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Sample records for nordheim integral treatment

  1. Fowler Nordheim theory of carbon nanotube based field emitters

    NASA Astrophysics Data System (ADS)

    Parveen, Shama; Kumar, Avshish; Husain, Samina; Husain, Mushahid

    2017-01-01

    Field emission (FE) phenomena are generally explained in the frame-work of Fowler Nordheim (FN) theory which was given for flat metal surfaces. In this work, an effort has been made to present the field emission mechanism in carbon nanotubes (CNTs) which have tip type geometry at nanoscale. High aspect ratio of CNTs leads to large field enhancement factor and lower operating voltages because the electric field strength in the vicinity of the nanotubes tip can be enhanced by thousand times. The work function of nanostructure by using FN plot has been calculated with reverse engineering. With the help of modified FN equation, an important formula for effective emitting area (active area for emission of electrons) has been derived and employed to calculate the active emitting area for CNT field emitters. Therefore, it is of great interest to present a state of art study on the complete solution of FN equation for CNTs based field emitter displays. This manuscript will also provide a better understanding of calculation of different FE parameters of CNTs field emitters using FN equation.

  2. Tuning contact transport mechanisms in bilayer MoSe2 transistors up to Fowler-Nordheim regime

    NASA Astrophysics Data System (ADS)

    Mouafo, L. D. N.; Godel, F.; Froehlicher, G.; Berciaud, S.; Doudin, B.; Venkata Kamalakar, M.; Dayen, J.-F.

    2017-03-01

    Atomically thin molybdenum diselenide (MoSe2) is an emerging two-dimensional (2D) semiconductor with significant potential for electronic, optoelectronic, spintronic applications and a common platform for their possible integration. Tuning interface charge transport between such new 2D materials and metallic electrodes is a key issue in 2D device physics and engineering. Here, we report tunable interface charge transport in bilayer MoSe2 field effect transistors with Ti/Au contacts showing high on/off ratio up to 107 at room temperature. Our experiments reveal a detailed map of transport mechanisms obtained by controlling the interface band bending profile via temperature, gate and source-drain bias voltages. This comprehensive investigation leads to demarcating regimes and tuning in transport mechanisms while controlling the interface barrier profile. The careful analysis allows us to identify thermally activated regime at low carrier density, and Schottky barrier driven mechanisms at higher carrier density demonstrating the transition from low-field direct tunneling/ thermionic emission to high-field Fowler-Nordheim tunneling. Furthermore, we show that the transition voltage V trans to Fowler-Nordheim correlates directly to the difference between the chemical potential of the metal electrode and the conduction band minimum in the 2D semiconductor, which opens up opportunities for new theoretical and experimental investigations. Our approach being generic can be extended to other 2D materials, and the possibility of tuning contact transport regimes is promising for designing MoSe2 device applications.

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

    NASA Astrophysics Data System (ADS)

    Murakami, Eiichi; Oda, Kazuhiro; Takeshita, Tatsuya

    2016-04-01

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

  4. Support Systems for Treatment Integrity

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  5. Integrated nonthermal treatment system study

    SciTech Connect

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

    1997-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Rokhlenko, A.; Lebowitz, J. L.

    2016-06-01

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

  7. High resolution Fowler-Nordheim field emission maps of thin silicon oxide layers

    NASA Astrophysics Data System (ADS)

    Ruskell, Todd G.; Workman, Richard K.; Chen, Dong; Sarid, Dror; Dahl, Sarah; Gilbert, Stephen

    1996-01-01

    An improved method for characterizing thin oxide films using Fowler-Nordheim field emission is reported. The method uses a conducting-tip atomic force microscope with dual feedback systems, one for the topography and a second for the field emission bias voltage. Images of the voltage required to maintain a 10 pA emission current through a 3 nm oxide film thermally grown on p-type Si(100) demonstrate a spatial resolution of 8 nm.

  8. Transition from Fowler-Nordheim field emission to space charge limited current density

    NASA Astrophysics Data System (ADS)

    Feng, Y.; Verboncoeur, J. P.

    2006-07-01

    The Fowler-Nordheim law gives the current density extracted from a surface under strong fields, by treating the emission of electrons from a metal-vacuum interface in the presence of an electric field normal to the surface as a quantum mechanical tunneling process. Child's law predicts the maximum transmitted current density by considering the space charge effect. When the electric field becomes high enough, the emitted current density will be limited by Child's law. This work analyzes the transition of the transmitted current density from the Fowler-Nordheim law to Child's law space charge limit using a one-dimensional particle-in-cell code. Also studied is the response of the emission model to strong electric fields near the transition point. We find the transition without geometrical effort is smooth and much slower than reported previously [J. P. Barbour, W. W. Dolan, J. K. Trolan, E. E. Martin, and W. P. Dyke, Phys. Rev. 92, 45 (1953)]. We analyze the effects of geometric field enhancement and work function on the transition. Using our previous model for effective field enhancement [Y. Feng and J. P. Verboncoeur, Phys. Plasmas 12, 103301 (2005)], we find the geometric effect dominates, and enhancement β >10 can accelerate the approach to the space charge limit at practical electric field. A damped oscillation near the local plasma frequency is observed in the transient system response.

  9. Transition from Fowler-Nordheim field emission to space charge limited current density

    SciTech Connect

    Feng, Y.; Verboncoeur, J. P.

    2006-07-15

    The Fowler-Nordheim law gives the current density extracted from a surface under strong fields, by treating the emission of electrons from a metal-vacuum interface in the presence of an electric field normal to the surface as a quantum mechanical tunneling process. Child's law predicts the maximum transmitted current density by considering the space charge effect. When the electric field becomes high enough, the emitted current density will be limited by Child's law. This work analyzes the transition of the transmitted current density from the Fowler-Nordheim law to Child's law space charge limit using a one-dimensional particle-in-cell code. Also studied is the response of the emission model to strong electric fields near the transition point. We find the transition without geometrical effort is smooth and much slower than reported previously [J. P. Barbour, W. W. Dolan, J. K. Trolan, E. E. Martin, and W. P. Dyke, Phys. Rev. 92, 45 (1953)]. We analyze the effects of geometric field enhancement and work function on the transition. Using our previous model for effective field enhancement [Y. Feng and J. P. Verboncoeur, Phys. Plasmas 12, 103301 (2005)], we find the geometric effect dominates, and enhancement {beta}>10 can accelerate the approach to the space charge limit at practical electric field. A damped oscillation near the local plasma frequency is observed in the transient system response.

  10. A model for effective field enhancement for Fowler-Nordheim field emission

    SciTech Connect

    Feng, Y.; Verboncoeur, J.P.

    2005-10-01

    The local field enhancement factor {beta} is often introduced in the Fowler-Nordheim equation to represent the geometrical effects at the surface of the cathode, where {beta}(s)=E{sub n}(s)/E{sub 0} for macroscopic applied field E{sub 0}. Local variation of {beta} determines the local normal surface electric field, E{sub n}(s), resulting in local dependence of injection current by the Fowler-Nordheim law. In computational models, it is impractical to determine the time-dependent local surface field each time step on a microscopic space scale. Effective {beta} is introduced in this paper which allows us to study the emission properties at a macroscopic scale. Microscopic (subgrid) local effective {beta} is calculated only at the initial time step, and then the effective {beta} can be recomputed for different surface electrical field through this model. The model allows reduction of dimensionality as well as the ability to include subgrid effects. The model is demonstrated on fundamental cases and compared to a calculation with a mesh fine enough to resolve the geometric features.

  11. V-shaped metallic-wire cantilevers for combined atomic force microscopy and Fowler-Nordheim imaging

    NASA Astrophysics Data System (ADS)

    Peterson, Charles A.; Workman, Richard K.; Yao, Xiaowei; Hunt, Jeffery P.; Sarid, Dror

    1998-12-01

    A method for fabricating V-shaped cantilevers from a flattened Pt/Ir metal wire for combined atomic force microscopy and Fowler-Nordheim imaging is described. These novel cantilevers have been found to be more robust then conventional ones used for scanning capacitance and magnetic force microscopy as their conductivity is maintained even after a large number of surface scans. The use of a V-shaped geometry improves on earlier single-beam geometries by reducing rms imaging noise. Characterization of these cantilevers and combined atomic force microscopy and Fowler-Nordheim images are reported.

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

    NASA Astrophysics Data System (ADS)

    Briant, Marc; Einav, Amit

    2016-06-01

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

  13. Analytic expression for the Fowler-Nordheim V- I characteristic including the series resistance effect

    NASA Astrophysics Data System (ADS)

    Miranda, E.; Palumbo, F.

    2011-07-01

    It is shown in this communication that the Fowler-Nordheim (FN) tunneling expression for the current-voltage ( I- V) characteristic can be analytically inverted so that an exact expression for the voltage-current ( V- I) characteristic can be obtained. The solution of the resulting implicit equation is found using the Lambert W function, i.e. the solution of the transcendental equation we w = x. The reported expressions are supported by experimental I- V curves measured in thin (≈5 nm) SiO 2 films in MOS capacitors. The analysis includes the case of a tunneling oxide with a large series resistance. For practical purposes, a closed-form expression for W based on a Padé-type approximation is also provided.

  14. Treatment Integrity: Revisiting Some Big Ideas

    ERIC Educational Resources Information Center

    Greenwood, Charles R.

    2009-01-01

    The contributors to this special issue have helped everyone consider the next steps in building a research and practice agenda regarding the use of treatment integrity. Such an agenda must converge with the big ideas that link treatment integrity to the effectiveness of evidence-based practices (EBPs), and ultimately that of the profession. In…

  15. Impact of Treatment Integrity on Intervention Effectiveness

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  16. From Fowler-Nordheim to Nonequilibrium Green's Function Modeling of Tunneling

    NASA Astrophysics Data System (ADS)

    Ilatikhameneh, Hesameddin; Salazar, Ramon B.; Klimeck, Gerhard; Rahman, Rajib; Appenzeller, Joerg

    2016-07-01

    In this work, an analytic model is proposed which provides in a continuous manner the current-voltage characteristic (I-V) of high performance tunneling field-effect transistors (TFETs) based on direct bandgap semiconductors. The model provides closed-form expressions for I-V based on: 1) a modified version of the well-known Fowler-Nordheim (FN) formula (in the ON-state), and 2) an equation which describes the OFF-state performance while providing continuity at the ON/OFF threshold by means of a term introduced as the "continuity factor". It is shown that traditional approaches such as FN are accurate in TFETs only through correct evaluation of the total band bending distance and the "tunneling effective mass". General expressions for these two key parameters are provided. Moreover, it is demonstrated that the tunneling effective mass captures both the ellipticity of evanescent states and the dual (electron/hole) behavior of the tunneling carriers, and it is further shown that such a concept is even applicable to semiconductors with nontrivial energy dispersion. Ultimately, it is found that the I-V characteristics obtained by using this model are in close agreement with state-of-the-art quantum transport simulations both in the ON- and OFF-state, thus providing validation of the analytic approach.

  17. INTEGRATED WATER TREATMENT SYSTEM PERFORMANCE EVALUATION

    SciTech Connect

    SEXTON RA; MEEUWSEN WE

    2009-03-12

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

  18. Waste treatment integration in space

    NASA Technical Reports Server (NTRS)

    Baresi, L.; Kern, R.

    1991-01-01

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

  19. Integrating spirituality into alcohol treatment.

    PubMed

    Delaney, Harold D; Forcehimes, Alyssa A; Campbell, William P; Smith, Bruce W

    2009-02-01

    Spirituality is presumed by millions of Americans to be directly relevant to problems of alcohol abuse. We summarize findings regarding the role of religion and spirituality in the prevention and treatment of substance abuse and present a case illustration. We also consider mechanisms responsible for these effects. We offer advice about why, by whom, and how religion and spirituality should be discussed with clients with substance use disorders. In a recent clinical trial, therapists trained in a client-centered approach to facilitate exploration of spirituality fostered clients' use of spiritual practices. We suggest that the therapist's ability to skillfully engage clients in a discussion of spirituality is largely determined by how the therapist balances the dual roles of authoritative expert and evocative facilitator.

  20. Waste treatment integration in space.

    PubMed

    Baresi, L; Kern, R

    1991-10-01

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

  1. Integrating Primary Medical Care With Addiction Treatment

    PubMed Central

    Weisner, Constance; Mertens, Jennifer; Parthasarathy, Sujaya; Moore, Charles; Lu, Yun

    2010-01-01

    Context The prevalence of medical disorders is high among substance abuse patients, yet medical services are seldom provided in coordination with substance abuse treatment. Objective To examine differences in treatment outcomes and costs between integrated and independent models of medical and substance abuse care as well as the effect of integrated care in a subgroup of patients with substance abuse–related medical conditions (SAMCs). Design Randomized controlled trial conducted between April 1997 and December 1998. Setting and Patients Adult men and women (n=592) who were admitted to a large health maintenance organization chemical dependency program in Sacramento, Calif. Interventions Patients were randomly assigned to receive treatment through an integrated model, in which primary health care was included within the addiction treatment program (n=285), or an independent treatment-as-usual model, in which primary care and substance abuse treatment were provided separately (n=307). Both programs were group based and lasted 8 weeks, with 10 months of aftercare available. Main Outcome Measures Abstinence outcomes, treatment utilization, and costs 6 months after randomization. Results Both groups showed improvement on all drug and alcohol measures. Overall, there were no differences in total abstinence rates between the integrated care and independent care groups (68% vs 63%, P=.18). For patients without SAMCs, there were also no differences in abstinence rates (integrated care, 66% vs independent care, 73%; P=.23) and there was a slight but nonsignificant trend of higher costs for the integrated care group ($367.96 vs $324.09, P=.19). However, patients with SAMCs (n=341) were more likely to be abstinent in the integrated care group than the independent care group (69% vs 55%, P=.006; odds ratio [OR], 1.90; 95% confidence interval [CI], 1.22-2.97). This was true for both those with medical (OR, 3.38; 95% CI, 1.68-6.80) and psychiatric (OR, 2.10; 95% CI, 1

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  3. Barriers to Infertility Treatment: An Integrated Study

    PubMed Central

    Mosalanejad, Leili; Parandavar, Nehle; Abdollahifard, Sareh

    2014-01-01

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

  4. Integrated odour modelling for sewage treatment works.

    PubMed

    Gostelow, P; Parsons, S A; Lovell, M

    2004-01-01

    Odours from sewage treatment works are a significant source of environmental annoyance. There is a need for tools to assess the degree of annoyance caused, and to assess strategies for mitigation of the problem. This is the role of odour modelling. Four main stages are important in the development of an odour problem. Firstly, the odorous molecules must be formed in the liquid phase. They must then transfer from the liquid to the gaseous phase. They are then transported through the atmosphere to the population surrounding the odour source, and are then perceived and assessed by that population. Odour modelling as currently practised tends to concentrate on the transportation of odorants through the atmosphere, with the other areas receiving less attention. Instead, odour modelling should consider each stage in an integrated manner. This paper describes the development of integrated odour models for annoyance prediction. The models describe the liquid-phase transformations and emission of hydrogen sulphide from sewage treatment processes. Model output is in a form suitable for integration with dispersion models, the predictions of which can in turn be used to indicate the probability of annoyance. The models have been applied to both hypothetical and real sewage treatment works cases. Simulation results have highlighted the potential variability of emission rates from sewage treatment works, resulting from flow, quality and meteorological variations. Emission rate variations can have significant effects on annoyance predictions, which is an important finding, as they are usually considered to be fixed and only meteorological variations are considered in predicting the odour footprint. Areas for further development of integrated odour modelling are discussed, in particular the search for improved links between analytical and sensory measurements, and a better understanding of dose/response relationships for odour annoyance.

  5. Treatment of pathological gambling - integrative systemic model.

    PubMed

    Mladenović, Ivica; Lažetić, Goran; Lečić-Toševski, Dušica; Dimitrijević, Ivan

    2015-03-01

    Pathological gambling was classified under impulse control disorders within the International Classification of Diseases (ICD-10) (WHO 1992), but the most recent Diagnostic and Statistical Manual, 5th edition (DSM-V), (APA 2013), has recognized pathological gambling as a first disorder within a new diagnostic category of behavioral addictions - Gambling disorder. Pathological gambling is a disorder in progression, and we hope that our experience in the treatment of pathological gambling in the Daily Hospital for Addictions at The Institute of Mental Health, through the original "Integrative - systemic model" would be of use to colleagues, dealing with this pathology. This model of treatment of pathological gambling is based on multi-systemic approach and it primarily represents an integration of family and cognitive-behavioral therapy, with traces of psychodynamic, existential and pharmacotherapy. The model is based on the book "Pathological gambling - with self-help manual" by Dr Mladenovic and Dr Lazetic, and has been designed in the form of a program that lasts 10 weeks in the intensive phase, and then continues for two years in the form of "extended treatment" ("After care"). The intensive phase is divided into three segments: educational, insight with initial changes and analysis of the achieved changes with the definition of plans and areas that need to be addressed in the extended treatment. "Extended treatment" lasts for two years in the form of group therapy, during which there is a second order change of the identified patient, but also of other family members. Pathological gambling has been treated in the form of systemic-family therapy for more than 10 years at the Institute of Mental Health (IMH), in Belgrade. For second year in a row the treatment is carried out by the modern "Integrative-systemic model". If abstinence from gambling witihin the period of one year after completion of the intensive phase of treatment is taken as the main criterion of

  6. Conceptual and Methodological Issues in Treatment Integrity Measurement

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  7. [Reflection on treatment of acquired immunodeficiency syndrome by integrative medicine].

    PubMed

    Wang, Dan-Ni

    2012-02-01

    The current situation of Chinese medicine and Western medicine treatment of acquired immunodeficiency syndrome (AIDS) has made the integrative medicine treatment of AIDS an important treatment strategy. Integrative medicine treatment of AIDS has made certain achievements in clinical research, basic research, and other aspects. It has good mass foundation and curative efficacy, as well as insufficiency. I hope integrative medicine can be brought into full play in the treatment of AIDS and make breakthrough progress.

  8. Enhanced integrated nonthermal treatment system study

    SciTech Connect

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

    1997-02-01

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

  9. Enhancing Treatment Integrity Maintenance through Fading with Indiscriminable Contingencies

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  10. A Systematic Framework for Addressing Treatment Integrity in School Settings

    ERIC Educational Resources Information Center

    Kupzyk, Sara; Shriver, Mark D.

    2016-01-01

    School psychologists are tasked with ensuring treatment integrity because the level of intervention implementation affects decisions about student progress. Treatment integrity includes multiple dimensions that may impact the effectiveness of an intervention including adherence, dosage, quality, and engagement. Unfortunately, treatment integrity…

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

    SciTech Connect

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

    2015-06-24

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

  12. Use of Millikan-Lauritsen plots, rather than Fowler-Nordheim plots, to analyze field emission current-voltage data

    NASA Astrophysics Data System (ADS)

    Forbes, Richard G.

    2009-06-01

    In the late 1920s, two forms of data plot were used to analyze the current-voltage (i-V) data obtained in experiments on cold field electron emission (CFE). Millikan-Lauritsen (ML) plots have the form [ln{i } versus 1/V]; Fowler-Nordheim (FN) plots have the form [ln{i /V2} versus 1/V]. In both cases common logarithms may be used instead. For historical reasons, it has become customary to use FN plots; but recent mathematical developments in CFE theory made these historical reasons less valid than they formerly were. ML plots are in fact easier to understand and use, and are more flexible when it is wanted to make corrections for all physical sources of voltage dependence in the data, or to estimate uncertainties in derived parameter values when the precise forms of voltage dependences are not known. This paper summarizes historical and recent background and argues that ML plots should now replace FN plots as the basic method of analyzing CFE i-V data (or related data involving current densities and/or fields). A formula for the interpretation of ML plot slopes is presented and discussed, and examples are given of its use.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

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

    SciTech Connect

    SEMMENS, L.S.

    1999-02-24

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  16. Enhanced Fowler-Nordheim tunneling effect in nanocrystallite Si based LED with interfacial Si nano-pyramids.

    PubMed

    Lin, Gong-Ru; Lin, Chun-Jung; Lin, Chi-Kuan

    2007-03-05

    The premier observation on the enhanced light emission from such a metal-SiO(x)-Si light emitting diode (MOSLED) with Si nano-pyramids at SiO(x)/Si interface is demonstrated at low biases. The Si nano-pyramids exhibits capability in providing the roughness of the SiO(x)/Si interface, and improving the Fowler-Nordheim (F-N) tunneling mechanism based carrier injection through the novel SiO(x)/nano-Si-pyramid/Si structure. HRTEM analysis reveals a precisely controllable size and concentration of the crystallized interfacial Si nano-pyramids at 10nm(height)x10nm(width) and within the range of 10(8)-10(11) cm(-2), respectively. With these Si nano-pyramids at a surface density of up to 1012/cm(2), the F-N tunneling threshold can be reduce from 7 MV/cm to 1.4 MV/cm. The correlation between surface density of the interfacial Si nano-pyramids and the threshold F-N tunneling field has been elucidated. Such a turn-on reduction essentially provides a less damaged SiO(x)/Si interface as the required bias for the electroluminescence of the MOSLED is greatly decreased, which thus suppresses the generation of structural damage related radiant defects under a lower biased condition and leads to a more stable near-infrared electroluminescence with a narrowing linewidth and an operating lifetime lengthened to >3 hours. An output EL power of nearly 150 nW under a biased voltage of 75 V and current density of 32 mA/cm(2) is reported for the first time.

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

    PubMed

    Forbes, Richard G

    2012-03-09

    In papers on cold field electron emission from large-area field emitters (LAFEs), it has become widespread practice to publish a misleading Fowler-Nordheim-type (FN-type) equation. This equation over-predicts the LAFE-average current density by a large highly variable factor thought to usually lie between 10(3) and 10(9). This equation, although often referenced to FN's 1928 paper, is a simplified equation used in undergraduate teaching, does not apply unmodified to LAFEs and does not appear in the 1928 paper. Technological LAFE papers often do not cite any theoretical work more recent than 1928, and often do not comment on the discrepancy between theory and experiment. This usage has occurred widely, in several high-profile American and UK applied-science journals (including Nanotechnology), and in various other places. It does not inhibit practical LAFE development, but can give a misleading impression of potential LAFE performance to non-experts. This paper shows how the misleading equation can be replaced by a conceptually complete FN-type equation that uses three high-level correction factors. One of these, or a combination of two of them, may be useful as an additional measure of LAFE quality; this paper describes a method for estimating factor values using experimental data and discusses when it can be used. Suggestions are made for improved engineering practice in reporting LAFE results. Some of these should help to prevent situations arising whereby an equation appearing in high-profile applied-science journals is used to support statements that an engineering regulatory body might deem to involve professional negligence.

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

    SciTech Connect

    1996-12-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-08-01

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

  1. [Assessing environmental and economical benefits of integrated sewage treatment systems].

    PubMed

    Li, Jin-rong; Zhang, Xiao-hong; Zhang, Hang-bin; Pan, Heng-yu; Liu, Qiang

    2015-08-01

    Sewage treatment, treated water treatment and sludge treatment are three basic units of an integrated sewage treatment system. This work assessed the influence of reusing or discharge of treated water and sludge landfill or compost on the sustainability of an integrated sewage treatment system using emergy analysis and newly proposed emergy indicators. This system's value included its environmental benefits and the products. Environmental benefits were the differences of the environmental service values before and after sewage treatment. Due to unavailability of data of the exchanged substance and energy in the internal system, products' values were attained by newly proposed substitution values. The results showed that the combination of sewage treatment, treated water reuse and sludge landfill had the strongest competitiveness, while the combination of sewage treatment, treated water reuse and earthworm compost was the most sustainable. Moreover, treated water reuse and earthworm compost were helpful for improving the sustainability of the integrated sewage treatment system. The quality of treated water and local conditions should be also considered when implementing the treated water reuse or discharge. The resources efficiency of earthworm compost unit needed to be further improved. Improved emergy indices were more suitable for integrated sewage treatment systems.

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

    NASA Astrophysics Data System (ADS)

    De, Sanchari; Ghosh, Sutapa; Chakrabarty, Somenath

    2015-11-01

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

  3. Spiritually Integrated Treatment of Depression: A Conceptual Framework

    PubMed Central

    Peteet, John R.

    2012-01-01

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

  4. A new integrated technique for the supportive treatment of sepsis.

    PubMed

    Hartmann, Jens; Harm, Stephan

    2017-03-06

    Although there has been continuous, intensive research for many years in the field of sepsis treatment, currently available treatment options are limited, and there is still a lack of systems that efficiently remove endotoxins as well as mediators. Here, we discuss a newly developed, integrated technique that combines different aspects for their use in extracorporeal blood purification for the supportive treatment of liver failure and sepsis.

  5. Clinical guide to periodontology: part 3. Multidisciplinary integrated treatment.

    PubMed

    Palmer, R M; Ide, M; Floyd, P D

    2014-05-01

    The establishment of periodontal health should be a primary aim in all treatment plans. The methods by which this can be achieved have been dealt with in previous chapters, but there are a number of situations where integration of these treatment methods with other dental disciplines needs to be clarified. To simplify matters this chapter will consider periodontal implications in three main areas: treatment of drifted anterior teeth, pre-restorative procedures and replacement of missing teeth.

  6. [Integral treatment of congenital Chagas disease: the Bolivian experience ].

    PubMed

    Suárez, Eduardo; Alonso-Vega, Cristina; Torrico, Faustino; Córdova, Marisol

    2005-01-01

    We have analyzed the response to the treatment with benznidazol in newborns and nurslings in the Hospital Materno Infantil Germán Urquidi of Cochabamba, Bolivia, between 1999 and 2002. It is important an integral treatment of the nursling with a subsequent information directed to the family. The response was close to 100% when the treatment was correctly administrated. They were not adverse effects and the detected biochemical alterations did not present clinical significance.

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

    SciTech Connect

    Durrani, H.A.; Schmidt, L.J.; Erickson, T.A.; Sondreal, E.A.; Erjavec, J.; Steadman, E.N.; Fabrycky, W.J.; Wilson, J.S.; Musich, M.A.

    1996-07-01

    This report analyzes three systems engineering (SE) studies performed on integrated thermal treatment systems (ITTSs) and integrated nonthermal treatment systems (INTSs) for the remediation of mixed low-level waste (MLLW) stored throughout the US Department of Energy (DOE) weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center (EERC), Science Applications International Corporation (SAIC), the Waste Policy Institute (WPI), and Virginia Tech (VT). The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions taken in the studies might bias the resulting economic evaluations of both thermal and nonthermal systems, (2) identify the critical areas of the studies that would benefit from further investigation, and (3) develop a standard template that could be used in future studies to produce sound SE applications.

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

    SciTech Connect

    1996-08-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

  9. Treatment of domain integrals in boundary element methods

    SciTech Connect

    Nintcheu Fata, Sylvain

    2012-01-01

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

  10. Hanford Site waste treatment/storage/disposal integration

    SciTech Connect

    MCDONALD, K.M.

    1999-02-24

    In 1998 Waste Management Federal Services of Hanford, Inc. began the integration of all low-level waste, mixed waste, and TRU waste-generating activities across the Hanford site. With seven contractors, dozens of generating units, and hundreds of waste streams, integration was necessary to provide acute waste forecasting and planning for future treatment activities. This integration effort provides disposition maps that account for waste from generation, through processing, treatment and final waste disposal. The integration effort covers generating facilities from the present through the life-cycle, including transition and deactivation. The effort is patterned after the very successful DOE Complex EM Integration effort. Although still in the preliminary stages, the comprehensive onsite integration effort has already reaped benefits. These include identifying significant waste streams that had not been forecast, identifying opportunities for consolidating activities and services to accelerate schedule or save money; and identifying waste streams which currently have no path forward in the planning baseline. Consolidation/integration of planned activities may also provide opportunities for pollution prevention and/or avoidance of secondary waste generation. A workshop was held to review the waste disposition maps, and to identify opportunities with potential cost or schedule savings. Another workshop may be held to follow up on some of the long-term integration opportunities. A change to the Hanford waste forecast data call would help to align the Solid Waste Forecast with the new disposition maps.

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

    SciTech Connect

    Brown, B.W.

    1997-04-01

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

  12. [Integration of nutritional care into cancer treatment: need for improvement].

    PubMed

    Joly, Caroline; Jacqueline-Ravel, Nathalie; Pugliesi-Rinaldi, Angela; Bigler-Perrotin, Lucienne; Chikhi, Marinette; Dietrich, Pierre-Yves; Dulguerov, Pavel; Miralbell, Raymond; Picard-Kossovsky, Michel; Seium, Yodit; Thériault, Michel; Pichard, Claude

    2011-11-16

    Progresses in cancer treatment transformed cancer into a chronic disease associated with growing nutritional problems. Poor nutritional status of cancer patients worsens morbidity, mortality, overall cost of care and decreases patients' quality of life, oncologic treatments tolerance and efficacy. These adverse effects lead to treatment modifications or interruptions, reducing the chances to control or cure cancer. Implementation of an interdisciplinary and longitudinal integration of nutritional care and nutritional information into cancer treatment (The OncoNut Program) could prevent or treat poor nutritional status and its adversely side effects.

  13. A Treatment Integrity Analysis of Function-Based Intervention

    ERIC Educational Resources Information Center

    Wood, Brenna K.; Umbreit, John; Liaupsin, Carl J.; Gresham, Frank M.

    2007-01-01

    This study examined whether direct, interval-by-interval measures of treatment integrity would make it possible to distinguish whether equivocal intervention results could be attributed to the intervention itself, or to poor implementation. Josh, an eight-year-old 3rd grader, performed at or slightly above his peers' academically, yet engaged in…

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

    ERIC Educational Resources Information Center

    Koh, Seong A.

    2010-01-01

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

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

    SciTech Connect

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

    2015-09-07

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

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

    PubMed

    Nattrass, Nicoli; Hodes, Rebecca; Cluver, Lucie

    2016-07-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-09-01

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

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

    PubMed Central

    Boisvert, Jennifer A.; Harrell, W. Andrew

    2015-01-01

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

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

    PubMed Central

    George, Sanju; Bowden-Jones, Henrietta

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Andersen, Melissa; Daly, Edward J., III

    2013-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    SciTech Connect

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

    1995-04-01

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

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

    SciTech Connect

    Feizollahi, F.; Quapp, W.J.

    1995-08-01

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

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

    SciTech Connect

    1996-10-01

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

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

    SciTech Connect

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

    1994-07-01

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

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

    PubMed Central

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

    2013-01-01

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

  7. Mixed Waste Treatment Project: Computer simulations of integrated flowsheets

    SciTech Connect

    Dietsche, L.J.

    1993-12-01

    The disposal of mixed waste, that is waste containing both hazardous and radioactive components, is a challenging waste management problem of particular concern to DOE sites throughout the United States. Traditional technologies used for the destruction of hazardous wastes need to be re-evaluated for their ability to handle mixed wastes, and in some cases new technologies need to be developed. The Mixed Waste Treatment Project (MWTP) was set up by DOE`s Waste Operations Program (EM30) to provide guidance on mixed waste treatment options. One of MWTP`s charters is to develop flowsheets for prototype integrated mixed waste treatment facilities which can serve as models for sites developing their own treatment strategies. Evaluation of these flowsheets is being facilitated through the use of computer modelling. The objective of the flowsheet simulations is to provide mass and energy balances, product compositions, and equipment sizing (leading to cost) information. The modelled flowsheets need to be easily modified to examine how alternative technologies and varying feed streams effect the overall integrated process. One such commercially available simulation program is ASPEN PLUS. This report contains details of the Aspen Plus program.

  8. Toward Developing a Science of Treatment Integrity: Introduction to the Special Series

    ERIC Educational Resources Information Center

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

    2009-01-01

    Treatment integrity (also referred to as "treatment fidelity," "intervention integrity," and "procedural reliability") is an important methodological concerning both research and practice because treatment integrity data are essential to making valid conclusions regarding treatment outcomes. Despite its relationship to validity, treatment…

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

    SciTech Connect

    Feizollahi, F.; Quapp, W.J.

    1996-02-01

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

  10. Integrative Treatments to Reduce Risk for Cardiovascular Disease

    PubMed Central

    Bradley, Ryan; Oberg, Erica

    2010-01-01

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

  11. Integrated pharmacologic treatment of attention-deficit hyperactivity disorder (ADHD).

    PubMed

    Horst, Robert O; Hendren, Robert L

    2005-01-01

    This article is a review of what is currently known about optimal treatments for patients with attention-deficit hyperactivity disorder (ADHD). It begins with a description of assessment techniques and the differential diagnosis, which includes learning disorders, anxiety disorders, and bipolar disorder. The high rate of comorbidity in patients with ADHD and the impact of comorbidity on treatment decisions are also discussed. Detailed descriptions of various pharmacologic treatments are provided, including a description of the role of combination pharmacotherapy and the integration of nonpharmacologic therapy. A decision-making model for selecting the most appropriate pharmacologic therapy versus combining pharmacotherapy with psychosocial interventions is described. The advantages and disadvantages of various pharmacologic agents--including long-acting stimulants and atomoxetine--are examined. Particular attention is paid to the recent Multimodal Treatment Study of Attention-Deficit Hyperactivity Disorder, sponsored by the National Institute of Mental Health, which includes a comparison of long-term pharmacotherapy, behavioral therapy, or a combination thereof, as well as an evaluation of the role of community-based therapy (i.e., treatment as usual). This article focuses on children and adolescents, because most of the research on ADHD has been conducted in this age group. However, a brief section on adults is also provided.

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

    PubMed

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

    2015-03-01

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

  13. Integrated Waste Treatment Unit GFSI Risk Management Plan

    SciTech Connect

    W. A. Owca

    2007-06-21

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

  14. West Valley operation of an integrated radwaste treatment system

    SciTech Connect

    Valenti, P.J.; Cwynar, J.C.; Gessner, R.F.

    1989-01-01

    The US Department of Energy is charged with the solidification of high-level liquid waste remaining from nuclear fuel reprocessing activities, which were conducted at West Valley, New York, between 1966 and 1972. One important aspect of the project's fully integrated waste program is the management of low-level wastes (LLWs) that result from treating high-level waste. At the West Valley Demonstration Project, {approximately}650,000 gal of high-level radioactive waste is stored in an underground tank. The waste has separated into two phases, i.e., a liquid or supernatant that comprises 90% of this 650,000 gal and a 10% layer of sludge on the bottom of the tank. Estimates based on radiochemical analysis show that the supernatant contains {approximately}7.4 million Ci of predominantly {sup 137}Cs. The purpose of the integrated radwaste treatment system (IRTS) is to remove as much {sup 137}Cs as possible from the supernatant by utilizing an ion exchange technique and to solidify the remaining liquid into a certifiable class C cement LLW form that meets the waste form criteria specified in the US Nuclear Regulatory Commission's (NRC's) 10CFR61. Waste is to be solidified in 71-gal square drums and remotely handled and stored on-site until determination of final disposition. This paper describes the very successful experiences gained in the treatment and solidification of the LLW stream produced as well as the processes and controls employed on the cemented waste.

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

    PubMed Central

    Scrimali, Tullio; Tomasello, Damiana; Sciuto, Massimo

    2015-01-01

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

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

    SciTech Connect

    Henry Y. Wang; Keeran R. Srinivasan

    1999-02-25

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

  17. A COMPARISON OF SENSORY INTEGRATIVE AND BEHAVIORAL THERAPIES AS TREATMENT FOR PEDIATRIC FEEDING DISORDERS

    PubMed Central

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

    2012-01-01

    We compared the effects of escape extinction (EE) plus noncontingent reinforcement (NCR) with sensory integration therapy as treatment for the feeding problems of 2 children. Results indicated that EE plus NCR was more effective in increasing acceptance, decreasing inappropriate behavior, and increasing amount consumed relative to sensory integration for both children. The results are discussed in terms of the challenges of evaluating sensory-integration-based treatments, and the reasons why component analyses of multicomponent treatments like sensory integration are important. PMID:23060661

  18. [Familial hypercholesterolemia: why screening, counselling and treatment should be integrated].

    PubMed

    Roeters van Lennep, Jeanine E; Visseren, Frank L J; Jira, Petr E

    2015-01-01

    Familial hypercholesterolemia (FH) is a monogenic autosomal dominant disorder. FH is the most common hereditary cause of raised serum cholesterol levels and is associated with an increased risk of premature cardiovascular disease (CVD). This disorder is known to have a genetic cause, and effective drug therapies exist for patients with FH. Successful cascade screening, within the framework of a national screening programme, gave the Netherlands an international role as model and pioneer as far as FH detection is concerned. With the ending of this screening programme as of 1 January 2014 the care for FH patients, including screening and counselling has had to be incorporated within the basic Dutch healthcare insurance system. It is essential that detection of FH should continue in as efficient and cost-effective a manner as possible. Our proposal is that this detection should be performed and co-ordinated by those treating patients with FH so that FH screening, counselling and treatment are integrated.

  19. Integrated chemical-biological treatment of benzo[a]pyrene

    SciTech Connect

    Zeng, Yu; Hong, P.K.A.; Wavrek, D.A.

    2000-03-01

    Benzo[a]pyrene of natural and anthropogenic sources is one of the toxic, mutagenic, polycyclic aromatic hydrocarbons (PAHs) listed as priority pollutants. This study focuses on an integrated treatment of benzo[a]pyrene involving sequential chemical oxidation and biological degradation. The objectives are to (1) provide mechanistic details in the ozone-mediated degradation of benzo[a]pyrene in the aqueous phase, (2) test the biodegradability of resultant intermediates, and (3) test the feasibility for the coupled chemical-biological treatment of the five-ring PAH. Batch and packed column reactors were used to examine the degradation pathways of benzo[a]pyrene subject to ozonation in the aqueous phase. After different ozonation times, samples containing reaction intermediates and byproducts from both reactors were collected, identified for organic contents, and further biologically inoculated to determine their biodegradability. The O{sub 3}-pretreated samples were incubated for 5, 10, 15, and 20 days; afterward biochemical oxygen demand (BOD), chemical oxygen demand (COD), and E. coli toxicity tests were conducted along with qualitative and quantitative determinations of benzo[a]pyrene, intermediates, and reaction products by GC/FID and GC/MS methods. Prevalent intermediates identified at different stages included ring-opened aldehydes, phthalic derivatives, and aliphatics. The degradation of benzo[a]pyrene is primarily initiated via O{sub 3}-mediated ring-opening, followed by O{sub 3} and hydroxyl radical fragmentation, and ultimately brought to complete mineralization primarily via hydroxyl radicals. Intermediates formed during chemical oxidation were biodegradable with a measured first-order rate constant (k{sub 0}) of 0.18 day{sup {minus}1}. The integrated chemical-biological system seems feasible for treating recalcitrant compounds, while pretreatment by chemical oxidation appears useful in promoting soluble intermediates from otherwise highly insoluble

  20. Integrating Multiscale Modeling with Drug Effects for Cancer Treatment

    PubMed Central

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

    2015-01-01

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

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

    SciTech Connect

    1996-08-01

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

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

    SciTech Connect

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

    2014-02-15

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

  3. Integrated treatment of PAH contaminated soil by soil washing, ozonation and biological treatment.

    PubMed

    Haapea, Pia; Tuhkanen, Tuula

    2006-08-21

    The aim of the study was to optimise three different treatment methods and to find out if the integration of soil washing, ozonation and biological treatment could be a feasible method for the remediation of aged oil contaminated with PAHs. Three different ozone doses and soil washing were studied in different pHs in order to assess their effect to the degradation and enhancement of biodegradability of PAH in the soil and water phase. Main target of the study was to find out a method with which the PAH concentrations could be decreased below the Finnish guideline level for total PAHs. In this case, the initial concentration of PAHs was 1200 mg kg(-1) and therefore almost 85% degradation of PAHs was required. Any of the methods studied was not able to reach this target level alone, but by several combinations of the methods studied achieved 90% reduction of PAHs. The consumption of ozone was 5-10 times lower in the integrated treatments of soil washing, ozonation and biological treatment than without prewashing.

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

    ERIC Educational Resources Information Center

    Gresham, Frank M.

    2009-01-01

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

  5. Integrative Treatment of Reflux and Functional Dyspepsia in Children

    PubMed Central

    Yeh, Ann Ming; Golianu, Brenda

    2014-01-01

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

  6. Integration of alternative feedstreams for biomass treatment and utilization

    DOEpatents

    Hennessey, Susan Marie [Avondale, PA; Friend, Julie [Claymont, DE; Dunson, Jr., James B.; Tucker, III, Melvin P.; Elander, Richard T [Evergreen, CO; Hames, Bonnie [Westminster, CO

    2011-03-22

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

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

    SciTech Connect

    Wolf, Gregory T.

    2007-10-01

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

  8. The perturbative approach to path integrals: A succinct mathematical treatment

    NASA Astrophysics Data System (ADS)

    Nguyen, Timothy

    2016-09-01

    We study finite-dimensional integrals in a way that elucidates the mathematical meaning behind the formal manipulations of path integrals occurring in quantum field theory. This involves a proper understanding of how Wick's theorem allows one to evaluate integrals perturbatively, i.e., as a series expansion in a formal parameter irrespective of convergence properties. We establish invariance properties of such a Wick expansion under coordinate changes and the action of a Lie group of symmetries, and we use this to study essential features of path integral manipulations, including coordinate changes, Ward identities, Schwinger-Dyson equations, Faddeev-Popov gauge-fixing, and eliminating fields by their equation of motion. We also discuss the asymptotic nature of the Wick expansion and the implications this has for defining path integrals perturbatively and nonperturbatively.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  10. A Descriptive Evaluation of Long-Term Treatment Integrity

    ERIC Educational Resources Information Center

    Arkoosh, Maire Kathryn; Derby, K. Mark; Wacker, David P.; Berg, Wendy; McLaughlin, T. F.; Barretto, Anjali

    2007-01-01

    The validity of selecting treatment contingencies on the basis of the results obtained through functional analysis is well documented. However, a number of second-generation questions have emerged: For example, what are the parameters required to achieve desired treatment outcomes? More specifically, what is the degree of treatment integrity…

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

    PubMed

    Craig, Andrew R

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  13. Conservative integrated treatment of adhesive capsulitis of the shoulder

    PubMed Central

    RUSSO, ADRIANO; ARRIGHI, ANNALISA; VIGNALE, LUIGI; MOLFETTA, LUIGI

    2014-01-01

    Purpose the aim of this study was to present the results of a conservative treatment for adhesive capsulitis based on an original protocol of combined pharmacological and rehabilitation treatment. Methods fifty-two patients with idiopathic adhesive capsulitis were enrolled in the present study. The treatment protocol included the use of hyaluronic acid and anaesthetic periarticular and intra-articular injections followed by a specific program of capsule and muscle stretching. Results the results of this treatment showed complete recovery of range of motion (ROM) in 50 of the 52 cases. The mean pre-treatment ROM values were: 85° for forward elevation, 75° for abduction, 25° for external rotation, and 15° for internal rotation. The post-treatment mean ROM values showed marked improvements: 175° for forward elevation, 175° for abduction, 87.5° for external rotation and 75° for internal rotation. Conclusions conservative treatment of adhesive capsulitis based on a combined pharmacological and rehabilitation approach was found to be effective in resolving pain and stiffness in 96% of the patients. Level of evidence level IV, therapeutic case series. PMID:25606536

  14. New perspectives in treatment decision for integrated management of rectal cancer: multimodal research for multimodal treatments

    PubMed Central

    VALENTINI, V.; CELLINI, F.

    2014-01-01

    Rectal cancer management improved results in the last thirty-five applying new integrated treatment options. Preoperative radiochemotherapy or radiotherapy alone joined to the modern surgery gaining significant improvement of outcomes. Nevertheless, a definitive conclusion about superiority of one on the other in term of survival and toxicity is still lacking, and further improvement is in general required and seems obtainable. The need for a wide sharing of the accumulated knowledge is represented by the consensus conferences that over the years summarizes the state of the art for the management of rectal cancer. One of the most promising opportunities comes from the attempt of characterization of the tumor heterogeneity. An always-increasing number of new parameters come from different sources including genomic, imaging, pathological features and many others. The need of new informatics technologies able to handle and continuously incorporate new inputs derived from the evidences is also imperative. The combined use of large shared databases and “learning models” could allow generating and rapidly testing new hypotheses, providing further survival improvement in the next years. PMID:24979100

  15. High-level-waste treatment at West Valley: integrated radwaste treatment system

    SciTech Connect

    Baker, M.N. )

    1992-01-01

    The West Valley Site was the location of the only operating nuclear fuel reprocessing plant in the United States. A private firm operated the facility from 1966 to 1972, processing 640 tonnes of commercial and defense fuels using the plutonium uranium reduction extraction (Purex) process. Approximately 2.1 million liters of liquid reprocessing waste resulted from this operation. These wastes were stored in an underground storage tank. The integrated radwaste treatment system (IRTS) began operation in May 1988. This is a liquid waste pretreatment system designated to decontaminate the high-level liquid waste (HLLW), forming a low-level liquid waste (LLLW). The LLLW is encapsulated in cement, poured into 71-gal square drums and stored in a remotely operated shielded retrievable storage location. From May 1988 through November 1990, the IRTS decontaminated 450,000 gal of HLLW, encapsulating the resulting concentrates into 10,393, 71-gal square drums. All of the technical difficulties encountered during 2 1/2 yr of processing were resolved using available technology without compromising safety or product quality. There was no abnormal or unacceptable personnel exposure during this processing period.

  16. Evaluating an Integrated Support Model for Increasing Treatment Plan Implementation Following Consultation in Schools.

    PubMed

    Noell, George H; Volz, Jennifer R; Henderson, Marie Y; Williams, Kashunda L

    2017-02-20

    This study examined the percentage of steps implemented from treatment plans following consultation with teachers. Interventions were implemented for 39 elementary school students referred for consultation and treatment for challenging behavior or academic deficits. An integrated support model that included antecedent social influence and planning combined with follow-up performance feedback was compared to weekly structured follow-up interviews. Participating teacher-student dyads were randomly assigned to conditions. Integrated support produced superior treatment implementation and child outcomes compared to weekly follow-up meetings. In contrast, teachers' ratings of consultants' effectiveness, treatment acceptability, and treatment implementation were undifferentiated across conditions. Treatment plan implementation and child behavioral outcomes were statistically significantly correlated. Treatment acceptability and implementation were not correlated at a statistically significant level. The implications of these findings for consultation and treatment research and practice are discussed. (PsycINFO Database Record

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

    EPA Science Inventory

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

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

    SciTech Connect

    Not Available

    1993-10-01

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

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

    EPA Science Inventory

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  1. An Integrated Evaluation of Nonspeech Oral Motor Treatments

    ERIC Educational Resources Information Center

    Powell, Thomas W.

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  3. Methane from an integrated hyacinth treatment anaerobic digestion facility

    SciTech Connect

    Hayes, T.D.; Chynoweth, D.P.; Reddy, K.R.; Schwegler, B.

    1985-08-01

    Results to date indicate that the Hyacinth Project could lead to the production of cost-competitive methane from a hyacinth wastewater treatment system. An information base from the project will be available by the end of 1985 to support a decision on whether methane generation from a hyacinth facility is sufficiently attractive for communities and gas companies to pursue at a commercial scale. If the economics are promising, construction of a full-scale plant could begin in the late 1980s. The project could ultimately provide a low-cost supplemental source of pipeline-quality gas while offering a cost-effective wastewater treatment alternative. 9 references, 4 figures, 2 tables.

  4. Pesticide and toxicity reduction using an integrated vegetated treatment system.

    PubMed

    Anderson, Brian; Phillips, Bryn; Hunt, John; Largay, Bryan; Shihadeh, Rami; Tjeerdema, Ronald

    2011-05-01

    The California, USA, central coast is one of the most productive agricultural areas in the world, and numerous stakeholders are working there to implement conservation practices to reduce contaminated runoff. Practices include vegetated treatment systems (VTS) designed to promote contaminant reduction and breakdown. The current study evaluated the effectiveness of a vegetated drainage ditch incorporating a sedimentation basin, a vegetated section, and a Landguard organophosphate-A (OP-A) enzyme dosing system. The VTS was constructed on a working farm and was designed to remove organophosphate and pyrethroid pesticides, the primary pesticides causing toxicity in Salinas Valley watersheds. The present study was conducted during five separate irrigation events on tailwater runoff containing mixtures of pesticides and suspended sediments. Water samples were collected at four stations within the system, and these were subjected to chemical analyses and tested for toxicity to Ceriodaphnia dubia. All inflow samples were highly toxic to C. dubia, and this was largely because of diazinon. Treatment of diazinon-contaminated runoff was only partially effective using aquatic vegetation. All diazinon remaining after vegetated treatment was effectively removed after treatment with the Landguard OP-A enzyme. Chemical analysis of the VTS water samples showed that pyrethroid and organochlorine pesticide concentrations in water were greatly reduced in the sedimentation section of the ditch, and these pesticides were further reduced in the vegetated section of the ditch. The overall conclusion from these analyses is that the VTS was effective at reducing the more hydrophobic organochlorine and pyrethroid pesticides from water. The water-soluble pesticide diazinon was not sufficiently removed during the VTS residence times observed in this study; however, residual diazinon was effectively removed using Landguard OP-A.

  5. Integrating Spiritual and Western Treatment Modalities in a Native American Substance User Center: Provider Perspectives

    PubMed Central

    Moghaddam, Jacquelene F.; Momper, Sandra L.

    2014-01-01

    Few studies examine how traditional Native American and Western healing practices are being integrated in Native American substance user treatment centers. Data are presented from a 2008 study of providers of integrated substance user treatment for Native Americans at an urban Western US center. Nineteen semi-structured interviews were conducted to examine 10 providers’ views of the integration of traditional and Western healing and the impact on recovery for clients. We used a grounded theory approach to data analysis with manual and NVivo codes and themes developed. Limitations and implications for practice are discussed. PMID:21810077

  6. Integration of second cancer risk calculations in a radiotherapy treatment planning system

    NASA Astrophysics Data System (ADS)

    Hartmann, M.; Schneider, U.

    2014-03-01

    Second cancer risk in patients, in particular in children, who were treated with radiotherapy is an important side effect. It should be minimized by selecting an appropriate treatment plan for the patient. The objectives of this study were to integrate a risk model for radiation induced cancer into a treatment planning system which allows to judge different treatment plans with regard to second cancer induction and to quantify the potential reduction in predicted risk. A model for radiation induced cancer including fractionation effects which is valid for doses in the radiotherapy range was integrated into a treatment planning system. From the three-dimensional (3D) dose distribution the 3D-risk equivalent dose (RED) was calculated on an organ specific basis. In addition to RED further risk coefficients like OED (organ equivalent dose), EAR (excess absolute risk) and LAR (lifetime attributable risk) are computed. A risk model for radiation induced cancer was successfully integrated in a treatment planning system. Several risk coefficients can be viewed and used to obtain critical situations were a plan can be optimised. Risk-volume-histograms and organ specific risks were calculated for different treatment plans and were used in combination with NTCP estimates for plan evaluation. It is concluded that the integration of second cancer risk estimates in a commercial treatment planning system is feasible. It can be used in addition to NTCP modelling for optimising treatment plans which result in the lowest possible second cancer risk for a patient.

  7. Using Performance Feedback to Improve Treatment Integrity of Classwide Behavior Plans: An Investigation of Observer Reactivity

    ERIC Educational Resources Information Center

    Codding, Robin S.; Livanis, Andrew; Pace, Gary M.; Vaca, Leslie

    2008-01-01

    The current study replicated the positive effects of performance feedback on treatment integrity and extended previous work by examining reactivity using a multiple baseline design with alternating treatments for observer-present and observer-absent conditions on teachers' implementation of a classwide behavior plan. No differences were found…

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

    ERIC Educational Resources Information Center

    Teater, Barbra; Hammond, Gretchen Clark

    2009-01-01

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

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

    PubMed Central

    Valencia, Marcelo; Juarez, Francisco; Ortega, Hector

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  11. [Integrative treatment of instable diabetes mellitus: education or psychotherapy?].

    PubMed

    Leweke, Frank; Kurth, Regina; Milch, Wolfgang; Brosig, Burkhard

    2004-01-01

    The term "brittle diabetes" describes a subtype of instable type-I diabetes, characterized by high variations of blood sugar without any evident cause and despite careful clinical management. Clear guidelines for a precise definition of the condition are still lacking; this fosters insecurities concerning diagnosis and therapy of the disease. Psychosocial influences, triggering these conditions, were discussed. The patient-doctor-relationship appears to be tensed due to an often missing compliance. Using a paradigmatic case study as background, the specific diagnostic and therapeutic problems in brittle diabetes were presented. Brittle diabetes advocates a close cooperation between internal and psychosomatic medicine units and a combination of patient education and psychotherapy. Seen under a psychosomatic paradigm, brittle diabetes can be detected early and effective treatment may avoid further complications in these young patients.

  12. A novel, integrated treatment system for coal wastewaters

    SciTech Connect

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

    1991-01-01

    This is the first quarterly report of the above project. The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and the inorganics present in coal conversion wastewaters. The initial phase of the work has been focused on the development of modified clays for use in the selective removal and recovery of heavy metals such as Cd, Cu, chromate and selenate. The results presented here show that a surfactant-modified clay adsorbs Cd strongly at a pH of 8.5 and poorly at pH 4.0. Further, the adsorption of Cd on modified clay is unaffected by the ionic strength of the medium. In the case of Cu, it has been shown that the metal forms a complex with alkyl diamines in aqueous solutions at a pH of 6.0 and does not bind to these surfactants at a lower pH of 3.0. These findings are a preliminary indication that the surface and solution chemistry of amine surfactants can be gainfully modified to adsorb and desorb cationic heavy metals.

  13. A novel, integrated treatment systems for coal wastewaters

    SciTech Connect

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

    1992-01-01

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

  14. Low-pressure membrane integrity tests for drinking water treatment: A review.

    PubMed

    Guo, H; Wyart, Y; Perot, J; Nauleau, F; Moulin, P

    2010-01-01

    Low-pressure membrane systems, including microfiltration (MF) and ultrafiltration (UF) membranes, are being increasingly used in drinking water treatments due to their high level of pathogen removal. However, the pathogen will pass through the membrane and contaminate the product if the membrane integrity is compromised. Therefore, an effective on-line integrity monitoring method for MF and UF membrane systems is essential to guarantee the regulatory requirements for pathogen removal. A lot of works on low-pressure membrane integrity tests have been conducted by many researchers. This paper provides a literature review about different low-pressure membrane integrity monitoring methods for the drinking water treatment, including direct methods (pressure-based tests, acoustic sensor test, liquid porosimetry, etc.) and indirect methods (particle counting, particle monitoring, turbidity monitoring, surrogate challenge tests). Additionally, some information about the operation of membrane integrity tests is presented here. It can be realized from this review that it remains urgent to develop an alternative on-line detection technique for a quick, accurate, simple, continuous and relatively inexpensive evaluation of low-pressure membrane integrity. To better satisfy regulatory requirements for drinking water treatments, the characteristic of this ideal membrane integrity test is proposed at the end of this paper.

  15. Review of the integrated thermal and nonthermal treatment system studies. Final report

    SciTech Connect

    1996-10-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1 -- issued July 1994; Integrated Thermal Treatment System Study, Phase 2 -- issued February 1996; and Integrated Nonthermal Treatment System Study -- drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

  16. Comparison of behavioral intervention and sensory-integration therapy in the treatment of challenging behavior.

    PubMed

    Devlin, Sarah; Healy, Olive; Leader, Geraldine; Hughes, Brian M

    2011-10-01

    The objective of the current study was to compare the effects of sensory-integration therapy (SIT) and a behavioral intervention on rates of challenging behavior (including self-injurious behavior) in four children diagnosed with Autism Spectrum Disorder. For each of the participants a functional assessment was conducted to identify the variables maintaining challenging behavior. Results of these assessments were used to design function-based behavioral interventions for each participant. Recommendations for the sensory-integration treatment were designed by an Occupational Therapist, trained in the use of sensory-integration theory and techniques. The sensory-integration techniques were not dependent on the results of the functional assessments. The study was conducted within an alternating treatments design, with initial baseline and final best treatment phase. For each participant, results demonstrated that the behavioral intervention was more effective than the sensory integration therapy in the treatment of challenging behavior. In the best treatment phase, the behavioral intervention alone was implemented and further reduction was observed in the rate of challenging behavior. Analysis of saliva samples revealed relatively low levels of cortisol and very little stress-responsivity across the SIT condition and the behavioral intervention condition, which may be related to the participants' capacity to perceive stress in terms of its social significance.

  17. Psychosomatic patients in integrated care: Which treatment mediators do we have to focus on?

    PubMed

    Parth, Karoline; Rosar, Ania; Stastka, Kurt; Storck, Timo; Löffler-Stastka, Henriette

    2016-01-01

    The field of psychosomatics has gained increasing significance; it has been struggling to establish its position as either an independent discipline or a subdomain of specific areas such as internal medicine or psychiatry. However, the rise of psychosomatic syndromes and disease patterns as well as an increase of specific integrated psychosomatic wards is a clear indication for the growing importance of interdisciplinary approaches to psychosomatic disorders. The study presents data from an 8-week inpatient treatment at a psychosomatic facility and investigates whether patients improved in their subjective symptom experience. A complex treatment approach, ranging from pharmacological treatment and group and individual psychotherapy to physiotherapy and ergotherapy was integrated into this intervention. In essence, containment of intrapsychic aggression derivatives played a central role in the treatment of psychosomatic symptoms. A significant factor contributing to a successful treatment is the doctor-patient relationship. All these factors were investigated in the present study.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Becker, Carol-Lynne J.

    2015-01-01

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

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

    SciTech Connect

    Jin Jianyue; Drzymala, Robert; Li Zuofeng

    2004-12-01

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

  2. Measuring collaboration and integration activities in criminal justice and substance abuse treatment agencies.

    PubMed

    Fletcher, Bennett; Lehman, Wayne; Wexler, Harry; Melnick, Gerald; Taxman, Faye; Young, Douglas

    2009-08-01

    Individuals with substance abuse problems who are involved in the criminal justice system frequently need community-based drug and alcohol abuse treatment and other services. To reduce the risk of relapse to illicit drugs and criminal recidivism, criminal justice agencies may need to establish collaborations with substance abuse treatment and other community-based service providers. Although there are many variations of interorganizational relationships, the nature of these interagency collaborations among justice agencies and treatment providers has received little systematic study. As a first step,we present an instrument to measure interagency collaboration and integration activities using items in the National Criminal Justice Treatment Practices Surveys conducted as part of the Criminal Justice Drug Abuse Treatment Studies(CJ-DATS). Collaboration and integration activities related to drug-involved offenders were examined between substance abuse treatment providers, correctional agencies, and the judiciary. The measurement scale reliably identified two levels of collaboration: less structured, informal networking and coordination and more structured and formalized levels of cooperation and collaboration. An illustration of the use of the systems integration tool is presented.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Plumb, Jennifer C.; Vilardaga, Roger

    2010-01-01

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

  7. Increasing Treatment Integrity through Negative Reinforcement: Effects on Teacher and Student Behavior

    ERIC Educational Resources Information Center

    DiGennaro, Florence D.; Martens, Brian K.; McIntyre, Laura Lee

    2005-01-01

    The current study examined the extent to which treatment integrity was increased and maintained for 4 teachers in their regular classroom settings as a result of performance feedback and negative reinforcement. Teachers received daily written feedback about their accuracy in implementing an intervention and were able to avoid meeting with a…

  8. Successful Integrative Medicine Assessment and Treatment of Chronic Pain Associated With Breast Surgery

    PubMed Central

    Chung, Myung Kyu

    2017-01-01

    Presented is the first reported case series of chronic neck and back pain associated with breast scars from breast surgery and successfully treated with an integrative medicine assessment and treatment approach, which included the assessment technique of autonomic response testing and the scar therapy technique of neural therapy. Implications for nursing practice are discussed. PMID:27782920

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

    ERIC Educational Resources Information Center

    Vujnovic, Rebecca Kate

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  12. Integrated Educational and Mental Health Services within a Day Treatment Setting.

    ERIC Educational Resources Information Center

    Francis, Greta; Radka, Dale F.

    This paper discusses the integration of educational and mental health services for children and adolescents within a psychiatric day treatment setting at the Bradley School housed in a private psychiatric hospital affiliated with Brown University in Rhode Island. A full range of mental health services are used, and therapies are delivered in the…

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

    ERIC Educational Resources Information Center

    Din, Feng S.; Lodato, Donna M.

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

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

    SciTech Connect

    PIEPHO, M.G.

    2000-01-10

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

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

    SciTech Connect

    RITTMANN, P.D.

    1999-10-07

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

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

    SciTech Connect

    Pauly, T.R., Westinghouse Hanford

    1996-08-12

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Wells, Karen C.; Heilbron, Nicole

    2012-01-01

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

  20. The Relationship between Pre-Treatment Clinical Profile and Treatment Outcome in an Integrated Stuttering Program

    ERIC Educational Resources Information Center

    Huinck, Wendy J.; Langevin, Marilyn; Kully, Deborah; Graamans, Kees; Peters, Herman F. M.; Hulstijn, Wouter

    2006-01-01

    A procedure for subtyping individuals who stutter and its relationship to treatment outcome is explored. Twenty-five adult participants of the Comprehensive Stuttering Program (CSP) were classified according to: (1) stuttering severity and (2) severity of negative emotions and cognitions associated with their speech problem. Speech characteristics…

  1. Verification of Fowler-Nordheim electron tunneling mechanism in Ni/SiO2/n-4H SiC and n+ poly-Si/SiO2/n-4H SiC MOS devices by different models

    NASA Astrophysics Data System (ADS)

    Kodigala, Subba Ramaiah

    2016-11-01

    This article emphasizes verification of Fowler-Nordheim electron tunneling mechanism in the Ni/SiO2/n-4H SiC MOS devices by developing three different kinds of models. The standard semiconductor equations are categorically solved to obtain the change in Fermi energy level of semiconductor with effect of temperature and field that extend support to determine sustainable and accurate tunneling current through the oxide layer. The forward and reverse bias currents with variation of electric field are simulated with help of different models developed by us for MOS devices by applying adequate conditions. The latter is quite different from former in terms of tunneling mechanism in the MOS devices. The variation of barrier height with effect of quantum mechanical, temperature, and fields is considered as effective barrier height for the generation of current-field (J-F) curves under forward and reverse biases but quantum mechanical effect is void in the latter. In addition, the J-F curves are also simulated with variation of carrier concentration in the n-type 4H SiC semiconductor of MOS devices and the relation between them is established.

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

    PubMed

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

    2011-10-01

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

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

    PubMed

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

    2013-11-01

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

  4. Integrated care for chronic migraine patients: epidemiology, burden, diagnosis and treatment options.

    PubMed

    Diener, Hans-Christoph; Solbach, Kasja; Holle, Dagny; Gaul, Charly

    2015-08-01

    Migraine is a common neurological disorder, characterised by severe headaches. Epidemiological studies in the USA and Europe have identified a subgroup of migraine patients with chronic migraine. Chronic migraine is defined as ≥15 headache days per month for ≥3 months, in which ≥8 days of the month meet criteria for migraine with or without aura, or respond to treatment specifically for migraine. Chronic migraine is associated with a higher burden of disease, more severe psychiatric comorbidity, greater use of healthcare resources, and higher overall costs than episodic migraine (<15 headache days per month). There is a strong need to improve diagnosis and therapeutic treatment of chronic migraine. Primary care physicians, as well as hospital-based physicians, are integral to the identification and treatment of these patients. The latest epidemiological data, as well as treatment options for chronic migraine patients, are reviewed here.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2014-08-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-09-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2015-02-21

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

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

    SciTech Connect

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

    2014-12-08

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

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

    PubMed

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

    2015-11-01

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

  13. Promotoras' roles in integrative validity and treatment fidelity efforts in randomized controlled trials.

    PubMed

    Keller, Colleen; Records, Kathie; Coe, Kathryn; Ainsworth, Barbara; Vega López, Sonia; Nagle-Williams, Allison; Permana, Paska

    2012-01-01

    Promotoras from the communities in which interventions are implemented can be effective contributors to validity and fidelity efforts. This article describes a 48-week randomized controlled trial Madres para la Salud (Mothers for Health) and illustrates the use of promotoras as collaborative members of the research team to contribute to attaining integrative validity and treatment fidelity. Madres para la Salud implements a culturally tailored physical activity program to effect changes in body fat, systemic and fat tissue inflammation, and depression symptoms. The significance of Madres para la Salud treatment validity and fidelity processes includes cultural tailoring of a social support intervention, and a promotora model to incorporate initial and ongoing fidelity monitoring.

  14. Using enhanced and integrated services to improve response to standard methadone treatment: changing the clinical infrastructure of treatment networks.

    PubMed

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

    2010-03-01

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

  15. [Establishment of diagnosis and treatment patterns of holistic integrated medicine for neuro-ophthalmology].

    PubMed

    Wang, Yanling

    2014-12-01

    Neuro-ophthalmology, as an interdisciplinary, covers at least three disciplines- ophthalmology, neurology and neurosurgery. With limited knowledge in each discipline, doctors often make misdiagnoses for neuro-ophthalmology diseases. Therefore, it is imperative to abandon the distinction between disciplines and combine all the knowledge to diagnose and treat patients in patterns of holistic integrated medicine in order to effectively improve the diagnosis and treatment of neuro-ophthalmology.

  16. Review of Liebman et al.'s 'An integrated treatment program for anorexia nervosa'.

    PubMed

    Wright, Shelagh

    2006-07-01

    This article reviews the paper by Liebman, Minuchin, and Baker (1974) describing the use of a family meal as part of an integrated treatment approach for anorexia nervosa. The ideas laid out in the paper are described and discussed in terms of the understanding of anorexia nervosa at the time as well as placed in a current clinical and theoretical context. A comment is made on whether or not, in this author's opinion, the paper stands 'the test of time'.

  17. Modulating Wnt Signaling Pathway to Enhance Allograft Integration in Orthopaedic Trauma Treatment

    DTIC Science & Technology

    2012-10-01

    neutralizing the LRP5/Wnt pathway inhibitors Sost or DKK1 with monoclonal antibodies will enhance allograft integration to the host bone. The proposed work in...endpoints. Aim 2: Determine the effect of modulating the LRP-5/Wnt pathway with anti- Dkk1 monoclonal antibody on allograft incorporation in a rat...time point, saline/anti-Sost/Anti- Dkk1 ; N=16 each treatment) have been treated, samples harvested and banked for analysis. In vivo radiographs as

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

    SciTech Connect

    Hsu, P.C.

    1997-11-01

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

  19. Nutrient removal and biodiesel production by integration of freshwater algae cultivation with piggery wastewater treatment.

    PubMed

    Zhu, Liandong; Wang, Zhongming; Shu, Qing; Takala, Josu; Hiltunen, Erkki; Feng, Pingzhong; Yuan, Zhenhong

    2013-09-01

    An integrated approach, which combined freshwater microalgae Chlorella zofingiensis cultivation with piggery wastewater treatment, was investigated in the present study. The characteristics of algal growth, lipid and biodiesel production, and nutrient removal were examined by using tubular bubble column photobioreactors to cultivate C. zofingiensis in piggery wastewater with six different concentrations. Pollutants in piggery wastewater were efficiently removed among all the treatments. The specific growth rate and biomass productivity were different among all the cultures. As the initial nutrient concentration increased, the lipid content of C. zofingiensis decreased. The differences in lipid and biodiesel productivity of C. zofingiensis among all the treatments mainly resulted from the differences in biomass productivity. It is worthy of note that the diluted piggery wastewater with 1900 mg L(-1) COD provided an optimal nutrient concentration for C. zofingiensis cultivation, where the advantageous nutrient removal and the highest productivities of biomass, lipid and biodiesel were presented.

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

    SciTech Connect

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

    1995-04-01

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

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

    PubMed

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

    2016-02-01

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

  2. Degradation of chlorinated paraben by integrated irradiation and biological treatment process.

    PubMed

    Wang, Shizong; Wang, Jianlong; Sun, Yuliang

    2017-03-15

    Chlorinated paraben, namely, methyl 3, 5-dichloro-4-hydroxybenzoate (MDHB) is the by-product of chlorination disinfection of paraben and frequently detected in the aquatic environments, which exhibited higher persistence and toxicity than paraben itself. In this paper, the combined irradiation and biological treatment process was employed to investigate the removal of MDHB from aqueous solution. The results showed that the removal efficiency of MDHB and total organic carbon (TOC) by irradiation process increased with radiation dose no matter what the initial concentration of MDHB was. The maximum removal efficiency of MDHB was 100%, 91.1%, 93%, respectively, for the initial concentration of MDHB of 1 mg/L, 5 mg/L and 10 mg/L with the radiation dose of 800 Gy. However, the maximum removal efficiency of TOC among all the experimental groups was only 15.3% obtained with the initial concentration of 1 mg/L at dose of 800 Gy. The subsequent biological treatment enhanced the mineralization of MDHB. The suitable radiation dose for the subsequent biological treatment was determined to be 600 Gy. In this case the removal efficiency of TOC increased to about 70%. Compared to the single biological treatment, the integrated irradiation and biological treatment significantly increase the degradation and mineralization of MDHB. Moreover, the dechlorination efficiency reached 77.4% during the integrated irradiation and biological treatment process. In addition, eight intermediates were identified during the combined process and the possible degradation pathway was proposed.

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

    PubMed

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

    2012-01-01

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

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

    PubMed

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

    2015-05-01

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

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

    PubMed

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

    2016-03-15

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

  6. Integrative Therapeutic Approaches for the Management and Control of Nausea in Children Undergoing Cancer Treatment.

    PubMed

    Momani, Tha'er G; Berry, Donna L

    2017-02-01

    Chemotherapy-induced nausea and vomiting (CINV) continues to be a common symptom experienced by children undergoing cancer treatment despite the use of contemporary antiemetics. Integrative therapeutic approaches in addition to standard pharmacologic antiemetic regimes offer potential to control CINV. The purpose of this review was to identify current evidence on integrative therapeutic approaches for the control of CINV in children with cancer. Online search engines (PubMed, CINAHL, PsychINFO) were queried using MESH terms. Titles, abstracts, and then full-text articles were reviewed for relevance to the review. The search resulted in 53 studies. Twenty-one studies met our review criteria. Integrative therapies identified included acupuncture/acupressure, aromatherapy, herbal supplements, hypnosis, and other cognitive behavioral interventions. Our review identified little information on the effectiveness and safety of most integrative therapeutic approaches for the control and management of CINV in children with cancer. However, evidence from adult cancer studies and some pediatric studies identify promising interventions for further testing.

  7. Integration

    ERIC Educational Resources Information Center

    Kalyn, Brenda

    2006-01-01

    Integrated learning is an exciting adventure for both teachers and students. It is not uncommon to observe the integration of academic subjects such as math, science, and language arts. However, educators need to recognize that movement experiences in physical education also can be linked to academic curricula and, may even lead the…

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

    NASA Astrophysics Data System (ADS)

    Adelodun, Adedeji Adebukola; Jo, Young-Min

    2013-12-01

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

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

    PubMed

    Kumar, Ramesh; Pal, Parimal

    2013-08-01

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

  10. Integrative Therapies in Anxiety Treatment with Special Emphasis on the Gut Microbiome.

    PubMed

    Schnorr, Stephanie L; Bachner, Harriet A

    2016-09-01

    Over the past decade, research has shown that diet and gut health affects symptoms expressed in stress related disorders, depression, and anxiety through changes in the gut microbiota. Psycho-behavioral function and somatic health interaction have often been ignored in health care with resulting deficits in treatment quality and outcomes. While mental health care requires the professional training in counseling, psychotherapy and psychiatry, complimentary therapeutic strategies, such as attention to a nutritional and diverse diet and supplementation of probiotic foods, may be integrated alongside psychotherapy treatment models. Development of these alternative strategies is predicated on experimental evidence and diligent research on the biology of stress, fear, anxiety-related behaviors, and the gut-brain connection. This article provides a brief overview on biological markers of anxiety and the expanding nutritional literature relating to brain health and mental disorders. A case study demonstrates an example of a biopsychosocial approach integrating cognitive psychotherapy, dietary changes, and mindfulness activities, in treating symptoms of anxiety. This case study shows a possible treatment protocol to explore the efficacy of targeting the gut-brain-axis that may be used as an impetus for future controlled studies.

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

    PubMed

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

    2016-07-05

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

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

    PubMed

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

    2011-01-01

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

  13. Integrative Therapies in Anxiety Treatment with Special Emphasis on the Gut Microbiome

    PubMed Central

    Schnorr, Stephanie L.; Bachner, Harriet A.

    2016-01-01

    Over the past decade, research has shown that diet and gut health affects symptoms expressed in stress related disorders, depression, and anxiety through changes in the gut microbiota. Psycho-behavioral function and somatic health interaction have often been ignored in health care with resulting deficits in treatment quality and outcomes. While mental health care requires the professional training in counseling, psychotherapy and psychiatry, complimentary therapeutic strategies, such as attention to a nutritional and diverse diet and supplementation of probiotic foods, may be integrated alongside psychotherapy treatment models. Development of these alternative strategies is predicated on experimental evidence and diligent research on the biology of stress, fear, anxiety-related behaviors, and the gut-brain connection. This article provides a brief overview on biological markers of anxiety and the expanding nutritional literature relating to brain health and mental disorders. A case study demonstrates an example of a biopsychosocial approach integrating cognitive psychotherapy, dietary changes, and mindfulness activities, in treating symptoms of anxiety. This case study shows a possible treatment protocol to explore the efficacy of targeting the gut-brain-axis that may be used as an impetus for future controlled studies. PMID:27698624

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

    DOE PAGES

    Pienaar, Elsje; Cilfone, Nicholas A.; Lin, Philana Ling; ...

    2014-12-08

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

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

    NASA Astrophysics Data System (ADS)

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

    2010-11-01

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

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

    SciTech Connect

    Matthew Bruff; Ned Godshall; Karen Evans

    2011-04-30

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

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

    SciTech Connect

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

    1997-10-01

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

  18. Asynchronous collision integrators: Explicit treatment of unilateral contact with friction and nodal restraints

    PubMed Central

    Wolff, Sebastian; Bucher, Christian

    2013-01-01

    This article presents asynchronous collision integrators and a simple asynchronous method treating nodal restraints. Asynchronous discretizations allow individual time step sizes for each spatial region, improving the efficiency of explicit time stepping for finite element meshes with heterogeneous element sizes. The article first introduces asynchronous variational integration being expressed by drift and kick operators. Linear nodal restraint conditions are solved by a simple projection of the forces that is shown to be equivalent to RATTLE. Unilateral contact is solved by an asynchronous variant of decomposition contact response. Therein, velocities are modified avoiding penetrations. Although decomposition contact response is solving a large system of linear equations (being critical for the numerical efficiency of explicit time stepping schemes) and is needing special treatment regarding overconstraint and linear dependency of the contact constraints (for example from double-sided node-to-surface contact or self-contact), the asynchronous strategy handles these situations efficiently and robust. Only a single constraint involving a very small number of degrees of freedom is considered at once leading to a very efficient solution. The treatment of friction is exemplified for the Coulomb model. Special care needs the contact of nodes that are subject to restraints. Together with the aforementioned projection for restraints, a novel efficient solution scheme can be presented. The collision integrator does not influence the critical time step. Hence, the time step can be chosen independently from the underlying time-stepping scheme. The time step may be fixed or time-adaptive. New demands on global collision detection are discussed exemplified by position codes and node-to-segment integration. Numerical examples illustrate convergence and efficiency of the new contact algorithm. Copyright © 2013 The Authors. International Journal for Numerical Methods in

  19. Screening, brief intervention, and referral to treatment (SBIRT) as an integral part of nursing practice.

    PubMed

    Finnell, Deborah S; Nowzari, Shahrzad; Reimann, Brie; Fischer, Leigh; Pace, Elizabeth; Goplerud, Eric

    2014-01-01

    ABSTRACT. Substance use screening, brief intervention, and referral to treatment (SBIRT) should be an integral part of the scope of nursing practice. This commentary is an appeal for nurses to advance their knowledge and competencies related to SBIRT. The question of how to move SBIRT into the mainstream of nursing practice was posed to several leaders of federal agencies, health care and nursing organizations, nurse educators, and nurse leaders. The authors provide recommendations for moving this set of clinical strategies (i.e., SBIRT) into day-to-day nursing practice.

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

    PubMed

    Yuan, Heyang; He, Zhen

    2015-11-01

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

  1. The integration of nutrients, cyanobacterial biomass and toxins: from a multi-use reservoir through water treatment

    EPA Science Inventory

    This presentation is an integrated evaluation of cyanobacterial growth and toxin production, from a reservoir through drinking water treatment - where biomass and toxin removal are achieved. Data is generated by a variety of methods: online instrumentation for chlorophyll, diss...

  2. Integration of wet oxidation and nanofiltration for treatment of recalcitrant organics in wastewater

    SciTech Connect

    Hellenbrand, R.; Mantzavinos, D.; Metcalfe, I.S.; Livingston, A.G.

    1997-12-01

    Wet oxidation and nanofiltration are employed in an integrated system for the treatment of bioresistant industrial wastewaters. The partial oxidation products formed during a brief period of pretreatment in a low pressure WO reactor are separated by nanofiltration, and larger molecules are recycled into the reactor where they undergo further oxidation. Experiments were carried out with polyethylene glycol as a model compound in aqueous solution, representing polymer manufacture wastewater. The results demonstrate that by using a combination of an oxidative and a separative step, a higher selectivity of the overall process toward partial oxidation can be achieved. The permeate leaving the filtration step is mainly composed of short chain organic acids which could be readily biodegraded in a subsequent biological treatment, or discharged if concentrations are low.

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

    PubMed

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

    2002-01-01

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

  4. Sustainable development and migration policies: their treatment within the Latin American economic integration blocks.

    PubMed

    Marmora, L

    1994-01-01

    Without an equal sharing of costs and benefits of natural and human resources worldwide, imbalances and lack of human development lead to migration within and between countries. Economic integration blocks in Latin America provide a context for shared development: in Central America, in the Andean Region, and in the Southern Cone. Over the past 60 years migration policy was based on national protectionism, labor supply, and/or occupation of territory. When economic conditions changed to market economies and world markets, migration policy was redefined. Each of the economic integration blocks has developed its own strategies. The Andean Agreement on Labor Migrations was established to determine the rules for bilateral and multilateral treatment of problems. In the Southern Cone bilateral agreements have been longstanding. Multilateral efforts were recently underway within the Southern Common Market and throughout the region. The Central American Organization for Migrations has spearheaded the adoption of a multilateral strategy. All three regions have made considerable progress in the last three years in constructing multilateral policies for economic integration. Government awareness has been the primary force in these policy changes. Government has come to an understanding that clear domestic and regional migration policies were lacking and that obsolete migration practices of the 1930s did not meet the needs of the 1990s. Migration policy was considered an instrument of development. Movement of economic factors or goods was considered equally with movement of labor. Migration policies must integrate the human rights of migrants into their definitions. Methods of facilitating the movements of populations need to be constructed within the computerization and modernization of the migration administration. Legalization of illegal immigrants has occurred among a number of countries. PROCAM and PRIMCOS were action programs which aimed to integrate migration and

  5. Treatment plan for integrating evidence-based decision making into dental education.

    PubMed

    Forrest, Jane L

    2006-03-01

    The aims of this paper are to present the findings from the scientific literature that discuss strategies that can contribute to a "best practices" treatment plan model for effectively integrating Evidence-Based Decision Making (EBDM) into curricula. MEDLINE, CINAHL, and HealthSTAR databases were searched, as was the Cochrane Database of Systematic Reviews. Studies and articles, ranging from systematic reviews to articles proposing models and recommendations for how to implement EBDM into curricula and faculty development were reviewed. Several common themes emerged and form the basis for a treatment plan model. The first step in developing any treatment plan is a thorough assessment of the current situation or problem. Recognizing that there are multiple phases to the assessment of an educational system, the focus of this paper will be to understand which teaching and learning strategies are most effective. These, in turn, will inform faculty of needed curricular changes and skill development training, requisites in order for them to prepare students to be successful in providing patient care using the best available evidence. Elements of a suggested treatment plan will be presented with the caveat that each dental school will need to develop an implementation plan based on an assessment of its own environment and needs.

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

    NASA Astrophysics Data System (ADS)

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

    2007-04-01

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

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

    PubMed Central

    Heinz, Jürgen; Fiori, Wolfgang; Heusser, Peter

    2013-01-01

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

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

    PubMed

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

    2012-09-01

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

  9. BOLD fMRI integration into radiosurgery treatment planning of cerebral vascular malformations

    SciTech Connect

    Stancanello, Joseph; Cavedon, Carlo; Francescon, Paolo; Causin, Francesco; Avanzo, Michele; Colombo, Federico; Cerveri, Pietro; Ferrigno, Giancarlo; Uggeri, Fulvio

    2007-04-15

    Functional magnetic resonance imaging (fMRI) is used to distinguish areas of the brain responsible for different tasks and functions. It is possible, for example, by using fMRI images, to identify particular regions in the brain which can be considered as 'functional organs at risk' (fOARs), i.e., regions which would cause significant patient morbidity if compromised. The aim of this study is to propose and validate a method to exploit functional information for the identification of fOARs in CyberKnife (Accuray, Inc., Sunnyvale, CA) radiosurgery treatment planning; in particular, given the high spatial accuracy offered by the CyberKnife system, local nonrigid registration is used to reach accurate image matching. Five patients affected by arteriovenous malformations (AVMs) and scheduled to undergo radiosurgery were scanned prior to treatment using computed tomography (CT), three-dimensional (3D) rotational angiography (3DRA), T2 weighted and blood oxygenation level dependent echo planar imaging MRI. Tasks were chosen on the basis of lesion location by considering those areas which could be potentially close to treatment targets. Functional data were superimposed on 3DRA and CT used for treatment planning. The procedure for the localization of fMRI areas was validated by direct cortical stimulation on 38 AVM and tumor patients undergoing conventional surgery. Treatment plans studied with and without considering fOARs were significantly different, in particular with respect to both maximum dose and dose volume histograms; consideration of the fOARs allowed quality indices of treatment plans to remain almost constant or to improve in four out of five cases compared to plans with no consideration of fOARs. In conclusion, the presented method provides an accurate tool for the integration of functional information into AVM radiosurgery, which might help to minimize undesirable side effects and to make radiosurgery less invasive.

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

    SciTech Connect

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

    2013-12-18

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

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

    PubMed

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

    2012-11-06

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

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

    PubMed

    Milani, M; Montorsi, L; Stefani, M

    2014-07-01

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

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

    PubMed

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

    2014-08-13

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

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

    PubMed

    Mena-Ulecia, Karel; Hernández, Heykel Hernández

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Fiorina, E.

    2016-07-01

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

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

    PubMed Central

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

    2014-01-01

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

  18. Plant-integrated measurement of greenhouse gas emissions from a municipal wastewater treatment plant.

    PubMed

    Yoshida, Hiroko; Mønster, Jacob; Scheutz, Charlotte

    2014-09-15

    Wastewater treatment plants (WWTPs) contribute to anthropogenic greenhouse gas (GHG) emissions. Due to its spatial and temporal variation in emissions, whole plant characterization of GHG emissions from WWTPs face a number of obstacles. In this study, a tracer dispersion method was applied to quantify plant-integrated, real-time emissions of methane and nitrous oxides. Two mobile cavity ring-down spectroscopy sampling devices were used to record downwind gas concentrations emitted from a municipal WWTP situated in Copenhagen, Denmark. This plant is equipped to remove biological nitrogen and employs anaerobic digestion for sludge stabilization. Over the course of nine measurement campaigns, a wide range of emissions were detected: methane from 4.99 kg h(-1) up to 92.3 kg h(-1) and nitrous oxide from below the detection limit (0.37 kg h(-1)) up to 10.5 kg h(-1). High emissions were observed during periods experiencing operational problems, such as during foaming events in anaerobic digesters and during sub-optimal operation of biological nitrogen removal in the secondary treatment of wastewater. Methane emissions detected during measurement campaigns corresponded to 2.07-32.7% of the methane generated in the plant. As high as 4.27% of nitrogen entering the WWTP was emitted as nitrous oxide under the sub-optimal operation of biological treatment processes. The study shows that the unit process configuration, as well as the operation of the WWTP, determines the rate of GHG emission. The applied plant-integrated emission measurement method could be used to ease the burden of quantifying GHG emissions from WWTPs for reporting purposes and could contribute to the development of more accurate depictions of environmental performance of WWTPs.

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

    SciTech Connect

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

    2002-02-27

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

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

    NASA Astrophysics Data System (ADS)

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

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

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

    PubMed

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

    2015-08-01

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

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

    ERIC Educational Resources Information Center

    Calley, Nancy G.

    2007-01-01

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

  3. Affect integration as a predictor of change: affect consciousness and treatment response in open-ended psychotherapy.

    PubMed

    Solbakken, Ole André; Hansen, Roger Sandvik; Havik, Odd E; Monsen, Jon Trygve

    2012-01-01

    The present study investigated the relationship between baseline levels of affect integration and the magnitude of change during and after open-ended psychotherapy. Affect integration reflects the capacity for accessing and utilizing the adaptive properties of affects for personal adjustment, along with the more general capability of tolerating and regulating affective activation. It is thus a capacity with relevance for the postulated mechanisms of change in various treatment modalities. Overall, the results indicated that patients with more severe problems in affect integration had larger improvements in symptoms, interpersonal and personality problems in open-ended treatment than those with less severe problems. This was also the case when examining the predictive effects of the integration of specific affects on changes in interpersonal relatedness. It was indicated that increasing problems with the integration of discrete affects were associated with distinct patterns of change in different interpersonal problem domains.

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

    SciTech Connect

    Sanjoy Barman; Ligy Philip

    2006-02-01

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

  5. An integrated decision making approach for assessing healthcare waste treatment technologies from a multiple stakeholder.

    PubMed

    Shi, Hua; Liu, Hu-Chen; Li, Ping; Xu, Xue-Guo

    2017-01-01

    With increased worldwide awareness of environmental issues, healthcare waste (HCW) management has received much attention from both researchers and practitioners over the past decade. The task of selecting the optimum treatment technology for HCWs is a challenging decision making problem involving conflicting evaluation criteria and multiple stakeholders. In this paper, we develop an integrated decision making framework based on cloud model and MABAC method for evaluating and selecting the best HCW treatment technology from a multiple stakeholder perspective. The introduced framework deals with uncertain linguistic assessments of alternatives by using interval 2-tuple linguistic variables, determines decision makers' relative weights based on the uncertainty and divergence degrees of every decision maker, and obtains the ranking of all HCW disposal alternatives with the aid of an extended MABAC method. Finally, an empirical example from Shanghai, China, is provided to illustrate the feasibility and effectiveness of the proposed approach. Results indicate that the methodology being proposed is more suitable and effective to handle the HCW treatment technology selection problem under vague and uncertain information environment.

  6. Energy-nutrients-water nexus: integrated resource recovery in municipal wastewater treatment plants.

    PubMed

    Mo, Weiwei; Zhang, Qiong

    2013-09-30

    Wastewater treatment consumes large amounts of energy and materials to comply with discharge standards. At the same time, wastewater contains resources, which can be recovered for secondary uses if treated properly. Hence, the goal of this paper is to review the available resource recovery methods onsite or offsite of municipal wastewater treatment plants. These methods are categorized into three major resource recovery approaches: onsite energy generation, nutrient recycling and water reuse. Under each approach, the review provides the advantages and disadvantages, recovery potentials and current application status of each method, as well as the synthesized results of the life cycle studies for each approach. From a comprehensive literature review, it was found that, in addition to technology improvements, there is also a need to evaluate the applications of the resource recovery methods in wastewater treatment plants from a life cycle perspective. Future research should investigate the integration of the resource recovery methods to explore the combined benefits and potential tradeoffs of these methods under different scales.

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

    PubMed

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

    2015-11-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

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

  10. Treatment integrity of school-based interventions with children in the journal of applied behavior analysis 1991-2005.

    PubMed

    McIntyre, Laura Lee; Gresham, Frank M; DiGennaro, Florence D; Reed, Derek D

    2007-01-01

    We reviewed all school-based experimental studies with individuals 0 to 18 years published in the Journal of Applied Behavior Analysis (JABA) between 1991 and 2005. A total of 142 articles (152 studies) that met review criteria were included. Nearly all (95%) of these experiments provided an operational definition of the independent variable, but only 30% of the studies provided treatment integrity data. Nearly half of studies (45%) were judged to be at high risk for treatment inaccuracies. Treatment integrity data were more likely to be included in studies that used teachers, multiple treatment agents, or both. Although there was a substantial increase in reporting operational definitions of independent variables, results suggest that there was only a modest improvement in reported integrity over the past 30 years of JABA studies. Recommendations for research and practice are discussed.

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

    NASA Astrophysics Data System (ADS)

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

    2015-06-01

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

  12. Disability among Attendees with Schizophrenia in a Nigerian Hospital: Further Evidence for Integrated Rehabilitative Treatment Designs.

    PubMed

    Olagunju, Andrew Toyin; Adegbaju, Dapo Adebowale; Uwakwe, Richard

    2016-11-23

    Evidence-based rehabilitative treatment is constrained due to limited knowledge about disability and its related factors among individuals with schizophrenia across West Africa. This study aims to investigate the pattern of disability, and the associated factors among individuals with schizophrenia. One hundred consecutively recruited consenting participants were subjected to designed questionnaire to inquire about their demographic and illness-related variables. This was followed by the administration of Structured Clinical Interview for DSM-IV-TR Axis I Disorders and Brief Psychiatric Rating Scale to confirm the diagnosis of schizophrenia and rate severity of symptoms respectively in them. In addition, the World Health Organisation Disability Assessment Scale II (WHODAS-II) was used to assess for disability in all participants. Different degrees of disability based on WHODAS-II mean score of 27.02±3.49 were noted among individuals with schizophrenia, and affectation of domains of disability like self care, getting along with others, life activities and participation in the society among others were observed. In addition, high level of disability was significantly associated with younger adults in the age group 18-44 years (P=0.007), unemployment status (P=0.003), remittance source of income (P=0.034) and ethnicity (P=0.017); conversely, less number of children (P=0.033), less amount spent on treatment (P<0.001) and lower BPRS score (P<0.001) correlated negatively with high level of disability. In spite of clinical stability following treatment, individuals with schizophrenia were disabled to varied degrees, and socioeconomic as well as illness-related factors constituted important correlates. Integration of rehabilitation along with social intervention into treatment design to reduce disability is implied, and further research is also warranted.

  13. Disability among Attendees with Schizophrenia in a Nigerian Hospital: Further Evidence for Integrated Rehabilitative Treatment Designs

    PubMed Central

    Olagunju, Andrew Toyin; Adegbaju, Dapo Adebowale; Uwakwe, Richard

    2016-01-01

    Evidence-based rehabilitative treatment is constrained due to limited knowledge about disability and its related factors among individuals with schizophrenia across West Africa. This study aims to investigate the pattern of disability, and the associated factors among individuals with schizophrenia. One hundred consecutively recruited consenting participants were subjected to designed questionnaire to inquire about their demographic and illness-related variables. This was followed by the administration of Structured Clinical Interview for DSM-IV-TR Axis I Disorders and Brief Psychiatric Rating Scale to confirm the diagnosis of schizophrenia and rate severity of symptoms respectively in them. In addition, the World Health Organisation Disability Assessment Scale II (WHODAS-II) was used to assess for disability in all participants. Different degrees of disability based on WHODAS-II mean score of 27.02±3.49 were noted among individuals with schizophrenia, and affectation of domains of disability like self care, getting along with others, life activities and participation in the society among others were observed. In addition, high level of disability was significantly associated with younger adults in the age group 18-44 years (P=0.007), unemployment status (P=0.003), remittance source of income (P=0.034) and ethnicity (P=0.017); conversely, less number of children (P=0.033), less amount spent on treatment (P<0.001) and lower BPRS score (P<0.001) correlated negatively with high level of disability. In spite of clinical stability following treatment, individuals with schizophrenia were disabled to varied degrees, and socioeconomic as well as illness-related factors constituted important correlates. Integration of rehabilitation along with social intervention into treatment design to reduce disability is implied, and further research is also warranted. PMID:28217272

  14. Tradeoffs of integrating real-time tracking into IGRT for prostate cancer treatment.

    PubMed

    Zhu, X; Bourland, J D; Yuan, Y; Zhuang, T; O'Daniel, J; Thongphiew, D; Wu, Q J; Das, S K; Yoo, S; Yin, F F

    2009-09-07

    This study investigated the integration of the Calypso real-time tracking system, based on implanted ferromagnetic transponders and a detector array, into the current process for image-guided radiation treatment (IGRT) of prostate cancer at our institution. The current IGRT process includes magnetic resonance imaging (MRI) for prostate delineation, CT simulation for treatment planning, daily on-board kV and CBCT imaging for target alignment, and MRI/MRS for post-treatment assessment. This study assesses (1) magnetic-field-induced displacement and radio-frequency (RF)-induced heating of transponders during MRI at 1.5 T and 3 T, and (2) image artifacts caused by transponders and the detector array in phantom and patient cases with the different imaging systems. A tissue-equivalent phantom mimicking prostate tissue stiffness was constructed and implanted with three operational transponders prior to phantom solidification. The measurements show that the Calypso system is safe with all the imaging systems. Transponder position displacements due to the MR field are minimal (<1.0 mm) for both 1.5 T and 3 T MRI scanners, and the temperature variation due to MRI RF heating is <0.2 degrees C. The visibility of transponders and bony anatomy was not affected on the OBI kV and CT images. Image quality degradation caused by the detector antenna array is observed in the CBCT image. Image artifacts are most significant with the gradient echo sequence in the MR images, producing null signals surrounding the transponders with radii approximately 1.5 cm and length approximately 4 cm. Thus, Calypso transponders can preclude the use of MRI/MRS in post-treatment assessment. Modifications of the clinical flow are required to accommodate and minimize the substantial MRI artifacts induced by the Calypso transponders.

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

    PubMed

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

    2010-01-01

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

  16. [Implementation in Quebec of the Integrated Psychological Treatment (IPT) for people with schizophrenia: five years later].

    PubMed

    Briand, Catherine; Reinharz, Daniel; Lesage, Alain; Nicole, Luc; Stip, Emmanuel; Lalonde, Pierre; Villeneuve, Kathe; Planet-Sultan, Sarah

    2010-01-01

    This article examines the adoption in Québec of the evidence-based practice, Integrated Psychological Treatment (IPT) of people with schizophrenia and the longevity of this practice within nine clinical milieus in a context of transformation of services. A team of researchers of the Centre de recherche Fernand Seguin has closely followed the implementation and the maintenance of the IPT in nine clinical milieus. More specifically, this article presents the factors that have contributed, on a five year period, to the maintenance (or not) of the IPT in these settings. It raises the important question of longevity of an approach that is specialized and specific to a clientele in contexts of transformation of services.

  17. Integrative approach for the treatment of PTSD in 9/11 first responders: Three core techniques

    PubMed Central

    Haugen, Peter T.; Splaun, Allison Keisler; Evces, Mark R.; Weiss, Daniel S.

    2014-01-01

    We describe an integrative psychotherapy for first responders to the September 11, 2001 terrorist attack, including those who continue to be psychologically impacted by these events, most of whom meet criteria for a diagnosis of PTSD. Three core techniques utilized in this treatment are described: (a) an emphasis on meaning making, particularly regarding the traumatic event; (b) focus on the most affect-laden components of the traumatic exposure; and (c) identifying and challenging the implicit strategies used by individuals to avoid discussion of components of their traumatic memories and the attendant negative affect. For each intervention, a theoretical rationale and the presumed mechanism of operation are presented. We discuss the clinical and research implications of this intervention. PMID:24000847

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

    PubMed

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

    2015-11-01

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

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

    PubMed Central

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

    2015-01-01

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

  20. Integrated catalytic wet air oxidation and biological treatment of wastewater from Vitamin B 6 production

    NASA Astrophysics Data System (ADS)

    Kang, Jianxiong; Zhan, Wei; Li, Daosheng; Wang, Xiaocong; Song, Jing; Liu, Dongqi

    This study investigated the feasibility of coupling a catalytic wet air oxidation (CWAO), with CuO/Al 2O 3 as catalyst, and an anaerobic/aerobic biological process to treat wastewater from Vitamin B 6 production. Results showed that the CWAO enhanced the biodegradability (BOD 5/COD) from 0.10 to 0.80. The oxidized effluents with COD of 10,000 mg l -1 was subjected to subsequent continuous anaerobic/aerobic oxidation, and 99.3% of total COD removal was achieved. The quality of the effluent obtained met the discharge standards of water pollutants for pharmaceutical industry Chemical Synthesis Products Category (GB21904-2008), and thereby it implies that the integrated CWAO and anaerobic/aerobic biological treatment may offer a promising process to treat wastewater from Vitamin B 6 production.

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

    NASA Astrophysics Data System (ADS)

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

    2016-09-01

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

  2. Integrated monitoring and assessment of soil restoration treatments in the Lake Tahoe Basin.

    PubMed

    Grismer, M E; Schnurrenberger, C; Arst, R; Hogan, M P

    2009-03-01

    Revegetation and soil restoration efforts, often associated with erosion control measures on disturbed soils, are rarely monitored or otherwise evaluated in terms of improved hydrologic, much less, ecologic function and longer term sustainability. As in many watersheds, sediment is a key parameter of concern in the Tahoe Basin, particularly fine sediments less than about ten microns. Numerous erosion control measures deployed in the Basin during the past several decades have under-performed, or simply failed after a few years and new soil restoration methods of erosion control are under investigation. We outline a comprehensive, integrated field-based evaluation and assessment of the hydrologic function associated with these soil restoration methods with the hypothesis that restoration of sustainable function will result in longer term erosion control benefits than that currently achieved with more commonly used surface treatment methods (e.g. straw/mulch covers and hydroseeding). The monitoring includes cover-point and ocular assessments of plant cover, species type and diversity; soil sampling for nutrient status; rainfall simulation measurement of infiltration and runoff rates; cone penetrometer measurements of soil compaction and thickness of mulch layer depths. Through multi-year hydrologic and vegetation monitoring at ten sites and 120 plots, we illustrate the results obtained from the integrated monitoring program and describe how it might guide future restoration efforts and monitoring assessments.

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

    PubMed

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

    2016-09-06

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2004-01-01

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

  6. The impact of an integrated treatment on HIV risk behavior among homeless youth: a randomized controlled trial

    PubMed Central

    Slesnick, Natasha; Kang, Min Ju

    2008-01-01

    While many studies provide useful information on the risk behaviors in which homeless youth engage, few prior studies evaluate Human Immunodeficiency Virus (HIV) risk related reduction strategies. In this study, homeless youth (n = 180) were recruited from a drop-in center and randomly assigned to one of two conditions, either an integrated individual cognitive-behavioral treatment and HIV prevention intervention that focused on skills building and education or to treatment as usual. All youth were assessed at entry into the program and at 3 and 6 month follow-up points. Findings showed an interaction between treatment condition, age and time. In the interaction, youth assigned to the integrated treatment reported greater condom usage than youth assigned to treatment as usual, with younger youth assigned to treatment as usual showing no change in condom use. The number of sexual partners reported by youth in both treatment conditions was also reduced over time. However, youth in both conditions continued to engage in other high-risk behaviors. The integrated treatment findings are promising and suggest that interventions which target both HIV risk behavior in addition to other life areas (substance use, mental health and housing) among homeless youth may be necessary in order to significantly impact high-risk behaviors among this unique group. PMID:17940861

  7. Evaluation of an integrated group cognitive-behavioral treatment for comorbid mood, anxiety, and substance use disorders: A pilot study.

    PubMed

    Milosevic, Irena; Chudzik, Susan M; Boyd, Susan; McCabe, Randi E

    2017-03-01

    This paper presents the development and preliminary evaluation of an integrated group cognitive-behavioral treatment (CBT) for comorbid mood, anxiety, and substance use disorders. The 12-session, manualized treatment was developed collaboratively by a mental health program in a teaching hospital and a community-based addictions service and administered in both settings. Results from an uncontrolled effectiveness trial of 29 treatment completers suggest that integrated group CBT may reduce stress and alcohol use symptoms and improve substance refusal self-efficacy. Changes in symptoms of anxiety, depression, and drug use were not significant, although the effect size for anxiety reduction was in the medium range. Nonetheless, the clinical significance of treatment effects on mood, anxiety, and substance use symptoms was modest. Changes in coping skills and quality of life were not significant, although medium-to-large effects were observed for changes in several coping skills. Participants reported being highly satisfied with treatment, found the treatment strategies to be useful, and noted an improvement in their functioning, particularly socially. Methodological and sample size limitations warrant more rigorous follow-up investigations of this treatment. Results are considered in the context of the current literature on integrated psychological treatments for these common comorbidities.

  8. Integrated community-directed treatment for the control of onchocerciasis, schistosomiasis and intestinal helminths infections in Uganda: advantages and disadvantages.

    PubMed

    Ndyomugyenyi, Richard; Kabatereine, Narcis

    2003-11-01

    Onchocerciasis is co-endemic with schistosomiasis and intestinal helminths infections, which are all diseases of the rural and the poorest communities in Africa. Community-directed treatment (ComDT) for the control of onchocerciasis is the only functional health approach in most of these communities and the strategy has proven to be effective for onchocerciasis control. This study was conducted to assess the feasibility of integrating ComDT with ivermectin for the control of onchocerciasis, and with praziquantel (PZQ) and mebendazole (MBD) for the control of schistosomiasis and intestinal helminths infections in children aged 5-14 years, and to assess advantages and disadvantages of the integrated ComDT over the routine ComDT and the school-based treatment approach. Integrated ComDT achieved higher treatment coverage (85%) for PZQ and MBD than the school-based treatment approach (79%) among children aged 5-14 years (P = 0.03). There were more reported adverse reactions after treatment with a combination of PZQ and MBD in the school-based treatment approach (33%) than for the combination of ivermectin and MBD on day 1 and PZQ on day 2 in the integrated ComDT (18%). However, all adverse reactions were mild (headache, nausea/vomiting and abdominal pain). The integrated ComDT also achieved higher ivermectin treatment coverage for all ages (81.3%) than routine ComDT (77.2%) (P = 0.0003). To achieve even better coverage for PZQ and MBD among the targeted high risk groups, integrated ComDT should treat all age groups in areas where the prevalence of schistosomiasis and intestinal helminths infections is >50%. This would minimize the shortage of the drugs targeted to treat the high risk groups, as the non-targeted groups, will inevitably demand and receive the treatment from the distributors. The results of this study show that PZQ and MBD treatment for the control of schistosomiasis and intestinal helminths, respectively, can be integrated with ivermectin treatment for

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2011-04-01

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

  11. Metabolic cardiology: an integrative strategy in the treatment of congestive heart failure.

    PubMed

    Sinatra, Stephen T

    2009-01-01

    Congestive heart failure (CHF) and dilated cardiomyopathy are life-threatening conditions in which the heart muscle is so weak that effective pulsatile action is compromised. Pulmonary vascular congestion and swelling in the lower extremities as well as in the liver and lining of the gastrointestinal tract frequently cause overwhelming symptoms and disability. Millions of Americans suffer from CHF, and more than 500,000 cases are diagnosed annually. Cardiovascular diseases such as hypertension with left ventricular hypertrophy, valvular heart disease, coronary artery disease, myocarditis, and various cardiomyopathies can lead to the progressive onset of CHF. The purpose of this communication article is to introduce metabolic cardiology as a vital therapeutic strategy utilizing nutritional biochemical interventions that preserve and promote adenosine triphosphate (ATP) production. Treatment options that incorporate metabolic interventions targeted to preserve energy substrates (D-ribose) or accelerate ATP turnover (L-carnitine and coenzyme Q10) are indicated for at-risk populations or patients at any stage of CHF. The integration of these metabolic supports provides the missing link in CHF treatment that has been eluding physicians for decades.

  12. Integration of treatment innovation planning and implementation: strategic process models and organizational challenges.

    PubMed

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

    2011-06-01

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

  13. Treatment of vegetable oily wastewater using an integrated microfiltration-reverse osmosis system.

    PubMed

    Yu, Xiaoli; Zhong, Zhaoxiang; Xing, Weihong

    2010-01-01

    Vegetable oil processing plants and catering trade often generate a large amount of oil-containing wastewater, which causes serious environmental problems. The objective of this work was to explore the feasibility of vegetable oil wastewater treatment with an integrated microfiltration-reverse osmosis (MF-RO) process. The influence of operational parameters on the separation behaviors were investigated in MF process. In MF continuous process the steady flux was around 90 (L/m(2) h) when the concentrated multiple reached 16, and the oil content in permeate was less than 12 mg/L. In the RO continuous process, antifouling membrane was used to treat permeate from the ceramic membrane process in order to improve the water quality. The RO process had a permeate flux of 24 (L/m(2) h) and water recovery rate of 95%. The permeate from the RO stage was free of oil, and its TOC and conductivity were less than 0.6 mg/L and 50 micros/cm, respectively. The results demonstrated that the two stage membrane process combining MF and RO is highly efficient in the treatment of oil-containing wastewater.

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

    PubMed

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

    2015-02-03

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

  15. The BraveNet prospective observational study on integrative medicine treatment approaches for pain

    PubMed Central

    2013-01-01

    Background Chronic pain affects nearly 116 million American adults at an estimated cost of up to $635 billion annually and is the No. 1 condition for which patients seek care at integrative medicine clinics. In our Study on Integrative Medicine Treatment Approaches for Pain (SIMTAP), we observed the impact of an integrative approach on chronic pain and a number of other related patient-reported outcome measures. Methods Our prospective, non-randomized, open-label observational evaluation was conducted over six months, at nine clinical sites. Participants received a non-standardized, personalized, multimodal approach to chronic pain. Validated instruments for pain (severity and interference levels), quality of life, mood, stress, sleep, fatigue, sense of control, overall well-being, and work productivity were completed at baseline and at six, 12, and 24 weeks. Blood was collected at baseline and week 12 for analysis of high-sensitivity C-reactive protein and 25-hydroxyvitamin D levels. Repeated-measures analysis was performed on data to assess change from baseline at 24 weeks. Results Of 409 participants initially enrolled, 252 completed all follow-up visits during the 6 month evaluation. Participants were predominantly white (81%) and female (73%), with a mean age of 49.1 years (15.44) and an average of 8.0 (9.26) years of chronic pain. At baseline, 52% of patients reported symptoms consistent with depression. At 24 weeks, significantly decreased pain severity (−23%) and interference (−28%) were seen. Significant improvements in mood, stress, quality of life, fatigue, sleep and well-being were also observed. Mean 25-hydroxyvitamin D levels increased from 33.4 (17.05) ng/mL at baseline to 39.6 (16.68) ng/mL at week 12. Conclusions Among participants completing an integrative medicine program for chronic pain, significant improvements were seen in pain as well as other relevant patient-reported outcome measures. Trial Registration ClinicalTrials.gov, NCT

  16. White matter integrity as a link in the association between motivation to abstain and treatment outcome in adolescent substance users.

    PubMed

    Chung, Tammy; Pajtek, Stefan; Clark, Duncan B

    2013-06-01

    Readiness to change constitutes an important treatment target. This study examined white matter (WM) integrity as a possible link in the pathway between motivation to abstain and treatment outcome. Adolescents (age 14-18 years, n = 32) were recruited from intensive outpatient (IOP) substance use treatment and reported on motivation to abstain from alcohol and marijuana shortly after treatment admission (i.e., at baseline). Diffusion tensor imaging data were collected approximately 7 weeks after starting IOP and were used to quantify WM integrity (indexed by fractional anisotropy, FA) using a region of interest (ROI) approach. Treatment outcomes were assessed 6 months after baseline. Indirect effects analyses tested FA in prefrontal, orbitofrontal, and temporal ROIs as a linking variable in the pathway from motivation to abstain to alcohol and marijuana outcomes. Bivariate correlations indicated that greater motivation to abstain from alcohol was associated with lower FA in prefrontal, orbitofrontal, and temporal ROIs and that lower FA in these three ROIs was associated with greater 6-month alcohol problem severity. The indirect effect of FA was significant for the prefrontal ROI in the pathway from motivation to outcome for alcohol. FA values were not associated with motivation to abstain from marijuana or marijuana-related outcomes. Results suggest that lower WM integrity, particularly in the prefrontal brain region, may help to explain greater alcohol problem severity at 6 months despite higher motivation to abstain from alcohol. Interventions that aim to enhance WM integrity warrant attention to improve adolescent treatment outcomes.

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

    PubMed

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

    2015-01-01

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

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

    SciTech Connect

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

    2014-07-15

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    PubMed

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

    2015-03-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    SciTech Connect

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

    2013-01-01

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

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

    PubMed

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

    2015-12-01

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

  4. Enhanced treatment of coking wastewater containing phenol, pyridine, and quinoline by integration of an E-Fenton process into biological treatment.

    PubMed

    Xue, Lanlan; Liu, Jiaxin; Li, Meidi; Tan, Liang; Ji, Xiangyu; Shi, Shengnan; Jiang, Bei

    2017-03-01

    In this study, the pyridine and quinoline could be cometabolically degraded by phenol-cultivated Comamonas sp. strain JB(strain JB). The integration of magnetically immobilized cells of JB and an E-Fenton process into one entity has been designed to prepare a novel integration system to improve the treatment efficiency of phenol, pyridine, and quinoline in coking wastewater. The optimal pH for the integration system was 3.5. Degradation rates of phenol, pyridine, quinoline, and COD by the integration system were significantly exceeded the sum degradation rates of the single E-Fenton process and magnetically immobilized cells at the optimal voltage of 1 V. During the 6 cycles, the integration system still showed higher degradation rates than that by the single magnetically immobilized cells for all the compounds. These findings demonstrated that a synergistic effect existed between the biological treatment and the E-Fenton process, and the applied voltage in the integration system played the key roles in the synergistic effect, which not only electrogenerated H2O2 but also improved the activity of phenol hydroxylase and strain JB concentration.

  5. Collaborative behavioral management: integration and intensification of parole and outpatient addiction treatment services in the Step'n Out study.

    PubMed

    Friedmann, Peter D; Rhodes, Anne G; Taxman, Faye S

    2009-09-01

    Integration of community parole and addiction treatment holds promise for optimizing the participation of drug-involved parolees in re-entry services, but intensification of services might yield greater rates of technical violations. Collaborative behavioral management (CBM) integrates the roles of parole officers and treatment counselors to provide role induction counseling, contract for pro-social behavior, and to deliver contingent reinforcement of behaviors consistent with contracted objectives. Attendance at both parole and addiction treatment are specifically reinforced. The Step'n Out study of the Criminal Justice-Drug Abuse Treatment Studies (CJ-DATS) randomly allocated 486 drug-involved parolees to either collaborative behavioral management or traditional parole with 3-month and 9-month follow-up. Bivariate and multivariate regression models found that, in the first 3 months, the CBM group had more parole sessions, face-to-face parole sessions, days on which parole and treatment occurred on the same day, treatment utilization and individual counseling, without an increase in parole violations. We conclude that CBM integrated parole and treatment as planned, and intensified parolees' utilization of these services, without increasing violations.

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

    PubMed

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

    2014-06-25

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

  7. Integrating evidence into practice: use of McKenzie-based treatment for mechanical low back pain.

    PubMed

    Dunsford, Angela; Kumar, Saravana; Clarke, Sarah

    2011-01-01

    Low back pain (LBP) is a major health issue with significant socioeconomic implications in most Western countries. Many forms of treatment have been proposed and investigated in the past, with exercise being a commonly prescribed intervention. Within allied health, in particular physiotherapy, there has been a growing movement that recognizes the role of the McKenzie method in treating LBP. Within the McKenzie framework, directional preference (DP) exercises are one such intervention, with preliminary data demonstrating its effectiveness in the management of LBP. In this paper, we aim to integrate the evidence from current research, identified using a systematic review, and utilize a practical real-life case scenario to outline how evidence from the literature can be implemented in clinical practice. The findings from the systematic review indicate that DP exercises may have positive effects in the management of LBP. While the body of evidence to support this is limited (only four studies) and therefore modest at best, it does provide some emerging evidence to support the use of DP exercises in clinical practice. Despite this, gaps also persist in the literature on DP exercises, and this relates to the exercise parameters and the compliance rates. Recognizing this dichotomy (modest evidence in some areas and evidence gaps in other areas), which is likely to confront health practitioners, using a practical approach with a real-life clinical scenario, we outline how the evidence from the systematic review can be implemented in clinical practice. This approach builds on the philosophy of evidence-based practice of integrating research evidence with clinical expertise and patient values.

  8. Integrating evidence into practice: use of McKenzie-based treatment for mechanical low back pain

    PubMed Central

    Dunsford, Angela; Kumar, Saravana; Clarke, Sarah

    2011-01-01

    Low back pain (LBP) is a major health issue with significant socioeconomic implications in most Western countries. Many forms of treatment have been proposed and investigated in the past, with exercise being a commonly prescribed intervention. Within allied health, in particular physiotherapy, there has been a growing movement that recognizes the role of the McKenzie method in treating LBP. Within the McKenzie framework, directional preference (DP) exercises are one such intervention, with preliminary data demonstrating its effectiveness in the management of LBP. In this paper, we aim to integrate the evidence from current research, identified using a systematic review, and utilize a practical real-life case scenario to outline how evidence from the literature can be implemented in clinical practice. The findings from the systematic review indicate that DP exercises may have positive effects in the management of LBP. While the body of evidence to support this is limited (only four studies) and therefore modest at best, it does provide some emerging evidence to support the use of DP exercises in clinical practice. Despite this, gaps also persist in the literature on DP exercises, and this relates to the exercise parameters and the compliance rates. Recognizing this dichotomy (modest evidence in some areas and evidence gaps in other areas), which is likely to confront health practitioners, using a practical approach with a real-life clinical scenario, we outline how the evidence from the systematic review can be implemented in clinical practice. This approach builds on the philosophy of evidence-based practice of integrating research evidence with clinical expertise and patient values. PMID:22135496

  9. Integrated biological and physiochemical treatment process for nitrate and fluoride removal.

    PubMed

    Mekonen, A; Kumar, P; Kumar, A

    2001-09-01

    The feasibility of an integrated biological and physiochemical water treatment process for nitrate and fluoride removal has been evaluated. It consisted of two sequencing batch reactors (SBRs) in series. Performance of the process in the treatment of 24 synthetic water samples having nitrate concentrations of 40, 80, 120, 160, 200, and 250 mg/l (as N) and fluoride concentrations of 6, 10, 15, and 20 mg/l at different combinations was studied. Denitrification followed by defluoridation proved to be the best sequence of treatment. In all cases nitrate could be reduced to an acceptable level of less than 10 mg/l (as N) at 3, 5, and 7 h hydraulic retention times (HRTs) depending on its initial concentration. Fluoride concentrations up to 15 mg/l associated with nitrate concentrations up to 80 mg/l (as N) could be reduced acceptable 1.5 mg/l by alum-PAC slurry using alum doses up 850 mg/l [as Al2(SO4)3 x 16H2O] along with 100 mg/l of powdered activated carbon (PAC). Additional alkalinity produced during denitrification was used up during defluoridation for maintenance of pH avoiding the need for lime addition. On the other hand, residual organics, turbidity, and sulfide present in the denitrified water are removed by alum and PAC at the defluoridation stage along with fluoride, eliminating the need for an additional post-treatment step. At higher nitrate concentrations (> or = 120 mg/l as N), the alkalinity produced at the denitrification stage was in the range of 715-1175 mg/l as CaCO3. This excessive alkalinity inhibited reduction of fluoride to the level of 1.5 mg/l at the defluoridation stage, using alum doses up to 900 mg/l along with 100 mg/l of PAC. In all cases a fluoride concentration of 20 mg/l in water could not be reduced to the acceptable level of 1.5 mg/l.

  10. A community-based organization's integration of HIV and substance abuse treatment services for ex-offenders.

    PubMed

    Strauss, Danielle

    2006-01-01

    This paper explores the point of intersection of the substance abuse treatment and HIV services industries with the criminal justice system. Section I reviews the literature and "best practices" that have integrated substance abuse treatment and HIV care and prevention services for ex-offenders and which informed the development of a community- based organization's initiative, the VIP STRIVE Project. Section II presents a brief history of VIP in the context of its ability to adapt to its environment and to the changing needs of its target population,with specific reference to the development of HIV and substance abuse treatment services for members of the criminal justice population. The concluding section brings the two previous sections together by explaining how the VIP STRIVE Project can assist VIP in enhancing its capacity to integrate its substance abuse treatment and HIV services in order to improve services for this target population.

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

    SciTech Connect

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

    2011-11-01

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

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

    SciTech Connect

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

    2014-07-01

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

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

    SciTech Connect

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

    2014-06-15

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

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

    PubMed Central

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

    2015-01-01

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

  15. Primary care-mental health integration and treatment retention among Iraq and Afghanistan war veterans.

    PubMed

    Tsan, Jack Y; Zeber, John E; Stock, Eileen M; Sun, Fangfang; Copeland, Laurel A

    2012-11-01

    Despite the high prevalence of posttraumatic stress disorder (PTSD) and medical comorbidity among veterans from Iraq/Afghanistan (OEF/OIF), keeping these patients engaged in health care is challenging. Primary Care-Mental Health Integration (PC-MHI), an initiative in the Veterans Health Administration (VA), sought to improve access to mental health care from within primary care. This study examined the lag between first PC-MHI visit and next mental/medical care visit, if any, and the relationship of PC-MHI with short-term (subsequent year) and long-term (4 years later) use of VA. We identified 2,470 OEF/OIF veterans receiving care during fiscal year 2006 (FY06) in a regional VA health care system. Unconditional survival analysis modeled time to next mental/medical visit and logistic regression modeled short- and long-term care as a function of PC-MHI, demographics, and clinical covariates. Of 181 patients in the PC-MHI program, 60%/18% returned for mental/medical care within 1 month, and 82%/74% within 1 year. Sixty-one percent (1,503) were still using the VA in FY09. Short-term mental care was related to prior-year PC-MHI. Consistent correlates of short- and long-term mental/medical care included physical comorbidity and Priority 1 status. Most patients attended mental health appointments subsequent to PC-MHI, and PC-MHI was correlated with mental health treatment retention in adjusted models for our cohort. Need for treatment, notably VA Priority 1 status and physical comorbidity, were the primary correlates of care-seeking. Developing innovative approaches to engaging new veterans in care remains imperative as multiple options will be necessary to meet the needs of these complex patients.

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

    PubMed Central

    2011-01-01

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

  17. An investigation of multidisciplinary complex health care interventions - steps towards an integrative treatment model in the rehabilitation of People with Multiple Sclerosis

    PubMed Central

    2012-01-01

    Background The Danish Multiple Sclerosis Society initiated a large-scale bridge building and integrative treatment project to take place from 2004–2010 at a specialized Multiple Sclerosis (MS) hospital. In this project, a team of five conventional health care practitioners and five alternative practitioners was set up to work together in developing and offering individualized treatments to 200 people with MS. The purpose of this paper is to present results from the six year treatment collaboration process regarding the development of an integrative treatment model. Discussion The collaborative work towards an integrative treatment model for people with MS, involved six steps: 1) Working with an initial model 2) Unfolding the different treatment philosophies 3) Discussing the elements of the Intervention-Mechanism-Context-Outcome-scheme (the IMCO-scheme) 4) Phrasing the common assumptions for an integrative MS program theory 5) Developing the integrative MS program theory 6) Building the integrative MS treatment model. The model includes important elements of the different treatment philosophies represented in the team and thereby describes a common understanding of the complexity of the courses of treatment. Summary An integrative team of practitioners has developed an integrative model for combined treatments of People with Multiple Sclerosis. The model unites different treatment philosophies and focuses on process-oriented factors and the strengthening of the patients’ resources and competences on a physical, an emotional and a cognitive level. PMID:22524586

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

    PubMed

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

    2013-02-01

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

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

    PubMed

    Echardt, J; Kornmueller, A

    2009-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  2. The relationship of scoring treatment and age in perceptual-integrative performance.

    PubMed

    Klodin, V M

    1976-07-01

    The present study was designed to reexamine the hypothesis that timed perceptual-integrative performance tests are negatively biased measures of the abilities of the elderly. Unlike an earlier study by Doppelt and Wallace (1955) which did not support this hypothesis, the current study consisted of a college-age group in addition to the elderly group, and also included an additional scoring treatment. Each subject was tested with the WAIS Block Design and Object Assembly. Tests were scored in three ways: (1) Standard scoring (WAIS Manual); (2) "regular" scoring (timed, omitting bonus points); (3) "Irregular" scoring (untimed, omitting bonus points). For both tests, Age, Scoring, and the Age by Scoring ineraction were significant. Post hoc analyses for significant effects suggest that the elderly are helped most by additional solution time, whereas younger adults derive greater benefits from the bonus points for quick performance. The results also suggest that subjects must be of sufficiently high ability to effectively use increased or unlimited solution time.

  3. [The Integrated Psychological Treatment (IPT) program in an ambulatory psychiatric context: a clinical study].

    PubMed

    Zanello, Adriano; Merlo, Marco

    2004-01-01

    Among the actual rehabilitation programs offered to patients with schizophrenic disorders, the IPT (Integrated Psychological Treatment) is one paradigm which combines cognitive and psychosocial strategies. A solid body of evidence, derived from controlled studies, indicates that IPT improves cognitive and social functioning and reduces symptoms severity. Nevertheless, little is known about its efficacy in routine clinical conditions. In this article, the authors address this issue. Our clinical experience with IPT in an ambulatory psychiatric service is presented. The results show that only few patients find useful to participate to all IPT strategies. Patients who refuse or accept to be enrolled in this rehabilitation program share the same demographic, clinical., symptoms and cognitive characteristics. After two years, the outcome of these two groups is similar when we consider the rate of readmissions, the number of hospitalisations, the length of stay and the number of suicides. These observations suggest that IPT strategies in clinical routine are probably less efficient than in well controlled studies. They also raise the question to define an individualised rehabilitation program that fits particular patients' needs.

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

    PubMed

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

    2015-08-01

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

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

    PubMed

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

    2012-06-01

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

  6. Integrating composting and vermicomposting in the treatment and bioconversion of biosolids.

    PubMed

    Ndegwa, P M; Thompson, S A

    2001-01-01

    Traditional thermophilic composting is commonly adopted for treatment of organic wastes or for production of organic/natural fertilizers. A related technique, called vermicomposting (using earthworms to breakdown the organic wastes) is also becoming popular. These two techniques have their inherent advantages and disadvantages. The integrated approach suggested in this study borrows pertinent attributes from each of these two processes and combines them to enhance the overall process and improve the products qualities. Two approaches investigated in this study are: (1) pre-composting followed by vermicomposting, and (2) pre-vermicomposting followed by composting. The substrate was biosolids (activated sewage sludge) with mixed paper-mulch as the carbon base. Eisenia fetida (red wigglers) was the species of earthworms used in the vermicomposting processes. The results indicate that, a system that combines the two processes not only shortens stabilization time, but also improves the products quality. Combining the two systems resulted in a product that was more stable and consistent (homogenous), had less potential impact on the environment and for compost-vermicomposting (CV) system, the product met the pathogen reduction requirements.

  7. An integrated genomic approach to the assessment and treatment of acute myeloid leukemia.

    PubMed

    Godley, Lucy A; Cunningham, John; Dolan, M Eileen; Huang, R Stephanie; Gurbuxani, Sandeep; McNerney, Megan E; Larson, Richard A; Leong, Hoyee; Lussier, Yves; Onel, Kenan; Odenike, Olatoyosi; Stock, Wendy; White, Kevin P; Le Beau, Michelle M

    2011-04-01

    Traditionally, new scientific advances have been applied quickly to the leukemias based on the ease with which relatively pure samples of malignant cells can be obtained. Currently, our arsenal of approaches used to characterize an individual's acute myeloid leukemia (AML) combines hematopathologic evaluation, flow cytometry, cytogenetic analysis, and molecular studies focused on a few key genes. The advent of high-throughput methods capable of full-genome evaluation presents new options for a revolutionary change in the way we diagnose, characterize, and treat AML. Next-generation DNA sequencing techniques allow full sequencing of a cancer genome or transcriptome, with the hope that this will be affordable for routine clinical care within the decade. Microarray-based testing will define gene and miRNA expression, DNA methylation patterns, chromosomal imbalances, and predisposition to disease and chemosensitivity. The vision for the future entails an integrated and automated approach to these analyses, bringing the possibility of formulating an individualized treatment plan within days of a patient's initial presentation. With these expectations comes the hope that such an approach will lead to decreased toxicities and prolonged survival for patients.

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  9. A Preliminary Study in Applying the Function-Based Intervention Decision Model in Consultation to Increase Treatment Integrity

    ERIC Educational Resources Information Center

    Gann, Candace J.; Kunnavatana, S. Shanun

    2016-01-01

    This preliminary study investigated the use of the Function-Based Intervention Decision Model (Decision Model; Umbreit, Ferro, Liaupsin, & Lane, 2007) to improve teacher treatment integrity for a function-based classroom management plan. The participants were a special education teacher and three elementary-age students receiving special…

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

    ERIC Educational Resources Information Center

    Shepard, Suzanne

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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

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

    PubMed Central

    Santisteban, Daniel; Mena, Maite P.

    2009-01-01

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

  13. Advanced treatment of biologically pretreated coal gasification wastewater by a novel integration of heterogeneous catalytic ozonation and biological process.

    PubMed

    Zhuang, Haifeng; Han, Hongjun; Jia, Shengyong; Hou, Baolin; Zhao, Qian

    2014-08-01

    Advanced treatment of biologically pretreated coal gasification wastewater (CGW) was investigated employing heterogeneous catalytic ozonation integrated with anoxic moving bed biofilm reactor (ANMBBR) and biological aerated filter (BAF) process. The results indicated that catalytic ozonation with the prepared catalyst (i.e. MnOx/SBAC, sewage sludge was converted into sludge based activated carbon (SBAC) which loaded manganese oxides) significantly enhanced performance of pollutants removal by generated hydroxyl radicals. The effluent of catalytic ozonation process was more biodegradable and less toxic than that in ozonation alone. Meanwhile, ANMBBR-BAF showed efficient capacity of pollutants removal in treatment of the effluent of catalytic ozonation at a shorter reaction time, allowing the discharge limits to be met. Therefore, the integrated process with efficient, economical and sustainable advantages was suitable for advanced treatment of real biologically pretreated CGW.

  14. Effects of an integrative treatment, therapeutic acupuncture and conventional treatment in alleviating psychological distress in primary care patients - a pragmatic randomized controlled trial

    PubMed Central

    2013-01-01

    Background To evaluate and compare effects of an integrative treatment (IT), therapeutic acupuncture (TA), and conventional treatment (CT) in alleviating symptoms of anxiety and depression in psychologically distressed primary care patients. Methods An open, pragmatic randomized controlled trial comparing the three treatment regimens at four and eight weeks after treatment. The study sample consisted of 120 adults (40 per treatment arm) aged 20 to 55 years referred from four different primary health care centres in western Sweden for psychological distress. Psychological distress was evaluated at baseline, and after 4 and 8 weeks of treatment using the Hospital Anxiety and Depression scale (HAD). Treatment sessions lasted about 60 minutes in IT and 45 minutes in TA. Results No baseline differences were found between groups on HAD depression or anxiety. HAD anxiety and depression decreased significantly more in the IT and TA groups than in the CT group both after 4 and 8 weeks of treatment, but not between IT and TA. Improvements in the TA and IT groups were large and clinically significant, whereas CT effects were small and clinically non-significant. Conclusions Both IT and TA appear to be beneficial in reducing anxiety and depression in primary care patients referred for psychological distress, whereas CT does not. These results need to be confirmed in larger, longer-term studies addressing potentially confounding design issues in the present study. Trial registration ISRCTN trial number NCT01631500. PMID:24200100

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

    PubMed Central

    Drožđek, Boris

    2015-01-01

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

  16. Effects of iron and calcium carbonate on the variation and cycling of carbon source in integrated wastewater treatments.

    PubMed

    Zhimiao, Zhao; Xinshan, Song; Yufeng, Zhao; Yanping, Xiao; Yuhui, Wang; Junfeng, Wang; Denghua, Yan

    2017-02-01

    Iron and calcium carbonate were added in wastewater treatments as the adjusting agents to improve the contaminant removal performance and regulate the variation of carbon source in integrated treatments. At different temperatures, the addition of the adjusting agents obviously improved the nitrogen and phosphorous removals. TN and TP removals were respectively increased by 29.41% and 23.83% in AC-100 treatment under 1-day HRT. Carbon source from dead algae was supplied as green microbial carbon source and Fe(2+) was supplied as carbon source surrogate. COD concentration was increased to 30mg/L and above, so the problem of the shortage of carbon source was solved. Dead algae and Fe(2+) as carbon source supplement or surrogate played significant role, which was proved by microbial community analysis. According to the denitrification performance in the treatments, dead algae as green microbial carbon source combined with iron and calcium carbonate was the optimal supplement carbon source in wastewater treatment.

  17. Institutional profile: integrated center for research and treatment of vertigo, balance and ocular motor disorders.

    PubMed

    Brandt, Thomas; Zwergal, Andreas; Jahn, Klaus; Strupp, Michael

    2010-01-01

    In 2009 the German BMBF (German Ministry of Education and Research) established an Integrated Center for Research and Treatment (IFB(LMU)) of Vertigo, Balance and Ocular Motor Disorders in Munich. After the 10-year period of funding by the BMBF, it is envisioned that the (IFB(LMU)) will continue over the long term with the joint support of the University Hospital, the Medical Faculty, and the Bavarian State. Vertigo is one of the most common complaints in medicine. Despite its high prevalence, patients with vertigo generally receive either inappropriate or inadequate treatment. This deplorable situation is internationally well known and its causes are multiple: insufficient interdisciplinary cooperation, no standardized diagnostics and therapy, the failure to translate findings of basic science into clinical applications, and the scarcity of clinical multicenter studies. The (IFB(LMU)) will constitute a suitable tool with which these structural, clinical, and scientific deficits can be overcome. It will also make possible the establishment of an international interdisciplinary referral center. Munich has become the site of a unique concentration of leading experts on vertigo, balance and ocular motor disorders, both in the clinical and basic sciences. Academic structures have paved the way for the creation of an interdisciplinary horizontal network that also allows structured, vertical academic career paths via the Bachelor's and Master's degree programs in Neuroscience, a Graduate School of Systemic Neurosciences, and the Munich Center for Neurosciences - Brain and Mind. The (IFB(LMU)) has the following objectives as regards structure and content: to create an independent patient-oriented clinical research center under the auspices of the Medical Faculty but with autonomous administration and budget; to overcome existing clinical and academic barriers separating the traditional specializations; to establish a standardized interdisciplinary longitudinal and

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

    PubMed

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

    2016-02-01

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

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

    SciTech Connect

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

    1995-05-01

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

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

    PubMed Central

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

    2015-01-01

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

  1. Applied Behavioral Typologies: Implications for the Residential Treatment and Community Re-Integration of Juvenile Offenders.

    ERIC Educational Resources Information Center

    Brannon, James M.; And Others

    1989-01-01

    Investigated validity of juvenile offender treatment typology utilized within peer treatment programs of youth services agency with 60 male delinquents. Results suggest behavior typology described in peer treatment literature has basis in psychological theory and can provide information for treatment and community reintegration and program…

  2. Construction of an integrated surgical suite in a military treatment facility.

    PubMed

    Acevedo, Anibal L

    2009-01-01

    The OR has long existed as a highly specialized and distinct entity within a hospital. Recent technological advances have allowed the OR to be seamlessly integrated with the larger hospital and, in a virtual sense, with the world. The modern, integrated OR can enhance patients' surgical experiences, improve surgeons' control of OR technology, and increase OR efficiency by reducing surgical times. The Naval Medical Center in San Diego, California, is one of the first military health care systems in the southwest to build a fully integrated, voice-controlled OR. The renovation project transformed 12 ORs into fully integrated surgical suites.

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

    PubMed Central

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

    2016-01-01

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

  4. Issues and Applications of Sensory Integration Theory and Treatment with Children with Language Disorders.

    ERIC Educational Resources Information Center

    Mauer, Daria M.

    1999-01-01

    This review of sensory integration (SI) intervention with children who have language disorders discusses research which both supports and fails to support SI constructs and efficacy. Sections cover theory and principles of SI, assessment of sensory integrative dysfunction, SI therapy, and implications for language learning and academic success.…

  5. On the use of the line integral in the numerical treatment of conservative problems

    NASA Astrophysics Data System (ADS)

    Brugnano, Luigi; Iavernaro, Felice

    2016-06-01

    We sketch out the use of the line integral as a tool to devise numerical methods suitable for conservative and, in particular, Hamiltonian problems. The monograph [3] presents the fundamental theory on line integral methods and this short note aims at exploring some aspects and results emerging from their study.

  6. Integrated services plus drug treatment as a system alternative to crime control and parole.

    PubMed

    Danzer, Graham

    2012-01-01

    Integrated services have the potential to facilitate recovery in drug offenders as well as reduce criminal recidivism. This is significant given that prison overcrowding has led many drug offenders to be released from custody into society via the "reentry movement." Offenders incarcerated for many years often return to society with medical, mental health, behavioral, and drug abuse issues. These issues have been found in similar populations, including those with severe mental illness and the homeless, for which integrated services has shown to have a significant impact on improving functioning. Thus the argument of this article is that because integrated services have shown to be effective with somewhat similar populations, integrated services can be effective in treating paroled drug offenders. These benefits are expected to be to a greater degree than that achieved by current system policy regarding paroled drug offenders being supervised by parole officers rather than case managers facilitating integrated services.

  7. The energy trilogy: An integrated sustainability model to bridge wastewater treatment plant energy and emissions gaps

    NASA Astrophysics Data System (ADS)

    Al-Talibi, A. Adhim

    An estimated 4% of national energy consumption is used for drinking water and wastewater services. Despite the awareness and optimization initiatives for energy conservation, energy consumption is on the rise owing to population and urbanization expansion and to commercial and industrial business advancement. The principal concern is since energy consumption grows, the higher will be the energy production demand, leading to an increase in CO2 footprints and the contribution to global warming potential. This research is in the area of energy-water nexus, focusing on wastewater treatment plant (WWTP) energy trilogy -- the group of three related entities, which includes processes: (1) consuming energy, (2) producing energy, and (3) the resulting -- CO2 equivalents. Detailed and measurable energy information is not readily obtained for wastewater facilities, specifically during facility preliminary design phases. These limitations call for data-intensive research approach on GHG emissions quantification, plant efficiencies and source reduction techniques. To achieve these goals, this research introduced a model integrating all plant processes and their pertinent energy sources. In a comprehensive and "Energy Source-to-Effluent Discharge" pattern, this model is capable of bridging the gaps of WWTP energy, facilitating plant designers' decision-making for meeting energy assessment, sustainability and the environmental regulatory compliance. Protocols for estimating common emissions sources are available such as for fuels, whereas, site-specific emissions for other sources have to be developed and are captured in this research. The dissertation objectives were met through an extensive study of the relevant literature, models and tools, originating comprehensive lists of processes and energy sources for WWTPs, locating estimation formulas for each source, identifying site specific emissions factors, and linking the sources in a mathematical model for site specific CO2 e

  8. Selection of forward osmosis draw solutes for subsequent integration with anaerobic treatment to facilitate resource recovery from wastewater.

    PubMed

    Ansari, Ashley J; Hai, Faisal I; Guo, Wenshan; Ngo, Hao H; Price, William E; Nghiem, Long D

    2015-09-01

    Forward osmosis (FO) can be used to extract clean water and pre-concentrate municipal wastewater to make it amenable to anaerobic treatment. A protocol was developed to assess the suitability of FO draw solutes for pre-concentrating wastewater for potential integration with anaerobic treatment to facilitate resource recovery from wastewater. Draw solutes were evaluated in terms of their ability to induce osmotic pressure, water flux, and reverse solute flux. The compatibility of each draw solute with subsequent anaerobic treatment was assessed by biomethane potential analysis. The effect of each draw solute (at concentrations corresponding to the reverse solute flux at ten-fold pre-concentration of wastewater) on methane production was also evaluated. The results show that ionic organic draw solutes (e.g., sodium acetate) were most suitable for FO application and subsequent anaerobic treatment. On the other hand, the reverse solute flux of inorganic draw solutions could inhibit methane production from FO pre-concentrated wastewater.

  9. Advanced treatment of biologically pretreated coal gasification wastewater by a novel integration of heterogeneous Fenton oxidation and biological process.

    PubMed

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

    2015-04-01

    Laboratorial scale experiments were conducted in order to investigate a novel system integrating heterogeneous Fenton oxidation (HFO) with anoxic moving bed biofilm reactor (ANMBBR) and biological aerated filter (BAF) process on advanced treatment of biologically pretreated coal gasification wastewater (CGW). The results indicated that HFO with the prepared catalyst (FeOx/SBAC, sewage sludge based activated carbon (SBAC) which loaded Fe oxides) played a key role in eliminating COD and COLOR as well as in improving the biodegradability of raw wastewater. The surface reaction and hydroxyl radicals (OH) oxidation were the mechanisms for FeOx/SBAC catalytic reaction. Compared with ANMBBR-BAF process, the integrated system was more effective in abating COD, BOD5, total phenols (TPs), total nitrogen (TN) and COLOR and could shorten the retention time. Therefore, the integrated system was a promising technology for engineering applications.

  10. Efficient treatment of phenolic wastewater with high salinity using a novel integrated system of magnetically immobilized cells coupling with electrodes.

    PubMed

    Jiang, Bei; Shi, Shengnan; Song, Lun; Tan, Liang; Li, Meidi; Liu, Jiaxin; Xue, Lanlan

    2016-10-01

    A novel integrated system in which magnetically immobilized cells coupled with a pair of stainless iron meshes-graphite plate electrodes has been designed and operated to enhance the treatment performance of phenolic wastewater under high salinity. With NaCl concentration increased, phenol, o-cresol, m-cresol, p-cresol and COD removal rates by integrated system increased significantly, which were obviously higher than the sum of removal rates by single magnetically immobilized cells and electrode reaction. This integrated system exhibited higher removal rates for all the compounds than that by single magnetically immobilized cells during six cycles for reuse, and it still performed better, even when the voltage was cut off. These results indicated that there was a coupling effect between biodegradation and electrode reaction. The investigation of phenol hydroxylase activity and cells concentration confirmed that electrode reaction played an important role in this coupling effect.

  11. [Establishing the idea of holistic integrative medicine, optimizing the quality of health care service in prevention and treatment].

    PubMed

    Sun, Xing-guo

    2015-07-01

    Under background of reductionism in the modern science, physiology and medicine are stepwise refined into system, organ, disease, cell and gene etc. Although clinical medicine, only service in whole human object, obviously brought tremendous progress, it also appeared obvious defects and limits at the same time. Professionalized and specialized medicine not only needs to be integrated from basics to clinical fields, but also from prevention, health management, clinical treatment and functional rehabilitation medicine. People are indivisible organic whole. Professionalization, translation and integration must be combined. In order to provide the best quality and optimized medical service for the Chinese people and to lead in the world, we have to strengthen professional and technical knowledge, and have to establish the holistic integrative medical philosophy for physiology and medicine too.

  12. Integration of surgery with fractionated stereotactic radiotherapy for treatment of nonfunctioning pituitary macroadenomas

    SciTech Connect

    Paek, Sun Ha; Downes, M. Beverly; Bednarz, Greg; Keane, William M.; Werner-Wasik, Maria; Curran, Walter J.; Andrews, David W. . E-mail: david.andrews@jefferson.edu

    2005-03-01

    FSRT as a safe, effective, and integrated treatment for nonfunctioning pituitary adenomas. Additional follow-up is needed to document the long-term tumor control rates, preservation rates for vision and pituitary function, and neurocognitive outcomes.

  13. Central treatment of different emulsion wastewaters by an integrated process of physicochemically enhanced ultrafiltration and anaerobic-aerobic biofilm reactor.

    PubMed

    Zhang, Weijun; Xiao, Ping; Wang, Dongsheng

    2014-05-01

    The feasibility of an integrated process of ultrafiltration (UF) enhanced by combined chemical emulsion breaking with vibratory shear and anaerobic/aerobic biofilm reactor for central treatment of different emulsion wastewaters was investigated. Firstly, it was found that calcium chloride exhibited better performance in oil removal than other inorganic salts. Chemical demulsification pretreatment could efficiently improve oil removal and membrane filtration in emulsion wastewater treatment by VSEP. According to aerobic batch bioassay, UF permeate exhibited good biodegradability and could be further treated with biological process. Additionally, pilot test indicated that anaerobic-aerobic biofilm exhibited an excellent ability against rise in organic loading and overall chemical oxygen demand (COD) removal efficiency of biological system was more than 93% of which 82% corresponded to the anaerobic process and 11% to the aerobic degradation. The final effluent of integrated process could meet the "water quality standards for discharge to municipal sewers" in China.

  14. Integrating screening, brief intervention and referral to treatment (SBIRT) into an abortion clinic: an exploratory study of acceptability.

    PubMed

    Appel, Lindsay; Ramanadhan, Shaalini; Hladky, Katherine; Welsh, Chris; Terplan, Mishka

    2015-04-01

    Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an effective means of identifying problematic substance use. We evaluated the acceptability of SBIRT in an abortion clinic via an anonymous survey of 100 participants. Clients were comfortable being asked about their substance use, receiving counseling, and treatment referral (mean Likert 1.1, 1.5, and 1.6, respectively) and were only minimally embarrassed when asked about substance use (mean Likert 3.6). These findings suggest that integrating SBIRT into an abortion clinic may be feasible. However, future studies are needed to assess the efficacy of abortion clinic SBIRT in reducing risky substance use.

  15. [Analysis of Musculoskeletal Systems and Their Diseases. Integrated treatments for osteoporosis toward harmony of bone and muscle].

    PubMed

    Kanazawa, Ippei; Sugimoto, Toshitsugu

    2015-08-01

    Osteoporosis and sarcopenia directly affect healthy life expectancy in elderly people ; therefore, both diseases become social problem around the world. Sarcopenia increases the risk of osteoporotic fracture. Thus, not only agents affecting bone tissue directly but also treatments for sarcopenia are important for management of osteoporosis. Recently, it has been shown that there is an interaction between bone and muscle. Several hormones affect muscle and bone simultaneously. Moreover, myokines secreted from muscle are reported to regulate bone metabolism. On the other hand, several systemic and local factors derived from bone also affect muscle tissue. Therefore, further studies are necessary to develop the integrated treatments for osteoporosis toward harmony of bone and muscle.

  16. An Integrated, Multidimensional Treatment Model for Individuals Living with HIV, Mental Illness, and Substance Abuse

    ERIC Educational Resources Information Center

    Bouis, Stephanie; Reif, Susan; Whetten, Kathryn; Scovil, Janet; Murray, Andrea; Swartz, Marvin

    2007-01-01

    The challenge of providing effective treatment services for the growing population of HIV-positive individuals who are also dually diagnosed with substance use and mental disorders has only recently been recognized as an important public health concern affecting both HIV treatment and prevention. This article describes a treatment model that was…

  17. Dual Treatments as Starting Point for Integrative Perceptions in Teaching Mathematics

    ERIC Educational Resources Information Center

    Kërënxhi, Svjetllana; Gjoci, Pranvera

    2015-01-01

    In this paper, we recommend mathematical teaching through dual treatments. The dual treatments notion, classified in dual interpretations, dual analyses, dual solutions, and dual formulations, is explained through concrete examples taken from mathematical textbooks of elementary education. Dual treatments provide opportunities for creating…

  18. Integrating Religion and Spirituality into Treatment for Late-Life Anxiety: Three Case Studies

    ERIC Educational Resources Information Center

    Barrera, Terri L.; Zeno, Darrell; Bush, Amber L.; Barber, Catherine R.; Stanley, Melinda A.

    2012-01-01

    Generalized anxiety disorder (GAD) is common in older adults and, although cognitive behavioral therapy (CBT) is an efficacious treatment for late-life GAD, effect sizes are only moderate and attrition rates are high. One way to increase treatment acceptability and enhance current cognitive behavioral treatments for GAD in older adults might be to…

  19. Numerical Treatment of Differential and Integral Equations by the P and H-P Versions of the Finite Element Method

    DTIC Science & Technology

    1992-01-01

    mathematical papers which describe various locking effects and analyze methods (mainly mixed methods ) to overcome it. However, the treatment in these...finite element method in various areas, such as the numerical approximation of three-dimensional PDEs anu integral equations, the investigation of mixed ... methods for these versions and, most importantly, the uniform approximation of parameter-dependent problems by these versions. By the p version, we

  20. Feasibility of laser-integrated high intensity focused ultrasound (HIFU) treatment for bladder tumors: in vitro study (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Nguyen, Van Phuc; Park, Suhyun; Oh, Junghwan; Kang, Hyun Wook

    2016-02-01

    Previous studies have shown that photothemal therapy combined with high intensity focused ultrasound (HIFU) can provide a promising method to achieve rapid thermal coagulation during surgical procedures. The current study investigated the feasibility of the laser-integrated high intensity focused ultrasound (HIFU) application to treat bladder tumors by enhancing thermal effects and therapeutic depth in vitro. To generate thermal coagulation, a single element HIFU transducer with a central frequency of 2.0 MHz was used to transmit acoustic energy to 15 fresh porcine bladders injected with an artificial tumor (100 µl gelatin and hemoglobin solution) in vitro. Simultaneously, an 80-W 532-nm laser system was also implemented to induce thermal necrosis in the targeted tissue. The intensity of 570 W/cm2 at the focus of HIFU and laser energy of 0.9 W were applied to all the samples for 40 s. The temperature rise increased up to about 1.6 or 3 folds (i.e., ΔT=32±3.8 K for laser-integrated HIFU, ΔT=20±6.5 K for HIFU only, and ΔT=11±5.6 K for laser only). The estimated lesion depth also increased by 1.3 and 2 folds during the dual-thermal treatment, in comparison with the treatment by either HIFU or laser. The results indicated that the laser-integrated HIFU treatment can be an efficient hyperthermic method for tumor coagulation.

  1. Intravenous Mistletoe Treatment in Integrative Cancer Care: A Qualitative Study Exploring the Procedures, Concepts, and Observations of Expert Doctors

    PubMed Central

    Kienle, Gunver S.; Mussler, Milena; Fuchs, Dieter; Kiene, Helmut

    2016-01-01

    Background. Mistletoe therapy (MT) is widely used in patient-centered integrative cancer care. The objective of this study was to explore the concepts, procedures, and observations of expert doctors, with a focus on intravenous MT. Method. A qualitative interview study was conducted with 35 highly experienced doctors specialized in integrative and anthroposophic medicine. Structured qualitative content analysis was applied. For triangulation, the results were compared with external evidence that was systematically collected, reviewed, and presented. Results. Doctors perform individualized patient assessments that lead to multimodal treatment approaches. The underlying goal is to help patients to live with and overcome disease. Mistletoe infusions are a means of accomplishing this goal. They are applied to stabilize disease, achieve responsiveness, induce fever, improve quality of life, and improve the tolerability of conventional cancer treatments. The doctors reported long-term disease stability and improvements in patients' general condition, vitality, strength, thermal comfort, appetite, sleep, pain from bone metastases, dyspnea in pulmonary lymphangitis carcinomatosa, fatigue, and cachexia; chemotherapy was better tolerated. Also patients' emotional and mental condition was reported to have improved. Conclusion. Individualized integrative cancer treatment including MT aims to help cancer patients to live well with their disease. Further research should investigate the reported observations. PMID:27239209

  2. Non-partial wave treatment of reactive and non-reactive scattering Coupled integral equation formalism.

    NASA Technical Reports Server (NTRS)

    Hayes, E. F.; Kouri, D. J.

    1971-01-01

    Coupled integral equations are derived for the full scattering amplitudes for both reactive and nonreactive channels. The equations do not involve any partial wave expansion and are obtained using channel operators for reactive and nonreactive collisions. These coupled integral equations are similar in nature to equations derived for purely nonreactive collisions of structureless particles. Using numerical quadrature techniques, these equations may be reduced to simultaneous algebraic equations which may then be solved.

  3. Gauge-invariant treatment of the integrated Sachs-Wolfe effect on general spherically symmetric spacetimes

    SciTech Connect

    Tomita, Kenji

    2010-03-15

    On the basis of the Gerlach-Sengupta theory of gauge-invariant perturbations, a formula of the integrated Sachs-Wolfe effect for a central observer is derived on general spherically symmetric spacetimes. It will be useful for comparative studies of theoretical and observational aspects of the integrated Sachs-Wolfe effect in the Lemaitre-Tolman-Bondi cosmological models which have been noticed by explaining the apparent acceleration without cosmological constant.

  4. Integrated Treatment of PTSD and Substance Use Disorders: The Mediating Role of PTSD Improvement in the Reduction of Depression

    PubMed Central

    Korte, Kristina J.; Bountress, Kaitlin E.; Tomko, Rachel L.; Killeen, Therese; Moran-Santa Maria, Megan; Back, Sudie E.

    2017-01-01

    Posttraumatic stress disorder (PTSD) represents one of the most common mental health disorders, particularly among veterans, and is associated with significant distress and impairment. This highly debilitating disorder is further complicated by common comorbid psychiatric disorders, such as substance use disorders (SUD). Individuals with PTSD and co-occurring SUD also commonly present with secondary symptoms, such as elevated depression. Little is known, however, about how these secondary symptoms are related to treatment outcome. The aim of the present study, therefore, was to examine (1) the effects of treatment of comorbid PTSD/SUD on depressive symptoms; and (2) whether this effect was mediated by changes in PTSD severity or changes in SUD severity. Participants were 81 U.S. military veterans (90.1% male) with PTSD and SUD enrolled in a randomized controlled trial examining the efficacy of an integrated, exposure-based treatment (Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure; n = 54) versus relapse prevention (n = 27). Results revealed significantly lower depressive symptoms at post-treatment in the COPE group, as compared to the relapse prevention group. Examination of the mechanisms associated with change in depression revealed that reduction in PTSD severity, but not substance use severity, mediated the association between the treatment group and post-treatment depression. The findings underscore the importance of treating PTSD symptoms in order to help reduce co-occurring symptoms of depression in individuals with PTSD/SUD. Clinical implications and avenues for future research are discussed. PMID:28098747

  5. Fate of As, Se, and Hg in a Passive Integrated System for Treatment of Fossil Plant Wastewater

    SciTech Connect

    Terry Yost; Paul Pier; Gregory Brodie

    2007-12-31

    TVA is collaborating with EPRI and DOE to demonstrate a passive treatment system for removing SCR-derived ammonia and trace elements from a coal-fired power plant wastewater stream. The components of the integrated system consist of trickling filters for ammonia oxidation, reaction cells containing zero-valent iron (ZVI) for trace contaminant removal, a settling basin for storage of iron hydroxide floc, and anaerobic vertical-flow wetlands for biological denitrification. The passive integrated treatment system will treat up to 0.25 million gallons per day (gpd) of flue gas desulfurization (FGD) pond effluent, with a configuration requiring only gravity flow to obviate the need for pumps. The design of the system will enable a comparative evaluation of two parallel treatment trains, with and without the ZVI extraction trench and settling/oxidation basin components. One of the main objectives is to gain a better understanding of the chemical transformations that species of trace elements such as arsenic, selenium, and mercury undergo as they are treated in passive treatment system components with differing environmental conditions. This progress report details the design criteria for the passive integrated system for treating fossil power plant wastewater as well as performance results from the first several months of operation. Engineering work on the project has been completed, and construction took place during the summer of 2005. Monitoring of the passive treatment system was initiated in October 2005 and continued until May 18 2006. The results to date indicate that the treatment system is effective in reducing levels of nitrogen compounds and trace metals. Concentrations of both ammonia and trace metals were lower than expected in the influent FGD water, and additions to increase these concentrations will be done in the future to further test the removal efficiency of the treatment system. In May 2006, the wetland cells were drained of FGD water, refilled with

  6. CHALLENGES AND OPPORTUNITIES--INTEGRATED LIFE-CYCLE OPTIMIZATION INITIATIVES FOR THE HANFORD RIVER PROTECTION PROJECT--WASTE TREATMENT PLANT

    SciTech Connect

    Auclair, K. D.

    2002-02-25

    This paper describes the ongoing integrated life-cycle optimization efforts to achieve both design flexibility and design stability for activities associated with the Waste Treatment Plant at Hanford. Design flexibility is required to support the Department of Energy Office of River Protection Balance of Mission objectives, and design stability to meet the Waste Treatment Plant construction and commissioning requirements in order to produce first glass in 2007. The Waste Treatment Plant is a large complex project that is driven by both technology and contractual requirements. It is also part of a larger overall mission, as a component of the River Protection Project, which is driven by programmatic requirements and regulatory, legal, and fiscal constraints. These issues are further complicated by the fact that both of the major contractors involved have a different contract type with DOE, and neither has a contract with the other. This combination of technical and programmatic drivers, constraints, and requirements will continue to provide challenges and opportunities for improvement and optimization. The Bechtel National, Inc. team is under contract to engineer, procure, construct, commission and test the Waste Treatment Plant on or ahead of schedule, at or under cost, and with a throughput capacity equal to or better than specified. The Department of Energy is tasked with the long term mission of waste retrieval, treatment, and disposal. While each mission is a compliment and inextricably linked to one another, they are also at opposite ends of the spectrum, in terms of expectations of one another. These mission requirements, that are seemingly in opposition to one another, pose the single largest challenge and opportunity for optimization: one of balance. While it is recognized that design maturation and optimization are the normal responsibility of any engineering firm responsible for any given project, the aspects of integrating requirements and the management

  7. Development and validation of a novel modeling framework integrating ion exchange and resin regeneration for water treatment.

    PubMed

    Zhang, Jie; Amini, Adib; O'Neal, Jeremy A; Boyer, Treavor H; Zhang, Qiong

    2015-11-01

    Models have been developed to simulate the process of ion exchange for water treatment. However the modeling of resin regeneration process, which can predict regeneration efficiency and residual stream for determining technology sustainability, was not incorporated into previous models. Therefore a model integrating both ion exchange and resin regeneration considering regeneration efficiency is needed for evaluating and improving ion exchange technology. This study developed an integrated model aiming to simulate ion exchange and resin regeneration in different configurations (fixed bed, fluidized bed) for the first time. The integrated model has been validated via comparing model predictions with experimental data. The impacts of dimensionless groups (i.e. the Péclet number, the diffusion modulus, and the Biot number) on ion exchange breakthrough curve have been analyzed using this model. In addition, this integrated model has been used to optimize the regeneration frequency to improve the overall performance of ion exchange. It demonstrated this integrated model could be a useful tool for further studies in ion exchange technology.

  8. [Integrated headache care network. Kiel Migraine and Headache Center and German National Headache Treatment Network].

    PubMed

    Göbel, H; Heinze-Kuhn, K; Petersen, I; Göbel, A; Heinze, A

    2013-04-01

    Migraine and other headaches affect 54 million people in Germany. They rank among the ten most severely disabling complaints and the three most expensive neurological disorders. Nevertheless, they are not adequately recognized in the healthcare system with sketchy diagnoses and inadequate treatment. This inadequate care is not primarily due to a lack of medical and scientific knowledge on the development and treatment of headaches but is predominantly due to organizational deficits in the healthcare system and in the implementation of current knowledge. To overcome the organizational barriers the national headache treatment network was initiated in Germany. For the first time it allows national cross-sectoral and multidisciplinary links between inpatient and outpatient care. A hand in hand treatment programme, better education, better information exchange between all partners and combined efforts using clearly defined treatment pathways and goals are the basis for state of the art and efficient treatment results. The treatment network is geared towards the specialized treatment of severely affected patients with chronic headache disorders. A national network of outpatient and inpatient pain therapists in both practices and hospitals works hand in hand to optimally alleviate pain in a comprehensive cross-sectoral and multidisciplinary manner. For therapy refractive disorders, a high-intensive supraregional fully inpatient treatment can be arranged. This concept offers for the first time a nationwide coordinated treatment without limitation by specialization and bureaucratic remuneration sectors.

  9. The treatment of social phobia: the differential effectiveness of exposure in vivo and an integration of exposure in vivo, rational emotive therapy and social skills training.

    PubMed

    Mersch, P P

    1995-03-01

    Thirty-four social phobic patients were treated with either exposure in vivo or an integrated treatment, consisting of rational emotive therapy, social skills training and exposure in vivo. Comparison with a waiting-list control group showed the effectiveness of both treatments. Contrary to expectations, the integrated approach was not superior over exposure in vivo alone. Also, the long-term effectiveness of both treatments was equally good.

  10. Integrating sequencing batch reactor with bio-electrochemical treatment for augmenting remediation efficiency of complex petrochemical wastewater.

    PubMed

    Yeruva, Dileep Kumar; Jukuri, Srinivas; Velvizhi, G; Naresh Kumar, A; Swamy, Y V; Venkata Mohan, S

    2015-01-01

    The present study evaluates the sequential integration of two advanced biological treatment methods viz., sequencing batch reactor (SBR) and bioelectrochemical treatment systems (BET) for the treatment of real-field petrochemical wastewater (PCW). Initially two SBR reactors were operated in aerobic (SBR(Ae)) and anoxic (SBR(Ax)) microenvironments with an organic loading rate (OLR) of 9.68 kg COD/m(3)-day. Relatively, SBR(Ax) showed higher substrate degradation (3.34 kg COD/m(3)-day) compared to SBR(Ae) (2.9 kg COD/m(3)-day). To further improve treatment efficiency, the effluents from SBR process were fed to BET reactors. BET(Ax) depicted higher SDR (1.92 kg COD/m(3)-day) with simultaneous power generation (17.12 mW/m(2)) followed by BET(Ae) (1.80 kg COD/m(3)-day; 14.25 mW/m(2)). Integrating both the processes documented significant improvement in COD removal efficiency due to the flexibility of combining multiple microenvironments sequentially. Results were supported with GC-MS and FTIR, which confirmed the increment in biodegradability of wastewater.

  11. Optimizing fracture stimulation using treatment-well tiltmeters and integrated fracture modeling

    SciTech Connect

    Mayerhofer, M.; Stutz, L.; Davis, E.; Wolhart, S.

    2006-05-15

    This paper covers the optimization of hydraulic fracture treatments in a new coalbed methane (CBM) reservoir in Wyoming. A multiwell pilot project was conducted in the Copper Ridge (CR) field to assess future development potential. Hydraulic fracture mapping was successfully performed with treatment-well tiltmeters on six wells including the first-ever used on propped treatments. The mapped fracture height was then used to calibrate the fracture model, perform on-site fracture-design changes, and optimize future fracture treatments. This paper shows how early use of fracture diagnostics can assist in the development of a new reservoir.

  12. Integrating Antimicrobial Therapy with Host Immunity to Fight Drug-Resistant Infections: Classical vs. Adaptive Treatment.

    PubMed

    Gjini, Erida; Brito, Patricia H

    2016-04-01

    Antimicrobial resistance of infectious agents is a growing problem worldwide. To prevent the continuing selection and spread of drug resistance, rational design of antibiotic treatment is needed, and the question of aggressive vs. moderate therapies is currently heatedly debated. Host immunity is an important, but often-overlooked factor in the clearance of drug-resistant infections. In this work, we compare aggressive and moderate antibiotic treatment, accounting for host immunity effects. We use mathematical modelling of within-host infection dynamics to study the interplay between pathogen-dependent host immune responses and antibiotic treatment. We compare classical (fixed dose and duration) and adaptive (coupled to pathogen load) treatment regimes, exploring systematically infection outcomes such as time to clearance, immunopathology, host immunization, and selection of resistant bacteria. Our analysis and simulations uncover effective treatment strategies that promote synergy between the host immune system and the antimicrobial drug in clearing infection. Both in classical and adaptive treatment, we quantify how treatment timing and the strength of the immune response determine the success of moderate therapies. We explain key parameters and dimensions, where an adaptive regime differs from classical treatment, bringing new insight into the ongoing debate of resistance management. Emphasizing the sensitivity of treatment outcomes to the balance between external antibiotic intervention and endogenous natural defenses, our study calls for more empirical attention to host immunity processes.

  13. Integrating Antimicrobial Therapy with Host Immunity to Fight Drug-Resistant Infections: Classical vs. Adaptive Treatment

    PubMed Central

    Gjini, Erida; Brito, Patricia H.

    2016-01-01

    Antimicrobial resistance of infectious agents is a growing problem worldwide. To prevent the continuing selection and spread of drug resistance, rational design of antibiotic treatment is needed, and the question of aggressive vs. moderate therapies is currently heatedly debated. Host immunity is an important, but often-overlooked factor in the clearance of drug-resistant infections. In this work, we compare aggressive and moderate antibiotic treatment, accounting for host immunity effects. We use mathematical modelling of within-host infection dynamics to study the interplay between pathogen-dependent host immune responses and antibiotic treatment. We compare classical (fixed dose and duration) and adaptive (coupled to pathogen load) treatment regimes, exploring systematically infection outcomes such as time to clearance, immunopathology, host immunization, and selection of resistant bacteria. Our analysis and simulations uncover effective treatment strategies that promote synergy between the host immune system and the antimicrobial drug in clearing infection. Both in classical and adaptive treatment, we quantify how treatment timing and the strength of the immune response determine the success of moderate therapies. We explain key parameters and dimensions, where an adaptive regime differs from classical treatment, bringing new insight into the ongoing debate of resistance management. Emphasizing the sensitivity of treatment outcomes to the balance between external antibiotic intervention and endogenous natural defenses, our study calls for more empirical attention to host immunity processes. PMID:27078624

  14. The integration of relationship-focused group therapy with couples treatment.

    PubMed

    Feldman, Darryl B; Kahn, Gloria Batkin

    2009-01-01

    Abstract This article discusses a new treatment paradigm combining couples therapy with a separate relationship-focused group therapy for each partner. This model is thought to be especially efficacious for those couples experiencing difficulty in making progress in couples treatment alone. The authors postulate that the addition of a separate group process utilizing object relations and self-psycho- logical theories, as well as concepts borrowed from Imago relationship therapy, enhance the probability of working through intractable transference projections that tend to be impervious to either treatment modality on its own. Challenges created by this combined approach as well as benefits are addressed. Theoretical rationale and treatment implications are discussed.

  15. Long-term Impact of Integration of Household Water Treatment and Hygiene Promotion with Antenatal Services on Maternal Water Treatment and Hygiene Practices in Malawi

    PubMed Central

    Loharikar, Anagha; Russo, Elizabeth; Sheth, Anandi; Menon, Manoj; Kudzala, Amose; Tauzie, Blessius; Masuku, Humphreys D.; Ayers, Tracy; Hoekstra, Robert M.; Quick, Robert

    2013-01-01

    A clinic-based program to integrate antenatal services with distribution of hygiene kits including safe water storage containers, water treatment solution (brand name WaterGuard), soap, and hygiene education, was implemented in Malawi in 2007 and evaluated in 2010. We surveyed 389 participants at baseline in 2007, and found and surveyed 232 (60%) participants to assess water treatment, test stored drinking water for residual chlorine (an objective measure of treatment), and observe handwashing technique at follow-up in 2010. Program participants were more likely to know correct water treatment procedures (67% versus 36%; P < 0.0001), treat drinking water with WaterGuard (24% versus 2%; P < 0.0001), purchase and use WaterGuard (21% versus 1%; P < 0.001), and demonstrate correct handwashing technique (50% versus 21%; P < 0.001) at the three-year follow-up survey than at baseline. This antenatal-clinic-based program may have contributed to sustained water treatment and proper handwashing technique among program participants. PMID:23243106

  16. Integral dose investigation of non-coplanar treatment beam geometries in radiotherapy

    SciTech Connect

    Nguyen, Dan; Dong, Peng; Ruan, Dan; Low, Daniel A.; Sheng, Ke; Long, Troy; Romeijn, Edwin

    2014-01-15

    Purpose: Automated planning and delivery of non-coplanar plans such as 4π radiotherapy involving a large number of fields have been developed to take advantage of the newly available automated couch and gantry on C-arm gantry linacs. However, there is an increasing concern regarding the potential changes in the integral dose that needs to be investigated. Methods: A digital torso phantom and 22 lung and liver stereotactic body radiation therapy (SBRT) patients were included in the study. The digital phantom was constructed as a water equivalent elliptical cylinder with a major axis length of 35.4 cm and minor axis of 23.6 cm. A 4.5 cm diameter target was positioned at varying depths along the major axis. Integral doses from intensity modulated, non-coplanar beams forming a conical pattern were compared against the equally spaced coplanar beam plans. Integral dose dependence on the phantom geometry and the beam number was also quantified. For the patient plans, the non-coplanar and coplanar beams and fluences were optimized using a column generation and pricing approach and compared against clinical VMAT plans using two full (lung) or partial coplanar arcs (liver) entering at the side proximal to the tumor. Both the average dose to the normal tissue volume and the total volumes receiving greater than 2 Gy (V2) and 5 Gy (V5) were evaluated and compared. Results: The ratio of integral dose from the non-coplanar and coplanar plans depended on the tumor depth for the phantom; for tumors shallower than 10 cm, the non-coplanar integral doses were lower than coplanar integral doses for non-coplanar angles less than 60°. Similar patterns were observed in the patient plans. The smallest non-coplanar integral doses were observed for tumor 6–8 cm deep. For the phantom, the integral dose was independent of the number of beams, consistent with the liver SBRT patients but the lung SBRT patients showed slight increase in the integral dose when more beams were used. Larger

  17. A path-integral Langevin equation treatment of low-temperature doped helium clusters

    NASA Astrophysics Data System (ADS)

    Ing, Christopher; Hinsen, Konrad; Yang, Jing; Zeng, Toby; Li, Hui; Roy, Pierre-Nicholas

    2012-06-01

    We present an implementation of path integral molecular dynamics for sampling low temperature properties of doped helium clusters using Langevin dynamics. The robustness of the path integral Langevin equation and white-noise Langevin equation [M. Ceriotti, M. Parrinello, T. E. Markland, and D. E. Manolopoulos, J. Chem. Phys. 133, 124104 (2010)], 10.1063/1.3489925 sampling methods are considered for those weakly bound systems with comparison to path integral Monte Carlo (PIMC) in terms of efficiency and accuracy. Using these techniques, convergence studies are performed to confirm the systematic error reduction introduced by increasing the number of discretization steps of the path integral. We comment on the structural and energetic evolution of HeN-CO2 clusters from N = 1 to 20. To quantify the importance of both rotations and exchange in our simulations, we present a chemical potential and calculated band origin shifts as a function of cluster size utilizing PIMC sampling that includes these effects. This work also serves to showcase the implementation of path integral simulation techniques within the molecular modelling toolkit [K. Hinsen, J. Comp. Chem. 21, 79 (2000)], 10.1002/(SICI)1096-987X(20000130)21:2<79::AID-JCC1>3.0.CO;2-B, an open-source molecular simulation package.

  18. Evaluating Outcomes in Patients with Overactive Bladder within an Integrated Healthcare Delivery System Using a Treatment Patterns Analyzer

    PubMed Central

    Ng, Daniel B.; McCart, Melissa; Klein, Christopher; Campbell, Chelsey; Schoenhaus, Robert; Berner, Todd

    2016-01-01

    Background Overactive bladder (OAB) is a relatively common disease that has been linked to a variety of comorbidities, reductions in quality of life, and increased healthcare costs. Antimuscarinic agents are the standard of care among pharmacologic treatments for OAB, but these drugs are linked to high levels of anticholinergic burden, especially in the elderly. Objective To demonstrate how efficient data analysis can be used to identify gaps in care as a result of improvement strategies for OAB within an integrated healthcare delivery system setting. Methods We developed an OAB treatment patterns analyzer, a clinical outcomes software analysis program, to identify gaps in care, high anticholinergic burden, and potential quality improvement initiatives. Deidentified pharmacy and medical claims data from an integrated delivery network were imported into the OAB treatment patterns analyzer. Patients with a diagnosis of OAB who were continuously enrolled in the network between January 1, 2009, and December 31, 2013, were identified and were imported into the analyzer. The analyzer used National Drug Code; International Classification of Diseases, Ninth Edition, Clinical Modification; Current Procedural Terminology; and UB-92 codes to measure treatment patterns, comorbid conditions, anticholinergic burden, concomitant use with anticholinesterases, costs, and healthcare resource utilization. Results Of 157,710 members in the integrated delivery network population, 7309 patients met the study eligibility criteria. Of patients taking medications for OAB, 85% were nonadherent and 73% discontinued treatment within 1 year. Among 1147 patients in the integrated healthcare delivery system who were using medications for OAB, 39 (3.4%) patients were concomitantly taking anticholinesterase drugs and an antimuscarinic agent. The per-month plan-paid cost per member was $318.67. Of all the patients with OAB within the population, the rates of all-cause office visits, emergency

  19. Advanced treatment of oilfield production wastewater by an integration of coagulation/flotation, catalytic ozonation and biological processes.

    PubMed

    Chen, Ke-Yong; Zhang, Xiao-Bing; Li, Jun

    2016-10-01

    In this study, advanced treatment of heavily polluted oilfield production wastewater (OPW) was investigated employing the combination of coagulation/dissolved air flotation, heterogeneous catalytic ozonation and sequencing batch reactor (SBR) processes. Two SBR reactors were separately set up before and after the ozonation unit. The results show that microbubble flotation was more efficient than macrobubble flotation in pollutant removal. Catalytic ozonation with the prepared Fe/activated carbon catalyst significantly enhanced pollutant removal in the second SBR by improving wastewater biodegradability and reducing wastewater microtoxicity. The treatment technique decreased oil, chemical oxygen demand and NH3-N by about 97%, 88% and 91%, respectively, allowing the discharge limits to be met. Therefore, the integrated process with efficient, economical and sustainable advantages was suitable for advanced treatment of real OPW.

  20. Integrated Waste Treatment Unit (IWTU) Input Coal Analyses and Off-Gass Filter (OGF) Content Analyses

    SciTech Connect

    Jantzen, Carol M.; Missimer, David M.; Guenther, Chris P.; Shekhawat, Dushyant; VanEssendelft, Dirk T.; Means, Nicholas C.

    2015-04-23

    A full engineering scale Fluidized Bed Steam Reformer (FBSR) system is being used at the Idaho Nuclear Technology and Engineering Center (INTEC) to stabilize acidic Low Activity Waste (LAW) known as Sodium Bearing Waste (SBW). The INTEC facility, known as the Integrated Waste Treatment Unit (IWTU), underwent an Operational Readiness Review (ORR) and a Technology Readiness Assessment (TRA) in March 2014. The IWTU began non-radioactive simulant processing in late 2014 and by January, 2015 ; the IWTU had processed 62,000 gallons of simulant. The facility is currently in a planned outage for inspection of the equipment and will resume processing simulated waste feed before commencing to process 900,000 gallons of radioactive SBW. The SBW acidic waste will be made into a granular FBSR product (carbonate based) for disposal in the Waste Isolation Pilot Plant (WIPP). In the FBSR process calcined coal is used to create a CO2 fugacity to force the waste species to convert to carbonate species. The quality of the coal, which is a feed input, is important because the reactivity, moisture, and volatiles (C,H,N,O, and S) in the coal impact the reactions and control of the mineralizing process in the primary steam reforming vessel, the Denitration and Mineralizing Reformer (DMR). Too much moisture in the coal can require that additional coal be used. However since moisture in the coal is only a small fraction of the moisture from the fluidizing steam this can be self-correcting. If the coal reactivity or heating value is too low then the coal feedrate needs to be adjusted to achieve the desired heat generation. Too little coal and autothermal heat generation in the DMR cannot be sustained and/or the carbon dioxide fugacity will be too low to create the desired carbonate mineral species. Too much coal and excess S and hydroxide species can form. Excess sulfur from coal that (1) is too rich in sulfur or (2) from overfeeding coal can promote wall scale and contribute to corrosion

  1. The treatment of climate science in Integrated Assessment Modelling: integration of climate step function response in an energy system integrated assessment model.

    NASA Astrophysics Data System (ADS)

    Dessens, Olivier

    2016-04-01

    Integrated Assessment Models (IAMs) are used as crucial inputs to policy-making on climate change. These models simulate aspect of the economy and climate system to deliver future projections and to explore the impact of mitigation and adaptation policies. The IAMs' climate representation is extremely important as it can have great influence on future political action. The step-function-response is a simple climate model recently developed by the UK Met Office and is an alternate method of estimating the climate response to an emission trajectory directly from global climate model step simulations. Good et al., (2013) have formulated a method of reconstructing general circulation models (GCMs) climate response to emission trajectories through an idealized experiment. This method is called the "step-response approach" after and is based on an idealized abrupt CO2 step experiment results. TIAM-UCL is a technology-rich model that belongs to the family of, partial-equilibrium, bottom-up models, developed at University College London to represent a wide spectrum of energy systems in 16 regions of the globe (Anandarajah et al. 2011). The model uses optimisation functions to obtain cost-efficient solutions, in meeting an exogenously defined set of energy-service demands, given certain technological and environmental constraints. Furthermore, it employs linear programming techniques making the step function representation of the climate change response adapted to the model mathematical formulation. For the first time, we have introduced the "step-response approach" method developed at the UK Met Office in an IAM, the TIAM-UCL energy system, and we investigate the main consequences of this modification on the results of the model in term of climate and energy system responses. The main advantage of this approach (apart from the low computational cost it entails) is that its results are directly traceable to the GCM involved and closely connected to well-known methods of

  2. Heat treatment of nuclear reactor pump part in integrated furnace facility

    SciTech Connect

    Not Available

    1983-08-01

    A flexible heat treating system is meeting strict work specifications while accommodating the production flow pattern requirements and floor space needs of Advanced Metal Treating, Inc., Butler, Wis. Modular design and appropriate furnace configurations allow realization of the most efficient heat treat processing and energy use in a relatively small production area. The totally-integrated system (Pacemaker--manufactured by Lindberg, A Unit of General Signal, Chicago) consists of an electric integral-quench furnace with companion draw furnaces, washer unit and a material transfer car. With its one-side, inout configuration, the furnace operates with a minimum of drawing and washing equipment. The integral-quench furnace has a work chamber dimension of 30 by 48 by 30 inches (76.2 x 122 x 76.2 cm). The firm has two of these units, plus three in-out draw furnaces, one washer, one transfer car and two endothermic gas generators.

  3. Treatment of Sexual Disorders in the 1990s: An Integrated Approach.

    ERIC Educational Resources Information Center

    Rosen, Raymond C.; Leiblum, Sandra R.

    1995-01-01

    Reviews existing data regarding the etiology and treatment of male and female sexual dysfunctions. Discusses the use of multidimensional assessment models, especially in the evaluation of erectile dysfunction and sexual pain disorders. Despite the conceptual and technological sophistication of current approaches, treatment outcomes are…

  4. Evaluating the Role of Seed Treatments in Canola/Oilseed Rape Production: Integrated Pest Management, Pollinator Health, and Biodiversity

    PubMed Central

    Sekulic, Gregory; Rempel, Curtis B.

    2016-01-01

    The use patterns and role of insecticide seed treatments, with focus on neonicotinoid insecticides, were examined for canola/oilseed rape production in Canada and the EU. Since nearly all planted canola acres in Western Canada and, historically, a majority of planted oilseed acres in the EU, use seed treatments, it is worth examining whether broad use of insecticidal seed treatments (IST) is compatible with principles of integrated pest management (IPM). The neonicotinoid insecticide (NNI) seed treatment (NNI ST) use pattern has risen due to effective control of several early season insect pests, the most destructive being flea beetles (Phyllotreta sp.). Negative environmental impact and poor efficacy of foliar applied insecticides on flea beetles led growers to look for better alternatives. Due to their biology, predictive models have been difficult to develop for flea beetles, and, therefore, targeted application of seed treatments, as part of an IPM program, has contributed to grower profitability and overall pollinator success for canola production in Western Canada. Early evidence suggests that the recent restriction on NNI may negatively impact grower profitability and does not appear to be having positive impact on pollinator health. Further investigation on impact of NNI on individual bee vs. hive health need to be conducted. Predictive models for flea beetle emergence/feeding activity in canola/oilseed rape need to be developed, as broad acre deployment of NNI seed treatments may not be sustainable due to concerns about resistance/tolerance in flea beetles and other pest species. PMID:27527233

  5. Evaluating the Role of Seed Treatments in Canola/Oilseed Rape Production: Integrated Pest Management, Pollinator Health, and Biodiversity.

    PubMed

    Sekulic, Gregory; Rempel, Curtis B

    2016-08-03

    The use patterns and role of insecticide seed treatments, with focus on neonicotinoid insecticides, were examined for canola/oilseed rape production in Canada and the EU. Since nearly all planted canola acres in Western Canada and, historically, a majority of planted oilseed acres in the EU, use seed treatments, it is worth examining whether broad use of insecticidal seed treatments (IST) is compatible with principles of integrated pest management (IPM). The neonicotinoid insecticide (NNI) seed treatment (NNI ST) use pattern has risen due to effective control of several early season insect pests, the most destructive being flea beetles (Phyllotreta sp.). Negative environmental impact and poor efficacy of foliar applied insecticides on flea beetles led growers to look for better alternatives. Due to their biology, predictive models have been difficult to develop for flea beetles, and, therefore, targeted application of seed treatments, as part of an IPM program, has contributed to grower profitability and overall pollinator success for canola production in Western Canada. Early evidence suggests that the recent restriction on NNI may negatively impact grower profitability and does not appear to be having positive impact on pollinator health. Further investigation on impact of NNI on individual bee vs. hive health need to be conducted. Predictive models for flea beetle emergence/feeding activity in canola/oilseed rape need to be developed, as broad acre deployment of NNI seed treatments may not be sustainable due to concerns about resistance/tolerance in flea beetles and other pest species.

  6. Treatment of the hydrogen atom in an electric field by the path-integral formalism

    SciTech Connect

    Chetouani, L.; Hammann, T.F.

    1986-12-01

    The Feynman path-integral method is applied to solve the problem of a H atom in an electric field. In accordance with the midpoint philosophy, the propagators are symmetrized in every time interval and, via several transformations, one of which is the Langer modification, the Green's function is calculated in parabolic coordinates, decomposed into partial propagators, and expressed in terms of two one-dimensional Green's functions. The perturbation method being no more valid for high excited levels, the spectrum is given, according to the WKB method, as a solution of a system of two elliptic integral equations. The exact spectrum of the H atom is obtained for a zero electric field.

  7. Use of integrated dual disorder treatment via assertive community treatment versus clinical case management for persons with co-occurring disorders and antisocial personality disorder.

    PubMed

    Frisman, Linda K; Mueser, Kim T; Covell, Nancy H; Lin, Hsiu-Ju; Crocker, Anne; Drake, Robert E; Essock, Susan M

    2009-11-01

    We conducted secondary analyses of data from a randomized trial testing the effectiveness of Assertive Community Treatment (ACT) in delivery of integrated dual disorder treatment (IDDT) to explore the impact of IDDT delivered through ACT teams compared with standard clinical case management for dually-disordered persons with and without antisocial personality disorder (ASPD). This analysis included 36 individuals with ASPD and 88 individuals without ASPD. Participants with ASPD assigned to ACT showed a significantly greater reduction in alcohol use and were less likely to go to jail than those in standard clinical case management, whereas participants without ASPD did not differ between the 2 case management approaches. There were no significant differences for other substance use or criminal justice outcomes. This study provides preliminary evidence that persons with co-occurring serious mental illness, substance use disorders, and ASPD may benefit from delivery of IDDT through ACT teams.

  8. Addressing the unique psychosocial barriers to breast cancer treatment experienced by African-American women through integrative navigation.

    PubMed

    Chatman, Michelle C; Green, Rodney D

    2011-12-01

    African-American women face a disproportionally high breast cancer mortality rate and a significantly low five-year survival rate after breast cancer treatment. This study investigated, through a series of focus groups, how 32 African-American women (N = 32) breast cancer patients and survivors managed their cancer-related health needs. Participants also reported important barriers to care including problematic interactions with medical professionals, challenges in intimate relations, difficulties in handling the stigma and myths about breast cancer, and the psychological challenges that they faced. A patient navigation model was implemented at an eastern urban hospital that emphasized integrative therapies such as meditation, nutritional instruction, and yoga. Follow-up telephone interviews with 37 additional African-American participants (N = 37) indicated the rating of effectiveness to be at 3.8 to 3.9 out of 4 for the integrative patient navigation program. Over half of the survivors reported using some complementary techniques after treatment was completed, thus suggesting a long-term improvement in their quality of life as a result of the integrative techniques.

  9. Violence Survivors with Posttraumatic Stress Disorder: Treatment by Integrating Existential and Narrative Therapies

    ERIC Educational Resources Information Center

    Day, Kristen W.

    2009-01-01

    In this article, the author proposes an integration of existential and narrative therapies with current evidence-supported approaches to treating the aforementioned population. First, she briefly defines interpersonal violence, then provides a history and review of the diagnostic criteria for Posttraumatic Stress Disorder (PTSD), which frequently…

  10. Integrating Behavioral and Psychodynamic Therapies: Issues in Training and Treatment. Symposium Papers.

    ERIC Educational Resources Information Center

    Halgin, Richard P.; And Others

    These five symposium papers address the gap between behavioral and psychoanalytic theories. "Teaching the Integration of Different Models to Therapists-in-Training," by Richard P. Halgin, suggests that students should concentrate on a broad-based education, using the best of several approaches to fit individual client needs, rather than…

  11. Comparison of Behavioral Intervention and Sensory-Integration Therapy in the Treatment of Challenging Behavior

    ERIC Educational Resources Information Center

    Devlin, Sarah; Healy, Olive; Leader, Geraldine; Hughes, Brian M.

    2011-01-01

    The objective of the current study was to compare the effects of sensory-integration therapy (SIT) and a behavioral intervention on rates of challenging behavior (including self-injurious behavior) in four children diagnosed with Autism Spectrum Disorder. For each of the participants a functional assessment was conducted to identify the variables…

  12. Integrating Fasciolosis Control in the Dry Cow Management: The Effect of Closantel Treatment on Milk Production

    PubMed Central

    Charlier, Johannes; Hostens, Miel; Jacobs, Jos; Van Ranst, Bonny; Duchateau, Luc; Vercruysse, Jozef

    2012-01-01

    The liver fluke Fasciola hepatica is a parasite of ruminants with a worldwide distribution and an apparent increasing incidence in EU member states. Effective control in dairy cattle is hampered by the lack of flukicides with a zero-withdrawal time for milk, leaving the dry period as the only time that preventive treatment can be applied. Here, we present the results of a blinded, randomized and placebo-controlled trial on 11 dairy herds (402 animals) exposed to F. hepatica to 1) assess the effect of closantel treatment at dry-off (or 80–42 days before calving in first-calving heifers) on milk production parameters and 2) evaluate if a number of easy-to-use animal parameters is related to the milk production response after treatment. Closantel treatment resulted in a noticeable decrease of anti-F. hepatica antibody levels from 3–6 months after treatment onwards, a higher peak production (1.06 kg) and a slightly higher persistence (9%) of the lactation, resulting in a 305-day milk production increase of 303 kg. No effects of anthelmintic treatment were found on the average protein and fat content of the milk. Milk production responses after treatment were poor in meagre animals and clinically relevant higher milk production responses were observed in first-lactation animals and in cows with a high (0.3–0.5 optical density ratio (ODR)), but not a very high (≥0.5 ODR) F. hepatica ELISA result on a milk sample from the previous lactation. We conclude that in dairy herds exposed to F. hepatica, flukicide treatment at dry-off is a useful strategy to reduce levels of exposure and increase milk production in the subsequent lactation. Moreover, the results suggest that treatment approaches that only target selected animals within a herd can be developed based on easy-to-use parameters. PMID:22916226

  13. Sensory integration intervention: historical concepts, treatment strategies and clinical experiences in three patients with succinic semialdehyde dehydrogenase (SSADH) deficiency.

    PubMed

    Kratz, S V

    2009-06-01

    This paper is a review of clinical experiences providing developmental therapy services for three boys diagnosed with paediatric neurotransmitter disease. The clinical presentation of paediatric neurotransmitter diseases might parallel other diagnostic characteristics seen in a typical paediatric therapy clinic (i.e. hypotonia, motor and cognitive delays, coordination, expressive speech, and ocular motor difficulties.) From the clinical perspective of the author, sensory integrative function is but one aspect of a thorough evaluation and treatment plan for all patients. The manifestations of sensory integration dysfunction (SID), also known as sensory processing dysfunction (SPD), can occur alone or be concurrent with a variety of known medical, behavioural and neurological diagnoses. These manifestations of SPD can include, but are not limited to: hypotonia, hyperactivity, irritability, distractibility, attention difficulties, learning difficulties, clumsiness and incoordination, instability, poor motor skills, social-emotional difficulties, and behavioural problems. This paper summarizes the theory and practice applications of sensory integration. The author discusses clinical experiences providing occupational therapy services utilizing sensory integration methods and strategies with clients who were eventually diagnosed with SSADH deficiency.

  14. Risk assessment of Giardia from a full scale MBR sewage treatment plant caused by membrane integrity failure.

    PubMed

    Zhang, Yu; Chen, Zhimin; An, Wei; Xiao, Shumin; Yuan, Hongying; Zhang, Dongqing; Yang, Min

    2015-04-01

    Membrane bioreactors (MBR) are highly efficient at intercepting particles and microbes and have become an important technology for wastewater reclamation. However, many pathogens can accumulate in activated sludge due to the long residence time usually adopted in MBR, and thus may pose health risks when membrane integrity problems occur. This study presents data from a survey on the occurrence of water-borne Giardia pathogens in reclaimed water from a full-scale wastewater treatment plant with MBR experiencing membrane integrity failure, and assessed the associated risk for green space irrigation. Due to membrane integrity failure, the MBR effluent turbidity varied between 0.23 and 1.90 NTU over a period of eight months. Though this turbidity level still met reclaimed water quality standards (≤5 NTU), Giardia were detected at concentrations of 0.3 to 95 cysts/10 L, with a close correlation between effluent turbidity and Giardia concentration. All β-giardin gene sequences of Giardia in the WWTP influents were genotyped as Assemblages A and B, both of which are known to infect humans. An exponential dose-response model was applied to assess the risk of infection by Giardia. The risk in the MBR effluent with chlorination was 9.83×10(-3), higher than the acceptable annual risk of 1.0×10(-4). This study suggested that membrane integrity is very important for keeping a low pathogen level, and multiple barriers are needed to ensure the biological safety of MBR effluent.

  15. HIV treatment and reproductive health in the health system in Burkina Faso: resource allocation and the need for integration.

    PubMed

    Windisch, Ricarda; de Savigny, Don; Onadja, Geneviève; Somda, Antoine; Wyss, Kaspar; Sié, Ali; Kouyaté, Bocar

    2011-11-01

    Organizational changes, increased funding and the demands of HIV antiretroviral (ARV) treatment create particular challenges for governance in the health sector. We assess resource allocation, policy making and integration of the national responses to ARV provision and reproductive health in Burkina Faso, using national and district budgets related to disease burden, policy documents, organizational structures, and coordination and implementation processes. ARV provision represents the concept of a "crisis scenario", in which reforms are pushed due to a perception of urgent need, whereas the national reproductive health programme, which is older and more integrated, represents a "politics-as-usual scenario". Findings show that the early years of the national response to HIV and AIDS were characterized by new institutions with overlapping functions, and failure to integrate with and strengthen existing structures. National and district budget allocations for HIV compared to other interventions were disproportionately high when assessed against burden of disease. Strategic documents for ARV provision were relatively less developed and referred to, compared to those of the Ministry of Health Directorates for HIV and for Family Health and district health planning teams for reproductive health services. Imbalances and new structures potentially trigger important adverse effects which are difficult to remedy and likely to increase due to the dynamics they create. It therefore becomes crucial, from the outset, to integrate HIV/AIDS funding and responses into health systems.

  16. Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG): toward integrated treatment of symptoms related to traumatic loss

    PubMed Central

    Smid, Geert E.; Kleber, Rolf J.; de la Rie, Simone M.; Bos, Jannetta B. A.; Gersons, Berthold P. R.; Boelen, Paul A.

    2015-01-01

    Background Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends). Current evidence-based treatments for PTSD do not focus on traumatic grief. Objective To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief. Method To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette. Results Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual. Conclusion Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components. PMID:26154434

  17. Integrated Chemical and Toxicological Investigation of UV-Chlorine/Chloramine Drinking Water Treatment

    EPA Science Inventory

    As the use of alternative drinking water treatment increases, it is important to understand potential public health•implications associated with these processes. The objective of this study was to evaluate the formation of disinfection byproducts (DBPs) and cytotoxicity of ...

  18. Integrated water quality, emergy and economic evaluation of three bioremediation treatment systems for eutrophic water

    EPA Science Inventory

    This study was targeted at finding one or more environmentally efficient, economically feasible and ecologically sustainable bioremediation treatment modes for eutrophic water. Three biological species, i.e. water spinach (Ipomoea aquatica), loach (Misgurus anguillicaudatus) and ...

  19. Integrated application of upflow anaerobic sludge blanket reactor for the treatment of wastewaters.

    PubMed

    Latif, Muhammad Asif; Ghufran, Rumana; Wahid, Zularisam Abdul; Ahmad, Anwar

    2011-10-15

    The UASB process among other treatment methods has been recognized as a core method of an advanced technology for environmental protection. This paper highlights the treatment of seven types of wastewaters i.e. palm oil mill effluent (POME), distillery wastewater, slaughterhouse wastewater, piggery wastewater, dairy wastewater, fishery wastewater and municipal wastewater (black and gray) by UASB process. The purpose of this study is to explore the pollution load of these wastewaters and their treatment potential use in upflow anaerobic sludge blanket process. The general characterization of wastewater, treatment in UASB reactor with operational parameters and reactor performance in terms of COD removal and biogas production are thoroughly discussed in the paper. The concrete data illustrates the reactor configuration, thus giving maximum awareness about upflow anaerobic sludge blanket reactor for further research. The future aspects for research needs are also outlined.

  20. Integrated approach to treatment of children and adults with eosinophilic esophagitis.

    PubMed

    Aceves, Seema S; Furuta, Glenn T; Spechler, Stuart Jon

    2008-01-01

    Over the last decade, treatment plans for eosinophilic esophagitis included the use of elemental formula, elimination diets, systemic corticosteroids, and the gavage of aerosolized steroids. Except for one placebo-controlled blinded prospective study, most decision making has been based on retrospective or uncontrolled studies and clinical experience. In this article, three authors from diverse backgrounds combine their resources to propose treatment paths with justification based on their clinical experience and interpretation of the literature.

  1. The effects of various control and water treatment processes on the membrane integrity and toxin fate of cyanobacteria.

    PubMed

    Fan, Jiajia; Hobson, Peter; Ho, Lionel; Daly, Robert; Brookes, Justin

    2014-01-15

    Cyanobacterial blooms are one of the main contaminants that can degrade drinking water quality with the associated taste, odour and toxic compounds. Although a wide range of techniques have shown promise for cyanobacterial bloom control and cyanobacterial cell/metabolite removal in reservoirs and water treatment plants (WTPs), these treatments may have negative consequences through release of intracellular metabolites into the surrounding water. This study assessed the impact of copper sulphate (CuSO4), chlorine, potassium permanganate (KMnO4), hydrogen peroxide (H2O2) and ozone on Microcystis aeruginosa culture and the toxins it produced. All of these agents induced the loss of cyanobacterial membrane integrity. However, no associated increase in dissolved toxins was detected during chlorine and H2O2 treatments which may be due to faster toxin oxidation rates than release rates. KMnO4 doses of 1 and 3mgL(-1) degraded dissolved toxins while having no impact on cyanobacterial membrane integrity. In contrast, ozone induced a significant increase in extracellular toxins but it was unable to degrade these toxins to the same degree as the other oxidants which may due to the lack of residual. All chemicals, except CuSO4, were able to reduce cyanotoxins and chlorine was the most effective with a rate up to 2161M(-1)s(-1).

  2. Effect of nonionic surfactant on the degradation of glass-sorbed PCB congeners by integrated chemical-biological treatment

    SciTech Connect

    Aronstein, B.N.; Paterek, J.R.

    1995-05-01

    A study was conducted on the effect of a nonionic surfactant on the efficiency of the integrated chemical-biological treatment (ICBT) of polychlorinated biphenyls (PCBs) sorbed to the glass walls of the experimental vessels. The addition of surfactant associated with the chemical oxidation was proposed to overcome two limitations of biodegradation of hydrophobic compounds: adsorption to surfaces,a nd lack of solubility and thus availability to the microorganisms. Two {sup 14}C-labeled PCB congeners, 2-chlorobiphenyl and 2,2{prime},4,4{prime}-tetrachlorobiphenyl, were used as the test compounds. The integrated chemical-biological treatment consisted of sequential applications of Fenton`s reagent (5% H{sub 2}O{sub 2}, 1 mM FeSO{sub 4}) at pH 4.0 (with and without non-ionic surfactant Novel 2 1412-60) and the inoculation with a mixed culture of Pseudomonas sp., strain LB400, and Alcaligenes eutrophus, strain H850, at pH 8.0. The chemical treatment in the presence of surfactant affected the removal of the congeners bound to the glass surfaces of the experimental test systems. As indicated by high-pressure liquid chromatography analysis, these PCBs were converted to unidentified soluble products that are hypothesized to be partial oxidation products. No parent test compounds were detectable in the system after chemical treatment with or without surfactant. The addition of the mixed culture of PCB-degrading bacteria after completion of chemical treatment in the presence of surfactant resulted in the removal of approximately 45% of 2-chlorobiphenyl and 32% of 2,2{prime},4,4{prime}-tetrachlorobiphenyl in the form of {sup 14}CO{sub 2}. This compared to 29% and 23% without the addition of surfactant, respectively. The authors suggest that the combination of surfactant-induced desorption and chemical oxidation would increase the availability of hydrophobic pollutants for microbial degradation.

  3. [Integrated management of diabetic kidney disease: from prevention to treatment, from biomedicine to translation medicine].

    PubMed

    Fu, Ping; Liu, Fang

    2012-05-01

    Diabetes Mellitus (DM) is a worldwide epidemic health and life threatening disease with rapidly increasing prevalence and incidence. Diabetic kidney disease (DKD) is one of the most critical microvascular complications of DM, acts as the leading cause of end stage renal disease (ESRD) in developed countries with less great break in the fields of prevention, treatment and research. The comprehensive therapy of DKD includes the management of blood glucose, blood pressure and lipid, the usage of rennin-angiotension-aldosterone system inhibitors, the improvement of endothelial dysfunction, hemorheology and so on. However, once macroproteinura is detected, the progression into ESRD is irreversible and renal replacement therapy is needed. Cardiovascular morbidity and other complications of DKD patients contribute greatly to the poor outcome. In west China, DKD patients are characterized with low disease awareness, late treatment, low treatment rates, severe status of the illness, long period of hospitalization, more complicated situation and higher mortality rate. Therefore, comprehensive management and care should play more important role in the prevention, treatment and research of DKD, which is composed of health education, guidelines implementation, early screening and diagnosis; standardizing the treatment of DKD according to clinical and pathologic characteristics; individualized renal replacement treatment modalities; practicing translational medicine, carrying out more clinical trials, applying new ideas, techniques and new equipment to the clinical practice and basic researches.

  4. An integrative review of attention biases and their contribution to treatment for anxiety disorders

    PubMed Central

    Barry, Tom J.; Vervliet, Bram; Hermans, Dirk

    2015-01-01

    Models of exposure therapy, one of the key components of cognitive behavioral therapy for anxiety disorders, suggest that attention may play an important role in the extinction of fear and anxiety. Evidence from cognitive research suggests that individual differences may play a causal role in the onset and maintenance of anxiety disorders and so it is also likely to influence treatment. We review the evidence concerning attention and treatment outcomes in anxiety disorders. The evidence reviewed here suggests that that attention biases assessed at pre-treatment might actually predict improved response to treatment, and in particular that prolonged engagement with threat as measured in tasks such as the dot probe is associated with greater reductions in anxious symptoms following treatment. We examine this research within a fear learning framework, considering the possible role of individual differences in attention in the extinction of fear during exposure. Theoretical, experimental and clinical implications are discussed, particularly with reference to the potential for attention bias modification programs in augmenting treatment, and also with reference to how existing research in this area might inform best practice for clinicians. PMID:26217284

  5. Life cycle assessment of nutrient removal technologies for the treatment of anaerobic digestion supernatant and its integration in a wastewater treatment plant.

    PubMed

    Rodriguez-Garcia, G; Frison, N; Vázquez-Padín, J R; Hospido, A; Garrido, J M; Fatone, F; Bolzonella, D; Moreira, M T; Feijoo, G

    2014-08-15

    The supernatant resulting from the anaerobic digestion of sludge generated by wastewater treatment plants (WWTP) is an attractive flow for technologies such as partial nitritation-anammox (CANON), nitrite shortcut (NSC) and struvite crystallization processes (SCP). The high concentration of N and P and its low flow rate facilitate the removal of nutrients under more favorable conditions than in the main water line. Despite their operational and economic benefits, the environmental burdens of these technologies also need to be assessed to prove their feasibility under a more holistic perspective. The potential environmental implications of these technologies were assessed using life cycle assessment, first at pilot plant scale, later integrating them in a modeled full WWTP. Pilot plant results reported a much lower environmental impact for N removal technologies than SCP. Full-scale modeling, however, highlighted that the differences between technologies were not relevant once they are integrated in a WWTP. The impacts associated with the WWTP are slightly reduced in all categories except for eutrophication, where a substantial reduction was achieved using NSC, SCP, and especially when CANON and SCP were combined. This study emphasizes the need for assessing wastewater treatment technologies as part of a WWTP rather than as individual processes and the utility of modeling tools for doing so.

  6. Treatment of Posttraumatic Abdominal Autonomic Neuropathy Manifesting as Functional Dyspepsia and Chronic Constipation: An Integrative East-West Approach

    PubMed Central

    Taw, Lawrence

    2015-01-01

    A 52-year-old male with a history of spinal cord injury and cauda equina syndrome resulting in neurogenic bladder presented with chronic constipation and functional dyspepsia that was refractory to medical management. He was treated with an integrative East-West approach including acupuncture, trigger point injections, and Tui Na massage. Both his pain and constipation improved after a series of treatments, and this improvement was largely sustained at 2-year follow-up. This patient's symptoms are consistent with damage to the visceral parasympathetic nervous system. Interestingly, many studies evaluating the mechanisms of acupuncture point to restoration of parasympathetic tone as a mechanism of action. In this article, we describe a case of complex functional gastrointestinal disorders associated with posttraumatic autonomic neuropathy that was refractory to pharmacotherapy and was successfully treated with an integrative East-West approach PMID:26331105

  7. CATTLE (CAncer treatment treasury with linked evidence): An integrated knowledge base for personalized oncology research and practice.

    PubMed

    Soysal, E; Lee, H-J; Zhang, Y; Huang, L-C; Chen, X; Wei, Q; Zheng, W; Chang, J T; Cohen, T; Sun, J; Xu, H

    2017-03-01

    Despite the existence of various databases cataloging cancer drugs, there is an emerging need to support the development and application of personalized therapies, where an integrated understanding of the clinical factors and drug mechanism of action and its gene targets is necessary. We have developed CATTLE (CAncer Treatment Treasury with Linked Evidence), a comprehensive cancer drug knowledge base providing information across the complete spectrum of the drug life cycle. The CATTLE system collects relevant data from 22 heterogeneous databases, integrates them into a unified model centralized on drugs, and presents comprehensive drug information via an interactive web portal with a download function. A total of 2,323 unique cancer drugs are currently linked to rich information from these databases in CATTLE. Through two use cases, we demonstrate that CATTLE can be used in supporting both research and practice in personalized oncology.

  8. CATTLE (CAncer treatment treasury with linked evidence): An integrated knowledge base for personalized oncology research and practice

    PubMed Central

    Soysal, E; Lee, H‐J; Zhang, Y; Huang, L‐C; Chen, X; Wei, Q; Zheng, W; Chang, JT; Cohen, T; Sun, J

    2017-01-01

    Despite the existence of various databases cataloging cancer drugs, there is an emerging need to support the development and application of personalized therapies, where an integrated understanding of the clinical factors and drug mechanism of action and its gene targets is necessary. We have developed CATTLE (CAncer Treatment Treasury with Linked Evidence), a comprehensive cancer drug knowledge base providing information across the complete spectrum of the drug life cycle. The CATTLE system collects relevant data from 22 heterogeneous databases, integrates them into a unified model centralized on drugs, and presents comprehensive drug information via an interactive web portal with a download function. A total of 2,323 unique cancer drugs are currently linked to rich information from these databases in CATTLE. Through two use cases, we demonstrate that CATTLE can be used in supporting both research and practice in personalized oncology. PMID:28296354

  9. Treatment of Posttraumatic Abdominal Autonomic Neuropathy Manifesting as Functional Dyspepsia and Chronic Constipation: An Integrative East-West Approach.

    PubMed

    Shubov, Andrew; Taw, Lawrence

    2015-07-01

    A 52-year-old male with a history of spinal cord injury and cauda equina syndrome resulting in neurogenic bladder presented with chronic constipation and functional dyspepsia that was refractory to medical management. He was treated with an integrative East-West approach including acupuncture, trigger point injections, and Tui Na massage. Both his pain and constipation improved after a series of treatments, and this improvement was largely sustained at 2-year follow-up. This patient's symptoms are consistent with damage to the visceral parasympathetic nervous system. Interestingly, many studies evaluating the mechanisms of acupuncture point to restoration of parasympathetic tone as a mechanism of action. In this article, we describe a case of complex functional gastrointestinal disorders associated with posttraumatic autonomic neuropathy that was refractory to pharmacotherapy and was successfully treated with an integrative East-West approach.

  10. Feasibility of Typha latifolia for high salinity effluent treatment in constructed wetlands for integration in resource management systems.

    PubMed

    Jesus, J M; Calheiros, C S C; Castro, P M L; Borges, M T

    2014-01-01

    High salinity wastewaters have limited treatment options due to the occurrence of salt inhibition in conventional biological treatments. Using recirculating marine aquaculture effluents as a case study, this work explored the use of Constructed Wetlands as a treatment option for nutrient and salt loads reduction. Three different substrates were tested for nutrient adsorption, of which expanded clay performed better. This substrate adsorbed 0.31 mg kg(-1) of NH4(+)-N and 5.60 mg kg(-1) of PO4(3-)-P and 6.9 mg kg(-1) dissolved salts after 7 days of contact. Microcosms with Typha latifolia planted in expanded clay and irrigated with aquaculture wastewater (salinity 2.4%, 7 days hydraulic retention time, for 4 weeks), were able to remove 94% NH(4+)-N (inlet 0.25 +/- 0.13 mg L(-1)), 78% NO2(-)-N (inlet 0.78 +/- 0.62 mg L(-1)), 46% NO3(-)-N (inlet 18.83 +/- 8.93 mg L(-1)) whereas PO4(3-)-P was not detected (inlet 1.41 +/- 0.21 mg L(-1)). Maximum salinity reductions of 52% were observed. Despite some growth inhibition, plants remained viable, with 94% survival rate. Daily treatment dynamics studies revealed rapid PO4(3-)-P adsorption, unbalancing the N:P ratio and possibly affecting plant development. An integrated treatment approach, coupled with biomass valorization, is suggested to provide optimal resource management possibilities.

  11. An integrated approach for monitoring efficiency and investments of activated sludge-based wastewater treatment plants at large spatial scale.

    PubMed

    De Gisi, Sabino; Sabia, Gianpaolo; Casella, Patrizia; Farina, Roberto

    2015-08-01

    WISE, the Water Information System for Europe, is the web-portal of the European Commission (EU) that disseminates the quality state of the receiving water bodies and the efficiency of the municipal wastewater treatment plants (WWTPs) in order to monitor advances in the application of both the Water Framework Directive (WFD) as well as the Urban Wastewater Treatment Directive (UWWTD). With the intention to develop WISE applications, the aim of the work was to define and apply an integrated approach capable of monitoring the efficiency and investments of activated sludge-based WWTPs located in a large spatial area, providing the following outcomes useful to the decision-makers: (i) the identification of critical facilities and their critical processes by means of a Performance Assessment System (PAS), (ii) the choice of the most suitable upgrading actions, through a scenario analysis. (iii) the assessment of the investment costs to upgrade the critical WWTPs and (iv) the prioritization of the critical facilities by means of a multi-criteria approach which includes the stakeholders involvement, along with the integration of some technical, environmental, economic and health aspects. The implementation of the proposed approach to a high number of municipal WWTPs highlighted how the PAS developed was able to identify critical processes with a particular effectiveness in identifying the critical nutrient removal ones. In addition, a simplified approach that considers the cost related to a basic-configuration and those for the WWTP integration, allowed to link the critical processes identified and the investment costs. Finally, the questionnaire for the acquisition of data such as that provided by the Italian Institute of Statistics, the PAS defined and the database on the costs, if properly adapted, may allow for the extension of the integrated approach on an EU-scale by providing useful information to water utilities as well as institutions.

  12. Antiretroviral Treatment with Efavirenz Disrupts the Blood-Brain Barrier Integrity and Increases Stroke Severity

    PubMed Central

    Bertrand, Luc; Dygert, Levi; Toborek, Michal

    2016-01-01

    The introduction of antiretroviral drugs (ARVd) changed the prognosis of HIV infection from a deadly disease to a chronic disease. However, even with undetectable viral loads, patients still develop a wide range of pathologies, including cerebrovascular complications and stroke. It is hypothesized that toxic side effects of ARVd may contribute to these effects. To address this notion, we evaluated the impact of several non-nucleoside reverse transcriptase inhibitors (NNRTI; Efavirenz, Etravirine, Rilpivirine and Nevirapine) on the integrity of the blood-brain barrier, and their impact on severity of stroke. Among studied drugs, Efavirenz, but not other NNRTIs, altered claudin-5 expression, increased endothelial permeability, and disrupted the blood-brain barrier integrity. Importantly, Efavirenz exposure increased the severity of stroke in a model of middle cerebral artery occlusion in mice. Taken together, these results indicate that selected ARVd can exacerbate HIV-associated cerebrovascular pathology. Therefore, careful consideration should be taken when choosing an anti-retroviral therapy regimen. PMID:28008980

  13. Modulating Wnt Signaling Pathway to Enhance Allograft Integration in Orthopedic Trauma Treatment

    DTIC Science & Technology

    2014-04-01

    DKK1 with monoclonal antibodies will enhance allograft integration to the host bone. The proposed work in this project was designed to test this...of modulating the LRP-5/Wnt pathway with anti- Dkk1 monoclonal antibody on allograft incorporation in a rat segmental repair model using radiographical...Frozen and Freeze-Dried allografts at 4, 8 and 12 week time points for saline, anti- Sost and anti- Dkk1 using µCT scanning. Data is presented below

  14. [Integration without equalization: on necessary modifications of therapeutic strategies in the treatment of migrants].

    PubMed

    Behrens, Katharina; Calliess, Iris Tatjana

    2008-12-01

    Given an increased knowledge for the special requirements of patients with a history of migration in mental health care, different approaches varying between an adaptation of existing systems and the implementation of specialized institutions are being discussed. The present study investigates the treatment courses of 55 first generation immigrants and a control sample of 55 native patients treated in a psychiatric day clinic of a university clinic. Besides the application of questionnaires concerning treatment outcome, a detailed content analysis of treatment records was performed investigating the preference for different therapeutic approaches, migration- and culture-related aspects as well as language problems. Treatment outcome and the reactions to different therapeutic strategies (i. e., verbal-oriented vs. body-centered approaches) suggest a good fit of a common treatment concept also for patients from different countries of origin and ethnic backgrounds. Qualitative analyses, however, imply that migration biography and cultural diversity should be included in diagnostic and therapeutic considerations to a much bigger extent. Language problems, in contrast, appeared to be less salient in the present study.

  15. Energy performance of an integrated bio-and-thermal hybrid system for lignocellulosic biomass waste treatment.

    PubMed

    Kan, Xiang; Yao, Zhiyi; Zhang, Jingxin; Tong, Yen Wah; Yang, Wenming; Dai, Yanjun; Wang, Chi-Hwa

    2017-03-01

    Lignocellulosic biomass waste, a heterogeneous complex of biodegradables and non-biodegradables, accounts for large proportion of municipal solid waste. Due to limitation of single-stage treatment, a two-stage hybrid AD-gasification system was proposed in this work, in which AD acted as pre-treatment to convert biodegradables into biogas followed by gasification converting solid residue into syngas. Energy performance of single and two-stage systems treating 3 typical lignocellulosic wastes was studied using both experimental and numerical methods. In comparison with conventional single-stage gasification treatment, this hybrid system could significantly improve the quality of produced gas for all selected biomass wastes and show its potential in enhancing total gas energy production by a maximum value of 27% for brewer's spent grain treatment at an organic loading rate (OLR) of 3gVS/L/day. The maximum overall efficiency of the hybrid system for horticultural waste treatment was 75.2% at OLR of 11.3gVS/L/day, 5.5% higher than conventional single-stage system.

  16. Prescription drug monitoring program data tracking of opioid addiction treatment outcomes in integrated dual diagnosis care involving injectable naltrexone

    PubMed Central

    Sajid, Ayesha; Whiteman, Aaron; Bell, Richard L.; Greene, Marion S.; Engleman, Eric A.

    2016-01-01

    Background and Objectives Fourfold increases in opioid prescribing and dispensations over 2 decades in the U.S. has paralleled increases in opioid addictions and overdoses, requiring new preventative, diagnostic, and treatment strategies. This study examines Prescription Drug Monitoring Program (PDMP) tracking as a novel measure of opioid addiction treatment outcomes in a university‐affiliated integrated mental health‐addiction treatment clinic. Methods Repeated measure parametrics examined PDMP and urine drug screening (UDS) data before and after first injection for all patients (N = 68) who received at least one long‐acting naltrexone injection (380 mg/IM) according to diagnostic groupings of having either (i) alcohol (control); (ii) opioid; or (iii) combined alcohol and opioid use disorders. Results There were no group differences post‐injection in treatment days, injections delivered, or treatment service encounters. UDS and PDMP measures of opioid exposures were greater in opioid compared to alcohol‐only patients. Post‐first injection, UDS's positive for opioids declined (p < .05) along with PDMP measures of opioid prescriptions (p < .001), doses (p < .01), types (p < .001), numbers of dispensing prescribers (p < .001) and pharmacies (p < .001). Opioid patients without alcohol disorders showed the best outcomes with 50% to 80% reductions in PDMP‐measures of opioids, down to levels of alcohol‐only patients. Conclusions This study shows PDMP utility for measuring opioid addiction treatment outcomes, supporting the routine use of PDMPs in clinical and research settings. Scientific Significance These findings demonstrate that opioid addiction in patients with complex addictions and mental illnesses comorbidities can show effective treatment responses as measured by PDMP tracking of decreases in opioid prescriptions to those patients. (Am J Addict 2016;25:557–564) PMID:27647699

  17. An integrated in vitro and in vivo high throughput screen identifies treatment leads for ependymoma

    PubMed Central

    Atkinson, Jennifer M.; Shelat, Anang A.; Carcaboso, Angel Montero; Kranenburg, Tanya A.; Arnold, Alexander; Boulos, Nidal; Wright, Karen; Johnson, Robert A.; Poppleton, Helen; Mohankumar, Kumarasamypet M.; Feau, Clementine; Phoenix, Timothy; Gibson, Paul; Zhu, Liqin; Tong, Yiai; Eden, Chris; Ellison, David W.; Priebe, Waldemar; Koul, Dimpy; Yung, W. K. Alfred; Gajjar, Amar; Stewart, Clinton F.; Guy, R. Kip; Gilbertson, Richard J.

    2011-01-01

    Summary Using a mouse model of ependymoma—a chemoresistant brain tumor—we combined multi-cell high-throughput screening (HTS), kinome-wide binding assays, and in vivo efficacy studies, to identify potential treatments with predicted toxicity against neural stem cells (NSC). We identified kinases within the insulin signaling pathway and centrosome cycle as regulators of ependymoma cell proliferation, and their corresponding inhibitors as potential therapies. FDA approved drugs not currently used to treat ependymoma were also identified that posses selective toxicity against ependymoma cells relative to normal NSCs both in vitro and in vivo e.g., 5-fluoruracil. Our comprehensive approach advances understanding of the biology and treatment of ependymoma including the discovery of several treatment leads for immediate clinical translation. PMID:21907928

  18. Alternative and Integrative Medicine

    MedlinePlus

    ... Alternative & Integrative Medicine Clinical Trials GBM AGILE TTFields – Optune™ Brain Tumor Treatment Locations Treatment Side Effects & their ... Alternative & Integrative Medicine Clinical Trials GBM AGILE TTFields – Optune™ Brain Tumor Treatment Locations Treatment Side Effects & their ...

  19. An integrated analysis of the efficacy and safety of desvenlafaxine in the treatment of major depressive disorder.

    PubMed

    Carrasco, José L; Kornstein, Susan G; McIntyre, Roger S; Fayyad, Rana; Prieto, Rita; Salas, Maribel; Mackell, Joan; Boucher, Matthieu

    2016-05-01

    The chronic course of major depressive disorder (MDD) often impedes the ability of patients to achieve full remission. Return of full functioning is a critical goal of antidepressant pharmacotherapy as the presence of residual depressive symptoms is associated with an increased risk of relapse. Treatment guidelines recommend selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, or atypical antidepressants as first-line treatment for moderate to severe MDD. Desvenlafaxine, administered as desvenlafaxine succinate, is an serotonin-norepinephrine reuptake inhibitor approved for the treatment of adults with MDD at the recommended dose of 50 mg/day. The aim of this integrated analysis was to assess the efficacy and safety of desvenlafaxine 50 and 100 mg/day compared with placebo in adult outpatients with MDD. The analysis used data from nine fixed-dose, short-term, placebo-controlled studies in adult outpatients diagnosed with MDD who had depressive symptoms for at least 30 days. Data from 4279 and 4317 patients were pooled for the efficacy and safety analyses, respectively. Statistically significant improvements were observed with desvenlafaxine 50 and 100 mg/day versus placebo for all efficacy endpoints assessed, including improvements in depressive symptoms, response and remission rates, as well as functional and cognitive outcomes. Treatment with desvenlafaxine 50 and 100 mg/day was generally safe and well tolerated. The findings of this integrated analysis of data from a large population of patients with MDD confirmed the antidepressant efficacy of both desvenlafaxine doses and add to previous evidence supporting the efficacy of desvenlafaxine.

  20. Size does matter: an integrative in vivo-in silico approach for the treatment of critical size bone defects.

    PubMed

    Carlier, Aurélie; van Gastel, Nick; Geris, Liesbet; Carmeliet, Geert; Van Oosterwyck, Hans

    2014-11-01

    Although bone has a unique restorative capacity, i.e., it has the potential to heal scarlessly, the conditions for spontaneous bone healing are not always present, leading to a delayed union or a non-union. In this work, we use an integrative in vivo-in silico approach to investigate the occurrence of non-unions, as well as to design possible treatment strategies thereof. The gap size of the domain geometry of a previously published mathematical model was enlarged in order to study the complex interplay of blood vessel formation, oxygen supply, growth factors and cell proliferation on the final healing outcome in large bone defects. The multiscale oxygen model was not only able to capture the essential aspects of in vivo non-unions, it also assisted in understanding the underlying mechanisms of action, i.e., the delayed vascularization of the central callus region resulted in harsh hypoxic conditions, cell death and finally disrupted bone healing. Inspired by the importance of a timely vascularization, as well as by the limited biological potential of the fracture hematoma, the influence of the host environment on the bone healing process in critical size defects was explored further. Moreover, dependent on the host environment, several treatment strategies were designed and tested for effectiveness. A qualitative correspondence between the predicted outcomes of certain treatment strategies and experimental observations was obtained, clearly illustrating the model's potential. In conclusion, the results of this study demonstrate that due to the complex non-linear dynamics of blood vessel formation, oxygen supply, growth factor production and cell proliferation and the interactions thereof with the host environment, an integrative in silico-in vivo approach is a crucial tool to further unravel the occurrence and treatments of challenging critical sized bone defects.

  1. Performance Improvement in Behavioral Health Care: Collateral Effects of Planned Treatment Integrity Observations as an Applied Example of Schedule-Induced Responding

    ERIC Educational Resources Information Center

    Reed, Derek D.; Fienup, Daniel M.; Luiselli, James K.; Pace, Gary M.

    2010-01-01

    With rising interest in the role of treatment integrity on student outcomes, research has primarily focused on isolating the techniques and procedures necessary to improve staff's acquisition and maintenance of adequate levels of integrity. Despite increasing numbers of publications on this topic, there has been little discussion of the variables…

  2. Advances in Integrative Nanomedicine for Improving Infectious Disease Treatment in Public Health

    PubMed Central

    Bell, Iris R.; Schwartz, Gary E.; Boyer, Nancy N.; Koithan, Mary; Brooks, Audrey J.

    2012-01-01

    Introduction Infectious diseases present public health challenges worldwide. An emerging integrative approach to treating infectious diseases is using nanoparticle (NP) forms of traditional and alternative medicines. Advantages of nanomedicine delivery methods include better disease targeting, especially for intracellular pathogens, ability to cross membranes and enter cells, longer duration drug action, reduced side effects, and cost savings from lower doses. Methods We searched Pubmed articles in English with keywords related to nanoparticles and nanomedicine. Nanotechnology terms were also combined with keywords for drug delivery, infectious diseases, herbs, antioxidants, homeopathy, and adaptation. Results NPs are very small forms of material substances, measuring 1–100 nanometers along at least one dimension. Compared with bulk forms, NPs’ large ratio of surface-area-to-volume confers increased reactivity and adsorptive capacity, with unique electromagnetic, chemical, biological, and quantum properties. Nanotechnology uses natural botanical agents for green manufacturing of less toxic NPs. Discussion Nanoparticle herbs and nutriceuticals can treat infections via improved bioavailability and antiinflammatory, antioxidant, and immunomodulatory effects. Recent studies demonstrate that homeopathic medicines may contain source and/or silica nanoparticles because of their traditional manufacturing processes. Homeopathy, as a form of nanomedicine, has a promising history of treating epidemic infectious diseases, including malaria, leptospirosis and HIV/AIDS, in addition to acute upper respiratory infections. Adaptive changes in the host’s complex networks underlie effects. Conclusions Nanomedicine is integrative, blending modern technology with natural products to reduce toxicity and support immune function. Nanomedicine using traditional agents from alternative systems of medicine can facilitate progress in integrative public health approaches to infectious

  3. Experiential Education as an Integral Part of Day Treatment for Adjudicated Delinquent Youth.

    ERIC Educational Resources Information Center

    Gaus, Charles

    The role of experiential education is the focus of this paper describing the treatment program at De La Salle Vocational, a day vocational high school for adjudicated delinquent youth. The paper begins by discussing the characteristics and needs of the students and describing the Off-Campus Program, a 3-year research model designed to address the…

  4. Integrative Treatment in Persons with Intellectual Disability and Mental Health Problems

    ERIC Educational Resources Information Center

    Dosen, A.

    2007-01-01

    Background: Clinical experience has proven thus far that a monodisciplinary treatment approach to behavioural and psychiatric problems in persons with intellectual disability (ID), such as psychotropic medication or behaviour modification programmes, has yielded limited success. It is clear that the complexity of behavioural and psychiatric…

  5. Integrated and Holistic Treatment Approach to PTSD and SUD: A Synergy

    ERIC Educational Resources Information Center

    Weis, Melanie

    2010-01-01

    Individuals living with posttraumatic stress disorder (PTSD) and addiction experience a complex and dynamic interaction of symptoms from both diagnoses. However, heretofore, each diagnosis has been approached as if it were a separate treatment consideration. Therefore, an individual may be treated for either a substance use disorder (SUD) or PTSD,…

  6. Treatment of Childhood and Adolescent Obesity: An Integrative Review of Recent Recommendations from Five Expert Groups

    ERIC Educational Resources Information Center

    Kirschenbaum, Daniel S.; Gierut, Kristen

    2013-01-01

    Objective: To compare and contrast 5 sets of expert recommendations about the treatment of childhood and adolescent obesity. Method: We reviewed 5 sets of recent expert recommendations: 2007 health care organizations' four stage model, 2007 Canadian clinical practice guidelines, 2008 Endocrine Society recommendations, 2009 seven step model, and…

  7. Integrated chemical and toxicological investigation of UV-chlorine/chloramine drinking water treatment.

    PubMed

    Lyon, Bonnie A; Milsk, Rebecca Y; DeAngelo, Anthony B; Simmons, Jane Ellen; Moyer, Mary P; Weinberg, Howard S

    2014-06-17

    As the use of alternative drinking water treatment increases, it is important to understand potential public health implications associated with these processes. The objective of this study was to evaluate the formation of disinfection byproducts (DBPs) and cytotoxicity of natural organic matter (NOM) concentrates treated with chlorine, chloramine, and medium pressure ultraviolet (UV) irradiation followed by chlorine or chloramine, with and without nitrate or iodide spiking. The use of concentrated NOM conserved volatile DBPs and allowed for direct analysis of the treated water. Treatment with UV prior to chlorine in ambient (unspiked) samples did not affect cytotoxicity as measured using an in vitro normal human colon cell (NCM460) assay, compared to chlorination alone when toxicity is expressed on the basis of dissolved organic carbon (DOC). Nitrate-spiked UV+chlorine treatment produced greater cytotoxicity than nitrate-spiked chlorine alone or ambient UV+chlorine samples, on both a DOC and total organic halogen basis. Samples treated with UV+chloramine were more cytotoxic than those treated with only chloramine using either dose metric. This study demonstrated the combination of cytotoxicity and DBP measurements for process evaluation in drinking water treatment. The results highlight the importance of dose metric when considering the relative toxicity of complex DBP mixtures formed under different disinfection scenarios.

  8. The Substance Abuse Treatment Needs of Prisoners: Implementation of an Integrated Statewide Approach

    ERIC Educational Resources Information Center

    Kubiak, Sheryl Pimlott; Boyd, Carol J.; Slayden, Janie; Young, Amy

    2005-01-01

    Studies have demonstrated that treatment for drug-involved offenders can reduce relapse and recidivism. However, few institutions utilize validated assessments of drug dependence, limiting the ability to determine and prioritize services. Toward this goal, we explain an assessment method implemented statewide using a sample of 22,069 prisoners.…

  9. Policy Issues for Integrating Parenting Interventions and Addiction Treatment for Women.

    ERIC Educational Resources Information Center

    VanBremen, Jane R.; Chasnoff, Ira J.

    1994-01-01

    This article addresses the rationale for linking addiction treatment programs and parenting education interventions in substance-abusing families. Specific components of a parenting program for women in recovery are detailed, including parenting classes and support groups, mother-child play groups, and family literacy activities. Program…

  10. Production integrated treatment of textile wastewater by closing raw material cycles.

    PubMed

    Krull, R

    2005-01-01

    A method for the in-house treatment of partial wastewater flows and the recycling of treated process water into the textile finishing process was developed in order to recycle effluents from textile finishing industry and feed them back into the production process. The method is based on a two-stage biological anaerobic-aerobic process to split colouring wastewater agents and to degrade organic substances contained in the water as well as a chemical stage to remove the remaining color of the water with the help of ozone. In the framework of a research and development project a demonstration plant for a treatment capacity of 1440 m3 per working day was installed and started in a textile finishing company. At the plant, a wastewater flow and a recycling flow are treated separately in two different treatment lanes. Approximately 40% of the total wastewater flows, i.e. 576 m3/d are treated in the wastewater lane, and a maximum of 60% of total wastewater, i.e. 864 m3/d are treated in the recycling lane. Thanks to the preliminary treatment of wastewater flows, which are discharged into the municipal sewage works, a reduction of average COD levels in the sewage works effluents could be achieved.

  11. Evaluation of Family Impairment Following an Integrative Treatment Program for Children with Autism

    ERIC Educational Resources Information Center

    Lambert, Ashley Nehrt

    2012-01-01

    Research has shown that behaviors associated with Autism Spectrum Disorder (ASD) are a consistent source of stress on the family unit. Given the increased amount of stress that families endure and the importance of the family unit to the child with ASD, treatment programs should not only take the child with ASD's needs into account, but also the…

  12. High level nuclear waste treatment in the Defense Waste Processing Facility: Overview and integrated flowsheet model

    SciTech Connect

    Choi, A.S.; Fowler, J.R.; Edwards, R.E. Jr.; Randall, C.T.

    1991-01-01

    Design and construction of the world's largest vitrification facility for high level nuclear waste has been nearly completed at the US Department of Energy's Savannah River Site. Equipment testing and calibration are currently being performed in preparation for the nonradioactive Chemical Runs in the late 1991. In 1993, the Defense Waste Processing Facility (DWPF) will begin producing 100 kg/hr of radioactive waste glass at 28 wt% waste oxide loading. This paper describes all phases of waste processing operations in DWPF and waste tank farms using the integrated flowsheet modeling approach. Particular emphases are given to recent developments in the DWPF processes and design.

  13. High level nuclear waste treatment in the Defense Waste Processing Facility: Overview and integrated flowsheet model

    SciTech Connect

    Choi, A.S.; Fowler, J.R.; Edwards, R.E. Jr.; Randall, C.T.

    1991-12-31

    Design and construction of the world`s largest vitrification facility for high level nuclear waste has been nearly completed at the US Department of Energy`s Savannah River Site. Equipment testing and calibration are currently being performed in preparation for the nonradioactive Chemical Runs in the late 1991. In 1993, the Defense Waste Processing Facility (DWPF) will begin producing 100 kg/hr of radioactive waste glass at 28 wt% waste oxide loading. This paper describes all phases of waste processing operations in DWPF and waste tank farms using the integrated flowsheet modeling approach. Particular emphases are given to recent developments in the DWPF processes and design.

  14. Modulating Wnt Signaling Pathway to Enhance Allograft Integration in Orthopedic Trauma Treatment

    DTIC Science & Technology

    2013-10-01

    inhibitors Sost or DKK1 with monoclonal antibodies will enhance allograft integration to the host bone. The proposed work in this project was designed...Determine the effect of modulating the LRP-5/Wnt pathway with anti- Dkk1 monoclonal antibody on allograft incorporation in a rat segmental repair model using...bones from Fresh Frozen and Freeze-Dried allografts at 4, 8 and 12 week time points for saline, anti- Sost and anti- Dkk1 using µCT scanning. Data is

  15. Integrated chemical/biological treatment of paint stripper mixed waste: Metals toxicity and separation

    SciTech Connect

    Vanderberg-Twary, L.; Grumbine, R.K.; Foreman, T.; Hanners, J.L.; Brainard, J.R.; Sauer, N.N.; Unkefer, P.J.

    1995-05-01

    The DOE complex has generated vast quantities of complex heterogeneous mixed wastes. Paint stripper waste (PSW) is a complex waste that arose from decontamination and decommissioning activities. It contains paint stripper, cheesecloth, cellulose-based paints with Pb and Cr, and suspect Pu. Los Alamos National Laboratory has 150--200 barrels of PSW and other national laboratories such as Rocky Flats Plant have many more barrels of heterogeneous waste. Few technologies exist that can treat this complex waste. Our approach to solving this problem is the integration of two established technologies: biodegradation and metals chelation.

  16. Neuromodulation integrating rTMS and neurofeedback for the treatment of autism spectrum disorder: An exploratory study

    PubMed Central

    Sokhadze, Estate M.; El-Baz, Ayman S.; Tasman, Allan; Sears, Lonnie L.; Wang, Yao; Lamina, Eva V.; Casanova, Manuel F.

    2014-01-01

    Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by deficits in social interaction, language, stereotyped behaviors, and restricted range of interests. In previous studies low frequency repetitive transcranial magnetic stimulation (rTMS) has been used, with positive behavioral and electrophysiological results, for the experimental treatment in ASD. In this study we combined prefrontal rTMS sessions with electroencephalographic (EEG) neurofeedback (NFB) to prolong and reinforce TMS-induced EEG changes. The pilot trial recruited 42 children with ASD (~14.5 yrs). Outcome measures included behavioral evaluations and reaction time test with event-related potential (ERP) recording. For the main goal of this exploratory study we used rTMS-neurofeedback combination (TMS-NFB, N=20) and waitlist (WTL, N=22) groups to examine effects of 18 sessions of integrated rTMS-NFB treatment or wait period) on behavioral responses, stimulus and response-locked ERPs, and other functional and clinical outcomes. The underlying hypothesis was that combined TMS-NFB will improve executive functions in autistic patients as compared to the waitlist group. Behavioral and ERP outcomes were collected in pre- and post-treatment tests in both groups. Results of the study supported our hypothesis by demonstration of positive effects of combined TMS-NFB neurotherapy in active treatment group as compared to control waitlist group, as the TMS-NFB group showed significant improvements in behavioral and functional outcomes as compared to the waitlist group. PMID:25267414

  17. Integrated photochemical and biological treatment of a commercial textile surfactant: process optimization, process kinetics and COD fractionation.

    PubMed

    Arslan-Alaton, Idil; Cokgor, Emine Ubay; Koban, Baris

    2007-07-31

    The biodegradability of surfactants is a frequent and complex issue arising both at domestic as well as industrial treatment facilities. In the present experimental study, the integrated photochemical (H(2)O(2)/UV-C) and biochemical (activated sludge) treatment of a commercial grade nonionic/anionic textile surfactant formulation was investigated. Photochemical baseline experiments have shown that once the initial pH and H(2)O(2) dose were optimized, practically complete COD removal (COD(o)=500+/-30mgL(-1)) could be achieved. Once the COD was elevated to values being typical for the textile fabric preparation stage, treatment efficiency was seriously retarded provided that the photochemical treatment conditions remained constant. Moreover, a definite relationship existed between H(2)O(2) consumption and COD removal for H(2)O(2)/UV-C advanced oxidation of the textile surfactant. In the second part of the study, COD abatement was modeled for the biodegradation of untreated and photochemically pretreated textile surfactant formulation according to their COD fractions. Results have indicated that the readily biodegradable and rapidly hydrolysable COD fractions of the textile surfactant solution could be appreciably increased upon exposure to an optimum H(2)O(2) concentration (60mM; i.e. 2.1g H(2)O(2) (g COD(o))(-1)) and extended UV-C irradiation times (i.e. 90 and 120min).

  18. Integrated bicarbonate-form ion exchange treatment and regeneration for DOC removal: Model development and pilot plant study.

    PubMed

    Hu, Yue; Boyer, Treavor H

    2017-05-15

    The application of bicarbonate-form anion exchange resin and sodium bicarbonate salt for resin regeneration was investigated in this research is to reduce chloride ion release during treatment and the disposal burden of sodium chloride regeneration solution when using traditional chloride-form ion exchange (IX). The target contaminant in this research was dissolved organic carbon (DOC). The performance evaluation was conducted in a completely mixed flow reactor (CMFR) IX configuration. A process model that integrated treatment and regeneration was investigated based on the characteristics of configuration. The kinetic and equilibrium experiments were performed to obtain required parameters for the process model. The pilot plant tests were conducted to validate the model as well as provide practical understanding on operation. The DOC concentration predicted by the process model responded to the change of salt concentration in the solution, and showed a good agreement with pilot plant data with less than 10% difference in terms of percentage removal. Both model predictions and pilot plant tests showed over 60% DOC removal by bicarbonate-form resin for treatment and sodium bicarbonate for regeneration, which was comparable to chloride-form resin for treatment and sodium chloride for regeneration. Lastly, the DOC removal was improved by using higher salt concentration for regeneration.

  19. Neuromodulation integrating rTMS and neurofeedback for the treatment of autism spectrum disorder: an exploratory study.

    PubMed

    Sokhadze, Estate M; El-Baz, Ayman S; Tasman, Allan; Sears, Lonnie L; Wang, Yao; Lamina, Eva V; Casanova, Manuel F

    2014-12-01

    Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by deficits in social interaction, language, stereotyped behaviors, and restricted range of interests. In previous studies low frequency repetitive transcranial magnetic stimulation (rTMS) has been used, with positive behavioral and electrophysiological results, for the experimental treatment in ASD. In this study we combined prefrontal rTMS sessions with electroencephalographic (EEG) neurofeedback (NFB) to prolong and reinforce TMS-induced EEG changes. The pilot trial recruited 42 children with ASD (~14.5 years). Outcome measures included behavioral evaluations and reaction time test with event-related potential (ERP) recording. For the main goal of this exploratory study we used rTMS-neurofeedback combination (TMS-NFB, N = 20) and waitlist (WTL, N = 22) groups to examine effects of 18 sessions of integrated rTMS-NFB treatment or wait period) on behavioral responses, stimulus and response-locked ERPs, and other functional and clinical outcomes. The underlying hypothesis was that combined TMS-NFB will improve executive functions in autistic patients as compared to the WTL group. Behavioral and ERP outcomes were collected in pre- and post-treatment tests in both groups. Results of the study supported our hypothesis by demonstration of positive effects of combined TMS-NFB neurotherapy in active treatment group as compared to control WTL group, as the TMS-NFB group showed significant improvements in behavioral and functional outcomes as compared to the WTL group.

  20. Bioelectrochemical treatment of paper and pulp wastewater in comparison with anaerobic process: integrating chemical coagulation with simultaneous power production.

    PubMed

    Krishna, K Vamshi; Sarkar, Omprakash; Venkata Mohan, S

    2014-12-01

    The efficiency of a bioelectrochemical treatment system (BET) to treat complex paper and pulp wastewater at two different pH conditions (6 and 7) in comparison with conventional anaerobic treatment process (AnT) was evaluated. Among the operating conditions, BET showed good treatment efficiency at pH 7 in terms of COD (BET/AnT: 55%/51%), nitrates (33.5%/19.1%), phosphates (33%/19%) and sulfates (58%/41%) in removal. The effluent obtained from BET system was subjected to coagulation for further treatment which showed good COD removal (BET/AnT, 95%/69%) and color (100%/68%). Bioelectrochemical analysis revealed higher catalytic currents in BET than AnT specific to oxidation and reduction. Besides, derivative of cyclic voltammetric scans (DCV) also supported the involvement of various membrane bound electron transferring complexes like FAD(H) bound enzymes, ubiquinone, NADH(+)/H(+) bound enzymes, etc. Experimental results demonstrated that BET system can be a viable platform to treat complex wastewaters with simultaneous energy recovery in integrated approach.

  1. Environmental and economic assessment of integrated systems for dairy manure treatment coupled with algae bioenergy production.

    PubMed

    Zhang, Yongli; White, Mark A; Colosi, Lisa M

    2013-02-01

    Life cycle assessment (LCA) and life cycle costing (LCC) are used to investigate integrated algae bioenergy production and nutrient management on small dairy farms. Four cases are considered: a reference land-application scenario (REF), anaerobic digestion with land-application of liquid digestate (AD), and anaerobic digestion with recycling of liquid digestate to either an open-pond algae cultivation system (OPS) or an algae turf scrubber (ATS). LCA indicates that all three "improved" scenarios (AD, OPS, and ATS) are environmentally favorable compared to REF, exhibiting increases in net energy output up to 854GJ/yr, reductions in net eutrophication potential up to 2700kg PO(4)-eq/yr, and reductions in global warming potential up to 196Mg CO(2)-eq/yr. LCC reveals that the integrated algae systems are much more financially attractive than either AD or REF, whereby net present values (NPV) are as follows: $853,250 for OPS, $790,280 for ATS, -$62,279 for REF, and -$211,126 for AD. However, these results are highly dependent on the sale price for nutrient credits. Comparison of LCA and LCC results indicates that robust nutrient credit markets or other policy tools are required to align financial and environmental preferability of energy production systems and foster widespread adoption of sustainable nutrient management systems.

  2. Integration of STI and HIV prevention, care, and treatment into family planning services: a review of the literature.

    PubMed

    Church, Kathryn; Mayhew, Susannah H

    2009-09-01

    The last comprehensive literature review to examine the effectiveness of family planning (FP) services in delivering STI and HIV prevention and care was published in 2000. This review updates that report by examining evidence of the impact of integrating any component of STI or HIV prevention, care, and treatment into a family planning setting in developing countries. Forty-four reports were identified from a comprehensive search of published databases and "grey literature". The weight of evidence demonstrates that integrated services can have a positive impact on client satisfaction, improve access to component services, and reduce clinic-based HIV-related stigma, and that they are cost-effective. Evidence of FP services reaching men and adolescents and of their impact on health outcomes is inconclusive. Several studies found that providers frequently miss opportunities to integrate care and that the capacity to maintain the quality of care is also influenced by many programmatic challenges. The range of experiences indicates that managers need to determine appropriate health-care service-delivery models based on a consideration of epidemiological, structural, and health-systems factors.

  3. Nanotechnology for a safe and sustainable water supply: enabling integrated water treatment and reuse.

    PubMed

    Qu, Xiaolei; Brame, Jonathon; Li, Qilin; Alvarez, Pedro J J

    2013-03-19

    Ensuring reliable access to clean and affordable water is one of the greatest global challenges of this century. As the world's population increases, water pollution becomes more complex and difficult to remove, and global climate change threatens to exacerbate water scarcity in many areas, the magnitude of this challenge is rapidly increasing. Wastewater reuse is becoming a common necessity, even as a source of potable water, but our separate wastewater collection and water supply systems are not designed to accommodate this pressing need. Furthermore, the aging centralized water and wastewater infrastructure in the developed world faces growing demands to produce higher quality water using less energy and with lower treatment costs. In addition, it is impractical to establish such massive systems in developing regions that currently lack water and wastewater infrastructure. These challenges underscore the need for technological innovation to transform the way we treat, distribute, use, and reuse water toward a distributed, differential water treatment and reuse paradigm (i.e., treat water and wastewater locally only to the required level dictated by the intended use). Nanotechnology offers opportunities to develop next-generation water supply systems. This Account reviews promising nanotechnology-enabled water treatment processes and provides a broad view on how they could transform our water supply and wastewater treatment systems. The extraordinary properties of nanomaterials, such as high surface area, photosensitivity, catalytic and antimicrobial activity, electrochemical, optical, and magnetic properties, and tunable pore size and surface chemistry, provide useful features for many applications. These applications include sensors for water quality monitoring, specialty adsorbents, solar disinfection/decontamination, and high performance membranes. More importantly, the modular, multifunctional and high-efficiency processes enabled by nanotechnology provide a

  4. Membrane-integrated physico-chemical treatment of coke-oven wastewater: transport modelling and economic evaluation.

    PubMed

    Kumar, Ramesh; Chakrabortty, Sankha; Pal, Parimal

    2015-04-01

    A modelling and simulation study with economic evaluation was carried out for an advanced membrane-integrated hybrid treatment process that ensures reuse of water with recovery of ammoniacal nitrogen as struvite from coke-oven wastewater. Linearized transport model was developed based on extended Nernst-Plank and concentration polarization modulus equation. Effects of pH, transmembrane pressure and cross-flow rate of interest on membrane charge density, solute rejection and solvent flux were investigated. The membrane module was successful in yielding a pure water flux as high as 120 L m(-2) h(-1) removing more than 95 and 96% of the cyanide and phenol, respectively, while permeating more than 90% NH4 (+)-N at a transmembrane pressure of only 15 × 10(2) KPa and at a pH of 10 for a volumetric cross-flow rate of 800 L h(-1). The Fenton's reagents were used to degrade more than 99% of pollutants present in the concentrated stream. The developed model could successfully predict the plant performance as reflected in the very low relative error (0.01-0.12) and overall high correlation coefficient (R(2) > 0.96). Economic analysis indicated that such a membrane-integrated hybrid system could be quite promising in coke wastewater treatment at low cost i.e. $0.934/m(2) of wastewater.

  5. Integral approaches to wastewater treatment plant upgrading for odor prevention: Activated Sludge and Oxidized Ammonium Recycling.

    PubMed

    Estrada, José M; Kraakman, N J R; Lebrero, R; Muñoz, R

    2015-11-01

    Traditional physical/chemical end-of-the-pipe technologies for odor abatement are relatively expensive and present high environmental impacts. On the other hand, biotechnologies have recently emerged as cost-effective and environmentally friendly alternatives but are still limited by their investment costs and land requirements. A more desirable approach to odor control is the prevention of odorant formation before being released to the atmosphere, but limited information is available beyond good design and operational practices of the wastewater treatment process. The present paper reviews two widely applicable and economic alternatives for odor control, Activated Sludge Recycling (ASR) and Oxidized Ammonium Recycling (OAR), by discussing their fundamentals, key operating parameters and experience from the available pilot and field studies. Both technologies present high application potential using readily available plant by-products with a minimum plant upgrading, and low investment and operating costs, contributing to the sustainability and economic efficiency of odor control at wastewater treatment facilities.

  6. Integration of Osteopathic Manual Treatments in Management of Cervical Dystonia with Tremor: A Case Series

    PubMed Central

    Halimi, Miriam; Leder, Adena; Mancini, Jayme D.

    2017-01-01

    Background Cervical dystonia, also known as spasmodic torticollis, is a chronic disorder in which patients exhibit involuntary repetitive contractions of neck muscles resulting in abnormal postures or movements. Occasionally, there is also a dystonic head tremor. The underlying mechanisms for cervical dystonia and dystonic tremor are not clear, and treatments are limited. Case Report In the present cases, two females with head tremor starting in adolescence developed worsening symptoms of cervical dystonia with dystonic tremor in their 60s. On osteopathic physical examination, both had a vertical type strain to the sphenobasilar synchondrosis. Discussion Vertical strains are more frequently found in patients after head trauma, congenital or later in life, than in healthy patients, and head trauma may have been a precipitating factor in these patients. There were improvements in cervical dystonia symptoms, including tremor, in both patients after osteopathic manual treatment. PMID:28119789

  7. AlgaeSim: a model for integrated algal biofuel production and wastewater treatment.

    PubMed

    Drexler, Ivy L C; Joustra, Caryssa; Prieto, Ana; Bair, Robert; Yeh, Daniel H

    2014-02-01

    AlgaeSim, a dynamic multiple-systems (C, N, P) mass balance model, was developed to explore the potential for algae biomass production from wastewater by coupling two photobioreactors into the main treatment train at a municipal wastewater resource recovery facility (WRRF) in Tampa, Florida. The scoping model examined the synergy between algae cultivation and wastewater treatment through algal growth and substrate removal kinetics, as well as through macroeconomic analyses of biomass conversion to bioproducts. Sensitivity analyses showed that biomass production is strongly dependent on Monod variables and harvesting regime, with sensitivity changing with growth phase. Profitability was sensitive to processing costs and market prices of products. Under scenarios based on current market conditions and typical algae production, AlgaeSim shows that a WRRF can potentially generate significant profit if algae are processed for biodiesel, biogas, or fertilizer. Wastewater resource recovery facilities could similarly save on operating costs resulting from the reduction in aeration (for nitrification) and chemicals (for denitrification).

  8. Integration of aerobic granular sludge and mesh filter membrane bioreactor for cost-effective wastewater treatment.

    PubMed

    Li, Wen-Wei; Wang, Yun-Kun; Sheng, Guo-Ping; Gui, Yong-Xin; Yu, Lei; Xie, Tong-Qing; Yu, Han-Qing

    2012-10-01

    Conventional MBR has been mostly based on floc sludge and the use of costly microfiltration membranes. Here, a novel aerobic granule (AG)-mesh filter MBR (MMBR) process was developed for cost-effective wastewater treatment. During 32-day continuous operation, a predominance of granules was maintained in the system, and good filtration performance was achieved at a low trans-membrane pressure (TMP) of below 0.025 m. The granules showed a lower fouling propensity than sludge flocs, attributed to the formation of more porous biocake layer at mesh surface. A low-flux and low-TMP filtration favored a stable system operation. In addition, the reactor had high pollutant removal efficiencies, with a 91.4% chemical oxygen demand removal, 95.7% NH(4)(+) removal, and a low effluent turbidity of 4.1 NTU at the stable stage. This AG-MMBR process offers a promising technology for low-cost and efficient treatment of wastewaters.

  9. One System Integrated Project Team: Retrieval and Delivery of Hanford Tank Wastes for Vitrification in the Waste Treatment Plant - 13234

    SciTech Connect

    Harp, Benton J.; Kacich, Richard M.; Skwarek, Raymond J.

    2013-07-01

    The One System Integrated Project Team (IPT) was formed in late 2011 as a way for improving the efficiency of delivery and treatment of highly radioactive waste stored in underground tanks at the U.S. Department of Energy's (DOE's) 586-square-mile Hanford Site in southeastern Washington State. The purpose of the One System IPT is to improve coordination and integration between the Hanford's Waste Treatment Plant (WTP) contractor and the Tank Operations Contractor (TOC). The vision statement is: One System is a WTP and TOC safety-conscious team that, through integrated management and implementation of risk-informed decision and mission-based solutions, will enable the earliest start of safe and efficient treatment of Hanford's tank waste, to protect the Columbia River, environment and public. The IPT is a formal collaboration between Bechtel National, Inc. (BNI), which manages design and construction of the WTP for the U.S. Department of Energy's Office of River Protection (DOEORP), and Washington River Protection Solutions (WRPS), which manages the TOC for ORP. More than fifty-six (56) million gallons of highly radioactive liquid waste are stored in one hundred seventy-seven (177) aging, underground tanks. Most of Hanford's waste tanks - one hundred forty-nine (149) of them - are of an old single-shell tank (SST) design built between 1944 and 1964. More than sixty (60) of these tanks have leaked in the past, releasing an estimated one million gallons of waste into the soil and threatening the nearby Columbia River. There are another twenty-eight (28) new double-shelled tanks (DSTs), built from 1968 to 1986, that provide greater protection to the environment. In 1989, DOE, the U.S. Environmental Protection Agency (EPA), and the Washington State Department of Ecology (Ecology) signed a landmark agreement that required Hanford to comply with federal and state environmental standards. It also paved the way for agreements that set deadlines for retrieving the tank

  10. One System Integrated Project Team: Retrieval And Delivery Of The Hanford Tank Wastes For Vitrification In The Waste Treatment Plant

    SciTech Connect

    Harp, Benton J.; Kacich, Richard M.; Skwarek, Raymond J.

    2012-12-20

    The One System Integrated Project Team (IPT) was formed in late 2011 as a way for improving the efficiency of delivery and treatment of highly radioactive waste stored in underground tanks at the U.S. Department of Energy's (DOE's) 586-square-mile Hanford Site in southeastern Washington State. The purpose of the One System IPT is to improve coordination and integration between the Hanford's Waste Treatment Plant (WTP) contractor and the Tank Operations Contractor (TOC). The vision statement is: One System is a WTP and TOC safety conscious team that, through integrated management and implementation of risk-informed decision and mission-based solutions, will enable the earliest start of safe and efficient treatment of Hanford's tank waste, to protect the Columbia River, environment and public. The IPT is a formal collaboration between Bechtel National, Inc. (BNI), which manages design and construction of the WTP for the U.S. Department of Energy's Office of River Protection (DOEORP), and Washington River Protection Solutions (WRPS), which manages the TOC for ORP. More than fifty-six (56) million gallons of highly radioactive liquid waste are stored in one hundred seventy-seven (177) aging, underground tanks. Most of Hanford's waste tanks - one hundred forty-nine (149) of them - are of an old single-shell tank (SST) design built between 1944 and 1964. More than sixty (60) of these tanks have leaked in the past, releasing an estimated one million gallons of waste into the soil and threatening the nearby Columbia River. There are another twenty-eight (28) new double-shelled tanks (DSTs), built from 1968 to 1986, that provide greater protection to the environment. In 1989, DOE, the U.S. Environmental Protection Agency (EPA), and the Washington State Department of Ecology (Ecology) signed a landmark agreement that required Hanford to comply with federal and state environmental standards. It also paved the way for agreements that set deadlines for retrieving the tank

  11. Integrated treatment and handling of highly activated components from nuclear facilities

    SciTech Connect

    Schneider, K.A.; Kiolbassa, A.; Rose, K.A.; Raymont, J.M. Jr.

    1993-12-31

    A complete Underwater Treatment System (UTS) is described for activated/contaminated components of various origins in the nuclear industry. The system comprises different kinds of cutting/compacting equipment: the USC (Underwater Shear/compactor), the SCS (Stellite Corner Shear), the VLS (Velocity Limiter Shear) and the LCS (Light Crusher Shear). Transfer and loading equipment, the STB (Shielded Transfer Bell) provides safe and economic loading of containers with cut components. Operating experience and performance data are presented.

  12. The integrated melter off-gas treatment systems at the West Valley Demonstration Project

    SciTech Connect

    Vance, R.F.

    1991-12-01

    The West Valley Demonstration project was established by an act of Congress in 1980 to solidify the high level radioactive liquid wastes produced from operation of the Western New York Nuclear Services Center from 1966 to 1972. The waste will be solidified as borosilicate glass. This report describes the functions, the controlling design criteria, and the resulting design of the melter off-gas treatment systems.

  13. The Positive Impact of Integrative Medicine in the Treatment of Recalcitrant Chronic daily Headache: A Series of Case Reports

    PubMed Central

    Amoils, Sandi; Lester, Tiffany; Woolford, Liz; Gallagher, Lisa

    2014-01-01

    People who suffer from recalcitrant chronic daily headache (CDH)—a primary, episodic headache occurring at least 15 days per month, and lasting four or more hours per day for at least three consecutive months1—have generally tried many pain relief medications with few positive results. These patients often continue to add more and more medications and travel from clinician to clinician seeking help, without relief. Patients with recalcitrant CDH are often caught in a vicious cycle of increasing pain which results in a substantial impact from their disease on productivity and quality of life. Studies in the United States and Europe indicate that four to five percent of the general population has recalcitrant CDH,2 which encompasses transformed migraine and chronic tension-type headache.3 The disability associated with recalcitrant CDH is substantial, as patients have a significantly diminished quality of life and mental health, as well as impaired physical, social, and occupational functioning.4,5 Research shows that CDH may not be treated effectively with conventional medicine (CM). Integrative medicine (IM) offers a complex, personalized intervention necessary to treat CDH. Many integrative therapies have shown benefit, effectiveness, cost effectiveness and low side effect profile in patients with both chronic headache and chronic pain.6-17 Yet even within the IM community, clinicians often struggle with the balance between providing evidence-based therapy and patient-centered, complex, personalized integrative approaches, which may use popular but unproven therapies. In this article, we present a series of cases comprising patients with CDH who had previously been recalcitrant to CM approaches. In each case, employing a five-pronged treatment algorithm resulted in the successful IM treatment of CDH. By using this five-pronged approach, clinicians can offer the standardized protocols and scientific rationale they are accustomed to when employing CM options

  14. Biodegradation characteristics and size fractionation of landfill leachate for integrated membrane treatment.

    PubMed

    Insel, Güçlü; Dagdar, Mina; Dogruel, Serdar; Dizge, Nadir; Ubay Cokgor, Emine; Keskinler, Bülent

    2013-09-15

    The fate of organics and nitrogen during the biological treatment with MBR and subsequent membrane filtration processes (nano filtration, NF; reverse osmosis, RO) were investigated for a landfill leachate. The chemical oxygen demand (COD) and total Kjeldahl nitrogen (TKN) removal performances of membrane bioreactor (MBR) were obtained to be around 89% and 85%, respectively. The effluent COD of MBR was measured to be 1935 mg/L (30 kDa) which is much lower than experimentally determined soluble inert COD of 3200 mg/L using 0.45 μm filter. The readily and slowly biodegradable COD fractions were estimated to be 17% and 52% of raw influent COD, respectively. The respirometry based modeling test performed on raw leachate exhibited much slower degradation kinetics compared to municipal wastewater. A unique subset of model parameters was extracted from batch respirometry by using acclimated MBR sludge. The sequential ultrafiltration (UF) experiments (particle size distribution, PSD) revealed that most of the organics was below 2 nm filter mesh size. In addition, NF/RO post treatment after MBR system was required to increase COD and total nitrogen (TN) removal performances up to 99%. Relatively lower salt rejection rates around 94% was obtained for RO system as a post treatment of MBR system.

  15. Process Integrated Heat Treatment of a Microalloyed Medium Carbon Steel: Microstructure and Mechanical Properties

    NASA Astrophysics Data System (ADS)

    Herbst, Sebastian; Schledorn, Mareike; Maier, Hans Jürgen; Milenin, Andrij; Nürnberger, Florian

    2016-04-01

    Air-water spray cooling was employed during a heat treatment to enhance the mechanical properties of microalloyed medium carbon steel test cylinders (38MnVS6, 88 mm diameter). Using appropriate cooling times and intensities, the test cylinders' surfaces could be quenched and subsequently self-tempered by the residual heat of the core. Simultaneously, it was possible to keep the core regions of the cylinders in the bainitic regime and carry out a quasi-isothermal holding. The resulting microstructures consisted of tempered martensite (near-surface) and bainite with pearlite and ferrite (core). Compared to the standard heat treatment (controlled air cooling), the tensile properties (proof stress and ultimate tensile strength) could be improved for both near-surface and core regions with the adapted spray cooling. A hardness profile with 450 HV10 surface hardness and a hardening depth of more than 11 mm could be realized. In addition, an increase of the impact toughness for the core was achieved, resulting in approximately 25 J charpy impact energy. This is a substantial improvement compared to standard heat treatment procedure and values reported in the literature and can be attributed to the reduced pearlite volume fraction and the increased amount of fine bainite.

  16. [Cognitive behavioral treatment in the integral management of obesity in adolescents].

    PubMed

    Rodríguez-Morán, Martha; Mendoza-Ávila, Eduardo; Cumplido-Fuentes, Agustín; Simental-Mendía, Luis E; Rodríguez-Ramírez, Gabriela; Sánchez-Lazcano, Gloria Janeth; Ramírez-Bonilla, Paulina; Cumplido-González, Guadalupe; Ortiz-Martínez, Guadalupe; Pinedo-Rodríguez, Gustavo Alan; Meza-Villa, Ángel; Ortiz-Ramos, Alma Fátima; Puerta-Mota, Gerardo; Guerrero-Romero, Fernando

    2014-01-01

    INTRODUCTIÓN: la obesidad en niños y adolescentes y la morbilidad que se le asocia se han incrementado significativamente, lo cual se ha convertido en un problema de salud pública. El objetivo de este estudio fue evaluar la eficacia de la terapia cognitivo-conductual (TCC) en el manejo integral de la obesidad en adolescentes. MÉTODOS: estudio de intervención, aleatorio, doble ciego, controlado, de cuatro meses de seguimiento, al que se integraron 115 adolescentes obesos de 12 a 16 años de edad. El grupo de intervención recibió TCC como terapia coadyuvante, así como indicaciones de dieta y apoyo para el desarrollo de ejercicio. El grupo control solo recibió indicaciones de dieta y apoyo para el desarrollo de ejercicio.

  17. Advanced receiver autonomous integrity monitoring using triple frequency data with a focus on treatment of biases

    NASA Astrophysics Data System (ADS)

    El-Mowafy, Ahmed

    2017-04-01

    Most current Advanced Receiver Autonomous Integrity Monitoring (ARAIM) methods are designed to use dual-frequency ionosphere-free observations. These methods assume that receiver bias is absorbed in the common receiver clock offset and bound satellite biases by nominal values. However, most multi-constellation Global Navigation Satellite Systems (GNSS) can offer triple frequency data that can be used for civilian applications in the future, which can improve observation redundancy, solution precision and detection of faults. In this contribution, we explore the use of this type of observations from GPS, Galileo and BeiDou in ARAIM. Nevertheless, the use of triple frequency data introduces receiver differential biases that have to be taken into consideration. To demonstrate the significance of these additional biases we first present a method to quantify them at stations of known coordinates and using available products from the International GNSS service (IGS). To deal with the additional receiver biases, we use a between-satellite single difference (BSSD) observation model that eliminates their effect. A pilot test was performed to evaluate ARAIM availability for Localizer Performance with Vertical guidance down to 200 feet (LPV-200) when using the triple-frequency observations. Real data were collected for one month at stations of known coordinates located in regions of different satellite coverage characteristics. The BSSD triple-frequency model was evaluated to give early indication about its feasibility, where the implementation phase still requires further comprehensive studies. The vertical position error was always found to be bounded by the protection level proven initial validity of the proposed integrity model.

  18. An attenuation integral digital imaging technique for the treatment portal verification of conventional and intensity-modulated radiotherapy

    SciTech Connect

    Guan Huaiqun

    2010-07-15

    Purpose: To propose an attenuation integral digital imaging (AIDI) technique for the treatment portal verification of conventional and intensity-modulated radiotherapy (IMRT). Methods: In AIDI technique, an open in air fluence image I{sub o} and a patient fluence image I were acquired under the same exposure. Then after doing the dark field correction for both the I{sub o} and I, the AIDI image was simply calculated as log(I{sub o}/I), which is the attenuation integral along the ray path from the x-ray source to a detector pixel element. Theoretical analysis for the low contrast detection and the contrast to noise ratio (CNR) of AIDI was presented and compared to those for the fluence imaging. With AIDI, the variation of x-ray fluence and the variation of individual detector pixel's response can be automatically compensated without using the flood field correction. Results: The AIDI image for a contrast detail phantom demonstrated that it can efficiently suppress the background structures such as the couch and generate better visibility for low contrast objects with megavoltage x rays. The AIDI image acquired for a Catphan 500 phantom using a 60 deg. electronic dynamic wedge field also revealed more contrast disks than the fluence imaging did. Finally, AIDI for an IMRT field of a head/neck patient successfully displayed the anatomical structures underneath the treatment portal but not shown in fluence imaging. Conclusions: For IMRT and high degree wedge beams, direct imaging using them is difficult because their photon fluence is highly nonuniform. But AIDI can be used for the treatment portal verification of these beams.

  19. Prevention of hepatotoxicity due to anti tuberculosis treatment: A novel integrative approach

    PubMed Central

    Adhvaryu, Meghna R; Reddy, Narsimha M; Vakharia, Bhasker C

    2008-01-01

    AIM: To evaluate the ability of Curcuma longa (CL) and Tinospora cordifolia (TC) formulation to prevent anti-tuberculosis (TB) treatment (ATT) induced hepatotoxicity. METHODS: Patients with active TB diagnosis were randomized to a drug control group and a trial group on drugs plus an herbal formulation. Isoniazid, rifampicin, pyrazinamide and ethambutol for first 2 mo followed by continuation phase therapy excluding Pyrazinamide for 4 mo comprised the anti-tuberculous treatment. Curcumin enriched (25%) CL and a hydro-ethanolic extract enriched (50%) TC 1 g each divided in two doses comprised the herbal adjuvant. Hemogram, bilirubin and liver enzymes were tested initially and monthly till the end of study to evaluate the result. RESULTS: Incidence and severity of hepatotoxicity was significantly lower in trial group (incidence: 27/192 vs 2/316, P < 0.0001). Mean aspartate transaminase (AST) (195.93 ± 108.74 vs 85 ± 4.24, P < 0.0001), alanine transaminase (ALT) (75.74 ± 26.54 vs 41 ± 1.41, P < 0.0001) and serum bilirubin (5.4 ± 3.38 vs 1.5 ± 0.42, P < 0.0001). A lesser sputum positivity ratio at the end of 4 wk (10/67 vs 4/137, P = 0.0068) and decreased incidence of poorly resolved parenchymal lesion at the end of the treatment (9/152 vs 2/278, P = 0.0037) was observed. Improved patient compliance was indicated by nil drop-out in trial vs 10/192 in control group (P < 0.0001). CONCLUSION: The herbal formulation prevented hepatotoxicity significantly and improved the disease outcome as well as patient compliance without any toxicity or side effects. PMID:18720535

  20. Integrated treatment and recycling of stormwater: a review of Australian practice.

    PubMed

    Hatt, Belinda E; Deletic, Ana; Fletcher, Tim D

    2006-04-01

    With the use of water approaching, and in some cases exceeding, the limits of sustainability in many locations, there is an increasing recognition of the need to utilise stormwater for non-potable requirements, thus reducing the demand on potable sources. This paper presents a review of Australian stormwater treatment and recycling practices as well as a discussion of key lessons and identified knowledge gaps. Where possible, recommendations for overcoming these knowledge gaps are given. The review of existing stormwater recycling systems focussed primarily on the recycling of general urban runoff (runoff generated from all urban surfaces) for non-potable purposes. Regulations and guidelines specific to stormwater recycling need to be developed to facilitate effective design of such systems, and to minimise risks of failure. There is a clear need for the development of innovative techniques for the collection, treatment and storage of stormwater. Existing stormwater recycling practice is far ahead of research, in that there are no technologies designed specifically for stormwater recycling. Instead, technologies designed for general stormwater pollution control are frequently utilised, which do not guarantee the necessary reliability of treatment. Performance modelling for evaluation purposes also needs further research, so that industry can objectively assess alternative approaches. Just as many aspects of these issues may have impeded adoption of stormwater, another impediment to adoption has been the lack of a practical and widely accepted method for assessing the many financial, social and ecological costs and benefits of stormwater recycling projects against traditional alternatives. Such triple-bottom-line assessment methodologies need to be trialled on stormwater recycling projects. If the costs and benefits of recycling systems can be shown to compare favourably with the costs and benefits of conventional practices this will provide an incentive to overcome

  1. The population genetics of antibiotic resistance: integrating molecular mechanisms and treatment contexts.

    PubMed

    MacLean, R Craig; Hall, Alex R; Perron, Gabriel G; Buckling, Angus

    2010-06-01

    Despite efforts from a range of disciplines, our ability to predict and combat the evolution of antibiotic resistance in pathogenic bacteria is limited. This is because resistance evolution involves a complex interplay between the specific drug, bacterial genetics and both natural and treatment ecology. Incorporating details of the molecular mechanisms of drug resistance and ecology into evolutionary models has proved useful in predicting the dynamics of resistance evolution. However, putting these models to practical use will require extensive collaboration between mathematicians, molecular biologists, evolutionary ecologists and clinicians.

  2. Integrated gasification and plasma cleaning for waste treatment: A life cycle perspective

    SciTech Connect

    Evangelisti, Sara; Tagliaferri, Carla; Clift, Roland; Lettieri, Paola; Taylor, Richard; Chapman, Chris

    2015-09-15

    Highlights: • A life cycle assessment of an advanced two-stage process is undertaken. • A comparison of the impacts of the process when fed with 7 feedstock is presented. • Sensitivity analysis on the system is performed. • The treatment of RDF shows the lowest impact in terms of both GWP and AP. • The plasma shows a small contribution to the overall impact of the plant. - Abstract: In the past, almost all residual municipal waste in the UK was landfilled without treatment. Recent European waste management directives have promoted the uptake of more sustainable treatment technologies, especially for biodegradable waste. Local authorities have started considering other options for dealing with residual waste. In this study, a life cycle assessment of a future 20 MWe plant using an advanced two-stage gasification and plasma technology is undertaken. This plant can thermally treat waste feedstocks with different composition and heating value to produce electricity, steam and a vitrified product. The objective of the study is to analyse the environmental impacts of the process when fed with seven different feedstocks (including municipal solid waste, solid refuse fuel, reuse-derived fuel, wood biomass and commercial & industrial waste) and identify the process steps which contribute more to the environmental burden. A scenario analysis on key processes, such as oxygen production technology, metal recovery and the appropriate choice for the secondary market aggregate material, is performed. The influence of accounting for the biogenic carbon content in the waste from the calculations of the global warming potential is also shown. Results show that the treatment of the refuse-derived fuel has the lowest impact in terms of both global warming potential and acidification potential because of its high heating value. For all the other impact categories analysed, the two-stage gasification and plasma process shows a negative impact for all the waste streams

  3. Psychological Treatments for Provoked Vestibulodynia: Integration of Mindfulness-Based and Cognitive Behavioral Therapies.

    PubMed

    Dunkley, Cara R; Brotto, Lori A

    2016-07-01

    Provoked vestibulodynia (PVD) is a chronic and distressing genital pain condition involving sharp pain to the vulvar vestibule with lifetime prevalence as high as 12%. PVD is the most prevalent cause of pain during sexual intercourse (dyspareunia) in premenopausal women, and gives rise to considerable sexual and relational concerns. As intercourse for women with PVD is either painful or impossible, PVD has pronounced negative effects on women's romantic relationship adjustment and sexual intimacy, as well as their emotional well-being and sense of sexual self-efficacy. Given the low efficacy and high side-effect profile of medications for the treatment of PVD, attention has shifted toward psychological interventions over the past decade. Psychological treatments for PVD have the advantage of targeting both the experience of pain and its many psychosexual consequences, such as reduced desire and arousal. Cognitive behavioral therapy (CBT) currently represents one of the most popular first-line psychological interventions for PVD. Mindfulness has been increasingly used alongside, or instead of CBT for a variety of health-related conditions, particularly with respect to chronic pain disorders and more recently in women with PVD. This review provides a detailed overview of CBT and mindfulness-based approaches in treating PVD.

  4. Integrated nitrogen removal biofilter system with ceramic membrane for advanced post-treatment of municipal wastewater.

    PubMed

    Son, Dong-Jin; Yun, Chan-Young; Kim, Woo-Yeol; Zhang, Xing-Ya; Kim, Dae-Gun; Chang, Duk; Sunwoo, Young; Hong, Ki-Ho

    2016-12-01

    The pre-denitrification biofilm process for nitrogen removal was combined with ceramic membrane with pore sizes of 0.05-0.1 µm as a system for advanced post-treatment of municipal wastewater. The system was operated under an empty bed hydraulic retention time of 7.8 h, recirculation ratio of 3, and transmembrane pressure of 0.47 bar. The system showed average removals of organics, total nitrogen, and solids as high as 93%, 80%, and 100%, respectively. Rapid nitrification could be achieved and denitrification was performed in the anoxic filter without external carbon supplements. The residual particulate organics and nitrogen in effluent from biofilm process could be also removed successfully through membrane filtration and the removal of total coliform was noticeably improved after membrane filtration. Thus, a system composed of the pre-denitrification biofilm process with ceramic membrane would be a compact and flexible option for advanced post-treatment of municipal wastewater.

  5. Cancer treatment as a game: integrating evolutionary game theory into the optimal control of chemotherapy.

    PubMed

    Orlando, Paul A; Gatenby, Robert A; Brown, Joel S

    2012-12-01

    Chemotherapy for metastatic cancer commonly fails due to evolution of drug resistance in tumor cells. Here, we view cancer treatment as a game in which the oncologists choose a therapy and tumors 'choose' an adaptive strategy. We propose the oncologist can gain an upper hand in the game by choosing treatment strategies that anticipate the adaptations of the tumor. In particular, we examine the potential benefit of exploiting evolutionary tradeoffs in tumor adaptations to therapy. We analyze a math model where cancer cells face tradeoffs in allocation of resistance to two drugs. The tumor 'chooses' its strategy by natural selection and the oncologist chooses her strategy by solving a control problem. We find that when tumor cells perform best by investing resources to maximize response to one drug the optimal therapy is a time-invariant delivery of both drugs simultaneously. However, if cancer cells perform better using a generalist strategy allowing resistance to both drugs simultaneously, then the optimal protocol is a time varying solution in which the two drug concentrations negatively covary. However, drug interactions can significantly alter these results. We conclude that knowledge of both evolutionary tradeoffs and drug interactions is crucial in planning optimal chemotherapy schedules for individual patients.

  6. System-level effects of integrating a promising treatment into juvenile drug courts.

    PubMed

    McCart, Michael R; Henggeler, Scott W; Chapman, Jason E; Cunningham, Phillippe B

    2012-09-01

    This study examined the system-level effects of implementing a promising treatment for adolescent substance abuse in juvenile drug courts (JDCs). Six JDCs were randomized to receive training in the experimental intervention (contingency management-family engagement [CM-FAM]) or to continue their usual services (US). Participants were 104 families served by the courts, 51 therapists, and 74 JDC stakeholders (e.g., judges, prosecutors, defense attorneys). Assessments included repeated measurements of CM-FAM implementation by therapists and therapist and stakeholder perceptions of incentive-based interventions and organizational characteristics. Results revealed greater use of CM and family engagement techniques among CM-FAM relative to US therapists. In addition, therapists and stakeholders in the CM-FAM condition reported more favorable attitudes toward the use of incentives and greater improvement on several domains of organizational functioning relative to US counterparts. Taken together, these findings suggest that JDC professionals are amenable to the adoption and implementation of a treatment model that holds promise for improving youth outcomes.

  7. Immunotherapy in castration-resistant prostate cancer: integrating sipuleucel-T into our current treatment paradigm.

    PubMed

    Garcia, Jorge A; Dreicer, Robert

    2011-03-01

    The availability of several novel antibodies, coupled with viral, DNA, and dendritic-cell vaccines, has renewed interest in immunotherapeutic approaches to the treatment of advanced prostate cancer. Although promising, none of these approaches have led to major clinical activity, and in the case of cell-based immunotherapy with GVAX, new concerns about safety arose when this therapy was used in the castration-resistant setting. A more attractive yet toxic approach has also utilized a check-point blockade with CTLA-4 antibodies. Although initial clinical efficacy has been observed, toxicity appears to be the major limitation of its use in prostate cancer. Sipuleucel-T (Provenge) is an autologous active cellular immunotherapy product that includes autologous dendritic cells pulsed ex vivo with PAP2024, a recombinant fusion protein made of prostatic acid phosphataase (PAP) and granulocyte-macrophage colony-stimulating factor (GM-CSF). Despite the lack of objective anti-tumor activity seen with sipuleucel-T, a recently reported phase III trial demonstrated a significant improvement in the overall survival of men with asymptomatic, minimally symptomatic metastatic castration-resistant prostate cancer (CRPC). This agent is the first FDA-approved novel immunotherapeutic compound for the treatment of a solid malignancy. A better understanding of how clinicians should incorporate this novel agent into the current management of CRPC is needed.

  8. The mixed waste focus area mercury working group: an integrated approach for mercury treatment and disposal

    SciTech Connect

    Conley, T.B.; Morris, M.I.; Holmes-Burns, H.; Petersell, J.; Schwendiman, L.

    1997-02-01

    In May 1996, the U.S. Department of Energy (DOE) Mixed Waste Focus Area (MWFA) initiated the Mercury Work Group (HgWG), which was established to address and resolve the issues associated with mercury- contaminated mixed wastes. Three of the first four technology deficiencies identified during the MWFA technical baseline development process were related to mercury amalgamation, stabilization, and separation/removal. The HgWG will assist the MWFA in soliciting, identifying, initiating, and managing all the efforts required to address these deficiencies. The focus of the HgWG is to better establish the mercury-related treatment needs at the DOE sites, refine the MWFA technical baseline as it relates to mercury treatment, and make recommendations to the MWFA on how to most effectively address these needs. The team will initially focus on the sites with the most mercury-contaminated mixed wastes, whose representatives comprise the HgWG. However, the group will also work with the sites with less inventory to maximize the effectiveness of these efforts in addressing the mercury- related needs throughout the entire complex.

  9. Integrating forward osmosis into microbial fuel cells for wastewater treatment, water extraction and bioelectricity generation.

    PubMed

    Zhang, Fei; Brastad, Kristen S; He, Zhen

    2011-08-01

    A novel osmotic microbial fuel cell (OsMFC) was developed by using a forward osmosis (FO) membrane as a separator. The performance of the OsMFC was examined with either NaCl solution or artificial seawater as a catholyte (draw solution). A conventional MFC with a cation exchange membrane was also operated in parallel for comparison. It was found that the OsMFC produced more electricity than the MFC in both batch operation (NaCl solution) and continuous operation (seawater), likely due to better proton transport with water flux through the FO membrane. Water flux from the anode into the cathode was clearly observed with the OsMFC but not in the MFC. The solute concentration of the catholyte affected both electricity generation and water flux. These results provide a proof of concept that an OsMFC can simultaneously accomplish wastewater treatment, water extraction (from the wastewater), and electricity generation. The potential applications of the OsMFC are proposed for either water reuse (linking to reverse osmosis for reconcentration of draw solution) or seawater desalination (connecting with microbial desalination cells for further wastewater treatment and desalination).

  10. Cancer treatment as a game: integrating evolutionary game theory into the optimal control of chemotherapy

    NASA Astrophysics Data System (ADS)

    Orlando, Paul A.; Gatenby, Robert A.; Brown, Joel S.

    2012-12-01

    Chemotherapy for metastatic cancer commonly fails due to evolution of drug resistance in tumor cells. Here, we view cancer treatment as a game in which the oncologists choose a therapy and tumors ‘choose’ an adaptive strategy. We propose the oncologist can gain an upper hand in the game by choosing treatment strategies that anticipate the adaptations of the tumor. In particular, we examine the potential benefit of exploiting evolutionary tradeoffs in tumor adaptations to therapy. We analyze a math model where cancer cells face tradeoffs in allocation of resistance to two drugs. The tumor ‘chooses’ its strategy by natural selection and the oncologist chooses her strategy by solving a control problem. We find that when tumor cells perform best by investing resources to maximize response to one drug the optimal therapy is a time-invariant delivery of both drugs simultaneously. However, if cancer cells perform better using a generalist strategy allowing resistance to both drugs simultaneously, then the optimal protocol is a time varying solution in which the two drug concentrations negatively covary. However, drug interactions can significantly alter these results. We conclude that knowledge of both evolutionary tradeoffs and drug interactions is crucial in planning optimal chemotherapy schedules for individual patients.

  11. INTEGRATED OPTICAL TOOLS FOR MINIMALLY INVASIVE DIAGNOSIS AND TREATMENT AT GASTROINTESTINAL ENDOSCOPY

    PubMed Central

    Rodriguez-Diaz, Eladio; Bigio, Irving J.; Singh, Satish K.

    2010-01-01

    Over the past two decades, the bulk of gastrointestinal (GI) endoscopic procedures has shifted away from diagnostic and therapeutic interventions for symptomatic disease toward cancer prevention in asymptomatic patients. This shift has resulted largely from a decrease in the incidence of peptic ulcer disease in the era of antisecretory medications coupled with emerging evidence for the efficacy of endoscopic detection and eradication of dysplasia, a histopathological biomarker widely accepted as a precursor to cancer. This shift has been accompanied by a drive toward minimally-invasive, in situ optical diagnostic technologies that help assess the mucosa for cellular changes that relate to dysplasia. Two competing but complementary approaches have been pursued. The first approach is based on broad-view targeting of “areas of interest” or “red flags.” These broad-view technologies include standard white light endoscopy (WLE), high-definition endoscopy (HD), and “electronic” chromoendoscopy (narrow-band-type imaging). The second approach is based on multiple small area or point-source (meso/micro) measurements, which can be either machine (spectroscopy) or human-interpreted (endomicroscopy, magnification endoscopy), much as histopatholgy slides are. In this paper we present our experience with the development and testing of a set of familiar but “smarter” standard tissue-sampling tools that can be routinely employed during screening/surveillance endoscopy. These tools have been designed to incorporate fiberoptic probes that can mediate spectroscopy or endomicroscopy. We demonstrate the value of such tools by assessing their preliminary performance from several ongoing clinical studies. Our results have shown promise for a new generation of integrated optical tools for a variety of screening/surveillance applications during GI endoscopy. Integrated devices should prove invaluable for dysplasia surveillance strategies that currently result in large

  12. Patient Satisfaction with Methadone Maintenance Treatment in Vietnam: A Comparison of Different Integrative-Service Delivery Models

    PubMed Central

    Tran, Bach Xuan; Nguyen, Long Hoang; Phan, Huong Thu Thi; Latkin, Carl A.

    2015-01-01

    Background Patient satisfaction is an important component of quality in healthcare delivery. To inform the expansion of Methadone Maintenance Treatment (MMT) services in Vietnam, we examined the satisfaction of patients with regards to different services delivery models and identified its associated factors. Methods We interviewed 1,016 MMT patients at 5 clinics in Hanoi and Nam Dinh province. The modified SATIS instrument, a 10-item scale, was used to measure three dimensions: “Services quality and convenience”, “Health workers’ capacity and responsiveness” and “Inter-professional care”. Results The average score was high across three SATIS dimensions. However, only one third of patients completely satisfied with general health services and treatment outcomes. Older age, higher education, having any problem in self-care and anxiety/depression were negatively associated with patient’s satisfaction. Meanwhile, patients receiving MMT at clinics, where more comprehensive HIV and general health care services were available, were more likely to report a complete satisfaction. Conclusion Patients were highly satisfied with MMT services in Vietnam. However, treatment for drug users should go beyond methadone maintenance to address complicated health demands of drug users. Integrating MMT with comprehensive HIV and general health services together with improving the capacity of health workers and efficiency of services organisation to provide interconnected health care for drug users are critical for improving the outcomes of the MMT program. PMID:26556036

  13. Integrated hot-compressed water and laccase-mediator treatments of Eucalyptus grandis fibers: structural changes of fiber and lignin.

    PubMed

    Wu, Jian-Quan; Wen, Jia-Long; Yuan, Tong-Qi; Sun, Run-Cang

    2015-02-18

    Eucalyptus grandis fibers were treated with hot-compressed water (HCW) and laccase mediator to enhance the fiber characteristics and to produce an active lignin substrate for binderless fiberboard production. The composition, morphology, and crystallinity index (CrI) analysis of fibers showed that the HCW treatment increased the CrI and lignin content of the treated fibers through partial removal of hemicelluloses. Simultaneously, the HCW treatment produced some granules and holes on the surface of the fibers, which possibly facilitated the accessibility of the laccase mediator. Milled wood lignins and enzymatic hydrolysis lignins isolated from the control and treated fibers were comparatively characterized. A reduction of molecular weight was observed, which indicated that a preferential degradation of lignin occurred after exposure to the laccase mediator. Quantitative (13)C, 2D-HSQC and (31)P NMR characterization revealed that the integrated treatment resulted in the cleavage of β-O-4' linkages, removal of G' (oxidized α-ketone) substructures, and an increase in the S/G ratio and free phenolic hydroxyls.

  14. A line integration method for the treatment of 3D domain integrals and accelerated by the fast multipole method in the BEM

    NASA Astrophysics Data System (ADS)

    Wang, Qiao; Zhou, Wei; Cheng, Yonggang; Ma, Gang; Chang, Xiaolin

    2017-04-01

    A line integration method (LIM) is proposed to calculate the domain integrals for 3D problems. In the proposed method, the domain integrals are transformed into boundary integrals and only line integrals on straight lines are needed to be computed. A background cell structure is applied to further simplify the line integrals and improve the accuracy. The method creates elements only on the boundary, and the integral lines are created from the boundary elements. The procedure is quite suitable for the boundary element method, and we have applied it to 3D situations. Directly applying the method is time-consuming since the complexity of the computational time is O( NM), where N and M are the numbers of nodes and lines, respectively. To overcome this problem, the fast multipole method is used with the LIM for large-scale computation. The numerical results show that the proposed method is efficient and accurate.

  15. Integrated gasification and plasma cleaning for waste treatment: A life cycle perspective.

    PubMed

    Evangelisti, Sara; Tagliaferri, Carla; Clift, Roland; Lettieri, Paola; Taylor, Richard; Chapman, Chris

    2015-09-01

    In the past, almost all residual municipal waste in the UK was landfilled without treatment. Recent European waste management directives have promoted the uptake of more sustainable treatment technologies, especially for biodegradable waste. Local authorities have started considering other options for dealing with residual waste. In this study, a life cycle assessment of a future 20MWe plant using an advanced two-stage gasification and plasma technology is undertaken. This plant can thermally treat waste feedstocks with different composition and heating value to produce electricity, steam and a vitrified product. The objective of the study is to analyse the environmental impacts of the process when fed with seven different feedstocks (including municipal solid waste, solid refuse fuel, reuse-derived fuel, wood biomass and commercial & industrial waste) and identify the process steps which contribute more to the environmental burden. A scenario analysis on key processes, such as oxygen production technology, metal recovery and the appropriate choice for the secondary market aggregate material, is performed. The influence of accounting for the biogenic carbon content in the waste from the calculations of the global warming potential is also shown. Results show that the treatment of the refuse-derived fuel has the lowest impact in terms of both global warming potential and acidification potential because of its high heating value. For all the other impact categories analysed, the two-stage gasification and plasma process shows a negative impact for all the waste streams considered, mainly due to the avoided burdens associated with the production of electricity from the plant. The plasma convertor, key characteristic of the thermal process investigated, although utilising electricity shows a relatively small contribution to the overall environmental impact of the plant. The results do not significantly vary in the scenario analysis. Accounting for biogenic carbon

  16. Integration and application of a home treatment program: a study of parents and occupational therapists.

    PubMed

    Segal, Ruth; Beyer, Claudia

    2006-01-01

    The purpose of this article is to describe parental adherence to home treatment programs. A qualitative exploratory study with six parents and eight occupational therapists who used the brushing and compression technique (Wilbarger Protocol) was conducted. Participants were interviewed one or two times, exploring their experiences in adhering to the protocol. Data analysis focused on facilitators and hindrances to parental adherence and on occupational therapists' strategies used to encourage it. Parents identified their children's responses to brushing, its perceived efficacy, and interaction of the protocol with family daily schedules, as factors influencing their adherence. Occupational therapists identified only family daily schedules as influencing parental adherence. The findings are discussed in the context of the ecocultural theory of family accommodations.

  17. Integrated treatment of municipal sewage sludge by deep dewatering and anaerobic fermentation for biohydrogen production.

    PubMed

    Yu, Li; Yu, Yang; Jiang, Wentian; Wei, Huangzhao; Sun, Chenglin

    2015-02-01

    The increasing sludge generated in wastewater treatment plants poses a threat to the environment. Based on the traditional processes, sludge dewatered by usual methods was further dewatered by hydraulic compression and the filtrate released was treated by anaerobic fermentation. The difficulties in sludge dewatering were associated with the existence of sludge flocs or colloidal materials. A suitable CaO dosage of 125 mg/g dry sludge (DS) could further decrease the moisture content of sludge from 82.4 to 50.9 %. The filtrate from the dewatering procedure was a potential substrate for biohydrogen production. Adding zero-valent iron (ZVI) into the anaerobic system improved the biohydrogen yield by 20 %, and the COD removal rate was lifted by 10 % as well. Meanwhile, the sludge morphology and microbial community were altered. The novel method could greatly reduce the sludge volume and successfully treated filtrate along with the conversion of organics into biohydrogen.

  18. Integrated electrochemical treatment systems for facilitating the bioremediation of oil spill contaminated soil.

    PubMed

    Cheng, Ying; Wang, Liang; Faustorilla, Vilma; Megharaj, Mallavarapu; Naidu, Ravi; Chen, Zuliang

    2017-05-01

    Bioremediation plays an important role in oil spill management and bio-electrochemical treatment systems are supposed to represent a new technology for both effective remediation and energy recovery. Diesel removal rate increased by four times in microbial fuel cells (MFCs) since the electrode served as an electron acceptor, and high power density (29.05 W m(-3)) at current density 72.38 A m(-3) was achieved using diesel (v/v 1%) as the sole substrate. As revealed by Scanning electron microscope images, carbon fibres in the anode electrode were covered with biofilm and the bacterial colloids which build the link between carbon fibres and enhance electron transmission. Trace metabolites produced during the anaerobic biodegradation were identified by gas chromatography-mass spectrometry. These metabolites may act as emulsifying agents that benefit oil dispersion and play a vital role in bioremediation of oil spills in field applications.

  19. Integrated nanofiltration and upflow anaerobic sludge blanket treatment of textile wastewater for in-plant reuse.

    PubMed

    Gomes, Arlindo Canigo; Gonçalves, Isolina Cabral; de Pinho, Maria Norberta; Porter, John Jefferson

    2007-05-01

    The filtration characteristics of simulated dyeing effluents containing Acid Orange 7, sodium sulfate, and a pH buffer made of acetic acid and sodium acetate is described using a commercially available nanofiltration membrane. The original membrane filtration properties were characterized with deionized water to provide a baseline of membrane performance. At high volumetric concentration of the test solutions, greater than 98% rejection of dye and sodium sulfate were obtained. Rejection of buffering chemicals was approximately 50% in all experiments, giving a permeate water not suitable for reuse in most dyeing operations. The final composite concentrate had a chemical oxygen demand (COD) value > 2000 mg/L. No problems were encountered with anaerobic treatment of the concentrate obtained from the dyeing wastewater. Adjusting the sulfate concentration to give COD-to-sulfate ratios to 2.9, 5.4, and 18.2 in the reactor feed had no significant alterations in the performance of the upflow anaerobic sludge blanket reactor.

  20. An integrated perspective on diabetic, alcoholic, and drug-induced neuropathy, etiology, and treatment in the US

    PubMed Central

    Zeng, Lily; Alongkronrusmee, Doungkamol; van Rijn, Richard M

    2017-01-01

    Neuropathic pain (NeuP) is a syndrome that results from damaged nerves and/or aberrant regeneration. Common etiologies of neuropathy include chronic illnesses and medication use. Chronic disorders, such as diabetes and alcoholism, can cause neuronal injury and consequently NeuP. Certain medications with antineoplastic effects also carry an exquisitely high risk for neuropathy. These culprits are a few of many that are fueling the NeuP epidemic, which currently affects 7%–10% of the population. It has been estimated that approximately 10% and 7% of US adults carry a diagnosis of diabetes and alcohol disorder, respectively. Despite its pervasiveness, many physicians are unfamiliar with adequate treatment of NeuP, partly due to the few reviews that are available that have integrated basic science and clinical practice. In light of the recent Centers for Disease Control and Prevention guidelines that advise against the routine use of μ-opioid receptor-selective opioids for chronic pain management, such a review is timely. Here, we provide a succinct overview of the etiology and treatment options of diabetic and alcohol- and drug-induced neuropathy, three different and prevalent neuropathies fusing the combined clinical and preclinical pharmacological expertise in NeuP of the authors. We discuss the anatomy of pain and pain transmission, with special attention to key ion channels, receptors, and neurotransmitters. An understanding of pain neurophysiology will lead to a better understanding of the rationale for the effectiveness of current treatment options, and may lead to better diagnostic tools to help distinguish types of neuropathy. We close with a discussion of ongoing research efforts to develop additional treatments for NeuP. PMID:28176937

  1. Development of Site-Specific Soil Design Basis Earthquake (DBE) Parameters for the Integrated Waste Treatment Unit (IWTU)

    SciTech Connect

    Payne, Suzette

    2008-08-01

    Horizontal and vertical PC 3 (2,500 yr) Soil Design Basis Earthquake (DBE) 5% damped spectra, corresponding time histories, and strain-compatible soil properties were developed for the Integrated Waste Treatment Unit (IWTU). The IWTU is located at the Idaho Nuclear Technology and Engineering Center (INTEC) at the Idaho National Laboratory (INL). Mean and 84th percentile horizontal DBE spectra derived from site-specific site response analyses were evaluated for the IWTU. The horizontal and vertical PC 3 (2,500 yr) Soil DBE 5% damped spectra at the 84th percentile were selected for Soil Structure Interaction (SSI) analyses at IWTU. The site response analyses were performed consistent with applicable Department of Energy (DOE) Standards, recommended guidance of the Nuclear Regulatory Commission (NRC), American Society of Civil Engineers (ASCE) Standards, and recommendations of the Blue Ribbon Panel (BRP) and Defense Nuclear Facilities Safety Board (DNFSB).

  2. Integrating Social Determinants of Health With Treatment and Prevention: A New Tool to Assess Local Area Deprivation

    PubMed Central

    Doan, Thao M.; Arno, Peter S.; Hubel, Megan; Yi, Shirley; Viola, Deborah

    2016-01-01

    We assessed the appropriate geographic scale to apply an area deprivation index (ADI), which reflects a geographic area’s level of socioeconomic deprivation and is associated with health outcomes, to identify and screen patients for social determinants of health. We estimated the relative strength of the association between the ADI at various geographic levels and a range of hospitalization rates by using age-adjusted odds ratios in an 8-county region of New York State. The 10-km local ADI estimates had the strongest associations with all hospitalization rates (higher odds ratios) followed by estimates at 20 km, 30 km, and the regional scale. A locally sensitive ADI is an ideal measure to identify and screen for the health care and social services needs and to advance the integration of social determinants of health with clinical treatment and disease prevention. PMID:27634778

  3. Press fluid pre-treatment optimisation of the integrated generation of solid fuel and biogas from biomass (IFBB) process approach.

    PubMed

    Corton, John; Toop, Trisha; Walker, Jonathan; Donnison, Iain S; Fraser, Mariecia D

    2014-10-01

    The integrated generation of solid fuel and biogas from biomass (IFBB) system is an innovative approach to maximising energy conversion from low input high diversity (LIHD) biomass. In this system water pre-treated and ensiled LIHD biomass is pressed. The press fluid is anaerobically digested to produce methane that is used to power the process. The fibrous fraction is densified and then sold as a combustion fuel. Two process options designed to concentrate the press fluid were assessed to ascertain their influence on productivity in an IFBB like system: sedimentation and the omission of pre-treatment water. By concentrating press fluid and not adding water during processing, energy production from methane was increased by 75% per unit time and solid fuel productivity increased by 80% per unit of fluid produced. The additional energy requirements for pressing more biomass in order to generate equal volumes of feedstock were accounted for in these calculations.

  4. Highly integrated hybrid process with ceramic ultrafiltration-membrane for advanced treatment of drinking water: a pilot study.

    PubMed

    Guo, Jianning; Wang, Lingyun; Zhu, Jia; Zhang, Jianguo; Sheng, Deyang; Zhang, Xihui

    2013-01-01

    This article presents a highly integrated hybrid process for the advanced treatment of drinking water in dealing with the micro-polluted raw water. A flat sheet ceramic membrane with the pore size of 50∼60 nm for ultrafiltration (UF) is used to integrate coagulation and ozonation together. At the same time, biological activated carbon filtration (BAC) is used to remove the ammonia and organic pollutants in raw water. A pilot study in the scale of 120 m(3)/d has been conducted in Southern China. The mainly-analyzed parameters include turbidity, particle counts, ammonia, total organic carbon (TOC), UV254, biological dissolved organic carbon (BDOC), dissolved oxygen (DO) as well as trans-membrane pressure (TMP). The experiments demonstrated that ceramic UF-membrane was able to remove most of turbidity and suspended particulate matters. The final effluent turbidity reached to 0.14 NTU on average. BAC was effective in removing ammonia and organic matters. Dissolved oxygen (DO) is necessary for the biodegradation of ammonia at high concentration. The removal efficiencies reached to 90% for ammonia with the initial concentration of 3.6 mg/L and 76% for TOC with the initial concentration of 3.8 mg/L. Ozonation can alter the molecular structure of organics in terms of UV254, reduce membrane fouling, and extend the operation circle. It is believed the hybrid treatment process developed in this article can achieve high performance with less land occupation and lower cost compared with the conventional processes. It is especially suitable for the developing countries in order to obtain high-quality drinking water in a cost-effective way.

  5. Enhanced ethanol production from pomelo peel waste by integrated hydrothermal treatment, multienzyme formulation, and fed-batch operation.

    PubMed

    Huang, Renliang; Cao, Ming; Guo, Hong; Qi, Wei; Su, Rongxin; He, Zhimin

    2014-05-21

    Pomelo peel is an abundant pectin-rich biomass waste in China and has the potential to serve as a source of fuels and chemicals. This study reports a promising way to deal with pomelo peel waste and to utilize it as raw material for ethanol production via simultaneous saccharification and fermentation (SSF). An integrated strategy, incorporating hydrothermal treatment, multienzyme formulation, and fed-batch operation, was further developed to enhance the ethanol production. The results show that hydrothermal treatment (120 °C, 15 min) could significantly reduce the use of cellulase (from 7 to 3.8 FPU g(-1)) and pectinase (from 20 to 10 U g(-1)). A multienzyme complex, which consists of cellulase, pectinase, β-glucosidase, and xylanase, was also proven to be effective to improve the hydrolysis of pretreated pomelo peel, leading to higher concentrations of fermentative sugars (36 vs 14 g L(-1)) and galacturonic acid (23 vs 9 g L(-1)) than those with the use of a single enzyme. Furthermore, to increase the final ethanol concentration, fed-batch operation by adding fresh substrate was employed in the SSF process. A final solid loading of 25% (w/v), which is achieved by adding 15% fresh substrate to the SSF system at an initial solid loading of 10%, produced 36 g L(-1) ethanol product in good yield (73.5%). The ethanol concentration is about 1.73-fold that at the maximum solid loading of 14% for batch operation, whereas both of them have a closed ethanol yield. The results indicate that the use of the fed-batch mode could alleviate the decrease in ethanol yield at high solid loading, which is caused by significant mass transfer limitation and increased inhibition of toxic compounds in the SSF process. The integrated strategy demonstrated in this work could open a new avenue for dealing with pectin-rich biomass wastes and utilization of the wastes to produce ethanol.

  6. Biotic integrity of the Boise River upstream and downstream from two municipal wastewater treatment facilities, Boise, Idaho, 1995-96

    USGS Publications Warehouse

    Mullins, William H.

    1999-01-01

    Aquatic biological communities were used to assess the biotic integrity of the Boise River upstream and downstream from the Lander Street and West Boise municipal wastewater treatment facilities (WTFs) in Boise, Idaho. Samples of epilithic periphyton, benthic macroinvertebrates, and fish were collected in late February and early March 1995, in late October 1996, and in early December 1996. Epilithic periphyton biomass, expressed as chlorophyll-a and ash-free dry weight, declined substantially between 1995 and 1996. Chlorophyll-a concentrations were higher at sites downstream from WTFs in both years, but differences in concentrations between sites upstream and downstream from WTFs were not statistically significant. High withinsite variance suggests that greater sampling intensity would improve statistical comparison. Index of Biotic Integrity (IBI) scores calculated for benthic macroinvertebrates were higher for the sites upstream from WTFs in 1995 and were the same for all sites in 1996. Similarly, IBI scores calculated for fish were higher for the sites upstream from WTFs in 1995, were higher for the site upstream from the Lander Street WTF in 1996, and were the same for sites upstream and downstream from the West Boise WTF in 1996. Two species of sculpin (Cottus) were abundant at the site upstream from both WTFs but were absent at all other sites downstream from WTFs in 1995 and composed only 2 percent of the total number of fish collected downstream from the Lander Street WTF in 1996.

  7. Development of an integral damping treatment for NASA's next-generation hollow fan blades

    NASA Astrophysics Data System (ADS)

    Kosmatka, John B.; Mehmed, Oral

    2002-06-01

    A NASA research program is underway to develop fan blades that have significantly greater propulsive efficiency, lower acoustic noise, and lower weight. These blades have a large internal manifold and open trailing edge that is used to blow air in the downwash. The blades are composed of a titanium root and composite internal manifold with an outer graphite/epoxy shell. Due to the complex internal structure and open-cell design, these blades have low natural frequencies and bending-torsion coupled mode shapes that could potentially lead to aeroelastic instabilities. Increasing the damping levels in these blades will improve the fatigue life and reduce aeroelastic instability concerns. The vibratory modes of interest include the first and second bending modes as well as first torsion mode. Due to the geometric constraints of the outer blade shape and large internal manifold very little room is available for damping treatment placement. Results from the analysis study reveal that (1) significantly more damping can be obtained by embedding the material in the outer shells than within the manifold vanes, (2) carefully designing a patch that fills approximately 29% of the surface area and is only 0.005' thick will produce a loss factor of at least 0.01 for the first three structural modes, and (3) a patch that fills approximately 45% of the surface area will produce a loss factor of at least 0.02 for the first three structural modes.

  8. Effects of remifemin treatment on bone integrity and remodeling in rats with ovariectomy-induced osteoporosis.

    PubMed

    Cui, Guangxia; Leng, Huijie; Wang, Ke; Wang, Jianwei; Zhu, Sainan; Jia, Jing; Chen, Xing; Zhang, Weiguang; Qin, Lihua; Bai, Wenpei

    2013-01-01

    This study aims to evaluate the effects of Remifemin (isopropanolic extract of Cimicifuga Racemosa) on postmenopausal osteoporosis. 120 female Sprague-Dawley rats were randomly assigned to four groups: sham surgery with vehicle, ovariectomy with vehicle, ovariectomy with estradiol valerate, or ovariectomy with Remifemin. Daily oral administrations of the vehicle, estradiol valerate, or Remifemin began 2 weeks after surgery and lasted to 4, 8, or 12 weeks. Ten rats in each group were sacrificed at each timestep with assessment of bone mineral density, trabecular bone structure, and biomechanical parameters of the femur and lumbar vertebra. Bone turnover markers were evaluated 12 weeks after surgery. Both drugs prevented bone density loss in the distal end of the femur and preserved the trabecular bone structure in both the lumbar vertebra and distal end of the femur following ovariectomy. Both drugs protected bone stiffness at the tested regions and reduced bone reabsorption in ovariectomized rats. The preventive effects of Remifemin against bone-loss can rival those of estradiol valerate if treatment duration is adequately extended. In conclusion, Remifemin may demonstrate equivalent effects to estradiol valerate in terms of preventing postmenopausal osteoporosis.

  9. A novel, integrated treatment systems for coal wastewaters. Quarterly Report, June 2, 1992--September 1, 1992

    SciTech Connect

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

    1992-12-01

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

  10. A novel, integrated treatment system for coal wastewaters. Quarterly report, September 2, 1991--December 1, 1991

    SciTech Connect

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

    1991-12-31

    This is the first quarterly report of the above project. The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and the inorganics present in coal conversion wastewaters. The initial phase of the work has been focused on the development of modified clays for use in the selective removal and recovery of heavy metals such as Cd, Cu, chromate and selenate. The results presented here show that a surfactant-modified clay adsorbs Cd strongly at a pH of 8.5 and poorly at pH 4.0. Further, the adsorption of Cd on modified clay is unaffected by the ionic strength of the medium. In the case of Cu, it has been shown that the metal forms a complex with alkyl diamines in aqueous solutions at a pH of 6.0 and does not bind to these surfactants at a lower pH of 3.0. These findings are a preliminary indication that the surface and solution chemistry of amine surfactants can be gainfully modified to adsorb and desorb cationic heavy metals.

  11. Integrating biological treatment of crop residue into a hydroponic sweetpotato culture

    NASA Astrophysics Data System (ADS)

    Trotman, A. A.; David, P. P.; Bonsi, C. K.; Hill, W. A.; Mortley, D. G.; Loretan, P. A.

    1997-01-01

    Residual biomass from hydroponic culture of sweetpotato [Ipomoea batatas (L.) Lam.] was degraded using natural bacterial soil isolates. Sweetpotato was grown for 120 days in hydroponic culture with a nutrient solution comprised of a ratio of 80% modified half Hoagland solution to 20% filtered effluent from an aerobic starch hydrolysis bioreactor. The phytotoxicity of the effluent was assayed with `Waldmann's Green' lettuce (Lactuca sativa L.) and the ratio selected after a 60-day bioassay using sweetpotato plants propagated vegetatively from cuttings. Controlled environment chamber experiments were conducted to investigate the impact of filtrate from biological treatment of crop residue on growth and storage root production with plants grown in a modified half Hoagland solution. Incorporation of bioreactor effluent, reduced storage root yield of `Georgia Jet' sweetpotato but the decrease was not statistically significant when compared with yield for plants cultured in a modified half Hoagland solution without filtrate. However, yield of `TU-82-155' sweetpotato was significantly reduced when grown in a modified half Hoagland solution into which filtered effluent had been incorporated. Total biomass was significantly reduced for both sweetpotato cultivars when grown in bioreactor effluent. The leaf area and dry matter accumulation were significantly (P < 0.05) reduced for both cultivars when grown in solution culture containing 20% filtered effluent.

  12. Combining urban wastewater treatment with biohydrogen production--an integrated microalgae-based approach.

    PubMed

    Batista, Ana Paula; Ambrosano, Lucas; Graça, Sofia; Sousa, Catarina; Marques, Paula A S S; Ribeiro, Belina; Botrel, Elberis P; Castro Neto, Pedro; Gouveia, Luisa

    2015-05-01

    The aim of the present work was the simultaneous treatment of urban wastewater using microalgae and the energetic valorization of the obtained biomass. Chlorella vulgaris (Cv), Scenedesmus obliquus (Sc) and a naturally occurring algal Consortium C (ConsC) were grown in an urban wastewater. The nutrient removals were quite high and the treated water fits the legislation (PT Dec-Lei 236/98) in what concerns the parameters analysed (N, P, COD). After nutrient depletion the microalgae remained two more weeks in the photobioreactor (PBR) under nutritional stress conditions, to induce sugar accumulation (22-43%). The stressed biomass was converted into biohydrogen (bioH2), a clean energy carrier, through dark fermentation by a strain of the bacteria Enterobacter aerogenes. The fermentation kinetics were monitored and fitted to a modified Gompertz model. The highest bioH2 production yield was obtained for S. obliquus (56.8 mL H2/gVS) which was very similar when using the same algae grown in synthetic media.

  13. Integrating biological treatment of crop residue into a hydroponic sweetpotato culture.

    PubMed

    Trotman, A A; David, P P; Bonsi, C K; Hill, W A; Mortley, D G; Loretan, P A

    1997-01-01

    Residual biomass from hydroponic culture of sweetpotato [Ipomoea batatas (L.) Lam.] was degraded using natural bacterial soil isolates. Sweetpotato was grown for 120 days in hydroponic culture with a nutrient solution comprised of a ratio of 80% modified half Hoagland solution to 20% filtered effluent from an aerobic starch hydrolysis bioreactor. The phytotoxicity of the effluent was assayed with Waldmann's Green' lettuce (Lactuca sativa L.) and the ratio selected after a 60-day bioassay using sweetpotato plants propagated vegetatively from cuttings. Controlled environment chamber experiments were conducted to investigate the impact of filtrate from biological treatment of crop residue on growth and storage root production with plants grown in a modified half Hoagland solution. Incorporation of bioreactor effluent, reduced storage root yield of 'Georgia Jet' sweetpotato but the decrease was not statistically significant when compared with yield for plants cultured in a modified half Hoagland solution without filtrate. However, yield of 'TU-82-155' sweetpotato was significantly reduced when grown in a modified half Hoagland solution into which filtered effluent had been incorporated. Total biomass was significantly reduced for both sweetpotato cultivars when grown in bioreactor effluent. The leaf area and dry matter accumulation were significantly (P < 0.05) reduced for both cultivars when grown in solution culture containing 20% filtered effluent.

  14. Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study

    PubMed Central

    Middlemass, Jo; Davy, Zowie; Cavanagh, Kate; Linehan, Conor; Morgan, Kevin; Lawson, Shaun; Siriwardena, A Niroshan

    2012-01-01

    Background Insomnia is a common psychological complaint. Cognitive behavioural therapy for insomnia (CBT-I), although effective, is little used because of lack of trained providers. Computerised CBT-I (CCBT-I) may be a solution to this shortfall in access. Aim To explore patient and health professional perspectives and the role of social networking, to develop a novel CCBT-I programme to increase access to this form of intervention. Design and setting Qualitative methods underpinned by the theory of planned behaviour in primary care in Lincolnshire and Nottinghamshire. Method Semi-structured interviews and focus groups with a purposive sample of health professionals and adults with insomnia. Results A total of 23 health professionals and 28 patients were interviewed. Features designed to engender trust and improve functionality were perceived to improve uptake and adherence to CCBT-I. Trust lay in programme accreditation; for professionals, trust derived from evidence of effectiveness; for patients, trust depended on the doctor–patient relationship, professional support, the quality of online peer support, and perceptions of risk. Patients wanted mobile applications; access in short periods; self-assessment; interactive, personalised information on sleep; and moderated contact with other users. Patients and practitioners differed over whether useful information could be distinguished from less useful or potentially incorrect information. Conclusion Improving uptake and adherence to online programmes for insomnia requires design features focusing on trust and functionality. Enabling greater patient control and interaction with other users and professionals may stimulate positive experiences of online therapy. CCBT-I would enable greater access to treatment but is limited by lack of online access or poor computer literacy. PMID:23211265

  15. Designing a broad-spectrum integrative approach for cancer prevention and treatment.

    PubMed

    Block, Keith I; Gyllenhaal, Charlotte; Lowe, Leroy; Amedei, Amedeo; Amin, A R M Ruhul; Amin, Amr; Aquilano, Katia; Arbiser, Jack; Arreola, Alexandra; Arzumanyan, Alla; Ashraf, S Salman; Azmi, Asfar S; Benencia, Fabian; Bhakta, Dipita; Bilsland, Alan; Bishayee, Anupam; Blain, Stacy W; Block, Penny B; Boosani, Chandra S; Carey, Thomas E; Carnero, Amancio; Carotenuto, Marianeve; Casey, Stephanie C; Chakrabarti, Mrinmay; Chaturvedi, Rupesh; Chen, Georgia Zhuo; Chen, Helen; Chen, Sophie; Chen, Yi Charlie; Choi, Beom K; Ciriolo, Maria Rosa; Coley, Helen M; Collins, Andrew R; Connell, Marisa; Crawford, Sarah; Curran, Colleen S; Dabrosin, Charlotta; Damia, Giovanna; Dasgupta, Santanu; DeBerardinis, Ralph J; Decker, William K; Dhawan, Punita; Diehl, Anna Mae E; Dong, Jin-Tang; Dou, Q Ping; Drew, Janice E; Elkord, Eyad; El-Rayes, Bassel; Feitelson, Mark A; Felsher, Dean W; Ferguson, Lynnette R; Fimognari, Carmela; Firestone, Gary L; Frezza, Christian; Fujii, Hiromasa; Fuster, Mark M; Generali, Daniele; Georgakilas, Alexandros G; Gieseler, Frank; Gilbertson, Michael; Green, Michelle F; Grue, Brendan; Guha, Gunjan; Halicka, Dorota; Helferich, William G; Heneberg, Petr; Hentosh, Patricia; Hirschey, Matthew D; Hofseth, Lorne J; Holcombe, Randall F; Honoki, Kanya; Hsu, Hsue-Yin; Huang, Gloria S; Jensen, Lasse D; Jiang, Wen G; Jones, Lee W; Karpowicz, Phillip A; Keith, W Nicol; Kerkar, Sid P; Khan, Gazala N; Khatami, Mahin; Ko, Young H; Kucuk, Omer; Kulathinal, Rob J; Kumar, Nagi B; Kwon, Byoung S; Le, Anne; Lea, Michael A; Lee, Ho-Young; Lichtor, Terry; Lin, Liang-Tzung; Locasale, Jason W; Lokeshwar, Bal L; Longo, Valter D; Lyssiotis, Costas A; MacKenzie, Karen L; Malhotra, Meenakshi; Marino, Maria; Martinez-Chantar, Maria L; Matheu, Ander; Maxwell, Christopher; McDonnell, Eoin; Meeker, Alan K; Mehrmohamadi, Mahya; Mehta, Kapil; Michelotti, Gregory A; Mohammad, Ramzi M; Mohammed, Sulma I; Morre, D James; Muralidhar, Vinayak; Muqbil, Irfana; Murphy, Michael P; Nagaraju, Ganji Purnachandra; Nahta, Rita; Niccolai, Elena; Nowsheen, Somaira; Panis, Carolina; Pantano, Francesco; Parslow, Virginia R; Pawelec, Graham; Pedersen, Peter L; Poore, Brad; Poudyal, Deepak; Prakash, Satya; Prince, Mark; Raffaghello, Lizzia; Rathmell, Jeffrey C; Rathmell, W Kimryn; Ray, Swapan K; Reichrath, Jörg; Rezazadeh, Sarallah; Ribatti, Domenico; Ricciardiello, Luigi; Robey, R Brooks; Rodier, Francis; Rupasinghe, H P Vasantha; Russo, Gian Luigi; Ryan, Elizabeth P; Samadi, Abbas K; Sanchez-Garcia, Isidro; Sanders, Andrew J; Santini, Daniele; Sarkar, Malancha; Sasada, Tetsuro; Saxena, Neeraj K; Shackelford, Rodney E; Shantha Kumara, H M C; Sharma, Dipali; Shin, Dong M; Sidransky, David; Siegelin, Markus David; Signori, Emanuela; Singh, Neetu; Sivanand, Sharanya; Sliva, Daniel; Smythe, Carl; Spagnuolo, Carmela; Stafforini, Diana M; Stagg, John; Subbarayan, Pochi R; Sundin, Tabetha; Talib, Wamidh H; Thompson, Sarah K; Tran, Phuoc T; Ungefroren, Hendrik; Vander Heiden, Matthew G; Venkateswaran, Vasundara; Vinay, Dass S; Vlachostergios, Panagiotis J; Wang, Zongwei; Wellen, Kathryn E; Whelan, Richard L; Yang, Eddy S; Yang, Huanjie; Yang, Xujuan; Yaswen, Paul; Yedjou, Clement; Yin, Xin; Zhu, Jiyue; Zollo, Massimo

    2015-12-01

    address stages and types of cancer that lack conventional treatment, and it may reduce relapse risks. A proposed agenda for future research is offered.

  16. A novel, integrated treatment system for coal wastewaters. Quarterly report, December 2, 1992--March 1, 1993

    SciTech Connect

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

    1993-07-01

    The aims of this study are to develop, characterize and optimize a novel treatment scheme that would be effective simultaneously against the toxic organics and the heavy metals present in coal conversion wastewaters. In this report, the following findings have been reported and discussed. Hec-CBDA-PA, (HCPA), a modified hectorite containing a mixed bilayer of a cationic (CBDA) and a long chain carboxylic acid (palmitic acid, PA) type surfactants, has been shown to adsorb Cu (II) strongly at pH 6.0. Increasing concentrations of NaCl reduce the affinity of CU(II) adsorption onto HCPA. For example, the binding constants for CU(II) adsorption onto HCPA at pH 6.0 are 88 and 35 mM{sup {minus}1} at 20 and 200 mM NaCl respectively. The saturation binding capacity is also observed to decrease from 0.25 to 0.12 mmoles Cu(II)/g adsorbent in the same ionic strength range. Spectral properties of Cu(II)-DT complex have been examined. Our previous results had shown that DT, an alkyl diamine, binds Cu(II) strongly at pH 7.4, but very weakly at pH 3.0. The formation of Cu(II)-DT complex at pH 7.4 produces an intense blue color and spectral measurements at 626 mn reveal a stoichiometric ratio of 3:1 for the DT-Cu(II) complex. {beta}-naphthoic acid, a organic acid (pKa = 4.17), has been used to probe the pH dependent surface charge of montmorillonite-DT (MONT-DT) complex. Our results indicate that bulk of the surface diamines are de-protonated above pH 9.0.

  17. Improving Depression Treatment for Women: Integrating a Collaborative Care Depression Intervention into OB-GYN Care

    PubMed Central

    LaRocco-Cockburn, Anna; Reed, Susan D.; Melville, Jennifer; Croicu, Carmen; Russo, Joan; Inspektor, Michal; Edmondson, Eddie; Katon, Wayne

    2013-01-01

    Background Women have higher rates of depression and often experience depression symptoms during critical reproductive periods, including adolescence, pregnancy, postpartum, and menopause. Collaborative care intervention models for mood disorders in patients receiving care in an OB-GYN clinic setting have not been evaluated. Study design and methodology for a randomized, controlled trial of collaborative care depression management versus usual care in OB-GYN clinics and the details of the adapted collaborative care intervention and model implementation are described in this paper. Methods Women over age 18 years with clinically significant symptoms of depression, as measured by a Patient Health Questionnaire-9 (PHQ-9) score ≥10 and a clinical diagnosis of major depression or dysthymia, were randomized to the study intervention or to usual care and were followed for 18 months. The primary outcome assessed was change over time in the SCL-20 depression scale between baseline and 12 months. Baseline Results 205 women were randomized: 57% white, 20% African American, 9% Asian or Pacific Islander, 7% Hispanic, and 6% Native American. Mean age was 39 years. 4.6% were pregnant and 7.5% were within 12 months postpartum. The majority were single, (52%), and 95% had at least the equivalent of a high school diploma. Almost all patients met DSM IV criteria for major depression (99%) and approximately 33% met criteria for dysthymia. Conclusions An OB-GYN collaborative care team including a social worker, psychiatrist and OB-GYN physician who met weekly and used an electronic tracking system for patients were essential elements of the proposed depression care treatment model described here. Further study of models that improve quality of depression care that are adapted to the unique OB-GYN setting are needed. PMID:23939510

  18. An overview of child physical abuse: developing an integrated parent-child cognitive-behavioral treatment approach.

    PubMed

    Runyon, Melissa K; Deblinger, Esther; Ryan, Erika E; Thakkar-Kolar, Reena

    2004-01-01

    This article reviews and summarizes the extant literature regarding child physical abuse (CPA). Literature is summarized that describes the wide range of short- and long-term effects of CPA on children as well as the documented characteristics of parents/caregivers who engage in physically abusive parenting practices. Although the reviewed research documents that interventions geared only toward the parent have been found to produce significant improvements with respect to parenting abilities, parent-child interactions, and children's behavior problems, there is a paucity of research examining the efficacy of interventions developed specifically to target the child's emotional and behavioral difficulties. Based on the few studies that have shown emotional and behavioral gains for children who have participated in treatment, an integrated parent-child cognitive-behavioral therapy (CBT) approach is proposed here to address the complex issues presented by both parent and child in CPA cases. The direct participation of the child in treatment also may improve our ability to target posttraumatic stress disorder (PTSD), depressive symptoms as well as anger control and dysfunctional abuse attributions in the children themselves. Implications for practice, public policy, and research are also addressed.

  19. Systematic Understanding of Mechanisms of a Chinese Herbal Formula in Treatment of Metabolic Syndrome by an Integrated Pharmacology Approach

    PubMed Central

    Chen, Meimei; Yang, Fafu; Yang, Xuemei; Lai, Xinmei; Gao, Yuxing

    2016-01-01

    Metabolic syndrome (MS) is becoming a worldwide health problem. Wendan decoction (WDD)—a famous traditional Chinese medicine formula—has been extensively employed to relieve syndromes related to MS in clinical practice in China. However, its pharmacological mechanisms still remain vague. In this study, a comprehensive approach that integrated chemomics, principal component analysis, molecular docking simulation, and network analysis was established to elucidate the multi-component and multi-target mechanism of action of WDD in treatment of MS. The compounds in WDD were found to possess chemical diversity, complexity and drug-likeness compared to MS drugs. Six nuclear receptors were obtained to have strong binding affinity with 217 compounds of five herbs in WDD. The importance roles of targets and herbs were also identified due to network parameters. Five compounds from Radix Glycyrrhizae Preparata can hit all six targets, which can assist in screening new MS drugs. The pathway network analysis demonstrated that the main pharmacological effects of WDD might lie in maintaining lipid and glucose metabolisms and anticancer activities as well as immunomodulatory and hepatoprotective effects. This study provided a comprehensive system approach for understanding the multi-component, multi-target and multi-pathway mechanisms of WDD during the treatment of MS. PMID:27999264

  20. Machinability of Austempered Ductile Iron (ADI) Produced by Integrated Green Technology of Continuous Casting-Heat Treatment Processes

    SciTech Connect

    Meena, A.; El Mansori, M.; Ghidossi, P.

    2011-01-17

    This study presents the novel processing technique known as continuous casting-heat treatment processes to produce Austempered Ductile Iron (ADI) which is a new class of ductile iron. ADI is characterized by improved mechanical properties but has low machinability as compared to other cast irons and steel of similar strength. The novel technique is developed by the integration of casting (in die casting) and heat treatment processes in foundry to save cost energy and time. Specimens just after casting were austenitized at 930 deg. C for 90 min and then austempered in fluidized bed at 380 deg. C for 90 and 120 min. Hence, the effect of austempering time on the morphology of retained austenite and mechanical properties of the material were examined and compared with conventionally produced ADI. Drilling tests were then carried out to evaluate the machinability of ADI in terms of cutting forces, chip micro-hardness, chip morphology and surface roughness. The mechanical properties of ADI austempered for 120 min have found to be better as compare to the ADI austempered for 90 min.

  1. Gadolinium(III)-Chelated Silica Nanospheres Integrating Chemotherapy and Photothermal Therapy for Cancer Treatment and Magnetic Resonance Imaging.

    PubMed

    Cao, Mingjing; Wang, Pengyang; Kou, Yu; Wang, Jing; Liu, Jing; Li, Yanhui; Li, Jiayang; Wang, Liming; Chen, Chunying

    2015-11-18

    The combination of therapy and diagnosis has been emerging as a promising strategy for cancer treatment. To realize chemotherapy, photothermal therapy, and magnetic resonance imaging (MRI) in one system, we have synthesized a new magnetic nanoparticle (Gd@SiO2-DOX/ICG-PDC) integrating doxorubicin (DOX), indocyanine green (ICG), and gadolinium(III)-chelated silica nanospheres (Gd@SiO2) with a poly(diallyldimethylammonium chloride) (PDC) coating. PDC coating serves as a polymer layer to protect from quick release of drugs from the nanocarriers and increase cellular uptake. The DOX release from Gd@SiO2-DOX/ICG-PDC depends on pH and temperature. The process will be accelerated in the acidic condition than in a neutral pH 7.4. Meanwhile, upon laser irradiation, the photothermal effects promote DOX release and improve the therapeutic efficacy compared to either DOX-loaded Gd@SiO2 or ICG-loaded Gd@SiO2. Moreover, MRI results show that the Gd@SiO2-PDC nanoparticles are safe T1-type MRI contrast agents for imaging. The Gd@SiO2-PDC nanoparticles loaded with DOX and ICG can thus act as a promising theranostic platform for multimodal cancer treatment.

  2. Ozone-biological activated carbon integrated treatment for removal of precursors of halogenated nitrogenous disinfection by-products.

    PubMed

    Chu, Wenhai; Gao, Naiyun; Yin, Daqiang; Deng, Yang; Templeton, Michael R

    2012-03-01

    Pilot-scale tests were performed to reduce the formation of several nitrogenous and carbonaceous disinfection by-products (DBPs) with an integrated ozone and biological activated carbon (O(3)-BAC) treatment process following conventional water treatment processes (coagulation-sedimentation-filtration). Relative to the conventional processes alone, O(3)-BAC significantly improved the removal of turbidity, dissolved organic carbon, UV(254), NH(4)(+) and dissolved organic nitrogen from 98-99%, 58-72%, 31-53%, 16-93% and 35-74%, respectively, and enhanced the removal efficiency of the precursors for the measured DBPs. The conventional process was almost ineffective in removing the precursors of trichloronitromethane (TCNM) and dichloroacetamide (DCAcAm). Ozonation could not substantially reduce the formation of DCAcAm, and actually increased the formation potential of TCNM; it chemically altered the molecular structures of the precursors and increased the biodegradability of N-containing organic compounds. Consequently, the subsequent BAC filtration substantially reduced the formation of the both TCNM and DCAcAm, thus highlighting a synergistic effect of O(3) and BAC. Additionally, O(3)-BAC was effective at controlling the formation of the total organic halogen, which can be considered as an indicator of the formation of unidentified DBPs.

  3. Integrated treatment process using a natural Wyoming clinoptilolite for remediating produced waters from coalbed natural gas operations

    USGS Publications Warehouse

    Zhao, H.; Vance, G.F.; Urynowicz, M.A.; Gregory, R.W.

    2009-01-01

    Coalbed natural gas (CBNG) development in western U.S. states has resulted in an increase in an essential energy resource, but has also resulted in environmental impacts and additional regulatory needs. A concern associated with CBNG development relates to the production of the copious quantities of potentially saline-sodic groundwater required to recover the natural gas, hereafter referred to as CBNG water. Management of CBNG water is a major environmental challenge because of its quantity and quality. In this study, a locally available Na-rich natural zeolite (clinoptilolite) from Wyoming (WY) was examined for its potential to treat CBNG water to remove Na+ and lower the sodium adsorption ratio (SAR, mmol1/2 L- 1/2). The zeolite material was Ca-modified before being used in column experiments. Column breakthrough studies indicated that a metric tonne (1000??kg) of Ca-WY-zeolite could be used to treat 60,000??L of CBNG water in order to lower SAR of the CBNG water from 30 to an acceptable level of 10??mmol1/2 L- 1/2. An integrated treatment process using Na-WY-zeolite for alternately treating hard water and CBNG water was also examined for its potential to treat problematic waters in the region. Based on the results of this study, use of WY-zeolite appears to be a cost-effective water treatment technology for maximizing the beneficial use of poor-quality CBNG water. Ongoing studies are evaluating water treatment techniques involving infiltration ponds lined with zeolite. ?? 2008 Elsevier B.V. All rights reserved.

  4. Ozonation and ultrafiltration for the treatment of olive mill wastewaters: effect of key operating conditions and integration schemes.

    PubMed

    Martins, Rui C; Ferreira, Ana M; Gando-Ferreira, Licínio M; Quinta-Ferreira, Rosa M

    2015-10-01

    With the objective of reaching suitable techniques for olive mill wastewater treatment, ozonation and ultrafiltration were studied individually and combined. A continuous reactor was run for the treatment of a phenolic mixture mimicking an actual olive mill wastewater (OMW) by ozonation. The effect of the main operating parameters was analysed (pH, liquid flow rate and ozone inlet concentration). The increase of pH and ozone dose improved ozonation efficiency. As expected, the highest residence time led to higher steady-state degradation (35 % of chemical oxygen demand (COD) abatement). Even if the rise on ozone inlet gas concentration was able to remove COD in a higher extent, it should be taken into consideration that with the lowest oxidant load (15 g O3/m(3)), the maximum steady-state biochemical oxygen demand (BOD5)/COD ratio was reached which would reduce the process costs. These operating conditions (pH 9, 1 mL/min of liquid flow rate and 15 g O3/m(3)) were applied to an actual OMW leading to 80 % of phenolic content abatement and 12 % of COD removal at the steady state. Regarding ultrafiltration, it was concluded that the best total phenolic content (TPh) and COD abatement results (55 and 15 %) are attained for pH 9 and using a transmembrane pressure drop of 1 bar. Among the integration schemes that were tested, ultrafiltration followed by ozonation was able to reach 93 and 20 % of TPh and COD depletion, respectively. Moreover, this sequence led to an effluent with a BOD5/COD ratio of about 0.55 which means that it likely can be posteriorly refined in a municipal wastewater treatment plant.

  5. Integrated Bacillus sp. immobilized cell reactor and Synechocystis sp. algal reactor for the treatment of tannery wastewater.

    PubMed

    Sekaran, G; Karthikeyan, S; Nagalakshmi, C; Mandal, A B

    2013-01-01

    The wastewater discharged from leather industries lack biodegradability due to the presence of xenobiotic compounds. The primary clarification and aerobic treatment in Bacillus sp. immobilized Chemo Autotrophic Activated Carbon Oxidation (CAACO) reactor removed considerable amount of pollution parameters. The residual untreated organics in the wastewater was further treated in algal batch reactor inoculated with Synechocystis sp. Sodium nitrate, K(2)HPO(4), MgSO(4).7H(2)O, NH(4)Cl, CaCl(2)·2H(2)O, FeCl(3) (anhydrous), and thiamine hydrochloride, rice husk based activated carbon (RHAC), immobilization of Bacillus sp. in mesoporous activated carbon, sand filter of dimensions diameter, 6 cm and height, 30 cm; and the CAACO reactor of dimensions diameter, 5.5 cm and height, 30 cm with total volume 720 ml, and working volume of 356 ml. In the present investigation, the CAACO treated tannery wastewater was applied to Synechocystis sp. inoculated algal batch reactor of hydraulic residence time 24 h. The BOD(5), COD, and TOC of treated wastewater from algal batch reactor were 20 ± 7, 167 ± 29, and 78 ± 16 mg/l respectively. The integrated CAACO system and Algal batch reactor was operated for 30 days and they accomplished a cumulative removal of BOD(5),COD, TOC, VFA and sulphide as 98 %, 95 %, 93 %, 86 %, and 100 %, respectively. The biokinetic constants for the growth of algae in the batch reactor were specific growth rate, 0.095(day(-1)) and yield coefficient, 3.15 mg of algal biomass/mg of COD destructed. The degradation of xenobiotic compounds in the algal batch reactor was confirmed through HPLC and FT-IR techniques. The integrated CAACO-Algal reactor system established a credible reduction in pollution parameters in the tannery wastewater. The removal mechanism is mainly due to co-metabolism between algae and bacterial species and the organics were completely metabolized rather than by adsorption.

  6. Whole-body hybrid imaging concept for the integration of PET/MR into radiation therapy treatment planning

    NASA Astrophysics Data System (ADS)

    Paulus, Daniel H.; Oehmigen, Mark; Grueneisen, Johannes; Umutlu, Lale; Quick, Harald H.

    2016-05-01

    Modern radiation therapy (RT) treatment planning is based on multimodality imaging. With the recent availability of whole-body PET/MR hybrid imaging new opportunities arise to improve target volume delineation in RT treatment planning. This, however, requires dedicated RT equipment for reproducible patient positioning on the PET/MR system, which has to be compatible with MR and PET imaging. A prototype flat RT table overlay, radiofrequency (RF) coil holders for head imaging, and RF body bridges for body imaging were developed and tested towards PET/MR system integration. Attenuation correction (AC) of all individual RT components was performed by generating 3D CT-based template models. A custom-built program for μ-map generation assembles all AC templates depending on the presence and position of each RT component. All RT devices were evaluated in phantom experiments with regards to MR and PET imaging compatibility, attenuation correction, PET quantification, and position accuracy. The entire RT setup was then evaluated in a first PET/MR patient study on five patients at different body regions. All tested devices are PET/MR compatible and do not produce visible artifacts or disturb image quality. The RT components showed a repositioning accuracy of better than 2 mm. Photon attenuation of  -11.8% in the top part of the phantom was observable, which was reduced to  -1.7% with AC using the μ-map generator. Active lesions of 3 subjects were evaluated in terms of SUVmean and an underestimation of  -10.0% and  -2.4% was calculated without and with AC of the RF body bridges, respectively. The new dedicated RT equipment for hybrid PET/MR imaging enables acquisitions in all body regions. It is compatible with PET/MR imaging and all hardware components can be corrected in hardware AC by using the suggested μ-map generator. These developments provide the technical and methodological basis for integration of PET/MR hybrid imaging into RT planning.

  7. Whole-body hybrid imaging concept for the integration of PET/MR into radiation therapy treatment planning.

    PubMed

    Paulus, Daniel H; Oehmigen, Mark; Grüneisen, Johannes; Umutlu, Lale; Quick, Harald H

    2016-05-07

    Modern radiation therapy (RT) treatment planning is based on multimodality imaging. With the recent availability of whole-body PET/MR hybrid imaging new opportunities arise to improve target volume delineation in RT treatment planning. This, however, requires dedicated RT equipment for reproducible patient positioning on the PET/MR system, which has to be compatible with MR and PET imaging. A prototype flat RT table overlay, radiofrequency (RF) coil holders for head imaging, and RF body bridges for body imaging were developed and tested towards PET/MR system integration. Attenuation correction (AC) of all individual RT components was performed by generating 3D CT-based template models. A custom-built program for μ-map generation assembles all AC templates depending on the presence and position of each RT component. All RT devices were evaluated in phantom experiments with regards to MR and PET imaging compatibility, attenuation correction, PET quantification, and position accuracy. The entire RT setup was then evaluated in a first PET/MR patient study on five patients at different body regions. All tested devices are PET/MR compatible and do not produce visible artifacts or disturb image quality. The RT components showed a repositioning accuracy of better than 2 mm. Photon attenuation of  -11.8% in the top part of the phantom was observable, which was reduced to  -1.7% with AC using the μ-map generator. Active lesions of 3 subjects were evaluated in terms of SUVmean and an underestimation of  -10.0% and  -2.4% was calculated without and with AC of the RF body bridges, respectively. The new dedicated RT equipment for hybrid PET/MR imaging enables acquisitions in all body regions. It is compatible with PET/MR imaging and all hardware components can be corrected in hardware AC by using the suggested μ-map generator. These developments provide the technical and methodological basis for integration of PET/MR hybrid imaging into RT planning.

  8. Multidisciplinary assessment and treatment of self-injurious behavior in autism spectrum disorder and intellectual disability: integration of psychological and biological theory and approach.

    PubMed

    Minshawi, Noha F; Hurwitz, Sarah; Morriss, Danielle; McDougle, Christopher J

    2015-06-01

    The objective of this review is to consider the psychological (largely behavioral) and biological [neurochemical, medical (including genetic), and pharmacological] theories and approaches that contribute to current thinking about the etiology and treatment of self-injurious behavior (SIB) in individuals with autism spectrum disorder and/or intellectual disability. Algorithms for the assessment and treatment of SIB in this context, respectively, from a multidisciplinary, integrative perspective are proposed and challenges and opportunities that exist in clinical and research settings are discussed.

  9. Treatment

    MedlinePlus

    ... Ban For Clinicians Clinical Recognition Specimen Collection Treatment Smallpox Vaccine Guidance Infection Control: Hospital Infection Control: Home ... Mouth Infection) Poxvirus and Rabies Branch Travelers’ Health: Smallpox & Other Orthopoxvirus-Associated Infections Poxvirus Treatment Recommend on ...

  10. Integration of ozonation and an anaerobic sequencing batch reactor (AnSBR) for the treatment of cherry stillage.

    PubMed

    Alvarez, Pedro M; Beltrán, Fernando J; Rodríguez, Eva M

    2005-01-01

    Cherry stillage is a high strength organic wastewater arising from the manufacture of alcoholic products by distillation of fermented cherries. It is made up of biorefractory polyphenols in addition to readily biodegradable organic matter. An anaerobic sequencing batch reactor (AnSBR) was used to treat cherry stillage at influent COD ranging from 5 to 50 g/L. Different cycle times were selected to test biomass organic loading rates (OLR(B)), from 0.3 to 1.2 g COD/g VSS.d. COD and TOC efficiency removals higher than 80% were achieved at influent COD up to 28.5 g/L but minimum OLR(B) tested. However, as a result of the temporary inhibition of acetogens and methanogens, volatile fatty acids (VFA) noticeably accumulated and methane production came to a transient standstill when operating at influent COD higher than 10 g/L. At these conditions, the AnSBR showed signs of instability and could not operate efficiently at OLR(B) higher than 0.3 g COD/g VSS.d. A feasible explanation for this inhibition is the presence of toxic polyphenols in cherry stillage. Thus, an ozonation step prior to the AnSBR was observed to be useful, since more than 75% of polyphenols could be removed by ozone. The integrated process was shown to be a suitable treatment technology as the following advantages compared to the single AnSBR treatment were observed: greater polyphenols and color removals, higher COD and TOC removal rates thus enabling the process to effectively operate at higher OLR, higher degree of biomethanation, and good stability with less risk of acidification.

  11. Assessment and Evaluation of an Integrated Hybrid Anaerobic-Aerobic Sewage Treatment System for the Removal of Enteric Viruses.

    PubMed

    El-Senousy, Waled Morsy; Abou-Elela, Sohair Imam

    2017-02-14

    The capability of a cost-effective and a small size decentralized pilot wastewater treatment plant (WWTP) to remove enteric viruses such as rotavirus, norovirus genogroup I (GGI), norovirus genogroup II (GGII), Hepatitis E virus (HEV), and adenovirus was studied. This pilot plant is an integrated hybrid anaerobic/aerobic setup which consisted of anaerobic sludge blanket (UASB), biological aerated filter (BAF), and inclined plate settler (IPS). Both the UASB and BAF are packed with a non-woven polyester fabric (NWPF). Results indicated that the overall log10 reductions of enteric viruses' genome copies through the whole system were 3.1 ± 1, 3.3 ± 0.5, and 2.6 ± 0.9 log10 for rotavirus, norovirus GGI, and adenovirus, respectively. Reduction efficiency for both norovirus GGII and HEV after the different treatment steps could not be calculated because there were no significant numbers of positive samples for both viruses. The overall reduction of rotavirus infectious units through the whole system was 2.2 ± 0.8 log10 reduction which is very close to the overall log10 reduction of adenovirus infectious units through the whole system which was 2.1 ± 0.8 log10 reduction. There was no considerable difference in the removal efficiency for different rotavirus G and P types. Adenovirus 41 was the only type detected in the all positive samples. Although the pilot WWTP investigated is cost effective, has a small footprint, does not need a long distance network pipes, and easy to operate, its efficiency to remove enteric viruses is comparable with the conventional centralized WWTPs.

  12. The Adolescent Mentalization-based Integrative Treatment (AMBIT) approach to outcome evaluation and manualization: adopting a learning organization approach.

    PubMed

    Fuggle, Peter; Bevington, Dickon; Cracknell, Liz; Hanley, James; Hare, Suzanne; Lincoln, John; Richardson, Garry; Stevens, Nina; Tovey, Heather; Zlotowitz, Sally

    2015-07-01

    AMBIT (Adolescent Mentalization-Based Integrative Treatment) is a developing team approach to working with hard-to-reach adolescents. The approach applies the principle of mentalization to relationships with clients, team relationships and working across agencies. It places a high priority on the need for locally developed evidence-based practice, and proposes that outcome evaluation needs to be explicitly linked with processes of team learning using a learning organization framework. A number of innovative methods of team learning are incorporated into the AMBIT approach, particularly a system of web-based wiki-formatted AMBIT manuals individualized for each participating team. The paper describes early development work of the model and illustrates ways of establishing explicit links between outcome evaluation, team learning and manualization by describing these methods as applied to two AMBIT-trained teams; one team working with young people on the edge of care (AMASS - the Adolescent Multi-Agency Support Service) and another working with substance use (CASUS - Child and Adolescent Substance Use Service in Cambridgeshire). Measurement of the primary outcomes for each team (which were generally very positive) facilitated team learning and adaptations of methods of practice that were consolidated through manualization.

  13. Efficiency assessment of wastewater treatment plants: A data envelopment analysis approach integrating technical, economic, and environmental issues.

    PubMed

    Castellet, Lledó; Molinos-Senante, María

    2016-02-01

    The assessment of the efficiency of wastewater treatment plants (WWTPs) is essential to compare their performance and consequently to identify the best operational practices that can contribute to the reduction of operational costs. Previous studies have evaluated the efficiency of WWTPs using conventional data envelopment analysis (DEA) models. Most of these studies have considered the operational costs of the WWTPs as inputs, while the pollutants removed from wastewater are treated as outputs. However, they have ignored the fact that each pollutant removed by a WWTP involves a different environmental impact. To overcome this limitation, this paper evaluates for the first time the efficiency of a sample of WWTPs by applying the weighted slacks-based measure model. It is a non-radial DEA model which allows assigning weights to the inputs and outputs according their importance. Thus, the assessment carried out integrates environmental issues with the traditional "techno-economic" efficiency assessment of WWTPs. Moreover, the potential economic savings for each cost item have been quantified at a plant level. It is illustrated that the WWTPs analyzed have significant room to save staff and energy costs. Several managerial implications to help WWTPs' operators make informed decisions were drawn from the methodology and empirical application carried out.

  14. Integration of traditional systems and advanced oxidation process technologies for the industrial treatment of olive mill wastewaters.

    PubMed

    Amaral-Silva, Nuno; Martins, Rui C; Castro-Silva, Sérgio; Quinta-Ferreira, Rosa M

    2016-10-01

    A complete industrial treatment system (involving the integration of coagulation/flocculation and Fenton processes) to depurate real wastewaters coming from two-phase olive oil production mills has been studied. The experimental results indicated that at the end of this combined strategy, involving a primary physical separation stage followed by Fenton's chemical oxidation, chemical oxygen demand (COD) is reduced up to 90% and total polyphenols' concentration is decreased up to 92%. The treated stream biodegradability (BOD5/COD) reached 0.52 and the Total Suspended Solids (TSSs) and Total Dissolved Solids (TDSs) decreased up to 95% and 69%, respectively. Fenton's procedure was optimized bearing in mind the pH adjustment step, different procedures for hydrogen peroxide addition and the use of coagulants instead of the chemical precipitation (by raising pH) to promote iron sludge settling. Our results demonstrated that pH (3.0 ± 0.1) control during the oxidation reaction improves the oxidation efficiency. Moreover, the final NaOH addition is essential to a better sludge formation and consequent precipitation of the residual iron removing also some organic matter.

  15. New Strategies for Combining Mindfulness with Integrative Cognitive Behavioral Therapy for the Treatment of Generalized Anxiety Disorder.

    PubMed

    Rapgay, Lobsang; Bystritsky, Alexander; Dafter, Roger E; Spearman, Michelle

    2011-06-01

    Generalized anxiety disorder (GAD) severely impacts social functioning, distress levels, and utilization of medical care compared with that of other major psychiatric disorders. Neither pharmacological nor psychotherapy interventions have adequately controlled cardinal symptoms of GAD: pervasive excessive anxiety and uncontrollable worry. Research has established cognitive behavioral therapy (CBT) as the most effective psychotherapy for controlling GAD; however, outcomes remain at only 50% reduction, with high relapse rates. Mindfulness has been integrated with CBT to treat people suffering from numerous psychiatric disorders, with mindfulness based stress reduction (MBSR) being the most researched. Preliminary evidence supports MBSR's potential for controlling GAD symptoms and key researchers suggest mindfulness practices possess key elements for treating GAD. Classical mindfulness (CM) differs significantly from MBSR and possesses unique potentials for directly targeting process and state GAD symptoms inadequately treated by CBT. This article introduces the theory and practice of CM, its differences from MBSR, and a critical review of MBSR and CBT treatments for GAD. CM strategies designed to complement CBT targeting cardinal GAD symptoms are outlined with a case study illustrating its use.

  16. Hypofractionated high-dose irradiation for the treatment of malignant astrocytomas using simultaneous integrated boost technique by IMRT

    SciTech Connect

    Iuchi, Toshihiko; Hatano, Kazuo; Narita, Yuichiro; Kodama, Takashi; Yamaki, Tomohiro; Osato, Katsunobu

    2006-04-01

    Purpose: We evaluated the clinical significance of hypofractionated high-dose irradiation using simultaneous integrated boost technique with intensity-modulated radiation therapy (IMRT) for the treatment of malignant astrocytomas (MAs). Methods and Materials: Twenty-five patients with MAs were treated by IMRT. Three layered planning target volumes (PTVs) were contoured. PTV-1 was the area of enhanced lesion with 5-mm margin; PTV-2 was the area with 15-mm margin surrounding the PTV-1; PTV-3 was the area of perifocal edema. Irradiation was performed in 8 fractions, and only the dose for PTV-1 was escalated from 48 Gy to 68 Gy while maintaining the dose for PTV-2 (40 Gy) and PTV-3 (32 Gy). The clinical outcome of IMRT was compared with 60 MA patients treated by conventional external beam irradiation (EBI). Results: The progression-free survival of patients in the IMRT group was significantly longer than that in the EBI group (p < 0.0001). No distant failure was observed in both groups. In the IMRT group, dissemination was the most frequent cause of death (70%). The overall survival of patients in the IMRT group was better than that in the EBI group (p = 0.043). Conclusions: Our regimen of IMRT contributed to the control of both the regional and infiltrating tumors, resulting in better survival of patients.

  17. Integrated thermophilic submerged aerobic membrane bioreactor and electrochemical oxidation for pulp and paper effluent treatment--towards system closure.

    PubMed

    Qu, X; Gao, W J; Han, M N; Chen, A; Liao, B Q

    2012-07-01

    A novel integrated thermophilic submerged aerobic membrane bioreactor (TSAMBR) and electrochemical oxidation (EO) technology was developed for thermomechanical pulping pressate treatment with the aim of system closure. The TSAMBR was able to achieve a chemical oxygen demand (COD) removal efficiency of 88.6 ± 1.9-92.3 ± 0.7% under the organic loading rate of 2.76 ± 0.13-3.98 ± 0.23 kg COD/(m(3) d). An optimal hydraulic retention time (HRT) of 1.1 ± 0.1d was identified for COD removal. Cake formation was identified as the dominant mechanism of membrane fouling. The EO of the TSAMBR permeate was performed using a Ti/SnO(2)-Sb(2)O(5)-IrO(2) electrode. After 6-h EO, a complete decolourization was achieved and the COD removal efficiency was increased to 96.2 ± 1.2-98.2 ± 0.3%. The high-quality effluent produced by the TSAMBR-EO system can be reused as process water for system closure in pulp and paper mill.

  18. Benefits and risks of emerging technologies: integrating life cycle assessment and decision analysis to assess lumber treatment alternatives.

    PubMed

    Tsang, Michael P; Bates, Matthew E; Madison, Marcus; Linkov, Igor

    2014-10-07

    Assessing the best options among emerging technologies (e.g., new chemicals, nanotechnologies) is complicated because of trade-offs across benefits and risks that are difficult to quantify given limited and fragmented availability of information. This study demonstrates the integration of multicriteria decision analysis (MCDA) and life cycle assessment (LCA) to address technology alternative selection decisions. As a case study, prioritization of six lumber treatment alternatives [micronized copper quaternary (MCQ); alkaline copper quaternary (ACQ); water-borne copper naphthenate (CN); oil-borne copper naphthenate (CNo); water-borne copper quinolate (CQ); and water-borne zinc naphthenate (ZN)] for military use are considered. Multiattribute value theory (MAVT) is used to derive risk and benefit scores. Risk scores are calculated using a cradle-to-gate LCA. Benefit scores are calculated by scoring of cost, durability, and corrosiveness criteria. Three weighting schemes are used, representing Environmental, Military and Balanced stakeholder perspectives. Aggregated scores from all three perspectives show CQ to be the least favorable alterative. MCQ is identified as the most favorable alternative from the Environmental stakeholder perspective. From the Military stakeholder perspective, ZN is determined to be the most favorable alternative, followed closely by MCQ. This type of scoring and ranking of multiple heterogeneous criteria in a systematic and transparent way facilitates better justification of technology selection and regulation.

  19. Membrane gas absorbers for H2S removal--design, operation and technology integration into existing odour treatment strategies.

    PubMed

    Jefferson, B; Nazareno, C; Georgaki, S; Gostelow, P; Stuetz, R M; Longhurst, P; Robinson, T

    2005-07-01

    A hollow fibre (HF) polypropylene membrane gas absorber was investigated for the removal of hydrogen sulphide (H2S) from gas streams. Gas concentrations between 25-2010 ppmV were fed into the shell side of a membrane module whilst water-NaOH solutions flowed counter-currently in the fibre lumens. The process was effective at removing the H2S (96% at G:L ratios up to 50 and pH 13) from the gas phase in a single pass through the membrane at all the concentrations of HaS investigated. Analysis of the mass transfer process revealed the rate of transfer to be controlled by the gas phase transfer coefficient with a value between 1 and 25 x 10(-4) m.s(-1). The possible integration of a membrane absorber system into existing odour treatment strategies was assessed by comparing the membrane system, based on the experimentally determined mass transfer coefficient, with existing full scale biofiltration plants. The membrane system became economically favourable at gas flow rates lower than 1630 m(3) x h(-1).

  20. Integrated experimental investigation and mathematical modeling of brackish water desalination and wastewater treatment in microbial desalination cells.

    PubMed

    Ping, Qingyun; Huang, Zuyi; Dosoretz, Carlos; He, Zhen

    2015-06-15

    Desalination of brackish water can provide freshwater for potable use or non potable applications such as agricultural irrigation. Brackish water desalination is especially attractive to microbial desalination cells (MDCs) because of its low salinity, but this has not been well studied before. Herein, three brackish waters prepared according to the compositions of actual brackish water in three locations in Israel were examined with domestic wastewater as an electron source in a bench-scale MDC. All three brackish waters could be effectively desalinated with simultaneous wastewater treatment. The MDC achieved the highest salt removal rate of 1.2 g L(-1) d(-1) with an initial salinity of 5.9 g L(-1) and a hydraulic retention time (HRT) of 0.8 d. The desalinated brackish water could meet the irrigation standard of both salinity (450 mg L(-1) TDS) and the concentrations of major ionic species, given a sufficient HRT. The MDC also accomplished nearly 70% removal of organic compounds in wastewater with Coulombic efficiency varied between 5 and 10%. A previously developed MDC model was improved for brackish water desalination, and could well predict salinity variation and the concentrations of individual ions. The model also simulated a staged operation mode with improved desalination performance. This integrated experiment and mathematical modeling approach provides an effective method to understand the key factors in brackish water desalination by MDCs towards further system development.

  1. Development of a Novel Process Integrating the Treatment of Sludge Reject Water and the Production of Polyhydroxyalkanoates (PHAs).

    PubMed

    Frison, Nicola; Katsou, Evina; Malamis, Simos; Oehmen, Adrian; Fatone, Francesco

    2015-09-15

    Polyhydroxyalkanoates (PHAs) from activated sludge and renewable organic material can become an alternative product to traditional plastics since they are biodegradable and are produced from renewable sources. In this work, the selection of PHA storing bacteria was integrated with the side stream treatment of nitrogen removal via nitrite from sewage sludge reject water. A novel process was developed and applied where the alternation of aerobic-feast and anoxic-famine conditions accomplished the selection of PHA storing biomass and nitrogen removal via nitrite. Two configurations were examined: in configuration 1 the ammonium conversion to nitrite occurred in the same reactor in which the PHA selection process occurred, while in configuration 2 two separate reactors were used. The results showed that the selection of PHA storing biomass was successful in both configurations, while the nitrogen removal efficiency was much higher (almost 90%) in configuration 2. The PHA selection degree was evaluated by the volatile fatty acid (VFA) uptake rate (-qVFAs) and the PHA production rate (qPHA), which were 239 ± 74 and 89 ± 7 mg of COD per gram of active biomass (Xa) per hour, respectively. The characterization of the biopolymer recovered after the accumulation step, showed that it was composed of 3-hydroxybutyrate (3HB) (60%) and 3-hydroxyvalerate (3HV) (40%). The properties associated with the produced PHA suggest that they are suitable for thermoplastic processing.

  2. Antifogging and antireflection coatings fabricated by integrating solid and mesoporous silica nanoparticles without any post-treatments.

    PubMed

    Xu, Ligang; He, Junhui

    2012-06-27

    Antifogging and -reflection coatings were fabricated on glass and poly(methyl methacrylate) (PMMA) substrates by integrating solid silica nanoparticles of 25 nm (S-25) and mesoporous silica nanoparticles (MSNs) of 45 nm via layer-by-layer assembly without any post-treatments. Superhydrophilicity and a maximum transmittance of 98.5% in the visible spectral range was achieved for the (PDDA/S-25)4/(PDDA/MSNs) coating deposited on slide glass. The maximum transmittance even reached as high as 99.3% in the visible spectral range by applying a coating of (PDDA/S-25)8/(PDDA/MSNs) on PMMA substrate. Scanning and transmission electron microscopy were used to observe the morphology and structure of nanoparticles and coating surfaces. Optical properties were characterized by UV-visible spectrophotometer. Surface wettability was studied by a contact angle/interface system. The influence of mesopores was also discussed on the transmission and wetting properties of coatings. The high porosity of mesoporous nanoparticles and loose stacking of solid and mesoporous nanoparticles are considered to significantly contribute to the enhancements of both light transmission and hydrophilicity.

  3. Risk assessment, disease prevention and personalised treatments in breast cancer: is clinically qualified integrative approach in the horizon?

    PubMed Central

    2013-01-01

    Breast cancer is a multifactorial disease. A spectrum of internal and external factors contributes to the disease promotion such as a genetic predisposition, chronic inflammatory processes, exposure to toxic compounds, abundant stress factors, a shift-worker job, etc. The cumulative effects lead to high incidence of breast cancer in populations worldwide. Breast cancer in the USA is currently registered with the highest incidence rates amongst all cancer related patient cohorts. Currently applied diagnostic approaches are frequently unable to recognise early stages in tumour development that impairs individual outcomes. Early diagnosis has been demonstrated to be highly beneficial for significantly enhanced therapy efficacy and possibly full recovery. Actual paper shows that the elaboration of an integrative diagnostic approach combining several levels of examinations creates a robust platform for the reliable risk assessment, targeted preventive measures and more effective treatments tailored to the person in the overall task of breast cancer management. The levels of examinations are proposed, and innovative technological approaches are described in the paper. The absolute necessity to create individual patient profiles and extended medical records is justified for the utilising by routine medical services. Expert recommendations are provided to promote further developments in the field. PMID:23418957

  4. The effects of integrated treatment of UV light and low dose gamma radiation on Escherichia coli O157:H7 and Salmonella enterica on grape tomatoes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In recent years considerable numbers of foodborne disease outbreaks associated with produce were reported and specifically Tomatoes have been involved with a number of multi state outbreaks. The purpose of this study was to evaluate efficacy of integrated treatment of UVC and low dose Gamma radiatio...

  5. Efficacy of integrated treatment of UV light and low dose gamma irradiation on Escherichia coli O157:H7 and Salmonella enterica on grape tomatoes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Efficacy of integrated treatment of UVC and low dose Gamma irradiation to inactivate mixed Strains of Escherichia coli O157:H7 and Salmonella enterica inoculated on whole Grape tomatoes was evaluated. A mixed bacterial cocktail composed of a three strain mixture of E. coli O157:H7 (C9490, E02128 an...

  6. Functional Analytic Psychotherapy Is a Framework for Implementing Evidence-Based Practices: The Example of Integrated Smoking Cessation and Depression Treatment

    ERIC Educational Resources Information Center

    Holman, Gareth; Kohlenberg, Robert J.; Tsai, Mavis; Haworth, Kevin; Jacobson, Emily; Liu, Sarah

    2012-01-01

    Depression and cigarette smoking are recurrent, interacting problems that co-occur at high rates and--especially when depression is chronic--are difficult to treat and associated with costly health consequences. In this paper we present an integrative therapeutic framework for concurrent treatment of these problems based on evidence-based…

  7. Advanced treatment of biologically pretreated coal gasification wastewater by a novel integration of three-dimensional catalytic electro-Fenton and membrane bioreactor.

    PubMed

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

    2015-12-01

    Laboratorial scale experiments were conducted to investigate a novel system three-dimensional catalytic electro-Fenton (3DCEF, catalyst of sewage sludge based activated carbon which loaded Fe3O4) integrating with membrane bioreactor (3DCEF-MBR) on advanced treatment of biologically pretreated coal gasification wastewater. The results indicated that 3DCEF-MBR represented high efficiencies in eliminating COD and total organic carbon, giving the maximum removal efficiencies of 80% and 75%, respectively. The integrated 3DCEF-MBR system significantly reduced the transmembrane pressure, giving 35% lower than conventional MBR after 30 days operation. The enhanced hydroxyl radical oxidation and bacteria self repair function were the mechanisms for 3DCEF-MBR performance. Therefore, the integrated 3DCEF-MBR was expected to be the promising technology for advanced treatment in engineering applications.

  8. Buprenorphine maintenance treatment retention improves nationally recommended preventive primary care screenings when integrated into urban federally qualified health centers.

    PubMed

    Haddad, Marwan S; Zelenev, Alexei; Altice, Frederick L

    2015-02-01

    Buprenorphine maintenance therapy (BMT) expands treatment access for opioid dependence and can be integrated into primary health-care settings. Treating opioid dependence, however, should ideally improve other aspects of overall health, including preventive services. Therefore, we examined how BMT affects preventive health-care outcomes, specifically nine nationally recommended primary care quality health-care indicators (QHIs), within federally qualified health centers (FQHCs) from an observational cohort study of 266 opioid-dependent patients initiating BMT between 07/01/07 and 11/30/08 within Connecticut's largest FQHC network. Nine nationally recommended preventive QHIs were collected longitudinally from electronic health records, including screening for chronic infections, metabolic conditions, and cancer. A composite QHI score (QHI-S), based on the percentage of eligible QHIs achieved, was categorized as QHI-S ≥80% (recommended) and ≥90% (optimal). The proportion of subjects achieving a composite QHI-S ≥80 and ≥90 % was 57.1 and 28.6%, respectively. Screening was highest for hypertension (91.0%), hepatitis C (80.1%), hepatitis B (76.3%), human immunodeficiency virus (71.4%), and hyperlipidemia (72.9%) and lower for syphilis (49.3%) and cervical (58.5%), breast (44.4%), and colorectal (48.7%) cancer. Achieving QHI-S ≥80% was positively and independently associated with ≥3-month BMT retention (adjusted odds ratio (AOR) = 2.19; 95% confidence interval (CI) = 1.18-4.04) and BMT prescription by primary care providers (PCPs) rather than addiction psychiatric specialists (AOR = 3.38; 95% CI = 1.78-6.37), and negatively with being female (AOR = 0.30; 95% CI = 0.16-0.55). Within primary health-care settings, achieving greater nationally recommended health-care screenings or QHIs was associated with being able to successfully retain patients on buprenorphine longer (3 months or more) and when buprenorphine was prescribed

  9. Development of an integrated, in-situ remediation technology: Task 1 -- Evaluation of treatment zone formation options. Topical report, September 26, 1994--May 25, 1996

    SciTech Connect

    Shoemaker, S.H.; Landis, R.C.; Griffith, R.J.; Schultz, D.S.; Quinton, G.E.

    1997-05-01

    Contamination in low permeability soils poses a significant technical challenge to in-situ remediation efforts. Poor accessibility to the contaminants and difficulty in delivery of treatment reagents have rendered existing in-situ treatments such as bioremediation, vapor extraction, pump and treat rather ineffective when applied to low permeability soils present at many contaminated sites. The technology is an integrated in-situ treatment in which established geotechnical methods are used to install degradation zones directly in the contaminated soil and electro-osmosis is utilized to move the contaminants back and forth through those zones until the treatment is completed. This topical report presents the results of evaluations by E.I. duPont de Nemours and Co., Inc. of treatment zone and electrode emplacement alternatives for use in the integrated treatment process. Specifically, the scope of this study was limited to vertical configuration emplacements. Several promising alternatives were identified ranging from approaches involving standard excavation techniques to relatively specialized geotechnical construction methods which could be modified for the treatment zone emplacement purpose. Information developed in this report is designed to help the user select the most promising emplacement method(s) for a given site on the basis of (1) depth of emplacement, and (2) restrictions on handling excavated soils. Advantages, disadvantages, and estimated costs are identified for each alternative, and possible bases for improvement and cost reduction through further development are described.

  10. Colour and toxic characteristics of metakaolinite–hematite pigment for integrally coloured concrete, prepared from iron oxide recovered from a water treatment plant of an abandoned coal mine

    SciTech Connect

    Sadasivam, Sivachidambaram Thomas, Hywel Rhys

    2016-07-15

    A metakaolinite-hematite (KH) red pigment was prepared using an ocherous iron oxide sludge recovered from a water treatment plant of an abandoned coal mine. The KH pigment was prepared by heating the kaolinite and the iron oxide sludge at kaolinite's dehydroxylation temperature. Both the raw sludge and the KH specimen were characterised for their colour properties and toxic characteristics. The KH specimen could serve as a pigment for integrally coloured concrete and offers a potential use for the large volumes of the iron oxide sludge collected from mine water treatment plants. - Graphical abstract: A kaolinite based red pigment was prepared using an ocherous iron oxide sludge recovered from an abandoned coal mine water treatment plant. Display Omitted - Highlights: • A red pigment was prepared by heating a kaolinite and an iron oxide sludge. • The iron oxide and the pigment were characterised for their colour properties. • The red pigment can be a potential element for integrally coloured concrete.

  11. [Integrated treatment of cooccurring mental and substance use disorders in urban populations : the situation in Montréal].

    PubMed

    Dubreucq, Simon; Chanut, Florence; Jutras-Aswad, Didier

    2012-01-01

    The prevalence of patients diagnosed with both a psychiatric and an addiction disorder is considerable. Like many other large urban centers, Montreal harbors many of these socially marginalized individuals. In spite of a wide range of resources for the treatment of each condition taken singly, there has been until recently an alarming dearth of programs aimed at providing integrated treatment models. In recent years, the CHUM has endeavored to implement such a program in order to address the multiple needs of a population often rendered vulnerable in many respects. In this article, the authors address the magnitude of this "dual diagnosis" problem, existing intervention models and the obstacles faced by this population in terms of access to health care ; they describe the steps leading to the establishment of an Addiction Psychiatric Unit at the CHUM and the challenges arising from the creation of a multidisciplinary integrated treatment model in an urban setting.

  12. Comparison of whole-field simultaneous integrated boost VMAT and IMRT in the treatment of nasopharyngeal cancer

    SciTech Connect

    Jin, Xiance; Yi, Jinling; Zhou, Yongqiang; Yan, Huawei; Han, Ce; Xie, Congying

    2013-01-01

    To study the feasibility of using volumetric-modulated arc therapy (VMAT) to deliver whole-field simultaneous integrated boost (WF-SIB) to treat patients with nasopharyngeal cancer (NPC). WF-SIB intensity-modulated radiotherapy (IMRT) plans, one-arc WF-SIB VMAT plans, and two-arc WF-SIB VMAT plans were generated with identical objective functions for 8 patients with NPC of various stages. Isodose distributions and dose-volume histograms were evaluated. Dosimetric and biological quality indices of clinical target volume (CTV) and organs at risk (OARs) were calculated to study the optimization capability of these 3 modalities in the treatment of patients with NPC. The optimization time, delivery time, required monitor units (MUs), and delivery accuracy were also compared to investigate the feasibility of these 3 modalities. There was no significant difference (p = 0.92) in target coverage (TC) between WF-SIB IMRT (99.00 ± 0.79) and two-arc WF-SIB VMAT (97.98 ± 1.29). However, both had higher TC than one-arc VMAT plans (89.92 ± 6.32, p < 0.01). IMRT demonstrated the best protection of the spinal cord, whereas two-arc VMAT showed the minimum D{sub max} to OARs. No other significant differences were observed among these 3 modalities on CTV coverage and OAR sparing. The delivery and MU efficiency of one-arc and two-arc WF-SIB VMAT were greatly improved compared with WF-SIB IMRT. The optimization time of one-arc and two-arc WF-SIB VMAT plans were 5 and 10 times greater than that of WF-SIB IMRT, respectively. The delivery accuracy of WF-SIB VMAT was not affected by the increased freedom. For patients with NPC, one-arc WF-SIB VMAT might not be able to achieve sufficient TC, whereas two-arc WF-SIB VMAT was able to achieve reasonable TC. No significant advantage on OAR protection was demonstrated by VMAT compared with IMRT. WF-SIB VMAT has significantly shorter delivery times, but WF-SIB IMRT may still be the first treatment choice for patients with NPC.

  13. Radioactive Air Emissions Notice of Construction for the 105-KW Basin integrated water treatment system filter vessel sparging vent

    SciTech Connect

    Kamberg, L.D.

    1998-02-23

    This document serves as a notice of construction (NOC), pursuant to the requirements of Washington Administrative Code (WAC) 246-247-060, and as a request for approval to construct, pursuant to 40 Code of Federal Regulations (CFR) 61.07, for the Integrated Water Treatment System (IWTS) Filter Vessel Sparging Vent at 105-KW Basin. Additionally, the following description, and references are provided as the notices of startup, pursuant to 40 CFR 61.09(a)(1) and (2) in accordance with Title 40 Code of Federal Regulations, Part 61, National Emission Standards for Hazardous Air Pollutants. The 105-K West Reactor and its associated spent nuclear fuel (SNF) storage basin were constructed in the early 1950s and are located on the Hanford Site in the 100-K Area about 1,400 feet from the Columbia River. The 105-KW Basin contains 964 Metric Tons of SNF stored under water in approximately 3,800 closed canisters. This SNF has been stored for varying periods of time ranging from 8 to 17 years. The 105-KW Basin is constructed of concrete with an epoxy coating and contains approximately 1.3 million gallons of water with an asphaltic membrane beneath the pool. The IWTS, which has been described in the Radioactive Air Emissions NOC for Fuel Removal for 105-KW Basin (DOE/RL-97-28 and page changes per US Department of Energy, Richland Operations Office letter 97-EAP-814) will be used to remove radionuclides from the basin water during fuel removal operations. The purpose of the modification described herein is to provide operational flexibility for the IWTS at the 105-KW basin. The proposed modification is scheduled to begin in calendar year 1998.

  14. A new approach to integrate GPU-based Monte Carlo simulation into inverse treatment plan optimization for proton therapy.

    PubMed

    Li, Yongbao; Tian, Zhen; Song, Ting; Wu, Zhaoxia; Liu, Yaqiang; Jiang, Steve; Jia, Xun

    2017-01-07

    Monte Carlo (MC)-based spot dose calculation is highly desired for inverse treatment planning in proton therapy because of its accuracy. Recent studies on biological optimization have also indicated the use of MC methods to compute relevant quantities of interest, e.g. linear energy transfer. Although GPU-based MC engines have been developed to address inverse optimization problems, their efficiency still needs to be improved. Also, the use of a large number of GPUs in MC calculation is not favorable for clinical applications. The previously proposed adaptive particle sampling (APS) method can improve the efficiency of MC-based inverse optimization by using the computationally expensive MC simulation more effectively. This method is more efficient than the conventional approach that performs spot dose calculation and optimization in two sequential steps. In this paper, we propose a computational library to perform MC-based spot dose calculation on GPU with the APS scheme. The implemented APS method performs a non-uniform sampling of the particles from pencil beam spots during the optimization process, favoring those from the high intensity spots. The library also conducts two computationally intensive matrix-vector operations frequently used when solving an optimization problem. This library design allows a streamlined integration of the MC-based spot dose calculation into an existing proton therapy inverse planning process. We tested the developed library in a typical inverse optimization system with four patient cases. The library achieved the targeted functions by supporting inverse planning in various proton therapy schemes, e.g. single field uniform dose, 3D intensity modulated proton therapy, and distal edge tracking. The efficiency was 41.6  ±  15.3% higher than the use of a GPU-based MC package in a conventional calculation scheme. The total computation time ranged between 2 and 50 min on a single GPU card depending on the problem size.

  15. A new approach to integrate GPU-based Monte Carlo simulation into inverse treatment plan optimization for proton therapy

    NASA Astrophysics Data System (ADS)

    Li, Yongbao; Tian, Zhen; Song, Ting; Wu, Zhaoxia; Liu, Yaqiang; Jiang, Steve; Jia, Xun

    2017-01-01

    Monte Carlo (MC)-based spot dose calculation is highly desired for inverse treatment planning in proton therapy because of its accuracy. Recent studies on biological optimization have also indicated the use of MC methods to compute relevant quantities of interest, e.g. linear energy transfer. Although GPU-based MC engines have been developed to address inverse optimization problems, their efficiency still needs to be improved. Also, the use of a large number of GPUs in MC calculation is not favorable for clinical applications. The previously proposed adaptive particle sampling (APS) method can improve the efficiency of MC-based inverse optimization by using the computationally expensive MC simulation more effectively. This method is more efficient than the conventional approach that performs spot dose calculation and optimization in two sequential steps. In this paper, we propose a computational library to perform MC-based spot dose calculation on GPU with the APS scheme. The implemented APS method performs a non-uniform sampling of the particles from pencil beam spots during the optimization process, favoring those from the high intensity spots. The library also conducts two computationally intensive matrix-vector operations frequently used when solving an optimization problem. This library design allows a streamlined integration of the MC-based spot dose calculation into an existing proton therapy inverse planning process. We tested the developed library in a typical inverse optimization system with four patient cases. The library achieved the targeted functions by supporting inverse planning in various proton therapy schemes, e.g. single field uniform dose, 3D intensity modulated proton therapy, and distal edge tracking. The efficiency was 41.6  ±  15.3% higher than the use of a GPU-based MC package in a conventional calculation scheme. The total computation time ranged between 2 and 50 min on a single GPU card depending on the problem size.

  16. Mentalizing as a framework for integrating therapeutic exposure and relationship repair in the treatment of a patient with complex posttraumatic psychopathology.

    PubMed

    Stein, Helen; Allen, Jon G

    2007-01-01

    The concept of mentalizing-attending to mental states in oneself and others-provides an integrative conceptual framework to characterize the psychotherapeutic treatment of a patient with a history of attachment trauma and a comorbid schizoaffective disorder. The authors construe mentalizing failures in childhood attachment relationships as integral to the trauma and the promotion of mentalizing in the psychotherapy relationship as the cornerstone of healing. They employ mentalizing to conceptualize both the exposure-based interventions and the equally essential interruption of a problematic pattern of reenactment that continually fueled the patient's posttraumatic symptoms.

  17. Effects of Integrated Traditional Chinese and Western Medicine for the Treatment of Lupus Nephritis: A Meta-Analysis of Randomized Trials

    PubMed Central

    Heng, Mingli; Tu, Jinli; Hao, Yu; Zhao, Ye; Tian, Jinhui

    2016-01-01

    After a thorough search through the database as CNKI database, VIP database, Wanfang database, PubMed, and Cochrane Library, the clinical experimental articles have been selected out on the effects of Integrated Traditional Chinese and Western Medicine on the treatment of lupus nephritis. A meta-analysis was carried out in terms of clinical efficacy criteria and safety criteria by RevMan 5.3 software. Based on the results, we cautiously conclude that Integrated Traditional Chinese and Western Medicine used for lupus nephritis could improve the clinical efficacy while at same time lower the 24-hour urine protein, serum creatinine, and adverse drug reactions. PMID:28105057

  18. Early increase in marker of neuronal integrity with antidepressant treatment of major depression: 1H-magnetic resonance spectroscopy of N-acetyl-aspartate

    PubMed Central

    Taylor, Matthew J.; Godlewska, Beata R.; Norbury, Ray; Selvaraj, Sudhakar; Near, Jamie; Cowen, Philip J.

    2012-01-01

    Increasing interest surrounds potential neuroprotective or neurotrophic actions of antidepressants. While growing evidence points to important early clinical and neuropsychological effects of antidepressants, the time-course of any effect on neuronal integrity is unclear. This study used magnetic resonance spectroscopy to assess effects of short-term treatment with escitalopram on N-acetyl-aspartate (NAA), a marker of neuronal integrity. Thirty-nine participants with major depression were randomly assigned to receive either 10 mg escitalopram or placebo daily in a double-blind, parallel group design. On the seventh day of treatment, PRESS data were obtained from a 30×30×20 mm voxel placed in medial frontal cortex. Age and gender-matched healthy controls who received no treatment were also scanned. Levels of NAA were significantly higher in patients treated with escitalopram than in either placebo-treated patients (p<0.01) or healthy controls (p<0.01). Our findings are consistent with the proposition that antidepressant treatment in depressed patients can produce early changes in neuronal integrity. PMID:22449253

  19. Early increase in marker of neuronal integrity with antidepressant treatment of major depression: 1H-magnetic resonance spectroscopy of N-acetyl-aspartate.

    PubMed

    Taylor, Matthew J; Godlewska, Beata R; Norbury, Ray; Selvaraj, Sudhakar; Near, Jamie; Cowen, Philip J

    2012-11-01

    Increasing interest surrounds potential neuroprotective or neurotrophic actions of antidepressants. While growing evidence points to important early clinical and neuropsychological effects of antidepressants, the time-course of any effect on neuronal integrity is unclear. This study used magnetic resonance spectroscopy to assess effects of short-term treatment with escitalopram on N-acetyl-aspartate (NAA), a marker of neuronal integrity. Thirty-nine participants with major depression were randomly assigned to receive either 10 mg escitalopram or placebo daily in a double-blind, parallel group design. On the seventh day of treatment, PRESS data were obtained from a 30×30×20 mm voxel placed in medial frontal cortex. Age and gender-matched healthy controls who received no treatment were also scanned. Levels of NAA were significantly higher in patients treated with escitalopram than in either placebo-treated patients (p<0.01) or healthy controls (p<0.01). Our findings are consistent with the proposition that antidepressant treatment in depressed patients can produce early changes in neuronal integrity.

  20. Characterization and modeling of screen-printed metal insulator semiconductor tunnel junctions for integrated bypass functionality in crystalline silicon solar cells

    NASA Astrophysics Data System (ADS)

    Thaidigsmann, Benjamin; Lohmüller, Elmar; Fertig, Fabian; Clement, Florian; Wolf, Andreas

    2013-06-01

    This work investigates sintered, screen-printed silver contacts on lowly doped p-type silicon with different intermediate dielectric layer systems using scanning electron microscopy and dark current-voltage measurements. The data reveal electron tunneling through a thin insulating layer as the most probable transport mechanism. A model based on Fowler-Nordheim and direct tunneling is presented that allows for the description of reverse current-voltage characteristics and the extraction of effective contact properties. The investigated screen-printed metal insulator semiconductor structures are proposed as solar cell integrated bypass that reduces the risk of hot spot generation and power loss during partial shading of a module. Furthermore, the integrated bypass approach enables the fabrication of solar cells from silicon material that tends to show early breakdown of the p-n-junction.

  1. Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma

    PubMed Central

    Wootton, Jeffery H.; Hsu, I-Chow Joe; Diederich, Chris J.

    2011-01-01

    Purpose: The clinical success of hyperthermia adjunct to radiotherapy depends on adequate temperature elevation in the tumor with minimal temperature rise in organs at risk. Existing technologies for thermal treatment of the cervix have limited spatial control or rapid energy falloff. The objective of this work is to develop an endocervical applicator using a linear array of multisectored tubular ultrasound transducers to provide 3-D conformal, locally targeted hyperthermia concomitant to radiotherapy in the uterine cervix. The catheter-based device is integrated within a HDR brachytherapy applicator to facilitate sequential and potentially simultaneous heat and radiation delivery. Methods: Treatment planning images from 35 patients who underwent HDR brachytherapy for locally advanced cervical cancer were inspected to assess the dimensions of radiation clinical target volumes (CTVs) and gross tumor volumes (GTVs) surrounding the cervix and the proximity of organs at risk. Biothermal simulation was used to identify applicator and catheter material parameters to adequately heat the cervix with minimal thermal dose accumulation in nontargeted structures. A family of ultrasound applicators was fabricated with two to three tubular transducers operating at 6.6–7.4 MHz that are unsectored (360°), bisectored (2×180°), or trisectored (3×120°) for control of energy deposition in angle and along the device length in order to satisfy anatomical constraints. The device is housed in a 6 mm diameter PET catheter with cooling water flow for endocervical implantation. Devices were characterized by measuring acoustic efficiencies, rotational acoustic intensity distributions, and rotational temperature distributions in phantom. Results: The CTV in HDR brachytherapy plans extends 20.5±5.0 mm from the endocervical tandem with the rectum and bladder typically <8 mm from the target boundary. The GTV extends 19.4±7.3 mm from the tandem. Simulations indicate that for 60 min

  2. Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma

    SciTech Connect

    Wootton, Jeffery H.; Hsu, I-Chow Joe; Diederich, Chris J.

    2011-02-15

    Purpose: The clinical success of hyperthermia adjunct to radiotherapy depends on adequate temperature elevation in the tumor with minimal temperature rise in organs at risk. Existing technologies for thermal treatment of the cervix have limited spatial control or rapid energy falloff. The objective of this work is to develop an endocervical applicator using a linear array of multisectored tubular ultrasound transducers to provide 3-D conformal, locally targeted hyperthermia concomitant to radiotherapy in the uterine cervix. The catheter-based device is integrated within a HDR brachytherapy applicator to facilitate sequential and potentially simultaneous heat and radiation delivery. Methods: Treatment planning images from 35 patients who underwent HDR brachytherapy for locally advanced cervical cancer were inspected to assess the dimensions of radiation clinical target volumes (CTVs) and gross tumor volumes (GTVs) surrounding the cervix and the proximity of organs at risk. Biothermal simulation was used to identify applicator and catheter material parameters to adequately heat the cervix with minimal thermal dose accumulation in nontargeted structures. A family of ultrasound applicators was fabricated with two to three tubular transducers operating at 6.6-7.4 MHz that are unsectored (360 deg.), bisectored (2x180 deg.), or trisectored (3x120 deg.) for control of energy deposition in angle and along the device length in order to satisfy anatomical constraints. The device is housed in a 6 mm diameter PET catheter with cooling water flow for endocervical implantation. Devices were characterized by measuring acoustic efficiencies, rotational acoustic intensity distributions, and rotational temperature distributions in phantom. Results: The CTV in HDR brachytherapy plans extends 20.5{+-}5.0 mm from the endocervical tandem with the rectum and bladder typically <8 mm from the target boundary. The GTV extends 19.4{+-}7.3 mm from the tandem. Simulations indicate that for 60

  3. Family relations and eating disorders. The effectiveness of an integrated approach in the treatment of anorexia and bulimia in teenagers: results of a case-control systemic research.

    PubMed

    Onnis, L; Barbara, E; Bernardini, M; Caggese, A; Di Giacomo, S; Giambartolomei, A; Leonelli, A; Mule', A M; Nicoletti, P G; Vietri, A

    2012-03-01

    This article presents the results of a broader clinical research into the effectiveness of integrated treatments in teenage eating disorders, carried out at the Complex Operative Unit of Psychotherapy (Unità Operativa Complessa or U.O.C.) of the Department of Psychiatric Sciences and Psychological Medicine in collaboration with the Department of Neuropsychiatric Science for Child Development (Dipartimento di Scienze Neuropsichiatriche dell'Età Evolutiva), both at the "La Sapienza" University of Rome. The hypothesis of this research project is that in diagnosticable situations such as anorexia or bulimia, an integrated and multidisciplinary treatment, which combines medical-nutritional interventions and family psychotherapy, allows better results than a single kind of treatment, which is the usual medical- nutritional intervention supported by psychiatric counselling. Twenty-eight cases (16 of bulimia and 12 of anorexia) were selected and then subdivided, with a randomized distribution, into two (experimental and control) homogeneous groups of 14 patients. The grouping variables were the diagnosis, the disorder's seriousness and duration, BMI, gender, age, family composition and social status. The variables which have been examined in this article are the clinical parameters, which were valuated in accordance with the DSM IV-TR criteria, and relational parameters which were explored through the use of the W.F.T. Test (Wiltwyck Family Tasks). These parameters were tested at beginning as well as at the end of the therapies, in both the experimental group and the control group. Statistical analysis has shown that the experimental group, which was followed with the integrated treatment, experienced a significant improvement of the parameters as related to dysfunctional family interaction modalities, and that this improvement was correlated to the positive evolution of the clinical parameters. This improvement was not present or not of the same degree in the control

  4. SU-E-T-606: A Novel Integrated VMAT/IMRT Technique For the Treatment of Non-Small Cell Lung Cancer

    SciTech Connect

    Zhao, N; Yang, R; Wang, J

    2014-06-01

    Purpose: To investigate a novel Integrated VMAT/IMRT technique which combines volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT) for non-small cell lung cancer (NSCLC). Methods: 2 partial arcs VMAT, 5-field IMRT and Integrated VMAT/IMRT plans were created for 17 patients with NSCLC. The Integrated VMAT/IMRT technique consisted of 2 partial VMAT arcs and 5 IMRT fields. The dose distribution of planning target volume (PTV) and organs at risk (OARs) for Integrated VMAT/IMRT was compared with IMRT and VMAT. The monitor units (MUs) and treatment delivery time were also evaluated. For each plan, a dry run was performed to assess the dosimetric accuracy with MatriXX from IBA. Results: Integrated VMAT/IMRT significantly improved the target conformity and homogeneity. The V30 of normal lung for Integrated plans was significantly lower than IMRT plans (8.4% vs 9.2%; p<0.05). The V5 and mean lung dose (MLD) of normal lung for Integrated plans were 9.8% and 4.6% lower than VMAT plans (p<0.05). The maximum dose of spinal cord for Integrated plans was 4.9 Gy lower than IMRT plans (p<0.05). The mean delivery time of IMRT, VMAT and Integrated plans was 280 s, 114 s, and 327 s, respectively. The mean MUs needed for IMRT, VMAT and Integrated plans were 933, 512, and 737, respectively. The gamma pass rates were beyond 90% at the 3%/3 mm criteria when the gantry angles were set to 0° for pretreatment verification. Conclusion: Integrated VMAT/IMRT technique significantly reduced V5, V10 and MLD of normal lung compared with VMAT, and the irradiated volume of the OARs receiving medium to high dose with fewer MUs compared with IMRT. Integrated VMAT/IMRT technique can be a feasible radiotherapy technique with better plan quality and accurately delivered on the linear accelerator. Ruijie Yang was funded by the grant project: National Natural Science Foundation of China (No. 81071237). Other authors have no competing interest for this work.

  5. Integration of a kraft pulping mill into a forest biorefinery: pre-extraction of hemicellulose by steam explosion versus steam treatment.

    PubMed

    Martin-Sampedro, Raquel; Eugenio, Maria E; Moreno, Jassir A; Revilla, Esteban; Villar, Juan C

    2014-02-01

    Growing interest in alternative and renewable energy sources has brought increasing attention to the integration of a pulp mill into a forest biorefinery, where other products could be produced in addition to pulp. To achieve this goal, hemicelluloses were extracted, either by steam explosion or by steam treatment, from Eucalyptus globulus wood prior to pulping. The effects of both pre-treatments in the subsequent kraft pulping and paper strength were evaluated. Results showed a similar degree of hemicelluloses extraction with both options (32-67% of pentosans), which increased with the severity of the conditions applied. Although both pre-treatments increased delignification during pulping, steam explosion was significantly better: 12.9 kappa number vs 22.6 for similar steam unexploded pulps and 40.7 for control pulp. Finally, similar reductions in paper strength were found regardless of the type of treatment and conditions assayed, which is attributed to the increase of curled and kinked fibers.

  6. Sensitivity analysis of the pressure-based direct integrity test for membranes used in drinking water treatment.

    PubMed

    Minnery, John G; Jacangelo, Joseph G; Boden, Leslie I; Vorhees, Donna J; Heiger-Bernays, Wendy

    2009-12-15

    We conducted a sensitivity analysis of the commonly employed pressure-based direct integrity test (DIT), the most sensitive test for defects in low-pressure hollow fiber (LPHF) microfiltration and ultrafiltration systems used in drinking water treatment. Incorporating uncertainty to assess the practice of DIT, we find the resolution in some tests may be insufficient to verify the presence of a barrier to oocysts of Cryptosporidium. Applying distributions and boundaries derived from literature and practice, we solved for the defect size resolution (DSR) using Monte Carlo and Probability Bounds Analysis for five commercial membrane designs. Surface tension was modeled using annual temperature profiles from three rivers. Contact angle measurement error and variability were derived from literature, respectively, as a standard deviation of 5.7 degrees and +/- 9.6 degrees median change due to natural organic matter (NOM) fouling. These measures of contact angle uncertainty and variability were combined in a normal distribution with the discrete values currently applied. Additionally we considered model uncertainty, applying the maximum bubble pressure method, an established method of surface tension measurement in liquids in which the maximum air pressure in a submerged capillary is developed after the contact angle becomes zero prior to bubble formation. Where the DSR exceeds 3 microm the test design is not compliant with applicable drinking water regulations. Implications include uncertain and variable log-removal values (LRV) as determined by DIT due to the possible emergence of defects large enough to allow oocysts to pass without detection by the DIT. Specifically, we found the DSR may exceed 3 microm and may be as large as 8 microm. With the variable contact angle model, all lower bound possibilities are compliant, whereas the upper bound is over 80% noncompliant for three of five commercial designs. Using the Maximum Bubble Pressure Method, the lower bounds in

  7. Colour and toxic characteristics of metakaolinite-hematite pigment for integrally coloured concrete, prepared from iron oxide recovered from a water treatment plant of an abandoned coal mine

    NASA Astrophysics Data System (ADS)

    Sadasivam, Sivachidambaram; Thomas, Hywel Rhys

    2016-07-01

    A metakaolinite-hematite (KH) red pigment was prepared using an ocherous iron oxide sludge recovered from a water treatment plant of an abandoned coal mine. The KH pigment was prepared by heating the kaolinite and the iron oxide sludge at kaolinite's dehydroxylation temperature. Both the raw sludge and the KH specimen were characterised for their colour properties and toxic characteristics. The KH specimen could serve as a pigment for integrally coloured concrete and offers a potential use for the large volumes of the iron oxide sludge collected from mine water treatment plants.

  8. An Integrated, Community-Based Approach to the Diagnosis and Treatment of Disturbing Behaviors Shown by Children and Families.

    ERIC Educational Resources Information Center

    Pooley, Richard C.

    One of 52 theoretical papers on school crime and its relation to poverty, this chapter describes an interdisciplinary treatment program called the Pendleton Project. In this discussion, certain salient dimensions of the problem and its treatment are developed in some detail, namely, the diagnosis and treatment of learning disabilities and methods…

  9. Alliance-focused therapy for anorexia nervosa: integrative relational and behavioral change treatments in a single-case experimental design.

    PubMed

    Satir, Dana A; Goodman, David M; Shingleton, Rebecca M; Porcerelli, John H; Gorman, Bernard S; Pratt, Elizabeth M; Barlow, David H; Thompson-Brenner, Heather

    2011-12-01

    Evidence supporting outpatient treatments for anorexia nervosa (AN) is severely lacking, due to low retention and poor outcome. One explanation for drop-out is weak treatment alliances. A single-case experimental analysis accompanied by in-depth qualitative description is presented for Ms. O, who received a novel treatment for AN called Alliance Focused Treatment (AFT) that attends to ruptures in the alliance, interpersonal difficulties and emotional avoidance. At intake Ms. O met diagnostic criteria for AN, Major Depressive Disorder, and Social Phobia. She was characterized as having symptoms of Obsessive Compulsive, Avoidant, and Depressive personality disorders. Treatment began with a Baseline followed by the experimental (AFT) and comparison treatments (Behavioral Change Treatment [BCT]) using a replicated experimental single-case phase change design. Graphs of slopes of kilocalorie and alliance change facilitated observation of treatment effects. Ms. O participated in 16 sessions of AFT and 8 sessions of BCT with specific benefits. Ratings of the treatment alliance were consistently high and she evidenced significant changes in weight, quality of life, and personality pathology. Associations between rupture/repair episodes and kilocalorie increases were observed. The utility of the treatment relationship in facilitating emotional expression was evident. At posttreatment, Ms. O endorsed cognitive AN symptoms, although these were not explicitly treated. This study provides preliminary support for the feasibility and effect of AFT and BCT, and highlights the importance of the alliance in treating adults with AN. Further research on emotion regulation in AN and its effect on the treatment relationship are needed.

  10. Development and assessment of an integrated ecological modelling framework to assess the effect of investments in wastewater treatment on water quality.

    PubMed

    Holguin-Gonzalez, Javier E; Boets, Pieter; Everaert, Gert; Pauwels, Ine S; Lock, Koen; Gobeyn, Sacha; Benedetti, Lorenzo; Amerlinck, Youri; Nopens, Ingmar; Goethals, Peter L M

    2014-01-01

    Worldwide, large investments in wastewater treatment are made to improve water quality. However, the impacts of these investments on river water quality are often not quantified. To assess water quality, the European Water Framework Directive (WFD) requires an integrated approach. The aim of this study was to develop an integrated ecological modelling framework for the River Drava (Croatia) that includes physical-chemical and hydromorphological characteristics as well as the ecological river water quality status. The developed submodels and the integrated model showed accurate predictions when comparing the modelled results to the observations. Dissolved oxygen and nitrogen concentrations (ammonium and organic nitrogen) were the most important variables in determining the ecological water quality (EWQ). The result of three potential investment scenarios of the wastewater treatment infrastructure in the city of Varaždin on the EWQ of the River Drava was assessed. From this scenario-based analysis, it was concluded that upgrading the existing wastewater treatment plant with nitrogen and phosphorus removal will be insufficient to reach a good EWQ. Therefore, other point and diffuse pollution sources in the area should also be monitored and remediated to meet the European WFD standards.

  11. Fully Integrated e-Services for Prevention, Diagnosis, and Treatment of Sexually Transmitted Infections: Results of a 4-County Study in California

    PubMed Central

    Levy, Vivian; Lensing, Shelly; Chattopadhyay, Ishita; Venkatasubramanian, Lalitha; Acevedo, Nincoshka; Wolff, Peter; Callabresi, Debra; Philip, Susan; Lopez, Teresa P.; Padian, Nancy; Blake, Diane R.; Gaydos, Charlotte A.

    2014-01-01

    Objectives. We examined the acceptability, feasibility, and cost of a fully integrated online system (eSTI) for sexually transmitted infection (STI) testing, treatment, and linkage to care with 4 Northern California health departments. Methods. In April 2012, we implemented the eSTI system, which provided education; testing of self-collected vaginal swabs for chlamydia, gonorrhea, and trichomoniasis; e-prescriptions; e-partner notification; and data integration with clinic electronic health records. We analyzed feasibility, acceptability, and cost measures. Results. During a 3-month period, 217 women aged 18 to 30 years enrolled; 67% returned the kit. Of these, 92% viewed their results online. STI prevalence was 5.6% (chlamydia and trichomoniasis). All participants with STIs received treatment either the same day at a pharmacy (62%) or within 7 days at a clinic (38%). Among participants completing follow-up surveys, 99% would recommend the online eSTI system to a friend, and 95% preferred it over clinic-based testing within a study. Conclusions. The fully integrated eSTI system has the potential to increase diagnosis and treatment of STIs with higher patient satisfaction at a potentially lower cost. PMID:25320878

  12. A Retrospective Analysis of 5,195 Patient Treatment Sessions in an Integrative Veterinary Medicine Service: Patient Characteristics, Presenting Complaints, and Therapeutic Interventions

    PubMed Central

    Memon, Mushtaq A.

    2015-01-01

    Integrative veterinary medicine, the combination of complementary and alternative therapies with conventional care, is increasingly prevalent in veterinary practice and a focus of clinical instruction in many academic teaching institutions. However, the presenting complaints, therapeutic modalities, and patient population in an integrative medicine service have not been described. A retrospective analysis of 5,195 integrative patient treatment sessions in a veterinary academic teaching hospital demonstrated that patients most commonly received a combination of therapeutic modalities (39% of all treatment sessions). The 274 patients receiving multiple modalities were most frequently treated for neurologic and orthopedic disease (50.7% versus 49.6% of all presenting complaints, resp.). Older neutered or spayed dogs (mean age = 9.0 years) and Dachshunds were treated more often than expected based on general population statistics. Acupuncture, laser therapy, electroacupuncture, and hydrotherapy were frequently administered (>50% patients). Neurologic patients were more likely to receive acupuncture, electroacupuncture, and therapeutic exercises but less likely than orthopedic patients to receive laser, hydrotherapy, or therapeutic ultrasound treatments (P < 0.05). The results suggest that the application of these specific modalities to orthopedic and neurologic diseases should be subjected to increased evidence-based investigations. A review of current knowledge in core areas is presented. PMID:26798552

  13. Within-team Patterns of Communication and Referral in Multimodal Treatment of Chronic Low Back Pain Patients by an Integrative Care Team

    PubMed Central

    O'Connor, Bonnie B.; Eisenberg, David M.; Buring, Julie E.; Liang, Catherine L.; Osypiuk, Kamila; Levy, Donald B.

    2015-01-01

    Background: Nonspecific chronic low back pain (CLBP) is a highly prevalent and costly public health problem with few treatment options that provide consistent and greater than modest benefits. Treatment of CLBP is shifting from unimodal to multimodal and multidisciplinary approaches, including biopsychosocially-based complementary and integrative care. Multidisciplinary approaches require unique levels of communication and coordination amongst clinicians; however, to date few studies have evaluated patterns of communication and decision making amongst clinicians collaborating in the care of challenging patients with CLBP. Methods: As part of an observational study evaluating the effectiveness and cost-effectiveness of an integrative, team-based care model for the treatment of CLBP, we used multiple qualitative research methods to characterize within-team cross-referral and communication amongst jointly-trained practitioners representing diverse biomedical and complementary disciplines. Patterns of communication and coordinated care are summarized for 3 cases of CLBP treated by multiple members (≥3) of an integrative medical team embedded within an academic hospital. Results: Patients were aged from 36 to 88 years with varied comorbidities. Qualitative content analysis revealed 5 emergent themes regarding integrative patient care and treatment decision in this clinic: (1) the fundamental importance of the clinic's formal teamwork training; (2) the critical communicative and collaborative function of regular team meetings; (3) the importance to patient care goals of having the varied disciplines practicing “under one roof”; (4) a universal commitment to understanding and treating patients as whole persons; and (5) a shared philosophy of helping patients to help themselves. These key themes are all interconnected and form the foundation of the clinic's culture. Conclusions: Our qualitative findings provide context for current trends in enhancing patient

  14. Improvement of an integrated system of membrane bioreactor and worm reactor by phosphorus removal using additional post-chemical treatment.

    PubMed

    Liu, Jia; Zuo, Wei; Tian, Yu; Zhang, Jun; Li, Hui; Li, Lipin

    2016-11-01

    A membrane bioreactor (MBR) coupled with a worm reactor (SSBWR) was designed as SSBWR-MBR for sewage treatment and excess sludge reduction. However, total phosphorus (TP) release caused by worm predation in the SSBWR could increase the effluent TP concentration in the SSBWR-MBR. To decrease the amount of TP excreted, chemical treatment reactor was connected after the SSBWR-MBR to remove the excess phosphorus (P). The effects of chemical treatment at different time intervals on the performance of the SSBWR-MBR were assessed. The results showed that a maximum TP removal efficiency of 21.5 ± 1.0% was achieved in the SSBWR-MBR after chemical treatment. More importantly, a higher sulfate concentration induced by chemical treatment could promote TP release in the SSBWR, which provided further TP removal from the SSBWR-MBR. Additionally, chemical oxygen demand (COD) removal efficiency of the SSBWR-MBR was increased by 1.3% after effective chemical treatment. In the SSBWR-MBR, the chemical treatment had little effects on NH3-N removal and sludge production. Eventually, chemical treatment also alleviated the membrane fouling in the SSBWR-MBR. In this work, the improvement on TP, COD removal and membrane fouling alleviation was achieved in the SSBWR-MBR using additional chemical treatment.

  15. Treatment Access Barriers and Disparities Among Individuals with Co-Occurring Mental Health and Substance Use Disorders: An Integrative Literature Review.

    PubMed

    Priester, Mary Ann; Browne, Teri; Iachini, Aidyn; Clone, Stephanie; DeHart, Dana; Seay, Kristen D

    2016-02-01

    The purpose of this integrative review is to examine and synthesize extant literature pertaining to barriers to substance abuse and mental health treatment for persons with co-occurring substance use and mental health disorders (COD). Electronic searches were conducted using ten scholarly databases. Thirty-six articles met inclusion criteria and were examined for this review. Narrative review of these articles resulted in the identification of two primary barriers to treatment access for individuals with COD: personal characteristics barriers and structural barriers. Clinical implications and directions for future research are discussed. In particular, additional studies on marginalized sub-populations are needed, specifically those that examine barriers to treatment access among older, non-White, non-heterosexual populations.

  16. Treatment Access Barriers and Disparities Among Individuals with Co-occurring Mental Health and Substance Use Disorders: An Integrative Literature Review

    PubMed Central

    Ann Priester, Mary; Browne, Teri; Iachini, Aidyn; Clone, Stephanie; DeHart, Dana; Seay, Kristen D.

    2015-01-01

    The purpose of this integrative review is to examine and synthesize extant literature pertaining to barriers to substance abuse and mental health treatment for persons with co-occurring substance use and mental health disorders (COD). Electronic searches were conducted using ten scholarly databases. Thirty-six articles met inclusion criteria and were examined for this review. Narrative review of these articles resulted in the identification of two primary barriers to treatment access for individuals with COD: personal characteristics barriers and structural barriers. Clinical implications and directions for future research are discussed. In particular, additional studies on marginalized sub-populations are needed, specifically those that examine barriers to treatment access among older, non-white, non-heterosexual populations. PMID:26531892

  17. Setting the Stage for the Integration of Motivational Interviewing with Cognitive Behavioral Therapy in the Treatment of Depression

    ERIC Educational Resources Information Center

    Flynn, Heather A.

    2011-01-01

    Unipolar depression is one of the most disabling and costly medical illnesses in the world (Lancet Global Mental Health Group et al., 2007; Moussavi et al., 2007). Cognitive behavioral therapy (CBT), a widely studied and taught psychotherapeutic treatment for depression, is among the recommended evidence-based treatments. Although CBT and other…

  18. Effect of propofol post-treatment on blood-brain barrier integrity and cerebral edema after transient cerebral ischemia in rats.

    PubMed

    Lee, Jae Hoon; Cui, Hui Song; Shin, Seo Kyung; Kim, Jeong Min; Kim, So Yeon; Lee, Jong Eun; Koo, Bon-Nyeo

    2013-11-01

    Although propofol has been reported to offer neuroprotection against cerebral ischemia injury, its impact on cerebral edema following ischemia is not clear. The objective of this investigation is to evaluate the effects of propofol post-treatment on blood-brain barrier (BBB) integrity and cerebral edema after transient cerebral ischemia and its mechanism of action, focusing on modulation of aquaporins (AQPs), matrix metalloproteinases (MMPs), and hypoxia inducible factor (HIF)-1α. Cerebral ischemia was induced in male Sprague-Dawley rats (n = 78) by occlusion of the right middle cerebral artery for 1 h. For post-treatment with propofol, 1 mg kg(-1) min(-1) of propofol was administered for 1 h from the start of reperfusion. Nineteen rats undergoing sham surgery were also included in the investigation. Edema and BBB integrity were assessed by quantification of cerebral water content and extravasation of Evans blue, respectively, following 24 h of reperfusion. In addition, the expression of AQP-1, AQP-4, MMP-2, and MMP-9 was determined 24 h after reperfusion and the expression of HIF-1α was determined 8 h after reperfusion. Propofol post-treatment significantly reduced cerebral edema (P < 0.05) and BBB disruption (P < 0.05) compared with the saline-treated control. The expression of AQP-1, AQP-4, MMP-2, and MMP-9 at 24 h and of HIF-1α at 8 h following ischemia/reperfusion was significantly suppressed in the propofol post-treatment group (P < 0.05). Propofol post-treatment attenuated cerebral edema after transient cerebral ischemia, in association with reduced expression of AQP-1, AQP-4, MMP-2, and MMP-9. The decreased expression of AQPs and MMPs after propofol post-treatment might result from suppression of HIF-1α expression.

  19. TU-G-210-02: TRANS-FUSIMO - An Integrative Approach to Model-Based Treatment Planning of Liver FUS

    SciTech Connect

    Preusser, T.

    2015-06-15

    Modeling can play a vital role in predicting, optimizing and analyzing the results of therapeutic ultrasound treatments. Simulating the propagating acoustic beam in various targeted regions of the body allows for the prediction of the resulting power deposition and temperature profiles. In this session we will apply various modeling approaches to breast, abdominal organ and brain treatments. Of particular interest is the effectiveness of procedures for correcting for phase aberrations caused by intervening irregular tissues, such as the skull in transcranial applications or inhomogeneous breast tissues. Also described are methods to compensate for motion in targeted abdominal organs such as the liver or kidney. Douglas Christensen – Modeling for Breast and Brain HIFU Treatment Planning Tobias Preusser – TRANS-FUSIMO – An Integrative Approach to Model-Based Treatment Planning of Liver FUS Tobias Preusser – TRANS-FUSIMO – An Integrative Approach to Model-Based Treatment Planning of Liver FUS Learning Objectives: Understand the role of acoustic beam modeling for predicting the effectiveness of therapeutic ultrasound treatments. Apply acoustic modeling to specific breast, liver, kidney and transcranial anatomies. Determine how to obtain appropriate acoustic modeling parameters from clinical images. Understand the separate role of absorption and scattering in energy delivery to tissues. See how organ motion can be compensated for in ultrasound therapies. Compare simulated data with clinical temperature measurements in transcranial applications. Supported by NIH R01 HL172787 and R01 EB013433 (DC); EU Seventh Framework Programme (FP7/2007-2013) under 270186 (FUSIMO) and 611889 (TRANS-FUSIMO)(TP); and P01 CA159992, GE, FUSF and InSightec (UV)

  20. Structural elucidation of Eucalyptus lignin and its dynamic changes in the cell walls during an integrated process of ionic liquids and successive alkali treatments.

    PubMed

    Li, Han-Yin; Wang, Chen-Zhou; Chen, Xue; Cao, Xue-Fei; Sun, Shao-Ni; Sun, Run-Cang

    2016-12-01

    An integrated process based on ionic liquids ([Bmim]Cl and [Bmim]OAc) pretreatment and successive alkali post-treatments (0.5, 2.0, and 4.0% NaOH at 90°C for 2h) was performed to isolate lignins from Eucalyptus. The structural features and spatial distribution of lignin in the Eucalyptus cell wall were investigated thoroughly. Results revealed that the ionic liquids pretreatment promoted the isolation of alkaline lignin from the pretreated samples without obvious structural changes. Additionally, the integrated process resulted in syringyl-rich lignin macromolecules with more β-O-4' linkages and less phenolic hydroxyl groups. Confocal Raman microscopy analysis showed that the dissolution behavior of lignin was varied in the morphologically distinct regions during the successive alkali treatments, and lignin dissolved was mainly stemmed from the secondary wall regions. These results provided some useful information for understanding the mechanisms of delignification during the integrated process and enhancing the potential utilizations of lignin in future biorefineries.