http://sourceforge.net/projects/NOBLAST. Supplementary data are available at Bioinformatics online.

  15. An overview on exploration and environmental impact of unconventional gas sources and treatment options for produced water.

    PubMed

    Silva, Tânia L S; Morales-Torres, Sergio; Castro-Silva, Sérgio; Figueiredo, José L; Silva, Adrián M T

    2017-09-15

    Rising global energy demands associated to unbalanced allocation of water resources highlight the importance of water management solutions for the gas industry. Advanced drilling, completion and stimulation techniques for gas extraction, allow more economical access to unconventional gas reserves. This stimulated a shale gas revolution, besides tight gas and coalbed methane, also causing escalating water handling challenges in order to avoid a major impact on the environment. Hydraulic fracturing allied to horizontal drilling is gaining higher relevance in the exploration of unconventional gas reserves, but a large amount of wastewater (known as "produced water") is generated. Its variable chemical composition and flow rates, together with more severe regulations and public concern, have promoted the development of solutions for the treatment and reuse of such produced water. This work intends to provide an overview on the exploration and subsequent environmental implications of unconventional gas sources, as well as the technologies for treatment of produced water, describing the main results and drawbacks, together with some cost estimates. In particular, the growing volumes of produced water from shale gas plays are creating an interesting market opportunity for water technology and service providers. Membrane-based technologies (membrane distillation, forward osmosis, membrane bioreactors and pervaporation) and advanced oxidation processes (ozonation, Fenton, photocatalysis) are claimed to be adequate treatment solutions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Waste management options in southern Europe using field and experimental data.

    PubMed

    Koufodimos, George; Samaras, Zissis

    2002-01-01

    The applicability of the Waste Management Hierarchy concept that appeared to be an essential element in current national environmental policies was investigated in the case of a region in Southern Europe. The waste generation profile that determines the appropriateness of different waste management options was created after a 1-year municipal waste sampling investigation conducted in the Municipality of Pilea in Northern Greece. The paper describes the results of (1) the sampling method, which was conducted four times during 1 year (once per season) in selected areas of the city, (2) the qualitative analysis of the collected samples and (3) the waste treatment, which consisted of drying, grinding, calorific value measurement, incineration and chemical analysis of the collected samples. Comparative analysis between the above mentioned data and on past data derived from investigations conducted in other Greek regions with similar characteristics to those of Pilea were used to identify and discuss future trends in the composition of generated waste over time. An analysis of the current waste management status in Greece as well as the feasibility of implementing a comprehensive management approach is assessed taking into account guidelines set worldwide to promote renewable energy sources use. It is concluded that recycling, perhaps the most positively received of all waste management practices, is going to be an essential part of contemporary waste management strategies, composting can play an important role, while incineration seems to be a conditionally feasible solution.

  17. Measuring and managing reservoir greenhouse gas emissions

    EPA Science Inventory

    Methane (CH4) is the second most important anthropogenic greenhouse gas with a heat trapping capacity 34 times greater than that of carbon dioxide on a 100 year time scale. Known anthropogenic CH4 sources include livestock production, rice agriculture, landfills, and natural gas...

  18. Measuring and managing reservoir greenhouse gas emissions

    EPA Science Inventory

    Methane (CH4) is the second most important anthropogenic greenhouse gas with a heat trapping capacity 34 times greater than that of carbon dioxide on a 100 year time scale. Known anthropogenic CH4 sources include livestock production, rice agriculture, landfills, and natural gas...

  19. Employer-based coverage and medical travel options: lessons for healthcare managers.

    PubMed

    Karuppan, Corinne Marie

    2014-01-01

    Outbound medical travel (MT) involves U.S. patients going abroad to seek medical care. Over the past decade, there has been much discussion about MT's broadening appeal to several segments of U.S. healthcare consumers, but little is known about its penetration in the employer-based coverage (EBC) marketplace. The objectives of this article are to fill this gap and identify (1) the current status of MT options in EBC, (2) the differences between adopters and nonadopters of MT options, and (3) the factors that impede adoption. The results were obtained from a nationwide survey of human resources (HR) professionals making decisions regarding medical benefits. In this sample (n = 608), 16.8% of the respondents offered outbound MT options to their employees, often bypassing their insurance providers. Besides benefiting from a strong HR function, these organizations tended to be more involved in global business transactions, more open to change, more sensitive to cost savings, and more flexible in implementing administrative innovations than nonadopters were. An organizational climate conducive to innovation may explain their propensity to downplay the importance of well-known obstacles to implementation, such as the effort required to make changes, an emphasis on short-term goals, and the fear of liability. The lessons to be learned by U.S. healthcare managers are clear. To attract a value-conscious market, they must offer an attractive package of outstanding quality (clinical outcomes and patient experience) at competitive costs. Operational excellence may thus be the key to slowing the inevitable diffusion of MT options in EBC and maintaining or even expanding the U.S. market share of elective surgeries.

  20. Sustainability and energy development: influences of greenhouse gas emission reduction options on water use in energy production.

    PubMed

    Cooper, D Craig; Sehlke, Gerald

    2012-03-20

    Climate change mitigation strategies cannot be evaluated solely in terms of energy cost and greenhouse gas (GHG) mitigation potential. Maintaining GHGs at a "safe" level will require fundamental change in the way we approach energy production, and a number of environmental, economic, and societal factors will come into play. Water is an essential component of energy production, and water resource constraints will limit our options for meeting society's growing demand for energy while also reducing GHG emissions. This study evaluates these potential constraints from a global perspective by revisiting the climate wedges proposal of Pacala and Socolow (Science2004, 305 (5686), 968-972) and evaluating the potential water-use impacts of the wedges associated with energy production. GHG mitigation options that improve energy conversion or use efficiency can simultaneously reduce GHG emissions, lower energy costs, and reduce energy impacts on water resources. Other GHG mitigation options (e.g., carbon capture and sequestration, traditional nuclear, and biofuels from dedicated energy crops) increase water requirements for energy. Achieving energy sustainability requires deployment of alternatives that can reduce GHG emissions, water resource impacts, and energy costs.

  1. Mitigation of greenhouse gas emissions in livestock production: a review of technical options for non-C02 emissions

    USDA-ARS?s Scientific Manuscript database

    Animal production is a significant source of greenhouse gas (GHG) emissions worldwide. This analysis was done to evaluate the potential use of nutritional, manure, and animal management practices to mitigate non-CO2 GHG emissions (i.e., methane, CH4 and nitrous oxide, N2O) from enteric fermentation ...

  2. Energy production, nutrient recovery and greenhouse gas emission potentials from integrated pig manure management systems.

    PubMed

    Prapaspongsa, T; Poulsen, T G; Hansen, J A; Christensen, P

    2010-05-01

    Improper management of pig manure has resulted in environmental problems such as surface water eutrophication, ground water pollution, and greenhouse gas emissions. This study develops and compares 14 alternative manure management scenarios aiming at energy and nutrient extraction. The scenarios based on combinations of thermal pretreatment, anaerobic digestion, anaerobic co-digestion, liquid/solid separation, drying, incineration, and thermal gasification were compared with respect to their energy, nutrient and greenhouse gas balances. Both sole pig manure and pig manure mixed with other types of waste materials were considered. Data for the analyses were obtained from existing waste treatment facilities, experimental plants, laboratory measurements and literature. The assessment reveals that incineration combined with liquid/solid separation and drying of the solids is a promising management option yielding a high potential energy utilization rate and greenhouse gas savings. If maximum electricity production is desired, anaerobic digestion is advantageous as the biogas can be converted to electricity at high efficiency in a gas engine while allowing production of heat for operation of the digestion process. In conclusion, this study shows that the choice of technology has a strong influence on energy, nutrient and greenhouse gas balances. Thus, to get the most reliable results, it is important to consider the most representative (and up-to-date) technology combined with data representing the area or region in question.

  3. Subsurface Hybrid Power Options for Oil & Gas Production at Deep Ocean Sites

    SciTech Connect

    Farmer, J C; Haut, R; Jahn, G; Goldman, J; Colvin, J; Karpinski, A; Dobley, A; Halfinger, J; Nagley, S; Wolf, K; Shapiro, A; Doucette, P; Hansen, P; Oke, A; Compton, D; Cobb, M; Kopps, R; Chitwood, J; Spence, W; Remacle, P; Noel, C; Vicic, J; Dee, R

    2010-02-19

    An investment in deep-sea (deep-ocean) hybrid power systems may enable certain off-shore oil and gas exploration and production. Advanced deep-ocean drilling and production operations, locally powered, may provide commercial access to oil and gas reserves otherwise inaccessible. Further, subsea generation of electrical power has the potential of featuring a low carbon output resulting in improved environmental conditions. Such technology therefore, enhances the energy security of the United States in a green and environmentally friendly manner. The objective of this study is to evaluate alternatives and recommend equipment to develop into hybrid energy conversion and storage systems for deep ocean operations. Such power systems will be located on the ocean floor and will be used to power offshore oil and gas exploration and production operations. Such power systems will be located on the oceans floor, and will be used to supply oil and gas exploration activities, as well as drilling operations required to harvest petroleum reserves. The following conceptual hybrid systems have been identified as candidates for powering sub-surface oil and gas production operations: (1) PWR = Pressurized-Water Nuclear Reactor + Lead-Acid Battery; (2) FC1 = Line for Surface O{sub 2} + Well Head Gas + Reformer + PEMFC + Lead-Acid & Li-Ion Batteries; (3) FC2 = Stored O2 + Well Head Gas + Reformer + Fuel Cell + Lead-Acid & Li-Ion Batteries; (4) SV1 = Submersible Vehicle + Stored O{sub 2} + Fuel Cell + Lead-Acid & Li-Ion Batteries; (5) SV2 = Submersible Vehicle + Stored O{sub 2} + Engine or Turbine + Lead-Acid & Li-Ion Batteries; (6) SV3 = Submersible Vehicle + Charge at Docking Station + ZEBRA & Li-Ion Batteries; (7) PWR TEG = PWR + Thermoelectric Generator + Lead-Acid Battery; (8) WELL TEG = Thermoelectric Generator + Well Head Waste Heat + Lead-Acid Battery; (9) GRID = Ocean Floor Electrical Grid + Lead-Acid Battery; and (10) DOC = Deep Ocean Current + Lead-Acid Battery.

  4. A System Dynamics Approach for the Selection of Contaminated Land Management Options

    NASA Astrophysics Data System (ADS)

    McKnight, U. S.; Kuebert, M.; Finkel, M.; Bieg, M.

    2006-12-01

    Large-scale contaminated land and groundwater is a widespread problem that can severely impact human health, the environment and the economy at many urban sites all over the world. Usually a considerable number of potential management solutions exist at each of these sites. A detailed investigation of all these options, however, is not economically feasible which makes streamlining of the planning and decision process a mandatory requirement. Decisions to be taken should be made as early as possible in order to reduce expenditures on site investigation. Therefore, a tiered decision-making procedure is required, including (i) identification and prioritization of focal areas of risks, (ii) feasibility screening of remediation targets and available management alternatives to narrow the range of possible options for (iii) subsequent detailed investigations of only a select group of preferable options. For each of these elements, tailored decision and investigation concepts are required. These concepts and applied methods should be specifically adapted to the type and scale of the particular decision to be taken- more target-oriented, cost-efficient investigation programs, as well as model-based assessment methods are needed (Ruegner et al. 2006). A gap exists within this framework with respect to preliminary assessment methodologies representing the first decision level. To fill this gap, a new system dynamics approach has been developed that represents the system of source- pathway-receptor sequences by means of a mass flux model. The dynamics are governed by the effects of possible remedial actions, which are described as mass flux change over time (Serapiglia et al. 2005). This approach has been implemented in the preliminary evaluation tool CARO-plus (Cost-efficiency Assessment of Remediation Options) that models the effects of potential remedial actions, including tackling the contaminant source and managing the groundwater plume. The model represents the causal

  5. Gouty arthritis: understanding the disease state and management options in primary care.

    PubMed

    Sunkureddi, Prashanth

    2011-09-01

    Acute gouty arthritis is an inflammatory response triggered by the release of monosodium urate crystal deposits into the joint space. The disease is associated with debilitating clinical symptoms and functional impairments as well as adverse economic and quality-of-life burdens. Because gouty arthritis is typically diagnosed and managed in the primary care setting, clinicians require a thorough knowledge of the presenting clinical features, risk factors, differential diagnoses, and treatment options for appropriate management. Although generally effective, the use of currently available therapies to control gouty arthritis is challenging because many medications used to treat comorbidities can exacerbate gouty arthritis and because current agents are associated with a number of adverse events, contraindications, or both. Based on an understanding of the underlying inflammatory pathogenesis of gouty arthritis, several new agents are being developed that may provide improved efficacy.

  6. Management options for women with uterine prolapse interested in uterine preservation.

    PubMed

    Kow, Nathan; Goldman, Howard B; Ridgeway, Beri

    2013-10-01

    A variety of nonsurgical and surgical treatment options exist for the treatment of pelvic organ prolapse. While nonsurgical management is often selected as first-line treatment, many women eventually elect to undergo surgical management. Traditionally, prolapse repair often includes concomitant hysterectomy; however, women increasingly desire uterine preservation for a myriad of reasons. Multiple surgical procedures have been described to correct apical prolapse while preserving the uterus. Many studies suggest similar anatomic and functional outcomes compared to prolapse procedures with concomitant hysterectomy. Potential benefits include decreased operative time and avoidance of hysterectomy-specific complications, although there are several unique issues to consider if the uterus is retained. Surgeons must provide adequate counseling and preoperative evaluation before proceeding with uterine preservation.

  7. Miscellaneous: Uruguay energy supply options study assessing the market for natural gas - executive summary.

    SciTech Connect

    Conzelmann, G.; Veselka, T.; Decision and Information Sciences

    2008-03-04

    Uruguay is in the midst of making critical decisions affecting the design of its future energy supply system. Momentum for change is expected to come from several directions, including recent and foreseeable upgrades and modifications to energy conversion facilities, the importation of natural gas from Argentina, the possibility for a stronger interconnection of regional electricity systems, the country's membership in MERCOSUR, and the potential for energy sector reforms by the Government of Uruguay. The objective of this study is to analyze the effects of several fuel diversification strategies on Uruguay's energy supply system. The analysis pays special attention to fuel substitution trends due to potential imports of natural gas via a gas pipeline from Argentina and increasing electricity ties with neighboring countries. The Government of Uruguay has contracted with Argonne National Laboratory (ANL) to study several energy development scenarios with the support of several Uruguayan institutions. Specifically, ANL was asked to conduct a detailed energy supply and demand analysis, develop energy demand projections based on an analysis of past energy demand patterns with support from local institutions, evaluate the effects of potential natural gas imports and electricity exchanges, and determine the market penetration of natural gas under various scenarios.

  8. A comparison of costs associated with utility management options for dry active waste

    SciTech Connect

    Hornibrook, C.

    1995-12-31

    The economics of low level waste management is receiving more attention today than ever before. This is due to four factors: (1) the increases in the cost of processing of these wastes; (2) increases in the cost of disposal; (3) the addition of storage costs for those without access to disposal; and (4) the increasing competitive nature of the electric generation industry. These pressures are forcing the industry to update it`s evaluation of the mix of processing that will afford it the best long term economics and minimize it`s risks for unforeseen costs. Whether disposal is available or not, all utilities face the same challenge of minimizing the costs associated with the management of these wastes. There are a number of variables that will impact how a utility manages their wastes but the problem is the uncertainty of what will actually happen, i.e., will disposal be available, when and at what cost. Using the EPRI-developed WASTECOST: DAW code, this paper explores a variety of LLW management options available to utilities. Along with providing the costs and benefits, other technical considerations which play an important part in the management of these wastes are also addressed.

  9. Federal and Indian oil and gas royalty valuation and management

    SciTech Connect

    Not Available

    1992-01-01

    This book covers: Royalty management-an M.M.S. overview; Payor/operator/lessee royalty liability; Royalty issues for OCS lessees; Royalty valuation procedures; Gas marketing royalty issues - industry perspective; Gas marketing royalty issues - M.M.S. perspective; Settlements of gas contract disputes Royalty reporting issues; Production reporting issues; Indian royalty issues; Litigation/regulatory updates; Over/under production on federal leases, units, and communitized areas; Audit program; and M.M.S. Reference Handbook.

  10. Bayesian decision analysis for evaluating management options to promote recovery of a depleted salmon population.

    PubMed

    Pestes, Lynsey R; Peterman, Randall M; Bradford, Michael J; Wood, Chris C

    2008-04-01

    The endangered population of sockeye salmon (Oncorhynchus nerka) in Cultus Lake, British Columbia, Canada, migrates through commercial fishing areas along with other, much more abundant sockeye salmon populations, but it is not feasible to selectively harvest only the latter, abundant populations. This situation creates controversial trade-offs between recovery actions and economic revenue. We conducted a Bayesian decision analysis to evaluate options for recovery of Cultus Lake sockeye salmon. We used a stochastic population model that included 2 sources of uncertainty that are often omitted from such analyses: structural uncertainty in the magnitude of a potential Allee effect and implementation uncertainty (the deviation between targets and actual outcomes of management actions). Numerous state-dependent, time-independent management actions meet recovery objectives. These actions prescribe limitations on commercial harvest rates as a function of abundance of Cultus Lake sockeye salmon. We also quantified how much reduction in economic value of commercial harvests of the more abundant sockeye salmon populations would be expected for a given increase in the probability of recovery of the Cultus population. Such results illustrate how Bayesian decision analysis can rank options for dealing with conservation risks and can help inform trade-off discussions among decision makers and among groups that have competing objectives.

  11. Management of frontotemporal dementia: targeting symptom management in such a heterogeneous disease requires a wide range of therapeutic options

    PubMed Central

    Jicha, Gregory A; Nelson, Peter T

    2011-01-01

    SUMMARY There are no US FDA-approved therapies for the management of frontotemporal dementia (FTD). Evidence-based medicine that would support a FDA indication for the treatment of FTD requires large-scale, randomized, double-blind, placebo-controlled trials that do not currently exist. Progress in obtaining approval and therapeutic indications for FTD has been severely hampered by the heterogeneity of clinical and pathological phenotypes seen in various FTD disease states. These issues are often misinterpreted by clinicians, caregivers and patients suggesting that potential treatment options are nonexistent for this devastating disease. This article discusses these issues in the context of recent studies and publications investigating therapeutic options in FTD, and further suggests a rationale for individualized therapy in FTD. Targeting the myriad of symptoms seen in FTD requires recognition of such symptoms that may play primary or secondary roles in the spectrum of deficits that lead to functional disability in FTD, and the availability of a wide range of therapeutic options that may be helpful in alleviating such symptomatology. Fortunately, agents targeting the many cognitive, behavioral, psychiatric and motor symptoms that can be seen in FTD are readily available, having been previously developed and approved for symptomatic benefit in other disease states. In contrast to the widespread belief that beneficial treatments are not available for FTD today, our therapeutic armament is stocked with pharmacological tools that may improve quality of life for those suffering from this devastating and incurable class of degenerative diseases. PMID:21927623

  12. Placing the power of real options analysis into the hands of natural resource managers - taking the next step.

    PubMed

    Nelson, Rohan; Howden, Mark; Hayman, Peter

    2013-07-30

    This paper explores heuristic methods with potential to place the analytical power of real options analysis into the hands of natural resource managers. The complexity of real options analysis has led to patchy or ephemeral adoption even by corporate managers familiar with the financial-market origins of valuation methods. Intuitively accessible methods for estimating the value of real options have begun to evolve, but their evaluation has mostly been limited to researcher-driven applications. In this paper we work closely with Bush Heritage Australia to evaluate the potential of real options analysis to support the intuitive judgement of conservation estate managers in covenanting land with uncertain future conservation value due to climate change. The results show that modified decision trees have potential to estimate the option value of covenanting individual properties while time and ongoing research resolves their future conservation value. Complementing this, Luehrman's option space has potential to assist managers with limited budgets to increase the portfolio value of multiple properties with different conservation attributes.

  13. Non-deposit system option for waste management on small islands.

    PubMed

    Vilms, Monica; Voronova, Viktoria

    2016-08-01

    This paper analyses waste management on small islands (on a global scale these are micro-islands). In the context of the paper, small islands are islands that have an area less than 50 km(2) The study presents an overview of the problems connected with waste transport from islands to the mainland. Waste generation on islands is very much related to tourists. If tourists do not handle waste properly, it will cause problems. Four small Estonian islands in the range of 3-19 km(2) are studied in detail. For these and other small islands, the main problem is the waste produced by tourists, or related to tourists and waste transport to the mainland. Currently, the local municipality has to arrange and finance waste transport. In fact, and based on the polluter-pays principle, the tourists should bear the cost of waste management. There are different tax options available in order to collect the money from tourists - waste tax, harbour tax, tourist tax, donations, environmental tax and others. The study results revealed that the best possible solution for Estonian islands may be a non-deposit system - including an additional charge on ferry ticket prices. The extra money should cover the costs of waste management and waste shipping. The tourists arriving in their own boats should pay a harbour tax, which includes a waste tax to compensate for the cost of waste management.

  14. Crop Production under Drought and Heat Stress: Plant Responses and Management Options.

    PubMed

    Fahad, Shah; Bajwa, Ali A; Nazir, Usman; Anjum, Shakeel A; Farooq, Ayesha; Zohaib, Ali; Sadia, Sehrish; Nasim, Wajid; Adkins, Steve; Saud, Shah; Ihsan, Muhammad Z; Alharby, Hesham; Wu, Chao; Wang, Depeng; Huang, Jianliang

    2017-01-01

    Abiotic stresses are one of the major constraints to crop production and food security worldwide. The situation has aggravated due to the drastic and rapid changes in global climate. Heat and drought are undoubtedly the two most important stresses having huge impact on growth and productivity of the crops. It is very important to understand the physiological, biochemical, and ecological interventions related to these stresses for better management. A wide range of plant responses to these stresses could be generalized into morphological, physiological, and biochemical responses. Interestingly, this review provides a detailed account of plant responses to heat and drought stresses with special focus on highlighting the commonalities and differences. Crop growth and yields are negatively affected by sub-optimal water supply and abnormal temperatures due to physical damages, physiological disruptions, and biochemical changes. Both these stresses have multi-lateral impacts and therefore, complex in mechanistic action. A better understanding of plant responses to these stresses has pragmatic implication for remedies and management. A comprehensive account of conventional as well as modern approaches to deal with heat and drought stresses have also been presented here. A side-by-side critical discussion on salient responses and management strategies for these two important abiotic stresses provides a unique insight into the phenomena. A holistic approach taking into account the different management options to deal with heat and drought stress simultaneously could be a win-win approach in future.

  15. Crop Production under Drought and Heat Stress: Plant Responses and Management Options

    PubMed Central

    Fahad, Shah; Bajwa, Ali A.; Nazir, Usman; Anjum, Shakeel A.; Farooq, Ayesha; Zohaib, Ali; Sadia, Sehrish; Nasim, Wajid; Adkins, Steve; Saud, Shah; Ihsan, Muhammad Z.; Alharby, Hesham; Wu, Chao; Wang, Depeng; Huang, Jianliang

    2017-01-01

    Abiotic stresses are one of the major constraints to crop production and food security worldwide. The situation has aggravated due to the drastic and rapid changes in global climate. Heat and drought are undoubtedly the two most important stresses having huge impact on growth and productivity of the crops. It is very important to understand the physiological, biochemical, and ecological interventions related to these stresses for better management. A wide range of plant responses to these stresses could be generalized into morphological, physiological, and biochemical responses. Interestingly, this review provides a detailed account of plant responses to heat and drought stresses with special focus on highlighting the commonalities and differences. Crop growth and yields are negatively affected by sub-optimal water supply and abnormal temperatures due to physical damages, physiological disruptions, and biochemical changes. Both these stresses have multi-lateral impacts and therefore, complex in mechanistic action. A better understanding of plant responses to these stresses has pragmatic implication for remedies and management. A comprehensive account of conventional as well as modern approaches to deal with heat and drought stresses have also been presented here. A side-by-side critical discussion on salient responses and management strategies for these two important abiotic stresses provides a unique insight into the phenomena. A holistic approach taking into account the different management options to deal with heat and drought stress simultaneously could be a win-win approach in future. PMID:28706531

  16. NOHIMS (Naval Occupational Health Information Management System) Users’ Guide: Introduction and OHS (Occupational Health System) Options.

    DTIC Science & Technology

    1984-06-26

    irred. 2’. 4’.. Nava Het esarch CenterU 0i P. 0. Bx 8512 San iego Caiforia 2138917 P. W. SUMMARY The Naval Occupational Health information Management System (WHIMS...Introduction and OHS Options I. INTRODUCTION TO THE NAVY OCCUPATIONAL HEALTH INFORMATION MANAGEMENT SYSTEM (NOHIMS) The objective of NOHIMS is to provide an

  17. Fuels and fire in land-management planning: Part 3. Costs and losses for management options.

    Treesearch

    Wayne G. Maxwell; David V. Sandberg; Franklin R. Ward

    1983-01-01

    An approach is illustrated for computing expected costs of fire protection; fuel treatment; fire suppression; damage values; and percent of area lost to wildfire for a management or rotation cycle. Input is derived from Part 1, a method for collecting and classifying the total fuel complex, and Part 2, a method for appraising and rating probable fire behavior. This...

  18. Tadalafil - a therapeutic option in the management of BPH-LUTS.

    PubMed

    Carson, C C; Rosenberg, M; Kissel, J; Wong, D G

    2014-01-01

    Men with signs of benign prostatic hyperplasia (BPH) may experience lower urinary tract symptoms (LUTS) such as urinary frequency, urgency, intermittence, nocturia, straining, incomplete emptying or a weak urinary stream. The effective management of LUTS suggestive of BPH (BPH-LUTS) requires careful consideration of several factors, including the severity of a patient's symptoms, concurrent or other coexisting medical conditions, the ability to improve symptoms and impact quality of life (QOL), as well as the potential side effects of available treatment options. Several clinical studies have assessed phosphodiesterase type 5 (PDE5) inhibitors in reducing LUTS; however, tadalafil is the only PDE5 inhibitor approved for the treatment of signs and symptoms of BPH, as well as in men with both erectile dysfunction (ED) and the signs and symptoms of BPH. This review examined articles that assessed tadalafil in patients with signs and symptoms of BPH, with or without erectile dysfunction (ED), which led to regulatory approval in the United States and Europe. In dose-ranging and confirmatory studies, results demonstrate that tadalafil significantly improved total International Prostate Symptom Score (IPSS) following 12 weeks of treatment with once daily tadalafil 5 mg. Statistically significant improvements in Benign Prostatic Hyperplasia Impact Index (BII), IPSS subscores, IPSS QOL and International Index of Erectile Function (IIEF) were also observed. Improvement in urinary symptoms occurred regardless of age, previous treatment with an α1 -adrenergic blocker, BPH-LUTS severity at baseline or ED status. While tadalafil is most frequently recognised as a standard treatment option for men with ED, it also represents a well-tolerated and effective treatment option in men with moderate to severe BPH-LUTS. © 2013 John Wiley & Sons Ltd.

  19. A comparison of benefit and economic value between two sound therapy tinnitus management options.

    PubMed

    Newman, Craig W; Sandridge, Sharon A

    2012-02-01

    Sound therapy coupled with appropriate counseling has gained widespread acceptance in the audiological management of tinnitus. For many years, ear level sound generators (SGs) have been used to provide masking relief and to promote tinnitus habituation. More recently, an alternative treatment device was introduced, the Neuromonics Tinnitus Treatment (NTT), which employs spectrally-modified music in an acoustic desensitization approach in order to help patients overcome the disturbing consequences of tinnitus. It is unknown, however, if one treatment plan is more efficacious and cost-effective in comparison to the other. In today's economic climate, it has become critical that clinicians justify the value of tinnitus treatment devices in relation to observed benefit. To determine perceived benefit from, and economic value associated with, two forms of sound therapy, namely, SGs and NTT. Retrospective between-subject clinical study. A sample of convenience comprised of 56 patients drawn from the Tinnitus Management Clinic at the Cleveland Clinic participated. Twenty-three patients selected SGs, and 33 patients selected NTT as their preferred sound therapy treatment option. Sound therapy benefit was quantified using the Tinnitus Handicap Inventory (THI). The questionnaire was administered before and 6 mo after initiation of tinnitus treatment. Prior to device fitting, all patients participated in a 1.5 hr group education session about tinnitus and its management. Economic value comparisons between sound therapy options were made using a cost-effectiveness analysis (CEA) and cost-utility analysis (CUA). THI scores indicated a significant improvement (p < 0.001) in tinnitus reduction for both treatment types between a pre- and 6 mo postfitting interval, yet there were no differences (p > 0.05) between the treatment alternatives at baseline or 6 mo postfitting. The magnitude of improvement for both SGs and NTT was dependent on initial perceived tinnitus handicap. Based

  20. Quantifying greenhouse gas sources and sinks in managed wetland systems

    Treesearch

    Stephen M Ogle; Patrick Hunt; Carl Trettin

    2014-01-01

    This chapter provides methodologies and guidance for reporting greenhouse gas (GHG) emissions and sinks at the entity scale for managed wetland systems. More specifically, it focuses on methods for managed palustrine wetlands.1 Section 4.1 provides an overview of wetland systems and resulting GHG emissions, system boundaries and temporal scale, a summary of the...

  1. Endoscopic options in the management of isolated fourth ventricles. Case report.

    PubMed

    Mohanty, Aaron

    2005-07-01

    Isolation of the fourth ventricle is occasionally observed after shunt treatment of the lateral ventricles for obstructive panventricular hydrocephalus. Of the various surgical options currently available, placement of shunts in the fourth ventricle has remained as the mainstay of treatment. These shunts are difficult to place, however, and have been associated with higher complication rates. With the advent of neuroendoscopic techniques, the treatment of this condition has shifted from shunt therapy to endoscopic third ventriculostomy (ETV) and aqueductal reconstruction. The authors report on four patients (age range 11-28 years old) who had undergone fourth ventricular shunt placement earlier in childhood to treat panventricular hydrocephalus and who presented with an isolated fourth ventricle (IFV) during the follow-up period. All patients underwent magnetic resonance imaging to identify the extent of the stenosed aqueduct. Symptoms improved in all and the size of the fourth ventricle decreased as well, indicating a functioning stent. The ETV failed in two patients, however, and they required placement of a ventriculoperitoneal (VP) shunt. Aqueductal stenting with an ETV or a VP shunt is a promising option in the management of IFVs.

  2. Capturing and explaining preference heterogeneity for wetland management options in the Kilombero Valley, Tanzania.

    PubMed

    Speelman, Stijn; Mombo, Felister; Vandermeulen, Valerie; Phillip, Damas; Van Huylenbroeck, Guido

    2015-01-01

    Wetland degradation has recently received considerable research attention. Although wetlands are valuable ecosystems, their actual value is difficult to measure because the services they provide often do not have market values. The current study seeks to investigate the preferences for wetland management options in the Kilombero Valley, central Tanzania using choice modeling. The results show that both respondents from the Kilombero Valley and Morogoro Municipality desire improvements in the condition of the wetlands. This indicates that the ongoing degradation is not socially optimal. A second finding is that the preferences for wetland conservation are heterogeneous and can be linked to livelihood characteristics. Communities living in the area, for example, are highly dependent on the wetland for their livelihood and would be impacted by conservation measures. Therefore, in order to reduce the pressure on wetlands, it is necessary and imperative to explore the options for alternative income-generating activities or to focus, for example, on technologies to improve efficiency and effectiveness in crop production.

  3. Capturing and Explaining Preference Heterogeneity for Wetland Management Options in the Kilombero Valley, Tanzania

    NASA Astrophysics Data System (ADS)

    Speelman, Stijn; Mombo, Felister; Vandermeulen, Valerie; Phillip, Damas; Van Huylenbroeck, Guido

    2015-01-01

    Wetland degradation has recently received considerable research attention. Although wetlands are valuable ecosystems, their actual value is difficult to measure because the services they provide often do not have market values. The current study seeks to investigate the preferences for wetland management options in the Kilombero Valley, central Tanzania using choice modeling. The results show that both respondents from the Kilombero Valley and Morogoro Municipality desire improvements in the condition of the wetlands. This indicates that the ongoing degradation is not socially optimal. A second finding is that the preferences for wetland conservation are heterogeneous and can be linked to livelihood characteristics. Communities living in the area, for example, are highly dependent on the wetland for their livelihood and would be impacted by conservation measures. Therefore, in order to reduce the pressure on wetlands, it is necessary and imperative to explore the options for alternative income-generating activities or to focus, for example, on technologies to improve efficiency and effectiveness in crop production.

  4. Pharmacologic options in the management of upper gastrointestinal bleeding: focus on the elderly.

    PubMed

    Kyaw, Moe Htet; Chan, Francis Ka Leung

    2014-05-01

    Despite the major advances in the treatment of peptic ulcer disease, its complication in the elderly has increased. This is because of the increasing use of nonsteroidal anti-inflammatory drugs, and the high prevalence of Helicobacter pylori infection. The presentation of peptic ulcers in the elderly patients can be subtle, and late presentation with upper gastrointestinal bleeding of peptic ulcers is not uncommon in the elderly population. The aim of this article is to review the current treatment options for upper gastrointestinal bleeding, and to discuss the place of drug therapy in both the acute and ongoing management of individual patients. Its focus will be on the benefits and risks of each option in the elderly. There is significant evidence to suggest that anti-secretory medications are useful in the treatment of peptic ulcers and associated complications in the elderly. Although a large number of studies have reported potential adverse effects of proton pump inhibitors, this evidence comes from retrospective observational studies, and such reports should be regarded with caution, and randomized controlled studies are required to confirm or refute these results. Nonetheless, it will be important to practice the appropriate use of acid suppression therapy, and identify which patients will gain maximum benefit from proton pump inhibitor therapy.

  5. A review of the current management and treatment options for superficial venous insufficiency.

    PubMed

    Zhan, Henry T; Bush, Ruth L

    2014-10-01

    The recognition of lower extremity venous disease as a significant cause of morbidity and lower quality of life, afflicting up to 25 % of Western populations, has led to rapid and drastic improvements in treatment options as well as an increasing awareness of the disease. Superficial venous disease, a frequent medical problem encountered in clinical practices, is now a common reason for referral to providers offering a spectrum of interventions. Venous guidelines have been set forth by the American Venous Forum and Society for Vascular Surgery covering simple spider veins to chronic venous ulcerations. (Gloviczki et al. J Vas Surg 53:2S-48S, 2011) This review provides an overview of the modern management of varicose veins and venous insufficiency.

  6. Management options for children with attention-deficit/hyperactivity disorder: a regional perspective on value.

    PubMed

    Ollendorf, Daniel A; Migliaccio-Walle, Kristen; Colby, Jennifer A; Pearson, Steven D

    2013-05-01

    Use of comparative effectiveness information in local healthcare decisions can be confounded by variations in practice, barriers to access and population demographics. The New England Comparative Effectiveness Public Advisory Council was convened as a public deliberative panel that considers evidence on the comparative clinical effectiveness and comparative value of a variety of therapeutic interventions. The council is tasked with making summary judgments on the evidence and recommendations for applying the evidence in medical and drug coverage policy, as well as initiating educational efforts for patients and clinicians. The New England Comparative Effectiveness Public Advisory Council met in June 2012 to discuss management options for attention-deficit/hyperactivity disorder, guided by a recent comparative effectiveness review from the Agency for Healthcare Research and Quality and supplementary economic analyses conducted by the Institute for Clinical and Economic Review. This article summarizes the deliberations and reflects on lessons learned regarding use of region-specific economic analyses to guide decision-making.

  7. A new therapeutic option for postoperative pain management with oxycodone HCI injection

    PubMed Central

    2016-01-01

    Fentanyl is the most commonly used opioid analgesic in intravenous patient-controlled analgesia (IV PCA) in Korea. IV oxycodone was approved for postoperative IV PCA by the Ministry of Food and Drug Safety of Korea in 2013. The approved dosage regimen for postoperative pain relief with IV oxycodone is IV bolus loading of 2 mg followed by PCA composed of demand boluses of 1 mg and no background infusion with an oxycodone concentration of 1 mg/ml. However, a simulation study indicated that the minimum effective analgesic concentration (MEAC, as indicated by relief of pain by administering rescue analgesics) of oxycodone was reached most quickly with a higher loading dose of 0.1 mg/kg and IV PCA with background infusion. Oxycodone is a therapeutic option as an analgesic for postoperative pain management. It is necessary to reduce the analgesic dose of oxycodone in elderly patients because metabolic clearance decreases with age. PMID:27274364

  8. Pain management following spinal surgeries: An appraisal of the available options

    PubMed Central

    Bajwa, Sukhminder Jit Singh; Haldar, Rudrashish

    2015-01-01

    Spinal procedures are generally associated with intense pain in the postoperative period, especially for the initial few days. Adequate pain management in this period has been seen to correlate well with improved functional outcome, early ambulation, early discharge, and preventing the development of chronic pain. A diverse array of pharmacological options exists for the effective amelioration of post spinal surgery pain. Each of these drugs possesses inherent advantages and disadvantages which restricts their universal applicability. Therefore, combination therapy or multimodal analgesia for proper control of pain appears as the best approach in this regard. The current manuscript discussed the pathophysiology of postsurgical pain including its nature, the various tools for assessment, and the various pharmacological agents (both conventional and upcoming) available at our disposal to respond to post spinal surgery pain. PMID:26288544

  9. [Strategic options for the relationship-management between hospital and statutory health insurance - an explorative study].

    PubMed

    Pick, V; Rossbach, C

    2010-05-01

    This investigation examines the specific demands of statutory health insurance organisations on hospitals. The need for such an analysis is determined by the increasing competition in the German health care system in the past years. Hospitals are confronted with growing and perhaps conflictual demands on the hospital's stakeholders. An empirical investigation should provide first insight into the widely unexplored relationship between statutory health insurances and hospitals. For this reason, 23 explorative interviews with managers of hospitals and statutory health insurance organisations were conducted. The resulting demands are structured and assigned to identified areas of demand. Aspects which are important for statutory health insurance organisations and aspects that hospitals assume are important were compared. Thus, an existing gap was identified. Furthermore, options for statutory health insurance (dis-)satisfaction are shown. Such an analysis is essential for hospitals to develop and maintain a positive relationship to the statutory health insurances and to achieve competitive advantages. Georg Thieme Verlag KG Stuttgart, New York.

  10. Pharmacologic and nonpharmacologic options for the management of HIV infection during pregnancy

    PubMed Central

    Zorrilla, Carmen D; Tamayo-Agrait, Vivian

    2009-01-01

    Over the past decade, significant advances have been made in the treatment of HIV-1 infection using both pharmacologic and nonpharmacologic strategies to prevent mother-to-child transmission (MTCT). Optimal prevention of the MTCT of HIV requires antiretroviral drugs (ARV) during pregnancy, during labor, and to the infant. ARVs reduce viral replication, lowering maternal plasma viral load and thus the likelihood of MTCT. Postexposure prophylaxis of ARV agents in newborns protect against infection following potential exposure to maternal HIV during birth. In general, the choice of an ARV for treatment of HIV-infected women during pregnancy is complicated by the need to consider the effectiveness of the therapy for the maternal disease as well as the teratogenic or teratotoxic potential of these drugs. Clinicians managing HIV in pregnancy need to discuss the potential risks and benefits of available therapy options so that mothers can make informed decisions in choosing the best treatment regimen for themselves and for their children. PMID:22096378

  11. Contraception in women with epilepsy: pharmacokinetic interactions, contraceptive options, and management.

    PubMed

    Dutton, Caryn; Foldvary-Schaefer, Nancy

    2008-01-01

    Contraceptive counseling is a critical component of the management of the female patient with epilepsy because of the increased risk of pregnancy associated with epilepsy and the multitude of interactions between antiepileptic drugs (AEDs) and hormonal contraception. Steroid hormones and many of the AEDs are substrates for the cytochrome P450 enzyme system, in particular, the 3A4 isoenzyme. As a result, concomitant use of hormonal contraceptives and AEDs may pose a risk for unexpected pregnancy, seizures, and drug-related adverse effects. The risk of combined oral contraceptive (COC) failure is slightly increased in the presence of cytochrome P450 3A4 enzyme-inducing AEDs. Several AEDs induce the production of sex hormone binding globulin (SHBG) to which the progestins are tightly bound, resulting in lower concentrations of free progestin that may also lead to COC failure. There is no increase in the risk of COC failure in women taking nonenzyme-inducing AEDs. Oral contraceptives significantly increase the metabolism of lamotrigine, posing a risk of seizures when hormonal agents are initiated and/or toxicity during pill-free weeks. There is no evidence that COCs increase seizures in women with epilepsy. While higher dose COCs are one contraceptive option for women on enzyme-inducing AEDs, a variety of other options are available. Injectable contraception (depot medroxyprogesterone acetate) appears effective with AED use, but the potential for bone mineral density loss is a concern. Intrauterine devices (IUDs) and barrier methods do not rely on hormonal components for contraceptive efficacy, and are therefore appropriate to recommend for use in women using enzyme-inducing medications. This chapter reviews the evidence regarding the pharmacokinetic interaction between AEDs and oral contraceptive hormones, the known or potential interactions with alternative contraceptive methods, and provides practical advice for management of contraceptive needs in reproductive

  12. Greenhouse gas emission mitigation relevant to changes in municipal solid waste management system.

    PubMed

    Pikoń, Krzysztof; Gaska, Krzysztof

    2010-07-01

    Standard methods for assessing the environmental impact of waste management systems are needed to underpin the development and implementation of sustainable waste management practice. Life cycle assessment (LCA) is a tool for comprehensively ensuring such assessment and covers all impacts associated with waste management. LCA is often called "from cradle to grave" analysis. This paper integrates information on the greenhouse gas (GHG) implications of various management options for some of the most common materials in municipal solid waste (MSW). Different waste treatment options for MSW were studied in a system analysis. Different combinations of recycling (cardboard, plastics, glass, metals), biological treatment (composting), and incineration as well as land-filling were studied. The index of environmental burden in the global warming impact category was calculated. The calculations are based on LCA methodology. All emissions taking place in the whole life cycle system were taken into account. The analysis included "own emissions," or emissions from the system at all stages of the life cycle, and "linked emissions," or emissions from other sources linked with the system in an indirect way. Avoided emissions caused by recycling and energy recovery were included in the analysis. Displaced emissions of GHGs originate from the substitution of energy or materials derived from waste for alternative sources. The complex analysis of the environmental impact of municipal waste management systems before and after application of changes in MSW systems according to European Union regulations is presented in this paper. The evaluation is made for MSW systems in Poland.

  13. Technological and policy options for mitigating greenhouse gas emissions from mobile sources

    SciTech Connect

    Saricks, C.L.

    1990-01-01

    This paper presents issues and explores options for reducing emissions of carbonaceous pollutants from mobile sources. It discusses first what can be expected from current and proposed emission control system designed chiefly to reduce the output of regulated pollutants, then explores opportunities for incremental control of emissions of carbon (bound in gaseous form) that appear at this time to have good potential for success. The presentation of current and anticipated control technologies is organized by vehicle type, considering, in turn, passenger vehicles and light-duty trucks, medium- and heavy-duty vehicles, and non-highway vehicular modes. The discussion of incremental control opportunities focuses first on hardware and (existing) fuels modification for reduced emissions and improved fuel efficiency, then turns to advanced vehicular technologies and fuels, new refrigerants (to replace CFCs, which, in addition to being implicated in the destruction of stratospheric ozone, are molecule for molecule more potent than carbon dioxide as greenhouse gases), and in-use emissions testing and travel reduction strategies. Finally, opportunities for continuation of the current (net) downward trend in fuel consumption by most non-highway transportation activities are described. The paper concludes that evolutionary developments in most transportation activities-- developments driven in large measure by simple economics--could be at least as effective in mitigating the contribution of (domestic) mobile sources to greenhouse warming'' as any specific revolutionary change. 41 refs.

  14. Offsite commercial disposal of oil and gas exploration and production waste :availability, options, and cost.

    SciTech Connect

    Puder, M. G.; Veil, J. A.

    2006-09-05

    A survey conducted in 1995 by the American Petroleum Institute (API) found that the U.S. exploration and production (E&P) segment of the oil and gas industry generated more than 149 million bbl of drilling wastes, almost 18 billion bbl of produced water, and 21 million bbl of associated wastes. The results of that survey, published in 2000, suggested that 3% of drilling wastes, less than 0.5% of produced water, and 15% of associated wastes are sent to offsite commercial facilities for disposal. Argonne National Laboratory (Argonne) collected information on commercial E&P waste disposal companies in different states in 1997. While the information is nearly a decade old, the report has proved useful. In 2005, Argonne began collecting current information to update and expand the data. This report describes the new 2005-2006 database and focuses on the availability of offsite commercial disposal companies, the prevailing disposal methods, and estimated disposal costs. The data were collected in two phases. In the first phase, state oil and gas regulatory officials in 31 states were contacted to determine whether their agency maintained a list of permitted commercial disposal companies dedicated to oil. In the second stage, individual commercial disposal companies were interviewed to determine disposal methods and costs. The availability of offsite commercial disposal companies and facilities falls into three categories. The states with high oil and gas production typically have a dedicated network of offsite commercial disposal companies and facilities in place. In other states, such an infrastructure does not exist and very often, commercial disposal companies focus on produced water services. About half of the states do not have any industry-specific offsite commercial disposal infrastructure. In those states, operators take their wastes to local municipal landfills if permitted or haul the wastes to other states. This report provides state-by-state summaries of the

  15. A decision methodology for the evaluation of mixed low-level radioactive waste management options for DOE sites

    SciTech Connect

    Bassi, J.; Abashian, M.S.; Chakraborti, S.; Devarakonda, M.; Djordjevic, S.M.

    1993-03-01

    Currently, many DOE sites are developing site-specific solutions to manage their mixed low-level wastes. These site-specific MLLW programs often result in duplication of efforts between the different sites, and consequently, inefficient use of DOE system resources. A nationally integrated program for MLLW eliminates unnecessary duplication of effort, but requires a comprehensive analysis of waste management options to ensure that all site issues are addressed. A methodology for comprehensive analysis of the complete DOE MLLW system is being developed by DOE-HQ to establish an integrated and standardized solution for managing MLLW. To be effective, the comprehensive systems analysis must consider all aspects of MLLW management from cradle-to-grave (i.e. from MLLW generation to disposal). The results of the analysis will include recommendations for alternative management options for the complete DOE MLLW system based on various components such as effectiveness, cost, health and safety risks, and the probability of regulatory acceptance for an option. Because of the diverse nature of these various components and the associated difficulties in comparing between them, a decision methodology is being developed that will integrate the above components into a single evaluation scheme for performing relative comparisons between different MLLW management options. The remainder of this paper provides an overview of the roles and responsibilities of the various participants of the DOE MLLW Program, and discusses in detail the components involved in the development of the decision methodology for a comprehensive systems analysis.

  16. MELTER OFF-GAS FLAMMABILITY ASSESSMENT FOR DWPF ALTERNATE REDUCTANT FLOWSHEET OPTIONS

    SciTech Connect

    Choi, A.

    2011-07-08

    Glycolic acid and sugar are being considered as potential candidates to substitute for much of the formic acid currently being added to the Defense Waste Processing Facility (DWPF) melter feed as a reductant. A series of small-scale melter tests were conducted at the Vitreous State Laboratory (VSL) in January 2011 to collect necessary data for the assessment of the impact of these alternate reductants on the melter off-gas flammability. The DM10 melter with a 0.021 m{sup 2} melt surface area was run with three different feeds which were prepared at SRNL based on; (1) the baseline formic/nitric acid flowsheet, (2) glycolic/formic/nitric acid flowsheet, and (3) sugar/formic/nitric acid flowsheet - these feeds will be called the baseline, glycolic, and sugar flowsheet feeds, respectively, hereafter. The actual addition of sugar to the sugar flowsheet feed was made at VSL before it was fed to the melter. For each feed, the DM10 was run under both bubbled (with argon) and non-bubbled conditions at varying melter vapor space temperatures. The goal was to lower its vapor space temperature from nominal 500 C to less than 300 C at 50 C increments and maintain steady state at each temperature at least for one hour, preferentially for two hours, while collecting off-gas data including CO, CO{sub 2}, and H{sub 2} concentrations. Just a few hours into the first test with the baseline feed, it was discovered that the DM10 vapor space temperature would not readily fall below 350 C simply by ramping up the feed rate as the test plan called for. To overcome this, ambient air was introduced directly into the vapor space through a dilution air damper in addition to the natural air inleakage occurring at the operating melter pressure of -1 inch H{sub 2}O. A detailed description of the DM10 run along with all the data taken is given in the report issued by VSL. The SRNL personnel have analyzed the DM10 data and identified 25 steady state periods lasting from 32 to 92 minutes for all

  17. Management of a complex cavern storage facility for natural gas

    SciTech Connect

    1998-04-01

    The Epe cavern storage facility operated by Ruhrgas AG has developed into one of the largest gas cavern storage facilities in the world. Currently, there are 32 caverns and 18 more are planned in the future. Working gas volume will increase from approximately 1.5 {times} 10{sup 9} to 2 {times} 10{sup 9} m{sup 3}. The stratified salt deposit containing the caverns has a surface area of approximately 7 km{sup 2} and is 250 m thick at the edge and 400 m thick in the center. Caverns are leached by a company that uses the recovered brine in the chlorine industry. Cavern dimensions are determined before leaching. The behavior of each cavern, as well as the thermodynamic properties of natural gas must be considered in cavern management. The full-length paper presents the components of a complex management system covering the design, construction, and operation of the Epe gas-storage caverns.

  18. Options for diabetes management in sub-Saharan Africa with an electronic medical record system.

    PubMed

    Kouematchoua Tchuitcheu, G; Rienhoff, O

    2011-01-01

    An increase of diabetes prevalence of up to 80% is predicted in sub-Saharan Africa (SSA) by 2025 exceeding the worldwide 55%. Mortality rates of diabetes and HIV/AIDS are similar. Diabetes shares several common factors with HIV/AIDS and multidrug-resistant tuberculosis (MDR-TB). The latter two health problems have been efficiently managed by an open source electronic medical record system (EMRS) in Latin America. Therefore a similar solution for diabetes in SSA could be extremely helpful. The aim was to design and validate a conceptual model for an EMRS to improve diabetes management in SSA making use of the HIV and TB experience. A review of the literature addressed diabetes care and management in SSA as well as existing examples of information and communication technology (ICT) use in SSA. Based on a need assessment conducted in SSA a conceptual model based on the traditionally structured healthcare system in SSA was mapped into a three-layer structure. Application modules were derived and a demonstrator programmed based on an open source EMRS. Then the approach was validated by SSA experts. A conceptual model could be specified and validated which enhances a problem-oriented approach to diabetes management processes. The prototyp EMRS demonstrates options for a patient portal and simulation tools for education of health professional and patients in SSA. It is possible to find IT solutions for diabetes care in SSA which follow the same efficiency concepts as HIV or TB modules in Latin America. The local efficiency and sustainability of the solution will, however, depend on training and changes in work behavior.

  19. Management of multiple sclerosis in adolescents – current treatment options and related adherence issues

    PubMed Central

    Mah, Jean K; Thannhauser, Jennifer E

    2010-01-01

    Multiple sclerosis (MS) is a progressive inflammatory demyelinating disorder of the central nervous system that is increasingly recognized in children and adolescents. This realization comes with additional concerns about existing therapeutic options and the impact of the disease on health-related outcomes of adolescents with MS. This five-part review provides an update on management strategies relevant to the pediatric MS population. The first section gives an overview on the epidemiology and natural history of early onset MS. The second section outlines currently available MS treatments, including medications during acute relapses and long-term immunomodulatory therapies. The third section highlights adherence issues pertaining to MS, including the challenges uniquely faced by adolescents. The fourth section provides a summary of research into quality of life and psychosocial consequences of pediatric onset MS. Attention is drawn to the grief experience of affected adolescents and the importance of peer relationships. Finally, the family resilience framework is presented as a conceptual model to facilitate optimal adaptation of adolescents with MS. Healthcare professionals can promote resilience and treatment adherence by ensuring that these individuals and their families are sufficiently informed about available MS treatments, providing instrumental support for managing potential medication side effects, and addressing age-appropriate developmental needs. PMID:24600259

  20. The outcomes of 31 cases of trisomy 13 diagnosed in utero with various management options.

    PubMed

    Takahashi, Ken; Sasaki, Aiko; Wada, Seiji; Wada, Yuka; Tsukamoto, Keiko; Kosaki, Rika; Ito, Yushi; Sago, Haruhiko

    2017-04-01

    There are few reports on the prognosis of prenatally diagnosed trisomy 13 in relation to postnatal management. The aim of this study was to report on the prenatal and postnatal outcomes and postnatal management of trisomy 13 fetuses that were prenatally diagnosed at our center between 2003 and 2015. The data were retrospectively reviewed from medical records. Of the 31 cases of trisomy 13, 12 patients were diagnosed before 22 weeks of gestation, and 19 were diagnosed at or after 22 weeks of gestation. Nine families opted for termination of the pregnancy, 14 fetuses died, and 8 were born alive. Aggressive treatment was requested in two of the live births, with one patient achieving long-term survival (7 years). The other died during infancy (Day 61). One out of four who received palliative treatment is alive at two years of age with only nutrition supplementation. These three patients who achieved neonatal survival had few structural anomalies. Fetal death and early neonatal death are common in trisomy 13; however, fetuses that receive medical treatment for cases without major ultrasound abnormalities may achieve neonatal survival. Therefore, it is useful to provide comprehensive information, including precise ultrasound findings and treatment options, to parents with trisomy 13 fetuses during genetic counseling.

  1. Lethal trap trees: a potential option for emerald ash borer (Agrilus planipennis Fairmaire) management.

    PubMed

    McCullough, Deborah G; Poland, Therese M; Lewis, Phillip A

    2016-05-01

    Economic and ecological impacts of ash (Fraxinus spp.) mortality resulting from emerald ash borer (EAB) (Agrilus planipennis Fairmaire) invasion are severe in forested, residential and urban areas. Management options include girdling ash trees to attract ovipositing adult beetles and then destroying infested trees before larvae develop or protecting ash with a highly effective, systemic emamectin benzoate insecticide. Injecting this insecticide and then girdling injected trees a few weeks later could effectively create lethal trap trees, similar to a bait-and-kill tactic, if girdling does not interfere with insecticide translocation. We compared EAB larval densities on girdled trees, trees injected with the emamectin benzoate insecticide, trees injected with the insecticide and then girdled 18-21 days later and untreated controls at multiple sites. Pretreatment larval densities did not differ among treatments. Current-year larval densities were higher on girdled and control trees than on any trees treated with insecticide at all sites. Foliar residue analysis and adult EAB bioassays showed that girdling trees after insecticide injections did not reduce insecticide translocation. Girdling ash trees to attract adult EAB did not reduce efficacy of emamectin benzoate trunk injections applied ≥ 18 days earlier and could potentially be used in integrated management programs to slow EAB population growth. © 2015 Society of Chemical Industry.

  2. Preeclampsia – Aetiology, Current Diagnostics and Clinical Management, New Therapy Options and Future Perspectives

    PubMed Central

    Tallarek, A.-C.; Huppertz, B.; Stepan, H.

    2012-01-01

    Preeclampsia is a multisystem disease for which the exact causes have not yet been sufficiently clarified. However, in the past few years it has become clear that a placental imbalance between angiogenic and anti-angiogenic proteins is the decisive pathogenetic factor for the occurrence of preeclampsia. With the possibility to measure these angiogenic factors (sFlt-1/PlGF ratio) in maternal blood full new diagnostic possibilities have been opened that enable the certain diagnosis or exclusion of the diseases as well as a short-term prognosis to be made. In secondary prevention the current data situation for ASA confirms a moderate but measurable utility. The management concept depends on gestational age. In the case of early clinical manifestations (< 34th week of pregnancy) the clinical management in a perinatal centre remains unchanged with foeto-maternal monitoring and induction of pulmonary maturation, symptomatic therapy under careful blood pressure lowering and determination of the optimal delivery time. A balance must be made here between foetal immaturity and maternal risks upon prolongations. The pathomechanism of anti-angiogenic overload with sFlt-1 provides a starting point for first therapeutic interventions. The present article gives an overview of current diagnostic options and presents possible future therapeutic perspectives for discussion. PMID:26640284

  3. New treatment options in the management of hypertension: appraising the potential role of azilsartan medoxomil

    PubMed Central

    Volpe, Massimo; Savoia, Carmine

    2012-01-01

    Renin–angiotensin–system (RAS) activation plays a key role in the development of hypertension and cardiovascular disease. Drugs that antagonize the RAS (angiotensin-converting enzyme [ACE] inhibitors and angiotensin receptor blockers [ARBs]) have proven clinical efficacy in reducing blood pressure values and cardiovascular morbidity and mortality. ACE inhibitors partially inhibit plasma ACE, and angiotensin II generation. Thus, ARBs, which block selectively type 1 angiotensin II receptor (AT1R), have been developed and used in the clinical management of hypertension and cardiovascular disease. Experimental and clinical trials with ARBs indicate that this class of drug represents an effective, safe and well tolerated therapeutic option for the prevention and care of hypertension, even though there is no proven superiority as compared to ACE inhibitors except for the better tolerability. Most ARBs may not completely inhibit the AT1R at the approved clinical doses. Azilsartan medoxomil is a newly approved ARB for the management of hypertension. This ARB induces a potent and long-lasting antihypertensive effect and may have cardioprotective properties. This article reviews the current evidence on the clinical effectiveness of azilsartan in hypertension. PMID:22457601

  4. Fracture Dislocation of Shoulder with Brachial Plexus Palsy: A Case Report and Review of Management Options.

    PubMed

    Rathore, Sameer; Kasha, Srinivas; Yeggana, Srinivas

    2017-01-01

    Injuries causing fracture dislocation of shoulder and brachial plexus palsy are extremely rare. As per authors' knowledge, three part fracture of proximal humerus with shoulder dislocation and brachial plexus palsy has not been reported in the literature. A 53 year old female sustained a three part fracture of right proximal humerus along with dislocation of shoulder joint and brachial plexus palsy following a fall from a flight of stairs. Fracture was managed by plating of proximal humerus and brachial palsy was followed up with electrodiagnostic studies and regular physiotherapy. Fracture united by three months and patient had near complete recovery of brachial palsy. Authors have discussed diagnostic modalities and management options in the article. Clinician should always look for clinical evidence of brachial plexus injury in patients with anterior shoulder dislocation. Signs of nerve injury with shoulder fracture dislocation are easily overlooked or incorrectly attributed to pain due to bony injury. Subsequent loss of shoulder function in elderly is often thought to be due to immobilization and stiffness. Clinical suspicion can help in diagnosing the often missed neurological injuries and can help in improving outcomes.

  5. Fracture Dislocation of Shoulder with Brachial Plexus Palsy: A Case Report and Review of Management Options

    PubMed Central

    Rathore, Sameer; Kasha, Srinivas; Yeggana, Srinivas

    2017-01-01

    Introduction: Injuries causing fracture dislocation of shoulder and brachial plexus palsy are extremely rare. As per authors’ knowledge, three part fracture of proximal humerus with shoulder dislocation and brachial plexus palsy has not been reported in the literature. Case presentation: A 53 year old female sustained a three part fracture of right proximal humerus along with dislocation of shoulder joint and brachial plexus palsy following a fall from a flight of stairs. Fracture was managed by plating of proximal humerus and brachial palsy was followed up with electrodiagnostic studies and regular physiotherapy. Fracture united by three months and patient had near complete recovery of brachial palsy. Authors have discussed diagnostic modalities and management options in the article. Conclusion: Clinician should always look for clinical evidence of brachial plexus injury in patients with anterior shoulder dislocation. Signs of nerve injury with shoulder fracture dislocation are easily overlooked or incorrectly attributed to pain due to bony injury. Subsequent loss of shoulder function in elderly is often thought to be due to immobilization and stiffness. Clinical suspicion can help in diagnosing the often missed neurological injuries and can help in improving outcomes. PMID:28819602

  6. Postoperative pain management after total knee arthroplasty in elderly patients: treatment options.

    PubMed

    McCartney, Colin J L; Nelligan, Kathleen

    2014-02-01

    Total knee arthroplasty (TKA) is a common surgical procedure in the elderly and is associated with severe pain after surgery and a high incidence of chronic pain. Several factors are associated with severe acute pain after surgery, including psychological factors and severe preoperative pain. Good acute pain control can be provided with multimodal analgesia, including regional anesthesia techniques. Studies have demonstrated that poor acute pain control after TKA is strongly associated with development of chronic pain, and this emphasizes the importance of attention to good acute pain control after TKA. Pain after discharge from hospital after TKA is currently poorly managed, and this is an area where increased resources need to be focused to improve early pain control. This is particularly as patients are often discharged home within 4-5 days after surgery. Chronic pain after TKA in the elderly can be managed with both pharmacological and non-pharmacological techniques. After excluding treatable causes of pain, the simplest approach is with the use of acetaminophen combined with a short course of non-steroidal anti-inflammatory drugs (NSAIDs). Careful titration of opioid analgesics can also be helpful with other adjuvants such as the antidepressants or antiepileptic medications used especially for patients with neuropathic pain. Topical agents may provide benefit and are associated with fewer systemic side effects than oral administration. Complementary or psychological therapies may be beneficial for those patients who have failed other options or have depression associated with chronic pain.

  7. Gallstone ileus: management options and results on a series of 40 patients.

    PubMed

    Martínez Ramos, D; Daroca José, J M; Escrig Sos, J; Paiva Coronel, G; Alcalde Sánchez, M; Salvador Sanchís, J L

    2009-02-01

    Controversy remains about the management of gallstone ileus. While some authors propose enterotomy, others defend the one-stage procedure (simultaneously fistula repair). The objective of the present study was to analyze management options and comparative study their results. Retrospective and descriptive study with revision of clinical stories of patients with the diagnosis of gallstone ileus between 1987 and 2008. All the following variables were recorded: dates of hospital admission, surgery and discharge, age, sex, pathological antecedents, preoperative or intraoperative diagnosis, treatment, location of the fistula and location of the obstruction. End-result variables were: postoperative complications, mortality, complications during the follow-up and biliary complications. A total of 40 patients were included of 46,648 admissions. Age, comorbidity, and intraoperative diagnosis were related with poorer short- and long-outcomes. The percentage of postoperative complications was similar for groups with and without fistula repair. Mortality was higher in the group with fistula repair (15 vs. 25%). Biliary complications were more frequent in the group without fistula repair (11 vs. 0%). Sex, location of the fistula and location of the obstruction did not be related with the prognosis. One-stage procedure is related with higher mortality rate than enterotomy alone. Nevertheless, fistula repair reduces the number of biliary complications during the follow-up.

  8. A Life Cycle Assessment (LCA) comparison of three management options for waste papers: bioethanol production, recycling and incineration with energy recovery.

    PubMed

    Wang, Lei; Templer, Richard; Murphy, Richard J

    2012-09-01

    This study uses Life Cycle Assessment (LCA) to assess the environmental profiles and greenhouse gas (GHG) emissions for bioethanol production from waste papers and to compare them with the alternative waste management options of recycling or incineration with energy recovery. Bioethanol production scenarios both with and without pre-treatments were conducted. It was found that an oxidative lime pre-treatment reduced GHG emissions and overall environmental burdens for a newspaper-to-bioethanol process whereas a dilute acid pre-treatment raised GHG emissions and overall environmental impacts for an office paper-to-bioethanol process. In the comparison of bioethanol production systems with alternative management of waste papers by different technologies, it was found that the environmental profiles of each system vary significantly and this variation affects the outcomes of the specific comparisons made. Overall, a number of configurations of bioethanol production from waste papers offer environmentally favourable or neutral profiles when compared with recycling or incineration.

  9. Greenhouse Emission Reductions and Natural Gas Vehicles: A Resource Guide on Technology Options and Project Development

    SciTech Connect

    Orestes Anastasia; NAncy Checklick; Vivianne Couts; Julie Doherty; Jette Findsen; Laura Gehlin; Josh Radoff

    2002-09-01

    Accurate and verifiable emission reductions are a function of the degree of transparency and stringency of the protocols employed in documenting project- or program-associated emissions reductions. The purpose of this guide is to provide a background for law and policy makers, urban planners, and project developers working with the many Greenhouse Gas (GHG) emission reduction programs throughout the world to quantify and/or evaluate the GHG impacts of Natural Gas Vehicle (NGVs). In order to evaluate the GHG benefits and/or penalties of NGV projects, it is necessary to first gain a fundamental understanding of the technology employed and the operating characteristics of these vehicles, especially with regard to the manner in which they compare to similar conventional gasoline or diesel vehicles. Therefore, the first two sections of this paper explain the basic technology and functionality of NGVs, but focus on evaluating the models that are currently on the market with their similar conventional counterparts, including characteristics such as cost, performance, efficiency, environmental attributes, and range. Since the increased use of NGVs, along with Alternative Fuel Vehicle (AFVs) in general, represents a public good with many social benefits at the local, national, and global levels, NGVs often receive significant attention in the form of legislative and programmatic support. Some states mandate the use of NGVs, while others provide financial incentives to promote their procurement and use. Furthermore, Federal legislation in the form of tax incentives or procurement requirements can have a significant impact on the NGV market. In order to implement effective legislation or programs, it is vital to have an understanding of the different programs and activities that already exist so that a new project focusing on GHG emission reduction can successfully interact with and build on the experience and lessons learned of those that preceded it. Finally, most programs

  10. Use of population viability analysis to evaluate CITES trade-management options for threatened marine fishes.

    PubMed

    Curtis, Janelle M R; Vincent, Amanda C J

    2008-10-01

    Achieving multiple conservation objectives can be challenging, particularly under high uncertainty. Having agreed to limit seahorse (Hippocampus) exports to sustainable levels, signatories to the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) were offered the option of a single 10-cm minimum size limit (MSL) as an interim management measure for all Hippocampus species (> or =34). Although diverse stakeholders supported the recommended MSL, its biological and socioeconomic implications were not assessed quantitatively. We combined population viability analysis, model sensitivity analysis, and economic information to evaluate the trade-off between conservation threat to and long-term cumulative income from these exploited marine fishes of high conservation concern. We used the European long-snouted seahorse (Hippocampus guttulatus) as a representative species to compare the performance of MSLs set at alternative biological reference points. Our sensitivity analyses showed that in most of our scenarios, setting the MSL just above size at maturity (9.7 cm in H. guttulatus) would not prevent exploited populations from becoming listed as vulnerable. By contrast, the relative risk of decline and extinction were almost halved--at a cost of only a 5.6% reduction in long-term catches--by increasing the MSL to the size reached after at least one full reproductive season. On the basis of our analysis, a precautionary increase in the MSL could be compatible with sustaining fishers' livelihoods and international trade. Such management tactics that aid species conservation and have minimal effects on long term catch trends may help bolster the case for CITES trade management of other valuable marine fishes.

  11. Use of large-scale silvicultural studies to evaluate management options in Pacific Northwest forests of the United States.

    Treesearch

    Stephen E. Reutebuch; Constance A. Harrington; David D. Marshall; Leslie C. Brodie

    2004-01-01

    A suite of large-scale silvicultural experiments has been established to develop and assess operational silviculture options for the Pacific Northwest Douglas-fir (Pseudotsuga menziesii [Mirb.] Franco vat. menziesii) forests. This paper summarizes three such studies that focus on three major stages in the life of managed stands...

  12. An initial evaluation of potential options for managing riparian reserves of the Aquatic Conservation Strategy of the Northwest Forest Plan

    Treesearch

    Gordon H. Reeves; Brian R. Pickard; K. Norman. Johnson

    2016-01-01

    The Aquatic Conservation Strategy (ACS) of the Northwest Forest Plan guides management of riparian and aquatic ecosystems on federal lands in western Oregon, western Washington, and northern California. We applied new scientific findings and tools to evaluate two potential options, A and B, for refining interim riparian reserves to meet ACS goals and likely challenges...

  13. Assessment of Greenhouse Gas Control Technology Options within the Energy, Water and Food Nexus

    NASA Astrophysics Data System (ADS)

    Al-Ansari, Tareq; Korre, Anna; Nie, Zhenggang; Shah, Nilay

    2015-04-01

    The utilisation of Energy, Water and Food (EWF) resources can be described as a nexus of complex linkages embodied in industrial and natural processes. Food production is one such example of a system that mobilises EWF resources to deliver a product which is highly influenced by the efficiency of the industrial processes contributing to it and the conditions of the surrounding natural environment. Aggregating the utilisation of EWF resources into interconnected sub-systems is necessary for the accurate representation of the system's dynamics in terms of its material flow and resource consumption. The methodology used in this study is an extension of previous work developed regarding nexus analysis (Al-Ansari et al. 2014a, Al-Ansari et al. 2014b). Life cycle assessment (LCA) is used to prepare detailed models of the sub-system components, determine the linkages between the different nexus constituents and evaluate impacts on the natural environment. The nexus system is comprised of water sub-systems represented by a reverse osmosis (RO) desalination process. Energy sub-systems for power generation include models for a combined cycle gas turbine (CCGT) and solar Photovoltaics (PV) energy generation, as well as an amine based CO2 capture process enabling the utilisation of CO2 for the artificial fertilization of crops. The agricultural sub-systems include the production and application of fertilizers and the raising of livestock. A biomass integrated gasification combined cycle (BIGCC) for power generation using waste manure from the livestock sub-system is also included. The objective of this study is to consider a conventional food system in Qatar and enhance its environmental performance by using a nexus approach to examine different scenarios and operating modes. For the Qatar case study, three scenarios and four modes of operation were developed as part of the analysis. The baseline scenario uses fossil fuel to power the entire EWF nexus system using CCGT, the

  14. 40 CFR Appendix E to Part 75 - Optional NOX Emissions Estimation Protocol for Gas-Fired Peaking Units and Oil-Fired Peaking Units

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Optional NOX Emissions Estimation Protocol for Gas-Fired Peaking Units and Oil-Fired Peaking Units E Appendix E to Part 75 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION...

  15. 40 CFR Appendix D to Part 75 - Optional SO2 Emissions Data Protocol for Gas-Fired and Oil-Fired Units

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Optional SO2 Emissions Data Protocol for Gas-Fired and Oil-Fired Units D Appendix D to Part 75 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Pt. 75, App. D Appendix...

  16. EMERGING TECHNOLOGIES FOR THE MANAGEMENT AND UTILIZATION OF LANDFILL GAS

    EPA Science Inventory

    The report gives information on emerging technologies that are considered to be commercially available (Tier 1), currently undergoing research and development (Tier 2), or considered as potentially applicable (Tier 3) for the management of landfill gas (LFG) emissions or for the ...

  17. Nutritional and management strategies to mitigate animal greenhouse gas emissions

    USDA-ARS?s Scientific Manuscript database

    Animal production is a significant source of greenhouse gas (GHG) emissions worldwide. The current analysis was conducted to evaluate the potential of nutritional, manure and animal management practices for mitigating methane and nitrous oxide, i.e. non-carbon dioxide GHG emissions from enteric ferm...

  18. EMERGING TECHNOLOGIES FOR THE MANAGEMENT AND UTILIZATION OF LANDFILL GAS

    EPA Science Inventory

    The report gives information on emerging technologies that are considered to be commercially available (Tier 1), currently undergoing research and development (Tier 2), or considered as potentially applicable (Tier 3) for the management of landfill gas (LFG) emissions or for the ...

  19. Hydrological services and biodiversity conservation under forestation scenarios: comparing options to improve watershed management

    NASA Astrophysics Data System (ADS)

    Carvalho-Santos, Claudia; Nunes, João Pedro; Sousa-Silva, Rita; Gonçalves, João; Pradinho Honrado, João

    2015-04-01

    Humans rely on ecosystems for the provision of hydrological services, namely water supply and water damage mitigation, and promoting forests is a widely used management strategy for the provision of hydrological services. Therefore, it is important to model how forests will contribute for this provision, taking into account the environmental characteristics of each region, as well as the spatio-temporal patterns of societal demand. In addition, ensuring forest protection and the delivery of forest ecosystem services is one of the aims included in the European Union biodiversity strategy to 2020. On the other hand, forest management for hydrological services must consider possible trade-offs with other services provision, as well as with biodiversity conservation. Accurate modeling and mapping of both hydrological services and biodiversity conservation value is thus important to support spatial planning and land management options involving forests. The objectives of this study were: to analyze the provision and spatial dynamics of hydrological services under two forest cover change scenarios (oak and eucalyptus/pine) compared to the current shrubland-dominated landscape; and to evaluate their spatial trade-offs with biodiversity conservation value. The Vez watershed (250km2), in northwest Portugal, was used as case-study area. SWAT (Soil and Water Assessment Tool) was applied to simulate the provision of hydrological services (water supply quantity, timing and quality; soil erosion and flood regulation), and was calibrated against daily discharge, sediments, nitrates and evapotranspiration. Good agreement was obtained between model predictions and field measurements. The maps for each service under the different scenarios were produced at the Hydrologic Response Unit (HRU) level. Biodiversity conservation value was based on nature protection regimes and on expert valuation applied to a land cover map. Statistical correlations between hydrological services provision

  20. Management options for refractory chronic myeloid leukemia: considerations for the elderly.

    PubMed

    Breccia, Massimo; Alimena, Giuliana

    2013-07-01

    Despite the excellent results obtained with standard-dose imatinib as first-line therapy for chronic myeloid leukemia in the chronic phase, one third of patients do not achieve an optimal response and require alternative therapies due to the emergence of drug resistance. Studies of resistance mechanisms, first tested in vitro and then in vivo, have driven the development of second-generation tyrosine kinase inhibitors (TKIs), dasatinib and nilotinib. These agents have been proven effective in a large number of patients resistant to imatinib and are also effective in older patients. The use of second-generation TKIs in first-line treatment has increased the rate of cytogenetic and molecular responses and reduced the number of patients experiencing disease progression. In this review, we detail the various mechanisms of resistance and management options for refractory patients, in particular in older patients. No differences in terms of efficacy were reported in this subset of patients when treated with nilotinib or dasatinib after imatinib resistance. Results of trials that tested second-generation TKIs as first-line treatment showed similar results in older and younger patients.

  1. Current classification, treatment options, and new perspectives in the management of adipocytic sarcomas

    PubMed Central

    De Vita, Alessandro; Mercatali, Laura; Recine, Federica; Pieri, Federica; Riva, Nada; Bongiovanni, Alberto; Liverani, Chiara; Spadazzi, Chiara; Miserocchi, Giacomo; Amadori, Dino; Ibrahim, Toni

    2016-01-01

    Sarcomas are a heterogeneous group of mesenchymal tumors arising from soft tissue or bone, with an uncertain etiology and difficult classification. Soft tissue sarcomas (STSs) account for around 1% of all adult cancers. Till date, more than 50 histologic subtypes have been identified. Adipocyte sarcoma or liposarcoma (LPS) is one of the most common STS subtypes, accounting for 15% of all sarcomas, with an incidence of 24% of all extremity STSs and 45% of all retroperitoneal STSs. The new World Health Organization classification system has divided LPS into four different subgroups: atypical lipomatous tumor/well-differentiated LPS, dedifferentiated LPS, myxoid LPS, and pleomorphic LPS. These lesions can develop at any location and exhibit different aggressive potentials reflecting their morphologic diversity and clinical behavior. Patients affected by LPS should be managed in specialized multidisciplinary cancer centers. Whereas surgical resection is the mainstay of treatment for localized disease, the benefits of adjuvant and neoadjuvant chemotherapy are still unclear. Systemic treatment, particularly chemotherapy, is still limited in metastatic disease. Despite the efforts toward a better understanding of the biology of LPS, the outcome of advanced and metastatic patients remains poor. The advent of targeted therapies may lead to an improvement of treatment options and clinical outcomes. A larger patient enrollment into translational and clinical studies will help increase the knowledge of the biological behavior of LPSs, test new drugs, and introduce new methodological studies, that is, on treatment response. PMID:27785071

  2. Coronary risk assessment and management options in chronic kidney disease patients prior to kidney transplantation.

    PubMed

    Karthikeyan, Vanji; Ananthasubramaniam, Karthik

    2009-08-01

    Cardiovascular disease remains the most important cause of morbidity and mortality among kidney transplant recipients. Nearly half the deaths in transplanted patients are attributed to cardiac causes and almost 5% of these deaths occur within the first year after transplantation. The ideal strategies to screen for coronary artery disease (CAD) in chronic kidney disease patients who are evaluated for kidney transplantation (KT) remain controversial. The American Society of Transplantation recommends that patients with diabetes, prior history of ischemic heart disease or an abnormal ECG, or age >/=50 years should be considered as high-risk for CAD and referred for a cardiac stress test and only those with a positive stress test, for coronary angiography. Despite these recommendations, vast variations exist in the way these patients are screened for CAD at different transplant centers. The sensitivity and specificity of noninvasive cardiac tests in CKD patients is much lower than that in the general population. This has prompted the use of direct diagnostic cardiac catheterization in high-risk patients in several transplant centers despite the risks associated with this invasive procedure. No large randomized controlled trials exist to date that address these issues. In this article, we review the existing literature with regards to the available data on cardiovascular risk screening and management options in CKD patients presenting for kidney transplantation and outline a strategy for approach to these patients.

  3. Adaptive Flood Risk Management Under Climate Change Uncertainty Using Real Options and Optimization.

    PubMed

    Woodward, Michelle; Kapelan, Zoran; Gouldby, Ben

    2014-01-01

    It is well recognized that adaptive and flexible flood risk strategies are required to account for future uncertainties. Development of such strategies is, however, a challenge. Climate change alone is a significant complication, but, in addition, complexities exist trying to identify the most appropriate set of mitigation measures, or interventions. There are a range of economic and environmental performance measures that require consideration, and the spatial and temporal aspects of evaluating the performance of these is complex. All these elements pose severe difficulties to decisionmakers. This article describes a decision support methodology that has the capability to assess the most appropriate set of interventions to make in a flood system and the opportune time to make these interventions, given the future uncertainties. The flood risk strategies have been explicitly designed to allow for flexible adaptive measures by capturing the concepts of real options and multiobjective optimization to evaluate potential flood risk management opportunities. A state-of-the-art flood risk analysis tool is employed to evaluate the risk associated to each strategy over future points in time and a multiobjective genetic algorithm is utilized to search for the optimal adaptive strategies. The modeling system has been applied to a reach on the Thames Estuary (London, England), and initial results show the inclusion of flexibility is advantageous, while the outputs provide decisionmakers with supplementary knowledge that previously has not been considered.

  4. Novel and Expanded Oncology Drug Approvals of 2016-PART 1: New Options in Solid Tumor Management.

    PubMed

    Knepper, Todd C; Saller, James; Walko, Christine M

    2017-02-15

    The nonradiologic medical management of solid tumors has evolved from the use of traditional cytotoxic agents to modern targeted therapies, monoclonal antibodies, and immunotherapies. Advances in the understanding of cancer biology and therapeutic strategies have resulted in increasing numbers of new drug applications and approvals. Consequently, practicing oncologists need to learn how the newly available agents function and what toxicities to watch for, as well as ways to optimize the use of both new drugs and previously approved drugs with new indications. In 2016, the US Food and Drug Administration approved three novel drugs for the treatment of solid malignancies-olaratumab in selected patients with soft-tissue sarcoma, atezolizumab for the treatment of bladder cancer, and rucaparib for the treatment of ovarian cancer; also in 2016, the use of previously approved anticancer agents (including atezolizumab) was expanded into 11 new patient populations. The diversity of options for patients is evident in the broad range of the 2016 approvals, which include immune checkpoint inhibitors, targeted therapies, monoclonal antibodies, and traditional cytotoxic agents. This article focuses on the new agents and indications that emerged in 2016 for solid tumor treatment. We review the drug indications, mechanisms of action, pivotal trial data, pertinent toxicities, use in special populations, and the appropriate clinical contexts for treatment planning.

  5. Changing Climate, Challenging Choices: Identifying and Evaluating Climate Change Adaptation Options for Protected Areas Management in Ontario, Canada

    NASA Astrophysics Data System (ADS)

    Lemieux, Christopher J.; Scott, Daniel J.

    2011-10-01

    Climate change will pose increasingly significant challenges to managers of parks and other forms of protected areas around the world. Over the past two decades, numerous scientific publications have identified potential adaptations, but their suitability from legal, policy, financial, internal capacity, and other management perspectives has not been evaluated for any protected area agency or organization. In this study, a panel of protected area experts applied a Policy Delphi methodology to identify and evaluate climate change adaptation options across the primary management areas of a protected area agency in Canada. The panel identified and evaluated one hundred and sixty five (165) adaptation options for their perceived desirability and feasibility. While the results revealed a high level of agreement with respect to the desirability of adaptation options and a moderate level of capacity pertaining to policy formulation and management direction, a perception of low capacity for implementation in most other program areas was identified. A separate panel of senior park agency decision-makers used a multiple criterion decision-facilitation matrix to further evaluate the institutional feasibility of the 56 most desirable adaptation options identified by the initial expert panel and to prioritize them for consideration in a climate change action plan. Critically, only two of the 56 adaptation options evaluated by senior decision-makers were deemed definitely implementable, due largely to fiscal and internal capacity limitations. These challenges are common to protected area agencies in developed countries and pervade those in developing countries, revealing that limited adaptive capacity represents a substantive barrier to biodiversity conservation and other protected area management objectives in an era of rapid climate change.

  6. Reactor-Based Management of Used Nuclear Fuel: Assessment of Major Options

    SciTech Connect

    Phillip J. Finck; Roald A. Wigeland; Robert N. Hill

    2011-01-01

    This paper discusses the current status of the ongoing Advanced Fuel Cycle Initiative (AFCI) program in the U.S. Department of Energy that is investigating the potential for using the processing and recycling of used nuclear fuel to improve radioactive waste management, including used fuel. A key element of the strategies is to use nuclear reactors for further irradiation of recovered chemical elements to transmute certain long-lived highly-radioactive isotopes into less hazardous isotopes. Both thermal and fast neutron spectrum reactors are being studied as part of integrated nuclear energy systems where separations, transmutation, and disposal are considered. Radiotoxicity is being used as one of the metrics for estimating the hazard of used fuel and the processing of wastes resulting from separations and recycle-fuel fabrication. Decay heat from the used fuel and/or wastes destined for disposal is used as a metric for use of a geologic repository. Results to date indicate that the most promising options appear to be those using fast reactors in a repeated recycle mode to limit buildup of higher actinides, since the transuranic elements are a key contributor to the radiotoxicity and decay heat. Using such an approach, there could be much lower environmental impact from the high-level waste as compared to direct disposal of the used fuel, but there would likely be greater generation of low-level wastes that will also require disposal. An additional potential waste management benefit is having the ability to tailor waste forms and contents to one or more targeted disposal environments (i.e., to be able to put waste in environments best-suited for the waste contents and forms).

  7. Reactor-based management of used nuclear fuel: assessment of major options.

    PubMed

    Finck, Phillip J; Wigeland, Roald A; Hill, Robert N

    2011-01-01

    This paper discusses the current status of the ongoing Advanced Fuel Cycle Initiative (AFCI) program in the U.S. Department of Energy that is investigating the potential for using the processing and recycling of used nuclear fuel to improve radioactive waste management, including used fuel. A key element of the strategies is to use nuclear reactors for further irradiation of recovered chemical elements to transmute certain long-lived highly-radioactive isotopes into less hazardous isotopes. Both thermal and fast neutron spectrum reactors are being studied as part of integrated nuclear energy systems where separations, transmutation, and disposal are considered. Radiotoxicity is being used as one of the metrics for estimating the hazard of used fuel and the processing of wastes resulting from separations and recycle-fuel fabrication. Decay heat from the used fuel and/or wastes destined for disposal is used as a metric for use of a geologic repository. Results to date indicate that the most promising options appear to be those using fast reactors in a repeated recycle mode to limit buildup of higher actinides, since the transuranic elements are a key contributor to the radiotoxicity and decay heat. Using such an approach, there could be much lower environmental impact from the high-level waste as compared to direct disposal of the used fuel, but there would likely be greater generation of low-level wastes that will also require disposal. An additional potential waste management benefit is having the ability to tailor waste forms and contents to one or more targeted disposal environments (i.e., to be able to put waste in environments best-suited for the waste contents and forms).

  8. Canadian Environmental Protection Act, strategic options for the management of toxic substances: Electric power generation (fossil fuel) sector, report of stakeholder consultations

    SciTech Connect

    1997-12-31

    The Electric Power Generation Sector Issue Table was formed to assess the management of toxic substances released from that sector, and more specifically, to develop (where warranted) goals, targets, and effective and efficient options for managing toxic releases in order to reduce potential risks to human health and the environment. This strategic options report sets out the recommendations of Issue Table members for the management of toxic substances. The introduction includes an industry profile and a review of the provincial management of electric power sector strategic options priority (SOP) substances. Chapter 2 discusses what substances are toxic, estimates releases of SOP substances from the sector, and reviews Issue Table approaches to risk assessment. Chapter 3 outlines Issue Table activities. Chapter 4 screens toxic substance management options, with evaluation of options against 13 groups of criteria. Chapter 5 presents toxic substances management proposals made to the Issue Table by the electric power generation industry, environmental groups, and Environment Canada.

  9. Greenhouse gas emission impacts of alternative-fueled vehicles: Near-term vs. long-term technology options

    SciTech Connect

    Wang, M.Q.

    1997-12-31

    The U.S. transportation sector produces nearly one-third of total U.S. greenhouse gas (GHG) emissions. Among various transportation control strategies evaluated in the U.S., use of vehicles fueled with alternative fuels has been proposed to help solve urban air pollution problems, reduce U.S. dependence on imported oil, and reduce transportation GHG emissions. GHG emission impacts of alternative-fueled vehicles depend on type of fuels used, type of primary energy sources used to produce the fuels, and energy efficiencies of vehicles and up-stream energy production activities. Past studies have shown widely-varied, sometimes contradicting, results of GHG emissions by alternative-fueled vehicles. A fuel-cycle model has been developed at Argonne National Laboratory to estimate fuel-cycle emissions and energy consumption of various alternative-fueled vehicles. The model, called Greenhouse Gases, Regulated Emissions, and Energy use in Transportation (GREET), calculates fuel-cycle emissions of five criteria pollutants (volatile organic compounds, carbon monoxide, nitrogen oxides, sulfur oxides, and particulate matter) and three greenhouse gases (carbon dioxide, methanol, and nitrous oxide). In this paper, the GREET will be used to estimate fuel-cycle GHG emission impacts of near-term and long-term alternative-fueled vehicle technology options.

  10. Environmental assessment of management options for nutrient flows in the food chain in China.

    PubMed

    Ma, Lin; Wang, Fanghao; Zhang, Weifeng; Ma, Wenqi; Velthof, Gerard; Qin, Wei; Oenema, Oene; Zhang, Fusuo

    2013-07-02

    The nitrogen (N) and phosphorus (P) costs of food production have increased greatly in China during the last 30 years, leading to eutrophication of surface waters, nitrate leaching to groundwater, and greenhouse gas emissions. Here, we present the results of scenario analyses in which possible changes in food production-consumption in China for the year 2030 were explored. Changes in food chain structure, improvements in technology and management, and combinations of these on food supply and environmental quality were analyzed with the NUFER model. In the business as usual scenario, N and P fertilizer consumption in 2030 will be driven by population growth and diet changes and will both increase by 25%. N and P losses will increase by 44 and 73%, respectively, relative to the reference year 2005. Scenarios with increased imports of animal products and feed instead of domestic production, and with changes in the human diet, indicate reductions in fertilizer consumption and N and P losses relative to the business as usual scenario. Implementation of a package of integrated nutrient management measures may roughly nullify the increases in losses in the business as usual scenario and may greatly increase the efficiency of N and P throughout the whole food chain.

  11. Career options.

    PubMed

    2011-06-24

    Practitioners at all levels can plan their future career options through the NHS Nursing Career Framework interactive tool. The tool builds on the pathway-based framework set out in the post-registration career framework for nurses. Career pathways are outlined under each branch and the specialties within the branches, and cover topics including clinical careers, management and moving into education or research.

  12. A Study on Optimized Management Options for the Wolsong Low- and Intermediate - Level Waste Disposal Center in Korea - 13479

    SciTech Connect

    Park, JooWan; Kim, DongSun; Choi, DongEun

    2013-07-01

    The safe and effective management of radioactive waste is a national task required for sustainable generation of nuclear power and for energy self-reliance in Korea. Currently, for permanent disposal of low- and intermediate-level waste (LILW), the Wolsong LILW Disposal Center (WLDC) is under construction. It will accommodate a total of 800,000 drums at the final stage after stepwise expansion. As an implementing strategy for cost-effective development of the WLDC, various disposal options suitable for waste classification schemes would be considered. It is also needed an optimized management of the WLDC by taking a countermeasure of volume reduction treatment. In this study, various management options to be applied to each waste class are analyzed in terms of its inventory and disposal cost. For the volume reduction and stabilization of waste, the vitrification and plasma melting methods are considered for combustible and incombustible waste, respectively. (authors)

  13. Two-Stage Fracturing Wastewater Management in Shale Gas Development

    DOE PAGES

    Zhang, Xiaodong; Sun, Alexander Y.; Duncan, Ian J.; ...

    2017-01-19

    Here, management of shale gas wastewater treatment, disposal, and reuse has become a significant environmental challenge, driven by an ongoing boom in development of U.S. shale gas reservoirs. Systems-analysis based decision support is helpful for effective management of wastewater, and provision of cost-effective decision alternatives from a whole-system perspective. Uncertainties are inherent in many modeling parameters, affecting the generated decisions. In order to effectively deal with the recourse issue in decision making, in this work a two-stage stochastic fracturing wastewater management model, named TSWM, is developed to provide decision support for wastewater management planning in shale plays. Using the TSWMmore » model, probabilistic and nonprobabilistic uncertainties are effectively handled. The TSWM model provides flexibility in generating shale gas wastewater management strategies, in which the first-stage decision predefined by decision makers before uncertainties are unfolded is corrected in the second stage to achieve the whole-system’s optimality. Application of the TSWM model to a comprehensive synthetic example demonstrates its practical applicability and feasibility. Optimal results are generated for allowable wastewater quantities, excess wastewater, and capacity expansions of hazardous wastewater treatment plants to achieve the minimized total system cost. The obtained interval solutions encompass both optimistic and conservative decisions. Trade-offs between economic and environmental objectives are made depending on decision makers’ knowledge and judgment, as well as site-specific information. In conclusion, the proposed model is helpful in forming informed decisions for wastewater management associated with shale gas development.« less

  14. A cost-benefit analysis of produced water management opportunities in selected unconventional oil and gas plays

    NASA Astrophysics Data System (ADS)

    Marsters, P.; Macknick, J.; Bazilian, M.; Newmark, R. L.

    2013-12-01

    Unconventional oil and gas production in North America has grown enormously over the past decade. The combination of horizontal drilling and hydraulic fracturing has made production from shale and other unconventional resources economically attractive for oil and gas operators, but has also resulted in concerns over potential water use and pollution issues. Hydraulic fracturing operations must manage large volumes of water on both the front end as well as the back end of operations, as significant amounts of water are coproduced with hydrocarbons. This water--often called flowback or produced water--can contain chemicals from the hydraulic fracturing fluid, salts dissolved from the source rock, various minerals, volatile organic chemicals, and radioactive constituents, all of which pose potential management, safety, and public health issues. While the long-term effects of hydraulic fracturing on aquifers, drinking water supplies, and surface water resources are still being assessed, the immediate impacts of produced water on local infrastructure and water supplies are readily evident. Produced water management options are often limited to underground injection, disposal at centralized treatment facilities, or recycling for future hydraulic fracturing operations. The costs of treatment, transport, and recycling are heavily dependent on local regulations, existing infrastructure, and technologies utilized. Produced water treatment costs also change over time during energy production as the quality of the produced water often changes. To date there is no publicly available model that evaluates the cost tradeoffs associated with different produced water management techniques in different regions. This study addresses that gap by characterizing the volume, qualities, and temporal dynamics of produced water in several unconventional oil and gas plays; evaluating potential produced water management options, including reuse and recycling; and assessing how hydraulic

  15. Radioactive iodine ablation therapy: a viable option in the management of Graves' disease in Nigeria.

    PubMed

    Adedapo, K S; Fadiji, I O; Orunmuyi, A T; Onimode, Y; Osifo, B O A

    2012-12-01

    Graves' disease is an autoimmune disorder characterized by hyperthyroidism and associated features. Management of this disease condition for many decades has been largely by surgical and medical intervention. Usage of anti thyroid medication ameliorates the symptoms and effects of excessive production of thyroid hormones. Recently in Nigeria, Nuclear medicine facility became available with the option radioiodine ablative therapy for the management of Graves disease. This study highlights the benefits of radioiodine therapy against the background of equally viable medical and surgical practice. PATIENTS MATERIAL AND METHOD: All the 36 patients seen from the inception of Nuclear Medicine facility at the University College Hospital from June 2006 to May 2010 were included in this study. Sources of referral were compiled. All the patients were on anti thyroid medication at presentation. Thyroid scan was performed by Siemens E- cam gamma camera 20 minutes after intravenous injection of 3-5 mCi of Tc-99m-Pertechnetate. The patients with "diffuse toxic goiter" on thyroid scan were given 10 mCi of Iodine-131 orally and discharged home with radiosafety precautions. Most of the patients were treated 5 days post discontinuation of antithyroid medication. The patients were followed-up monthly with thyroid function tests to determine commencement of replacement therapy. Peak incidence of Graves' disease was at 6th decade (38.9%) of all patients studied. This disease was commoner in women with a ratio of 8 to 1. Ten (27.8%) patients became hypothyroid at the 3rd month post radioactive iodine-131 treatment, while the remaining 20 (55.6%) patients became hypothyroid at the 5th month. Six patients were lost to follow up. There was no recurrence of hyperthyroidism in all patients treated. Twenty eight (93.3%) patients were maintained on 100 mcg of levo-thyroxine daily, while 2 (6.7%) patients had more than 100 mcg of levo- thyroxine daily as maintenance dose. Radioactive iodine

  16. Environmental Monitoring and the Gas Industry: Program Manager Handbook

    SciTech Connect

    Gregory D. Gillispie

    1997-12-01

    This document has been developed for the nontechnical gas industry manager who has the responsibility for the development of waste or potentially contaminated soil and groundwater data or must make decisions based on such data for the management or remediation of these materials. It explores the pse of common analytical chemistry instrumentation and associated techniques for identification of environmentally hazardous materials. Sufficient detail is given to familiarize the nontechnical reader with the principles behind the operation of each technique. The scope and realm of the techniques and their constituent variations are portrayed through a discussion of crucial details and, where appropriate, the depiction of real-life data. It is the author's intention to provide an easily understood handbook for gas industry management. Techniques which determine the presence, composition, and quantification of gas industry wastes are discussed. Greater focus is given to traditional techniques which have been the mainstay of modem analytical benchwork. However, with the continual advancement of instrumental principles and design, several techniques have been included which are likely to receive greater attention in fiture considerations for waste-related detection. Definitions and concepts inherent to a thorough understanding of the principles common to analytical chemistry are discussed. It is also crucial that gas industry managers understand the effects of the various actions which take place before, during, and after the actual sampling step. When a series of sample collection, storage, and transport activities occur, new or inexperienced project managers may overlook or misunderstand the importance of the sequence. Each step has an impact on the final results of the measurement process; errors in judgment or decision making can be costly. Specific techniques and methodologies for the collection, storage, and transport of environmental media samples are not described or

  17. A decision support tool to prioritize risk management options for contaminated sites.

    PubMed

    Sorvari, Jaana; Seppälä, Jyri

    2010-03-15

    The decisions on risk management (RM) of contaminated sites in Finland have typically been driven by practical factors such as time and money. However, RM is a multifaceted task that generally involves several additional determinants, e.g. performance and environmental effects of remediation methods, psychological and social factors. Therefore, we adopted a multi-criteria decision analysis approach and developed a decision support tool (DST) that is viable in decision-making in such a complex situation. The basic components of the DST are based on the Dutch REC system. However, our DST is more case-specific and allows the consideration of the type, magnitude and scale of contamination, land use, environmental conditions and socio-cultural aspects (e.g. loss of cultural heritage, image aspects). The construction of the DST was started by structuring the decision problem using a value tree. Based on this work we adopted the Multi-Attribute Value Theory (MAVT) for data aggregation. The final DST was demonstrated by two model sites for which the RM alternatives and site-specific data were created on the basis of factual remediation projects and by interviewing experts. The demonstration of the DST was carried out in a workshop where representatives of different stakeholders were requested to rank and weight the decision criteria involved. To get information on the consistency of the ranking of the RM alternatives, we used different weighting techniques (ratio estimation and pair-wise weighting) and alternative ways to treat individual respondents' weights in calculating the preference scores for each RM alternative. These dissimilar approaches resulted in some differences in the preference order of the RM alternatives. The demonstration showed that attention has to be paid to the proper description of the site, the principles of the procedure and the decision criteria. Nevertheless, the procedure proved to enable efficient communication between different stakeholders

  18. [National survey about management and treatment options of hepatitis C recurrence after liver transplantation].

    PubMed

    Bittencourt, Paulo Lisboa; Silva, Rita de Cássia Silva Martins Alves da; Pessoa, Mário Guimarães; Marroni, Cláudio Augusto

    2007-01-01

    Recurrence of hepatitis C after orthotopic liver transplantation is one of the major clinical challenges faced by the liver transplantation community. Treatment of hepatitis C recurrence with peguilated interferon and ribavirin has been associated with sustained virological response in 21% to 45% of treated patients. Furthermore, it has been shown to halt disease progression after orthotopic liver transplantation and to prevent graft failure and the need for retransplantation at least in those subjects with sustained virological response. However, treatment of hepatitis C recurrence after orthotopic liver transplantation in Brazil was not recommended according to ministerial Law number 863. To assess the management and treatment options of hepatitis C recurrence after orthotopic liver transplantation in different liver transplantation centers in Brazil. Inquiries were sent to active liver transplantation centers throughout the country. Nineteen centers accepted to participate and answered the questionnaire. Altogether they transplanted around 2,800 subjects, half of them with hepatitis C. Immunosuppressive regimen is comprised by tacrolimus and short-term prednisone in 53% of the centers. One third of them claim to use different schedules for hepatitis C patients. Protocol biopsies for diagnosis of recurrence are employed by 13 centers. Different histological criteria are used for the either diagnosis or decision for treatment in most of the centers. Approximately half of them (42%) indicate treatment in subjects with less severe stages of fibrosis (less than F2 according to METAVIR classification). All centers are referring patients for treatment with peguilated interferon and ribavirin, for 1 year, for 6 months or 1 year based on the genotype, or a la carte based on response, respectively, in 32%, 21% and 47% of the centers. Most of them (84%) do not stop treatment in early non-responders at the 12th week. Even in the absence of national guidelines and federal

  19. Pasireotide and mifepristone: new options in the medical management of Cushing's disease.

    PubMed

    Cohan, Pejman

    2014-01-01

    To review and evaluate medical therapies for Cushing's disease (CD), with an emphasis on recent clinical trial experience with pasireotide and mifepristone, and to discuss the therapeutic potential and appropriate selection of these compounds in this patient population. Recently published Phase III trial data for each compound are reviewed and assessed, and relative benefits and risks are examined and compared where possible. Mifepristone and pasireotide are both potentially beneficial for CD patients but have greatly dissimilar mechanisms of action and adverse event (AE) profiles. Pasireotide acts at the level of the pituitary adenoma, reducing cortisol levels through inhibition of adrenocorticotropic hormone (ACTH) release. However, pasireotide reduces insulin secretion and incretin hormone response and is associated with significant risk for new or worsening hyperglycemia. Mifepristone ameliorates the signs and symptoms of hypercortisolemia via glucocorticoid receptor (GR2) blockade, but this approach raises serum cortisol levels and increases risk for adrenal insufficiency (AI), hypokalemia, and endometrial thickening. While response to pasireotide can be monitored via measurements of serum, urine, or late-night salivary cortisol, evaluation of response to mifepristone is solely based on changes in clinical parameters (e.g., hyperglycemia, hypertension, body weight/composition). Management of persistent CD is challenging, and the decision to initiate medical treatment hinges on many factors. Pasireotide may be a more attractive option for most patients due to its action at the underlying tumor and the ability to monitor biochemical responses. However, mifepristone may be more appropriate when it is necessary to avoid or minimize risk for hyperglycemia-related complications.

  20. Production of Ceratonova shasta Myxospores from Salmon Carcasses: Carcass Removal Is Not a Viable Management Option.

    PubMed

    Foott, J S; Stone, R; Fogerty, R; True, K; Bolick, A; Bartholomew, J L; Hallett, S L; Buckles, G R; Alexander, J D

    2016-06-01

    ) and 2009 (1,799 carcasses removed) failed to measurably influence the DNA quantity of C. shasta in targeted waters. Combined with the high numbers of carcasses that contributed myxospores, we therefore deemed that this labor-intensive approach is not a viable management option to reduce the infectivity of C. shasta in Chinook Salmon in the Klamath River. Received January 23, 2015; accepted September 28, 2015.

  1. Modelling the returns on options for improving malaria case management in Ethiopia.

    PubMed

    Gaumer, Gary; Zeng, Wu; Nandakumar, Allyala Krishna

    2014-12-01

    Diverse opinions have emerged about the best way to scale up malaria interventions. Three controversies seem most important: (1) should the scale-up focus on a broader target of febrile illness (including infectious disease and pneumonia)? (2) should the scale-up feature a single intervention or be targeted to the situation? (3) should scale-up have a preference for one kind of delivery mechanism or another? A decision model of 576 nodes describes the patterns of access, treatment and outcomes of an episode of febrile illness for a child below 5 years. Incremental costs and outcomes relative to baseline (2010) are computed for particular scenarios for Ethiopia using data from the literature. Two perspectives define the relevant costs: society at large and financiers (government and donors) where the costs borne by households are not included. Scaling up malaria interventions by one means or another is a very inexpensive way of saving young lives in poor countries. The low cost per life saved stems from two main reasons: the excessive baseline costs of presumptive use of antimalarial drugs for non-malaria cases, and the excessive costs of delayed treatment of pneumonia. A very limited policy of supplying antibiotics to facilities to eliminate stockouts would save 2100 lives, at a cost of only $615 a life. A much broader programme option, bundling malaria and pneumonia together for patients presenting with febrile illness [including rapid diagnostic test (RDT) for malaria, respiratory rate timers (RRTs) and free antibiotics], would save tens of thousands of young lives at and still cost society less than child fever management in the baseline situation! It is not clear that scale-up via community health workers (CHWs) is to be preferred to a facility-based intervention. The delivery through CHWs allows for a broader coverage of using RDT and RRT, but with limited effectiveness due to limited skills of CHWs in treating and managing patients. Published by Oxford

  2. 75 FR 5244 - Pipeline Safety: Integrity Management Program for Gas Distribution Pipelines; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-02

    ... implement integrity management programs. In addition to a minor correction in terminology, this document...: Integrity Management Program for Gas Distribution Pipelines; Correction AGENCY: Pipeline and...

  3. Stress urinary incontinence and overactive bladder syndrome: current options and new targets for management.

    PubMed

    Elser, Denise M

    2012-05-01

    In the United States, office visits for women seeking treatment for urinary incontinence more than doubled between 1994 and 2000, from 1845 per 100 000 women. This review article addresses treatment options for 2 common types of incontinence in women: stress urinary incontinence (SUI) and detrusor overactivity (DO), commonly referred to as urge urinary incontinence (UUI). In the past, those with SUI typically faced limited treatment options, such as Kegel exercises, pessaries, or major surgery (Burch or Marshall-Marchetti-Krantz operations). However, treatment options for women also included anticholinergic medications, behavioral therapy, and implantable neuromodulation. In recent years, more options have become available. For women with SUI, a variety of minimally invasive synthetic midurethral sling approaches (eg, retropubic, transobturator, and single incision) and office-based procedures (eg, periurethral injection of bulking agents and radiofrequency collagen denaturation [Renessa®; Novasys Medical]) are now offered. More outpatient options will hopefully be available soon, including an inflatable, free-floating balloon to act as a shock absorber, and injection of muscle-derived stem cells into the periurethral tissue. Women with UUI now have targeted options, such as posterior tibial nerve stimulation (PTNS) and intravesical injections of onabotulinumtoxinA (Botox®; Allergan, Inc.), in addition to nonoral systemic medications.

  4. NORM Management in the Oil and Gas Industry

    SciTech Connect

    Cowie, Michael; Mously, Khalid; Fageeha, Osama; Nassar, Rafat

    2008-08-07

    It has been established that Naturally Occurring Radioactive Materials (NORM) accumulates at various locations along the oil/gas production process. Components such as wellheads, separation vessels, pumps, and other processing equipment can become NORM contaminated, and NORM can accumulate in sludge and other waste media. Improper handling and disposal of NORM contaminated equipment and waste can create a potential radiation hazard to workers and the environment. Saudi Aramco Environmental Protection Department initiated a program to identify the extent, form and level of NORM contamination associated with the company operations. Once identified the challenge of managing operations which had a NORM hazard was addressed in a manner that gave due consideration to workers and environmental protection as well as operations' efficiency and productivity. The benefits of shared knowledge, practice and experience across the oil and gas industry are seen as key to the establishment of common guidance on NORM management. This paper outlines Saudi Aramco's experience in the development of a NORM management strategy and its goals of establishing common guidance throughout the oil and gas industry.

  5. NORM management in the oil and gas industry.

    PubMed

    Cowie, M; Mously, K; Fageeha, O; Nassar, R

    2012-01-01

    It has been established that naturally occurring radioactive material (NORM) may accumulate at various locations along the oil and gas production process. Components such as wellheads, separation vessels, pumps, and other processing equipment can become contaminated with NORM, and NORM can accumulate in the form of sludge, scale, scrapings, and other waste media. This can create a potential radiation hazard to workers, the general public, and the environment if certain controls are not established. Saudi Aramco has developed NORM management guidelines, and is implementing a comprehensive strategy to address all aspects of NORM management that aim to enhance NORM monitoring; control of NORM-contaminated equipment; control of NORM waste handling and disposal; and protection, awareness, and training of workers. The benefits of shared knowledge, best practice, and experience across the oil and gas industry are seen as key to the establishment of common guidance. This paper outlines Saudi Aramco's experience in the development of a NORM management strategy, and its goals of establishing common guidance throughout the oil and gas industry.

  6. Estimating gas kick arrival to better manage surface flow

    SciTech Connect

    Merryman, J.

    1997-06-01

    There are many quality, expertly designed programs for teaching rig crews prevention and control of well kicks. Much time and money has been spent training rig crews for procedures and methods to avoid kicks, and what to do if you have one, even though all accepted practices were followed. One false/bad result from this training is that individuals have come away from this training believing that once a gas kick is circulated through the choke, all problems are simple and manageable, i.e., the danger has passed. What you do with gas once it is downstream of the choke has not been given enough emphasis in some training programs, including the one the author is involved in. This article, prepared from experiences on actual rig locations in Wyoming and Argentina, and developed for well control training in Parker Drilling Co.`s Training Center, Odessa, Texas, describes a method for estimating the time, in pump strokes and/or minutes, for a gas kick to reach surface. Reducing pump strokes (circulating flowrate) and knowing available time to gas kick arrival allows the crew to prepare surface handling equipment. Common misconceptions about gas handling and potential resulting problems are noted. An example calculation describes the calculation procedure.

  7. Characterization of options and their analysis requirements for the long-term management of depleted uranium hexafluoride

    SciTech Connect

    Dubrin, J.W.; Rosen, R.S.; Zoller, J.N.; Harri, J.W.; Schwertz, N.L.

    1995-12-01

    The Department of Energy (DOE) is examining alternative strategies for the long-term management of depleted uranium hexafluoride (UF{sub 6}) currently stored at the gaseous diffusion plants at Portsmouth, Ohio, and Paducah, Kentucky, and on the Oak Ridge Reservation in Oak Ridge, Tennessee. This paper describes the methodology for the comprehensive and ongoing technical analysis of the options being considered. An overview of these options, along with several of the suboptions being considered, is presented. The long-term management strategy alternatives fall into three broad categories: use, storage, or disposal. Conversion of the depleted UF6 to another form such as oxide or metal is needed to implement most of these alternatives. Likewise, transportation of materials is an integral part of constructing the complete pathway between the current storage condition and ultimate disposition. The analysis of options includes development of pre-conceptual designs; estimates of effluents, wastes, and emissions; specification of resource requirements; and preliminary hazards assessments. The results of this analysis will assist DOE in selecting a strategy by providing the engineering information necessary to evaluate the environmental impacts and costs of implementing the management strategy alternatives.

  8. A risk-based framework for water resource management under changing water availability, policy options, and irrigation expansion

    NASA Astrophysics Data System (ADS)

    Hassanzadeh, Elmira; Elshorbagy, Amin; Wheater, Howard; Gober, Patricia

    2016-08-01

    Long-term water resource management requires the capacity to evaluate alternative management options in the face of various sources of uncertainty in the future conditions of water resource systems. This study proposes a generic framework for determining the relative change in probabilistic characteristics of system performance as a result of changing water availability, policy options and irrigation expansion. These probabilistic characteristics can be considered to represent the risk of failure in the system performance due to the uncertainty in future conditions. Quantifying the relative change in the performance risk can provide a basis for understanding the effects of multiple changing conditions on the system behavior. This framework was applied to the water resource system of the Saskatchewan River Basin (SaskRB) in Saskatchewan, Canada. A "bottom-up" flow reconstruction algorithm was used to generate multiple realizations for water availability within a feasible range of change in streamflow characteristics. Consistent with observed data and projected change in streamflow characteristics, the historical streamflow was perturbed to stochastically generate feasible future flow sequences, based on various combinations of changing annual flow volume and timing of the annual peak. In addition, five alternative policy options, with and without potential irrigation expansion, were considered. All configurations of water availability, policy decisions and irrigation expansion options were fed into a hydro-economic water resource system model to obtain empirical probability distributions for system performance - here overall and sectorial net benefits - under the considered changes. Results show that no one specific policy can provide the optimal option for water resource management under all flow conditions. In addition, it was found that the joint impacts of changing water availability, policy, and irrigation expansion on system performance are complex and

  9. National policies for biosphere greenhouse gas management: issues and opportunities.

    PubMed

    Kennett, Steven A

    2002-11-01

    Biosphere greenhouse gas (GHG) management consists of preserving and enhancing terrestrial carbon pools and producing biomass as a fossil fuel substitute. The discussion of this topic has focused primarily on carbon-accounting and project-level issues, particularly relating to carbon sequestration as a source of emissions credits under the Kyoto Protocol. While international consensus on these matters is needed, this paper argues that an important domestic policy agenda also deserves attention. National policies for biosphere GHG management are necessary to bring about large-scale changes in land-use, forestry, and agricultural practices and can address some of the technical and policy issues that have proven to be particularly problematic from carbon-accounting and project-level perspectives. These policies should minimize land-use and resource-management conflicts, account for collateral benefits, and ensure institutional compatibility with existing resource-management regimes. Issues relating to project permanence, leakage, and transaction costs should also be addressed. A range of policy instruments should be used and biosphere GHG management should be one component of an integrated approach to environmental and resource management. Countries promoting biosphere GHG management as an important element of their climate change strategies should be developing these domestic policies to complement international negotiations and to demonstrate that carbon sequestration and biomass production can make an effective contribution to the stabilization of atmospheric GHG concentrations.

  10. DRUMS: Disk Repository with Update Management and Select option for high throughput sequencing data

    PubMed Central

    2014-01-01

    Background New technologies for analyzing biological samples, like next generation sequencing, are producing a growing amount of data together with quality scores. Moreover, software tools (e.g., for mapping sequence reads), calculating transcription factor binding probabilities, estimating epigenetic modification enriched regions or determining single nucleotide polymorphism increase this amount of position-specific DNA-related data even further. Hence, requesting data becomes challenging and expensive and is often implemented using specialised hardware. In addition, picking specific data as fast as possible becomes increasingly important in many fields of science. The general problem of handling big data sets was addressed by developing specialized databases like HBase, HyperTable or Cassandra. However, these database solutions require also specialized or distributed hardware leading to expensive investments. To the best of our knowledge, there is no database capable of (i) storing billions of position-specific DNA-related records, (ii) performing fast and resource saving requests, and (iii) running on a single standard computer hardware. Results Here, we present DRUMS (Disk Repository with Update Management and Select option), satisfying demands (i)-(iii). It tackles the weaknesses of traditional databases while handling position-specific DNA-related data in an efficient manner. DRUMS is capable of storing up to billions of records. Moreover, it focuses on optimizing relating single lookups as range request, which are needed permanently for computations in bioinformatics. To validate the power of DRUMS, we compare it to the widely used MySQL database. The test setting considers two biological data sets. We use standard desktop hardware as test environment. Conclusions DRUMS outperforms MySQL in writing and reading records by a factor of two up to a factor of 10000. Furthermore, it can work with significantly larger data sets. Our work focuses on mid-sized data

  11. Phytoremediation of hydrocarbon contaminants in subantarctic soils: an effective management option.

    PubMed

    Bramley-Alves, Jessica; Wasley, Jane; King, Catherine K; Powell, Shane; Robinson, Sharon A

    2014-09-01

    Accidental fuel spills on world heritage subantarctic Macquarie Island have caused considerable contamination. Due to the island's high latitude position, its climate, and its fragile ecosystem, traditional methods of remediation are unsuitable for on-site clean up. We investigated the tolerance of a subantarctic native tussock grass, Poa foliosa (Hook. f.), to Special Antarctic Blend (SAB) diesel fuel and its potential to reduce SAB fuel contamination via phytoremediation. Toxicity of SAB fuel to P. foliosa was assessed in an 8 month laboratory growth trial under growth conditions which simulated the island's environment. Single seedlings were planted into 1 L pots of soil spiked with SAB fuel at concentrations of 1000, 5 000, 10,000, 2000 and 40,000 mg/kg (plus control). Plants were harvested at 0, 2, 4 and 8 months and a range of plant productivity endpoints were measured (biomass production, plant morphology and photosynthetic efficiency). Poa foliosa was highly tolerant across all SAB fuel concentrations tested with respect to biomass, although higher concentrations of 20,000 and 40,000 mg SAB/kg soil caused slight reductions in leaf length, width and area. To assess the phytoremediation potential of P. foliosa (to 10 000 mg/kg), soil from the planted pots was compared with that from paired unplanted pots at each SAB fuel concentration. The effect of the plant on SAB fuel concentrations and the associated microbial communities found within the soil (total heterotrophs and hydrocarbon degraders) were compared between planted and unplanted treatments at the 0, 2, 4 and 8 month harvest periods. The presence of plants resulted in significantly less SAB fuel in soils at 2 months and a return to background concentration by 8 months. Microbes did not appear to be the sole driving force behind the observed hydrocarbon loss. This study provides evidence that phytoremediation using P. foliosa is a valuable remediation option for use at Macquarie Island, and may be

  12. Using the Cancer Risk Management Model to evaluate colorectal cancer screening options for Canada

    PubMed Central

    Coldman, A.J.; Phillips, N.; Brisson, J.; Flanagan, W.; Wolfson, M.; Nadeau, C.; Fitzgerald, N.; Miller, A.B.

    2015-01-01

    Background Several screening methods for colorectal cancer (crc) are available, and some have been shown by randomized trials to be effective. In the present study, we used a well-developed population health simulation model to compare the risks and benefits of a variety of screening scenarios. Tests considered were the fecal occult blood test (fobt), the fecal immunochemical test (fit), flexible sigmoidoscopy, and colonoscopy. Outcomes considered included years of life gained, crc cases and deaths prevented, and direct health system costs. Methods A natural history model of crc was implemented and calibrated to specified targets within the framework of the Cancer Risk Management Model (crmm) from the Canadian Partnership Against Cancer. The crmm-crc permits users to enter their own parameter values or to use program-specified base values. For each of 23 screening scenarios, we used the crmm-crc to run 10 million replicate simulations. Results Using base parameter values and some user-specified values in the crmm-crc, and comparing our screening scenarios with no screening, all screening scenarios were found to reduce the incidence of and mortality from crc. The fobt was the least effective test; it was not associated with lower net cost. Colonoscopy screening was the most effective test; it had net costs comparable to those for several other strategies considered, but required more than 3 times the colonoscopy resources needed by other approaches. After colonoscopy, strategies based on the fit were predicted to be the most effective. In sensitivity analyses performed for the fobt and fit screening strategies, fobt parameter values associated with high-sensitivity formulations were associated with a substantial increase in test effectiveness. The fit was more cost-effective at the 50 ng/mL threshold than at the 100 ng/mL threshold. Conclusions The crmm-crc provides a sophisticated and flexible environment in which to evaluate crc control options. All screening

  13. Risk management with substitution options: Valuing flexibility in small-scale energy systems

    NASA Astrophysics Data System (ADS)

    Knapp, Karl Eric

    Several features of small-scale energy systems make them more easily adapted to a changing operating environment than large centralized designs. This flexibility is often manifested as the ability to substitute inputs. This research explores the value of this substitution flexibility and the marginal value of becoming a "little more flexible" in the context of real project investment in developing countries. The elasticity of substitution is proposed as a stylized measure of flexibility and a choice variable. A flexible alternative (elasticity > 0) can be thought of as holding a fixed-proportions "nflexible" asset plus a sequence of exchange options---the option to move to another feasible "recipe" each period. Substitutability derives value from following a contour of anticipated variations and from responding to new information. Substitutability value, a "cost savings option", increases with elasticity and price risk. However, the required premium to incrementally increase flexibility can in some cases decrease with an increase in risk. Variance is not always a measure of risk. Tools from stochastic dominance are newly applied to real options with convex payoffs to correct some misperceptions and clarify many common modeling situations that meet the criteria for increased variance to imply increased risk. The behavior of the cost savings option is explored subject to a stochastic input price process. At the point where costs are identical for all alternatives, the stochastic process for cost savings becomes deterministic, with savings directly proportional to elasticity of substitution and price variance. The option is also formulated as a derivative security via dynamic programming. The partial differential equation is solved for the special case of Cobb-Douglas (elasticity = 1) (also shown are linear (infinite elasticity), Leontief (elasticity = 0)). Risk aversion is insufficient to prefer a more flexible alternative with the same expected value. Intertemporal

  14. Integrating terrestrial sequestration into a greenhouse gas management plan

    NASA Astrophysics Data System (ADS)

    Brown, Joel R.; Sampson, Neil

    Terrestrial sequestration has the potential to contribute to national and global greenhouse gas management strategies. However, spatial and temporal variability in sequestration potential and in the implementation of sequestering technologies introduces serious questions about how to resolve uncertainties and raise the credibility of terrestrial sequestration. Carbon flux in terrestrial ecosystems without land use change generally is less than one ton CO2e/ha and driven primarily by precipitation. Land use and management changes are relatively common and are driven by economics and social considerations both in the private and public sectors. Implementing a credible greenhouse gas management program that integrates terrestrial sequestration along with other sources and sinks requires a systematic approach to identify and quantitatively monitor changes in the drivers of terrestrial sequestration. A credible terrestrial sequestration monitoring program will require close attention to integrating direct measurement of soils and vegetation, statistically valid scaling, remote sensing, and computer modeling. Predicting changes at a level of confidence useful to policy development will also require an understanding of how land owners and managers respond to private sector price signals and government conservation initiatives.

  15. Advanced reservoir management for independent oil and gas producers

    SciTech Connect

    Sgro, A.G.; Kendall, R.P.; Kindel, J.M.; Webster, R.B.; Whitney, E.M.

    1996-11-01

    There are more than fifty-two hundred oil and gas producers operating in the United States today. Many of these companies have instituted improved oil recovery programs in some form, but very few have had access to state-of-the-art modeling technologies routinely used by major producers to manage these projects. Since independent operators are playing an increasingly important role in the production of hydrocarbons in the United States, it is important to promote state-of-the-art management practices, including the planning and monitoring of improved oil recovery projects, within this community. This is one of the goals of the Strategic Technologies Council, a special interest group of independent oil and gas producers. Reservoir management technologies have the potential to increase oil recovery while simultaneously reducing production costs. These technologies were pioneered by major producers and are routinely used by them. Independent producers confront two problems adopting this approach: the high cost of acquiring these technologies and the high cost of using them even if they were available. Effective use of reservoir management tools requires, in general, the services of a professional (geoscientist or engineer) who is already familiar with the details of setting up, running, and interpreting computer models.

  16. Satellite Radar Interferometry For Risk Management Of Gas Pipeline Networks

    NASA Astrophysics Data System (ADS)

    Ianoschi, Raluca; Schouten, Mathijs; Bas Leezenberg, Pieter; Dheenathayalan, Prabu; Hanssen, Ramon

    2013-12-01

    InSAR time series analyses can be fine-tuned for specific applications, yielding a potential increase in benchmark density, precision and reliability. Here we demonstrate the algorithms developed for gas pipeline monitoring, enabling operators to precisely pinpoint unstable locations. This helps asset management in planning, prioritizing and focusing in-situ inspections, thus reducing maintenance costs. In unconsolidated Quaternary soils, ground settlement contributes to possible failure of brittle cast iron gas pipes and their connections to houses. Other risk factors include the age and material of the pipe. The soil dynamics have led to a catastrophic explosion in the city of Amsterdam, which triggered an increased awareness for the significance of this problem. As the extent of the networks can be very wide, InSAR is shown to be a valuable source of information for identifying the hazard regions. We monitor subsidence affecting an urban gas transportation network in the Netherlands using both medium and high resolution SAR data. Results for the 2003-2010 period provide clear insights on the differential subsidence rates in the area. This enables characterization of underground motion that affects the integrity of the pipeline. High resolution SAR data add extra detail of door-to-door pipeline connections, which are vulnerable due to different settlements between house connections and main pipelines. The rates which we measure represent important input in planning of maintenance works. Managers can decide the priority and timing for inspecting the pipelines. The service helps manage the risk and reduce operational cost in gas transportation networks.

  17. Managing produced water from coal seam gas projects: implications for an emerging industry in Australia.

    PubMed

    Davies, Peter J; Gore, Damian B; Khan, Stuart J

    2015-07-01

    This paper reviews the environmental problems, impacts and risks associated with the generation and disposal of produced water by the emerging coal seam gas (CSG) industry and how it may be relevant to Australia and similar physical settings. With only limited independent research on the potential environmental impacts of produced water, is it necessary for industry and government policy makers and regulators to draw upon the experiences of related endeavours such as mining and groundwater extraction accepting that the conclusions may not always be directly transferrable. CSG is widely touted in Australia as having the potential to provide significant economic and energy security benefits, yet the environmental and health policies and the planning and regulatory setting are yet to mature and are continuing to evolve amidst ongoing social and environmental concerns and political indecision. In this review, produced water has been defined as water that is brought to the land surface during the process of recovering methane gas from coal seams and includes water sourced from CSG wells as well as flowback water associated with drilling, hydraulic fracturing and gas extraction. A brief overview of produced water generation, its characteristics and environmental issues is provided. A review of past lessons and identification of potential risks, including disposal options, is included to assist in planning and management of this industry.

  18. Options for independent bladder management in patients with spinal cord injury and hand function prohibiting intermittent catheterization.

    PubMed

    Sorokin, Igor; De, Elise

    2015-02-01

    Choosing the appropriate bladder management strategy for the spinal cord injury patient with neurogenic bladder and hand function prohibitive of self catheterization (urethral or stomal) catheterization is complex and based on limited literature. We have catalogued the available data in this review. A literature review was conducted on external sphincterotomy, suprapubic tube, ileal conduit, and ileovesicostomy between 1994 and 2012. Articles on neurogenic bladder focused primarily on spinal cord injury were included. Important aspects of each technique, patient selection, urologic events, and quality of life are described. The available literature consists primarily of level 3 data. Patient reported outcomes were rarely measured. External sphincterotomy is a good option for males who are candidates for an external catheter and who wish to avoid a complicated reconstruction-most will need re-operations for failure. Suprapubic tube is an option in both genders. Complaints usually involve urine leakage and urinary tract infection, which typically resolve with conservative measures. There is some evidence to support patient satisfaction. Ileal conduit is an option for all patients with quadriplegia, offering continuous drainage and absence of foreign material. Many providers and patients will choose more conservative options first. The ileovesicostomy is best applied to small bladders with severe overactivity. The "reversibility" of this procedure makes it attractive to those not interested in an ileal conduit and who have had complications from prolonged suprapubic tube placement. The authors conclude with recommendations for future research, most importantly more standard reporting of objective data. © 2013 Wiley Periodicals, Inc.

  19. Options for management of municipal solid waste in New York City: A preliminary comparison of health risks and policy implications

    PubMed Central

    Moy, Pearl; Krishnan, Nikhil; Ulloa, Priscilla; Cohen, Steven; Brandt-Rauf, Paul W.

    2008-01-01

    Landfill disposal and waste-to-energy (WTE) incineration remain the two principal options for managing municipal solid waste (MSW). One critical determinant of the acceptability of these options is the different health risks associated with each. In this analysis relying on published data and exposure modeling, we have performed health risk assessments for landfill disposal versus WTE treatment options for the management of New York City’s MSW. These are based on the realistic scenario of using a waste transfer station (WTS) in Brooklyn and then transporting the untreated MSW by truck to a landfill in Pennsylvania or using a WTE facility in Brooklyn and then transporting the resultant ash by truck to a landfill in Pennsylvania. The overall results indicate that the individual cancer risks for both options would be considered generally acceptable, although the risk from landfilling is approximately 5 times greater than from WTE treatment; the individual non-cancer health risks for both options would be considered generally unacceptable, although once again the risk from landfilling is approximately 5 times greater than from WTE treatment. If one considers only the population in Brooklyn that would be directly affected by the siting of either a WTS or a WTE facility in their immediate neighborhood, individual cancer and non-cancer health risks for both options would be considered generally acceptable, but risks for the former remain considerably higher than for the latter. These results should be considered preliminary due to several limitations of this study such as: consideration of risks only from inhalation exposures; assumption that only volume and not composition of the waste stream is altered by WTE treatment; reliance on data from the literature rather than actual measurements of the sites considered, assuming comparability of the sites. However, the results of studies such as this, in conjunction with ecological, socioeconomic and equity considerations

  20. Gas cylinder disposal pit remediation waste minimization and management

    SciTech Connect

    Alas, C.A.; Solow, A.; Criswell, C.W.; Spengler, D.; Brannon, R.; Schwender, J.M.; Eckman, C.K.; Rusthoven, T.

    1995-02-01

    A remediation of a gas cylinder disposal pit at Sandia National Laboratories, New Mexico has recently been completed. The cleanup prevented possible spontaneous releases of hazardous gases from corroded cylinders that may have affected nearby active test areas at Sandia`s Technical Area III. Special waste management, safety, and quality plans were developed and strictly implemented for this project. The project was conceived from a waste management perspective, and waste minimization and management were built into the planning and implementation phases. The site layout was planned to accommodate light and heavy equipment, storage of large quantities of suspect soil, and special areas to stage and treat gases and reactive chemicals removed from the pit, as well as radiation protection areas. Excavation was a tightly controlled activity using experienced gas cylinder and reactive chemical specialists. Hazardous operations were conducted at night under lights, to allow nearby daytime operations to function unhindered. The quality assurance plan provided specific control of, and documentation for, critical decisions, as well as the record of daily operations. Both hand and heavy equipment excavation techniques were utilized. Hand excavation techniques were utilized. Hand excavation techniques allows sealed glass containers to be exhumed unharmed. In the end, several dozen thermal batteries; 5 pounds (2.3 kg) of lithium metal; 6.6 pounds (3.0 kg) of rubidium metal; several kilograms of unknown chemicals; 140 cubic yards (107 cubic meters) of thorium-contaminated soil; 270 cubic yards (205 cubic meters) of chromium-contaminated soil; and 450 gas cylinders, including 97 intact cylinders containing inert, flammable, toxic, corrosive, or oxidizing gases were removed and effectively managed to minimize waste.

  1. Report on ISS O2 Production, Gas Supply and Partial Pressure Management

    NASA Technical Reports Server (NTRS)

    Schaezler, Ryan N.; Cook, Anthony J.

    2015-01-01

    Oxygen is used on International Space Station (ISS) for metabolic support and denitrogenation procedures prior to Extra-Vehicular Activities. Nitrogen is used to maintain total pressure and account for losses associated with leakage and operational losses. Oxygen and nitrogen have been supplied by various visiting vehicles such as the Progress and Shuttle in addition to the on-orbit oxygen production capability. Starting in 2014, new high pressure oxygen/nitrogen tanks are available to launch on commercial cargo vehicles and will replace the high pressure gas source that Shuttle used to provide. To maintain a habitable atmosphere the oxygen and nitrogen partial pressures are controlled between upper and lower bounds. The full range of the allowable partial pressures along with the increased ISS cabin volume are utilized as a buffer allowing days to pass between oxygen production or direct addition of oxygen and nitrogen to the atmosphere from reserves. This paper summarizes the amount of gas supplied and produced from all of the sources and describes past experience of managing partial pressures along with the range of management options available to the ISS.

  2. Safe Management of Waste Generated during Shale Gas Operations

    NASA Astrophysics Data System (ADS)

    Kukulska-Zając, Ewa; Król, Anna; Holewa-Rataj, Jadwiga

    2017-04-01

    Exploration and exploitation of hydrocarbon deposits, regardless of their type, are connected with the generation of waste, which may have various environmental effects. Such wastes may pose a serious risk to the surrounding environment and public health because they usually contain numerous potentially toxic chemicals. Waste associated with exploration and exploitation of unconventional hydrocarbon deposits is composed of a mixture of organic and inorganic materials, the qualitative and quantitative composition of which changes widely over time, depending on numerous factors. As a result the proper characteristic of this type of waste is very important. Information gained from detailed chemical analyses of drilling chemicals, drilling wastes, and flowback water can be used to manage shale gas-related wastes more appropriately, to develop treatment methods, to store the waste, and assess the potential environmental and health risk. The following paper will focus mainly on the results of research carried out on waste samples coming from the unconventional hydrogen exploration sites. Additionally, regulatory frameworks applicable to the management of wastes produced during this type of works will be discussed. The scope of research concerning physicochemical parameters for this type of wastes will also be presented. The presented results were obtained during M4ShaleGas project realization. The M4ShaleGas project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement no. 640715.

  3. 76 FR 31998 - Cancellation of an Optional Form by the Office of Personnel Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... application process for both Federal agencies and job seekers, consistent with the goals of Federal hiring... the Optional Application for Federal Employment. The information contained in the OF 612 is now incorporated in the online Resume Builder on the USAJOBS Web site. The need to maintain the OF 612 as...

  4. Do School Boards Still Have Options? The Erosion of Management Authority.

    ERIC Educational Resources Information Center

    Lieberman, Myron

    1997-01-01

    School boards are woefully unprepared to deal with "make or buy" issues, due to massive union efforts to eliminate or restrict board freedom to contract for services. Teachers neither understand nor support a market economy. School boards' contracting out ability will not be secure until favorable legislative options are considered and…

  5. Emerging treatment options in the management of non-small cell lung cancer

    PubMed Central

    Filosso, Pier Luigi; Sandri, Alberto; Oliaro, Alberto; Filippi, Andrea Riccardo; Cassinis, Maria Carla; Ricardi, Umberto; Lausi, Paolo Olivo; Asioli, Sofia; Ruffini, Enrico

    2011-01-01

    Lung cancer (LC) has become the leading cancer-related cause of death in the US and in developed European countries in the last decade. Its incidence is still growing in females and in smokers. Surgery remains the treatment of choice whenever feasible, but unfortunately, many patients have an advanced LC at presentation and one-third of potentially operable patients do not receive a tumor resection because of their low compliance for intervention due to their compromised cardiopulmonary functions and other comorbidities. For these patients the alternative therapeutic options are stereotactic radiotherapy or percutaneous radiofrequency. When surgery is planned, an anatomical resection (segmentectomy, lobectomy, bilobectomy, pneumonectomy, sleeve lobectomy) is usually performed; wedge resection (considered as a nonanatomical one) is generally the accepted option for unfit patients. The recent increase in discovering small and peripheral LCs and/or ground-glass opacities with screening programs has dramatically increased surgeons’ interest in limited resections. The role of these resections is discussed. Also, recent improvements in molecular biology techniques have increased the chemotherapic options for neoadjuvant LC treatment. The role and the importance of targeted chemotherapy is also discussed. PMID:28210115

  6. Strategic options for sustainable water management at new developments: the application of a simulation model to explore potential water savings.

    PubMed

    Alegre, N; Jeffrey, P; McIntosh, B; Thomas, J S; Hardwick, I; Riley, S

    2004-01-01

    Research on appropriate technologies and infrastructures to support water reuse has progressed rapidly over recent decades and there are now a wide range of source--treatment--reuse options for planners to choose from. Although the economics of water reuse schemes favours application to new developments rather than retrofit projects, there are few studies which have sought to address strategic option selection issues for large developments. The potential advantages of using treatment and reuse systems in new developments require an understanding of the relationships between a wide variety of social, environmental, technological, and operational factors. The operational effectiveness and economic efficiency of specific technology choices will vary as a function of network configuration, wastewater characteristics, how different technologies respond to dynamic loading (variability of feed strength and flow) and potential spiking, as well as equipment reliability, climate and household behaviour. Using a commercially available software package, the study reports the design and implementation of a low resolution simulation tool to explore sustainable water management options for a live case study site in the south of England (a peri-urban development of 4,500 new homes) with particular reference to opportunities for rainwater harvesting, and water reuse.

  7. Using Department of Energy (DOE) Order 435.1 To Find a Cost Effective Waste Management Option. - 12241

    SciTech Connect

    LaBarge, Matt; Frost, Matt

    2012-07-01

    The Depleted Uranium Hexafluoride Project in Portsmouth Ohio was faced with an interesting dilemma. During hot functional testing in August 2010, an upset condition caused gaseous depleted uranium hexafluoride (UF{sub 6}) to come in contact with the hydrofluoric acid (HF) vapor stream. Although the resulting uranium contamination found in the condensed aqueous hydrofluoric acid was very low, it exceeded the Department of Energy (DOE) authorized release limit. After evaluating several commercial options for treatment and disposal using the guidelines found in DOE Order 435.1, Waste Control Specialists LLC was selected for the treatment of the waste, with EnergySolutions' Clive facility selected for disposal of the treated residues. The waste was safely transported from Piketon, Ohio to Andrews, Texas, where it was treated to meet the land Disposal Restrictions (LDR), and was disposed in EnergySolutions operational mixed waste cell. The entire effort was interesting for several reasons. The waste was generated during the last year of the first Depleted Uranium Hexafluoride contractor. The waste became additional scope for the new contractor, adding time delays and introducing new personnel into the project. The effort was also unique because it demonstrated the process mandated by DOE Order 435.1 to evaluate all options, including commercial options, could reveal solutions to waste management problems that are currently available and more cost effective, but not well know within the DOE complex. (authors)

  8. Many objective optimization and impact assessment of water management options in the Jaguaribe Basin of North East Brazil

    NASA Astrophysics Data System (ADS)

    Hurford, A. P.; Huskova, I.; Matrosov, E.; Harou, J. J.

    2012-12-01

    The Jaguaribe river basin in the north east of Brazil lies in the country's driest state, Ceará. Rainfall is concentrated in six months of the year, evapotranspiration can reach 2000 mm per year and a high proportion of the population relies on irrigated agriculture for their subsistence or livelihood. The current water management strategy involves negotiating monthly release rates from each of the basin's three major reservoirs twice a year. The state water management company leads these negotiations with representatives of various water user groups; releases are decided based on the currently stored volume and limited modelling of release scenarios. Presently reservoirs are managed such that municipal demands are guaranteed for 30 months from the date of negotiation. We use multi-objective optimization to search for the pareto-optimal number of months of municipal demand to be guaranteed, and the shape of release rules (based on stored volume). System performance is assessed by comparing flow-duration curves and livelihood factors, such as riparian farm land availability and fishery quality , in addition to the satisfaction of demands in the region supplied by each reservoir. Historical monthly flows are used to simulate the system over 90 years. Results shows the trade-offs between different performance measures and the effects of management option combinations on different water users. A few climate change projections of reservoir inflows are used to assess how a selection of the resulting release rules might perform against the same measures under altered future hydrological conditions. The proposed approach helps planners evaluate the impacts of management options and allows finding balanced stakeholder-backed ways to reduce negative impacts on the environment and the region's vulnerable groups while maintaining overall system performance.

  9. Developing Spatial Management Options for the Protection of Vulnerable Marine Ecosystems in the South Pacific Ocean Region.

    NASA Astrophysics Data System (ADS)

    Rowden, A. A.; Lundquist, C. J.; Clark, M. R.; Anderson, O. F.; Guinotte, J. M.; Baird, S. J.; Roux, M. J.; Wadhwa, S.

    2016-02-01

    The South Pacific Regional Fisheries Management Organisation (SPRFMO) Convention includes specific provisions to protect vulnerable marine ecosystems (VMEs). The SPRFMO Commission has determined that the interim measures put in place to protect VMEs would be replaced by an improved system of fishable and closed areas. These closures would effectively represent a preliminary spatial management plan, whereby conservation and management measures are implemented that will result in sustainable fisheries and benthic protection. We used the conservation planning tool Zonation to develop spatial management options that balance the protection of VMEs with utilisation of high value areas for fishing. Input data included habitat suitability maps, and uncertainties associated with these model predictions, for eleven VME indicator taxa (4 Scleractinian coral species; 3 other cnidarian groups (Family Stylasteridae, Order Antipatharia, Order Pennatulacea; 2 classes of sponges (Demospongiae, Hexactinellidae), and 2 echninoderm groups (Crinoidea and Brisingida)) at bathyal depths across the entire SPRFMO area (divided into 1 km2 grid cells); New Zealand fishing catch data (for two different time periods and trawl types); naturalness (represented by proxy variable using the number of trawl tows); and a bioregionalisation scheme. Running various scenario models for spatial planning allowed for the cost to fishing to be determined, in terms of the amount of the trawl catch footprint lost if high priority areas for VME indicator taxa are protected. Generally, the cost to fishing was low given the relatively high proportion of suitable habitat for VME indicator taxa protected. The main outcome of the present study is a demonstration of the practical utility of using available data, including modelled data, and the Zonation conservation planning software tool to develop options for the spatial management of the SPRFMO area.

  10. Estimation and evaluation of management options to control and/or reduce the risk of not complying with commercial sterility.

    PubMed

    Pujol, Laure; Albert, Isabelle; Magras, Catherine; Johnson, Nicholas Brian; Membré, Jeanne-Marie

    2015-11-20

    In a previous study, a modular process risk model, from the raw material reception to the final product storage, was built to estimate the risk of a UHT-aseptic line of not complying with commercial sterility (Pujol et al., 2015). This present study was focused on demonstrating how the model (updated version with uncertainty and variability separated and 2(nd) order Monte Carlo procedure run) could be used to assess quantitatively the influence of management options. This assessment was done in three steps: pinpoint which process step had the highest influence on the risk, identify which management option(s) could be the most effective to control and/or reduce the risk, and finally evaluate quantitatively the influence of changing process setting(s) on the risk. For Bacillus cereus, it was identified that during post-process storage in an aseptic tank, there was potentially an air re-contamination due to filter efficiency loss (efficiency loss due to successive in-place sterilizations after cleaning operations), followed by B. cereus growth. Two options were then evaluated: i) reducing by one fifth of the number of filter sterilizations before renewing the filters, ii) designing new UHT-aseptic lines without an aseptic tank, i.e. without a storage period after the thermal process and before filling. Considering the uncertainty in the model, it was not possible to confirm whether these options had a significant influence on the risk associated with B. cereus. On the other hand, for Geobacillus stearothermophilus, combinations of heat-treatment time and temperature enabling the control or reduction in risk by a factor of ca. 100 were determined; for ease of operational implementation, they were presented graphically in the form of iso-risk curves. For instance, it was established that a heat treatment of 138°C for 31s (instead of 138°C for 25s) enabled a reduction in risk to 18×10(-8) (95% CI=[10; 34]×10(-8)), instead of 578×10(-8) (95% CI=[429; 754]×10

  11. New Insights into Potential Prevention and Management Options for Chemotherapy-Induced Peripheral Neuropathy

    PubMed Central

    Schloss, Janet; Colosimo, Maree; Vitetta, Luis

    2016-01-01

    Objective: Neurological complications such as chemotherapy-induced peripheral neuropathy (CIPN) and neuropathic pain are frequent side effects of neurotoxic chemotherapy agents. An increasing survival rate and frequent administration of adjuvant chemotherapy treatments involving neurotoxic agents makes it imperative that accurate diagnosis, prevention, and treatment of these neurological complications be implemented. Methods: A consideration was undertaken of the current options regarding protective and treatment interventions for patients undergoing chemotherapy with neurotoxic chemotherapy agent or experience with CIPN. Current knowledge on the mechanism of action has also been identified. The following databases PubMed, the Cochrane Library, Science Direct, Scopus, EMBASE, MEDLINE, CINAHL, CNKI, and Google Scholar were searched for relevant article retrieval. Results: A range of pharmaceutical, nutraceutical, and herbal medicine treatments were identified that either showed efficacy or had some evidence of efficacy. Duloxetine was the most effective pharmaceutical agent for the treatment of CIPN. Vitamin E demonstrated potential for the prevention of cisplatin-IPN. Intravenous glutathione for oxaliplatin, Vitamin B6 for both oxaliplatin and cisplatin, and omega 3 fatty acids for paclitaxel have shown protection for CIPN. Acetyl-L-carnitine may provide some relief as a treatment option. Acupuncture may be of benefit for some patients and Gosha-jinki-gan may be of benefit for protection from adverse effects of oxaliplatin induced peripheral neuropathy. Conclusions: Clinicians and researchers acknowledge that there are numerous challenges involved in understanding, preventing, and treating peripheral neuropathy caused by chemotherapeutic agents. New insights into mechanisms of action from chemotherapy agents may facilitate the development of novel preventative and treatment options, thereby enabling medical staff to better support patients by reducing this

  12. Management of Candida biofilms: state of knowledge and new options for prevention and eradication.

    PubMed

    Bujdáková, Helena

    2016-01-01

    Biofilms formed by Candida species (spp.) on medical devices represent a potential health risk. The focus of current research is searching for new options for the treatment and prevention of biofilm-associated infections using different approaches including modern nanotechnology. This review summarizes current information concerning the most relevant resistance/tolerance mechanisms to conventional drugs and a role of additional factors contributing to these phenomena in Candida spp. (mostly Candida albicans). Additionally, it provides an information update in prevention and eradication of a Candida biofilm including experiences with 'lock' therapy, potential utilization of small molecules in biomedical applications, and perspectives of using photodynamic inactivation in the control of a Candida biofilm.

  13. Monitoring soil greenhouse gas emissions from managed grasslands

    NASA Astrophysics Data System (ADS)

    Díaz-Pinés, Eugenio; Lu, Haiyan; Butterbach-Bahl, Klaus; Kiese, Ralf

    2014-05-01

    Grasslands in Central Europe are of enormous social, ecological and economical importance. They are intensively managed, but the influence of different common practices (i.e. fertilization, harvesting) on the total greenhouse gas budget of grasslands is not fully understood, yet. In addition, it is unknown how these ecosystems will react due to climate change. Increasing temperatures and changing precipitation will likely have an effect on productivity of grasslands and on bio-geo-chemical processes responsible for emissions of carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O). In the frame of the TERENO Project (www.tereno.net), a long-term observatory has been implemented in the Ammer catchment, southern Germany. Acting as an in situ global change experiment, 36 big lysimeters (1 m2 section, 150 cm height) have been translocated along an altitudinal gradient, including three sites ranging from 600 to 860 meters above sea level. In addition, two treatments have been considered, corresponding to different management intensities. The overall aim of the pre-alpine TERENO observatory is improving our understanding of the consequences of climate change and management on productivity, greenhouse gas balance, soil nutritional status, nutrient leaching and hydrology of grasslands. Two of the sites are equipped with a fully automated measurement system in order to continuously and accurately monitor the soil-atmosphere greenhouse gas exchange. Thus, a stainless steel chamber (1 m2 section, 80 cm height) is controlled by a robotized system. The chamber is hanging on a metal structure which can move both vertically and horizontally, so that the chamber is able to be set onto each of the lysimeters placed on the field. Furthermore, the headspace of the chamber is connected with a gas tube to a Quantum Cascade Laser, which continuously measures CO2, CH4, N2O and H2O mixing ratios. The chamber acts as a static chamber and sets for 15 minutes onto each lysimeter

  14. Options for biodiversity conservation in managed forest landscapes of multiple ownerships in Oregon and Washington, USA.

    Treesearch

    N. Suzuki; D.H. Olson

    2007-01-01

    We review the policies and management approaches used in U.S. Pacific Northwest planted forest to address biodiversity protection. We provide a case-study watershed design from southern Oregon, integrating various stand-to-landscape biodiversity-management approaches.

  15. Life cycle assessment of three different management options for spent alkaline batteries.

    PubMed

    Xará, Susana; Almeida, Manuel Fonseca; Costa, Carlos

    2015-09-01

    The potential environmental impact of Landfilling, Incineration and Recycling of spent household alkaline batteries collected in continental Portugal was compared using LCA methodology and the Recipe Impact Assessment method. Major contributors and improvement opportunities for each system were identified and scenarios for 2012 and 2016 legislation targets were evaluated. For 13 out of the 18 impact categories, the Recycling system is the worst alternative, Incineration is the worst option for 4 and Landfill is the worst option only for one impact category. However if additionally in each system the recovery of materials and energy is taken into account there is a noticeable advantage of the Recycling system for all the impact categories. The environmental profiles for 2012 and 2016 scenarios (25% and 45% recycling rates, respectively) show the dominance of the Recycling system for most of the impact categories. Based on the results of this study, it is questioned whether there are environmental benefits of recycling abroad the household alkaline batteries collected in continental Portugal and, since the low environmental performance of the Recycling system is particularly due to the international transport of the batteries to the recycling plant, is foreseen that a recycling facility located in Portugal, could bring a positive contribution to the environmental impact of the legislation compliance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Current management of fecal incontinence: Choosing amongst treatment options to optimize outcomes

    PubMed Central

    Van Koughnett, Julie Ann M; Wexner, Steven D

    2013-01-01

    The severity of fecal incontinence widely varies and can have dramatic devastating impacts on a person’s life. Fecal incontinence is common, though it is often under-reported by patients. In addition to standard treatment options, new treatments have been developed during the past decade to attempt to effectively treat fecal incontinence with minimal morbidity. Non-operative treatments include dietary modifications, medications, and biofeedback therapy. Currently used surgical treatments include repair (sphincteroplasty), stimulation (sacral nerve stimulation or posterior tibial nerve stimulation), replacement (artificial bowel sphincter or muscle transposition) and diversion (stoma formation). Newer augmentation treatments such as radiofrequency energy delivery and injectable materials, are minimally invasive tools that may be good options before proceeding to surgery in some patients with mild fecal incontinence. In general, more invasive surgical treatments are now reserved for moderate to severe fecal incontinence. Functional and quality of life related outcomes, as well as potential complications of the treatment must be considered and the treatment of fecal incontinence must be individualized to the patient. General indications, techniques, and outcomes profiles for the various treatments of fecal incontinence are discussed in detail. Choosing the most effective treatment for the individual patient is essential to achieve optimal outcomes in the treatment of fecal incontinence. PMID:24409050

  17. The psychological impact of rosacea and the influence of current management options.

    PubMed

    Moustafa, Farah; Lewallen, Robin S; Feldman, Steven R

    2014-11-01

    Rosacea is a common problem that is underdiagnosed; if left untreated can result in physical disfigurement and emotional distress. We reviewed the current literature to determine the degree of psychosocial impact of rosacea and the importance of treatment. We also reviewed the current treatment options. A search of the MEDLINE, EMBASE, and psycINFO databases from 1946 to present was performed to identify previous articles regarding the psychosocial and quality-of-life (QoL) impact of rosacea. A total of 17 studies were found that focused on the following areas: impact of disease on QoL, improvement of QoL with treatment, and willingness to pay. Reviewed articles used different measurement systems to quantify impact on QoL making comparisons between studies difficult to interpret. Patients with rosacea have higher incidences of embarrassment, social anxiety, depression, and decreased QoL compared with the rest of the population. Adequate treatment of symptoms results in improvement of QoL in patients with rosacea. New options that target the facial erythema of rosacea may help mitigate the negative psychological impact of rosacea. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  18. Free-roaming dog populations: a cost-benefit model for different management options, applied to Abruzzo, Italy.

    PubMed

    Høgåsen, H R; Er, C; Di Nardo, A; Dalla Villa, P

    2013-11-01

    Since 1991, Italian free-roaming dogs have been under government protection and euthanasia is restricted by law. Management measures are regulated at the regional level and include: kennelling, adoptions, conversion of stray dogs into block dogs, and population control of owned dogs. "Block dogs" are free-roaming dogs that have been collected by the veterinary services, microchipped, sterilised, vaccinated, and released under the responsibility of the local municipalities. The present paper describes a cost-benefit model for different management options and applies it to two provinces in Abruzzo, central Italy. The model considers welfare, nuisance and direct costs to the municipality. Welfare is quantified based on the expert opinions of 60 local veterinarians, who were asked to assign a score for each dog category according to the five freedoms: freedom from pain, physical discomfort, disease, fear, and freedom to express normal behaviour. Nuisance was assessed only for comparisons between management options, using the number of free-roaming dogs per inhabitant as a proxy indicator. A community dog population model was constructed to predict the effect of management on the different subpopulations of dogs during a ten-year period. It is a user-friendly deterministic model in Excel, easily adaptable to different communities to assess the impact of their dog management policy on welfare, nuisance and direct monetary cost. We present results for Teramo and Pescara provinces. Today's management system is compared to alternative models, which evaluate the effect of specific interventions. These include either a 10% yearly increase in kennel capacity, an increase in adoptions from kennels, a doubling of the capture of stray dogs, or a stabilisation of the owned dog population. Results indicate that optimal management decisions are complex because welfare, nuisance and monetary costs may imply conflicting interventions. Nevertheless, they clearly indicate that

  19. An Estimation of Profitability of Investment Projects in The Oil and Gas Industry Using Real Options Theory / Ocena Opłacalności Projektów Inwestycyjnych W Przemyśle Naftowym Z Wykorzystaniem Teorii Opcji Realnych

    NASA Astrophysics Data System (ADS)

    Kosowski, Piotr; Stopa, Jerzy

    2012-11-01

    Paper discusses issues relating to the valuation of investment efficiency in the oil and gas industry using a real options theory. The example of investment pricing using real options was depicted and it was confronted with the analysis executed with the use of traditional methods. Indicators commonly used to evaluate profitability of investment projects, based on a discounted cash flow method, have a few significant drawbacks, the most meaningful of which is staticity which means that any changes resulting from a decision process during the time of investment cannot be taken into consideration. In accordance with a methodology that is currently used, investment projects are analysed in a way that all the key decisions are made at the beginning and are irreversible. This approach assumes, that all the cash flows are specified and does not let the fact that during the time of investment there may appear new information, which could change its original form. What is also not analysed is the possibility of readjustment, due to staff managment's decisions, to the current market conditions, by expanding, speeding up/slowing down, abandoning or changing an outline of the undertaking. In result, traditional methods of investment projects valuation may lead to taking wrong decisions, e.g. giving up an owned exploitation licence or untimely liquidation of boreholes, which seem to be unprofitable. Due to all the above-mentioned there appears the necessity of finding some other methods which would let one make real and adequate estimations about investments in a petroleum industry especially when it comes to unconventional resources extraction. One of the methods which has been recently getting more and more approval in a world petroleum economics, is a real options pricing method. A real option is a right (but not an obligation) to make a decision connected with an investment in a specified time or time interval. According to the method a static model of pricing using DCF is

  20. Perioperative atrial fibrillation: A systematic review of evolving therapeutic options in pharmacologic and procedural management

    PubMed Central

    Schleifer, J. William; Ramakrishna, Harish

    2015-01-01

    Given the high incidence of atrial fibrillation (AF) in the surgical population and the associated morbidity, physicians managing these complicated patients in the perioperative period need to be aware of the new and emerging trends in its therapy. The cornerstones of AF management have always been rate/rhythm control as well as anticoagulation. Restoration of sinus rhythm remains the fundamental philosophy as it maintains the atrial contribution to cardiac output and improves ventricular function. The recent years have seen a dramatic increase in the number of randomized AF trials that have made significant advances to our understanding of both pharmacologic and procedural management, from the introduction of the new generation of oral anticoagulants (NOAC's) to catheter approaches for AF ablation. This paper will summarize the newest data that will affect the perioperative management of these patients. PMID:26440243

  1. Management of the critical airway when an EXIT procedure is not an option: A case report.

    PubMed

    Diercks, Gillian R; Hartnick, Christopher J; Bates, Sara V

    2015-12-01

    Perinatal imaging facilitates detection of congenital head and neck masses to plan fetal procedures which secure the airway. Ex utero intrapartum therapy (EXIT) procedures are preferred to protect the neonatal airway. Herein we present a case in which a neonate with a large oropharyngeal lymphovascular malformation was delivered and the airway successfully managed without an EXIT procedure using a multidisciplinary approach. Preparations for the non-EXIT delivery and critical airway management are described.

  2. Management Options for Patients with Chronic Back Pain Without an Etiology

    PubMed Central

    Salzberg, Lenny D.; Manusov, Eron G.

    2013-01-01

    The treatment and management of low back pain is complex when there is no specific etiology such as cancer, fracture, or herniated disc. An organized approach to management that follows evidence based guidelines will facilitate care in a problem that reflects a lifetime prevalence of over 70 percent. The purpose of this review is to present a guideline to care for a common disabling process with a very heterogeneous etiology. PMID:25114558

  3. The syndrome of inappropriate antidiuretic hormone: current and future management options.

    PubMed

    Sherlock, Mark; Thompson, Chris J

    2010-06-01

    Hyponatraemia is the commonest electrolyte abnormality, and syndrome of inappropriate antidiuretic hormone (SIADH) is the most frequent underlying pathophysiology. Hyponatraemia is associated with significant morbidity and mortality, and as such appropriate treatment is essential. Treatment options for SIADH include fluid restriction, demeclocycline, urea, frusemide and saline infusion, all of which have their limitations. The introduction of the vasopressin-2 receptor antagonists has allowed clinicians to specifically target the underlying pathophysiology of SIADH. Initial studies have shown good efficacy and safety profiles in the treatment of mild to moderate hyponatraemia. However, studies assessing the efficacy and safety of these agents in acute severe symptomatic hyponatraemia are awaited. Furthermore, the cost of these agents at present may limit their use.

  4. Western corn rootworm Diabrotica v. virgifera in Europe: status, and options for future management.

    PubMed

    Hummel, H E; Deuker, A

    2009-01-01

    Diabrotica virgifero virgifera (Col.: Chrysomelidae) (western corn rootworm, WCR) unfortunately is now a firmly established European maize pest without indigenous natural enemies. Twenty years after its first introduction into Europe by traffic and trade, eradication is wishful thinking and not longer a viable option. Instead, European legislation calls for toxicological emergency measures on a case by case basis where and when new infestations occur either by new invasions from the native Americas or by introductions from other European countries. It is unclear at which point in time such treatment systems will break down because of development of resistant strains or by other complications of this seemingly unstable situation. Rather than proceeding as usual, sustainable biological, biotechnical and cultural methods should be practiced. Prominent among them are trapping and survey with attractants in conjunction with traditional crop rotation and phytosanitation.

  5. Phytoremediation as a management option for contaminated sediments in tidal marshes, flood control areas and dredged sediment landfill sites.

    PubMed

    Bert, Valérie; Seuntjens, Piet; Dejonghe, Winnie; Lacherez, Sophie; Thuy, Hoang Thi Thanh; Vandecasteele, Bart

    2009-11-01

    Polluted sediments in rivers may be transported by the river to the sea, spread over river banks and tidal marshes or managed, i.e. actively dredged and disposed of on land. Once sedimented on tidal marshes, alluvial areas or control flood areas, the polluted sediments enter semi-terrestrial ecosystems or agro-ecosystems and may pose a risk. Disposal of polluted dredged sediments on land may also lead to certain risks. Up to a few years ago, contaminated dredged sediments were placed in confined disposal facilities. The European policy encourages sediment valorisation and this will be a technological challenge for the near future. Currently, contaminated dredged sediments are often not valorisable due to their high content of contaminants and their consequent hazardous properties. In addition, it is generally admitted that treatment and re-use of heavily contaminated dredged sediments is not a cost-effective alternative to confined disposal. For contaminated sediments and associated disposal facilities used in the past, a realistic, low cost, safe, ecologically sound and sustainable management option is required. In this context, phytoremediation is proposed in the literature as a management option. The aim of this paper is to review the current knowledge on management, (phyto)remediation and associated risks in the particular case of sediments contaminated with organic and inorganic pollutants. This paper deals with the following features: (1) management and remediation of contaminated sediments and associated risk assessment; (2) management options for ecosystems on polluted sediments, based on phytoremediation of contaminated sediments with focus on phytoextraction, phytostabilisation and phytoremediation of organic pollutants and (3) microbial and mycorrhizal processes occurring in contaminated sediments during phytoremediation. In this review, an overview is given of phytoremediation as a management option for semi-terrestrial and terrestrial ecosystems

  6. Market Characteristics and Awareness of Managed Care Options Among Elderly Beneficiaries Enrolled in Traditional Medicare

    PubMed Central

    Mittler, Jessica N.; Landon, Bruce E.; Zaslavsky, Alan M.; Cleary, Paul D.

    2011-01-01

    Background Medicare beneficiaries' awareness of Medicare managed care plans is critical for realizing the potential benefits of coverage choices. Objectives To assess the relationships of the number of Medicare risk plans, managed care penetration, and stability of plans in an area with traditional Medicare beneficiaries' awareness of the program. Research Design Cross-sectional analysis of Medicare Current Beneficiary Survey data about beneficiaries' awareness and knowledge of Medicare managed care plan availability. Logistic regression models used to assess the relationships between awareness and market characteristics. Subjects Traditional Medicare beneficiaries (n = 3,597) who had never been enrolled in Medicare managed care, but had at least one plan available in their area in 2002, and excluding beneficiaries under 65, receiving Medicaid, or with end stage renal disease. Measures Traditional Medicare beneficiaries' knowledge of Medicare managed care plans in general and in their area. Results Having more Medicare risk plans available was significantly associated with greater awareness, and having an intermediate number of plans (2-4) was significantly associated with more accurate knowledge of Medicare risk plan availability than was having fewer or more plans. Conclusions Medicare may have more success engaging consumers in choice and capturing the benefits of plan competition by more actively selecting and managing the plan choice set. PMID:22340776

  7. Direct lymphangiography as treatment option of lymphatic leakage: indications, outcomes and role in patient's management.

    PubMed

    Gruber-Rouh, Tatjana; Naguib, Nagy N N; Lehnert, Thomas; Harth, Marc; Thalhammer, Axel; Beeres, Martin; Tsaur, Igor; Hammersting, Renate; Wichmann, Julian L; Vogl, Thomas J; Jacobi, Volkmar

    2014-12-01

    To evaluate the effectiveness of lymphography as a minimally invasive treatment option of lymphatic leakage in terms of local control and to investigate which parameters influence the success rate. This retrospective study protocol was approved by the ethic committee. Patient history, imaging data, therapeutic options and follow-up were recorded and retrospectively analyzed. Between June 1998 and February 2013, 71 patients (m:w = 42:29, mean age, 52.4; range 42–75 years) with lymphatic leakage in form of lymphatic fistulas (n = 37), lymphocele (n = 11), chylothorax (n = 13) and chylous ascites (n = 10)underwent lymphography. Sixty-four patients (90.1%) underwent successful lymphography while lymphography failed in 7 cases. Therapeutic success was evaluated and correlated to the volume of lymphatic leakage and to the volume of the applied iodized oil. Signs of leakage or contrast extravasation were directly detected in 64 patients. Of 64 patients, 45 patients (70.3%) were treated and cured after lymphography. Based on the lymphography findings, 19 patients (29.7%) underwent surgical intervention with a completely occlusion of lymphatic leakage. The lymphatic leak could be completely occluded in 96.8% of patients when the lymphatic drainage volume was less than 200 mL/day (n = 33). Even when lymphatic drainage was higher than 200 mL/day (n = 31),therapeutic lymphography was still successful in 58.1% of the patients. Lymphography is an effective, minimally invasive method in the detection and treatment of lymphatic leakage. The volume of lymphatic drainage per day is a significant predictor of the therapeutic success rate. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. MORECA-GT: Interactive simulator for gas-turbine modular HTGR transients and heatup accidents with ATWS options

    SciTech Connect

    Ball, S.J.; Nypaver, D.J.

    1994-03-01

    An interactive simulation code for studying postulated heatup accidents in modular high-temperature gas-cooled reactors (MHTGRs) has been adapted to assist with parametric design studies of the US Department of Energy`s (DOE`s) direct-cycle gas-turbine MHTGR concept. The studies show that the proposed MHTGR designs are very robust and can generally withstand the consequences of extremely low probability accidents with little or no damage to the reactor`s fuel or metallic components.

  9. Water management technologies used by Marcellus Shale Gas Producers.

    SciTech Connect

    Veil, J. A.; Environmental Science Division

    2010-07-30

    Natural gas represents an important energy source for the United States. According to the U.S. Department of Energy's (DOE's) Energy Information Administration (EIA), about 22% of the country's energy needs are provided by natural gas. Historically, natural gas was produced from conventional vertical wells drilled into porous hydrocarbon-containing formations. During the past decade, operators have increasingly looked to other unconventional sources of natural gas, such as coal bed methane, tight gas sands, and gas shales.

  10. Decision-making for ecosystem-based management: evaluating options for a krill fishery with an ecosystem dynamics model.

    PubMed

    Watters, G M; Hill, S L; Hinke, J T; Matthews, J; Reid, K

    2013-06-01

    Decision-makers charged with implementing ecosystem-based management (EBM) rely on scientists to predict the consequences of decisions relating to multiple, potentially conflicting, objectives. Such predictions are inherently uncertain, and this can be a barrier to decision-making. The Convention on the Conservation of Antarctic Marine Living Resources requires managers of Southern Ocean fisheries to sustain the productivity of target stocks, the health and resilience of the ecosystem, and the performance of the fisheries themselves. The managers of the Antarctic krill fishery in the Scotia Sea and southern Drake Passage have requested advice on candidate management measures consisting of a regional catch limit and options for subdividing this among smaller areas. We developed a spatially resolved model that simulates krill-predator-fishery interactions and reproduces a plausible representation of past dynamics. We worked with experts and stakeholders to identify (1) key uncertainties affecting our ability to predict ecosystem state; (2) illustrative reference points that represent the management objectives; and (3) a clear and simple way of conveying our results to decision-makers. We developed four scenarios that bracket the key uncertainties and evaluated candidate management measures in each of these scenarios using multiple stochastic simulations. The model emphasizes uncertainty and simulates multiple ecosystem components relating to diverse objectives. We summarize the potentially complex results as estimates of the risk that each illustrative objective will not be achieved (i.e., of the state being outside the range specified by the reference point). This approach allows direct comparisons between objectives. It also demonstrates that a candid appraisal of uncertainty, in the form of risk estimates, can be an aid, rather than a barrier, to understanding and using ecosystem model predictions. Management measures that reduce coastal fishing, relative to

  11. Storage management influences greenhouse gas emissions from biosolids.

    PubMed

    Majumder, Ramaprasad; Livesley, Stephen J; Gregory, David; Arndt, Stefan K

    2015-03-15

    Biosolids produced by wastewater treatment plants are often stored in stockpiles and can be a significant source of greenhouse gases (GHG). Growing trees in shallow stockpiled biosolids may remove nutrients, keep the biosolids drier and offset GHG emissions through C sequestration. We directly measured methane (CH4), carbon dioxide (CO2) and nitrous oxide (N2O) flux from a large biosolid stockpile and two shallow stockpiles, one planted with Salix reichardtii (willow) trees, from December 2009 to January 2011. All stockpiles emitted large annual amounts of GHG ranging from 38 kg CO2-e Mg(-1) dry biosolid for the large stockpile, to 65 kg CO2-e Mg(-1) for the unplanted shallow stockpile, probably due to the greater surface area to volume ratio. GHG emissions were dominated by N2O and CO2 whilst CH4 emissions were negligible (<2%) from the large stockpile and the shallow stockpiles were actually a CH4 sink. Annual willow tree growth was 12 Mg dry biomass ha(-1), but this only offset 8% of the GHG emissions from the shallow planted stockpile. Our data highlight that biosolid stockpiles are significant sources for GHG emissions but alternate management options such as shallow stockpiles or planting for biomass production will not lead to GHG emission reductions.

  12. Assessment of coastal management options by means of multilayered ecosystem models

    NASA Astrophysics Data System (ADS)

    Nobre, Ana M.; Ferreira, João G.; Nunes, João P.; Yan, Xiaojun; Bricker, Suzanne; Corner, Richard; Groom, Steve; Gu, Haifeng; Hawkins, Anthony J. S.; Hutson, Rory; Lan, Dongzhao; Silva, João D. Lencart e.; Pascoe, Philip; Telfer, Trevor; Zhang, Xuelei; Zhu, Mingyuan

    2010-03-01

    This paper presents a multilayered ecosystem modelling approach that combines the simulation of the biogeochemistry of a coastal ecosystem with the simulation of the main forcing functions, such as catchment loading and aquaculture activities. This approach was developed as a tool for sustainable management of coastal ecosystems. A key feature is to simulate management scenarios that account for changes in multiple uses and enable assessment of cumulative impacts of coastal activities. The model was applied to a coastal zone in China with large aquaculture production and multiple catchment uses, and where management efforts to improve water quality are under way. Development scenarios designed in conjunction with local managers and aquaculture producers include the reduction of fish cages and treatment of wastewater. Despite the reduction in nutrient loading simulated in three different scenarios, inorganic nutrient concentrations in the bay were predicted to exceed the thresholds for poor quality defined by Chinese seawater quality legislation. For all scenarios there is still a Moderate High to High nutrient loading from the catchment, so further reductions might be enacted, together with additional decreases in fish cage culture. The model predicts that overall, shellfish production decreases by 10%-28% using any of these development scenarios, principally because shellfish growth is being sustained by the substances to be reduced for improvement of water quality. The model outcomes indicate that this may be counteracted by zoning of shellfish aquaculture at the ecosystem level in order to optimize trade-offs between productivity and environmental effects. The present case study exemplifies the value of multilayered ecosystem modelling as a tool for Integrated Coastal Zone Management and for the adoption of ecosystem approaches for marine resource management. This modelling approach can be applied worldwide, and may be particularly useful for the application of

  13. Linking Domain-Specific Models to Describe the Complex Dynamics and Management Options of a Saline Floodplain

    NASA Astrophysics Data System (ADS)

    Woods, J.; Laattoe, T.

    2016-12-01

    Complex hydrological environments present management challenges where surface water-groundwater interactions involve interlinked processes at multiple scales. One example is Australia's River Murray, which flows through a semi-arid landscape with highly saline groundwater. In this region, the floodplain ecology depends on freshwater provided from the main river channel, anabranches, and floodwaters. However, in the past century access to freshwater has been further limited due to river regulation, land clearance, and irrigation. A programme to improve ecosystem health at Pike Floodplain, South Australia, is evaluating management options such as environmental watering and groundwater pumping. Due to the complicated interdependencies between processes moving water and salt within the floodplain, a series of inter-linked models were developed to assist with management decisions. The models differ by hydrological domain, scale, and dimensionality. Together they simulate surface water, the unsaturated zone, and groundwater on regional, floodplain, and local scales. Outputs from regional models provide boundary conditions for floodplain models, which in turn provide inputs for the local scale models. The results are interpreted based on (i) ecohydrological requirements for key species of tree and fish, and (ii) impacts on river salinity for downstream users. When combined, the models provide an integrated and interdiscplinary understanding of the hydrology and management of saline floodplains.

  14. Life cycle assessment of solid waste management options for Eskisehir, Turkey.

    PubMed

    Banar, Mufide; Cokaygil, Zerrin; Ozkan, Aysun

    2009-01-01

    Life cycle assessment (LCA) methodology was used to determine the optimum municipal solid waste (MSW) management strategy for Eskisehir city. Eskisehir is one of the developing cities of Turkey where a total of approximately 750tons/day of waste is generated. An effective MSW management system is needed in this city since the generated MSW is dumped in an unregulated dumping site that has no liner, no biogas capture, etc. Therefore, five different scenarios were developed as alternatives to the current waste management system. Collection and transportation of waste, a material recovery facility (MRF), recycling, composting, incineration and landfilling processes were considered in these scenarios. SimaPro7 libraries were used to obtain background data for the life cycle inventory. One ton of municipal solid waste of Eskisehir was selected as the functional unit. The alternative scenarios were compared through the CML 2000 method and these comparisons were carried out from the abiotic depletion, global warming, human toxicity, acidification, eutrophication and photochemical ozone depletion points of view. According to the comparisons and sensitivity analysis, composting scenario, S3, is the more environmentally preferable alternative. In this study waste management alternatives were investigated only on an environmental point of view. For that reason, it might be supported with other decision-making tools that consider the economic and social effects of solid waste management.

  15. Diagnosis and management of food allergies: new and emerging options: a systematic review

    PubMed Central

    O’Keefe, Andrew W; De Schryver, Sarah; Mill, Jennifer; Mill, Christopher; Dery, Alizee; Ben-Shoshan, Moshe

    2014-01-01

    It is reported that 6% of children and 3% of adults have food allergies, with studies suggesting increased prevalence worldwide over the last few decades. Despite this, our diagnostic capabilities and techniques for managing patients with food allergies remain limited. We have conducted a systematic review of literature published within the last 5 years on the diagnosis and management of food allergies. While the gold standard for diagnosis remains the double-blind, placebo-controlled food challenge, this assessment is resource intensive and impractical in most clinical situations. In an effort to reduce the need for the double-blind, placebo-controlled food challenge, several risk-stratifying tests are employed, namely skin prick testing, measurement of serum-specific immunoglobulin E levels, component testing, and open food challenges. Management of food allergies typically involves allergen avoidance and carrying an epinephrine autoinjector. Clinical research trials of oral immunotherapy for some foods, including peanut, milk, egg, and peach, are under way. While oral immunotherapy is promising, its readiness for clinical application is controversial. In this review, we assess the latest studies published on the above diagnostic and management modalities, as well as novel strategies in the diagnosis and management of food allergy. PMID:25368525

  16. Diagnosis and management of food allergies: new and emerging options: a systematic review.

    PubMed

    O'Keefe, Andrew W; De Schryver, Sarah; Mill, Jennifer; Mill, Christopher; Dery, Alizee; Ben-Shoshan, Moshe

    2014-01-01

    It is reported that 6% of children and 3% of adults have food allergies, with studies suggesting increased prevalence worldwide over the last few decades. Despite this, our diagnostic capabilities and techniques for managing patients with food allergies remain limited. We have conducted a systematic review of literature published within the last 5 years on the diagnosis and management of food allergies. While the gold standard for diagnosis remains the double-blind, placebo-controlled food challenge, this assessment is resource intensive and impractical in most clinical situations. In an effort to reduce the need for the double-blind, placebo-controlled food challenge, several risk-stratifying tests are employed, namely skin prick testing, measurement of serum-specific immunoglobulin E levels, component testing, and open food challenges. Management of food allergies typically involves allergen avoidance and carrying an epinephrine autoinjector. Clinical research trials of oral immunotherapy for some foods, including peanut, milk, egg, and peach, are under way. While oral immunotherapy is promising, its readiness for clinical application is controversial. In this review, we assess the latest studies published on the above diagnostic and management modalities, as well as novel strategies in the diagnosis and management of food allergy.

  17. Life cycle assessment of solid waste management options for Eskisehir, Turkey

    SciTech Connect

    Banar, Mufide Cokaygil, Zerrin; Ozkan, Aysun

    2009-01-15

    Life cycle assessment (LCA) methodology was used to determine the optimum municipal solid waste (MSW) management strategy for Eskisehir city. Eskisehir is one of the developing cities of Turkey where a total of approximately 750 tons/day of waste is generated. An effective MSW management system is needed in this city since the generated MSW is dumped in an unregulated dumping site that has no liner, no biogas capture, etc. Therefore, five different scenarios were developed as alternatives to the current waste management system. Collection and transportation of waste, a material recovery facility (MRF), recycling, composting, incineration and landfilling processes were considered in these scenarios. SimaPro7 libraries were used to obtain background data for the life cycle inventory. One ton of municipal solid waste of Eskisehir was selected as the functional unit. The alternative scenarios were compared through the CML 2000 method and these comparisons were carried out from the abiotic depletion, global warming, human toxicity, acidification, eutrophication and photochemical ozone depletion points of view. According to the comparisons and sensitivity analysis, composting scenario, S3, is the more environmentally preferable alternative. In this study waste management alternatives were investigated only on an environmental point of view. For that reason, it might be supported with other decision-making tools that consider the economic and social effects of solid waste management.

  18. Reservoir model for Hillsboro gas storage field management

    USGS Publications Warehouse

    Udegbunam, Emmanuel O.; Kemppainen, Curt; Morgan, Jim; ,

    1995-01-01

    A 3-dimensional reservoir model is used to understand the behavior of the Hillsboro Gas Storage Field and to investigate the field's performance under various future development. Twenty-two years of the gas storage reservoir history, comprising the initial gas bubble development and seasonal gas injection and production cycles, are examined with a full-field, gas water, reservoir simulation model. The results suggest that the gas-water front is already in the vicinity of the west observation well that increasing the field's total gas-in-place volume would cause gas to migrate beyond the east, north and west observation well. They also suggest that storage enlargement through gas injection into the lower layers may not prevent gas migration. Moreover, the results suggest that the addition of strategically-located new wells would boost the simulated gas deliverabilities.

  19. Public Response to Wildfire: Is the Australian "Stay and Defend or Leave Early" Approach an Option for Wildfire Management in the United States?

    Treesearch

    Sarah M. McCaffrey; Alan Rhodes

    2009-01-01

    In the United States, the increasing costs and negative impacts of wildfires are causing fire managers and policymakers to reexamine traditional approaches to fire management including whether mass evacuation of populations threatened by wildfire is always the most appropriate option. This article examines the Australian "stay and defend or leave early" (SDLE...

  20. 25 CFR 1200.5 - What are the advantages and disadvantages of managing trust funds under the options in § 1200.4?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 2 2013-04-01 2013-04-01 false What are the advantages and disadvantages of managing trust funds under the options in § 1200.4? 1200.5 Section 1200.5 Indians OFFICE OF THE SPECIAL TRUSTEE FOR AMERICAN INDIANS, DEPARTMENT OF THE INTERIOR AMERICAN INDIAN TRUST FUND MANAGEMENT REFORM ACT...

  1. 25 CFR 1200.5 - What are the advantages and disadvantages of managing trust funds under the options in § 1200.4?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 2 2014-04-01 2014-04-01 false What are the advantages and disadvantages of managing trust funds under the options in § 1200.4? 1200.5 Section 1200.5 Indians OFFICE OF THE SPECIAL TRUSTEE FOR AMERICAN INDIANS, DEPARTMENT OF THE INTERIOR AMERICAN INDIAN TRUST FUND MANAGEMENT REFORM ACT...

  2. RESTORATION PLUS: A COLLABORATIVE RESEARCH PROGRAM TO DEVELOP AND EVALUATE ECOSYSTEM RESTORATION AND MANAGEMENT OPTIONS TO ACHIEVE ECOLOGICALLY AND ECONOMICALLY SUSTAINABLE SOLUTIONS

    EPA Science Inventory

    EPA is evaluating ecosystem restoration and management techniques to ensure they create sustainable solutions for degraded watersheds. ORD NRMRL initiated the Restoration Plus (RePlus) program in 2002 to a) evaluate ecosystem restoration and management options, b) assess the non-...

  3. RESTORATION PLUS: A COLLABORATIVE RESEARCH PROGRAM TO DEVELOP AND EVALUATE ECOSYSTEM RESTORATION AND MANAGEMENT OPTIONS TO ACHIEVE ECOLOGICALLY AND ECONOMICALLY SUSTAINABLE SOLUTIONS

    EPA Science Inventory

    EPA is evaluating ecosystem restoration and management techniques to ensure they create sustainable solutions for degraded watersheds. ORD NRMRL initiated the Restoration Plus (RePlus) program in 2002 to a) evaluate ecosystem restoration and management options, b) assess the non-...

  4. Web-based citation management compared to EndNote: options for medical sciences.

    PubMed

    Gomis, Melissa; Gall, Carole; Brahmi, Frances A

    2008-01-01

    The authors of this article analyzed the differences in output when searching MEDLINE direct and MEDLINE via citation management software, EndNote X1, EndNote Web, and RefWorks. Several searches were performed on Ovid MEDLINE and PubMed directly. These searches were compared against the same searches conducted in Ovid MEDLINE and PubMed using the search features in EndNote X1, EndNote Web, and RefWorks. Findings indicated that for in-depth research users, should search the databases directly rather than through the citation management software interface. The search results indicated it would be appropriate to search databases via citation management software for citation verification tasks and for cursory keyword searching.

  5. Monitoring Requirements and Methods for Greenhouse Gas Management and Climate Change Detection

    NASA Astrophysics Data System (ADS)

    Birdsey, R.; Pan, Y.; Clark, K.; Hom, J.

    2007-12-01

    Climate change policy and management require monitoring data to support decision making. Availability of good data about past trends, and projections based on reasonable assumptions and models, can support debate about response options and avoid the pitfall of arguing about information quality. A hierarchical or multi-tier approach to environmental monitoring has been used efficiently for many decades, and can be linked with experiments and process modeling to improve natural resource assessments. Consideration of spatial and temporal scale can align data requirements with the information needed to facilitate separation of causal factors, e.g., factoring out natural effects from human-induced effects on the carbon cycle. Here we describe a 3-tier integrated monitoring hierarchy: intensive process-level monitoring, landscape-scale monitoring, and regional monitoring. Information at each tier may be used independently or integrated across tiers. Methods to integrate information include statistical techniques for diagnostic analysis, and ecosystem models for prognostic analysis. We illustrate the methods and results for each tier using data and analyses for the Pinelands Management Area of New Jersey, a reserved area of 360,000 ha. A cluster of flux towers and associated intensive-site measurements comprises the process monitoring. A network of biometric monitoring sites represents the landscape conditions, and forest inventory with remote sensing is used to characterize the region. This approach is capable of closing the regional carbon budget, i.e., accounting for all exchanges of carbon between the land, atmosphere, and ocean. It is also an excellent platform for monitoring the effects of climate change and factoring out different effects -- the system was designed to provide information about dangerous fire weather and identify needs to manage wildfire fuels. The New Jersey Pinelands site is part of a national network of multi-scale monitoring sites that can meet

  6. Options for venous access in ambulatory care: issues in selection and management.

    PubMed

    Herbst, S L

    1996-01-01

    As advances in VAD technology continue, the biggest challenge becomes the ability to stay abreast of all the emerging devices and the evolutions in management and care. Various resources are available which provide guidelines and standards to enable providers in the care of patients with VADs (see Table 6). It is incumbent upon caregivers to disseminate information as it is gained through observations and experience with VADs. The literature must remain current and accessible to all caregivers in order to ensure optimal management of patients with VADs.

  7. Different Management Options for Transplant Ureteral Obstructions within an Inguinal Hernia

    PubMed Central

    Cheung, Felix; Debartolo, Merrit Marion; Copertino, Leonard Michael; Szafran, April Adams; Estrada, Chelsea Caron; Lynch, Patrick Gerard; Darras, Frank Sam

    2016-01-01

    Ureteral obstruction secondary to an inguinal hernia with transplant ureteral component is an extremely rare entity with only several case reports found in literature. In all previously reported cases, management of the obstruction involved temporary drainage with ureteral stenting or nephrostomy tube placements followed by delayed definitive repair. We present two case reports, here one being the first one managed by immediate definitive repair via ureteral reimplant and herniorrhaphy and a second case by delayed definitive repair after percutaneous nephrostomy tube placement. Both patients continued to do well postoperatively with normalization of renal function on follow-up. PMID:27144049

  8. Management Options in Advanced Prostate Cancer: What is the Role for Sipuleucel-T?

    PubMed

    Bitting, Rhonda L; Armstrong, Andrew J; George, Daniel J

    2011-01-01

    Most prostate cancer-related deaths occur in patients with castration-resistant prostate cancer (CRPC). Until recently, only therapy with docetaxel and prednisone has been shown to prolong survival in men with metastatic CRPC. With the United States Food and Drug Administration (US FDA) approvals of sipuleucel-T, cabazitaxel, and abiraterone acetate, all based on improvement in overall survival, the landscape for management of men with metastatic CRPC has dramatically changed. In this review we will discuss the pivotal clinical trial data leading to these approvals, with particular focus on the unique indication for sipuleucel-T and the implications for optimal management and sequencing of treatment in this patient population.

  9. Greenhouse gas emissions from waste management--assessment of quantification methods.

    PubMed

    Mohareb, Eugene A; MacLean, Heather L; Kennedy, Christopher A

    2011-05-01

    Of the many sources of urban greenhouse gas (GHG) emissions, solid waste is the only one for which management decisions are undertaken primarily by municipal governments themselves and is hence often the largest component of cities' corporate inventories. It is essential that decision-makers select an appropriate quantification methodology and have an appreciation of methodological strengths and shortcomings. This work compares four different waste emissions quantification methods, including Intergovernmental Panel on Climate Change (IPCC) 1996 guidelines, IPCC 2006 guidelines, U.S. Environmental Protection Agency (EPA) Waste Reduction Model (WARM), and the Federation of Canadian Municipalities-Partners for Climate Protection (FCM-PCP) quantification tool. Waste disposal data for the greater Toronto area (GTA) in 2005 are used for all methodologies; treatment options (including landfill, incineration, compost, and anaerobic digestion) are examined where available in methodologies. Landfill was shown to be the greatest source of GHG emissions, contributing more than three-quarters of total emissions associated with waste management. Results from the different landfill gas (LFG) quantification approaches ranged from an emissions source of 557 kt carbon dioxide equivalents (CO2e) (FCM-PCP) to a carbon sink of -53 kt CO2e (EPA WARM). Similar values were obtained between IPCC approaches. The IPCC 2006 method was found to be more appropriate for inventorying applications because it uses a waste-in-place (WIP) approach, rather than a methane commitment (MC) approach, despite perceived onerous data requirements for WIP. MC approaches were found to be useful from a planning standpoint; however, uncertainty associated with their projections of future parameter values limits their applicability for GHG inventorying. MC and WIP methods provided similar results in this case study; however, this is case specific because of similarity in assumptions of present and future landfill

  10. Soil C storage and greenhouse gas emission perennial grasses managed for bio energy feedstock

    USDA-ARS?s Scientific Manuscript database

    Perennial grasses like switchgrass or big bluestem when managed as bioenergy feedstock require nitrogenous inputs. Nitrogen fertilizer frequently cause nitrous oxide emission. Therefore, managing grasses as feedstock may reduce the greenhouse gas (GHG) mitigation potential expected from perennial. ...

  11. THE IMPACT OF MUNICIPAL SOLID WASTE MANAGEMENT ON GREENHOUSE GAS EMISSIONS IN THE UNITED STATES

    EPA Science Inventory

    Technological advancements in United States (U.S.) municipal solid waste (MSW) disposal and a focus on the environmental advantages of integrated MSW management have greatly reduced the environmental impacts of MSW management, including greenhouse gas (GHG) emissions. This study ...

  12. THE IMPACT OF MUNICIPAL SOLID WASTE MANAGEMENT ON GREENHOUSE GAS EMISSIONS IN THE UNITED STATES

    EPA Science Inventory

    Technological advancements in United States (U.S.) municipal solid waste (MSW) disposal and a focus on the environmental advantages of integrated MSW management have greatly reduced the environmental impacts of MSW management, including greenhouse gas (GHG) emissions. This study ...

  13. [Standards, options and recommendations: Good clinical practice in the dietetic management of cancer patients: hospital catering].

    PubMed

    Dayot, F; Bataillard, A; Keré, C; Ducès, F; Bachmann, P; Blanc-Vincent, M P; Besnard, B; Bonneteau, C; Champetier, S; Claude, M; Combret, D; Cometto, F; Duguet, A; Duval, N; Finck, C; Freby-Lehner, A; Garabige, V; Lallemand, Y; Massoud, C; Meuric, J; Montane, C; Poirée, B; Puel, S; Rossignol, G; Roux-Bournay, P; Simon, M; Tran, M

    2001-10-01

    The "Standards, Options and Recommendations" (SOR) project, started in 1993, involves a collaboration between the Federation of the French Cancer Centres (FNCLCC), the 20 French Regional Cancer Centres, some French public university and general hospitals and private Clinics and medical scientific societies. Its main objective is the development of clinical practice guidelines to improve the quality of health care and outcome for cancer patients. The methodology is based on a literature review followed by a critical appraisal by a multidisciplinary group of experts to produce the draft guidelines which are then validated by specialists in cancer care delivery. To develop clinical practice guidelines for hospital catering for cancer patient using the methodology developed by the Standards, Options and Recommendations project. Data were identified by a literature search of Medline and the reference lists of experts in the groups. After the guidelines were drafted, they were validated by independent reviewers. The main recommendations are: 1) While taking into consideration the specific needs of cancer patients, the dietician is responsible for the hygiene, the sanitary quality of alimentation, the equilibrium and nutritional quality of the hospital catering. 2) Ordering and distribution of meals, and clearing up afterwards contribute to the quality of hospital catering and the personnel who do this should have time and be willing to listen to the patients. 3) The ordering of meals should be adapted to individual patient's requirements and must take into account the patient's medication. 4) The method of transporting the food chosen by the institution (cold or warm method) should be respected. The personnel responsible should receive regular and specific training to use the method correctly. 5) The intake of patients with nutritional follow-up should be reliably and reproducibly evaluated by the personnel after every meal. 6) Patient satisfaction should be assessed

  14. Current Options for the Management of Aneurysmal Subarachnoid Hemorrhage-Induced Cerebral Vasospasm: A Comprehensive Review of the Literature

    PubMed Central

    Dabus, Guilherme; Nogueira, Raul G.

    2013-01-01

    Objectives Cerebral vasospasm is one of the leading causes of morbi-mortality following aneurysmal subarachnoid hemorrhage. The aim of this article is to discuss the current status of vasospasm therapy with emphasis on endovascular treatment. Methods A comprehensive review of the literature obtained by a PubMed search. The most relevant articles related to medical, endovascular and alternative therapies were selected for discussion. Results Current accepted medical options include the oral nimodipine and ‘triple-H’ therapy (hypertension, hypervolemia and hemodilution). Nimodipine remains the only modality proven to reduce the incidence of infarction. Although widely used, ‘triple-H’ therapy has not been demonstrated to significantly change overall outcome after cerebral vasospasm. Indeed, both induced hypervolemia and hemodilution may have deleterious effects, and more recent physiologic data favor normovolemia with induced hypertension or optimization of cardiac output. Endovascular options include percutaneous transluminal balloon angioplasty (PTA) and intra-arterial (IA) infusion of vasodilators. Multiple case reports and case series have been encountered in the literature using different drug regimens with diverse mechanisms of action. Compared with PTA, IA drug infusion has the advantages of distal penetration and a better safety profile. Its main disadvantages are the more frequent need for repeat treatments and its systemic hemodynamic repercussions. Alternative options using intraventricular/cisternal drug therapy and flow augmentation strategies have also shown possible benefits; however, their use is not yet as well established. Conclusion Blood pressure or cardiac output optimization should be the mainstay of hyperdynamic therapy. Endovascular treatment appears to have a positive impact on neurological outcome compared with the natural history of the disease. The role of intraventricular therapy and flow augmentation strategies in association

  15. More than just timber: silvicultural options and ecosystem services from managed southern pine stands

    Treesearch

    Don C. Bragg; Jamie L. Schuler; Matthew H Pelkki; D. Andrew Scott; James M. Guldin

    2015-01-01

    The dramatic decline of timber harvests on public lands in the western United States (U.S.) has helped intensify silviculture in the southern U.S. Today, intensive southern pine management usually involves establishment of plantations using site preparation, genetically improved seedlings, chemical fertilization and competition control, early stand density regulation,...

  16. Young-stand management options and their implications for wood quality and other values.

    Treesearch

    R. James Barbour; Richard R. Zaborskeb; Michael H. McClellan; Linda Christian; Donald. Golnick

    2005-01-01

    This study used the forest vegetation Simulator (FVS), empirical wood product recovery information, and expert judgments to examine volume production and potential revenues for different silvicultural prescriptions grown to rotation ages of 70, 110, and 150 years. Our intention was to provide policymakers and managers with some of the information needed to evaluate the...

  17. Call It Trash, Garbage or Refuse: Four Case Studies Illustrate Community Waste Management Options.

    ERIC Educational Resources Information Center

    Kazzi, John W.

    1990-01-01

    Describes four successful community programs dealing with waste management issues, developed with assistance from Keep America Beautiful System: litter prevention (Beatrice, Nebraska); composting yard waste (Centralia, Illinois); recycling (Lake Jackson, Texas); and waste-to-energy incineration (Gastonia, North Carolina). Notes related education…

  18. Simulating Free-Roaming Cat Population Management Options in Open Demographic Environments

    PubMed Central

    Miller, Philip S.; Boone, John D.; Briggs, Joyce R.; Lawler, Dennis F.; Levy, Julie K.; Nutter, Felicia B.; Slater, Margaret; Zawistowski, Stephen

    2014-01-01

    Large populations of free-roaming cats (FRCs) generate ongoing concerns for welfare of both individual animals and populations, for human public health, for viability of native wildlife populations, and for local ecological damage. Managing FRC populations is a complex task, without universal agreement on best practices. Previous analyses that use simulation modeling tools to evaluate alternative management methods have focused on relative efficacy of removal (or trap-return, TR), typically involving euthanasia, and sterilization (or trap-neuter-return, TNR) in demographically isolated populations. We used a stochastic demographic simulation approach to evaluate removal, permanent sterilization, and two postulated methods of temporary contraception for FRC population management. Our models include demographic connectivity to neighboring untreated cat populations through natural dispersal in a metapopulation context across urban and rural landscapes, and also feature abandonment of owned animals. Within population type, a given implementation rate of the TR strategy results in the most rapid rate of population decline and (when populations are isolated) the highest probability of population elimination, followed in order of decreasing efficacy by equivalent rates of implementation of TNR and temporary contraception. Even low levels of demographic connectivity significantly reduce the effectiveness of any management intervention, and continued abandonment is similarly problematic. This is the first demographic simulation analysis to consider the use of temporary contraception and account for the realities of FRC dispersal and owned cat abandonment. PMID:25426960

  19. Designing Student Groupwork in Management Education: Widening the Palette of Options

    ERIC Educational Resources Information Center

    Holtham, Clive W.; Melville, Robert R.; Sodhi, ManMohan S.

    2006-01-01

    The authors describe innovation in practice through the unusual deployment of teams in a master's in management core course. Two parallel uses of teams were made, both drawing on the jigsaw team method, in one case with the team supporting individual work. The experiences support the idea of widening the palette of types of groupwork used in…

  20. Call It Trash, Garbage or Refuse: Four Case Studies Illustrate Community Waste Management Options.

    ERIC Educational Resources Information Center

    Kazzi, John W.

    1990-01-01

    Describes four successful community programs dealing with waste management issues, developed with assistance from Keep America Beautiful System: litter prevention (Beatrice, Nebraska); composting yard waste (Centralia, Illinois); recycling (Lake Jackson, Texas); and waste-to-energy incineration (Gastonia, North Carolina). Notes related education…

  1. Ixabepilone: a new treatment option for the management of taxane-resistant metastatic breast cancer

    PubMed Central

    Cobham, Marta Vallee; Donovan, Diana

    2009-01-01

    Ixabepilone (Ixempra®; Bristol-Myers Squibb) is a novel microtubule stabilizing agent recently approved for the treatment of metastatic breast cancer (MBC). This article focuses on considerations for ixabepilone administration and adverse event (AE) management, drawing from the biomedical literature indexed in PubMed, published abstracts from the American Society of Clinical Oncology annual meetings, and the manufacturer’s prescribing information for ixabepilone. Administered as monotherapy or in combination with capecitabine in clinical studies, ixabepilone demonstrated positive clinical response rates, prolonged progression-free survival, and a favorable safety profile in patients with MBC. Treatment-related AEs were predictable and manageable with dose modification, treatment interruption, and active management. As ixabepilone undergoes development in earlier lines of breast cancer therapy and in other solid tumors, oncology nurses will encounter more and more patients receiving ixabepilone therapy. If nurses are acquainted with the unique management strategies associated with ixabepilone treatment, as detailed herein, patients are more likely to receive the full benefit of therapy. PMID:21188125

  2. Ixabepilone: a new treatment option for the management of taxane-resistant metastatic breast cancer.

    PubMed

    Cobham, Marta Vallee; Donovan, Diana

    2009-06-29

    Ixabepilone (Ixempra(®); Bristol-Myers Squibb) is a novel microtubule stabilizing agent recently approved for the treatment of metastatic breast cancer (MBC). This article focuses on considerations for ixabepilone administration and adverse event (AE) management, drawing from the biomedical literature indexed in PubMed, published abstracts from the American Society of Clinical Oncology annual meetings, and the manufacturer's prescribing information for ixabepilone. Administered as monotherapy or in combination with capecitabine in clinical studies, ixabepilone demonstrated positive clinical response rates, prolonged progression-free survival, and a favorable safety profile in patients with MBC. Treatment-related AEs were predictable and manageable with dose modification, treatment interruption, and active management. As ixabepilone undergoes development in earlier lines of breast cancer therapy and in other solid tumors, oncology nurses will encounter more and more patients receiving ixabepilone therapy. If nurses are acquainted with the unique management strategies associated with ixabepilone treatment, as detailed herein, patients are more likely to receive the full benefit of therapy.

  3. Cracked tooth syndrome. Part 2: restorative options for the management of cracked tooth syndrome.

    PubMed

    Banerji, S; Mehta, S B; Millar, B J

    2010-06-01

    The second of this two part series on 'cracked tooth syndrome' will focus on the available methods for the immediate, intermediate and definitive management of patients affected by this condition. Included in this article is a comprehensive account of the relative merits/drawbacks of various restorative materials and their respective techniques of application for the treatment of symptomatic, incompletely fractured posterior teeth.

  4. Options for the management of white pine blister rust in the Rocky Mountain Region

    Treesearch

    Kelly S. Burns; Anna W. Schoettle; William R. Jacobi; Mary F. Mahalovich

    2008-01-01

    This publication synthesizes current information on the biology, distribution, and management of white pine blister rust (WPBR) in the Rocky Mountain Region. In this Region, WPBR occurs within the range of Rocky Mountain bristlecone pine (Pinus aristata), limber pine (P. flexilis), and whitebark pine (P. albicaulis...

  5. Simulating free-roaming cat population management options in open demographic environments.

    PubMed

    Miller, Philip S; Boone, John D; Briggs, Joyce R; Lawler, Dennis F; Levy, Julie K; Nutter, Felicia B; Slater, Margaret; Zawistowski, Stephen

    2014-01-01

    Large populations of free-roaming cats (FRCs) generate ongoing concerns for welfare of both individual animals and populations, for human public health, for viability of native wildlife populations, and for local ecological damage. Managing FRC populations is a complex task, without universal agreement on best practices. Previous analyses that use simulation modeling tools to evaluate alternative management methods have focused on relative efficacy of removal (or trap-return, TR), typically involving euthanasia, and sterilization (or trap-neuter-return, TNR) in demographically isolated populations. We used a stochastic demographic simulation approach to evaluate removal, permanent sterilization, and two postulated methods of temporary contraception for FRC population management. Our models include demographic connectivity to neighboring untreated cat populations through natural dispersal in a metapopulation context across urban and rural landscapes, and also feature abandonment of owned animals. Within population type, a given implementation rate of the TR strategy results in the most rapid rate of population decline and (when populations are isolated) the highest probability of population elimination, followed in order of decreasing efficacy by equivalent rates of implementation of TNR and temporary contraception. Even low levels of demographic connectivity significantly reduce the effectiveness of any management intervention, and continued abandonment is similarly problematic. This is the first demographic simulation analysis to consider the use of temporary contraception and account for the realities of FRC dispersal and owned cat abandonment.

  6. The Role of Topiramate in the Management of Cocaine Addiction: a Possible Therapeutic Option.

    PubMed

    Siniscalchi, Antonio; Bonci, Antonello; Biagio Mercuri, Nicola; Pirritano, Domenico; Squillace, Aida; De Sarro, Giovambattista; Gallelli, Luca

    2015-01-01

    Topiramate (TPM) is an antiepileptic drug able to play a role in both neurological and psychiatric disorders. TPM facilitates gamma-aminobutyric acid (GABA) transmission and inhibits glutamatergic transmission (i.e. AMPA/kainate receptors). Several studies reported that the modulation of GABAergic and glutamatergic synaptic transmission may reduce cocaine reinforcement. Therefore, TPM could be used in the management of cocaine dependence.

  7. Mitigation of methane and nitrous oxide emissions from animal operations: A review of manure management options

    USDA-ARS?s Scientific Manuscript database

    This review analyzes published data on manure management practices used to mitigate methane (CH4) and nitrous oxide (N2O) emissions from animal operations. This is the second in a series of reports commissioned by the Food and Agriculture Organization of the United Nations to evaluate mitigation pra...

  8. Update on the management of chronic eczema: new approaches and emerging treatment options

    PubMed Central

    Walling, Hobart W; Swick, Brian L

    2010-01-01

    Atopic dermatitis (AD) is a common disease with worldwide prevalence, affecting up to 20% of children and 3% of adults. Recent evidence regarding pathogenesis has implicated epidermal barrier defects deriving from filagrin mutations with resulting secondary inflammation. In this report, the authors comprehensively review the literature on atopic dermatitis therapy, including topical and systemic options. Most cases of AD will benefit from emollients to enhance the barrier function of skin. Topical corticosteroids are first-line therapy for most cases of AD. Topical calcineurin inhibitors (tacrolimus ointment, pimecrolimus cream) are considered second line therapy. Several novel barrier-enhancing prescription creams are also available. Moderate to severe cases inadequately controlled with topical therapy may require phototherapy or systemic therapy. The most commonly employed phototherapy modalites are narrow-band UVB, broadband UVB, and UVA1. Traditional systemic therapies include short-term corticosteroids, cyclosporine (considered to be the gold standard), methotrexate, azathioprine, mycophenolate mofetil, and most recently leflunamide. Biologic therapies include recombinant monoclonal antibodies acting on the immunoglobulin E / interleukin-5 pathway (omalizumab, mepolizumab), acting as tumor necrosis factor-α inhibitors (infliximab, etanercept, adalimumab), and acting as T-cell (alefacept) and B-cell (rituxumab) inhibitors, as well as interferon γ and intravenous immunoglobulin. Efficacy, safety, and tolerability are reviewed for each medication. PMID:21437065

  9. Glyburide/metformin tablets: a new therapeutic option for the management of Type 2 diabetes.

    PubMed

    Dailey, George E

    2003-08-01

    Oral antidiabetic combination therapy is a proven means of establishing glycaemic control in the hyperglycaemic, Type 2 diabetic patient, but co-administering two oral antidiabetic agents separately may hinder compliance with therapy. A new single-tablet of glyburide/metformin combination therapy (Glucovance), Bristol-Myers Squibb, Inc.) has recently been developed, which addresses the primary defects of Type 2 diabetes: beta-cell dysfunction and insulin resistance. The glyburide/metformin tablet, taken with meals, is designed to optimise the absorption of glyburide and to address the postprandial glucose rise. Glyburide/metformin tablets are more effective in controlling fasting and postprandial glycaemia than its component monotherapies, at lower doses of metformin and glyburide compared with monotherapy because of the synergy between its glyburide and metformin components. Moreover, a double-blind study showed that glyburide/metformin tablets are more effective than a free combination of glyburide co-administered with metformin in controlling postprandial glucose. Retrospective analyses suggested that glyburide/metformin tablets control glycated haemoglobin (A1C) more effectively than a free combination of glyburide co-administered with metformin, at lower mean doses of glyburide and metformin. The incidence of side effects is lower than separate component therapy for any given A1C. Glyburide/metformin tablets are an effective option for optimising the control of blood glucose in Type 2 diabetic patients and appear to enhance adherence to therapy.

  10. Current aproach to cancer pain management: Availability and implications of different treatment options

    PubMed Central

    Nersesyan, Hrachya; Slavin, Konstantin V

    2007-01-01

    Despite tremendous progress in medicine during last couple of decades, cancer still remains the most horrifying diagnosis for anybody due to its almost inevitable futility. According to American Cancer Society Statistics, it is estimated that only in the United States more than half a million people will die from cancer in 2006. For those who survive, probably the most fearsome symptom regardless of cancer type will be the pain. Although most pain specialists and oncologists worldwide are well aware of the importance to adequately treat the pain, it was yet established that more than half of cancer patients have insufficient pain control, and about quarter of them actually die in pain. Therefore, in this review article we attempted to provide the comprehensive information about different options available nowadays for treating cancer pain focusing on most widely used pharmacologic agents, surgical modalities for intractable pain control, their potential for adverse effects, and ways to increase the effectiveness of treatment maximally optimizing analgesic regimen and improving compliance. PMID:18488078

  11. Archaelogy of Arid Environment Points to Management Options for Yucca Mountain

    SciTech Connect

    N. Chapman; A. Dansie; C. McCombie

    2006-08-29

    As with all planned repositories for spent fuel, the critical period over which Yucca Mountain needs to provide isolation is the first hundreds to thousands of years after the fuel is emplaced, when it is at its most hazardous. Both the original and the proposed new EPA standards highlight the central importance of this performance period by focusing on repository behavior during the first 10,000 years. Archaeology has a lot to tell us about the behavior of materials and structures over this time period. There have been numerous studies of archaeological artifacts in conditions relevant to the groundwater saturated environments that are a feature of most international geological disposal concepts, but relatively few in arid environments like that of the Nevada desert. However, there is much information to be gleaned, not only from classic archaeological areas in the Middle East and around the Mediterranean but also, perhaps surprisingly to some, from Nevada itself. Our recent study evaluated archaeological materials from underground openings and shallow burial in arid environments relevant to Yucca Mountain, drawing conclusions about how their state and their environment of preservation could help to assess design and operational options for the high-level waste repository.

  12. Basic concepts regarding fracture healing and the current options and future directions in managing bone fractures.

    PubMed

    Bigham-Sadegh, Amin; Oryan, Ahmad

    2015-06-01

    Fracture healing is a complex physiological process, which involves a well-orchestrated series of biological events. Repair of large bone defects resulting from trauma, tumours, osteitis, delayed unions, non-unions, osteotomies, arthrodesis and multifragmentary fractures is a current challenge of surgeons and investigators. Different therapeutic modalities have been developed to enhance the healing response and fill the bone defects. Different types of growth factors, stem cells, natural grafts (autografts, allografts or xenografts) and biologic- and synthetic-based tissue-engineered scaffolds are some of the examples. Nevertheless, these organic and synthetic materials and therapeutic agents have some significant limitations, and there are still no well-approved treatment modalities to meet all the expected requirements. Bone tissue engineering is a newer option than the traditional grafts and may overcome many limitations of the bone graft. To select an appropriate treatment strategy in achieving a successful and secure healing, more information concerning injuries of bones, their healing process and knowledge of the factors involved are required. The main goals of this work are to present different treatment modalities of the fractured bones and to explain how fractures normally heal and what factors interfere with fracture healing. This study provides an overview of the processes of fracture healing and discusses the current therapeutic strategies that have been claimed to be effective in accelerating fracture healing.

  13. Tissue-selective estrogen complexes: a promising option for the comprehensive management of menopausal symptoms.

    PubMed

    Archer, David F

    2010-07-01

    At menopause many women experience undesired symptoms such as hot flashes and those associated with vulvovaginal atrophy, and are susceptible to loss of bone mass. Menopausal therapies to date include various estrogen and estrogen-progestin (progesterone congener) formulations. However, both physicians and women became concerned about hormone-related therapies following publication of data from the Women's Health Initiative. Thus, the need exists for alternative therapies for postmenopausal women. Tissue-selective estrogen complexes (TSECs) are the pairing of estrogen(s) with a selective estrogen receptor modulator (SERM). The goal of developing a TSEC is to provide the clinical benefits of each of its components with improved tolerability. This goal can potentially be achieved by the result of the different molecular and cellular activities of the treatment's estrogen and SERM components. The therapeutic profile of a TSEC would optimally include relief of hot flashes, treatment of vulvovaginal atrophy and its symptoms, and prevention of bone loss, while providing safety for the endometrium and breast. Recent data indicate that the TSEC containing the SERM bazedoxifene and conjugated estrogens relieves hot flashes, improves vulvovaginal atrophy and its symptoms, and prevents loss of bone mass without stimulating the endometrium. This article reviews the current options for menopausal treatment as well as the environment that has driven the most recent evolution of new therapies for menopausal women, including the most recent development of the TSEC bazedoxifene and its early preclinical and clinical data.

  14. Petroleum coke adsorption as a water management option for oil sands process-affected water.

    PubMed

    Zubot, Warren; MacKinnon, Michael D; Chelme-Ayala, Pamela; Smith, Daniel W; Gamal El-Din, Mohamed

    2012-06-15

    Water is integral to both operational and environmental aspects of the oil sands industry. A water treatment option based on the use of petroleum coke (PC), a by-product of bitumen upgrading, was examined as an opportunity to reduce site oil sands process-affected water (OSPW) inventories and net raw water demand. Changes in OSPW quality when treated with PC included increments in pH levels and concentrations of vanadium, molybdenum, and sulphate. Constituents that decreased in concentration after PC adsorption included total acid-extractable organics (TAO), bicarbonate, calcium, barium, magnesium, and strontium. Changes in naphthenic acids (NAs) speciation were observed after PC adsorption. A battery of bioassays was used to measure the OSPW toxicity. The results indicated that untreated OSPW was toxic towards Vibrio fischeri and rainbow trout. However, OSPW treated with PC at appropriate dosages was not acutely toxic towards these test organisms. Removal of TAO was found to be an adsorption process, fitting the Langmuir and Langmuir-Freundlich isotherm models. For TAO concentrations of 60 mg/L, adsorption capacities ranged between 0.1 and 0.46 mg/g. This study demonstrates that freshly produced PC from fluid cokers provides an effective treatment of OSPW in terms of key constituents' removal and toxicity reduction.

  15. Numerical modelling to assess maintenance strategy management options for a small tidal inlet

    NASA Astrophysics Data System (ADS)

    Shaeri, Saeed; Tomlinson, Rodger; Etemad-Shahidi, Amir; Strauss, Darrell

    2017-03-01

    Small tidal inlets are found to be more sensitive to anthropogenic alteration than their larger counterparts. Such alterations, although typically supported by technical design reports, sometimes require amendments or modification. One of the most suitable tools to conduct the necessary studies in this regard is numerical modelling, since the behaviour of the inlet system in response to proposed remedial actions, can easily be identified. In this paper, various alternative proposals are investigated to determine the most practical and viable option to mitigate the need for ongoing maintenance at a typical small, jettied tidal inlet. The main tool to investigate the alternatives is the hydro-sedimentological modelling of the inlet system, which was performed using the Delft3D software package. The proposed alternative entrance modifications were based upon structural alterations of the inlet system (such as a jetty extension or submerged weir) and non-structural scenarios (such as a change of the time of the dredging campaign or the deposition location of the dredged material). It was concluded that whilst a detailed study is inevitable in order to achieve a comprehensive design plan, based upon the results of this study the construction of a submerged weir at the entrance channel can satisfy the needs of most of the stakeholders, with justifiable costs over a longer period.

  16. Modelling population dynamics and response to management options in the poultry red mite Dermanyssus gallinae (Acari: Dermanyssidae).

    PubMed

    Huber, K; Zenner, L; Bicout, D J

    2011-02-28

    The poultry red mite Dermanyssus gallinae is a major pest and widespread ectoparasite of laying hens and other domestic and wild birds. Under optimal conditions, D. gallinae can complete its lifecycle in less than 10 days, leading to rapid proliferation of populations in poultry systems. This paper focuses on developing a theoretical model framework to describe the population dynamics of D. gallinae. This model is then used to test the efficacy and residual effect of different control options for managing D. gallinae. As well as allowing comparison between treatment options, the model also allows comparison of treatment efficacies to different D. gallinae life stages. Three different means for controlling D. gallinae populations were subjected to the model using computer simulations: mechanical cleaning (killing once at a given time all accessible population stages), sanitary clearance (starving the mite population for a given duration, e.g. between flocks) and acaricide treatment (killing a proportion of nymphs and adults during the persistence of the treatment). Simulations showed that mechanical cleaning and sanitary clearance alone could not eradicate the model D. gallinae population, although these methods did delay population establishment. In contrast, the complete eradication of the model D. gallinae population was achieved by several successive acaricide treatments in close succession, even when a relatively low treatment level was used. Copyright © 2010 Elsevier B.V. All rights reserved.

  17. Anticipated Consequences of Increasing Temperature and Ocean Acidification on Cold-Water Coral Reefs and Options for Managing Impacts

    NASA Astrophysics Data System (ADS)

    Guinotte, J. M.; Thresher, R.; Matear, R.; Hobday, A. J.

    2015-12-01

    The deep sea hosts some of the world's largest, oldest, and most sensitive ecosystems. Climate change and ocean acidification are likely to have severe implications for many deep-sea ecosystems and communities, but what, if anything, can be done to mitigate these threats is poorly understood. This presentation will focus on: the climate related threats cold-water coral reef ecosystems face in the coming decades, the current state of knowledge regarding reef-forming cold water coral species responses to increasing temperature and ocean acidification, and conclusions reached by an expert panel tasked with prioritizing management options for legislatively protected cold-water coral reefs off southeast Australia that are likely to be severely degraded within decades due to climate change. The panel explored seventeen possible options spanning biological, engineering and regulatory domains that differed widely in perceived costs, benefits, time to implementation, and risks. In the short term, the highest priority identified was the need to urgently locate and protect sites globally that are, or will become, refugia areas for the coral and its associated community as climate change progresses.

  18. A socio-ecological investigation of options to manage groundwater degradation in the Western Desert, Egypt.

    PubMed

    King, Caroline; Salem, Boshra

    2012-07-01

    Under increasing water scarcity, collective groundwater management is a global concern. This article presents an interdisciplinary analysis of this challenge drawing on a survey including 50 large and small farms and gardens in a village in an agricultural land reclamation area on the edge of the Western Desert of Egypt. Findings revealed that smallholders rely on a practice of shallow groundwater use, through which drainage water from adjacent irrigation areas is effectively recycled within the surface aquifer. Expanding agroindustrial activities in the surrounding area are socio-economically important, but by mining non-renewable water in the surrounding area, they set in motion a degradation process with social and ecological consequences for all users in the multi-layered aquifer system. Based on the findings of our investigation, we identify opportunities for local authorities to more systematically connect available environmental information sources and common pool resource management precedents, to counterbalance the degradation threat.

  19. 40 CFR 60.648 - Optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure. 1

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... per cubic feet of gas. (3) Starch solution. Rub into a thin paste about one teaspoonful of wheat starch with a little water; pour into about a pint of boiling water; stir; let cool and decant off clear solution. Make fresh solution every few days. (d) Procedure. Fill leveling bulb with starch solution. Raise...

  20. 40 CFR 60.5408 - What is an optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... solution is equivalent to 100 grains H2S per cubic feet of gas. (3) Starch solution. Rub into a thin paste about one teaspoonful of wheat starch with a little water; pour into about a pint of boiling water; stir... leveling bulb with starch solution. Raise (L), open cock (G), open (F) to (A), and close (F) when solutions...

  1. 40 CFR 60.5408 - What is an optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... solution is equivalent to 100 grains H2S per cubic feet of gas. (3) Starch solution. Rub into a thin paste about one teaspoonful of wheat starch with a little water; pour into about a pint of boiling water; stir... leveling bulb with starch solution. Raise (L), open cock (G), open (F) to (A), and close (F) when solutions...

  2. 40 CFR 60.648 - Optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure. 1

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... per cubic feet of gas. (3) Starch solution. Rub into a thin paste about one teaspoonful of wheat starch with a little water; pour into about a pint of boiling water; stir; let cool and decant off clear solution. Make fresh solution every few days. (d) Procedure. Fill leveling bulb with starch solution. Raise...

  3. A Review of the Capability Options Development and Analysis System and the Role of Risk Management

    DTIC Science & Technology

    2006-08-01

    contribution to Army’s modernisation extends beyond the Army chain of command . Numerous elements in Defence contribute to the modernisation process at...better- defined chain of command and thus allow accountability and responsibility to be identified more clearly. The proposed structural changes offer...given a clear indication of the potential of risk management. The risk analysis studies of the rotation model in Land Command 2003 and the HNA are

  4. Nonoperative options for management of residual stones after cholecystostomy in high-risk patients

    NASA Astrophysics Data System (ADS)

    Reed, David M.; Daye, S. S.; Lincer, R. M.

    1993-05-01

    Cholecystostomy is frequently performed to obtain control of sepsis in high risk patients with acute cholecystitis. Retained stones in the gallbladder may cause future clinical problems. We present two patients with cholecystostomy tubes managed non-operatively. A review of other reported methods for stone extraction or destruction is also presented. Knowledge of safe and effective techniques for removal of these stones, using minimally invasive techniques is useful to the general surgeon.

  5. The Role of Topiramate in the Management of Cocaine Addiction: A Possible Therapeutic Option

    PubMed Central

    Siniscalchi, Antonio; Bonci, Antonello Bonci; Mercuri, Nicola Biagio; Pirritano, Domenico; Squillace, Aida; Sarro, Giovambattista De; Gallelli, Luca

    2015-01-01

    Topiramate (TPM) is an antiepileptic drug able to play a role in both neurological and psychiatric disorders. TPM facilitates gamma-aminobutyric acid (GABA) transmission and inhibits glutamatergic transmission (i.e. AMPA/kainate receptors). Several studies reported that the modulation of GABAergic and glutamatergic synaptic transmission may reduce cocaine reinforcement. Therefore, TPM could be used in the management of cocaine dependence. PMID:26630959

  6. An economic analysis of poliovirus risk management policy options for 2013-2052.

    PubMed

    Duintjer Tebbens, Radboud J; Pallansch, Mark A; Cochi, Stephen L; Wassilak, Steven G F; Thompson, Kimberly M

    2015-09-24

    The Global Polio Eradication Initiative plans for coordinated cessation of oral poliovirus vaccine (OPV) after interrupting all wild poliovirus (WPV) transmission, but many questions remain related to long-term poliovirus risk management policies. We used an integrated dynamic poliovirus transmission and stochastic risk model to simulate possible futures and estimate the health and economic outcomes of maintaining the 2013 status quo of continued OPV use in most developing countries compared with OPV cessation policies with various assumptions about global inactivated poliovirus vaccine (IPV) adoption. Continued OPV use after global WPV eradication leads to continued high costs and/or high cases. Global OPV cessation comes with a high probability of at least one outbreak, which aggressive outbreak response can successfully control in most instances. A low but non-zero probability exists of uncontrolled outbreaks following a poliovirus reintroduction long after OPV cessation in a population in which IPV-alone cannot prevent poliovirus transmission. We estimate global incremental net benefits during 2013-2052 of approximately $16 billion (US$2013) for OPV cessation with at least one IPV routine immunization dose in all countries until 2024 compared to continued OPV use, although significant uncertainty remains associated with the frequency of exportations between populations and the implementation of long term risk management policies. Global OPV cessation offers the possibility of large future health and economic benefits compared to continued OPV use. Long-term poliovirus risk management interventions matter (e.g., IPV use duration, outbreak response, containment, continued surveillance, stockpile size and contents, vaccine production site requirements, potential antiviral drugs, and potential safer vaccines) and require careful consideration. Risk management activities can help to ensure a low risk of uncontrolled outbreaks and preserve or further increase the

  7. Agricultural land management options after the Chernobyl and Fukushima accidents: The articulation of science, technology, and society.

    PubMed

    Vandenhove, Hildegarde; Turcanu, Catrinel

    2016-10-01

    The options adopted for recovery of agricultural land after the Chernobyl and Fukushima accidents are compared by examining their technical and socio-economic aspects. The analysis highlights commonalities such as the implementation of tillage and other types of countermeasures and differences in approach, such as preferences for topsoil removal in Fukushima and the application of K fertilizers in Chernobyl. This analysis shows that the recovery approach needs to be context-specific to best suit the physical, social, and political environment. The complex nature of the decision problem calls for a formal process for engaging stakeholders and the development of adequate decision support tools. Integr Environ Assess Manag 2016;12:662-666. © 2016 SETAC.

  8. Promoting invasive species control and eradication in the sea: options for managing the tunicate invader Didemnum vexillum in Sitka, Alaska.

    PubMed

    McCann, Linda D; Holzer, Kimberly K; Davidson, Ian C; Ashton, Gail V; Chapman, Marnie D; Ruiz, Gregory M

    2013-12-15

    Bioinvasions are a significant force of change--and economic and ecological threat--in marine ecosystems. The threat now encroaches on Alaska, which has had relatively few invasions compared to other global regions, prompting need to develop new incursion response tools. We appraised five 'eco-friendly' immersion treatment options (dilute acetic acid, dilute bleach, freshwater, brine and hypoxia) at either minute- or hour-scale exposures to kill the invasive tunicate Didemnum vexillum. Data revealed 100% treatment efficacy after two minutes in acetic acid, ten minutes in bleach, four hours in freshwater and over four hours in brine solution. We also demonstrated the importance of monitoring D. vexillum recovery for at least three weeks, since seemingly destroyed colonies rebounded during this timeframe. Combined, these findings provide insights towards a bay-scale eradication and post-border management plan applicable to the recent D. vexillum incursion in Whiting Harbor, Alaska and other shallow, inshore invasion sites.

  9. Committee opinion no. 606: Options for prevention and management of heavy menstrual bleeding in adolescent patients undergoing cancer treatment.

    PubMed

    2014-08-01

    Adolescents undergoing cancer treatment are at high risk of heavy menstrual bleeding, and gynecologists may be consulted either before the initiation of cancer treatment to request strategies for menstrual suppression or during an episode of severe heavy bleeding to stop the bleeding emergently. Therapy in both situations should be tailored to the patient, her cancer diagnosis and treatment plan, and her desires for contraception and fertility. Options for menstrual suppression include combined hormonal contraceptives, progestin-only therapy, and gonadotropin-releasing hormone agonists. Adolescents presenting emergently with severe uterine bleeding may benefit from hormonal therapy, antifibrinolytics or, as a last resort, surgical management. In choosing appropriate treatment, considerations such as current platelet count, course of treatment, time to expected nadir, risk of thromboembolism, and need for contraception should be considered. Because of the complex nature of cancer care, collaboration with the adolescent's oncologist is highly recommended.

  10. Endocrine hypertension: An overview on the current etiopathogenesis and management options

    PubMed Central

    Thomas, Reena M; Ruel, Ewa; Shantavasinkul, Prapimporn Ch; Corsino, Leonor

    2015-01-01

    Endocrine causes of secondary hypertension include primary aldosteronism, pheochromocytoma, cushing’s syndrome, hyperparathyroidism and hypo- and hyperthyroidism. They comprise of the 5%–10% of the causes of secondary hypertension. Primary hyperaldosteronism, the most common of the endocrine cause of hypertension often presents with resistant or difficult to control hypertension associated with either normo-or hypokalemia. Pheochromocytoma, the great mimicker of many conditions, is associated with high morbidity and mortality if left untreated. A complete history including pertinent family history, physical examination along with a high index of suspicion with focused biochemical and radiological evaluation is important to diagnose and effectively treat these conditions. The cost effective targeted genetic screening for current known mutations associated with pheochromocytoma are important for early diagnosis and management in family members. The current review focuses on the most recent evidence regarding causes, clinical features, methods of diagnosis, and management of these conditions. A multidisciplinary approach involving internists, endocrinologists and surgeons is recommended in optimal management of these conditions. PMID:26413481

  11. Small-scale Arctic charr Salvelinus alpinus fisheries in Canada's Nunavut: management challenges and options.

    PubMed

    Roux, M J; Tallman, R F; Lewis, C W

    2011-12-01

    The Arctic charr Salvelinus alpinus is a diverse and abundant resource in Canada's Nunavut. The anadromous form is primarily targeted by exploitation in small-scale fisheries. The continued importance of subsistence fisheries and growing interest in further developing commercial fisheries underline the need for proper management of S. alpinus in northern Canada. This paper presents the current state of S. alpinus fisheries in Nunavut and related management challenges. An alternate framework for assessment using life-history information as it determines stock productivity and resilience to harvesting is presented. This framework combines (1) a risk assessment tool [productivity-susceptibility analysis (PSA)] to evaluate the relative vulnerability of S. alpinus stocks to harvest and (2) a conceptual model for quantitative assessment to determine sustainable harvest levels. Diversity in S. alpinus life history and contrast in vulnerability scores derived from PSA assessment are demonstrated for a sample of 86 anadromous stocks from throughout Nunavut. These data provide evidence in support of an alternate strategy for assessment permitting to integrate diversity in S. alpinus life history for improved generalization and representativeness. Salvelinus alpinus fisheries in Arctic regions exemplify the need for stock assessment and management alternatives to ensure fish conservation in remote, sensitive ecosystems and in data-poor circumstances. © 2011 The Authors. Journal of Fish Biology © 2011 The Fisheries Society of the British Isles.

  12. Management options and fertility-preserving therapy for premenopausal endometrial hyperplasia and early-stage endometrial cancer.

    PubMed

    Gressel, Gregory M; Parkash, Vinita; Pal, Lubna

    2015-12-01

    Definitive management with hysterectomy could be appropriate for some patients with endometrial cancer and its precursor lesions, but poses challenges for those desiring future fertility. To review risk factors for endometrial hyperplasia/cancer among premenopausal women and discuss management options for fertility preservation. A literature search through the PubMed, Ovid, and Cochrane databases was conducted using the terms "endometrial hyperplasia" and "endometrial cancer," cross-referenced with "fertility preservation." All articles published in English between January 1, 2000, and January 1, 2015, were considered if they were readily available online. Articles were analyzed and information was synthesized into a comprehensive review. Chronic anovulation, obesity, polycystic ovarian syndrome, metabolic syndrome, insulin resistance, and type 2 diabetes mellitus must be appreciated as risk factors for endometrial pathology. Providers must exert vigilance in identifying patients at risk and in initiating pre-emptive strategies. Risk reduction with lifestyle modification, weight loss, and glycemic control can improve regression and overall health. Fertility outcomes for these patients are promising, especially with assisted reproductive technology. Conservative management could be appropriate for carefully selected women with complex atypical endometrial hyperplasia or early-stage endometrial cancer who desire future fertility. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  13. Treatment options and barriers to case management of neonatal pneumonia in India: a protocol for a scoping review.

    PubMed

    Nair, N Sreekumaran; Lewis, Leslie Edward; Murthy, Shruti; Godinho, Myron Anthony; Lakiang, Theophilus; Venkatesh, Bhumika T

    2017-09-15

    India contributes to the highest neonatal deaths globally. Case management is said to be the cornerstone of pneumonia control. Much of the published evidence focuses on children aged 1 to 59 months. This scoping review, thus, aims to identify the treatment options for and barriers to case management of neonatal pneumonia in India. This protocol is part of a series of three reviews on neonatal pneumonia in India. Studies addressing treatment of or barriers to case management of neonatal pneumonia in Indian context, published in English in peer-reviewed and indexed journals will be eligible for inclusion. Electronic search will be conducted on nine databases. Hand searching and snowballing will be done for published and grey literature. Selection of studies will be done in title, abstract and full-text stages. A narrative summary will be performed to summarise the details of evidence. As this is a review involving analysis of secondary data which is available in the public domain and does not involve human participants, ethical approval was not required. The findings of the study will be shared with all stakeholders of this research. Knowledge dissemination workshops will be conducted with relevant stakeholders to ultimately transfer the evidence tailored to the stakeholder (eg, policy briefs, publications, information booklets and so on). PROSPERO 2016: CRD42016045449. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Conservative management in ureteric hydronephrosis due to deep endometriosis: Could the levonorgestrel-intrauterine device be an option?

    PubMed

    Simón, Elisa; Tejerizo, Álvaro; Muñoz, José Luis; Álvarez, Carmen; Marqueta, Laura; Jiménez, Jesús S

    2017-07-01

    Endometriosis can affect up to 10% of women of reproductive age, in a wide range of clinical presentations that vary from mild to severe or deep endometriosis. Deep endometriosis can affect the urinary tract in 1-5% to 15-25% cases. Even though deep endometriosis' surgeries are usually complex with higher rate of complications, conservative management is not always considered as an option because of its high failure rates. This paper describes two cases of deep endometriosis with ureteric involvement (hydronephrosis) treated conservatively with a double-pigtail stent plus a Levonorgestrel intrauterine device, after conservative surgery, who remained symptom free with no evidence of recurrence at 3 years follow-up, avoiding radical high-risk surgery. Impact statement Several treatments have been described for endometriosis. From a symptomatic perspective, conservative medical management has been proposed with a variable response. Concerning deep endometriosis (affecting the urinary or digestive tract), the definitive treatment has always been thought to be radical surgery. However, this can lead to several complications. To illustrate a possible more conservative approach this paper describes two cases of deep infiltrating endometriosis affecting the ureter, treated conservatively with a temporary pigtail ureter stent plus a Levonorgestrel intrauterine device. The management demonstrates that, in a selected population, conservative treatment solves the urinary disease avoiding the surgical complications and, what is more, improving patients' symptoms in a permanent way. Further prospective studies are needed to confirm whether the introduction of this management in clinical practice would reduce the need for surgery thereby, avoiding high-risk surgery and improving the success rate of conservative management.

  15. Scheduling fertilizer applications as a simple mitigation option for reducing N2O emission in intensively managed mown grassland systems

    NASA Astrophysics Data System (ADS)

    Neftel, Albrecht; Calanca, Pierluigi; Felber, Raphael; Grant, Robert; Conen, Franz

    2014-05-01

    A general principle in all proposed N2O mitigation options is the fertilization according to plants' requirements. Meanwhile the amount of N fertilization allowed is regulated in many countries. Due to the high pressure from food security and the need for economic efficiency the given limits are generally used up. In mown grassland systems a simple mitigation option is to optimize the timing of the fertilizer applications. Application of fertilizer, both organic manure and mineral fertilizer, is generally scheduled after each cut in a narrow time window. In practice, the delay between cut and fertilizer application is determined by weather conditions, management conditions and most important by the planning and experience of the individual farmer. Many field experiments have shown that enhanced N2O emissions tend to occur after cuts but before the application of fertilizer, especially when soils are characterized by a high WFPS. These findings suggest that the time of fertilizer application has an important implications for the N2O emission rate and that scheduling fertilization according to soil conditions might be a simple, cheap and efficient measure to mitigate N2O emissions. In this paper we report on results from a sensitivity analysis aiming at quantifying the effects of the timing of the fertilizer applications on N2O emissions from intensively managed, mown grasslands. Simulations for different time schedules were carried out with the comprehensive ecosystem model "ECOSYS" . To our knowledge this aspect has not been systematically investigated from a scientific point of view, but might have been always there within the experiences of attentive environmentally concerned farmers.

  16. Life cycle assessment of municipal solid waste management with regard to greenhouse gas emissions: case study of Tianjin, China.

    PubMed

    Zhao, Wei; van der Voet, Ester; Zhang, Yufeng; Huppes, Gjalt

    2009-02-15

    The environmental impacts of municipal solid waste (MSW) management have been highlighted in China, due to the continually increasing amount of MSW being generated and the limited capacity of waste treatment facilities. Of particular interest is greenhouse gas (GHG) mitigation, aided by the Kyoto Mechanisms. China is an important case study for this global issue; however, an analysis of the entire life cycle of MSW management on GHG emissions is not available for China. This study evaluates the current and possible patterns of MSW management with regard to GHG emissions, using life cycle assessment (LCA), based on the Tianjin case. We assess the baseline scenario, reflecting the existing MSW management system, as well as a set of alternative scenarios, five exploring waste treatment technology innovations and one exploring integrated MSW management, to quantitatively predict potentials of GHG mitigation for Tianjin. Additionally, a sensitivity analysis is used to investigate the influence of landfill gas (LFG) collection efficiency, recycling rate and methodological choice, especially allocation, on the outcomes. The results show GHG emissions from Tianjin's MSW management system amount to 467.34 Mg CO2 eq. per year, based on the treatment of MSW collected in the central districts in 2006, and the key issue is LFG released. The integrated MSW management scenario, combining different improvement options, shows the highest GHG mitigation potential. Given the limited financial support and the current waste management practice in Tianjin, LFG utilization scenario would be the preferred choice. The sensitivity analysis of recycling rate shows an approximately linear relation of inverse proportion between recycling rate and total GHG emissions. Kitchen waste composting makes a considerable contribution to total GHG emissions reduction. Allocation choices result in differences in total quantitative outcomes, but preference orders and contributions analysis are found to be

  17. Low back pain in older adults: risk factors, management options and future directions.

    PubMed

    Wong, Arnold Yl; Karppinen, Jaro; Samartzis, Dino

    2017-01-01

    Low back pain (LBP) is one of the major disabling health conditions among older adults aged 60 years or older. While most causes of LBP among older adults are non-specific and self-limiting, seniors are prone to develop certain LBP pathologies and/or chronic LBP given their age-related physical and psychosocial changes. Unfortunately, no review has previously summarized/discussed various factors that may affect the effective LBP management among older adults. Accordingly, the objectives of the current narrative review were to comprehensively summarize common causes and risk factors (modifiable and non-modifiable) of developing severe/chronic LBP in older adults, to highlight specific issues in assessing and treating seniors with LBP, and to discuss future research directions. Existing evidence suggests that prevalence rates of severe and chronic LBP increase with older age. As compared to working-age adults, older adults are more likely to develop certain LBP pathologies (e.g., osteoporotic vertebral fractures, tumors, spinal infection, and lumbar spinal stenosis). Importantly, various age-related physical, psychological, and mental changes (e.g., spinal degeneration, comorbidities, physical inactivity, age-related changes in central pain processing, and dementia), as well as multiple risk factors (e.g., genetic, gender, and ethnicity), may affect the prognosis and management of LBP in older adults. Collectively, by understanding the impacts of various factors on the assessment and treatment of older adults with LBP, both clinicians and researchers can work toward the direction of more cost-effective and personalized LBP management for older people.

  18. Strategic balance of drug lifecycle management options differs between domestic and foreign companies in Japan.

    PubMed

    Yamanaka, Takayuki; Kano, Shingo

    2016-01-01

    Drug approvals and patent protections are critical in drug lifecycle management (LCM) in order to maximize drug discovery investment returns. We analyzed drug LCM activities implemented by 10 top companies in Japan, focusing on drug approvals and patent term extensions. Foreign companies acquired numerous drug approvals primarily for new molecular entities (NMEs), while Japanese companies mainly obtained approvals for improved drugs including new indications, and intensively extended patent terms. Furthermore, we discovered three factors likely responsible for differences in drug LCM strategies of Japanese and foreign companies: research and development capacities for drugs, drug lags of foreign-origin NMEs, and cooperation between Research and Development Departments and Intellectual Property Departments.

  19. EU strategies and policies on soil and waste management to offset greenhouse gas emissions.

    PubMed

    Marmo, L

    2008-01-01

    Climate change has become an important political priority in the environmental field, and beyond. To revert the increase in the Earth's temperature, developed country parties to the Kyoto Protocol committed to limit their greenhouse gas emissions. The 15 Member States that made up the European Community in 1997 have a combined reduction target of 8% in CO2-equivalent emissions in the period 2008-2012 compared to 1990. The role of soil, both as a source and a sink for carbon, is particularly important. How can soil organic matter be maintained or increased? There is no single answer, and a broad range of options need to be explored. Among the different measures proposed, the promotion of organic input on arable land (crop residues, cover crops, farm yard manure, compost, sewage sludge) has been mentioned. The challenge is to ensure that organic wastes of good quality are used to increase soil organic matter in carbon depleted soils and that appropriate monitoring is established. On the waste management front, the European Commission intends to produce guidance for Member States on the management of biowaste that will take into account all related environmental issues, including soil aspects. As for monitoring, the European Commission has put forward legislation according to which Member States would have to identify the areas at risk of soil organic matter decline in their national territory. Such legislation should be regarded as a major step forward for Europe, as it would ensure a high level of soil protection across the Community. This development will have the potential to enable the kind of estimation, measurement or modelling of crop or grazing land management needed for accounting under Article 3.4 of the Kyoto Protocol.

  20. New treatment options in the management of fibromyalgia: role of pregabalin

    PubMed Central

    Zareba, Grazyna

    2008-01-01

    Fibromyalgia (FM) is a common, chronic pain disorder with unknown etiology, characterized by widespread musculoskeletal pain and tenderness, and accompanied by several other symptoms such as sleep disturbance, fatigue, and mood disorders. Pregabalin is the first drug approved for the treatment of FM. Pregabalin has analgesic, anticonvulsant, and anxiolytic activity and has earlier demonstrated efficacy in the management of neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, and as adjuvant therapy for adult patients with partial onset seizures. Pregabalin, a lipophilic gamma-aminobutyric acid (GABA) analog, is α2δ-1 ligand that binds to, and modulates, voltage-gated calcium channels. This modulation is characterized by a reduction of the excessive neurotransmitter release that is observed in certain neurological and psychotic disorders. Several randomized, double-blind, placebo-controlled studies have demonstrated that pregabalin has been effective in pain management, improving sleep quality and fatigue, as well as in several domains of health related quality of life. Because of mild to moderate adverse effects it can be considered a well-tolerated therapy for FM. PMID:19337459

  1. Monochorionic and dichorionic twin pregnancies discordant for fetal anencephaly: a systematic review of prenatal management options.

    PubMed

    Lust, Annelies; De Catte, Luc; Lewi, Liesbeth; Deprest, Jan; Loquet, Philippe; Devlieger, Roland

    2008-04-01

    The aim of this study was to evaluate the effect of selective feticide (SF) compared to expectant management (EM) on perinatal outcome in dichorionic and monochorionic twins discordant for anencephaly. For this purpose, we conducted a systematic review of literature and added ten unpublished cases. As a result, we found that in dichorionic twins, mean gestational age (GA) at birth in the SF group was 38.0 weeks versus 34.9 weeks (P = 0.0002). Mean birth weight was 2922 g in the SF group versus 2474 g (P = 0.03). In monochorionic twins, mean GA at birth was 35.2 weeks versus 32.7 weeks (P = 0.1). Mean birth weight was 2711 g versus 1667 g (P = 0.0001). We conclude that while SF does not reduce perinatal mortality, it does result in significantly longer gestations and higher birth weight, and appears to be the management of choice in dichorionic twins discordant for anencephaly. In monochorionic twins, SF also increases birth weight, but in view of the complexity of this group, no clear recommendations can be made.

  2. Diagnostic work-up and therapeutic options in management of pediatric status epilepticus.

    PubMed

    Mastrangelo, Mario; Celato, Andrea

    2012-05-01

    Status epilepticus (SE) is a life-threatening neurologic disorder comprising prolonged and unremitting crisis, and two or more series of seizures without complete intercritical recovery. We reviewed the literature through a Pubmed/Medline research using key words including status epilepticus, antiepileptic drugs and children, in order to revise and compare international/national protocols and to examine pediatric guidelines in SE management. Neurologic impairment and SE etiology seem to be the most independent risks for mortality. A deep semiologic evaluation is essential to addressing diagnostic work-up. Ematochemical parameters, plasma levels of antiepileptic drugs and clinically oriented toxic/metabolic screening should be mandatory for investigating both causes and effects of SE. Electroencephalography is clearly helpful to characterize focal from generalized SE and to distinguish epileptic events from pseudoseizures, and it is deal to find nonconvulsive SE. Neuroimaging techniques could detect epileptogenic lesions (such as cortical malformations, tumors, demyelinating disorders or strokes) but are common in practice to find negative or controversial results. Pharmacologic management can be essentially arranged in three stages: benzodiazepines for early SE (lasting less than 30 minutes), phenytoin/fosphenytoin, phenobarbital, valproate, levetiracetam or lacosamide for established SE (30-90 minutes), and anesthetics for refractory SE (more than 90 minutes). Status epilepticus is the most common neurologic emergency in childhood. A systematic diagnostic work-up and a three steps based therapeutic approach is required at this age.

  3. Could hydroxyethyl starch be a therapeutic option in management of acute aluminum phosphide toxicity?

    PubMed

    Marashi, Sayed Mahdi; Arefi, Mohammad; Behnoush, Behnam; Nasrabad, Mahdi Ghazanfari; Nasrabadi, Zeynab Nasri

    2011-04-01

    Acute aluminum phosphide poisoning is a serious toxicity and results in high mortality rate despite the progress of critical care. After ingestion, phosphine gas is released and absorbed quickly, causing systemic poisoning and cell hypoxia. Excessive thirst, severe hypotension, arrhythmias, tachypnea, and severe metabolic acidosis are the common clinical manifestations. We think acute metabolic response which characteristically occurs in severe injury also happens in aluminum phosphide poisoning. Necropsy examinations indicate congestion in almost all vital organs because of leakage of fluids from intravascular to extravascular space. The most favorable type of fluid for intravascular volume resuscitation persists and is disputed. Colloids remain in the intravascular space rather than crystalloids, and provide more rapid hemodynamic stabilization. Furthermore, hydroxyethyl starch solution may have other benefits e.g. it can reduce the extra vascular leak of albumin and fluids from an endothelial injury site. As refractory hypotension and cardiovascular collapse, because leakage of fluids from intravascular to extravascular space are common cause of death in this toxicity, we propose that hydroxyethyl starch can dominate this refractory hypotension and consequently acute metabolic response.

  4. C1 fractures: a review of diagnoses, management options, and outcomes.

    PubMed

    Mead, Loren B; Millhouse, Paul W; Krystal, Jonathan; Vaccaro, Alexander R

    2016-09-01

    The atlas is subject to fracture under axial load, often due to traumatic injuries such as shallow dives and automobile accidents. These fractures account for 2-13 % of injuries to the cervical spine [Marcon RM et al. Clinics (Sao Paulo) 68(11):1455-61, 2013]. Fractures of the C1 vertebra are often difficult to diagnose, as there is often no neurological deficit or easily identifiable findings on radiographs. However, injuries to the atlas can be associated with vertebral artery injury and atlantoaxial or atlanto-occipital instability, making prompt and accurate diagnosis imperative. A detailed understanding of the anatomy, inherent stability, and common injury patterns is essential for any surgeon treating spinal trauma. This chapter explores the diagnosis and management of C1 fractures, as well as outcomes after treatment.

  5. Endovascular Treatment Options in the Management of Lower Limb Deep Venous Thrombosis

    SciTech Connect

    Nazir, Sarfraz Ahmed Ganeshan, Arul; Nazir, Sheraz; Uberoi, Raman

    2009-09-15

    Lower limb deep vein thrombosis (DVT) is a common cause of significant morbidity and mortality. Systemic anticoagulation therapy is the mainstay of conventional treatment instituted by most physicians for the management of DVT. This has proven efficacy in the prevention of thrombus extension and reduction in the incidence of pulmonary embolism and rethrombosis. Unfortunately, especially in patients with severe and extensive iliofemoral DVT, standard treatment may not be entirely adequate. This is because a considerable proportion of these patients eventually develops postthrombotic syndrome. This is characterized by chronic extremity pain and trophic skin changes, edema, ulceration, and venous claudication. Recent interest in endovascular technologies has led to the development of an assortment of minimally invasive, catheter-based strategies to deal with venous thrombus. These comprise catheter-directed thrombolysis, percutaneous mechanical thrombectomy devices, adjuvant venous angioplasty and stenting, and inferior vena cava filters. This article reviews these technologies and discusses their current role as percutaneous treatment strategies for venous thrombotic conditions.

  6. Sleep disturbances in Parkinson’s disease patients and management options

    PubMed Central

    Claassen, Daniel O; Kutscher, Scott J

    2011-01-01

    Sleep disturbances are among the most common nonmotor complaints of patients with Parkinson’s disease (PD), and can have a great impact on quality of life. These disturbances manifest in a variety of ways; for instance, insomnia, sleep fragmentation, and excessive daytime sleepiness. Sleep-related movement disorders such as restless legs syndrome and periodic leg movements may share a common pathophysiology, and occurrence of rapid eye movement behavior disorder may predate the onset of PD or other synucleinopathies by several years. Medications for PD can have a significant impact on sleep, representing a great challenge to the treating physician. Awareness of the complex relationship between PD and sleep disorders, as well as the varied way in which sleep disturbances appear, is imperative for successful long-term management. PMID:23616723

  7. Operative Treatments for Reflux After Bariatric Surgery: Current and Emerging Management Options.

    PubMed

    Treitl, Daniela; Nieber, Derek; Ben-David, Kfir

    2017-03-01

    Gastroesophageal reflux disease (GERD) is a common disorder that has a well-established connection with obesity. To ameliorate the morbidity associated with obesity, bariatric procedures have become an established pathway to accomplish sustained weight loss. In some procedures, such as with the Roux-en-Y gastric bypass surgery, weight loss is also accompanied by the resolution of GERD symptoms. However, other popular bariatric surgeries, such as the sleeve gastrectomy, have a controversial impact on their effect on reflux. Consequently, increased attention has been given to the development of strategies for the management of de novo or recurrent reflux after bariatric surgery. This article aims to discuss medical and surgical strategies for reflux after bariatric surgery, and their outcomes.

  8. Pulsed Radiofrequency: A Management Option for Recurrent Trigeminal Neuralgia Following Radiofrequency Thermocoagulation.

    PubMed

    Liao, Chenlong; Visocchi, Massimiliano; Yang, Min; Liu, Pengfei; Li, Shiting; Zhang, Wenchuan

    2017-01-01

    Pain relief comparable with radiofrequency thermocoagulation (RFT) alone and fewer side effects than RFT have been achieved by combination treatment with pulsed radiofrequency (PRF) and short-duration RFT in trigeminal neuralgia (TN). We report the successful management of recurrent TN after RFT with single PRF in 2 patients. The RFT treatment was performed in 2-3 cycles for each division, with the lesion setting at 75°C-80°C for 90 seconds. The PRF treatment was applied for 120 seconds, with a generator output of 45 V, not exceeding a temperature of 42°C at the tip of the electrode. In case 1, pain relief was immediately achieved by RFT (75°C for 90 seconds), with moderate hypesthesia. Relapse of the triggered pain occurred 6 months later, and PRF was then applied. Long-term (18 months) pain relief without any additional pharmacologic or other treatment was reported. In case 2, a second RFT treatment at a higher temperature (80°C) was performed after recurrence after the first RFT within a week. Accompanied by worse hypesthesia, complete pain relief lasted for 6 months until the recurrence of pain was triggered by toothbrushing. PRF was then applied, and complete analgesia with long-term follow-up (28 months) was achieved. The PRF treatment for recurrent TN after RFT in this study could be viewed as a combination of PRF and RFT treatments in succession. Therefore, PRF and RFT should be considered to be complementary rather than alternative in the management of TN. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Options for Managing Hypoxic Blackwater in River Systems: Case Studies and Framework

    NASA Astrophysics Data System (ADS)

    Whitworth, Kerry L.; Kerr, Janice L.; Mosley, Luke M.; Conallin, John; Hardwick, Lorraine; Baldwin, Darren S.

    2013-10-01

    Hypoxic blackwater events occur when large amounts of organic material are leached into a water body (e.g., during floodplain inundation) and rapid metabolism of this carbon depletes oxygen from the water column, often with catastrophic effects on the aquatic environment. River regulation may have increased the frequency and severity of hypoxic blackwater events in lowland river systems, necessitating management intervention to mitigate the impacts of these events on aquatic biota. We examine the effectiveness of a range of mitigation interventions that have been used during large-scale hypoxic blackwater events in the Murray-Darling Basin, Australia and that may be applicable in other environments at risk from hypoxic blackwater. Strategies for hypoxia mitigation include: delivery of dilution flows; enhancement of physical re-aeration rates by increasing surface turbulence; and diversion of blackwater into shallow off-channel storages. We show that the impact of dilution water delivery is determined by relative volumes and water quality and can be predicted using simple models. At the dilution water inflow point, localized oxygenated plumes may also act as refuges. Physical re-aeration strategies generally result in only a small increase in dissolved oxygen but may be beneficial for local refuge protection. Dilution and natural re-aeration processes in large, shallow lake systems can be sufficient to compensate for hypoxic inflows and water processed in off-channel lakes may be able to be returned to the river channel as dilution flows. We provide a set of predictive models (as electronic supplementary material) for estimation of the re-aeration potential of intervention activities and a framework to guide the adaptive management of future hypoxic blackwater events.

  10. Options for managing hypoxic blackwater in river systems: case studies and framework.

    PubMed

    Whitworth, Kerry L; Kerr, Janice L; Mosley, Luke M; Conallin, John; Hardwick, Lorraine; Baldwin, Darren S

    2013-10-01

    Hypoxic blackwater events occur when large amounts of organic material are leached into a water body (e.g., during floodplain inundation) and rapid metabolism of this carbon depletes oxygen from the water column, often with catastrophic effects on the aquatic environment. River regulation may have increased the frequency and severity of hypoxic blackwater events in lowland river systems, necessitating management intervention to mitigate the impacts of these events on aquatic biota. We examine the effectiveness of a range of mitigation interventions that have been used during large-scale hypoxic blackwater events in the Murray-Darling Basin, Australia and that may be applicable in other environments at risk from hypoxic blackwater. Strategies for hypoxia mitigation include: delivery of dilution flows; enhancement of physical re-aeration rates by increasing surface turbulence; and diversion of blackwater into shallow off-channel storages. We show that the impact of dilution water delivery is determined by relative volumes and water quality and can be predicted using simple models. At the dilution water inflow point, localized oxygenated plumes may also act as refuges. Physical re-aeration strategies generally result in only a small increase in dissolved oxygen but may be beneficial for local refuge protection. Dilution and natural re-aeration processes in large, shallow lake systems can be sufficient to compensate for hypoxic inflows and water processed in off-channel lakes may be able to be returned to the river channel as dilution flows. We provide a set of predictive models (as electronic supplementary material) for estimation of the re-aeration potential of intervention activities and a framework to guide the adaptive management of future hypoxic blackwater events.

  11. Managed grasslands: A greenhouse gas sink or source?

    NASA Astrophysics Data System (ADS)

    Leahy, Paul; Kiely, Ger; Scanlon, Todd M.

    2004-10-01

    We describe a unique, one year investigation of CO2 and N2O fluxes over a fertilized grassland in Ireland using two eddy covariance systems. As the global warming potential (GWP) of N2O is 296 (100 year time horizon), relatively small N2O emissions have a potentially large impact on overall radiative forcing. Therefore nitrogen fertilizer application practices may possibly turn a site with a net CO2 uptake into a net radiative forcing source. We observed a net annual uptake of 9.45 T CO2 ha-1. N2O emissions equivalent to 5.42 T ha-1 CO2 GWP counteracted 57% of the effect of the CO2 uptake. Estimated methane emissions from ruminants (3.74 T ha-1 CO2 GWP) further counteract the CO2 uptake, making the overall GWP nearly neutral. This delicate balance of the greenhouse gas fluxes underscores the significance of fertilizer application strategies in determining whether a managed grassland is a net GWP source or sink.

  12. Personalizing, not patronizing: the case for patient autonomy by unbiased presentation of management options in stage I testicular cancer.

    PubMed

    Oldenburg, J; Aparicio, J; Beyer, J; Cohn-Cedermark, G; Cullen, M; Gilligan, T; De Giorgi, U; De Santis, M; de Wit, R; Fosså, S D; Germà-Lluch, J R; Gillessen, S; Haugnes, H S; Honecker, F; Horwich, A; Lorch, A; Ondruš, D; Rosti, G; Stephenson, A J; Tandstad, T

    2015-05-01

    Testicular cancer (TC) is the most common neoplasm in males aged 15-40 years. The majority of patients have no evidence of metastases at diagnosis and thus have clinical stage I (CSI) disease [Oldenburg J, Fossa SD, Nuver J et al. Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24(Suppl 6): vi125-vi132; de Wit R, Fizazi K. Controversies in the management of clinical stage I testis cancer. J Clin Oncol 2006; 24: 5482-5492.]. Management of CSI TC is controversial and options include surveillance and active treatment. Different forms of adjuvant therapy exist, including either one or two cycles of carboplatin chemotherapy or radiotherapy for seminoma and either one or two cycles of cisplatin-based chemotherapy or retroperitoneal lymph node dissection for non-seminoma. Long-term disease-specific survival is ∼99% with any of these approaches, including surveillance. While surveillance allows most patients to avoid additional treatment, adjuvant therapy markedly lowers the relapse rate. Weighing the net benefits of surveillance against those of adjuvant treatment depends on prioritizing competing aims such as avoiding unnecessary treatment, avoiding more burdensome treatment with salvage chemotherapy and minimizing the anxiety, stress and life disruption associated with relapse. Unbiased information about the advantages and disadvantages of surveillance and adjuvant treatment is a prerequisite for informed consent by the patient. In a clinical scenario like CSI TC, where different disease-management options produce indistinguishable long-term survival rates, patient values, priorities and preferences should be taken into account. In this review, we provide an overview about risk factors for relapse, potential benefits and harms of adjuvant chemotherapy and active surveillance and a rationale for involving patients in individualized decision making about their treatment rather than adopting

  13. Threshold values and management options for nutrients in a catchment of a temperate estuary with poor ecological status

    NASA Astrophysics Data System (ADS)

    Hinsby, K.; Markager, S.; Kronvang, B.; Windolf, J.; Sonnenborg, T. O.; Thorling, L.

    2012-02-01

    Intensive farming has severe impacts on the chemical status of groundwater and streams and consequently on the ecological status of dependent ecosystems. Eutrophication is a widespread problem in lakes and marine waters. Common problems are hypoxia, algal blooms and fish kills, and loss of water clarity, underwater vegetation, biodiversity, and recreational value. In this paper we evaluate the nitrogen (N) and phosphorus (P) chemistry of groundwater and surface water in a coastal catchment, the loadings and sources of N and P and their effect on the ecological status of an estuary. We calculate the necessary reductions in N and P loadings to the estuary for obtaining a good ecological status, which we define based on the number of days with N and P limitation, and the equivalent stream and groundwater threshold values assuming two different management options. The calculations are performed by the combined use of empirical models and a physically based 3-D integrated hydrological model of the whole catchment. The assessment of the ecological status indicates that the N and P loads to the investigated estuary should be reduced by a factor of 0.52 and 0.56, respectively, to restore good ecological status. Model estimates show that threshold total N concentrations should be in the range of 2.9 to 3.1 mg l-1 in inlet freshwater to Horsens Estuary and 6.0 to 9.3 mg l-1 in shallow aerobic groundwater (∼27-41 mg l-1 of nitrate), depending on the management measures implemented in the catchment. The situation for total P is more complex but data indicate that groundwater threshold values are not needed. The inlet freshwater threshold value for total P to Horsens Estuary for the selected management options is 0.084 mg l-1. Regional climate models project increasing winter precipitation and runoff in the investigated region resulting in increasing runoff and nutrient loads to coastal waters if present land use and farming practices continue. Hence, lower threshold values

  14. Threshold values and management options for nutrients in a catchment of a temperate estuary with poor ecological status

    NASA Astrophysics Data System (ADS)

    Hinsby, K.; Markager, S.; Kronvang, B.; Windolf, J.; Sonnenborg, T. O.; Thorling, L.

    2012-08-01

    Intensive farming has severe impacts on the chemical status of groundwater and streams and consequently on the ecological status of dependent ecosystems. Eutrophication is a widespread problem in lakes and marine waters. Common problems are hypoxia, algal blooms, fish kills, and loss of water clarity, underwater vegetation, biodiversity and recreational value. In this paper we evaluate the nitrogen (N) and phosphorus (P) concentrations of groundwater and surface water in a coastal catchment, the loadings and sources of N and P, and their effect on the ecological status of an estuary. We calculate the necessary reductions in N and P loadings to the estuary for obtaining a good ecological status, which we define based on the number of days with N and P limitation, and the corresponding stream and groundwater threshold values assuming two different management options. The calculations are performed by the combined use of empirical models and a physically based 3-D integrated hydrological model of the whole catchment. The assessment of the ecological status indicates that the N and P loads to the investigated estuary should be reduced to levels corresponding to 52 and 56% of the current loads, respectively, to restore good ecological status. Model estimates show that threshold total N (TN) concentrations should be in the range of 2.9 to 3.1 mg l-1 in inlet freshwater (streams) to Horsens estuary and 6.0 to 9.3 mg l-1 in shallow aerobic groundwater (∼ 27-41 mg l-1 of nitrate), depending on the management measures implemented in the catchment. The situation for total P (TP) is more complex, but data indicate that groundwater threshold values are not needed. The stream threshold value for TP