Treatment Options for Childhood Rhabdomyosarcoma

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options for Kaposi Sarcoma

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options for Childhood Craniopharyngioma

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... the brain where it was first found. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Myelodysplastic/Myeloproliferative Neoplasms)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ...

Treatment Option Overview (Chronic Lymphocytic Leukemia)

Science.gov (United States)

... examination under a microscope. Certain factors affect treatment options and prognosis (chance of recovery). Treatment options depend ... that does not get better with treatment. Treatment Option Overview Key Points There are different types of ...

Hairy Cell Leukemia Treatment Option Overview

Science.gov (United States)

... or a swollen spleen. Certain factors affect treatment options and prognosis (chance of recovery). The treatment options ... cell leukemia has not responded to treatment. Treatment Option Overview Key Points There are different types of ...

Treatment Options for Gastrointestinal Carcinoid Tumors

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... body. Has not gotten better with treatment. Treatment Option Overview Key Points There are different types of ...

Treatment Options by Stage (Pancreatic Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options by Stage (Esophageal Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options by Stage (Vulvar Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options by Stage (Penile Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options for Non-Hodgkin Lymphoma

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... lymphoma may come back as indolent lymphoma. Treatment Option Overview Key Points There are different types of ...

Treatment Options by Stage (Prostate Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options by Stage (Adrenocortical Carcinoma)

Science.gov (United States)

... affect the prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options for Childhood Hodgkin Lymphoma

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... the lungs , liver , bones, or bone marrow . Treatment Option Overview Key Points There are different types of ...

Treatment Options for Adult Hodgkin Lymphoma

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Small Intestine Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Adult Hodgkin Lymphoma)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Merkel Cell Carcinoma)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... common for Merkel cell carcinoma to recur. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Childhood Hodgkin Lymphoma)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... the lungs , liver , bones, or bone marrow . Treatment Option Overview Key Points There are different types of ...

Treatment Options for AIDS-Related Lymphoma

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... nervous system is not primary CNS lymphoma. Treatment Option Overview Key Points There are different types of ...

Treatment Options for Renal Cell Cancer

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options by Stage (Gastric Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... such as the liver or lymph nodes . Treatment Option Overview Key Points There are different types of ...

Treatment Options by Stage (Thyroid Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options for Chronic Myelogenous Leukemia

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... of blast cells increases after a remission . Treatment Option Overview Key Points There are different types of ...

Treatment Options for Actinic Keratosis

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends mostly on ... helped by lip balm or petroleum jelly . Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Vaginal Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on the ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Anal Cancer)

Science.gov (United States)

... affect the prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on the ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options by Stage (Chronic Lymphocytic Leukemia)

Science.gov (United States)

... examination under a microscope. Certain factors affect treatment options and prognosis (chance of recovery). Treatment options depend ... that does not get better with treatment. Treatment Option Overview Key Points There are different types of ...

Documentation of a restart option for the U.S. Geological Survey coupled Groundwater and Surface-Water Flow (GSFLOW) model

Science.gov (United States)

Regan, R. Steve; Niswonger, Richard G.; Markstrom, Steven L.; Barlow, Paul M.

2015-10-02

A new option to write and read antecedent conditions (also referred to as initial conditions) has been developed for the U.S. Geological Survey (USGS) Groundwater and Surface-Water Flow (GSFLOW) numerical, hydrologic simulation code. GSFLOW is an integration of the USGS Precipitation-Runoff Modeling System (PRMS) and USGS Modular Groundwater-Flow Model (MODFLOW), and provides three simulation modes: MODFLOW-only, PRMS-only, and GSFLOW (or coupled). The new capability, referred to as the restart option, can be used for all three simulation modes, such that the results from a pair (or set) of spin-up and restart simulations are nearly identical to results produced from a continuous simulation for the same time period. The restart option writes all results to files at the end of a spin-up simulation that are required to initialize a subsequent restart simulation. Previous versions of GSFLOW have had some capability to save model results for use as antecedent condiitions in subsequent simulations; however, the existing capabilities were not comprehensive or easy to use. The new restart option supersedes the previous methods. The restart option was developed in collaboration with the National Oceanic and Atmospheric Administration, National Weather Service as part of the Integrated Water Resources Science and Services Partnership. The primary focus for the development of the restart option was to support medium-range (7- to 14-day) forecasts of low streamflow conditions made by the National Weather Service for critical water-supply basins in which groundwater plays an important role.

Two passive groundwater treatment installations at DOE facilities

International Nuclear Information System (INIS)

Barton, W.D.; Craig, P.M.; Stone, W.C.

1997-01-01

Groundwater is being successfully treated by reactive media at two DOE sites. Passive treatment utilizing containerized treatment media has been installed on a radioactive groundwater seep at Oak Ridge National Lab, Oak Ridge, Tennessee, and on a TCE plume at the Portsmouth Gaseous Diffusion Plant in Piketon, Ohio. In both applications, flow is conducted by gravity through canisters of reactive treatment media. The canister-based treatment installation at ORNL utilizes a natural sodium-chabazite zeolite to remove radiological cations (Sr, Cs) from contaminated groundwater at greater than 99.9% efficiency. Portsmouth is currently conducting tests on three different types of treatment media for reductive dehalogenation of TCE

Traditional preventive treatment options

DEFF Research Database (Denmark)

Longbottom, C; Ekstrand, K; Zero, D

2009-01-01

Preventive treatment options can be divided into primary, secondary and tertiary prevention techniques, which can involve patient- or professionally applied methods. These include: oral hygiene (instruction), pit and fissure sealants ('temporary' or 'permanent'), fluoride applications (patient...... options....

Treatment Options for Adult Soft Tissue Sarcoma

Science.gov (United States)

... reacts to the light. Certain factors affect treatment options and prognosis (chance of recovery). The treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options by Stage (Merkel Cell Carcinoma)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... common for Merkel cell carcinoma to recur. Treatment Option Overview Key Points There are different types of ...

Treatment Options for Hodgkin Lymphoma during Pregnancy

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Adult Soft Tissue Sarcoma)

Science.gov (United States)

... reacts to the light. Certain factors affect treatment options and prognosis (chance of recovery). The treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Adult Non-Hodgkin Lymphoma)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... lymphoma may come back as indolent lymphoma. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Small Cell Lung Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Adult Acute Lymphoblastic Leukemia)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... marrow , or other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options for Adult Acute Lymphoblastic Leukemia

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... marrow , or other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options for Adult Acute Myeloid Leukemia

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... back in the blood or bone marrow . Treatment Option Overview Key Points There are different types of ...

Novel preventive treatment options

DEFF Research Database (Denmark)

Longbottom, C; Ekstrand, K; Zero, D

2009-01-01

A number of novel preventive treatment options which, as with traditional methods, can be differentiated into 3 categories of prevention (primary, secondary and tertiary), have been and are being currently investigated. Those reviewed are either commercially available or appear relatively close...... of these techniques show considerable promise and dentists should be aware of these developments and follow their progress, the evidence for each of these novel preventive treatment options is currently insufficient to make widespread recommendations. Changes in dental practice should be explored to see how oral...

Participatory groundwater management in Jordan: Development and analysis of options

Science.gov (United States)

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

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

Treatment Options by Stage (Vaginal Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on the ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options for Chronic Myeloproliferative Neoplasms

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options for primary myelofibrosis. Prognosis (chance of recovery ) depends ... factors affect prognosis (chance of recovery) and treatment options for essential thrombocythemia. Prognosis (chance of recovery ) and ...

Treatment Options for Nonmelanoma Skin Cancer

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends mostly on ... helped by lip balm or petroleum jelly . Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Chronic Myeloproliferative Neoplasms)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options for primary myelofibrosis. Prognosis (chance of recovery ) depends ... factors affect prognosis (chance of recovery) and treatment options for essential thrombocythemia. Prognosis (chance of recovery ) and ...

Treatment Option Overview (Kaposi Sarcoma)

Science.gov (United States)

... Treatment Childhood Vascular Tumors Treatment Research Kaposi Sarcoma Treatment (PDQ®)–Patient Version General Information About Kaposi Sarcoma ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

Treatment Options by Stage (Small Cell Lung Cancer)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Childhood Acute Lymphoblastic Leukemia)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on: How ... cancer that does not respond to treatment. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Ewing Sarcoma)

Science.gov (United States)

... Ewing Sarcoma Treatment Osteosarcoma Treatment Research Ewing Sarcoma Treatment (PDQ®)–Patient Version General Information About Ewing Sarcoma ... started or in another part of the body. Treatment Option Overview Key Points There are different types ...

Treatment Option Overview (Ovarian Germ Cell Tumors)

Science.gov (United States)

... Germ Cell Tumors Treatment (PDQ®)–Patient Version Treatment Option Overview Go to Health Professional Version Key Points ... and restore) the body’s blood cells. New treatment options Combination chemotherapy (the use of more than one ...

Treatment options for Primary CNS Lymphoma.

Science.gov (United States)

Laghari, Altaf Ali; Ahmed, Syed Ijlal; Jabbar, Adnan; Shamim, Muhammad Shahzad

2018-03-01

Primary CNS lymphoma (PCNSL) is a rare and aggressive brain tumour that is uniformly fatal. The rarity of the disease and the poor response to treatment makes it difficult to reach a consensus with regards to treatment options. In this review, the authors have discussed different treatment modalities used in the management of PCNSL including chemotherapy, surgery and radiation, as well as the results of recent clinical trials on treatment options for PCNSL.

Potassium ferrate treatment of RFETS' contaminated groundwater

International Nuclear Information System (INIS)

1995-01-01

The potassium ferrate treatment study of Rocky Flats Environmental Technology Site (RFETS) groundwater was performed under the Sitewide Treatability Studies Program (STSP). This study was undertaken to determine the effectiveness of potassium ferrate in a water treatment system to remove the contaminants of concern (COCS) from groundwater at the RFETS. Potassium ferrate is a simple salt where the iron is in the plus six valence state. It is the iron at the plus six valence state (Fe +6 ) that makes it an unique water treatment chemical, especially in waters where the pH is greater than seven. In basic solutions where the solubility of the oxides/hydroxides of many of the COCs is low, solids are formed as the pH is raised. By using ferrate these solids are agglomerated so they can be effectively removed by sedimentation in conventional water treatment equipment. The objective of this study was to determine the quality of water after treatment with potassium ferrate and to determine if the Colorado Water Quality Control Commission (CWQCC) discharge limits for the COCs listed in Table 1.0-1 could be met. Radionuclides in the groundwater were of special concern

Performance assessment techniques for groundwater recovery and treatment systems

Energy Technology Data Exchange (ETDEWEB)

Kirkpatrick, G.L. [Environmental Resources Management, Inc., Exton, PA (United States)

1993-03-01

Groundwater recovery and treatment (pump and treat systems) continue to be the most commonly selected remedial technology for groundwater restoration and protection programs at hazardous waste sites and RCRA facilities nationwide. Implementing a typical groundwater recovery and treatment system includes the initial assessment of groundwater quality, characterizing aquifer hydrodynamics, recovery system design, system installation, testing, permitting, and operation and maintenance. This paper focuses on methods used to assess the long-term efficiency of a pump and treat system. Regulatory agencies and industry alike are sensitive to the need for accurate assessment of the performance and success of groundwater recovery systems for contaminant plume abatement and aquifer restoration. Several assessment methods are available to measure the long-term performance of a groundwater recovery system. This paper presents six assessment techniques: degree of compliance with regulatory agency agreement (Consent Order of Record of Decision), hydraulic demonstration of system performance, contaminant mass recovery calculation, system design and performance comparison, statistical evaluation of groundwater quality and preferably, integration of the assessment methods. Applying specific recovery system assessment methods depends upon the type, amount, and quality of data available. Use of an integrated approach is encouraged to evaluate the success of a groundwater recovery and treatment system. The methods presented in this paper are for engineers and corporate management to use when discussing the effectiveness of groundwater remediation systems with their environmental consultant. In addition, an independent (third party) system evaluation is recommended to be sure that a recovery system operates efficiently and with minimum expense.

U1/U2 crib groundwater biological treatment demonstration project

International Nuclear Information System (INIS)

Koegler, S.S.; Brouns, T.M.; Heath, W.O.

1989-11-01

The primary objective of the biological treatment project is to develop and demonstrate a process for Hanford groundwater remediation. Biodenitrification using facultative anaerobic microorganisms is a promising technology for the simultaneous removal of nitrates and organics from contaminated aqueous streams. During FY 1988, a consortium of Hanford groundwater microorganisms was shown to degrade both nitrates and carbon tetrachloride (CC1 4 ). A pilot-scale treatment system was designed and constructed based on the results of laboratory-and-bench-scale testing. This report summarizes the results of biological groundwater treatment studies performed during FY 1989 at the pilot-scale. These tests were conducted using a simulated Hanford groundwater with a continuous stirred-tank bioreactor, and a fluidized-bed bioreactor that was added to the pilot-scale treatment system in FY 1989. The pilot-scale system demonstrated continuous degradation of nitrates and CC1 4 in a simulated groundwater. 4 refs., 7 figs., 1 tab

Current and future groundwater withdrawals: Effects, management and energy policy options for a semi-arid Indian watershed

Science.gov (United States)

Sishodia, Rajendra P.; Shukla, Sanjay; Graham, Wendy D.; Wani, Suhas P.; Jones, James W.; Heaney, James

2017-12-01

Effects of future expansion/intensification of irrigated agriculture on groundwater and surface water levels and availability in a semi-arid watershed were evaluated using an integrated hydrologic model (MIKE SHE/MIKE 11) in conjunction with biophysical measurements. Improved water use efficiency, water storage, and energy policy options were evaluated for their ability to sustain the future (2035) increased groundwater withdrawals. Three future withdrawal scenarios (low = 20, medium = 30, high = 50 wells/100 km2/year) based on the historical rate of growth of irrigation wells were formulated. While well drying from falling groundwater levels was limited to drought and consecutive below average rainfall years, under the current (2015) withdrawals, significant increases in frequency and duration (17-97 days/year) of well drying along with 13-26% (19-37 mm) reductions in surface flows were predicted under the future withdrawals. Higher (27-108%) energy demands of existing irrigation pumps due to declining groundwater levels and reduced hydroelectric generation due to decreased surface flows would create a vicious water-food-energy nexus in the future. Crop failure, one of the main causes of farmers' emotional distress and death in the region, is predicted to exacerbate under the future withdrawal scenarios. Shift to negative net recharge (-63 mm) and early and prolonged drying of wells under the high scenario will reduce the groundwater availability and negatively affect crop production in more than 60% and 90% of cropped areas in the Rabi (November-February) and summer (March-May) seasons, respectively during a drought year. Individual and combined demand (drip irrigation and reduced farm electricity subsidy) and supply (water storage) management options improved groundwater levels and reduced well drying by 55-97 days/year compared to business-as-usual management under the high scenario. The combined management (50% drip conversion, 50% reduction in subsidy, and

Nail Psoriasis: A Review of Treatment Options.

Science.gov (United States)

Pasch, Marcel C

2016-04-01

Nail involvement affects 80-90 % of patients with plaque psoriasis, and is even more prevalent in patients with psoriatic arthritis. This review is the result of a systemic approach to the literature and covers topical, intralesional, conventional systemic, and biologic systemic treatments, as well as non-pharmacological treatment options for nail psoriasis. The available evidence suggests that all anti-tumor necrosis factor-α, anti-interleukin (IL)-17, and anti-IL-12/23 antibodies which are available for plaque psoriasis and psoriatic arthritis are highly effective treatments for nail psoriasis. Conventional systemic treatments, including methotrexate, cyclosporine, acitretin, and apremilast, as well as intralesional corticosteroids, can also be effective treatments for nail psoriasis. Topical treatments, including corticosteroids, calcipotriol, tacrolimus, and tazarotene, have also been shown to have a position in the treatment of nail psoriasis, particularly in mild cases. Finally, non-pharmacological treatment options, including phototherapy, photodynamic therapy, laser therapy, and several radiotherapeutic options, are also reviewed but cannot be advised as first-line treatment options. Another conclusion of this review is that the lack of a reliable core set of outcomes measures for trials in nail psoriasis hinders the interpretation of results, and is urgently needed.

Removal of dissolved organic matter in municipal effluent with ozonation, slow sand filtration and nanofiltration as high quality pre-treatment option for artificial groundwater recharge.

Science.gov (United States)

Linlin, Wu; Xuan, Zhao; Meng, Zhang

2011-04-01

In the paper the combination process of ozonation, slow sand filtration (SSF) and nanofiltration (NF) was investigated with respect to dissolved organic matter (DOM) removal as high quality pre-treatment option for artificial groundwater recharge. With the help of ozonation leading to breakdown of the large organic molecules, SSF preferentially removes soluble microbial by-product-like substances and DOM with molecular weight (MW) less than 1.0 kDa. NF, however, removes aromatic, humic acid-like and fulvic acid-like substances efficiently and specially removes DOM with MW above 1.0 kDa. The residual DOM of the membrane permeate is dominated by small organics with MW 500 Da, which can be further reduced by the aquifer treatment, despite of the very low concentration. Consequently, the O(3)/SSF/NF system offers a complementary process in DOM removal. Dissolved organic carbon (DOC) and trihalomethane formation potential (THMFP) can be reduced from 6.5±1.1 to 0.7±0.3 mg L(-1) and from 267±24 to 52±6 μg L(-1), respectively. The very low DOC concentration of 0.6±0.2 mg L(-1) and THMFP of 44±4 μg L(-1) can be reached after the aquifer treatment. Copyright © 2011 Elsevier Ltd. All rights reserved.

Treatment Option Overview (Mycosis Fungoides and the Sezary Syndrome)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

Treatment Options By Stage (Ovarian Germ Cell Tumors)

Science.gov (United States)

... Germ Cell Tumors Treatment (PDQ®)–Patient Version Treatment Option Overview Go to Health Professional Version Key Points ... and restore) the body’s blood cells. New treatment options Combination chemotherapy (the use of more than one ...

Simplified Method for Groundwater Treatment Using Dilution and Ceramic Filter

Science.gov (United States)

Musa, S.; Ariff, N. A.; Kadir, M. N. Abdul; Denan, F.

2016-07-01

Groundwater is one of the natural resources that is not susceptible to pollutants. However, increasing activities of municipal, industrial, agricultural or extreme land use activities have resulted in groundwater contamination as occured at the Research Centre for Soft Soil Malaysia (RECESS), Universiti Tun Hussein Onn Malaysia (UTHM). Thus, aims of this study is to treat groundwater by using rainwater and simple ceramic filter as a treatment agent. The treatment uses rain water dilution, ceramic filters and combined method of dilute and filtering as an alternate treatment which are simple and more practical compared to modern or chemical methods. The water went through dilution treatment processes able to get rid of 57% reduction compared to initial condition. Meanwhile, the water that passes through the filtering process successfully get rid of as much as 86% groundwater parameters where only chloride does not pass the standard. Favorable results for the combination methods of dilution and filtration methods that can succesfully eliminate 100% parameters that donot pass the standards of the Ministry of Health and the Interim National Drinking Water Quality Standard such as those found in groundwater in RECESS, UTHM especially sulfate and chloride. As a result, it allows the raw water that will use clean drinking water and safe. It also proves that the method used in this study is very effective in improving the quality of groundwater.

Nitrate leaching affected by management options with respect to urine-affected areas and groundwater levels for grazed grassland

NARCIS (Netherlands)

Hack-ten Broeke, M.J.D.; Putten, van der A.H.J.

1997-01-01

Simulations were performed to quantify the effects of management options on nitrate leaching to the groundwater in grazed pastures. At the experimental farm for sustainable dairy farming ‘De Marke’, experimental data on soil water and nitrates were gathered for two fields during the years 1991–1995.

In-Situ Bioremediation of Perchlorate in Groundwater and Soil

OpenAIRE

Jin, Liyan

2012-01-01

Historical, uncontrolled disposal practices have made perchlorate a significant threat to drinking water supplies in the United States. In-situ bioremediation (ISB) technologies are cost effective and provide an environmental friendly solution for treating contaminated groundwater and soil. In situ bioremediation was considered as an option for treatment of perchlorate in groundwater and soil in Lockheed Martin Corporation's Beaumont Site 2 (Beaumont, CA). Based on the perchlorate distribu...

Treatment Option Overview (Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... the cancer does not respond to treatment. Treatment Option Overview Key Points There are different types of ...

Technical/ administrative options for managing tritium MCL exceedances in P-area groundwater and Steel Creek

Energy Technology Data Exchange (ETDEWEB)

Ross, J. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2017-04-01

This white paper was requested by the Core Team (United States Department of Energy [USDOE], United States Environmental Protection Agency [USEPA], and South Carolina Department of Health and Environmental Control [SCDHEC]) at the P-Area Groundwater (PAGW) Operable Unit (OU) Scoping Meeting held in January 2017 to discuss recent data and potential alternatives in support of a focused Corrective Measures Study/Feasibility Study (CMS/FS). This white paper presents an overview of the problem, and a range of technical and administrative options for addressing the tritium contamination in groundwater and Steel Creek. As tritium cannot be treated practicably, alternatives are limited to media transfer, containment and natural attenuation principally relying on radioactive decay. Using other groundwater OU decisions involving tritium as precedent, Savannah River Nuclear Solutions (SRNS) recommends that final tritium alternatives be evaluated in a CMS/FS, understanding that the likely preferred remedy will include natural attenuation with land use controls (LUCs). This is based on the inability to significantly reduce tritium impact to Steel Creek using an engineered solution as compared to natural attenuation. The timing of this evaluation could be conducted concurrently with the final remedy evaluation for volatile organic compounds (VOCs).

Treatment Option Overview (Wilms Tumor and Other Childhood Kidney Tumors)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... come back) after it has been treated. Treatment Option Overview Key Points There are different types of ...

Treatment Option Overview (Plasma Cell Neoplasms Including Multiple Myeloma)

Science.gov (United States)

... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on the ... going up even though treatment is given. Treatment Option Overview Key Points There are different types of ...

Fibromyalgia Pathogenesis and Treatment Options Update.

Science.gov (United States)

Chinn, Steven; Caldwell, William; Gritsenko, Karina

2016-04-01

This review article presents and summarizes up-to-date literature on the clinical manifestations, diagnosis, pathophysiological mechanisms, and treatment options for fibromyalgia patients. First, the most recent diagnostic criteria for fibromyalgia, as put forth by the American College of Rheumatology will be summarized. Clinical features, including chronic widespread pain, hyperalgesia, mood disorders, anxiety, and disturbed sleep patterns will be explored in-depth. The pathogenesis and pathophysiology of fibromyalgia involves alterations in multiple ascending and descending central nervous system pathways, as well as peripheral pathways, leading to heightened pain sensitivity. Risk factors have been studied extensively, and the most recent research focuses on various genetic influences and the contributions of stress and poor sleep. Lastly, the discussion in this article focuses on treatment options for fibromyalgia; some have been mainstay options for many years. Pharmacological agents include tricyclic antidepressants, anti-epileptic drugs, selective serotonin reuptake inhibitors, norepinephrine/serotonin reuptake inhibitors, as well as some investigational agents. The evidence behind non-pharmacologic treatments, including massage therapy, exercise, and acupuncture, are discussed.

Current options for the treatment of pathological scarring.

Science.gov (United States)

Poetschke, Julian; Gauglitz, Gerd G

2016-05-01

Scarring is the consequence of surgery, trauma or different skin diseases. Apart from fresh, immature scars,that transform into mature scars over the course of would healing and that do not require further treatment,linear hypertrophic scars, widespread hypertrophic scars, keloids and atrophic scars exist. Symptoms like pruritusand pain, stigmatization as well as functional and aesthetic impairments that are very disturbing for the affected patients can bethe basis for the desire for treatment. Today, a multitude of options for the treatment and prevention of scars exists. Topical agents based on silicone or onion extract, intralesional injections of cristalline glucocorticoids (oftentimes in combinationwith cryotherapy) or 5-Fluorouracil as well as ablative and nonablative laser treatment are used. Current guidelines summarize the multitude of available treatment options and the currently available datafor the treating physicians, allowing them to make clear therapy recommendations for every single scar type. Relieving patients of their discomfort and doing their aesthetic demands justice is thus possible. Apart from scar prevention becoming more and more important, the increased use of modernlaser treatment options constitutes a key point in clinical scar treatment. At the same time the attention is turned to evaluating current therapeutic options with the help of contemporary study designs so as to graduallyimprove the level of evidence in scar treatment. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Automated Groundwater Screening

International Nuclear Information System (INIS)

Taylor, Glenn A.; Collard, Leonard B.

2005-01-01

The Automated Intruder Analysis has been extended to include an Automated Ground Water Screening option. This option screens 825 radionuclides while rigorously applying the National Council on Radiation Protection (NCRP) methodology. An extension to that methodology is presented to give a more realistic screening factor for those radionuclides which have significant daughters. The extension has the promise of reducing the number of radionuclides which must be tracked by the customer. By combining the Automated Intruder Analysis with the Automated Groundwater Screening a consistent set of assumptions and databases is used. A method is proposed to eliminate trigger values by performing rigorous calculation of the screening factor thereby reducing the number of radionuclides sent to further analysis. Using the same problem definitions as in previous groundwater screenings, the automated groundwater screening found one additional nuclide, Ge-68, which failed the screening. It also found that 18 of the 57 radionuclides contained in NCRP Table 3.1 failed the screening. This report describes the automated groundwater screening computer application

In situ treatment of mixed contaminants in groundwater: Application of zero-valence iron and palladized iron for treatment of groundwater contaminated with trichloroethene and technetium-99

International Nuclear Information System (INIS)

Korte, N.E.; Muck, M.T.; Zutman, J.L.; Schlosser, R.M.; Liang, L.; Gu, B.; Houk, T.C.; Fernando, Q.

1997-04-01

The overall goal of this portion of the project was to package one or more unit processes, as modular components in vertical and/or horizontal recirculation wells, for treatment of volatile organic compounds (VOCs) [e.g., trichloroethene (TCE)] and radionuclides [e.g., technetium (Tc) 99 ] in groundwater. The project was conceived, in part, because the coexistence of chlorinated hydrocarbons and radionuclides has been identified as the predominant combination of groundwater contamination in the US Department of Energy (DOE) complex. Thus, a major component of the project was the development of modules that provide simultaneous treatment of hydrocarbons and radionuclides. The project objectives included: (1) evaluation of horizontal wells for inducing groundwater recirculation, (2) development of below-ground treatment modules for simultaneous removal of VOCs and radionuclides, and (3) demonstration of a coupled system (treatment module with recirculation well) at a DOE field site where both VOCs and radionuclides are present in the groundwater. This report is limited to the innovative treatment aspects of the program. A report on pilot testing of the horizontal recirculation system was the first report of the series (Muck et al. 1996). A comprehensive report that focuses on the engineering, cost and hydrodynamic aspects of the project has also been prepared (Korte et al. 1997a)

In situ treatment of mixed contaminants in groundwater: Application of zero-valence iron and palladized iron for treatment of groundwater contaminated with trichloroethene and technetium-99

Energy Technology Data Exchange (ETDEWEB)

Korte, N.E.; Muck, M.T.; Zutman, J.L.; Schlosser, R.M. [Oak Ridge National Lab., Grand Junction, CO (United States); Liang, L.; Gu, B. [Oak Ridge National Lab., TN (United States). Environmental Sciences Div.; Siegrist, R.L. [Oak Ridge National Lab., TN (United States). Environmental Sciences Div.]|[Colorado School of Mines, Golden, CO (United States); Houk, T.C. [Portsmouth Gaseous Diffusion Plant, Piketon, OH (United States); Fernando, Q. [Univ. of Arizona, Tucson, AZ (United States)

1997-04-01

The overall goal of this portion of the project was to package one or more unit processes, as modular components in vertical and/or horizontal recirculation wells, for treatment of volatile organic compounds (VOCs) [e.g., trichloroethene (TCE)] and radionuclides [e.g., technetium (Tc){sup 99}] in groundwater. The project was conceived, in part, because the coexistence of chlorinated hydrocarbons and radionuclides has been identified as the predominant combination of groundwater contamination in the US Department of Energy (DOE) complex. Thus, a major component of the project was the development of modules that provide simultaneous treatment of hydrocarbons and radionuclides. The project objectives included: (1) evaluation of horizontal wells for inducing groundwater recirculation, (2) development of below-ground treatment modules for simultaneous removal of VOCs and radionuclides, and (3) demonstration of a coupled system (treatment module with recirculation well) at a DOE field site where both VOCs and radionuclides are present in the groundwater. This report is limited to the innovative treatment aspects of the program. A report on pilot testing of the horizontal recirculation system was the first report of the series (Muck et al. 1996). A comprehensive report that focuses on the engineering, cost and hydrodynamic aspects of the project has also been prepared (Korte et al. 1997a).

Microwave treatment of BPH: still an option?

NARCIS (Netherlands)

de la Rosette, J. J.

1994-01-01

Surgery, the gold standard in the treatment of benign prostatic hyperplasia (BPH), is presently performed in the majority of patients who receive treatment. An increasing number of alternative options recently became available for treatment of BPH and especially minimal invasive treatment

Alternative Cancer Treatments: 10 Options to Consider

Science.gov (United States)

Alternative cancer treatments: 10 options to consider Alternative cancer treatments can't cure your cancer, but they may provide some ... that may help them, including complementary and alternative cancer treatments. If cancer makes you feel as if you ...

Phosphate interference during in situ treatment for arsenic in groundwater.

Science.gov (United States)

Brunsting, Joseph H; McBean, Edward A

2014-01-01

Contamination of groundwater by arsenic is a problem in many areas of the world, particularly in West Bengal (India) and Bangladesh, where reducing conditions in groundwater are the cause. In situ treatment is a novel approach wherein, by introduction of dissolved oxygen (DO), advantages over other treatment methods can be achieved through simplicity, not using chemicals, and not requiring disposal of arsenic-rich wastes. A lab-scale test of in situ treatment by air sparging, using a solution with approximately 5.3 mg L(-1) ferrous iron and 200 μg L(-1) arsenate, showed removal of arsenate in the range of 59%. A significant obstacle exists, however, due to the interference of phosphate since phosphate competes for adsorption sites on oxidized iron precipitates. A lab-scale test including 0.5 mg L(-1) phosphate showed negligible removal of arsenate. In situ treatment by air sparging demonstrates considerable promise for removal of arsenic from groundwater where iron is present in considerable quantities and phosphates are low.

Review of Saccharomyces boulardii as a treatment option in IBD

DEFF Research Database (Denmark)

Sivananthan, Kavitha; Petersen, Andreas Munk

2018-01-01

CONTEXT: Review of the yeast Saccharomyces boulardii as a treatment option for the inflammatory bowel diseases (IBD) ulcerative colitis and Crohn's disease. OBJECTIVE: IBD is caused by an inappropriate immune response to gut microbiota. Treatment options could therefore be prebiotics, probiotics......, antibiotics and/or fecal transplant. In this review, we have looked at the evidence for the yeast S. boulardii as a treatment option. MATERIAL AND METHODS: Searches in PubMed and the Cochrane Library with the MeSH words 'Saccharomyces boulardii AND IBD', 'Saccharomyces boulardii AND Inflammatory Bowel Disease....... Saccharomyces boulardii is, however, a plausible treatment option in the future, but more placebo-controlled clinical studies on both patients with ulcerative colitis and Crohn's disease are needed....

Achalasia: Treatment Options Revisited

Directory of Open Access Journals (Sweden)

Willemijntje A Hoogerwerf

2000-01-01

Full Text Available The aim of all current forms of treatment of achalasia is to enable the patient to eat without disabling symptoms such as dysphagia, regurgitation, coughing or choking. Historically, this has been accomplished by mechanical disruption of the lower esophageal sphincter fibres, either by means of pneumatic dilation (PD or by open surgical myotomy. The addition of laparoscopic myotomy and botulinum toxin (BTX injection to the therapeutic armamentarium has triggered a recent series of reviews to determine the optimal therapeutic approach. Both PD and BTX have excellent short term (less than three months efficacy in the majority of patients. New data have been published that suggest that PD and BTX (with repeat injections can potentially obtain long term efficacy. PD is still considered the first-line treatment by most physicians; its main disadvantage is risk of perforation. BTX injection is evolving as an excellent, safe option for patients who are considered high risk for more invasive procedures. Laparoscopic myotomy with combined antireflux surgery is an increasingly attractive option in younger patients with achalasia, but long term follow-up studies are required to establish its efficacy and the potential for reflux-related sequelae.

Venture Guidance Appraisal cost estimates for groundwater protection Environmental Impact Statement

International Nuclear Information System (INIS)

Moyer, R.A.

1987-01-01

Cost estimates were prepared for closure options at criteria waste sites and alternatives for new disposal facilities for hazardous wastes, mixed wastes, low level radioactive wastes and slurry from liquid waste treatment facilities. Because these cost estimates will be used in the Groundwater Protection EIS, the goal was to develop ''enveloping'' costs, i.e., the alternative or option chosen for execution at a later date should cost no more than the estimate. This report summarizes scenarios for making detailed cost estimates. Also included are unit costs for disposition of potential excavations, for operational activities, and for groundwater monitoring and site maintenance after closure of the site. The cost numbers presented are intended for study purposes only and not for budgetary activities

Treatment options for hepatocellular carcinoma.

Science.gov (United States)

Sandhu, Dalbir S; Tharayil, Vivek S; Lai, Jin-Ping; Roberts, Lewis R

2008-02-01

Hepatocellular carcinoma (HCC) is frequently diagnosed at advanced stages and has a high mortality rate. With improved survival of patients with cirrhotic liver disease and increased prevalence of chronic hepatitis C viral infections, a rise in the number of HCC cases is being reported worldwide. Early diagnosis and treatment can significantly improve the prognosis of patients with HCC. Although surgical resection is an important potentially curative therapy for liver tumors, in appropriately selected patients, liver transplantation has been shown to achieve excellent survival rates for a solid tumor. Locally ablative and locoregional therapies in the form of percutaneous ethanol injection, radiofrequency ablation, transcatheter arterial chemoembolization and transcatheter arterial radioembolization (TheraSphere) are viable options in patients with unresectable HCC. Unfortunately, the role of systemic therapy has been very limited in the treatment of these patients. Novel treatment options based on an improved understanding of the molecular pathogenesis of HCC are being explored. These targeted molecular therapies are aimed at growth factors and their receptors, intracellular signal transduction and cell cycle control. A substantial improvement in outcomes of intermediate and advanced stage HCC is expected with the advent of these targeted therapies, used in combination with surgical or locoregional therapies. Recent positive results from a large Phase III study of the receptor tyrosine kinase inhibitor, sorafenib, hold great promise in the treatment of HCC.

Use of Interface Treatment to Reduce Emissions from Residuals in Lower Permeability Zones to Groundwater flowing Through More Permeable Zones (Invited)

Science.gov (United States)

Johnson, P.; Cavanagh, B.; Clifton, L.; Daniels, E.; Dahlen, P.

2013-12-01

Many soil and groundwater remediation technologies rely on fluid flow for contaminant extraction or reactant delivery (e.g., soil vapor extraction, pump and treat, in situ chemical oxidation, air sparging, enhanced bioremediation). Given that most unconsolidated and consolidated settings have permeability contrasts, the outcome is often preferential treatment of more permeable zones and ineffective treatment of the lower permeability zones. When this happens, post-treatment contaminant emissions from low permeability zone residuals can cause unacceptable long-term impacts to groundwater in the transmissive zones. As complete remediation of the impacted lower permeability zones may not be practicable with conventional technologies, one might explore options that lead to reduction of the contaminant emissions to acceptable levels, rather than full remediation of the lower permeability layers. This could be accomplished either by creating a sustained emission reaction/attenuation zone at the high-low permeability interface, or by creating a clean soil zone extending sufficiently far into the lower permeability layer to cause the necessary reduction in contaminant concentration gradient and diffusive emission. These options are explored in proof-of-concept laboratory-scale physical model experiments. The physical models are prepared with two layers of contrasting permeability and either dissolved matrix storage or nonaqueous phase liquid (NAPL) in the lower permeability layer. A dissolved oxidant is then delivered to the interface via flow across the higher permeability layer and changes in contaminant emissions from the low permeability zone are monitored before, during, and after oxidant delivery. The use of three oxidants (dissolved oxygen, hydrogen peroxide and sodium persulfate) for treatment of emissions from petroleum hydrocarbon residuals is examined.

Patient knowledge on stroke risk factors, symptoms and treatment options.

Science.gov (United States)

Faiz, Kashif Waqar; Sundseth, Antje; Thommessen, Bente; Rønning, Ole Morten

2018-01-01

Public campaigns focus primarily on stroke symptom and risk factor knowledge, but patients who correctly recognize stroke symptoms do not necessarily know the reason for urgent hospitalization. The aim of this study was to explore knowledge on stroke risk factors, symptoms and treatment options among acute stroke and transient ischemic attack patients. This prospective study included patients admitted to the stroke unit at the Department of Neurology, Akershus University Hospital, Norway. Patients with previous cerebrovascular disease, patients receiving thrombolytic treatment and patients who were not able to answer the questions in the questionnaire were excluded. Patients were asked two closed-ended questions: "Do you believe that stroke is a serious disorder?" and "Do you believe that time is of importance for stroke treatment?". In addition, patients were asked three open-ended questions where they were asked to list as many stroke risk factors, stroke symptoms and stroke treatment options as they could. A total of 173 patients were included, of whom 158 (91.3%) confirmed that they regarded stroke as a serious disorder and 148 patients (85.5%) considered time being of importance. In all, 102 patients (59.0%) could not name any treatment option. Forty-one patients (23.7%) named one or more adequate treatment options, and they were younger ( p options, which may contribute to reduce prehospital delay and onset-to-treatment-time.

Treatment Option Overview (AIDS Related-Lymphoma)

Science.gov (United States)

... and treatment options. AIDS-related lymphoma is a disease in which malignant (cancer) cells form in the ... cord. The sample may also be checked for Epstein-Barr virus . This procedure is also called an LP ...

Novel treatment options in depression and psychosis

Directory of Open Access Journals (Sweden)

Ceskova E

2018-03-01

Full Text Available Eva Ceskova, Petr Silhan Department of Psychiatry, University Hospital Ostrava, Ostrava, Czech Republic Abstract: In spite of tremendous development in central nervous system research, current treatment is suboptimal, especially in severe mental disorders. In medicine, there are two main methods of improving the health care provided: seeking new treatment procedures and perfecting (optimizing the existing ones. Optimization of treatment includes not only practical tools such as therapeutic drug monitoring but also implementation of general trends in the clinical practice. New pharmacological options include new more sophisticated forms of monoaminergic drugs, old drugs rediscovered on the base of a better understanding of pathophysiology of mental illnesses, and drugs aimed at new treatment targets. In depression, treatment resistance to antidepressive pharmacotherapy represents one of the most important clinical challenges. Switching to monotherapy with new multimodal/multifunctional antidepressants and augmentation with new atypical antipsychotics (aripiprazole and brexpiprazole may be promising options. Further, current evidence supports utility and safety of adjunctive treatment of nutraceuticals. Novel approaches being studied include ketamine and opioids. Recent advances in technology and emerging knowledge about dysfunctional brain circuits and neuroplasticity have led to the development of different new neuromodulation techniques usually used as add-on therapy. Antipsychotics are still the cornerstone of the current treatment of schizophrenia. Two new partial dopamine agonists, brexpiprazole and cariprazine, are now available in addition to aripiprazole. Although the mechanisms of action are similar, the two agents differ in terms of their pharmacodynamic profiles. Further, two new formulations of long-acting injections of second-generation antipsychotics (aripiprazole lauroxil and 3-month paliperidone palmitate were introduced into

Cyanobacterial Treatment Options: Permanganate and ...

Science.gov (United States)

This presentation will begin with a brief overview of drinking water treatment options for cyanobacteria and their toxins. The treatment discussion will focus on the impacts of permanganate addition to suspensions of toxin-producing Microcystis aeruginosa, followed by powdered activated carbon (PAC) addition. Results will be presented that show changes in toxin concentrations, chlorophyll-a concentrations and cell membrane integrity. The EPA Small Systems Webinar Presentations allow the dissemination of the latest Agency guidance and research to a large geographically dispersed audience while minimizing taxpayer expense

In situ treatment of arsenic-contaminated groundwater by air sparging.

Science.gov (United States)

Brunsting, Joseph H; McBean, Edward A

2014-04-01

Arsenic contamination of groundwater is a major problem in some areas of the world, particularly in West Bengal (India) and Bangladesh where it is caused by reducing conditions in the aquifer. In situ treatment, if it can be proven as operationally feasible, has the potential to capture some advantages over other treatment methods by being fairly simple, not using chemicals, and not necessitating disposal of arsenic-rich wastes. In this study, the potential for in situ treatment by injection of compressed air directly into the aquifer (i.e. air sparging) is assessed. An experimental apparatus was constructed to simulate conditions of arsenic-rich groundwater under anaerobic conditions, and in situ treatment by air sparging was employed. Arsenic (up to 200 μg/L) was removed to a maximum of 79% (at a local point in the apparatus) using a solution with dissolved iron and arsenic only. A static "jar" test revealed arsenic removal by co-precipitation with iron at a molar ratio of approximately 2 (iron/arsenic). This is encouraging since groundwater with relatively high amounts of dissolved iron (as compared to arsenic) therefore has a large theoretical treatment capacity for arsenic. Iron oxidation was significantly retarded at pH values below neutral. In terms of operation, analysis of experimental results shows that periodic air sparging may be feasible. Copyright © 2014 Elsevier B.V. All rights reserved.

Treatment options for carcinoma in situ testis

DEFF Research Database (Denmark)

Mortensen, M S; Gundgaard, M.G.; Daugaard, G

2011-01-01

countries only offer this to high-risk patients. The treatment options range from orchidectomy and chemotherapy to radiotherapy and in rare cases surveillance. Results of the different treatment strategies are presented in this review. The optimal radiation dose is still not clarified. Most patients have...

Proven Alternatives for Aboveground Treatment of Arsenic in Groundwater

Science.gov (United States)

This issue paper, developed for EPA's Engineering Forum, identifies and summarizes experiences with proven aboveground treatment alternatives for arsenic in groundwater, and provides information on their relative effectiveness and cost.

[Necessary and unnecessary treatment options for hemorrhoids].

Science.gov (United States)

Zindel, Joel; Inglin, Roman; Brügger, Lukas

2014-12-01

Up to one third of the general population suffers from symptoms caused by hemorrhoids. Conservative treatment comes first unless the patient presents with an acute hemorrhoidal prolapse or a thrombosis. A fiber enriched diet is the primary treatment option, recommended in the perioperative period as well as a long-term prophylaxis. A timely limited application of topical ointments or suppositories and/or flavonoids are further treatment options. When symptoms persist interventional procedures for grade I-II hemorrhoids, and surgery for grade III-IV hemorrhoids should be considered. Rubber band ligation is the interventional treatment of choice. A comparable efficacy using sclerosing or infrared therapy has not yet been demonstrated. We therefore do not recommend these treatment options for the cure of hemorrhoids. Self-treatment by anal insertion of bougies is of lowrisk and may be successful, particularly in the setting of an elevated sphincter pressure. Anal dilation, sphincterotomy, cryosurgery, bipolar diathermy, galvanic electrotherapy, and heat therapy should be regarded as obsolete given the poor or missing data reported for these methods. For a long time, the classic excisional hemorrhoidectomy was considered to be the gold standard as far as surgical procedures are concerned. Primary closure (Ferguson) seems to be superior compared to the "open" version (Milligan Morgan) with respect to postoperative pain and wound healing. The more recently proposed stapled hemorrhoidopexy (Longo) is particularly advisable for circular hemorrhoids. Compared to excisional hemorrhoidectomy the Longo-operation is associated with reduced postoperative pain, shorter operation time and hospital stay as well as a faster recovery, with the disadvantage though of a higher recurrence rate. Data from Hemorrhoidal Artery Ligation (HAL)-, if appropriate in combination with a Recto-Anal Repair (HAL/RAR)-, demonstrates a similar trend towards a better tolerance of the procedure at the

Treatment options in otitis media with effusion.

Science.gov (United States)

Upadhya, Ila; Datar, J

2014-01-01

Secretary Otitis media with effusion (OME) is the accumulation of mucus in the middle ear and sometimes in the mastoid air cell system. The main etiological factor is alteration in mucociliary system of middle ear secondary to ET malfunction which may be primary or secondary. OME is the cause of concern due to its occurance in paediatric age group, highest at 2 years of age, presenting as impairment of hearing leading to delayed speech and language development, poor academic performance and behavioral problems. In spite of this there are no confirmed guidelines of treatment to overcome. Many treatment options are available medical as well as surgical. Prospective study conducted to evaluate various treatment options revealed that auto inflation of ET is the main stay of treatment. If the ET malfunction is due to any reasons like adenoids, deviated nasal septum, hypertrophied turbinates or any other cause surgical intervention of the same gives 100% results. Medical management gives good results but recurrence is equally common.

[Treatment options for patellar tendinopathy].

Science.gov (United States)

Duthon, V B; Borloz, S; Ziltener, J-L

2012-07-25

Patellar tendinopathy is also called jumper's knee because of its high incidence in athletes with jumping or cutting activities as soccer, basketball, volleyball. Many different treatment methods have been described. However, no consensus exists regarding the optimal treatment for this condition. According to the literature, eccentric exercise-based physical therapy should be proposed first because of its strong scientific evidence. Shockwave therapy and injections may be useful but their real efficacy still has to be proven by randomized controlled study. For patients recalcitrant to more conservative options, operative management may be indicated.

Simulation of groundwater flow and analysis of the effects of water-management options in the North Platte Natural Resources District, Nebraska

Science.gov (United States)

Peterson, Steven M.; Flynn, Amanda T.; Vrabel, Joseph; Ryter, Derek W.

2015-08-12

The North Platte Natural Resources District (NPNRD) has been actively collecting data and studying groundwater resources because of concerns about the future availability of the highly inter-connected surface-water and groundwater resources. This report, prepared by the U.S. Geological Survey in cooperation with the North Platte Natural Resources District, describes a groundwater-flow model of the North Platte River valley from Bridgeport, Nebraska, extending west to 6 miles into Wyoming. The model was built to improve the understanding of the interaction of surface-water and groundwater resources, and as an optimization tool, the model is able to analyze the effects of water-management options on the simulated stream base flow of the North Platte River. The groundwater system and related sources and sinks of water were simulated using a newton formulation of the U.S. Geological Survey modular three-dimensional groundwater model, referred to as MODFLOW–NWT, which provided an improved ability to solve nonlinear unconfined aquifer simulations with wetting and drying of cells. Using previously published aquifer-base-altitude contours in conjunction with newer test-hole and geophysical data, a new base-of-aquifer altitude map was generated because of the strong effect of the aquifer-base topography on groundwater-flow direction and magnitude. The largest inflow to groundwater is recharge originating from water leaking from canals, which is much larger than recharge originating from infiltration of precipitation. The largest component of groundwater discharge from the study area is to the North Platte River and its tributaries, with smaller amounts of discharge to evapotranspiration and groundwater withdrawals for irrigation. Recharge from infiltration of precipitation was estimated with a daily soil-water-balance model. Annual recharge from canal seepage was estimated using available records from the Bureau of Reclamation and then modified with canal

An update on adjunctive treatment options for bipolar disorder.

Science.gov (United States)

Dean, Olivia M; Gliddon, Emma; Van Rheenen, Tamsyn E; Giorlando, Francesco; Davidson, Sandra K; Kaur, Manreena; Ngo, Trung T; Williams, Lana J

2018-03-01

Bipolar disorder is a complex illness often requiring combinations of therapies to successfully treat symptoms. In recent years, there have been significant advancements in a number of therapies for bipolar disorder. It is therefore timely to provide an overview of current adjunctive therapeutic options to help treating clinicians to inform their patients and work towards optimal outcomes. Publications were identified from PubMed searches on bipolar disorder and pharmacotherapy, nutraceuticals, hormone therapy, psychoeducation, interpersonal and social rhythm therapy, cognitive remediation, mindfulness, e-Health and brain stimulation techniques. Relevant articles in these areas were selected for further review. This paper provides a narrative review of adjunctive treatment options and is not a systematic review of the literature. A number of pharmacotherapeutic, psychological and neuromodulation treatment options are available. These have varying efficacy but all have shown benefit to people with bipolar disorder. Due to the complex nature of treating the disorder, combination treatments are often required. Adjunctive treatments to traditional pharmacological and psychological therapies are proving useful in closing the gap between initial symptom remission and full functional recovery. Given that response to monotherapy is often inadequate, combination regimens for bipolar disorder are typical. Correspondingly, psychiatric research is working towards a better understanding of the disorder's underlying biology. Therefore, treatment options are changing and adjunctive therapies are being increasingly recognized as providing significant tools to improve patient outcomes. Towards this end, this paper provides an overview of novel treatments that may improve clinical outcomes for people with bipolar disorder. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Emerging treatment options for meibomian gland dysfunction

Directory of Open Access Journals (Sweden)

Qiao J

2013-09-01

Full Text Available Jing Qiao, Xiaoming YanDepartment of Ophthalmology, Peking University First Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, People's Republic of ChinaAbstract: Meibomian gland dysfunction (MGD is one of the most common diseases observed in clinics; it influences a great number of people, and is the leading cause of evaporative dry eye. Given the increased recognition of the importance of MGD, a great amount of attention has been paid to therapies targeting this condition. The traditional treatments of MGD consist of warm compresses and lid hygiene for removing an obstructed meibum, as well as antibiotics and anti-inflammatory agents to improve the quality of the meibum. However, each of these treatments has a different shortcoming and the treatment of MGD remains challenging. Despite the numerous possible treatment options for MGD, it is still difficult to obtain complete relief of signs and symptoms. This review focuses on current emerging treatment options for MGD including intraductal meibomian gland probing, emulsion eye drops containing lipids, the LipiFlow® thermal pulsation system, N-acetyl-cysteine, azithromycin, oral supplementation with omega-3 essential fatty acids, and cyclosporine A.Keywords: meibomian gland dysfunction, dry eye, emerging treatment

Cyanobacterial Treatment Options: Permanganate and Powdered Activated Carbon

Science.gov (United States)

This presentation will begin with a brief overview of drinking water treatment options for cyanobacteria and their toxins. The treatment discussion will focus on the impacts of permanganate addition to suspensions of toxin-producing Microcystis aeruginosa, followed by powdered ac...

The option value of innovative treatments in the context of chronic myeloid leukemia.

Science.gov (United States)

Sanchez, Yuri; Penrod, John R; Qiu, Xiaoli Lily; Romley, John; Thornton Snider, Julia; Philipson, Tomas

2012-11-01

To quantify in the context of chronic myeloid leukemia (CML) the additional value patients receive when innovative treatments enable them to survive until the advent of even more effective future treatments (ie, the "option value"). Observational study using data from the Surveillance, Epidemiology and End Results (SEER) cancer registry comprising all US patients with CML diagnosed between 2000 and 2008 (N = 9,760). We quantified the option value of recent breakthroughs in CML treatment by first conducting retrospective survival analyses on SEER data to assess the effectiveness of TKI treatments, and then forecasting survival from CML and other causes to measure expected future medical progress. We then developed an analytical framework to calculate option value of innovative CML therapies, and used an economic model to value these gains. We calculated the option value created both by future innovations in CML treatment and by medical progress in reducing background mortality. For a recently diagnosed CML patient, the option value of innovative therapies from future medical innovation amounts to 0.76 life-years. This option value is worth $63,000, equivalent to 9% of the average survival gains from existing treatments. Future innovations in CML treatment jointly account for 96% of this benefit. The option value of innovative treatments has significance in the context of CML and, more broadly, in disease areas with rapid innovation. Incorporating option value into traditional valuations of medical innovations is both a feasible and a necessary practice in health technology assessment.

Tooth wear : a systematic review of treatment options

NARCIS (Netherlands)

Muts, Erik-Jan; van Pelt, Hans; Edelhoff, Daniel; Krejci, Ivo; Cune, Marco

2014-01-01

STATEMENT OF PROBLEM: Treatment of tooth wear is increasing. Because no evidence-based guidelines are available, the clinician may have difficulties deciding which treatment option to choose to resolve complex situations. PURPOSE: The purpose of this systematic review was to identify similarities

Proven Alternatives for Aboveground Treatment of Arsenic in Groundwater

Science.gov (United States)

2002-10-01

issue paper does not address three technologies that have been used to treat water containing arsenic: • Biological treatment • Phytoremediation ...arsenic in water, and no aboveground treatments of groundwater conducted at full scale were found. Phytoremediation and electrokinetics are not...Roundtable. September 1998. http://www.frtr.gov/costperf.htm. 1.16 U.S. EPA. Office of Research and Development. Arsenic & Mercury - Workshop on Removal

Sampling and treatment of rock cores and groundwater under reducing environments of deep underground

International Nuclear Information System (INIS)

Ebashi, Katsuhiro; Yamaguchi, Tetsuji; Tanaka, Tadao

2005-01-01

A method of sampling and treatment of undisturbed rock cores and groundwater under maintained reducing environments of deep underground was developed and demonstrated in a Neogene's sandy mudstone layer at depth of GL-100 to -200 m. Undisturbed rock cores and groundwater were sampled and transferred into an Ar gas atmospheric glove box with minimized exposure to the atmosphere. The reducing conditions of the sampled groundwater and rock cores were examined in the Ar atmospheric glove box by measuring pH and Eh of the sampled groundwater and sampled groundwater contacting with disk type rock samples, respectively. (author)

Stereotactic Neurosurgical Treatment Options for Childhood Craniopharyngioma

Directory of Open Access Journals (Sweden)

Michael eTrippel

2012-05-01

Full Text Available Craniopharyngioma are the most common non glial tumors in childhood. The results of different studies indicate that radical excision surgery is not an appropriate treatment strategy for childhood craniopharyngioma with hypothalamic involvement. Stereotactic neurosurgery provides save, minimal invasive and cost efficient options in the treatment of childhood craniopharyngioma. In this review a summary of the contribution of the stereotactic neurosurgery in the interdisciplinary treatment regime of childhood craniopharyngioma will be given and discussed in detail.

Lack of tolerable treatment options for patients with schizophrenia

Directory of Open Access Journals (Sweden)

Citrome L

2015-12-01

Full Text Available Leslie Citrome,1 Anna Eramo,2 Clement Francois,2 Ruth Duffy,3 Susan N Legacy,3 Steve J Offord,3 Holly B Krasa,3 Stephen S Johnston,4 Alice Guiraud-Diawara,5 Siddhesh A Kamat,3 Patricia Rohman3 1Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, NY, 2Lundbeck, Deerfield, IL, 3Otsuka America Pharmaceuticals, Princeton, NJ, 4Truven Health Analytics, Bethesda, MD, USA; 5Lundbeck SAS, Issy-les-Moulineaux, France Purpose: Atypical antipsychotics (AAs, an effective treatment for schizophrenia, have a range of pharmacologic properties leading to differences in tolerability as well as heterogeneity in treatment response. Individual patient characteristics must be considered when making treatment choices, especially from an adverse event (AE or tolerability perspective. Despite the availability of numerous AAs, after appraising patient characteristics at the time of treatment selection, physicians may quickly run out of tolerable treatment options. Patients and methods: AE risk factors, defined as having either a prior history of an AE or a risk factor for that AE, were determined for Medicaid-insured and Commercially insured patients using database analysis. Patients receiving AA treatment between January 1, 2010 and December 31, 2012 defined the index date of first observed AA prescription during this period. Nine AAs were evaluated for association with AE risk factors as informed by drug prescribing information from the different manufacturers and published meta-analyses. The proportion of patients with pre-index AE risk factors prescribed an AA associated with that risk factor was then determined. Results: A high proportion of patients (>80% were prescribed an AA associated with extrapyramidal symptoms or akathisia despite experiencing extrapyramidal symptoms or akathisia prior to AA treatment initiation. Similar trends were observed among patients with diabetes (>60% and obesity (>40%. From the nine treatment

Nitrate and Perchlorate removal from groundwater by ion exchange; TOPICAL

International Nuclear Information System (INIS)

Burge, S; Halden, R

1999-01-01

This study was conducted to evaluate the performance of a small scale ion exchange unit (Krudico, Inc of Auborn, IA) for removal of nitrate and perchlorate from groundwater at Lawrence Livermore National Laboratory's Site 300. The unit was able to treat 3,600 gallons of Site 300 groundwater, at an average influent concentration of 100 mg/L NO(sub 3)(sup -) before breakthrough occurred. The unit contained 2.5 ft(sup 3) of Sybron SR-7 resin. Seventy gallons of regeneration waste were generated (water treated to waste ratio of 51:1). The effluent concentration was about 20 mg/L NO(sub 3)(sup -), which is equivalent to a treatment efficiency of at least 80%. There are several options for implementing this technology at Site 300. A target well, in the 817 area, has been selected. It has a 3 to 4 gpm flow rate, and concentrations of 90 mg/L NO(sub 3)(sup -) and 40(micro)g/L perchlorate. The different treatment options include ion exchange treatment of nitrate only, nitrate and perchlorate, or perchlorate only. Option 1: For the treatment of nitrate only, this unit will be able to treat 3,700 gallons of water before regeneration is required. If both columns of the ion exchange unit are used, 7,400 gallons could be treated before the columns will need to be regenerated (producing 140 gallons of waste, per cycle or every 1.5 days). The effluent nitrate concentration is expected to be about 17 mg/L. Annual operation and maintenance costs are estimated to be$0.14 per gallon of water treated. Option 2: If only perchlorate is to be removed with ion exchange at the 817 area, a smaller unit should be considered. A 55 gallon canister filled with ion exchange resin should be able to reduce perchlorate concentrations in the groundwater from 40(micro)g/L to non-detect levels for three years before the resin would need to be replaced. The contaminant-laden resin would be disposed of as hazardous waste. It is not practical to regenerate the resin because of the extreme difficulty of

Treatment options for patellofemoral instability in sports traumatology

Directory of Open Access Journals (Sweden)

Philippe M. Tscholl

2013-09-01

Full Text Available Patellofemoral instability not only involves lateral patellar dislocation, patellar mal-tracking or subluxation but can also cause a limiting disability for sports activities. Its underlying causes are known as morphological anomalies of the patellofemoral joint or the mechanical axis, femorotibial malrotation, variants of the knee extensor apparatus, and ligamentous insufficiencies often accompanied by poor proprioception. Athletes with such predisposing factors are either suffering from unspecific anterior knee pain or from slightly traumatic or recurrent lateral patellar dislocation Treatment options of patellar instability are vast, and need to be tailored individually depending on the athlete’s history, age, complaints and physical demands. Different conservative and surgical treatment options are reviewed and discussed, especially limited expectations after surgery.

Water Quality, Mitigation Measures of Arsenic Contamination and Sustainable Rural Water Supply Options in Bangladesh

Directory of Open Access Journals (Sweden)

HOSSAIN M. ANAWAR

2012-06-01

Full Text Available Arsenic contamination of groundwater has created a serious public health issue in Bangladesh and West Bengal (India, because groundwater is widely used for drinking, household and agriculture purposes. Given the magnitude of the problem of groundwater contamination facing Bangladesh, effective, acceptable and sustainable solutions are urgently required. Different NGOs (Non-government organizations and research organizations are using their extensive rural networks to raise awareness and conduct pilot projects. The implication of the results from the previous studies is robust, but coastly arsenic reduction technologies such as activated alumina technology, and As and Fe removal filters may find little social acceptance, unless heavily subsidized. This review paper analysed the quality of surface water and ground water, all mitigation measures and the most acceptable options to provide sustainable access to safe- water supply in the rural ares of Bangladesh. Although there are abundant and different sources of surface water, they can not be used for drinking and hosehold purposes due to lack of sanitation, high faecal coliform concentration, turibidity and deterioration of quality of surface water sources. There are a few safe surface water options; and also there are several methods available for removal of arsenic and iron from groundwater in large conventional treatments plants. This review paper presented a short description of the currently available and most sustainable technologies for arsenic and iron removal, and alternative water supply options in the rural areas.

Laboratory evaluation of the potential for in situ treatment of chromate-contaminated groundwater by chemical precipitation

International Nuclear Information System (INIS)

Thornton, E.C.; Beck, M.A.; Jurgensmeier, C.A.

1995-03-01

The objective of this paper is to present the results of a series of small-scale batch tests performed to assess the effectiveness of chemical precipitation in the remediation of chromate-contaminated groundwater. These tests involved treatment of chromate solutions with ferrous and sulfide ions. In addition, tests were conducted that involved treatment of mixtures of chromate-contaminated groundwater and uncontaminated soil with the ferrous ion. A combination of ferrous sulfate and sodium sulfide was also tested in the groundwater treatment tests, since this approach has been shown to be an efficient method for treating electroplating wastewaters

Implementation of a permeable reactive barrier for treatment of groundwater impacted by strontium-90

International Nuclear Information System (INIS)

Przepiora, A.; Bodine, D.; Dollar, P.; Smith, P.

2014-01-01

A funnel and gate permeable reactive barrier (PRB) system was constructed to treat strontium-90 (Sr- 90) in groundwater migrating from a legacy waste disposal area into an adjacent wetland. The PRB system was designed to contain and direct the Sr-90 impacted groundwater into treatment 'gates' containing zeolite using a low permeability 'funnel' sections constructed with soil-bentonite slurry. The constructed PRB met all dimension and permeability specifications. Initial performance monitoring results indicate that the PRB captured the Sr-90 impacted groundwater plume and the beta radiation values in groundwater emerging from the treatment gates ranged from 35 to 86 Becquerel's per litre (Bq/L), equivalent to a reduction by 88% to 99% from the influent values. Those initial performance results were influenced by residual impacts present in the aquifer material prior to PRB installation. It is anticipated that the clean-up target of 5 Bq/L will be achieved with time as treated groundwater emerging from the PRB flushes through the downgradient aquifer zone. (author)

Nonsurgical Treatment Options for Basal Cell Carcinoma

International Nuclear Information System (INIS)

Lien, M. H.; Sondak, V. K.; Sondak, V. K.

2011-01-01

Basal cell carcinoma (BCC) remains the most common form of non melanoma skin cancer (NMSC) in Caucasians, with perhaps as many as 2 million new cases expected to occur in the United States in 2010. Many treatment options, including surgical interventions and nonsurgical alternatives, have been utilized to treat BCC. In this paper, two non-surgical options, imiquimod therapy and photodynamic therapy (PDT), will be discussed. Both modalities have demonstrated acceptable disease control rates, cosmetically superior outcomes, and short-term cost-effectiveness. Further studies evaluating long-term cure rates and long-term cost effectiveness of imiquimod therapy and PDT are needed.

In-situ remediation of brine impacted soils and groundwater using hydraulic fracturing, desalinization and recharge wells

Energy Technology Data Exchange (ETDEWEB)

Robertson, C. [Wiebe Environmental Services Inc., Calgary, AB (Canada); Ratiu, I. [GeoGrid Environmental Inc., Calgary, AB (Canada)

2006-07-01

This conference presentation focused on the in-stu remediation of brine impacted soils and groundwater using hydraulic fracturing, desalinization and recharge wells. A former oil battery was established in the 1940s, decommissioned in the late 1960s with a reclamation certificate issued in 1972. The land owner reported poor vegetative growth in the former battery area. The purpose of the study was to investigate the cause of poor growth and delineate contaminants of concern and to remediate impacted soil and groundwater associated with the former battery site. The investigation involved agrological, geophysical and hydrogeological investigation into the extent of anthropogenic impacts as well as the development of remediation options and plans to deal with issues of concern. The presentation provided the results of the investigation, options identified, and discussed limitation on salt remediation and treatment of saline soils. Other topics included hydraulic fracturing, injection wells that were installed to re-circulate treated groundwater though the salt plume, desalinization processes, and next steps. figs.

A pilot study for the extraction and treatment of groundwater from a manufactured gas plant site. Final report

International Nuclear Information System (INIS)

1997-12-01

This report describes a pilot study involving treatment of contaminated groundwater at a former manufactured gas plant site on the eastern seaboard of the US. The work was performed in order to provide the design basis for a full-scale groundwater extraction and treatment system at the site, as well as to develop a generic approach to selection of groundwater treatment sequences at other MGP sites. It included three main components: hydrogeologic investigations, bench-scale treatability studies, and pilot-scale treatability studies. Technologies evaluated in bench-scale work included gravity settling, filtration, and dissolved air flotation (DAF) for primary treatment of nonaqueous phase materials; biological degradation, air stripping, and carbon adsorption for secondary treatment of dissolved organics; and carbon adsorption as tertiary treatment of remaining dissolved contaminants. Pilot-scale studies focused on collecting system performance data fore three distinct levels of contamination. Two treatment trains were evaluated. One consisted of DAF, fluidized-bed biotreatment, and filtration plus carbon adsorption; the other used the same steps except to substitute air stripping for fluidized bed treatment. The final effluents produced by both treatment sequences were similar and demonstrated complete treatment of the groundwater. Besides detailing system design and performance for the treatability studies, the report includes an analysis of groundwater treatment applications to MGP sites in general, including a discussion of capital and operating costs

Hydraulic performance of permeable barriers for in situ treatment of contaminated groundwater

International Nuclear Information System (INIS)

Smyth, D.J.A.; Shikaze, S.G.; Cherry, J.A.

1997-01-01

The passive interception and in situ treatment of dissolved contaminants in groundwater by permeable reactive barriers has recently gained favor at an increasing number of sites as an alternative to conventional approaches to groundwater remediation such as the pump-and-treat method. Permeable reactive barriers have two essential functions. The first is that the barriers must be installed in a position such that all of the plume passes through the reactive system. The second function is to achieve acceptable treatment of the contamination by physical, chemical or biological means within or downgradient of the barrier. In this paper, issues associated with the hydraulic performance of permeable reaction barriers are evaluated using a three-dimensional groundwater flow model. The efficiency of plume capture by permeable wall and funnel-and-gate systems is examined for some generic and for site-specific hydrogeologic systems. The results have important implications to decisions pertaining to the selection, design and installation of permeable reactive barrier systems

Review of Saccharomyces boulardii as a treatment option in IBD.

Science.gov (United States)

Sivananthan, Kavitha; Petersen, Andreas Munk

2018-05-17

Review of the yeast Saccharomyces boulardii as a treatment option for the inflammatory bowel diseases (IBD) ulcerative colitis and Crohn's disease. IBD is caused by an inappropriate immune response to gut microbiota. Treatment options could therefore be prebiotics, probiotics, antibiotics and/or fecal transplant. In this review, we have looked at the evidence for the yeast S. boulardii as a treatment option. Searches in PubMed and the Cochrane Library with the MeSH words 'Saccharomyces boulardii AND IBD', 'Saccharomyces boulardii AND Inflammatory Bowel Disease', 'Saccharomyces boulardii AND ulcerative colitis' and 'Saccharomyces boulardii AND Crohn's disease' gave total a total of 80 articles. After exclusions because of irrelevance, articles in other languages and some articles that were not available, 16 articles were included in this review. Three of the clinical trials showed a positive effect of S. boulardii in IBD patients (two Crohn's disease, one ulcerative colitis), while there was one trial that didn't prove any effect (Crohn's disease). Included Animal trials and cell assays describes different anti-inflammatory mechanisms of S. boulardii supporting a possible effect when treating IBD patients. The number of studies of S. boulardii as treatment for IBD is limited. Furthermore, the existing trials have small populations and short duration. We do not have enough evidence to prove the effect of S. boulardii in IBD. Saccharomyces boulardii is, however, a plausible treatment option in the future, but more placebo-controlled clinical studies on both patients with ulcerative colitis and Crohn's disease are needed.

In situ treatment of cyanide-contaminated groundwater by iron cyanide precipitation

International Nuclear Information System (INIS)

Ghosh, R.S.; Dzombak, D.A.; Luthy, R.G.; Smith, J.R.

1999-01-01

Groundwater contamination with cyanide is common at many former or active industrial sites. Metal-cyanide complexes typically dominate aqueous speciation of cyanide in groundwater systems, with iron-cyanide complexes often most abundant. Typically, metal-cyanide complexes behave as nonadsorbing solutes in sand-gravel aquifer systems in the neutral pH range, rendering cyanide relatively mobile in groundwater systems. Groundwater pump-and-treat systems have often been used to manage cyanide contamination in groundwater. This study examined the feasibility of using in situ precipitation of iron cyanide in a reactive barrier to attenuate the movement of cyanide in groundwater. Laboratory column experiments were performed in which cyanide solutions were passed through mixtures of sand and elemental iron filings. Removal of dissolved cyanide was evaluated in a variety of cyanide-containing influents under various flow rates and sand-to-iron weight ratios. Long-term column tests performed with various cyanide-containing influents under both oxic and anoxic conditions, at neutral pH and at flow rates typical of sand-gravel porous media, yielded effluent concentrations of total cyanide as low as 0.5 mg/L. Effluent cyanide concentrations achieved were close to the solubilities of Turnbull's blue-hydrous ferric oxide solid solutions, indicating co-precipitation of the two solids. Maximum cyanide removal efficiency was achieved with approximately 10% by weight of iron in the sand-iron mixtures; higher iron contents did not increase removal efficiency significantly. Results obtained indicate that in situ precipitation is a promising passive treatment approach for cyanide in groundwater

Acute intermittent porphyria: Diagnostic dilemma and treatment options

Directory of Open Access Journals (Sweden)

Mohan Deep Kaur

2015-01-01

Full Text Available Acute intermittent porphyria (AIP presents with diverse group of symptoms making its early diagnosis difficult. Delaying diagnosis and treatment of AIP can be fatal or can cause long term or permanent neurological damage. We present here a case report of AIP where the diagnosis was missed. The diversity of symptoms and details concerning the treatment options for AIP are discussed.

Acute intermittent porphyria: Diagnostic dilemma and treatment options

Science.gov (United States)

Kaur, Mohan Deep; Hazarika, Nita; Saraswat, Namita; Sood, Rajesh

2015-01-01

Acute intermittent porphyria (AIP) presents with diverse group of symptoms making its early diagnosis difficult. Delaying diagnosis and treatment of AIP can be fatal or can cause long term or permanent neurological damage. We present here a case report of AIP where the diagnosis was missed. The diversity of symptoms and details concerning the treatment options for AIP are discussed. PMID:26330726

A new separation and treatment method for soil and groundwater restoration

Energy Technology Data Exchange (ETDEWEB)

Hitchens, G.D. [Lynntech, Inc., College Station, TX (United States)

1997-10-01

Soil and groundwater contamination by organic compounds is a widespread environmental pollution problem. In many cases, contaminated soil is excavated and transported to a landfill or is incinerated to remove contaminants. These remediation practices are expensive, environmentally disruptive, require extensive permitting, and only move contamination from one location to another. Onsite and in situ treatment techniques offer a safer, more cost-effective, and permanent solution. Many soil and groundwater contaminants are highly volatile, enabling the use of methods such as in situ vacuum extraction and air injection for their removal. However, these methods are often difficult to use because of slow volatilization rates and the lack of effective methods to treat the extracted hazardous material. This Phase I Small Business Innovation Research program focuses on developing an in situ soil and groundwater remediation technique that is effective against volatile as well as nonvolatile compounds and that will shorten treatment times. The technique forms the basis of a new catalytic process to degrade extracted contaminants onsite. Key hardware elements on which the new technique is based have been proven in preliminary research. The method has a high potential for public and regulatory acceptance because of its low environment impact.

A new separation and treatment method for soil and groundwater restoration

International Nuclear Information System (INIS)

Hitchens, G.D.

1997-01-01

Soil and groundwater contamination by organic compounds is a widespread environmental pollution problem. In many cases, contaminated soil is excavated and transported to a landfill or is incinerated to remove contaminants. These remediation practices are expensive, environmentally disruptive, require extensive permitting, and only move contamination from one location to another. Onsite and in situ treatment techniques offer a safer, more cost-effective, and permanent solution. Many soil and groundwater contaminants are highly volatile, enabling the use of methods such as in situ vacuum extraction and air injection for their removal. However, these methods are often difficult to use because of slow volatilization rates and the lack of effective methods to treat the extracted hazardous material. This Phase I Small Business Innovation Research program focuses on developing an in situ soil and groundwater remediation technique that is effective against volatile as well as nonvolatile compounds and that will shorten treatment times. The technique forms the basis of a new catalytic process to degrade extracted contaminants onsite. Key hardware elements on which the new technique is based have been proven in preliminary research. The method has a high potential for public and regulatory acceptance because of its low environment impact

Evaluation of the Hanford 200 West Groundwater Treatment System: Fluidized Bed Bioreactor

Energy Technology Data Exchange (ETDEWEB)

Looney, Brian B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Jackson, Dennis G. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Dickson, John O. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Eddy-Dilek, Carol A. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2017-05-12

A fluidized bed reactor (FBR) in the 200W water treatment facility at Hanford is removing nitrate from groundwater as part of the overall pump-treat-reinject process. Control of the FBR bed solids has proven challenging, impacting equipment, increasing operations and maintenance (O&M), and limiting the throughput of the facility. In response to the operational challenges, the Department of Energy Richland Office (DOE-RL) commissioned a technical assistance team to facilitate a system engineering evaluation and provide focused support recommendations to the Hanford Team. The DOE Environmental Management (EM) technical assistance process is structured to identify and triage technologies and strategies that address the target problem(s). The process encourages brainstorming and dialog and allows rapid identification and prioritization of possible options. Recognizing that continuous operation of a large-scale FBR is complex, requiring careful attention to system monitoring data and changing conditions, the technical assistance process focused on explicit identification of the available control parameters (“knobs”), how these parameters interact and impact the FBR system, and how these can be adjusted under different scenarios to achieve operational goals. The technical assistance triage process was performed in collaboration with the Hanford team.

A comparative review of the options for treatment of erectile dysfunction: which treatment for which patient?

Science.gov (United States)

Hatzimouratidis, Konstantinos; Hatzichristou, Dimitrios G

2005-01-01

The field of erectile dysfunction (ED) has been revolutionised over the last two decades. Several treatment options are available today, most of which are associated with high efficacy rates and favourable safety profiles. A MEDLINE search was undertaken in order to evaluate all currently available data on treatment modalities for ED. Phosphodiesterase type 5 (PDE5) inhibitors (sildenafil, tadalafil, vardenafil) are currently the first-choice of most physicians and patients for the treatment of ED. PDE5 inhibitors have differences in their pharmacological profiles, the most obvious being the long duration of action of tadalafil, but there are no data supporting superiority for any one of them in terms of efficacy or safety. Sublingual apomorphine has limited efficacy compared with the PDE5 inhibitors, and its use is limited to patients with mild ED. Treatment failures with oral drugs may be due to medication, clinician and patient issues. The physician needs to address all of these issues in order to identify true treatment failures. Patients who are truly unresponsive to oral drugs may be offered other treatment options.Intracavernous injections of alprostadil alone, or in combination with other vasoactive agents (papaverine and phentolamine), remain an excellent treatment option, with proven efficacy and safety over time. Topical pharmacotherapy is appealing in nature, but currently available formulations have limited efficacy. Vacuum constriction devices may be offered mainly to elderly patients with occasional intercourse attempts, as younger patients show limited preference because of the unnatural erection that is associated with this treatment modality. Penile prostheses are generally the last treatment option offered, because of invasiveness, cost and non-reversibility; however, they are associated with high satisfaction rates in properly selected patients. All treatment options are associated with particular strengths and weaknesses. A patient

The application of illite supported nanoscale zero valent iron for the treatment of uranium contaminated groundwater.

Science.gov (United States)

Jing, C; Landsberger, S; Li, Y L

2017-09-01

In this study, nanoscale zero valent iron I-NZVI was investigated as a remediation strategy for uranium contaminated groundwater from the former Cimarron Fuel Fabrication Site in Oklahoma, USA. The 1 L batch-treatment system was applied in the study. The result shows that 99.9% of uranium in groundwater was removed by I-NZVI within 2 h. Uranium concentration in the groundwater stayed around 27 μg/L, and there was no sign of uranium release into groundwater after seven days of reaction time. Meanwhile the release of iron was significantly decreased compared to NZVI which can reduce the treatment impact on the water environment. To study the influence of background pH of the treatment system on removal efficiency of uranium, the groundwater was adjusted from pH 2-10 before the addition of I-NZVI. The pH of the groundwater was from 2.1 to 10.7 after treatment. The removal efficiency of uranium achieved a maximum in neutral pH of groundwater. The desorption of uranium on the residual solid phase after treatment was investigated in order to discuss the stability of uranium on residual solids. After 2 h of leaching, 0.07% of the total uranium on residual solid phase was leached out in a HNO 3 leaching solution with a pH of 4.03. The concentration of uranium in the acid leachate was under 3.2 μg/L which is below the EPA's maximum contaminant level of 30 μg/L. Otherwise, the concentration of uranium was negligible in distilled water leaching solution (pH = 6.44) and NaOH leaching solution (pH = 8.52). A desorption study shows that an acceptable amount of uranium on the residuals can be released into water system under strong acid conditions in short terms. For long term disposal management of the residual solids, the leachate needs to be monitored and treated before discharge into a hazardous landfill or the water system. For the first time, I-NZVI was applied for the treatment of uranium contaminated groundwater. These results provide proof that I-NZVI has

Treatment Options for Narcolepsy.

Science.gov (United States)

Barateau, Lucie; Lopez, Régis; Dauvilliers, Yves

2016-05-01

Narcolepsy type 1 and narcolepsy type 2 are central disorders of hypersomnolence. Narcolepsy type 1 is characterized by excessive daytime sleepiness and cataplexy and is associated with hypocretin-1 deficiency. On the other hand, in narcolepsy type 2, cerebrospinal fluid hypocretin-1 levels are normal and cataplexy absent. Despite major advances in our understanding of narcolepsy mechanisms, its current management is only symptomatic. Treatment options may vary from a single drug that targets several symptoms, or multiple medications that each treats a specific symptom. In recent years, narcolepsy treatment has changed with the widespread use of modafinil/armodafinil for daytime sleepiness, antidepressants (selective serotonin and dual serotonin and noradrenalin reuptake inhibitors) for cataplexy, and sodium oxybate for both symptoms. Other psychostimulants can also be used, such as methylphenidate, pitolisant and rarely amphetamines, as third-line therapy. Importantly, clinically relevant subjective and objective measures of daytime sleepiness are required to monitor the treatment efficacy and to provide guidance on whether the treatment goals are met. Associated symptoms and comorbid conditions, such as hypnagogic/hypnopompic hallucinations, sleep paralysis, disturbed nighttime sleep, unpleasant dreams, REM- and non REM-related parasomnias, depressive symptoms, overweight/obesity, and obstructive sleep apnea, should also be taken into account and managed, if required. In the near future, the efficacy of new wake-promoting drugs, anticataplectic agents, hypocretin replacement therapy and immunotherapy at the early stages of the disease should also be evaluated.

Toxicological and chemical assessment of arsenic-contaminated groundwater after electrochemical and advanced oxidation treatments.

Science.gov (United States)

Radić, Sandra; Crnojević, Helena; Vujčić, Valerija; Gajski, Goran; Gerić, Marko; Cvetković, Želimira; Petra, Cvjetko; Garaj-Vrhovac, Vera; Oreščanin, Višnja

2016-02-01

Owing to its proven toxicity and mutagenicity, arsenic is regarded a principal pollutant in water used for drinking. The objective of this study was the toxicological and chemical evaluation of groundwater samples obtained from arsenic enriched drinking water wells before and after electrochemical and ozone-UV-H2O2-based advanced oxidation processes (EAOP). For this purpose, acute toxicity test with Daphnia magna and chronic toxicity test with Lemna minor L. were employed as well as in vitro bioassays using human peripheral blood lymphocytes (HPBLs). Several oxidative stress parameters were estimated in L.minor. Physicochemical analysis showed that EAOP treatment was highly efficient in arsenic but also in ammonia and organic compound removal from contaminated groundwater. Untreated groundwater caused only slight toxicity to HPBLs and D. magna in acute experiments. However, 7-day exposure of L. minor to raw groundwater elicited genotoxicity, a significant growth inhibition and oxidative stress injury. The observed genotoxicity and toxicity of raw groundwater samples was almost completely eliminated by EAOP treatment. Generally, the results obtained with L. minor were in agreement with those obtained in the chemical analysis suggesting the sensitivity of the model organism in monitoring of arsenic-contaminated groundwater. In parallel to chemical analysis, the implementation of chronic toxicity bioassays in a battery is recommended in the assessment of the toxic and genotoxic potential of such complex mixtures. Copyright © 2015 Elsevier B.V. All rights reserved.

Technical approach to groundwater restoration

International Nuclear Information System (INIS)

1993-01-01

The Technical Approach to Groundwater Restoration (TAGR) provides general technical guidance to implement the groundwater restoration phase of the Uranium Mill Tailings Remedial Action (UMTRA) Project. The TAGR includes a brief overview of the surface remediation and groundwater restoration phases of the UMTRA Project and describes the regulatory requirements, the National Environmental Policy Act (NEPA) process, and regulatory compliance. A section on program strategy discusses program optimization, the role of risk assessment, the observational approach, strategies for meeting groundwater cleanup standards, and remedial action decision-making. A section on data requirements for groundwater restoration evaluates the data quality objectives (DQO) and minimum data required to implement the options and comply with the standards. A section on sits implementation explores the development of a conceptual site model, approaches to site characterization, development of remedial action alternatives, selection of the groundwater restoration method, and remedial design and implementation in the context of site-specific documentation in the site observational work plan (SOWP) and the remedial action plan (RAP). Finally, the TAGR elaborates on groundwater monitoring necessary to evaluate compliance with the groundwater cleanup standards and protection of human health and the environment, and outlines licensing procedures

Desmoid tumors: clinical features and treatment options: a case ...

African Journals Online (AJOL)

Desmoid tumors: clinical features and treatment options: a case report and a review of literature. Amel Achour Jenayah, Hajer Bettaieb, Sarra Saoudi, Anissa Gharsa, Ezzeddine Sfar, Fethia Boudaya, Dalenda Chelli ...

Groundwater regulation and integrated planning

Science.gov (United States)

Quevauviller, Philippe; Batelaan, Okke; Hunt, Randall J.

2016-01-01

The complex nature of groundwater and the diversity of uses and environmental interactions call for emerging groundwater problems to be addressed through integrated management and planning approaches. Planning requires different levels of integration dealing with: the hydrologic cycle (the physical process) including the temporal dimension; river basins and aquifers (spatial integration); socioeconomic considerations at regional, national and international levels; and scientific knowledge. The great natural variation in groundwater conditions obviously affects planning needs and options as well as perceptions from highly localised to regionally-based approaches. The scale at which planning is done therefore needs to be carefully evaluated against available policy choices and options in each particular setting. A solid planning approach is based on River Basin Management Planning (RBMP), which covers: (1) objectives that management planning are designed to address; (2) the way various types of measures fit into the overall management planning; and (3) the criteria against which the success or failure of specific strategies or interventions can be evaluated (e.g. compliance with environmental quality standards). A management planning framework is to be conceived as a “living” or iterated document that can be updated, refined and if necessary changed as information and experience are gained. This chapter discusses these aspects, providing an insight into European Union (EU), United States and Australia groundwater planning practices.

Engineered Option Treatment of Remediated Nitrate Salts: Surrogate Batch-Blending Testing

Energy Technology Data Exchange (ETDEWEB)

Anast, Kurt Roy [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-03-11

This report provides results from batch-blending test work for remediated nitrate salt (RNS) treatment. Batch blending was identified as a preferred option for blending RNS and unremediated nitrate salt (UNS) material with zeolite to effectively safe the salt/Swheat material identified as ignitable (U.S. Environmental Protection Agency code D001). Blending with zeolite was the preferred remediation option identified in the Options Assessment Report and was originally proposed as the best option for remediation by Clark and Funk in their report, Chemical Reactivity and Recommended Remediation Strategy for Los Alamos Remediated Nitrate Salt (RNS) Wastes, and also found to be a preferred option in the Engineering Options Assessment Report: Nitrate Salt Waste Stream Processing. This test work evaluated equipment and recipe alternatives to achieve effective blending of surrogate waste with zeolite.

Current status in the treatment options for esophageal achalasia.

Science.gov (United States)

Chuah, Seng-Kee; Chiu, Chien-Hua; Tai, Wei-Chen; Lee, Jyong-Hong; Lu, Hung-I; Changchien, Chi-Sin; Tseng, Ping-Huei; Wu, Keng-Liang

2013-09-07

Recent advances in the treatment of achalasia include the use of high-resolution manometry to predict the outcome of patients and the introduction of peroral endoscopic myotomy (POEM). The first multicenter randomized, controlled, 2-year follow-up study conducted by the European Achalasia Trial group indicated that laparoscopic Heller myotomy (LHM) was not superior to pneumatic dilations (PD). Publications on the long-term success of laparoscopic surgery continue to emerge. In addition, laparoscopic single-site surgery is applicable to advanced laparoscopic operations such as LHM and anterior fundoplication. The optimal treatment option is an ongoing matter of debate. In this review, we provide an update of the current progress in the treatment of esophageal achalasia. Unless new conclusive data prove otherwise, LHM is considered the most durable treatment for achalasia at the expense of increased reflux-associated complications. However, PD is the first choice for non-surgical treatment and is more cost-effective. Repeated PD according to an "on-demand" strategy based on symptom recurrence can achieve long-term remission. Decision making should be based on clinical evidence that identifies a subcategory of patients who would benefit from specific treatment options. POEM has shown promise but its long-term efficacy and safety need to be assessed further.

Angina pectoris: current therapy and future treatment options.

Science.gov (United States)

Parikh, Raj; Kadowitz, Philip J

2014-02-01

Angina pectoris is the consequence of an inequality between the demand and supply of blood to the heart. Angina manifests itself as chest pain or discomfort and is a common complaint of patients in the hospital and in the clinic. There are, in fact, roughly half a million new cases of angina per year. Chest pain, while having many etiologies, is generally considered to be most lethal when related to a cardiac cause. In this review, the authors outline the current medical and surgical therapies that are used in the management of angina. Highlights of the various clinical trials that have assisted in the investigation of these therapies are summarized also. Then, the authors provide a focused review of the novel therapy options for angina that are currently being explored. From new medical treatments to revised surgical techniques to the discovery of stem cell therapy, many innovative options are being investigated for the treatment of angina.

Current treatment options for vulvovaginal candidiasis caused by azole-resistant Candida species.

Science.gov (United States)

Sobel, J D; Sobel, R

2018-06-22

Clinicians are increasingly challenged by patients with refractory vulvovaginal candidiasis (VVC) caused by azole-resistant Candida species. Fluconazole resistant C.albicans is a growing and perplexing problem following years of indiscriminate drug prescription and unnecessary drug exposure and for which there are few therapeutic alternatives. Regrettably, although the azole class of drugs has expanded, new classes of antifungal drugs have not been forthcoming, limiting effective treatment options in patients with azole resistant Candida vaginitis. Areas covered: This review covers published data on epidemiology, pathophysiology and treatment options for women with azole-resistant refractory VVC. Expert opinion: Fluconazole resistant C.albicans adds to the challenge of azole resistant non-albicans Candida spp. Both issues follow years of indiscriminate drug prescription and unnecessary fluconazole exposure. Although an understanding of azole resistance in yeast has been established, this knowledge has not translated into useful therapeutic advantage. Treatment options for such women with refractory symptoms are extremely limited. New therapeutic options and strategies are urgently needed to meet this challenge of azole drug resistance.

Public policy perspective on groundwater quality

International Nuclear Information System (INIS)

Libby, L.W.

1990-01-01

Groundwater pollution problems are fundamentally institutional problems. The means for reducing contamination are institutional: the mix of incentives, rights and obligations confronting resource users. Only changes in the rights and obligations of users or the economic and social cost of water use options will reduce groundwater pollution. Policy is the process by which those changes are made. The essential purpose of groundwater quality policy is to change water use behavior. For the most part, people do respond to evidence that a failure to change could be painful. New information can produce the support necessary for regulation or other policy change. It is essential to maintain healthy respect for the rights and intentions of individuals. Improved understanding of human behavior is essential to success in groundwater policy

New Fathers' Perinatal Depression and Anxiety-Treatment Options: An Integrative Review.

Science.gov (United States)

O'Brien, Anthony P; McNeil, Karen A; Fletcher, Richard; Conrad, Agatha; Wilson, Amanda J; Jones, Donovan; Chan, Sally W

2017-07-01

More than 10% of fathers experience depression and anxiety during the perinatal period, but paternal perinatal depression (PPND) and anxiety have received less attention than maternal perinatal mental health problems. Few mainstream treatment options are available for men with PPND and anxiety. The aim of this literature review was to summarize the current understanding of PPND and the treatment programs specifically designed for fathers with perinatal depression. Eight electronic databases were searched using a predefined strategy, and reference lists were also hand searched. PPND and anxiety were identified to have a negative impact on family relationships, as well as the health of mothers and children. Evidence suggests a lack of support and tailored treatment options for men having trouble adjusting to the transition to fatherhood. Of the limited options available, cognitive behavioral therapy, group work, and blended delivery programs, including e-support approaches appear to be most effective in helping fathers with perinatal depression and anxiety. The review findings have important implications for the understanding of PPND and anxiety. Future research is needed to address the adoption of father-inclusive and father-specific models of care to encourage fathers' help-seeking behavior. Inclusion of male-specific requirements into support and treatment options can improve the ability of services to engage new fathers. Psychotherapeutic intervention could assist to address the cognitive differences and dissonance for men adjusting to the role of father, including male identity and role expectations.

Current treatment options for meningioma.

Science.gov (United States)

Apra, Caroline; Peyre, Matthieu; Kalamarides, Michel

2018-03-01

With an annual incidence of 5/100,000, meningioma is the most frequent primary tumor of the central nervous system. Risk factors are radiotherapy and hormone intake. Most meningiomas are grade I benign tumors, but up to 15% are atypical and 2% anaplastic according to the WHO 2016 histological criteria. Areas covered: This review details the current standard therapy based on international guidelines and recent literature, and describes new approaches developed to treat refractory cases. First-line treatments are observation and surgery, but adjuvant radiotherapy/radiosurgery is discussed for atypical and indicated for anaplastic meningiomas. The most problematic cases include skull base meningiomas that enclose vasculo-nervous structures and surgery- and radiation-refractory tumors that present with significant morbidity and mortality. The treatment of recurrent tumors is based on radiotherapy and repeated surgery. Systematic therapies are not effective in general but several clinical trials are ongoing. Expert commentary: Molecular characterization of the tumors, based on genetic mutations such as NF2, SMO, TERT, TRAF7, and on the methylation profile are developing, completing the histological classification and giving new insights into prognosis and treatment options.

Options of sustainable groundwater supply from safe aquifers in areas with elevated arsenic - a case study from Bangladesh

Science.gov (United States)

Jakariya, M.; Bhattacharya, P.; Bromssen, M. V.

2008-05-01

Access to safe drinking water is a basic human right. Several millions of people, mainly in developing countries are affected by arsenic in drinking water and the global impact now makes it a top priority water quality issue. A wide gap between the number of exposed people and the pace of mitigation programmes in rural areas of developing countries is the main problem in providing safe drinking water. The main challenge is to develop a sustainable mitigation option that rural and disadvantaged people can adopt and implement themselves to overcome possible public heath hazards. During the recent years, new approaches have emerged in Bangladesh, primarily emerging out of people's own initiative. The local drillers target presumed safe aquifers on the basis of colour and texture of the sediments. A recent study by our research group revealed a distinct correlation between the colour characteristics of the sediments and the groundwater redox conditions. The coupling between the colour of sediments and the redox characteristics of groundwater may thus be used as a tool to assess the risk for As mobilization from the aquifers. The study showed that it is possible to assess the relative risk of high concentrations of As in aquifers if the colour characteristics of the sediments are known and thus, local drillers may target safe aquifers. For validating the sustainability of this mitigation option geological, hydrogeological and microbiological investigations are needed. The sustainability of the aquifers needs to be assessed by combining results from various field and laboratory investigations and by running predictive models. There is also a need to raise the awareness and thereby create a platform for motivating the local drillers to be educated in installing safe tubewells. Awareness raising and community mobilisation are two top priorities for implementing a sustainable safe water project in rural village areas. Significant preparation, attention, and focus must be

Effects of residential wastewater treatment systems on ground-water quality in west-central Jefferson County, Colorado

Science.gov (United States)

Hall, Dennis C.; Hillier, D.E.; Nickum, Edward; Dorrance, W.G.

1981-01-01

The use of residential wastewater-treatment systems in Evergreen Meadows, Marshdale, and Herzman Mesa, Colo., has degraded ground-water quality to some extent in each community. Age of community; average lot size; slope of land surface; composition, permeability, and thickness of surficial material; density, size , and orientation of fractures; maintenance of wastewater-treatment systems; and presence of animals are factors possibly contributing to the degradation of ground-water quality. When compared with effluent from aeration-treatment tanks, effluent fom septic-treatment tanks is characterized by greater biochemical oxygen demand and greater concentrations of detergents. When compared with effluent from septic-treatment tanks, effluent from aeration-treatment tanks is characterized by greater concentrations of dissolved oxygen, nitrite, nitrate, sulfate, and dissolved solids. (USGS)

Permeable sorptive walls for treatment of hydrophobic organic contaminant plumes in groundwater

International Nuclear Information System (INIS)

Grathwohl, P.; Peschik, G.

1997-01-01

Highly hydrophobic contaminants are easily adsorbed from aqueous solutions. Since for many of these compounds sorption increases with increasing organic carbon content natural materials such as bituminous shales and coals may be used in permeable sorptive walls. This, however, only applies if sorption is at equilibrium, which may not always be the case in groundwater treatment using a funnel-and-gate system. In contrast to the natural solids, granular activated carbons (GACs) have very high sorption capacities and reasonably fast sorption kinetics. The laboratory results show that application of GACs (e.g. F100) is economically feasible for in situ removal of polycyclic aromatic hydrocarbons (PAH) from groundwater at a former manufactured gas plant site (MGP). For less sorbing compounds (such as benzene, toluene, xylenes) a combination of adsorption and biodegradation is necessary (i.e. sorptive + reactive treatment)

Neonatal hepatic haemangioendothelioma: treatment options and dilemmas

International Nuclear Information System (INIS)

Meijs, Bram B. van der; Merks, Johannes H.M.; Haan, Timo R. de; Tabbers, Merit M.; Rijn, Rick R. van

2009-01-01

We describe a case of rapidly progressive neonatal diffuse hepatic haemangioendotheliomas. The clinical picture was characterized by respiratory insufficiency due to gross abdominal enlargement, coagulopathy, and the development of cardiovascular insufficiency during the course of disease. Pharmacological, radiotherapeutic and endovascular treatment options all proved ineffective. We describe our own experience and the steps taken to treat this child. Unfortunately, the child died as a consequence of the disease. As cases like this are rare and are associated with severe morbidity and high mortality, more knowledge needs to be gained on infantile hepatic haemangioendotheliomas and their optimal treatment. The use of a web-based data registry could be beneficial. (orig.)

Hyaluronic acid and other conservative treatment options for osteoarthritis of the ankle

NARCIS (Netherlands)

Witteveen, Angelique G. H.; Hofstad, Cheriel J.; Kerkhoffs, Gino M. M. J.

2015-01-01

Background The cause of ankle osteoarthritis (OA) is usually trauma. Patients are relatively young, since ankle trauma occurs at a relatively young age. Several conservative treatment options are available, evidence of the benefits and harms of these options are lacking. Objectives To assess the

Progressive Supranuclear Palsy and Corticobasal Degeneration: Pathophysiology and Treatment Options

OpenAIRE

Lamb, Ruth; Rohrer, Jonathan D.; Lees, Andrew J.; Morris, Huw R.

2016-01-01

Opinion statement There are currently no disease-modifying treatments for progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD), and no approved pharmacological or therapeutic treatments that are effective in controlling their symptoms. The use of most pharmacological treatment options are based on experience in other disorders or from non-randomized historical controls, case series, or expert opinion. Levodopa may provide some improvement in symptoms of Parkinsonism (specif...

Progressive Supranuclear Palsy and Corticobasal Degeneration: Pathophysiology and Treatment Options

OpenAIRE

Lamb, R.; Rohrer, J. D.; Lees, A. J.; Morris, H. R.

2016-01-01

There are currently no disease-modifying treatments for progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD), and no approved pharmacological or therapeutic treatments that are effective in controlling their symptoms. The use of most pharmacological treatment options are based on experience in other disorders or from non-randomized historical controls, case series, or expert opinion. Levodopa may provide some improvement in symptoms of Parkinsonism (specifically bradykinesi...

Evaluation of biological hydrogen sulfide oxidation coupled with two-stage upflow filtration for groundwater treatment.

Science.gov (United States)

Levine, Audrey D; Raymer, Blake J; Jahn, Johna

2004-01-01

Hydrogen sulfide in groundwater can be oxidized by aerobic bacteria to form elemental sulfur and biomass. While this treatment approach is effective for conversion of hydrogen sulfide, it is important to have adequate control of the biomass exiting the biological treatment system to prevent release of elemental sulfur into the distribution system. Pilot scale tests were conducted on a Florida groundwater to evaluate the use of two-stage upflow filtration downstream of biological sulfur oxidation. The combined biological and filtration process was capable of excellent removal of hydrogen sulfide and associated turbidity. Additional benefits of this treatment approach include elimination of odor generation, reduction of chlorine demand, and improved stability of the finished water.

In Situ Catalytic Groundwater Treatment Using Palladium Catalysts and Horizontal Flow Treatment Wells

Science.gov (United States)

2008-01-01

may enter the soil , and subsequently the groundwater, along any portion of this unlined channel. The area south of the buildings has not been...the 1960s in the northwestern corner of Site 19, and an estimated 250,000 gallons of JP-4 jet fuel were released. Soil was excavated and...16,000 Pd catalyst treatment system $61,000 Pd catalyst with eggshell coating (20 kg @ $245 per lb) $11,000 Skid-mounted reactor system and

24-h Efficacy of Glaucoma Treatment Options.

Science.gov (United States)

Konstas, Anastasios G P; Quaranta, Luciano; Bozkurt, Banu; Katsanos, Andreas; Garcia-Feijoo, Julian; Rossetti, Luca; Shaarawy, Tarek; Pfeiffer, Norbert; Miglior, Stefano

2016-04-01

Current management of glaucoma entails the medical, laser, or surgical reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which is commensurate with either stability or delayed progression of visual loss. In the published literature, the hypothesis is often made that IOP control implies a single IOP measurement over time. Although the follow-up of glaucoma patients with single IOP measurements is quick and convenient, such measurements often do not adequately reflect the untreated IOP characteristics, or indeed the quality of treated IOP control during the 24-h cycle. Since glaucoma is a 24-h disease and the damaging effect of elevated IOP is continuous, it is logical that we should aim to understand the efficacy of all treatment options throughout the 24-h period. This article first reviews the concept and value of diurnal and 24-h IOP monitoring. It then critically evaluates selected available evidence on the 24-h efficacy of medical, laser and surgical therapy options. During the past decade several controlled trials have significantly enhanced our understanding on the 24-h efficacy of all glaucoma therapy options. Nevertheless, more long-term evidence is needed to better evaluate the 24-h efficacy of glaucoma therapy and the precise impact of IOP characteristics on glaucomatous progression and visual prognosis.

Current options for the treatment of facial angiofibromas.

Science.gov (United States)

Salido-Vallejo, R; Garnacho-Saucedo, G; Moreno-Giménez, J C

2014-01-01

Facial angiofibromas are hamartomatous growths that are closely associated with tuberous sclerosis complex and, in fact, they constitute one of the main diagnostic criteria for that disease. These lesions composed of blood vessels and fibrous tissue appear on the face at an early age. Since they have important physical and psychological repercussions for patients, several treatment options have been used to remove them or improve their appearance. However, the lack of treatment guidelines prevents us from developing a common protocol for patients with this condition. The present article aims to review the treatments for facial angiofibromas used to date and to propose a new evidence-based treatment protocol. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

Alternative pharmacological treatment options for agitation in Alzheimer’s disease

Directory of Open Access Journals (Sweden)

Francesco Panza

2015-11-01

Full Text Available In patients with dementia and Alzheimer’s disease (AD, treatment of neuropsychiatric symptoms (NPS is a major concern in the management of these devastating diseases. Among NPS in AD, agitation and aggression are common with earlier institutionalization, increased morbidity and mortality, and greater caregiver burden. Pharmacological treatments for AD-related agitation, specifically off-label use of atypical antipsychotics, showed only modest improvements, with increased side-effect burden and risk of mortality. Non-pharmacological treatment approaches have become the preferred firstline option. However, when such treatments fail, pharmacological options are often used. Therefore, there is an urgent need to identify effective and safe pharmacological treatments for agitation/aggression in AD and dementia. Unfortunately, progresses have been slow, with a small number of methodologically heterogeneous randomized controlled trials (RCTs, with disappointing results. However, evidence coming from recently completed RCTs on novel or repositioned drugs (mibampator, dextromethorphan/ quinidine, cannabinoids, and citalopram showed some promise in treating agitation in AD, but still with safety concerns. Further evidence will come from ongoing Phase II and III trials on promising novel drugs for treating these distressing symptoms in patients with AD and dementia.

Current Treatment Options for Auricular Hematomas.

Science.gov (United States)

MacPhail, Catriona

2016-07-01

Ear disease, such as otitis externa, resulting in aggressive head shaking or ear scratching, is the most common cause of the development of aural hematomas in dogs and cats. An underlying immunologic cause has also been proposed to explain cartilage and blood vessel fragility. Numerous options exist for management of aural hematomas, from medical management alone with corticosteroids, to simple hematoma centesis, to surgical intervention. Because this condition is usually secondary to another disease process, regardless of mode of treatment, likelihood of recurrence is low if the underlying condition is managed properly. Copyright © 2016 Elsevier Inc. All rights reserved.

Preliminary engineering assessment of treatment alternatives for groundwater from the Hanford 200 Area 200-BP-5 plumes

International Nuclear Information System (INIS)

1996-05-01

This report presents the results of the Preliminary Engineering Assessment of Treatment Alternatives (PEATA), an engineering evaluation of potential treatment alternatives for groundwater extracted from the 200-BP-5 Area's 216-BY Cribs and 216-B-5 Reverse Well plumes. The primary objective of the PEATA was to identify treatment technologies that are worth further consideration (i.e., treatability testing or a more refined engineering evaluation). It will also provide a basis for evaluating the results of the treatability testing that is currently being conducted on the presumptive remedy of ion exchange with disposal of spent resin and will serve as a guide for selection of other technologies for additional testing. Because there are little data or past experience with groundwater similar to the BY-Crib and B-5 Reverse Well Plumes, treatment efficiencies cannot be predicted with certainty and rigorous treatment system designs and costs cannot be developed. This applies to all alternatives, including the presumptive remedy of ion exchange. The approach for this study was to develop conceptual designs and approximate costs for the treatment technologies that were most likely to be effective on the BY-Crib and B-5 Reverse Well groundwater

Large scale treatment of total petroleum-hydrocarbon contaminated groundwater using bioaugmentation.

Science.gov (United States)

Poi, Gregory; Shahsavari, Esmaeil; Aburto-Medina, Arturo; Mok, Puah Chum; Ball, Andrew S

2018-05-15

Bioaugmentation or the addition of microbes to contaminated sites has been widely used to treat contaminated soil or water; however this approach is often limited to laboratory based studies. In the present study, large scale bioaugmentation has been applied to total petroleum hydrocarbons (TPH)-contaminated groundwater at a petroleum facility. Initial TPH concentrations of 1564 mg L -1 in the field were reduced to 89 mg L -1 over 32 days. This reduction was accompanied by improved ecotoxicity, as shown by Brassica rapa germination numbers that increased from 52 at day 0 to 82% by the end of the treatment. Metagenomic analysis indicated that there was a shift in the microbial community when compared to the beginning of the treatment. The microbial community was dominated by Proteobacteria and Bacteroidetes from day 0 to day 32, although differences at the genus level were observed. The predominant genera at the beginning of the treatment (day 0 just after inoculation) were Cloacibacterium, Sediminibacterium and Brevundimonas while at the end of the treatment members of Flavobacterium dominated, reaching almost half the population (41%), followed by Pseudomonas (6%) and Limnobacter (5.8%). To the author's knowledge, this is among the first studies to report the successful large scale biodegradation of TPH-contaminated groundwater (18,000 L per treatment session) at an offshore petrochemical facility. Copyright © 2018 Elsevier Ltd. All rights reserved.

Assessment of Options for the Treatment of Nitrate Salt Wastes at Los Alamos National Laboratory

International Nuclear Information System (INIS)

Robinson, Bruce Alan; Funk, David John; Stevens, Patrice Ann

2016-01-01

This paper summarizes the methodology used to evaluate options for treatment of the remediated nitrate salt waste containers at Los Alamos National Laboratory. The method selected must enable treatment of the waste drums, which consist of a mixture of complex nitrate salts (oxidizer) improperly mixed with sWheat Scoop®1, an organic kitty litter and absorbent (fuel), in a manner that renders the waste safe, meets the specifications of waste acceptance criteria, and is suitable for transport and final disposal in the Waste Isolation Pilot Plant located in Carlsbad, New Mexico. A Core Remediation Team was responsible for comprehensively reviewing the options, ensuring a robust, defensible treatment recommendation. The evaluation process consisted of two steps. First, a prescreening process was conducted to cull the list on the basis for a decision of feasibility of certain potential options with respect to the criteria. Then, the remaining potential options were evaluated and ranked against each of the criteria in a consistent methodology. Numerical scores were established by consensus of the review team. Finally, recommendations were developed based on current information and understanding of the scientific, technical, and regulatory situation. A discussion of the preferred options and documentation of the process used to reach the recommended treatment options are presented.

Assessment of Options for the Treatment of Nitrate Salt Wastes at Los Alamos National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Robinson, Bruce Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Funk, David John [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Stevens, Patrice Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-03-17

This paper summarizes the methodology used to evaluate options for treatment of the remediated nitrate salt waste containers at Los Alamos National Laboratory. The method selected must enable treatment of the waste drums, which consist of a mixture of complex nitrate salts (oxidizer) improperly mixed with sWheat Scoop®1, an organic kitty litter and absorbent (fuel), in a manner that renders the waste safe, meets the specifications of waste acceptance criteria, and is suitable for transport and final disposal in the Waste Isolation Pilot Plant located in Carlsbad, New Mexico. A Core Remediation Team was responsible for comprehensively reviewing the options, ensuring a robust, defensible treatment recommendation. The evaluation process consisted of two steps. First, a prescreening process was conducted to cull the list on the basis for a decision of feasibility of certain potential options with respect to the criteria. Then, the remaining potential options were evaluated and ranked against each of the criteria in a consistent methodology. Numerical scores were established by consensus of the review team. Finally, recommendations were developed based on current information and understanding of the scientific, technical, and regulatory situation. A discussion of the preferred options and documentation of the process used to reach the recommended treatment options are presented.

For Some Breast Cancers, New Drug May Be Treatment Option

Science.gov (United States)

Results from an international clinical trial suggest that women with metastatic, HER2-positive breast cancer that is no longer responding to the targeted therapy trastuzumab (Herceptin) may soon have a new treatment option.

The X-625 Groundwater Treatment Facility: A field-scale test of trichloroethylene dechlorination using iron filings for the X-120/X-749 groundwater plume

International Nuclear Information System (INIS)

Liang, L.; West, O.R.; Korte, N.E.

1997-09-01

The dehalogenation of chlorinated solvents by zero-valence iron has recently become the subject of intensive research and development as a potentially cost-effective, passive treatment for contaminated groundwater through reactive barriers. Because of its successful application in the laboratory and other field sites, the X-625 Groundwater Treatment Facility (GTF) was constructed to evaluate reactive barrier technology for remediating trichloroethylene (TCE)-contaminated groundwater at the Portsmouth Gaseous Diffusion Plant (PORTS). The X-625 GTF was built to fulfill the following technical objectives: (1) to test reactive barrier materials (e.g., iron filings) under realistic groundwater conditions for long term applications, (2) to obtain rates at which TCE degrades and to determine by-products for the reactive barrier materials tested, and (3) to clean up the TCE-contaminated water in the X-120 plume. The X-625 is providing important field-scale and long-term for the evaluation and design of reactive barriers at PORTS. The X-625 GTS is a unique facility not only because it is where site remediation is being performed, but it is also where research scientists and process engineers can test other promising reactive barrier materials. In addition, the data collected from X-625 GTF can be used to evaluate the technical and economic feasibility of replacing the activated carbon units in the pump-and-treat facilities at PORTS

Selection of water treatment processes special study

International Nuclear Information System (INIS)

1991-11-01

Characterization of the level and extent of groundwater contamination in the vicinity of Title I mill sites began during the surface remedial action stage (Phase 1) of the Uranium Mill Tailings Remedial Action (UMTRA) Project. Some of the contamination in the aquifer(s) at the abandoned sites is attributable to milling activities during the years the mills were in operation. The restoration of contaminated aquifers is to be undertaken in Phase II of the UMTRA Project. To begin implementation of Phase II, DOE requested that groundwater restoration methods and technologies be investigated by the Technical Assistance Contractor (TAC). and that the results of the TAC investigations be documented in special study reports. Many active and passive methods are available to clean up contaminated groundwater. Passive groundwater treatment includes natural flushing, geochemical barriers, and gradient manipulation by stream diversion or slurry walls. Active groundwater.cleanup techniques include gradient manipulation by well extraction or injection. in-situ biological or chemical reclamation, and extraction and treatment. Although some or all of the methods listed above may play a role in the groundwater cleanup phase of the UMTRA Project, the extraction and treatment (pump and treat) option is the only restoration alternative discussed in this report. Hence, all sections of this report relate either directly or indirectly to the technical discipline of process engineering

Municipal solid waste options : integrating organics management and residual disposal treatment : executive summary

Energy Technology Data Exchange (ETDEWEB)

Cant, M. (comp.) [Totten Sims Hubicki Associates Ltd., Calgary, AB (Canada); Van der Werf, P. [2cg Inc., Edmonton, AB (Canada); Kelleher, M. [Kelleher Environmental, Toronto, ON (Canada); Merriman, D. [MacViro Consultants, Markham, ON (Canada); Fitcher, K. [Gartner Lee Ltd., Toronto, ON (Canada); MacDonald, N. [CH2M Hill Engineering Ltd., Calgary, AB (Canada)

2006-04-15

The Municipal Solid Waste (MSW) Options Report explored different MSW management options for 3 community sizes: 20,000, 80,000 and 200,0000 people. It was released at a time when many communities were developing waste management plans to cost-effectively reduce environmental impacts and conserve landfill capacity. The purpose of this report was to provide a greater understanding on the environmental, social, economic, energy recovery/utilization and greenhouse gas (GHG) considerations of MSW management. The report also demonstrated the interrelationships between the management of organics and residuals. It was based on information from existing waste diversion and organics management options and emerging residual treatment technology options. The following organics management and residual treatment disposal options were evaluated: composting; anaerobic digestion; sanitary landfills; bioreactor landfills; and thermal treatment. Composting was examined with reference to both source separated organics (SSO) and mixed waste composting. SSO refers to the separation of materials suitable for composting solid waste from households, while mixed waste composting refers to the manual or mechanical removal of recyclable material from the waste, including compost. The composting process was reviewed along with available technologies such as non-reactor windrow; aerated static pile; reactor enclosed channel; and, container tunnel. An evaluation of SSO and mixed waste composting was then presented in terms of environmental, social, financial and GHG impacts. refs., tabs., figs.

Current options for the treatment of optic neuritis

Directory of Open Access Journals (Sweden)

Pula JH

2012-07-01

Full Text Available John H Pula,1 Christopher J MacDonald21Division of Neuro-ophthalmology, University of Illinois College of Medicine at Peoria, Peoria; 2University of Illinois College of Medicine at Urbana-Champaign, Champaign, IL, USAAbstract: Optic neuritis can be defined as typical (associated with multiple sclerosis, improving independent of steroid treatment, or atypical (not associated with multiple sclerosis, steroid-dependent improvement. Causes of atypical optic neuritis include connective tissue diseases (eg, lupus, vasculitis, sarcoidosis, or neuromyelitis optica. In this manuscript, updated treatment options for both typical and atypical optic neuritis are reviewed. Conventional treatments, such as corticosteroids, therapeutic plasma exchange, and intravenous immunoglobulin therapy are all discussed with commentary regarding evidence-based outcomes. Less commonly used treatments and novel purported therapies for optic neuritis are also reviewed. Special scenarios in the treatment of optic neuritis – pediatric optic neuritis, acute demyelinating encephalomyelitis, and optic neuritis occurring during pregnancy – are specifically examined.Keywords: optic neuritis, optic neuropathy, treatment, neuroophthalmology

Current and emerging treatment options for nasopharyngeal carcinoma

Directory of Open Access Journals (Sweden)

Spratt DE

2012-10-01

Full Text Available Daniel E Spratt, Nancy LeeDepartment of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USAAbstract: In this article, we focus on the current and emerging treatments in nasopharyngeal cancer (NPC. A detailed evolution of the current standard of care, and new techniques and treatment options will be reviewed. Intergroup 0099 established the role for chemoradiotherapy (chemo-RT in the treatment of nasopharyngeal carcinoma. Multiple randomized Phase III trials have shown the benefit of chemo-RT; however, none of these studies utilized modern radiotherapy (RT techniques of intensity-modulated radiation therapy (IMRT. IMRT has the ability to deliver high doses of radiation to the target structures while sparing adjacent bystander healthy tissues, and has now become the preferred RT treatment modality. Chemotherapy also has had a shifting paradigm of induction and/or adjuvant chemotherapy combined with RT alone, to the investigation with concurrent chemo-RT. New treatment options including targeted monoclonal antibodies and small molecule tyrosine kinase inhibitors are being studied in NPC. These new biologic therapies have promising in vitro activity for NPC, and emerging clinical studies are beginning to define their role. RT continues to expand its capabilities, and since IMRT and particle therapy, specifically intensity-modulated proton therapy (IMPT, has reports of impressive dosimetric efficacy in-silica. Adaptive RT is attempting to reduce toxicity while maintaining treatment efficacy, and the clinical results are still in their youth. Lastly, Epstein–Barr virus (EBV DNA has recently been studied for prediction of tumor response and its use as a biomarker is increasingly promising to aid in early detection as well as supplementing the current staging system. RT with or without chemotherapy remains the standard of care for nasopharyngeal carcinoma. Advances in RT technique, timing of chemotherapy, biologically

Treatment Options for Primary Nocturnal Enuresis by Parents in a ...

African Journals Online (AJOL)

femi oloka

common treatment option was waking up child at intervals during the night to void by 103 (45.2 ... patient/family education, simple behavioral ... nocturnal enuresis were employing in managing ..... Dental and Medical Sciences 2014;13:41 – 4.

Current and emerging treatment options for myopic choroidal neovascularization

Directory of Open Access Journals (Sweden)

El Matri L

2015-04-01

Full Text Available Leila El Matri, Ahmed Chebil, Fedra Kort Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Faculty of Medicine of Tunis, University of El Manar, Tunis, Tunisia Abstract: Choroidal neovascularization (CNV is the main cause of visual impairment in highly myopic patients younger than 50 years of age. There are different treatments for myopic CNV (mCNV, with 5- to 10-year outcomes currently. Chorioretinal atrophy is still the most important determinant factor for visual outcome. The purpose of this study is to provide an overview of the current treatments for mCNV, including laser, surgical management, verteporfin photodynamic therapy, and mainly anti-vascular endothelial growth factor therapy. Emerging treatment options are also discussed. Keywords: myopia, choroidal neovascularization, current treatment, emerging treatment

Current and future treatment options in osteoporosis.

LENUS (Irish Health Repository)

Brewer, Linda

2012-02-01

PURPOSE: The incidence of osteoporosis-related fractures will increase substantially over the coming decades as the population ages globally. This has important economic and public health implications, contributing substantially to morbidity and excess mortality in this population. METHODS: When prescribing for older patients the effectiveness profile of drugs needs to be balanced against their tolerability in individual patients. RESULTS: Currently we have good anti-fracture data to support the use of many available anti-resorptive and anabolic drugs including bisphosphonates, strontium ranelate and recombinant human parathyroid hormone. We also have evidence to demonstrate the importance of calcium and vitamin D repletion in these patients. However, in recent years our understanding of normal bone physiology and the mechanisms underlying the development of osteoporosis has significantly advanced and this has led to the development of new therapies. Novel agents, particularly denosumab, but also inhibitors of cathepsin K and anabolic agents that act on Wnt signalling, will increase the therapeutic options for clinicians in the coming years. CONCLUSION: This review discusses the evidence supporting the use of currently available treatment options for osteoporosis and potential future advances in drug therapy. Particular consideration should be given when prescribing for certain older patients who have issues with compliance or tolerance and also in those with co-morbidities or levels of frailty that may restrict the choice of therapy. Understanding the evidence for the benefit and possible harm of osteoporosis treatments is critical to appropriate management of this patient population.

Nitrate contamination of groundwater: A conceptual management framework

International Nuclear Information System (INIS)

Almasri, Mohammad N.

2007-01-01

In many countries, public concern over the deterioration of groundwater quality from nitrate contamination has grown significantly in recent years. This concern has focused increasingly on anthropogenic sources as the potential cause of the problem. Evidence indicates that the nitrate (NO 3 ) levels routinely exceed the maximum contaminant level (MCL) of 10 mg/l NO 3 -N in many aquifer systems that underlie agriculture-dominated watersheds. Degradation of groundwater quality due to nitrate pollution along with the increasing demand for potable water has motivated the adoption of restoration actions of the contaminated aquifers. Restoration efforts have intensified the dire need for developing protection alternatives and management options such that the ultimate nitrate concentrations at the critical receptors are below the MCL. This paper presents a general conceptual framework for the management of groundwater contamination from nitrate. The management framework utilizes models of nitrate fate and transport in the unsaturated and saturated zones to simulate nitrate concentration at the critical receptors. To study the impact of different management options considering both environmental and economic aspects, the proposed framework incorporates a component of a multi-criteria decision analysis. To enhance spatiality in model development along with the management options, the utilization of a land use map is depicted for the allocation and computation of on-ground nitrogen loadings from the different sources

Options Assessment Report: Treatment of Nitrate Salt Waste at Los Alamos National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Robinson, Bruce Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Stevens, Patrice Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2015-12-17

This report documents the methodology used to select a method of treatment for the remediated nitrate salt (RNS) and unremediated nitrate salt (UNS) waste containers at Los Alamos National Laboratory (LANL). The method selected should treat the containerized waste in a manner that renders the waste safe and suitable for transport and final disposal in the Waste Isolation Pilot Plant (WIPP) repository, under specifications listed in the WIPP Waste Acceptance Criteria (DOE/CBFO, 2013). LANL recognizes that the results must be thoroughly vetted with the New Mexico Environment Department (NMED) and that a modification to the LANL Hazardous Waste Facility Permit is a necessary step before implementation of this or any treatment option. Likewise, facility readiness and safety basis approvals must be received from the Department of Energy (DOE). This report presents LANL’s preferred option, and the documentation of the process for reaching the recommended treatment option for RNS and UNS waste, and is presented for consideration by NMED and DOE.

Options assessment report: Treatment of nitrate salt waste at Los Alamos National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Robinson, Bruce Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Stevens, Patrice Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2015-09-16

This report documents the methodology used to select a method of treatment for the remediated nitrate salt (RNS) and unremediated nitrate salt (UNS) waste containers at Los Alamos National Laboratory (LANL). The method selected should treat the containerized waste in a manner that renders the waste safe and suitable for transport and final disposal in the Waste Isolation Pilot Plant (WIPP) repository, under specifications listed in the WIPP Waste Acceptance Criteria (DOE/CBFO, 2013). LANL recognized that the results must be thoroughly vetted with the New Mexico Environment Department (NMED) and the a modification to the LANL Hazardous Waste Facility Permit is a necessary step before implementation of this or any treatment option. Likewise, facility readiness and safety basis approvals must be received from the Department of Energy (DOE). This report presents LANL's preferred option, and the documentation of the process for reaching the recommended treatment option for RNS and UNS waste, and is presented for consideration by NMED and DOE.

Gastroparesis: a review of current and emerging treatment options

Directory of Open Access Journals (Sweden)

Enweluzo C

2013-09-01

Full Text Available Chijioke Enweluzo, Fahad AzizHospital Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC, USAAbstract: Gastroparesis is a motility disorder of the stomach causing delay in food emptying from the stomach without any evidence of mechanical obstruction. The majority of cases are idiopathic. Patients need to be diagnosed properly by formal testing, and the evaluation of the severity of the gastroparesis may assist in guiding therapy. Initially, dietary modifications are encouraged, which include frequent and small semisolid-based meals. Promotility medications, like erythromycin, and antiemetics, like prochlorperazine, are offered for symptom relief. In patients who are refractory to pharmacologic treatment, more invasive options, such as intrapyloric botulinum toxin injections, placement of a jejunostomy tube, or implantation of a gastric stimulator, can be considered. Hemin therapy and gastric electric stimulation are emerging treatment options that are still at different stages of research. Regenerative medicine and stem cell-based therapies also hold promise for gastroparesis in the near future.Keywords: Gastroparesis, gastric emptying, gastric electrical stimulation, hemin

SURGICAL TREATMENT OF HEMORRHOIDS: A CRITICAL APPRAISAL OF THE CURRENT OPTIONS

Science.gov (United States)

CERATO, Marlise Mello; CERATO, Nilo Luiz; PASSOS, Patrícia; TREIGUE, Alberto; DAMIN, Daniel C.

2014-01-01

Introduction Surgical treatment of hemorrhoids is still a dilemma. New techniques have been developed leading to a lower rate of postoperative pain; however, they are associated with a greater likelihood of recurrence. Aim To review current indications as well as the results and complications of the main techniques currently used in the surgical treatment of hemorrhoidal disease. Methods A systematic search of the published data on the options for treatment of hemorrhoids up to December 2012 was conducted using Medline/PubMed, Cochrane, and UpToDate. Results Currently available surgical treatment options include procedure for prolapse and hemorrhoids (PPH), transanal hemorrhoidal dearterialization (THD), and conventional hemorrhoidectomy techniques. Excisional techniques showed similar results regarding pain, time to return to normal activities, and complication rates. PPH and THD were associated with less postoperative pain and lower complication rates; however, both had higher postoperative recurrence rates. Conclusion Conventional surgical techniques yield better long-term results. Despite good results in the immediate postoperative period, PPH and THD have not shown consistent long-term favorable results. PMID:24676303

HEAVY METALS AS UNWANTED COMPONENTS OF BACKWASH WATER DERIVED FROM GROUNDWATER TREATMENT

Directory of Open Access Journals (Sweden)

Robert Nowak

2016-06-01

Full Text Available The paper presents some aspects of the problem of heavy metals presence in wastewater and sewage sludge from water treatment. In the first part, issues on quality of wastewaters and sludge produced during water treatment along with actions aimed at the neutralization of such wastes, were discussed. Subsequent parts of the work present the example of 12 groundwater treatment stations in a particular municipality, and the problem of backwash water quality, in particular, heavy metals contents. The analysis covered a period of three years: 2013, 2014, and 2015. The authors, using the discussed examples, have shown that besides hydrated iron and manganese oxides, also other toxic contaminants can be present in backwash water from groundwater treatment. In particular, the qualitative analysis of the backwash water revealed the presence of heavy metals, mainly zinc. The test results for backwash water were compared with those of filtrate qualitative assessment, wherein the heavy metals were not found. This fact indicated the metal retention in the filter bed and their unsustainable immobilization resulting in penetration of heavy metals from deposit to the backwash water along with other impurities, mainly iron and manganese oxides. The main conclusion from the study is to demonstrate the need for constant monitoring of the backwash water quality, including the presence of toxic heavy metals. This is also important because of the requirement to minimize the negative environmental impact of wastes generated during the water treatment process.

In Situ Treatment of Chlorinated Ethene-Contaminated Groundwater Using horizontal Flow Treatment Wells

National Research Council Canada - National Science Library

Ferland, Derek

2000-01-01

The limitations of conventional containment technologies for groundwater contaminated with chlorinated solvents have motivated development of innovative technologies to achieve national groundwater...

Current options for palliative treatment in patients with pancreatic cancer.

Science.gov (United States)

Ridwelski, K; Meyer, F

2001-01-01

Palliative treatment is often the only remaining option in the management of pancreatic carcinoma, but its efficacy is poor due to low tumor sensitivity and inadequate treatment protocols. There are several options of palliative treatment with antitumor or supportive intention. Classical end points of palliative treatment are survival, tumor response, and quality of life. A decade ago, palliative chemotherapy consisted mainly of 5-fluorouracil as the standard agent in combination with either other agents and/or radiotherapy. Only the new antineoplastic drug gemcitabine, which was introduced simultaneously with the definition of novel end points of chemotherapy such as clinical benefit, allowed to achieve some progress. However, while gemcitabine monotherapy appeared to be superior to 5-fluorouracil and improved important parameters of quality of life, it could not provide a significant improvement of survival. A novel concept, therefore, is to improve this beneficial cytostatic response in pancreatic carcinoma using a gemcitabine-based protocol by combining it with antineoplastic drugs such as taxanes or platin analogs. This strategy may have the potential to improve the outcome in palliative chemotherapy of pancreatic carcinoma patients with advanced tumor growth or metastases. Best supportive care in pancreatic cancer consists of the treatment of symptoms, such as pain, jaundice, duodenal obstruction, weight loss, exocrine pancreatic insufficiency, and tumor-associated depression. Copyright 2001 S. Karger AG, Basel

Soil treatment and groundwater control for No. 6 fuel oil and PCB contamination

International Nuclear Information System (INIS)

Girioni, M.J.; St. Hilaire, W.J.

1991-01-01

This paper reports that as part of a Short-Term Measure ordered by the Massachusetts Department of Environmental Protection (DEP), soil contaminated by No. 6 fuel oil and low-level polychlorinated biphenyls (PCBs) was excavated, treated and recycled on-site as an asphalt base course for a parking lot at an industrial complex in New Bedford, Massachusetts. Approximately 300 cubic yards of contaminated soil were treated with an asphalt emulsion and utilized as a aggregate component for asphalt processed at ambient temperatures during the month of December 1990. In order to determine if the contaminated soils to be recycled would be classified as a hazardous waste (as defined by the Massachusetts Hazardous Waste Regulations, 310 CMR 30.000), or if the soil to be recycled would pose a significant risk to health, safety or the environment, analytical testing of the contaminated soil was conducted prior, during and after treatment. Analytical testing included Toxicity Characteristics Leaching Procedure (TCLP) analyses of the untreated and treated soil. An alternative solution to the standard groundwater pump-and-treat method was designed and constructed to control and recover the highly viscous floating petroleum product. A series of precast leaching galleys (oil collection chambers) and a precast leach pit (groundwater discharge structure) were constructed to alter the local groundwater table to induce groundwater flow by gravity into the leaching chambers. Passive (i.e., nonpumping) groundwater flow to the leaching chambers was induced by placing of the groundwater discharge structure hydraulically downgradient of the leaching chambers. Collected oil, separated by gravity, will be periodically vacuumed, as necessary, for proper off-site disposal. Excess water discharges to the downgradient leach pit

Managing AVN following internal fixation: treatment options and clinical results.

Science.gov (United States)

Hoskinson, Simon; Morison, Zachary; Shahrokhi, Shahram; Schemitsch, Emil H

2015-03-01

Avascular necrosis (AVN) after internal fixation of intracapsular hip fractures is a progressive multifactorial disease that ultimately results in local ischemia with ensuing osteocyte necrosis and structural compromise. This disease can cause significant clinical morbidity and affects patients of any age, including young and active patients. Effective treatment of this condition among young adults is challenging due to their high functional demands. The aim of managing AVN is to relieve pain, preserve range of movement and improve function. Treatment methods vary depending on the stage of the disease and can be broadly categorised into two options, hip preserving surgery and hip arthroplasty. Although, hip preserving techniques are attractive in the young adult, they may alter the morphology of the proximal femur and make subsequent arthroplasty more challenging. Conversely, arthroplasty in the young adult may require repeat revision procedures throughout the patient's life. Current evidence suggests that modifications of prevailing treatments, in addition to new technologies, have led to the development of management strategies that may be able to alter the course of femoral head osteonecrosis. This review aims to summarise the options available for treatment of AVN in the young adult and review the clinical results. Copyright © 2014 Elsevier Ltd. All rights reserved.

LONG-TERM GEOCHEMICAL BEHAVIOR OF A ZEROVALENT IRON PERMEABLE REACTIVE BARRIER FOR THE TREATMENT OF HEXAVALENT CHROMIUM IN GROUNDWATER

Science.gov (United States)

Passive, in-situ reactive barriers have proven to be viable, cost-effective systems for the remediation of Cr-contaminated groundwater at some sites. Permeable reactive barriers (PRBs) are installed in the flow-path of groundwater, most typically as vertical treatment walls. Re...

Development of HUMASORB trademark, a lignite derived humic acid for removal of metals and organic contaminants from groundwater

International Nuclear Information System (INIS)

Sanjay, H.G.; Srivastava, K.C.; Walia, D.S.

1995-01-01

Heavy metal and organic contamination of surface and groundwater systems is a major environmental concern. The contamination is primarily due to improperly disposed industrial wastes. The presence of toxic heavy metal ions, volatile organic compounds (VOCs) and pesticides in water is of great concern and could affect the safety of drinking water. Decontamination of surface and groundwater can be achieved using a broad spectrum of treatment options such as precipitation, ion-exchange, microbial digestion, membrane separation, activated carbon adsorption, etc. The state of the art technologies for treatment of contaminated water however, can in one pass remediate only one class of contaminants, i.e., either VOCs (activated carbon) or heavy metals (ion exchange). This would require the use of at a minimum, two different stepwise processes to remediate a site. The groundwater contamination at different Department of Energy (DOE) sites (e.g., Hanford) is due to the presence of both VOCs and heavy metals. The two-step approach increases the cost of remediation. To overcome the sequential treatment of contaminated streams to remove both organics and metals, a novel material having properties to remove both classes of contaminants in one step is being developed as part of this project

Grey water characteristics and treatment options for rural areas in Jordan.

Science.gov (United States)

Halalsheh, M; Dalahmeh, S; Sayed, M; Suleiman, W; Shareef, M; Mansour, M; Safi, M

2008-09-01

Low water consumption in rural areas in Jordan had resulted in the production of concentrated grey water. Average COD, BOD and TSS values were 2568mg/l, 1056mg/l and 845mg/l, respectively. The average grey water generation was measured to be 14L/c.d. Three different treatment options were selected based on certain criterions, and discussed in this article. The examined treatment systems are septic tank followed by intermittent sand filter; septic tank followed by wetlands; and UASB-hybrid reactor. Advantages and disadvantages of each system are presented. It was concluded that UASB-hybrid reactor would be the most suitable treatment option in terms of compactness and simplicity in operation. The volume of UASB-hybrid reactor was calculated to be 0.268m(3) with a surface area of 0.138m(2) for each house having 10 inhabitants on average. Produced effluent is expected to meet Jordanian standards set for reclaimed water reuse in irrigating fruit trees.

Accounting treatment of currency options

Directory of Open Access Journals (Sweden)

Prošić Danica

2016-01-01

Full Text Available Currency options are often used to mitigate currency risk resulting from corporate activities. Their implementation can be complex, and there could be problems if the essential elements and principles are not fully understood. Although they are not the simplest financial products, currency options are interesting and useful to those who are trying to make a step forward in the area of currency risk management. This paper aims to present the general principles and specifics of accounting records and valuation of currency options used for hedging against risk. It is a complex process which, in addition to numerous conditions, also involves the implementation of accounting rules that deviate from the generally accepted accounting principles.

Current Treatment Options in Challenging Oral Diseases: Burning Mouth Syndrome

OpenAIRE

Bilgen Erdoğan; Murat Yılmaz

2012-01-01

Burning mouth syndrome is a chronic condition characterized by burning pain without any signs of an oral mucosal pathology, that usually affects postmenopausal women. Burning sensation is often accompanied by dysgeusia and xerostomia. The pathogenesis of the disease is unknown and an effective treatment option for most of the patients has not been defined yet. The aim of this review is to present current pharmacological and physicological treatments of burning mouth syndrome.

Current Treatment Options in Challenging Oral Diseases: Burning Mouth Syndrome

Directory of Open Access Journals (Sweden)

Bilgen Erdoğan

2012-12-01

Full Text Available Burning mouth syndrome is a chronic condition characterized by burning pain without any signs of an oral mucosal pathology, that usually affects postmenopausal women. Burning sensation is often accompanied by dysgeusia and xerostomia. The pathogenesis of the disease is unknown and an effective treatment option for most of the patients has not been defined yet. The aim of this review is to present current pharmacological and physicological treatments of burning mouth syndrome.

Ground-Water Protection and Monitoring Program

Energy Technology Data Exchange (ETDEWEB)

Dresel, P.E.

1995-06-01

This section of the 1994 Hanford Site Environmental Report summarizes the ground-water protection and monitoring program strategy for the Hanford Site in 1994. Two of the key elements of this strategy are to (1) protect the unconfined aquifer from further contamination, and (2) conduct a monitoring program to provide early warning when contamination of ground water does occur. The monitoring program at Hanford is designed to document the distribution and movement of existing ground-water contamination and provides a historical baseline for evaluating current and future risk from exposure to the contamination and for deciding on remedial action options.

Ground-Water Protection and Monitoring Program

International Nuclear Information System (INIS)

Dresel, P.E.

1995-01-01

This section of the 1994 Hanford Site Environmental Report summarizes the ground-water protection and monitoring program strategy for the Hanford Site in 1994. Two of the key elements of this strategy are to (1) protect the unconfined aquifer from further contamination, and (2) conduct a monitoring program to provide early warning when contamination of ground water does occur. The monitoring program at Hanford is designed to document the distribution and movement of existing ground-water contamination and provides a historical baseline for evaluating current and future risk from exposure to the contamination and for deciding on remedial action options

Geohydrology, geochemistry, and groundwater simulation (1992-2011) and analysis of potential water-supply management options, 2010-60, of the Langford Basin, California

Science.gov (United States)

Voronin, Lois M.; Densmore, Jill N.; Martin, Peter; Brush, Charles F.; Carlson, Carl S.; Miller, David M.

2013-01-01

the NTC. Measured groundwater-level declines since the initiation of withdrawals (1992–2011) were used to calibrate the groundwater-flow model. The simulated recharge was about 46 acre-feet per year, including approximately 6 acre-feet per year of natural recharge derived from precipitation runoff and as much as 40 acre-feet per year of underflow from the Irwin Basin. Between April 1992 and December 2010, an average of about 650 acre-feet per year of water was withdrawn from the Langford Basin. Groundwater withdrawals in excess of natural recharge resulted in a net loss of 11,670 acre-feet of groundwater storage within the basin for the simulation period. The Fort Irwin NTC is considering various groundwater-management options to address the limited water resources in the Langford Basin. The calibrated Langford Basin groundwater-flow model was used to evaluate the hydrologic effects of four groundwater-withdrawal scenarios being considered by the Fort Irwin NTC over the next 50 years (January 2011 through December 2060). Continuation of the 2010 withdrawal rate in the three existing production wells will result in 70 feet of additional drawdown in the central part of the basin. Redistributing the 2010 withdrawal rate equally to the three existing wells and two proposed new wells in the northern and southern parts of the basin would result in about 10 feet less drawdown in the central part of the basin but about 100 feet of additional drawdown in the new well in the northern part of the basin and about 50 feet of additional drawdown in the new well in the southern part of the basin. Reducing the withdrawals from the three existing production wells in the central part of the basin from about 45,000 acre-feet to about 32,720 acre-feet would result in about 40 feet of additional drawdown in the central basin near the pumping wells, about 25 feet less than if withdrawals were not reduced. The combination of reducing and redistributing the cumulative withdrawals to the

Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options.

Science.gov (United States)

Tanbo, Tom; Fedorcsak, Peter

2017-06-01

Endometriosis is a common condition in women of reproductive age. In addition to pain, endometriosis may also reduce fertility. The causes of infertility in women with endometriosis may range from anatomical distortions due to adhesions and fibrosis to endocrine abnormalities and immunological disturbances. In some cases, the various pathophysiological disturbances seem to interact through mechanisms so far not fully understood. Whether surgery should be offered as a treatment option in endometriosis-associated infertility has become controversial, partly due to its modest or undocumented effect. Medical or hormonal treatment alone has little or no effect and should only be used in conjunction with assisted reproductive technology (ART). Of the various methods of ART, intrauterine insemination, due to its simplicity, can be recommended in women with minimal or mild peritoneal endometriosis, even though insemination may yield a lower success rate than in women without endometriosis. In vitro fertilization (IVF) is an effective treatment option in less-advanced disease stages, and the success rates are similar to the results in other causes of infertility. However, women with more advanced stages of endometriosis have lower success rates with IVF. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Treatment options for permanent teeth with deep caries

OpenAIRE

Marending, Monika; Attin, Thomas; Zehnder, Matthias

2016-01-01

The goal of this narrative review was to summarize and compare treatment options for permanent teeth carious lesions that are radiographically close to the pulp chamber. Thanks to adhesive restorative materials, minimally invasive approaches are possible. In this context, the old question arises as to whether caries must be excavated completely, i.e., down to hard dentin, or whether it could be advantageous to leave some soft dentin, or even merely seal the whole lesion. To answer this questi...

Effluent treatment options for nuclear thermal propulsion system ground tests

International Nuclear Information System (INIS)

Shipers, L.R.; Brockmann, J.E.

1992-01-01

A variety of approaches for handling effluent from nuclear thermal propulsion system ground tests in an environmentally acceptable manner are discussed. The functional requirements of effluent treatment are defined and concept options are presented within the framework of these requirements. System concepts differ primarily in the choice of fission-product retention and waste handling concepts. The concept options considered range from closed cycle (venting the exhaust to a closed volume or recirculating the hydrogen in a closed loop) to open cycle (real time processing and venting of the effluent). This paper reviews the strengths and weaknesses of different methods to handle effluent from nuclear thermal propulsion system ground tests

Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options

DEFF Research Database (Denmark)

Uhlving, H H; Buchvald, F; Heilmann, C J

2012-01-01

Bronchiolitis obliterans (BO) following allogeneic haematopoietic SCT (HSCT) is a serious complication affecting 1.7-26% of the patients, with a reported mortality rate of 21-100%. It is considered a manifestation of chronic graft-versus-host disease, but our knowledge of aetiology and pathogenes...... treatment options for BO and presents the treatment results with HDPM in a paediatric national HSCT-cohort.Bone Marrow Transplantation advance online publication, 29 August 2011; doi:10.1038/bmt.2011.161....

Technical framework for groundwater restoration

International Nuclear Information System (INIS)

1991-04-01

This document provides the technical framework for groundwater restoration under Phase II of the Uranium Mill Tailings Remedial Action (UMTRA) Project. A preliminary management plan for Phase II has been set forth in a companion document titled ''Preplanning Guidance Document for Groundwater Restoration''. General principles of site characterization for groundwater restoration, restoration methods, and treatment are discussed in this document to provide an overview of standard technical approaches to groundwater restoration

[Female sexual dysfunction: Drug treatment options].

Science.gov (United States)

Alcántara Montero, A; Sánchez Carnerero, C I

2016-01-01

Many women will likely experience a sexual problem in their lifetime. Female sexual dysfunction is a broad term used to describe 3 categories of disorders of a multifactorial nature. Effective, but limited pharmacotherapeutic options exist to address female sexual dysfunction. The FDA recently approved the first agent for treatment of hypoactive sexual desire disorder in pre-menopausal women. Off-label use of hormonal therapies, particularly oestrogen and testosterone, are the most widely employed for female sexual dysfunction, particularly in post-menopausal women. Other drugs currently under investigation include phosphodiesterase inhibitors and agents that modulate dopamine or melanocortin receptors. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Investigations of Chemical and Biological Treatment Options for the Attenuation of Hexahydro-1,3,5-trinitro-1,3,5-triazine Contamination in Groundwater at Los Alamos, New Mexico

Science.gov (United States)

Heerspink, B. P.; Wang, D.; Ware, D.; Marina, O.; Perkins, G.; WoldeGabriel, G. W.; Goering, T.; Boukhalfa, H.

2017-12-01

High-explosive compounds including hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) were used extensively in weapons research and testing at Los Alamos National Laboratory (LANL) in Los Alamos, NM. Liquid effluents containing RDX released at LANL's Technical Area 16 (TA-16) resulted in the contamination of alluvial, perched-intermediate, and regional groundwater bodies. Past investigations have shown persistent RDX contamination in the perched-intermediate zone located between 225 to 311 m below ground surface, where transport studies have shown that RDX and its degradation products transport conservatively. In this study, we compared RDX degradation by chemical treatments using reduction by sodium dithionite, oxidation by potassium permanganate, and alkaline hydrolysis by carbonate/bicarbonate buffering, with microbial degradation under biostimulated conditions. The experiments were conducted using groundwater and sediments representative of the contaminated aquifer beneath TA-16. Batch testing showed that all chemical treatments degraded RDX very rapidly, with half-lives ranging from 50 minutes to 22 hours. Comparatively, RDX degradation in biostimulated reactors under strict anaerobic conditions was significantly slower, with half-lives of about 3 weeks. Results from column experiments with chemically treated sediments deviated from the results of the batch testing. Dithionite treated sediments reduced RDX with no breakthrough observed before clogging occurred at 50 pour volumes. Treatments by oxidation using potassium permanganate, and hydrolysis under buffered alkaline conditions, were less effective with complete RDX breakthrough after 2 pore volumes. No known degradation products were observed in the column effluents. RDX degradation in biostimulated columns was very effective initially for both treatments. However, the column biostimulated with safflower oil clogged very rapidly. The column biostimulated with molasses was very effective when molasses was

Assessment of options for the treatment of Sizewell PWR liquid effluent

International Nuclear Information System (INIS)

Hornby, J.; Allam, J.; Knibbs, R.H.

1992-01-01

This report describes the origins of PWR liquid waste streams, their composition and rates of arising. Data has been collected from operational PWRs and estimates obtained for Sizewell B PWR liquid waste streams. Current liquid waste treatment practices are reviewed and assessments made of established and novel treatment techniques which could be applicable to Sizewell B. A short list of treatment options is given and recommendations are made relating to established treatment technologies suitable for Sizewell B and also to development work on more novel treatments which could lead to a reduction in waste disposal volumes. (author)

F/H seepage basin groundwater influent, effluent, precipitated sludge characterization task technical plan

International Nuclear Information System (INIS)

Siler, J.L.

1993-01-01

A treatability study to support the development of a remediation system which would reduce the contaminant levels in groundwater removed from the aquifers in the vicinity of the F/H seepage basins and southwest of the Mixed Waste Management Facility (MWMF) at the Savannah River facility was conducted. Proposed changes in the remediation system require an additional study to determine whether precipitated sludge generated from the proposed remediation system will be hazardous as defined by RCRA. Several contaminants, such as lead and mercury, are above the groundwater protection standards. The presence of radionuclides and other contaminants in the sludge does not present a problem provided that the sludge can pass the Toxicity Characteristic Leaching Procedure (TCLP) test. The study has been developed in such a manner as to cover the possible range of treatment options that may be used

Ragweed-induced allergic rhinoconjunctivitis: current and emerging treatment options

Directory of Open Access Journals (Sweden)

Ihler F

2015-02-01

Full Text Available Friedrich Ihler, Martin CanisDepartment of Otorhinolaryngology, University Medical Center Göttingen, Göttingen, GermanyAbstract: Ragweed (Ambrosia spp. is an annually flowering plant whose pollen bears high allergenic potential. Ragweed-induced allergic rhinoconjunctivitis has long been seen as a major immunologic condition in Northern America with high exposure and sensitization rates in the general population. The invasive occurrence of ragweed (A. artemisiifolia poses an increasing challenge to public health in Europe and Asia as well. Possible explanations for its worldwide spread are climate change and urbanization, as well as pollen transport over long distances by globalized traffic and winds. Due to the increasing disease burden worldwide, and to the lack of a current and comprehensive overview, this study aims to review the current and emerging treatment options for ragweed-induced rhinoconjunctivitis. Sound clinical evidence is present for the symptomatic treatment of ragweed-induced allergic rhinoconjunctivitis with oral third-generation H1-antihistamines and leukotriene antagonists. The topical application of glucocorticoids has also been efficient in randomized controlled clinical trials. Combined approaches employing multiple agents are common. The mainstay of causal treatment to date, especially in Northern America, is subcutaneous immunotherapy with the focus on the major allergen, Amb a 1. Beyond this, growing evidence from several geographical regions documents the benefit of sublingual immunotherapy. Future treatment options promise more specific symptomatic treatment and fewer side effects during causal therapy. Novel antihistamines for symptomatic treatment are aimed at the histamine H3-receptor. New adjuvants with toll-like receptor 4 activity or the application of the monoclonal anti-immunoglobulin E antibody, omalizumab, are supposed to enhance conventional immunotherapy. An approach targeting toll-like receptor 9 by

Vaccines against drugs of abuse: a viable treatment option?

Science.gov (United States)

Kantak, Kathleen M

2003-01-01

Drug addiction is a chronically relapsing brain disorder. There is an urgent need for new treatment options for this disease because the relapse rate among drug abusers seeking treatment is quite high. During the past decade, many groups have explored the feasibility of using vaccines directed against drugs of abuse as a means of eliminating illicit drug use as well as drug overdose and neurotoxicity. Vaccines work by inducing drug-specific antibodies in the bloodstream that bind to the drug of abuse and prevent its entry into the brain. The majority of work in this area has been conducted with vaccines and antibodies directed against cocaine and nicotine. On the basis of preclinical work, vaccines for cocaine and nicotine are now in clinical trials because they can offer long-term protection with minimal treatment compliance. In addition, vaccines and antibodies for phencyclidine, methamphetamine and heroin abuse are currently under development. An underlying theme in this research is the need for high concentrations of circulating drug-specific antibodies to reduce drug-seeking and drug-taking behaviour when the drug is repeatedly available, especially in high doses. Although vaccines against drugs of abuse may become a viable treatment option, there are several drawbacks that need to be considered. These include: a lack of protection against a structurally dissimilar drug that produces the same effects as the drug of choice;a lack of an effect on drug craving that predisposes an addict to relapse; and tremendous individual variability in antibody formation. Forced or coerced vaccination is not likely to work from a scientific perspective, and also carries serious legal and ethical concerns. All things considered, vaccination against a drug of abuse is likely to work best with individuals who are highly motivated to quit using drugs altogether and as part of a comprehensive treatment programme. As such, the medical treatment of drug abuse will not be radically

Impacts of Groundwater Constraints on Saudi Arabia's Low-Carbon Electricity Supply Strategy.

Science.gov (United States)

Parkinson, Simon C; Djilali, Ned; Krey, Volker; Fricko, Oliver; Johnson, Nils; Khan, Zarrar; Sedraoui, Khaled; Almasoud, Abdulrahman H

2016-02-16

Balancing groundwater depletion, socioeconomic development and food security in Saudi Arabia will require policy that promotes expansion of unconventional freshwater supply options, such as wastewater recycling and desalination. As these processes consume more electricity than conventional freshwater supply technologies, Saudi Arabia's electricity system is vulnerable to groundwater conservation policy. This paper examines strategies for adapting to long-term groundwater constraints in Saudi Arabia's freshwater and electricity supply sectors with an integrated modeling framework. The approach combines electricity and freshwater supply planning models across provinces to provide an improved representation of coupled infrastructure systems. The tool is applied to study the interaction between policy aimed at a complete phase-out of nonrenewable groundwater extraction and concurrent policy aimed at achieving deep reductions in electricity sector carbon emissions. We find that transitioning away from nonrenewable groundwater use by the year 2050 could increase electricity demand by more than 40% relative to 2010 conditions, and require investments similar to strategies aimed at transitioning away from fossil fuels in the electricity sector. Higher electricity demands under groundwater constraints reduce flexibility of supply side options in the electricity sector to limit carbon emissions, making it more expensive to fulfill climate sustainability objectives. The results of this analysis underscore the importance of integrated long-term planning approaches for Saudi Arabia's electricity and freshwater supply systems.

New treatment options for fibromyalgia: critical appraisal of duloxetine

Directory of Open Access Journals (Sweden)

Nurcan Üçeyler

2008-06-01

Full Text Available Nurcan Üçeyler1, Martin Offenbächer2, Frank Petzke3, Winfried Häuser4, Claudia Sommer11Department of Neurology, University of Würzburg, Germany; 2GRP – Generation Research Program, Human Science Center, University of Munich, Germany; 3Department of Anesthesiology, University of Cologne, Germany; 4Center of Pain Therapy, Klinikum Saarbrücken gGmbH, Winterberg 1, Saarbrücken, GermanyAbstract: Fibromyalgia syndrome (FMS is a chronic condition characterized by widespread pain, tender points, fatigue, and sleep disturbance. FMS leads to high disability levels, poor quality of life, and extensive use of medical care. Effective pharmacological treatment options are rare, and treatment effects are often of limited duration. Duloxetine is a new selective serotonin and norepinephrine reuptake inhibitor that is licensed for the treatment of pain in diabetic neuropathy. So far two randomized, placebo-controlled trials have investigated the short-term safety and efficacy of duloxetine 60 mg/day and 120 mg/day in patients suffering from FMS over a period of 12 weeks. Both dosages were superior to placebo in pain relief, and improvement in quality of life and depressive symptoms. The analgesic effect was largely independent of the antidepressant action of duloxetine. The higher dose of 120 mg/day further reduced the tender point count and elevated the tender point pain thresholds. Only mild to moderate adverse effects were reported. Duloxetine 60 mg/day and 120 mg/day has proven to be beneficial in the treatment of FMS symptoms. As true for other antidepressants further studies are needed to assess the long-term efficacy and safety of duloxetine as an additional pharmacological treatment option in FMS.Keywords: fibromyalgia syndrome, duloxetine, antidepressant, review, SNRI

Recharge Net Metering to Incentivize Sustainable Groundwater Management

Science.gov (United States)

Fisher, A. T.; Coburn, C.; Kiparsky, M.; Lockwood, B. S.; Bannister, M.; Camara, K.; Lozano, S.

2016-12-01

Stormwater runoff has often been viewed as a nuisance rather than a resource, but with passage of the Sustainable Groundwater Management Act (2014), many basins in California are taking a fresh look at options to enhance groundwater supplies with excess winter flows. In some basins, stormwater can be used for managed aquifer recharge (MAR), routing surface water to enhance groundwater resources. As with many public infrastructure programs, financing for stormwater-MAR projects can be a challenge, and there is a need for incentives that will engage stakeholders and offset operation and maintenance costs. The Pajaro Valley Water Management Agency (PVWMA), in central costal California, recently launched California's first Recharge Net Metering (ReNeM) program. MAR projects that are part of the ReNeM program are intended to generate ≥100 ac-ft/yr of infiltration benefit during a normal water year. A team of university and Resource Conservation District partners will collaborate to identify and assess potential project sites, screening for hydrologic conditions, expected runoff, ease and cost of project construction, and ability to measure benefits to water supply and quality. The team will also collect data and samples to measure the performance of each operating project. Groundwater wells within the PVWMA's service area are metered, and agency customers pay an augmentation fee for each unit of groundwater pumped. ReNeM projects will earn rebates of augmentation fees based on the amount of water infiltrated, with rebates calculated using a formula that accounts for uncertainties in the fate of infiltrated water, and inefficiencies in recovery. The pilot ReNeM program seeks to contribute 1000 ac-ft/yr of infiltration benefit by the end of the initial five-year operating period. ReNeM offers incentives that are distinct from those derived from traditional groundwater banking, and thus offers the potential for an innovative addition to the portfolio of options for

A groundwater-planning toolkit for the main Karoo basin:

African Journals Online (AJOL)

Identifying and quantifying groundwater-development options ... Two methods were developed, namely the Aquifer Assured Yield Model and the Aquifer Firm Yield Model (the ..... implies a risk that there may be shortages on average in 10.

Pelvic radiation disease: Updates on treatment options

Science.gov (United States)

Frazzoni, Leonardo; La Marca, Marina; Guido, Alessandra; Morganti, Alessio Giuseppe; Bazzoli, Franco; Fuccio, Lorenzo

2015-01-01

Pelvic cancers are among the most frequently diagnosed neoplasms and radiotherapy represents one of the main treatment options. The irradiation field usually encompasses healthy intestinal tissue, especially of distal large bowel, thus inducing gastrointestinal (GI) radiation-induced toxicity. Indeed, up to half of radiation-treated patients say that their quality of life is affected by GI symptoms (e.g., rectal bleeding, diarrhoea). The constellation of GI symptoms - from transient to long-term, from mild to very severe - experienced by patients who underwent radiation treatment for a pelvic tumor have been comprised in the definition of pelvic radiation disease (PRD). A correct and evidence-based therapeutic approach of patients experiencing GI radiation-induced toxicity is mandatory. Therapeutic non-surgical strategies for PRD can be summarized in two broad categories, i.e., medical and endoscopic. Of note, most of the studies have investigated the management of radiation-induced rectal bleeding. Patients with clinically significant bleeding (i.e., causing chronic anemia) should firstly be considered for medical management (i.e., sucralfate enemas, metronidazole and hyperbaric oxygen); in case of failure, endoscopic treatment should be implemented. This latter should be considered the first choice in case of acute, transfusion requiring, bleeding. More well-performed, high quality studies should be performed, especially the role of medical treatments should be better investigated as well as the comparative studies between endoscopic and hyperbaric oxygen treatments. PMID:26677440

Tailings From Mining Activities, Impact on Groundwater, and Remediation

Directory of Open Access Journals (Sweden)

Khalid Al-Rawahy

2001-12-01

Full Text Available Effluent wastes from mining operations and beneficiation processes are comprized mostly of the following pollutants: total suspended solids (TTS, alkalinity or acidity (pH, settleable solids, iron in ferrous mining, and dissolved metals in nonferrous mining. Suspended solids consist of small particles of solid pollutants that resist separation by conventional means. A number of dissolved metals are considered toxic pollutants. The major metal pollutants present in ore mining and beneficiation waste waters include arsenic, cadmium, copper, lead, mercury, nickel, and zinc. Tailings ponds are used for both the disposal of solid waste and the treatment of waste-water streams. The supernatant decanted from these ponds contains suspended solids and, at times, process reagents introduced to the water during ore beneficiation. Leakage of material from tailings pond into groundwater is one possible source of water pollution in the mining industry. Percolation of waste-water from impoundment may occur if tailings ponds are not properly designed. This paper addresses potential groundwater pollution due to effluent from mining activities, and the possible remediation options.

Novel treatment options for portal hypertension

Science.gov (United States)

Laleman, Wim

2017-01-01

Abstract Portal hypertension is most frequently associated with cirrhosis and is a major driver for associated complications, such as variceal bleeding, ascites or hepatic encephalopathy. As such, clinically significant portal hypertension forms the prelude to decompensation and impacts significantly on the prognosis of patients with liver cirrhosis. At present, non-selective β-blockers, vasopressin analogues and somatostatin analogues are the mainstay of treatment but these strategies are far from satisfactory and only target splanchnic hyperemia. In contrast, safe and reliable strategies to reduce the increased intrahepatic resistance in cirrhotic patients still represent a pending issue. In recent years, several preclinical and clinical trials have focused on this latter component and other therapeutic avenues. In this review, we highlight novel data in this context and address potentially interesting therapeutic options for the future. PMID:28533907

Field evaluation of a horizontal well recirculation system for groundwater treatment: Pilot test at the Clean Test Site Portsmouth Gaseous Diffusion Plant, Piketon, Ohio

International Nuclear Information System (INIS)

Muck, M.T.; Kearl, P.M.; Siegrist, R.L.

1998-01-01

This report presents the results of field testing a horizontal well recirculation system at the Portsmouth Gaseous Diffusion Plant (PORTS). The recirculation system uses a pair of horizontal wells, one for groundwater extraction and treatment and the other for reinjection of treated groundwater, to set up a recirculation flow field. The induced flow field from the injection well to the extraction well establishes a sweeping action for the removal and treatment of groundwater contaminants. The overall purpose of this project is to study treatment of mixed groundwater contaminants that occur in a thin water-bearing zone not easily targeted by traditional vertical wells. The project involves several research elements, including treatment-process evaluation, hydrodynamic flow and transport modeling, pilot testing at an uncontaminated site, and pilot testing at a contaminated site. The results of the pilot test at an uncontaminated site, the Clean Test Site (CTS), are presented in this report

Treatment Options for Severe Obesity in the Pediatric Population: Current Limitations and Future Opportunities.

Science.gov (United States)

Ryder, Justin R; Fox, Claudia K; Kelly, Aaron S

2018-06-01

Severe obesity is the only obesity classification increasing in prevalence among children and adolescents. Treatment options that produce meaningful and sustained weight loss and comorbidity resolution are urgently needed. The purpose of this review is to provide a brief overview of the current treatment options for pediatric severe obesity and offer suggestions regarding future opportunities for accelerating the development and evaluation of innovative treatment strategies. At present, there are three treatment options for youth with severe obesity: lifestyle modification therapy, pharmacotherapy, and bariatric surgery. Lifestyle modification therapy can be useful for improving many chronic disease risk factors and comorbid conditions but often fails to achieve clinically meaningful and sustainable weight loss. Pharmacotherapy holds promise as an effective adjunctive treatment but remains in the primordial stages of development in the pediatric population. Bariatric surgery provides robust weight loss and risk factor/comorbidity improvements but is accompanied by higher risks and lower uptake compared to lifestyle modification therapy and pharmacotherapy. New areas worth pursuing include combination pharmacotherapy, device therapy, identification of predictors of response aimed at precision treatment, and interventions in the postbariatric surgical setting to improve long-term outcomes. Treating pediatric severe obesity effectively and safely is extremely challenging. Some progress has been made, but substantially more effort and innovation are needed in the future to combat this serious and ongoing medical and public health issue. © 2018 The Obesity Society.

Ustekinumab as an Alternative Treatment Option for Chronic Pityriasis Rubra Pilaris

Directory of Open Access Journals (Sweden)

Mudit Chowdhary

2015-03-01

Full Text Available Pityriasis rubra pilaris (PRP is an exceptionally rare, chronic inflammatory dermatosis of unknown etiology. Patients classically present with small, follicular keratosis and salmon-colored plaques that begin at the head and neck and slowly progress to widespread erythroderma including the palms and soles. It is difficult to distinguish PRP from other inflammatory dermatoses; however, features that help aid in the diagnosis include ‘islands' of spared skin, orangish hue and typical findings on biopsy. There are no specific guidelines on therapy and treatment options include corticosteroids, vitamin D analogs, retinoids, methotrexate, cyclosporine, azathioprine and tumor necrosis factor alpha antagonists. Unfortunately options are limited for patients when these drugs do not work. We report a case of chronic PRP, refractory to conventional treatment, successfully treated with ustekinumab monotherapy. The patient was treated with 90 mg subcutaneous ustekinumab injections and began to show improvement within only 8 weeks. Long-term control of the disease has been attained without any significant side effects. We report this case to show that ustekinumab can be used as an alternative treatment method for patients with chronic, unremitting PRP. Treatment response is remarkably rapid and the infrequent dosing leads to patient compliance and a significantly improved quality of life.

Groundwater Pollution Arising From The Disposal Of Creosote Waste

DEFF Research Database (Denmark)

Arvin, Erik; Flyvbjerg, J.

1992-01-01

Creosote-contaminated groundwater contains a complex mixture of phenols, aromatic hydrocarbons and nitrogen-, sulphur- or oxygen-containing heterocyclic, aromatic compounds. One of the most important factors that limits the spreading of these contaminants in groundwater aquifers is degradation by...... enhancement of the native population of subsurface micro-organisms to degrade the contaminants (in situ treatment) and withdrawal of the groundwater followed by treatment by various wastewater treatment processes (above-ground treatment)....

Opportunity for peri-urban Perth groundwater trade

Science.gov (United States)

Gao, Lei; Connor, Jeff; Doble, Rebecca; Ali, Riasat; McFarlane, Don

2013-07-01

Groundwater trade is widely advocated for reallocating scarce groundwater resources between competing users, and managing over-allocated and declining aquifers. However, groundwater markets are still in their infancy, and the potential benefits and opportunities need investigation, particularly where there is a need to reduce the extraction from declining aquifers. This article evaluates economic impacts of reducing groundwater extraction for irrigation use in peri-urban Perth, Australia, where irrigation, a lake-based ecosystem, and public water supply are highly dependent on a declining groundwater resource. We present an assessment of market-based water trading approaches to reduce groundwater extraction with an economic model representing diversity in returns to groundwater use across a population of irrigators. The results indicate that potential economic costs of a proportional reduction in available groundwater for irrigation are 18-21% less if groundwater trade is possible. We also evaluate a water buyback from irrigation to provide public water supply as an alternative to new infrastructure. We find that buying back up to around 50% of current irrigation allocations could create new public water supply only at the cost of 0.32-0.39 million per GL, which is less than one fifth of the costs of new desalinisation or recycled water supply options (2-3 million per GL). We conclude that, with rapid development of computer and internet based trading platforms that allows fast, efficient and low cost multiple party trading, it is increasingly feasible to realise the economic potentials of market-based trade approaches for managing overexploited aquifers.

Treatment options for polycystic ovary syndrome

Directory of Open Access Journals (Sweden)

Ahmed Badawy

2011-02-01

Full Text Available Ahmed Badawy1 Abubaker Elnashar21Department of Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt; 2Department of Obstetrics and Gynecology, Benha University, Benha, EgyptAbstract: Polycystic ovary syndrome (PCOS is the most common endocrine disorder in women. The clinical manifestation of PCOS varies from a mild menstrual disorder to severe disturbance of reproductive and metabolic functions. Management of women with PCOS depends on the symptoms. These could be ovulatory dysfunction-related infertility, menstrual disorders, or androgen-related symptoms. Weight loss improves the endocrine profile and increases the likelihood of ovulation and pregnancy. Normalization of menstrual cycles and ovulation could occur with modest weight loss as little as 5% of the initial weight. The treatment of obesity includes modifications in lifestyle (diet and exercise and medical and surgical treatment. In PCOS, anovulation relates to low follicle-stimulating hormone concentrations and the arrest of antral follicle growth in the final stages of maturation. This can be treated with medications such as clomiphene citrate, tamoxifen, aromatase inhibitors, metformin, glucocorticoids, or gonadotropins or surgically by laparoscopic ovarian drilling. In vitro fertilization will remain the last option to achieve pregnancy when others fail. Chronic anovulation over a long period of time is also associated with an increased risk of endometrial hyperplasia and carcinoma, which should be seriously investigated and treated. There are androgenic symptoms that will vary from patient to patient, such as hirsutism, acne, and/or alopecia. These are troublesome presentations to the patients and require adequate treatment. Alternative medicine has been emerging as one of the commonly practiced medicines for different health problems, including PCOS. This review underlines the contribution to the treatment of different symptoms.Keywords: treatment, polycystic ovary

Petrol contaminated groundwater treatment with air-stripper in Balassagyarmat, Hungary

International Nuclear Information System (INIS)

Szabo, Peter; Bernath, Balazs

2005-01-01

Hydrocarbon contaminated groundwater is a common environmental problem in Hungary. Leakage of underground storage tanks, pipe break or illegal tapping as well as lorry accidents can be mentioned as main reasons. MEGATERRA Ltd. elaborated, adopted and tested several groundwater clean-up methods. These methods are based on detailed survey and investigation, sampling and analysis, delineation of contaminated groundwater, risk assessment, establishment of monitoring wells, pumping tests and remediation action plan. One of these methods was implemented by MEGATERRA Ltd. in Balassagyarmat, Hungary. Contamination source was a 10 m 3 vol. simple wall underground fuel-storage tank, which had been emptied. When the remediation started in April 1998, the petrol had already been accumulated on the ground water table forming a 5-7 m wide and 10-15 m long plume being expanded to SSE-NNW direction. The area of the dissolved hydrocarbon contaminated groundwater-body was 1 000 m 2 and its concentration reached up to 30-40 mg/l TPH. The free-phase hydrocarbon layer was 10 cm thick. For the remediation of contaminated groundwater MEGATERRA Ltd. applied pump and treat method, namely groundwater pumping using extraction well, skimming of free-phase hydrocarbon, stripping of the contaminated ground water in air-stripper tower and draining of the treated groundwater into a drainage ditch. In the centre of the plume we established an extraction well with 300 mm diameter in a 500 mm borehole. Peristaltic skimmer pump was used inside the extraction well to remove the free phase petrol from the ground water surface.Because of the intense volatility of the pollutant we applied aeration (stripping) technology. The extracted contaminated groundwater was cleaned in air-stripper equipment being able to eliminate efficiently the volatile pollutants from the water. The aeration tower is a compact cylindrical shaped column with 650 mm in diameter. Its height depends on the pollutant's type The

Groundwater Energy Designer (GED). Computerized design tool for use of groundwater as heating and cooling source - Final report; Groundwater Energy Designer (GED). Computergestuetztes Auslegungstool zur Waerme- und Kaeltenutzung von Grundwasser - Schlussbericht

Energy Technology Data Exchange (ETDEWEB)

Poppei, J.; Mayer, G.; Schwarz, R.

2006-11-15

We have developed the graphic-based tool Groundwater Energy Designer (GED) for the dimensioning of groundwater withdrawal and reinjection facilities for the purpose of thermal energy exploitation. The tool is designed to support persons planning and constructing small and medium sized installations as well as licensing authorities. GED takes into account the site-specific energy demand and hydrogeological situation. Starting from the analysis of heating or cooling demand, the possibilities of a direct utilization of the groundwater are tested interactively. The well bores for groundwater withdrawal are dimensioned based on a simplified hydrogeological characterisation. The options for the reinjection of used water are investigated considering the local situation (available area and natural groundwater flow). The situation is assessed with consideration of: (i) the technical feasibility at the site (drawdown in the well, distance between production and reinjection wells); (ii) the potential thermal impact on the groundwater (delineation of the heat propagation front for an evaluation of licensing feasibility). GED combines interactive user interfaces for the input of data and characterisation of the local situation, a database with technical and hydrogeological parameters and a flow and heat transfer simulator based on a finite volume code with an automatic mesh generator. The program is available for purchase from the developer. (authors)

Tritium monitoring in groundwater and evaluation of model predictions for the Hanford Site 200 Area Effluent Treatment Facility

International Nuclear Information System (INIS)

Barnett, D.B.; Bergeron, M.P.; Cole, C.R.; Freshley, M.D.; Wurstner, S.K.

1997-08-01

The Effluent Treatment Facility (ETF) disposal site, also known as the State-Approved Land Disposal Site (SALDS), receives treated effluent containing tritium, which is allowed to infiltrate through the soil column to the water table. Tritium was first detected in groundwater monitoring wells around the facility in July 1996. The SALDS groundwater monitoring plan requires revision of a predictive groundwater model and reevaluation of the monitoring well network one year from the first detection of tritium in groundwater. This document is written primarily to satisfy these requirements and to report on analytical results for tritium in the SALDS groundwater monitoring network through April 1997. The document also recommends an approach to continued groundwater monitoring for tritium at the SALDS. Comparison of numerical groundwater models applied over the last several years indicate that earlier predictions, which show tritium from the SALDS approaching the Columbia River, were too simplified or overly robust in source assumptions. The most recent modeling indicates that concentrations of tritium above 500 pCi/L will extend, at most, no further than ∼1.5 km from the facility, using the most reasonable projections of ETF operation. This extent encompasses only the wells in the current SALDS tritium-tracking network

Compendium of ordinances for groundwater protection

Energy Technology Data Exchange (ETDEWEB)

1990-08-01

Groundwater is an extremely important resource in the Tennessee Valley. Nearly two-thirds of the Tennessee Valley's residents rely, at least in part, on groundwater supplies for drinking water. In rural areas, approximately ninety-five percent of residents rely on groundwater for domestic supplies. Population growth and economic development increase the volume and kinds of wastes requiring disposal which can lead to groundwater contamination. In addition to disposal which can lead to groundwater contamination. In addition to disposal problems associated with increases in conventional wastewater and solid waste, technological advancements in recent decades have resulted in new chemicals and increased usage in agriculture, industry, and the home. Unfortunately, there has not been comparable progress in identifying the potential long-term effects of these chemicals, in managing them to prevent contamination of groundwater, or in developing treatment technologies for removing them from water once contamination has occurred. The challenge facing residence of the Tennessee Valley is to manage growth and economic and technological development in ways that will avoid polluting the groundwater resource. Once groundwater has been contaminated, cleanup is almost always very costly and is sometimes impractical or technically infeasible. Therefore, prevention of contamination -- not remedial treatment--is the key to continued availability of usable groundwater. This document discusses regulations to aid in this prevention.

Treatment of groundwater for nitrate removal by portable ion exchange resin, OSE

International Nuclear Information System (INIS)

Iriburo, A.; Pessi, M.; Castagnino, G.; Garat, S.; Hackenbruch, R.; Laguardia, J.; Yelpo, L.; Amondarain, A.; Brunetto, C.

2010-01-01

The locations of Palmitas in the Province of Soriano is supplied with groundwater from a shallow and high nitrogen content in sedimentary aquifer (Asencio Formation). Due to lack of alternative sources, groundwater or surface water, it was decided to test the water treatment from a perforation whose tenors were of the order of 51-66 mg / L of nitrates. The methodology used for the removal of nitrate is ion exchange resins .The main issue raised in this case was the disposal of effluent from the washing of the resins, because there is no collective sanitation network Palmitas nor a sufficient stream flow for discharge . Several alternatives (installation of a transitional deposit, haulage trucks, dumping at distant points, etc.), which were ruled by their poor viability and / or high costs were studied. Finally it was decided to install a device that will have three cylinders with resins were transportable, for which should have a weight less than 75 kg and those which would be used alternately. Regeneration of the resins is carried out in the city of Mercedes, distant 40 km, where the necessary water for the discharge conditions exist with a high content of sodium chloride, resulting from ion exchange. This pilot project represents a first step in treatment for nitrate removal in groundwater using transportable resins which aims to supply the public . Due to the nature of the above location , the chosen methodology had to be adapted to fulfill their duties satisfactorily. The first results of this project to a year of commissioning implementation, which has been funded by SBI and developed by his staff, in order to be used in other places with similar problems are presented in this report

Approved and Off-Label Uses of Obesity Medications, and Potential New Pharmacologic Treatment Options

Directory of Open Access Journals (Sweden)

Fernando Cordido

2010-01-01

Full Text Available Available anti-obesity pharmacotherapy options remain very limited and development of more effective drugs has become a priority. The potential strategies to achieve weight loss are to reduce energy intake by stimulating anorexigenic signals or by blocking orexigenic signals, and to increase energy expenditure. This review will focus on approved obesity medications, as well as potential new pharmacologic treatment options.

The Effects of Accounting Treatment and Financial Crisis on the Stock Option Plans of Italian Companies

Directory of Open Access Journals (Sweden)

Francesco Avallone

2014-03-01

Full Text Available Many studies state that favourable accounting treatment has been one of the main reasons behind employee stock options. In addition, stock options have recently been the target of growing criticism with a possible influence on incentive effectiveness and outrage costs. In such a perspective, the main purpose of the paper is to explore the impact of IFRS 2 and of the recent financial crisis on stock option compensation. Empirical evidence suggests that: (i IFRS 2 did not have a significant effect on stock option granting, (ii the issue of stock options is less likely to occur during the financial crisis.

Economic Feasibility of Irrigated Agricultural Land Use Buffers to Reduce Groundwater Nitrate in Rural Drinking Water Sources

Directory of Open Access Journals (Sweden)

Megan M. Mayzelle

2014-12-01

Full Text Available Agricultural irrigation leachate is often the largest source for aquifer recharge in semi-arid groundwater basins, but contamination from fertilizers and other agro-chemicals may degrade the quality of groundwater. Affected communities are frequently economically disadvantaged, and water supply alternatives may be too costly. This study aimed to demonstrate that, when addressing these issues, environmental sustainability and market profitability are not incompatible. We investigated the viability of two low impact crops, alfalfa and vineyards, and new recharge basins as an alternative land use in recharge buffer zones around affected communities using an integrated hydrologic, socio-geographic, and economic analysis. In the southern Central Valley, California, study area, alfalfa and vineyards currently constitute 30% of all buffer zone cropland. Economic analyses of alternative land use scenarios indicate a wide range of revenue outcomes. Sector output gains and potential cost saving through land use conversion and resulting flood control result in gains of at least $2.3 billion, as compared to costs of $0.3 to $0.7 billion for treatment options over a 20 year period. Buffer zones would maintain the economic integrity of the region and concur with prevailing policy options. Thus, managed agricultural recharge buffer zones are a potentially attractive option for communities facing financial constraint and needing to diversify their portfolio of policy and infrastructure approaches to meet drinking water quality objectives.

Safety of treatment options for spondyloarthritis: a narrative review.

Science.gov (United States)

D'Angelo, Salvatore; Carriero, Antonio; Gilio, Michele; Ursini, Francesco; Leccese, Pietro; Palazzi, Carlo

2018-05-01

Spondyloarthritis (SpA) are chronic inflammatory diseases with overlapping pathogenic mechanisms and clinical features. Treatment armamentarium against SpA includes non-steroidal anti-inflammatory drugs, glucocorticoids, conventional disease-modifying antirheumatic drugs (DMARDs, including sulfasalazine, methotrexate, leflunomide, cyclosporine), targeted synthetic DMARDs (apremilast) and biological DMARDs (TNF inhibitors, anti-IL 12/23 and anti-IL-17 agents). Areas covered: A narrative review of published literature on safety profile of available SpA treatment options was performed. Readers will be provided with a comprehensive overview on frequent and rare adverse events associated with each drug listed in current SpA treatment recommendations. Expert opinion: The overall safety profile of such molecules is good and serious adverse events are rare but need to be promptly recognized and treated. However, the monitoring of adverse events is a major challenge for clinicians because it is not adequately addressed by current treatment recommendations. A tailored treatment is crucial and rheumatologists must accurately select patients in order to identify those more susceptible to develop adverse events.

Treatment options for diabetic foot osteomyelitis.

Science.gov (United States)

Senneville, Eric; Robineau, Olivier

2017-06-01

Diabetic foot osteomyelitis therapeutical options are based on antibiotic therapy and surgical resection of the infected bone(s). Surgical and medical approaches of patients suffering from a diabetic foot osteomyelitis do not oppose but are complementary and need to be discussed as a tailored manner. Areas covered: The aim of the present article is to discuss data issued from the most recent guidelines of the Infectious Diseases Society of America and the International Working Group on the Diabetic Foot on the management of the diabetic foot infection and from a search in the current literature using the terms diabetic foot osteomyelitis and treatment/therapy/therapeutical in both PubMed and Medline, restricted to the last five years. Expert opinion: Surgical removal of the entire infected bone(s) has been considered in the past as the standard treatment but medical approach of these patients has now proven efficacy in selected situations. The current emergence of bacteria, especially among Gram negative rods, resistant to almost all the available antibiotics gradually augments the complexity of the management of these patients and is likely to decrease the place of the medical approach and to worsen the outcome of these infections in the next future.

Facial Pores: Definition, Causes, and Treatment Options.

Science.gov (United States)

Lee, Sang Ju; Seok, Joon; Jeong, Se Yeong; Park, Kui Young; Li, Kapsok; Seo, Seong Jun

2016-03-01

Enlarged skin pores refer to conditions that present with visible topographic changes of skin surfaces. Although not a medical concern, enlarged pores are a cosmetic concern for a large number of individuals. Moreover, clear definition and possible causes of enlarged pores have not been elucidated. To review the possible causes and treatment options for skin pores. This article is based on a review of the medical literature and the authors' clinical experience in investigating and treating skin pores. There are 3 major clinical causes of enlarged facial pores, namely high sebum excretion, decreased elasticity around pores, and increased hair follicle volume. In addition, chronic recurrent acne, sex hormones, and skin care regimen can affect pore size. Given the different possible causes for enlarged pores, therapeutic modalities must be individualized for each patient. Potential factors that contribute to enlarged skin pores include excessive sebum, decreased elasticity around pores, and increased hair follicle volume. Because various factors cause enlarged facial pores, it might be useful to identify the underlying causes to be able to select the appropriate treatment.

Explicit treatment for Dirichlet, Neumann and Cauchy boundary conditions in POD-based reduction of groundwater models

Science.gov (United States)

Gosses, Moritz; Nowak, Wolfgang; Wöhling, Thomas

2018-05-01

In recent years, proper orthogonal decomposition (POD) has become a popular model reduction method in the field of groundwater modeling. It is used to mitigate the problem of long run times that are often associated with physically-based modeling of natural systems, especially for parameter estimation and uncertainty analysis. POD-based techniques reproduce groundwater head fields sufficiently accurate for a variety of applications. However, no study has investigated how POD techniques affect the accuracy of different boundary conditions found in groundwater models. We show that the current treatment of boundary conditions in POD causes inaccuracies for these boundaries in the reduced models. We provide an improved method that splits the POD projection space into a subspace orthogonal to the boundary conditions and a separate subspace that enforces the boundary conditions. To test the method for Dirichlet, Neumann and Cauchy boundary conditions, four simple transient 1D-groundwater models, as well as a more complex 3D model, are set up and reduced both by standard POD and POD with the new extension. We show that, in contrast to standard POD, the new method satisfies both Dirichlet and Neumann boundary conditions. It can also be applied to Cauchy boundaries, where the flux error of standard POD is reduced by its head-independent contribution. The extension essentially shifts the focus of the projection towards the boundary conditions. Therefore, we see a slight trade-off between errors at model boundaries and overall accuracy of the reduced model. The proposed POD extension is recommended where exact treatment of boundary conditions is required.

DOE`s approach to groundwater compliance on the UMTRA project

Energy Technology Data Exchange (ETDEWEB)

Metzler, D. [Dept. of Energy, Washington, DC (United States); Gibb, J.P. [Geraghty and Miller, Inc. (United States); Glover, W.A. [Roy F. Weston, Inc. (United States)

1993-03-01

Compliance with the mandate of the Uranium Mill Tailings Radiation Control Act (UMTRCA) at Uranium Mill Tailings Remedial Action (UMTRA) Project sites requires implementation of a groundwater remedial action plan that meets the requirements of Subpart B of the US Environmental Protection Agency`s proposed groundwater protection standards (40 CFR 192). The UMTRA Groundwater Project will ensure that unacceptable current risk or potential risk to the public health, safety and the environment resulting from the groundwater contamination attributable to the UMTRA sites, is mitigated in a timely and cost-efficient manner. For each UMTRA processing site and vicinity property where contamination exists, a groundwater remedial action plan must be developed that identifies hazardous constituents and establishes acceptable concentration limits for the hazardous constituents as either (a) alternate concentration limits (ACL), (b) maximum concentration limits (MCLs), (c) supplemental standards, or (d) background groundwater quality levels. Project optimization is a strategy that will aggressively work within the current regulatory framework using all available options to meet regulatory requirements. This strategy is outlined within.

Patients' Values Related to Treatment Options for Teeth with Apical Periodontitis.

Science.gov (United States)

Azarpazhooh, Amir; Dao, Thuan; Ungar, Wendy J; Da Costa, Jose; Figueiredo, Rafael; Krahn, Murray; Friedman, Shimon

2016-03-01

This study aimed to explore patients' values when selecting treatment for a tooth with apical periodontitis (AP), namely retention via root canal treatment (RCT) and extraction without replacement or replacement with implant-supported crowns or fixed or removable partial prostheses. Through 2 surveys of patients (800 university patients and 200 community patients, response rate = 43%) and dentists (498 Ontario endodontists, periodontists, prosthodontists, oral and maxillofacial surgeons, response rate = 40% and 1983 Ontario general dentists, response rate = 15%), the importance of values that might be considered important to patients when selecting treatment options for a tooth with AP were recorded. Chi-square and Kendall's tau tests were used to respectively compare the importance rating frequency by each surveyed group and its correlation to their demographic variables (P ≤ .05). Patients considered communication and trust (94%), tooth retention (90%), esthetic outcome (84% regardless of location), cost (83%), longevity (83%), and preoperative pain (81%) as the most important decision values. Dentists overrated the importance of patients' previous experience with the treatment options (94% vs. 72%), dental insurance (90% vs. 70%), and intraoperative pain (79% vs. 60%) while underestimating the importance of maintenance cost (60% vs. 79%). Dentists should respect patients' views about esthetic outcome, longevity, and cost associated with treatment options for a tooth with AP. In particular, this survey highlights the value of communication and trust between patient and dentist and preservation of the natural tooth through RCT over implant-supported crown replacement when planning treatment for a tooth with AP. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Treatment of groundwater containing Mn(II), Fe(II), As(III) and Sb(III) by bioaugmented quartz-sand filters.

Science.gov (United States)

Bai, Yaohui; Chang, Yangyang; Liang, Jinsong; Chen, Chen; Qu, Jiuhui

2016-12-01

High concentrations of iron (Fe(II)) and manganese (Mn(II)) often occur simultaneously in groundwater. Previously, we demonstrated that Fe(II) and Mn(II) could be oxidized to biogenic Fe-Mn oxides (BFMO) via aeration and microbial oxidation, and the formed BFMO could further oxidize and adsorb other pollutants (e.g., arsenic (As(III)) and antimony (Sb(III))). To apply this finding to groundwater remediation, we established four quartz-sand columns for treating groundwater containing Fe(II), Mn(II), As(III), and Sb(III). A Mn-oxidizing bacterium (Pseudomonas sp. QJX-1) was inoculated into two parallel bioaugmented columns. Long-term treatment (120 d) showed that bioaugmentation accelerated the formation of Fe-Mn oxides, resulting in an increase in As and Sb removal. The bioaugmented columns also exhibited higher overall treatment effect and anti-shock load capacity than that of the non-bioaugmented columns. To clarify the causal relationship between the microbial community and treatment effect, we compared the biomass of active bacteria (reverse-transcribed real-time PCR), bacterial community composition (Miseq 16S rRNA sequencing) and community function (metagenomic sequencing) between the bioaugmented and non-bioaugmented columns. Results indicated that the QJX1 strain grew steadily and attached onto the filter material surface in the bioaugmented columns. In general, the inoculated strain did not significantly alter the composition of the indigenous bacterial community, but did improve the relative abundances of xenobiotic metabolism genes and Mn oxidation gene. Thus, bioaugmentation intensified microbial degradation/utilization for the direct removal of pollutants and increased the formation of Fe-Mn oxides for the indirect removal of pollutants. Our study provides an alternative method for the treatment of groundwater containing high Fe(II), Mn(II) and As/Sb. Copyright © 2016 Elsevier Ltd. All rights reserved.

Options for Healthcare Waste Management and Treatment in China

Institute of Scientific and Technical Information of China (English)

无

2006-01-01

Healthcare waste management and treatment is one of the national priority tasks of China's Tenth Five-Year Plan.Numerous installations disposing medical waste have already operated the project or under construction to the operation in 2006. This paper focuses on the assessment of existing and fu~re options to handle medical waste (MW). Internationally available and so far in China applied technologies and management practice are analysed, including the problems how to materials. Non-hazardous MW can be managed and treated in analogue to municipal solid waste (MSW). In most of the European countries decentralised hospital incinerators have been, because of high operation costs and pollution problems,widely banned and replaced by pre-treatment technologies at the source and centralised incineration plants for hazardous MW.Information for adapting and further developing MW management solutions and treatment technologies in China and applying the most appropriate MWM practice is provided.

Current treatment options for the management of patent ductus arteriosus

Directory of Open Access Journals (Sweden)

Takeuchi K

2013-03-01

Full Text Available Koh Takeuchi,1 Atsushi Hirota,2 Sachito Minegishi,1 Jotaro Kobayashi,1 Keiji Tsuchiya3 1Division of Cardiovascular Surgery, 2Department of Neonatology, 3Department of Pediatrics, Japanese Red Cross Medical Center, Shibuya, Tokyo, Japan Abstract: Pharmacological and/or surgical closure of a hemodynamically significant patent ductus arteriosus (PDA in the very premature infant has been the standard of care over the past few decades. However, the rationale for closure of PDA has recently been challenged. In this article, three ways of approaching the closure of PDA including pharmacological treatment, catheter intervention, and surgical intervention, are reviewed in detail. In addition, the different treatment strategies applied in clinical care are evaluated with a focus on the discussion of the available evidence of PDA treatment in the literature. Keywords: patent ductus arteriosus, premature infant, treatment option

Treatment options for permanent teeth with deep caries.

Science.gov (United States)

Marending, Monika; Attin, Thomas; Zehnder, Matthias

The goal of this narrative review was to summarize and compare treatment options for permanent teeth carious lesions that are radiographically close to the pulp chamber. Thanks to adhesive restorative materials, minimally invasive approaches are possible. In this context, the old question arises as to whether caries must be excavated completely, i.e., down to hard dentin, or whether it could be advantageous to leave some soft dentin, or even merely seal the whole lesion. To answer this question, the microbiological aspects of the lesion must be considered, along with the immunological response in the dental pulp, with the concurrent possible negative outcomes for the patient. Both aspects are considered in this review, and clinical studies comparing different treatment modalities are discussed. Situations in which calcium silicate cements could be advantageous over the gold standard calcium hydroxide preparations for covering the dentin/pulp wound are also discussed.

A groundwater data assimilation application study in the Heihe mid-reach

Science.gov (United States)

Ragettli, S.; Marti, B. S.; Wolfgang, K.; Li, N.

2017-12-01

The present work focuses on modelling of the groundwater flow in the mid-reach of the endorheic river Heihe in the Zhangye oasis (Gansu province) in arid north-west China. In order to optimise the water resources management in the oasis, reliable forecasts of groundwater level development under different management options and environmental boundary conditions have to be produced. For this means, groundwater flow is modelled with Modflow and coupled to an Ensemble Kalman Filter programmed in Matlab. The model is updated with monthly time steps, featuring perturbed boundary conditions to account for uncertainty in model forcing. Constant biases between model and observations have been corrected prior to updating and compared to model runs without bias correction. Different options for data assimilation (states and/or parameters), updating frequency, and measures against filter inbreeding (damping factor, covariance inflation, spatial localization) have been tested against each other. Results show a high dependency of the Ensemble Kalman filter performance on the selection of observations for data assimilation. For the present regional model, bias correction is necessary for a good filter performance. A combination of spatial localization and covariance inflation is further advisable to reduce filter inbreeding problems. Best performance is achieved if parameter updates are not large, an indication for good prior model calibration. Asynchronous updating of parameter values once every five years (with data of the past five years) and synchronous updating of the groundwater levels is better suited for this groundwater system with not or slow changing parameter values than synchronous updating of both groundwater levels and parameters at every time step applying a damping factor. The filter is not able to correct time lags of signals.

A Trans-disciplinary Hydrogeological Systems Analysis Approach for Identifying and Assessing Managed Aquifer Recharge Options: Example from the Darling River Floodplain, N.S.W., Australia

Science.gov (United States)

Lawrie, K.; Brodie, R. S.; Tan, K. P.; Halas, L.; Magee, J.; Gow, L.; Christensen, N. B.

2013-12-01

Surface water availability and quality generally limits managed aquifer recharge (MAR) opportunities in inland Australia's highly salinized landscapes and groundwater systems. Economic factors also commonly limit MAR investigations to shallow freshwater groundwater systems near existing infrastructure. Aquifer opportunities lie mainly in zones of fresh groundwater in relatively thin fluvial sedimentary aquifer systems with highly variable hydraulic properties. As part of a broader strategy to identify water savings in the Murray-Darling Basin, the Broken Hill Managed Aquifer Recharge (BHMAR) project was tasked with identifying and assessing MAR and/or groundwater extraction options to reduce evaporative losses from existing surface water storages, secure Broken Hill's water supply, protect the local environment and heritage, and return water to the river system. A trans-disciplinary research approach was used to identify and assess MAR options across a broad area of the Darling River floodplain. This methodology enabled the team to recognise fundamental problems in discipline approaches, helped identify critical data gaps, led to significant innovation across discipline boundaries, was critical in the development of a new hydrogeological conceptual model, facilitated development of new models of landscape, geological and tectonic evolution of the study area, and enabled completion of pre-commissioning maximal and residual MAR risk assessments. An airborne electromagnetics (AEM) survey, acquired over a large (>7,500 sq km) area of the Darling Floodplain, enabled rapid identification of a multi-layer sequence of aquifers and aquitards, while a phased assessment methodology was developed to rapidly identify and assess over 30 potential MAR targets (largely in fresh groundwater zones within palaeochannels and at palaeochannel confluences). Hydraulic properties were confirmed by a 7.5 km drilling program (100 sonic and rotary mud holes), and complementary field

Development of groundwater treatment methods using radiation-induced graft polymerization adsorbent at the Mizunami Underground Research Laboratory. Annual report for 2008 fiscal year (Joint research)

International Nuclear Information System (INIS)

Iyatomi, Yosuke; Shimada, Akiomi; Ogata, Nobuhisa; Sugihara, Kozo; Hoshina, Hiroyuki; Seko, Noriaki; Kasai, Noboru; Ueki, Yuji; Tamada, Masao

2011-02-01

The concentrations of fluorine (7.2-10mg/L) and boron (0.8-1.5mg/L) dissolved in groundwater pumped from the shafts during excavation of the Mizunami Underground Research Laboratory (MIU), Tono Geoscience Center, shall be reduced to levels below the environmental standards for fluorine: 0.8mg/L and boron: 1mg/L. Coagulation and ion exchange methods are being applied for fluorine and boron, respectively, at the operating water treatment facility at the MIU. As well, collaborative research on groundwater treatment started in 2006 between the Environmental and Industrial Materials Research Division, Quantum Beam Science Directorate and the Tono Geoscientific Research Unit, Geological Isolation Research and Development Directorate on a novel method to remove the fluorine and boron. The Quantum Beam Directorate has synthesized fibrous adsorbents with radiation-induced graft polymerization and applied the adsorbents to collect rare metals dissolved in hot springs and sea water. The results of previous testing indicated that the adsorbent was able to remove more than 95% of the boron and fluorine and that performance of adsorbent for boron removal was better than the performance using ion-exchange resin. It was also apparent that the pH of groundwater had an influence on the performance of the adsorbent with respect to boron removal. Therefore we reran the recycling tests using groundwater from the neutralization tank at the groundwater treatment facility were repeated. The results indicated that the performance of the adsorbent using neutral groundwater for boron removal was higher than using uncontrolled groundwater. However the bed volume (BV) with recycled adsorbent decreased compared to first use. It is thought that sulfur added at the groundwater treatment facility was retained by the adsorbent despite elution, and affected the performance such that repeat usage resulted in decreased efficiency. In addition, it is considered that the goals established in the first

Pazopanib for metastatic pulmonary epithelioid hemangioendothelioma—a suitable treatment option: case report and review of anti-angiogenic treatment options

International Nuclear Information System (INIS)

Semenisty, Valeriya; Naroditsky, Inna; Keidar, Zohar; Bar-Sela, Gil

2015-01-01

Epithelioid hemangioendothelioma is a rare vascular tumor of borderline or low-grade malignancy. The lungs and liver are the two common primary organs affected. Metastatic disease was reported in more than 100 cases in the literature. However, no firm conclusions can be determined for recommended treatment options. The current case presents a patient with metastatic pulmonary epithelioid hemangioendothelioma to the cervical and mediastinal lymph nodes, lungs and liver that has been treated with pazopanib for more than two years with PET avid complete metabolic response in the mediastinum and lungs, and long-lasting stable disease. Target therapies that block VEGFR have a logical base in this rare malignancy. The current case is the first to report objective, long-lasting response to pazopanib

Excoriation (skin-picking disorder: a systematic review of treatment options

Directory of Open Access Journals (Sweden)

Lochner C

2017-07-01

Full Text Available Christine Lochner,1 Annerine Roos,1 Dan J Stein2 1SU/UCT MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, South Africa; 2SU/UCT MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, South Africa Abstract: Although pathological skin-picking has been documented in the medical literature since the 19th century, it has only recently been included as a distinct entity in psychiatric classification systems. In the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition and the proposed International Classification of Diseases, Eleventh Revision, excoriation (skin-picking disorder (ED, also known as neurotic excoriation, psychogenic excoriation, or dermatillomania, is described as recurrent picking of skin, leading to skin lesions and significant distress or functional impairment. ED is listed as one of the obsessive–compulsive and related disorders, given its overlap with conditions such as trichotillomania (hair-pulling disorder. Arguably, its inclusion and delineation in the diagnostic nomenclature will lead to increased awareness of the condition, more research, and ultimately in treatment advances. This systematic review aims to provide readers with an up-to-date view of current treatment options for ED. A MEDLINE search of the ED treatment literature was conducted to collate relevant articles published between 1996 and 2017. The findings indicate that a number of randomized controlled trails on ED have now been published, and that current management options include behavioral therapy (habit reversal or acceptance-enhanced behavior therapy, and medication (selective serotonin reuptake inhibitors or N-acetyl cysteine. Keywords: excoriation, skin-picking, treatment, habit reversal therapy, behavioral therapy, pharmacotherapy, systematic review

Development of HUMASORB trademark, a lignite derived humic acid for removal of metals and organic contaminants from groundwater

International Nuclear Information System (INIS)

Sanjay, H.G.; Srivastave, K.C.; Walia, D.S.

1995-01-01

Heavy metal and organic contamination of surface and groundwater systems is a major environmental concern. The contamination is primarily due to improperly disposed industrial wastes. The presence of toxic heavy metal ions, volatile organic compounds (VOCs) and pesticides in water is of great concern and could affect the safety of drinking water. Decontamination of surface and groundwater can be achieved using a broad spectrum of treatment options such as precipitation, ion-exchange, microbial digestion, membrane separation, activated carbon adsorption, etc. The state of the art technologies for treatment of contaminated water however, can in one pass remediate only one class of contaminants, i.e., either VOCs (activated carbon) or heavy metals (ion exchange). This would require the use of at a minimum, two different stepwise processes to remediate a site. The groundwater contamination at different Department of Energy (DOE) sites (e.g., Hanford) is due to the presence of both VOCs and heavy metals. The two-step approach increases the cost of remediation. To overcome the sequential treatment of contaminated streams to remove both organics and metals, a novel material having properties to remove both classes of contaminants in one step is being developed as part of this project.The objective of this project is to develop a lignite-derived adsorbent, Humasorb TM to remove heavy metals and organics from ground water and surface water streams

The safety of treatment options available for gout.

Science.gov (United States)

Schlesinger, Naomi

2017-04-01

Gout is the most common inflammatory arthritis in humans. Gout treatment includes rapid initiation of anti-inflammatory medications for acute attacks and chronically treating with urate lowering drugs as well as chronic anti-inflammatory prophylaxis. Areas covered: This review aims to provide an overview and discussion of the safety concerns of current treatment options available for gout. Expert opinion: Gout is a curable disease with appropriate treatment. The advent of new therapies provides encouraging opportunities to improve gout management. However, clinicians should be aware of some of the safety concerns of medications used to treat acute and chronic gout. When prescribing medications for gout one has to be mindful of the presence of comorbidities commonly affecting gout patients that may affect drug safety and efficacy, especially in the elderly and in patients treated with multiple drugs. The benefits of gout drugs, usually, outweigh their safety concerns. Studies are needed in gout patients with chronic kidney disease and/or cardiovascular disease, so that escalation of dosing /combination of anti-inflammatory drugs needed to suppress gouty inflammation as well as escalation of dosing/combination of urate lowering drugs needed to achieve target serum urate level will lead to better understanding of gout treatment safety issues.

A Multi-Criteria Decision Analysis of Waste Treatment Options for Food and Biodegradable Waste Management in Japan

Directory of Open Access Journals (Sweden)

Micky A. Babalola

2015-10-01

Full Text Available Dealing with large-scale Food and Biodegradable Waste (FBW often results in many logistical problems and environmental impacts to be considered. These can become great hindrances when the integration of solid waste management is concerned. Extra care is needed to plan such waste disposal or treatment services and facilities, especially with respect to the ecological impact. Decision-making with regards to the sustainable use of these facilities also involves tradeoffs between a number of conflicting objectives, since increasing one benefit may decrease the others. In this study a Multi-Criteria Decision Analysis (MCDA is presented to evaluate different waste management options and their applicability in Japan. The analytical process aims at selecting the most suitable waste treatment option, using pairwise comparisons conducted within a decision hierarchy that was developed through the Analytical Hierarchy Process (AHP. The results of this study show that anaerobic digestion should be chosen as the best FBW treatment option with regards to resource recovery. The study also presents some conditions and recommendations that can enhance the suitability of other options like incineration and composting.

Understanding the hydrologic impacts of wastewater treatment plant discharge to shallow groundwater: Before and after plant shutdown

Science.gov (United States)

Hubbard, Laura E.; Keefe, Steffanie H.; Kolpin, Dana W.; Barber, Larry B.; Duris, Joseph W.; Hutchinson, Kasey J.; Bradley, Paul M.

2016-01-01

Effluent-impacted surface water has the potential to transport not only water, but wastewater-derived contaminants to shallow groundwater systems. To better understand the effects of effluent discharge on in-stream and near-stream hydrologic conditions in wastewater-impacted systems, water-level changes were monitored in hyporheic-zone and shallow-groundwater piezometers in a reach of Fourmile Creek adjacent to and downstream of the Ankeny (Iowa, USA) wastewater treatment plant (WWTP). Water-level changes were monitored from approximately 1.5 months before to 0.5 months after WWTP closure. Diurnal patterns in WWTP discharge were closely mirrored in stream and shallow-groundwater levels immediately upstream and up to 3 km downstream of the outfall, indicating that such discharge was the primary control on water levels before shutdown. The hydrologic response to WWTP shutdown was immediately observed throughout the study reach, verifying the far-reaching hydraulic connectivity and associated contaminant transport risk. The movement of WWTP effluent into alluvial aquifers has implications for potential WWTP-derived contamination of shallow groundwater far removed from the WWTP outfall.

Complexed iron removal from groundwater

Energy Technology Data Exchange (ETDEWEB)

Munter, R.; Ojaste, H.; Sutt, J. [Tallinn Technical University, Tallinn (Estonia). Dept. of Environmental & Chemical Technology

2005-07-01

The paper demonstrates an intensive work carried out and results obtained on the pilot plant of the City of Kogalym Water Treatment Station (Tjumen, Siberia, Russian Federation) to elaborate on a contemporary nonreagent treatment technology for the local iron-rich groundwater. Several filter materials (Birm, Pyrolox, hydroanthracite, Everzit, granulated activated carbon) and chemical oxidants (ozone, chlorine, hydrogen peroxide, oxygen, and potassium permanganate) were tested to solve the problem with complexed iron removal from groundwater. The final elaborated technology consists of raw water intensive aeration in the gas-degas treatment unit followed by sequential filtration through hydroanthracite and the special anthracite Everzit.

Therapeutic Success of the Ketogenic Diet as a Treatment Option for Epilepsy: a Meta-analysis

Science.gov (United States)

Li, Hai-feng; Zou, Yan; Ding, Gangqiang

2013-01-01

Objective To systematically evaluate therapeutic success of the ketogenic diet (KD) as a treatment option for epilepsy. Methods Using MEDLINE and Google Scholar search, we searched for studies investigating the therapeutic success of ketogenic diet for epilepsy. We estimated therapeutic success rate for ketogenic diet as a treatment option for epilepsy and its 95% CIs using generic inverse variance method. Findings A total of 38 studies met the inclusion criteria. In retrospective studies, the weighted success rate of the patients who take the KD as a treatment option for epilepsy was 58.4% (95% confidence interval (95%CI)=48.7% – 69.9%) at 3 months (n=336); 42.8% (95%CI =36.3% – 50.3%) at 6 months (n=492), and 30.1% (95%CI =24.3% – 37.2%) at 12 months (n=387); in prospective studies, weighted success rate was 53.9% (95%CI 45.5% – 63.8%) at 3 months (n=474); 53.2% (95%CI =44.0% – 64.2%) at 6 months (n=321), and 55.0% (95%CI =45.9% – 65.9%) at 12 months (n=347). Conclusion This meta-analysis provides formal statistical support for the efficacy of the ketogenic diet in the treatment of epileptic patients. PMID:24910737

Emerging treatment options for acute bacterial skin and skin structure infections: focus on intravenous delafloxacin

Directory of Open Access Journals (Sweden)

Righi E

2018-04-01

Full Text Available Elda Righi, Alessia Carnelutti, Antonio Vena, Matteo Bassetti Infectious Diseases Division, Santa Maria della Misericordia University Hospital, Udine, Italy Abstract: The increase in hospitalization due to acute bacterial skin and skin structure infections (ABSSSI caused by resistant pathogens supports the need for new treatment options. Antimicrobial options for ABSSSI that provide broad-spectrum coverage, including gram-negative pathogens and multidrug-resistant gram-positive bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA, are limited. Delafloxacin is a novel fluoroquinolone available as intravenous and oral formulations and is characterized by an increased efficacy in acidic environments and activity on bacterial biofilm. Delafloxacin displays enhanced in vitro activity against MRSA, and enterococci, while maintaining efficacy against gram-negative pathogens and anaerobes. Delafloxacin has been studied for the treatment of ABSSSI and respiratory infections. Phase III studies have demonstrated noninferiority of delafloxacin compared to vancomycin, linezolid, tigecycline, and the combination of vancomycin plus aztreonam in the treatment of ABSSSI. Due to its favorable pharmacokinetic characteristics, the wide spectrum of action, and the potential for sequential therapy, delafloxacin represents a promising option in the empirical and targeted treatment of ABSSSI, both in hospital- and in community-based care. Keywords: bacterial skin and skin structure infections, multidrug-resistant bacteria, methicillin-resistant Staphylococcus aureus, delafloxacin

Reactive barrier technologies for treatment of contaminated groundwater at Rocky Flats

International Nuclear Information System (INIS)

Marozas, D.C.; Bujewski, G.E.; Castaneda, N.

1997-01-01

The U.S. Department of Energy (DOE) Office of Science and Technology Subsurface Contaminants Focus Area is supporting the investigation of reactive barrier technologies to mitigate the risks associated with mixed organic/radioactive waste at several DOE sites. Groundwater from a small contaminated plume at the Rocky Flats Environmental Technology Site (RFETS) is being used to evaluate passive reactive material treatment. Permeable reactive barriers which intercept contaminants and destroy the VOC component while containing radionuclides are attractive for a number of reasons relating to public and regulatory acceptance. In situ treatment keeps contaminants away from the earth's surface, there is no above-ground treatment equipment that could expose workers and the public and operational costs are expected to be lower than currently used technologies. This paper will present results from preliminary site characterization and in-field small-scale column testing of reactive materials at RFETS. Successful demonstration is expected to lead to full-scale implementation of the technology at several DOE sites, including Rocky Flats

Groundwater management institutions to protect riparian habitat

Science.gov (United States)

Orr, Patricia; Colby, Bonnie

2004-12-01

Groundwater pumping affects riparian habitat when it causes the water table to drop beyond the reach of riparian plants. Riparian habitat provides services that are not directly traded in markets, as is the case with many environmental amenities. There is no direct market where one may buy or sell the mix of services provided by a riparian corridor. The objective of this article is to review groundwater management mechanisms and assess their strengths and weaknesses for preserving the ecological integrity of riparian areas threatened by groundwater pumping. Policy instruments available to those concerned with the effects of groundwater pumping on riparian areas fall into three broad categories: (1) command and control (CAC), (2) incentive-based economic instruments, and (3) cooperative/suasive strategies. The case of the San Pedro River illustrates multiple and overlapping strategies applied in an ongoing attempt to reverse accumulating damage to a riparian ecosystem. Policy makers in the United States can choose among a broad menu of policy options to protect riparian habitat from groundwater pumping. They can capitalize on the clarity of command-and-control strategies, the flexibility and less obtrusive nature of incentive-based economic strategies, and the benefits that collaborative efforts can bring in the form of mutual consideration. While collaborative problem solving and market-based instruments are important policy tools, experience indicates that a well-formulated regulatory structure to limit regional groundwater pumping is an essential component of an effective riparian protection strategy.

Phytoremediation of explosives in groundwater using innovative wetlands-based treatment technologies

Energy Technology Data Exchange (ETDEWEB)

Sikora, F.J.; Behrends, L.L.; Coonrod, H.S.; Phillips, W.D. [Tennessee Valley Authority, Muscle Shoals, AL (United States). Environmental Research Center; Bader, D.F. [Army Environmental Center, Aberdeen Proving Ground, MD (United States)

1997-12-31

Many army ammunition plants across the country have problems with groundwater contaminated with explosives. A field demonstration was initiated at the Milan Army Ammunition Plant near Milan, Tennessee early in 1996 to demonstrate the feasibility of treating contaminated groundwater with constructed wetlands. Two different systems were designed and installed. A lagoon system consisted of two cells in series with each cell having dimensions of 24 x 9.4 x 0.6 m (L x W x H). A gravel-bed system consisted of three gravel-beds operated in series with a primary anaerobic cell having dimensions of 32 x 11 x 1.4 m (L x W x H), followed by a pair of secondary cells each with dimensions of 5.5 x 11 x 1.4 m (L x W x H). The primary cell is maintained anaerobic by adding powdered milk to the water every two weeks. The secondary cells are maintained aerobic via reciprocation, whereby water is pumped back and forth from one cell to another to cause a recurrent fill and drain action. The lagoons were planted with sago pond weed, water stargrass, elodea, and parrot feather. The gravel-bed wetlands were planted with canary grass, wool grass, sweet flag, and parrot feather. Water began flowing to each of the wetland treatment systems at 19 L min{sup {minus}1} starting in June 1996. The design hydraulic retention time through each treatment system was approximately 10 days. Influent and effluent water samples were collected every 2 weeks. Intensive sampling of water interior to the wetlands occurred every 2 months.

Air sparging of organic compounds in groundwater

International Nuclear Information System (INIS)

Hicks, P.M.

1994-01-01

Soils and aquifers containing organic compounds have been traditionally treated by excavation and disposal of the soil and/or pumping and treating the groundwater. These remedial options are often not practical or cost effective solutions. A more favorable alternative for removal of the adsorbed/dissolved organic compounds would be an in situ technology. Air sparging will remove volatile organic compounds from both the adsorbed and dissolved phases in the saturated zone. This technology effectively creates a crude air stripper below the aquifer where the soil acts as the ''packing''. The air stream that contacts dissolved/adsorbed phase organics in the aquifer induces volatilization. A case history illustrates the effectiveness of air sparging as a remedial technology for addressing organic compounds in soil and groundwater. The site is an operating heavy equipment manufacturing facility in central Florida. The soil and groundwater below a large building at the facility was found to contain primarily diesel type petroleum hydrocarbons during removal of underground storage tanks. The organic compounds identified in the groundwater were Benzene, Xylenes, Ethylbenzene and Toluenes (BTEX), Methyl tert-Butyl Ether (MTBE) and naphthalenes in concentrations related to diesel fuel

Current Treatment Options for Bilateral Vocal Fold Paralysis: A State-of-the-Art Review

Science.gov (United States)

Li, Yike; Garrett, Gaelyn; Zealear, David

2017-01-01

Vocal fold paralysis (VFP) refers to neurological causes of reduced or absent movement of one or both vocal folds. Bilateral VFP (BVFP) is characterized by inspiratory dyspnea due to narrowing of the airway at the glottic level with both vocal folds assuming a paramedian position. The primary objective of intervention for BVFP is to relieve patients’ dyspnea. Common clinical options for management include tracheostomy, arytenoidectomy and cordotomy. Other options that have been used with varying success include reinnervation techniques and botulinum toxin (Botox) injections into the vocal fold adductors. More recently, research has focused on neuromodulation, laryngeal pacing, gene therapy, and stem cell therapy. These newer approaches have the potential advantage of avoiding damage to the voicing mechanism of the larynx with an added goal of restoring some physiologic movement of the affected vocal folds. However, clinical data are scarce for these new treatment options (i.e., reinnervation and pacing), so more investigative work is needed. These areas of research are expected to provide dramatic improvements in the treatment of BVFP. PMID:28669149

Blast furnace residues for arsenic removal from mining-contaminated groundwater.

Science.gov (United States)

Carrillo-Pedroza, Fco Raúl; Soria-Aguilar, Ma de Jesús; Martínez-Luevanos, Antonia; Narvaez-García, Víctor

2014-01-01

In this work, blast furnace (BF) residues were well characterized and then evaluated as an adsorbent material for arsenic removal from a mining-contaminated groundwater. The adsorption process was analysed using the theories of Freundlich and Langmuir. BF residues were found to be an effective sorbent for As (V) ions. The modelling of adsorption isotherms by empirical models shows that arsenate adsorption is fitted by the Langmuir model, suggesting a monolayer adsorption of arsenic onto adsorbents. Arsenate adsorption onto BF residue is explained by the charge density surface affinity and by the formation of Fe (II) and Fe (III) corrosion products onto BF residue particles. The results indicate that BF residues represent an attractive low-cost absorbent option for the removal of arsenic in wastewater treatment.

Remediation options and the significance of water treatment at former uranium production sites in Eastern Germany

International Nuclear Information System (INIS)

Gatzweiler, R.; Jakubick, A.T.; Kiessig, G.

2000-01-01

The WISMUT remediation project in the States of Saxony and Thuringia, Germany, comprises several mine and mill sites including large volumes of production residues. Due to the climate, the intensive land use and the regulatory conditions, the water path is most important in evaluating remediation options. Water treatment is an integral part of mine flooding, mine dump and tailings remediation, and treatment costs represent a major portion of the overall costs of the project. Uncertainties in the estimations of quantities of mine and seepage waters, variations in quality from site to site, and changing conditions in time demand a strategic approach to the selection and optimization of water treatment methods. The paper describes options considered and experience gained including efforts to limit long-term treatment costs by developing and applying passive treatment systems and negotiating acceptable discharge limits. (author)

Informing patients about emerging treatment options: creating "saviour siblings" for haemopoietic stem cell transplant.

Science.gov (United States)

Strong, Kimberly A

2009-05-04

In June 2008, the ABC screened a television documentary involving a couple who decided to have an additional child in the hope of obtaining umbilical cord blood to treat their daughter who had leukaemia. The couple conceived naturally, meaning that there was a one in four chance that their child would be suitably matched. They seemed to be unaware of technologies that, if successful, could provide a near certainty that the next child would be a matched "saviour sibling". This story raises questions about whether clinicians have an obligation to discuss emerging and morally contentious treatment options. Ignorance of technology, assumptions about availability, and medical assessment of burdens and benefits may affect attitudes towards treatment options, but they do not justify non-disclosure of information.

Diverse stakeholders create collaborative, multilevel basin governance for groundwater sustainability

Directory of Open Access Journals (Sweden)

Esther Conrad

2018-01-01

Full Text Available The Sustainable Groundwater Management Act (SGMA is introducing significant changes in the way groundwater is governed for agricultural use. It requires the formation of groundwater sustainability agencies (GSAs to manage groundwater basins for sustainability with the engagement of all users. That presents opportunities for collaboration, as well as challenges, particularly in basins with large numbers of agricultural water users who have longstanding private pumping rights. The GSA formation process has resulted in the creation of multiple GSAs in many such basins, particularly in the Central Valley. In case studies of three basins, we examine agricultural stakeholders' concerns about SGMA, and how these are being addressed in collaborative approaches to groundwater basin governance. We find that many water districts and private pumpers share a strong interest in maintaining local autonomy, but they have distinct concerns and different options for forming and participating in GSAs. Multilevel collaborative governance structures may help meet SGMA's requirements for broad stakeholder engagement, our studies suggest, while also addressing concerns about autonomy and including agricultural water users in decision-making.

Solidification of radioactive liquid wastes, Treatment options for spent resins and concentrates - 16405

International Nuclear Information System (INIS)

Roth, Andreas

2009-01-01

Ion exchange is one of the most common and effective treatment methods for liquid radioactive waste. However, spent ion exchange resins are considered to be problematic waste that in many cases require special approaches and pre-conditioning during its immobilization to meet the acceptance criteria for disposal. Because of the function that they fulfill, spent ion exchange resins often contain high concentrations of radioactivity and pose special handling and treatment problems. Another very common method of liquid radioactive waste treatment and water cleaning is the evaporation or diaphragm filtration. Both treatment options offer a high volume reduction of the total volume of liquids treated but generate concentrates which contain high concentrations of radioactivity. Both mentioned waste streams, spent resins as well as concentrates, resulting from first step liquid radioactive waste treatment systems have to be conditioned in a suitable manner to achieve stable waste products for final disposal. Spent resin and concentrate treatment often appear as a specific task in decommissioning projects, because in the past those waste streams typically had been stored in tanks for the lifetime of the plant and needs to be retrieved, conditioned and packed prior to dismantling activities. Additionally a large amount of contaminated liquids will be generated by utilizing decontamination processes and needs to be processed further on. Such treatment options need to achieve waste products acceptable for final disposal, because due to the closure of the site no interim storage can be envisaged. The most common method of treatment of such waste streams is the solidification in a solid matrix with additional inactive material like cement, polymer etc. In the past good results have been achieved and the high concentration of radioactivity can be reduced by adding the inactive material. On the other hand, under the environment of limited space for interim storage and the absence

Process options for treatment of organic containing ILWs by wet oxidation

International Nuclear Information System (INIS)

Holman, D.J.

1989-01-01

The process chemistry, applications and experience with several wet oxidation options are reviewed along with criteria for the selection of viable systems and plant designs, covering a range of organic wastes, including solvents, cellulosic filters, chelant decontamination reagents and ion exchange resins. The use of hydrogen peroxide to treat water-cooled reactor residues containing mixed inorganic and organic filter materials with ion exchange resins is examined in further detail along with treatment of secondary arisings. The technical and financial justifications for treatment are examined along with the engineering requirements to retro-fit the required plant to an existing cement encapsulation facility. (author)

Environmental implementation plan: Chapter 7, Groundwater protection

International Nuclear Information System (INIS)

Wells, D.

1994-01-01

The Savannah River Site (SRS) uses large quantities of groundwater for drinking, processing, and non-contact cooling. Continued industrial and residential growth along with additional agricultural irrigation in areas adjacent to SRS will increase the demand for groundwater. This increasing demand will require a comprehensive management system to ensure the needed quality and quantity of groundwater is available for all users. The Groundwater Protection Program and the Waste Management Program establish the overall framework for protecting this resource. Ground water under SRS is monitored extensively for radiological, hazardous, and water quality constituents. Groundwater quality is known to have been affected at 33 onsite locations, but none of the contaminant plumes have migrated offsite. Onsite and offsite drinking water supplies are monitored to ensure they are not impacted. The site has more than 1800 monitoring wells from which groundwater samples are analyzed for radiological and non-radiological constituents. SRS is complying with all applicable regulations related to groundwater protection, waste treatment, and waste disposal. The existing waste storage facilities are permitted or are being permitted. Existing hazardous- and mixed-waste storage facilities are being included in the site Resource Conservation and Recovery Act (RCRA) Part B Permit. Part B permitting has been initiated for many of the planned hazardous- and mixed-waste treatment and disposal facilities

Treatment of central sensitization in patients with 'unexplained' chronic pain: what options do we have?

Science.gov (United States)

Nijs, Jo; Meeus, Mira; Van Oosterwijck, Jessica; Roussel, Nathalie; De Kooning, Margot; Ickmans, Kelly; Matic, Milica

2011-05-01

Central sensitization accounts for chronic 'unexplained' pain in a wide variety of disorders, including chronic whiplash-associated disorders, temporomandibular disorders, chronic low back pain, osteoarthritis, fibromyalgia, chronic fatigue syndrome and chronic tension-type headache among others. Given the increasing evidence supporting the clinical significance of central sensitization in those with unexplained chronic pain, the awareness is growing that central sensitization should be a treatment target in these patients. This article provides an overview of the treatment options available for desensitizing the CNS in patients with chronic pain due to central sensitization. It focuses on those strategies that specifically target pathophysiological mechanisms known to be involved in central sensitization. In addition, pharmacological options, rehabilitation and neurotechnology options are discussed. Acetaminophen, serotonin-reuptake inhibitor drugs, selective and balanced serototin and norepinephrine-reuptake inhibitor drugs, the serotonin precursor tryptophan, opioids, N-methyl-d-aspartate (NMDA)-receptor antagonists, calcium-channel alpha(2)delta (a2δ) ligands, transcranial magnetic stimulation, transcutaneous electric nerve stimulation (TENS), manual therapy and stress management each target central pain processing mechanisms in animals that - theoretically - desensitize the CNS in humans. To provide a comprehensive treatment for 'unexplained' chronic pain disorders characterized by central sensitization, it is advocated to combine the best evidence available with treatment modalities known to target central sensitization. © 2011 Informa UK, Ltd

Taxing Options: Do Ceos Respond To Favorable Tax Treatment Of Stock Options?

OpenAIRE

Martin Gritsch; Tricia Coxwell Snyder

2007-01-01

CEO stock option compensation increased tremendously during the 1990s. During this period, the spread between the marginal income and capital gains tax rates increased substantially, creating the potential for tax avoidance. Using ExecuComp data from 1992-2000, we estimate CEOs’ responsiveness to changes in these tax rates. Our findings show that an increase in the marginal income and a decrease in the capital gains tax rate create a significant increase in stock option compensation. Furtherm...

In situ treatment of mixed contaminants in groundwater: Review of candidate processes

International Nuclear Information System (INIS)

Korte, N.E.; Siegrist, R.L.; Ally, M.

1994-10-01

This document describes the screening and preliminary evaluation of candidate treatment for use in treating mixed contaminants volatile organic compounds (VOCs) and radionuclides in groundwater. Treating mixed contaminants presents unusual difficulties. Typically, VOCs are the most abundant contaminants, but the presence of radionuclides results in additional health concerns that must be addressed, usually by a treatment approach different from that used for VOCs. Furthermore, the presence of radionuclides may yield mixed solid wastes if the VOCs are treated by conventional means. These issues were specifically addressed in the evaluation of candidate treatment processes for testing in this program. Moreover, because no research or early development of a particular process would be performed, the technology review also focused on technologies that could be readily adapted and integrated for use with mixed contaminants. The objective is to couple emerging or available processes into treatment modules for use in situ. The three year project, to be completed in September 1996, includes a full-scale field demonstration. The findings reported in this document encompass all activities through the treatment process evaluations

In situ treatment of mixed contaminants in groundwater: Review of candidate processes

Energy Technology Data Exchange (ETDEWEB)

Korte, N.E. [ed.] [Oak Ridge National Lab., Grand Junction, CO (United States); Siegrist, R.L. [ed.] [Oak Ridge National Lab., TN (United States); Ally, M. [and others

1994-10-01

This document describes the screening and preliminary evaluation of candidate treatment for use in treating mixed contaminants volatile organic compounds (VOCs) and radionuclides in groundwater. Treating mixed contaminants presents unusual difficulties. Typically, VOCs are the most abundant contaminants, but the presence of radionuclides results in additional health concerns that must be addressed, usually by a treatment approach different from that used for VOCs. Furthermore, the presence of radionuclides may yield mixed solid wastes if the VOCs are treated by conventional means. These issues were specifically addressed in the evaluation of candidate treatment processes for testing in this program. Moreover, because no research or early development of a particular process would be performed, the technology review also focused on technologies that could be readily adapted and integrated for use with mixed contaminants. The objective is to couple emerging or available processes into treatment modules for use in situ. The three year project, to be completed in September 1996, includes a full-scale field demonstration. The findings reported in this document encompass all activities through the treatment process evaluations.

New and current preventive treatment options in actinic keratosis.

Science.gov (United States)

Arenberger, P; Arenbergerova, M

2017-09-01

Actinic keratosis (AK) is a characteristic skin lesion on skin areas of subjects with mainly phototype I and phototype II, or with specific genetic factors and who are exposed to prolonged ultraviolet radiation. AK may be considered a precursor of in situ squamous cell carcinoma (SCC), a type of non-melanoma skin cancer (NMSC). However, it is still not possible to predict which AK lesions will develop into SCC. Early treatment of AK is therefore recommended. Despite the increasing number of patients with AK developing into SCC, to date, there is still no clear suggestion of therapeutic strategy for AK. Current treatment consists of a multitude of topical lesion-directed or field-directed therapies or a combination of both. Recently, orally administered nicotinamide has shown to significantly reduce rates of new NMSC and AK in high-risk patients. This study aims to provide an update on the most relevant information about AK and to provide an insight into current and new treatment options. © 2017 European Academy of Dermatology and Venereology.

Groundwater Security in Yemen: Who is Accountable to Whom? - Comment

Directory of Open Access Journals (Sweden)

Frank van Steenbergen, Omar Bamaga and Adel Al-Weshali

2011-09-01

Full Text Available The overuse of groundwater in Yemen is now recognized as a national security issue. Groundwater exploitation has increased rapidly over the last four decades. While this has boosted high value farming and created rural jobs, there are grave concerns whether agriculture is not bound for a potentially destabilizing setback. This paper discusses the emergence of local management rules – by water users themselves - and their interplay with formal state institutions. It argues that the existence of formal institutions - including the National Water Law – was more important than their actual almost non-existent implementation. Groundwater where managed is managed locally in Yemen – but in spite of this autonomy, the presence of the Water Law creates the context in which these otherwise contentious local rules develop. The implication is that further strengthening and promoting local regulation is the best option for groundwater management rather than refining and investing in national regulatory institutions.

Thyroid Cancer Treatment Choice: A pilot study of a tool to facilitate conversations with patients with papillary microcarcinomas considering treatment options.

Science.gov (United States)

Brito, Juan P; Moon, Jae Hoon; Zeuren, Rebecca; Kong, Sung Hye; Kim, Yeo Koon; Iñiguez-Ariza, Nicole M; Choi, June Young; Lee, Kyu Eun; Kim, Ji-Hoon; Hargraves, Ian; Bernet, Victor; Montori, Victor; Park, Young Joo; Tuttle, R Michael

2018-06-15

The 2015 American Thyroid Association guidelines recognize active surveillance as an alternative to immediate surgery in patients with papillary microcarcinomas (PMCs). As a way to incorporate active surveillance as one of the management options for patients with PMCs, we describe the development and initial testing of a tool to support conversations between clinicians and patients with PMCs considering treatment options. Thyroid Cancer Treatment Choice was developed using an iterative process based on the principles of interaction, design and participatory action research. To evaluate the impact of the tool on treatment choice, a prospective study was conducted in two thyroid cancer clinics in Seongnam-si and Seoul, South Korea: both clinics had the expertise to offer active surveillance as well as immediate surgery. One clinic was trained in the use of the conversation aid, while the other clinic continued to care for patients without access to the conversation aid. Between May 2016 and April 2017, 278 patients mostly women (n=220, 79%) were included in the study; 152 (53%) received care at the clinic using the conversation aid. Age, gender, and mean tumor size [6.6 mm (SD 1.6) and 6.5 mm (SD 1.9)] distributions were similar across clinics. Overall, 233 (84%) patients opted for active surveillance and 53 (16%) for thyroid surgery. Patients in the conversation aid group were more likely to choose active surveillance than the patients seen in the usual care clinic [relative risk (RR) = 1.16; 95% confidence interval (CI), 1.04 - 1.29]. Of all patients opting for active surveillance, more patients in the conversation aid group had thyroid cancer nodules > 5 mm than in the usual care group (81% vs. 67% P = 0.013). Thyroid Cancer Treatment Choice is an evidence-based tool that supports the presentation of treatment options for PMCs. Pilot testing suggests that this conversation tool increases acceptance of active surveillance, suggesting that this option is an

Ozone-augmented percutaneous discectomy: A novel treatment option for refractory discogenic sciatica

International Nuclear Information System (INIS)

Crockett, M.T.; Moynagh, M.; Long, N.; Kilcoyne, A.; Dicker, P.; Synnott, K.; Eustace, S.J.

2014-01-01

Aim: To assess the short and medium-term efficacy and safety of a novel, minimally invasive therapeutic option combining automated percutaneous lumbar discectomy, intradiscal ozone injection, and caudal epidural: ozone-augmented percutaneous discectomy (OPLD). Materials and methods: One hundred and forty-seven patients with a clinical and radiological diagnosis of discogenic sciatica who were refractory to initial therapy were included. Fifty patients underwent OPLD whilst 97 underwent a further caudal epidural. Outcomes were evaluated using McNab's score, improvement in visual analogue score (VAS) pain score, and requirement for further intervention. Follow-up occurred at 1 and 6 months, and comparison was made between groups. Results: OPLD achieved successful outcomes in almost three-quarters of patients in the short and medium term. OPLD achieved superior outcomes at 1 and 6 months compared to caudal epidural. There was a reduced requirement for further intervention in the OPLD group. No significant complications occurred in either group. Discussion: OPLD is a safe and effective treatment for patients with refractory discogenic sciatica in the short and medium term. OPLD has the potential to offer an alternative second-line minimally invasive treatment option that could reduce the requirement for surgery in this patient cohort. - Highlights: • Discogenic sciatica is a common condition which causes significant morbidity. • Ozone augmented percutaneous lumbar discectomy (OPLD) is a novel treatment. • Comparison was made to caudal epidural injection. • All outcomes were superior in the OPLD treatment group. • OPLD appears is an effective treatment for refractory discogenic sciatica

Insurance status effects on stage of diagnosis and surgical options used in the treatment of breast cancer.

Science.gov (United States)

Lukavsky, Robert; Sariego, Jack

2015-05-01

Insurance status has the potential to play a significant role in an individual's health care by affecting the time of diagnosis and the treatment options used. Our study reviewed insurance status as a determinant of the time of a breast cancer diagnosis as well as the surgical treatment options offered. The American College of Surgeons' National Cancer Database benchmark reports were used to examine first-course surgery stratified by the stage of breast cancer diagnosed between 2000 and 2010. The data were stratified according to insurance status with a focus on insured patients versus underinsured patients. The relations among insurance status, breast cancer stage at the time of presentation, and initial treatment offered were then evaluated. There was a statistically significant relation between breast cancer stage at the time of diagnosis and insurance status. There also was a relation between insurance status and the treatment offered. Adequately insured patients presented at an earlier stage than did underinsured patients. In addition, in patients who present with early-stage disease, insured patients had a higher rate of breast-conserving surgery than did underinsured patients, 62.4% and 55.5%, respectively. This trend continued in late-stage breast cancer, in which mastectomy was the predominant treatment option overall. Despite this, insured patients underwent breast-conserving therapy more frequently than did underinsured patients, 24.2% and 21.2%, respectively. The discrepancy of the stage of diagnosis between insured patients and underinsured patients can be attributed to a host of factors, among which are access to regular office visits and screening tests for breast cancer. In addition, the surgical treatment options used may depend on the cost of treatment and accessibility to and compliance with follow-up care.

Current and emerging treatment options for Peyronie's disease

Directory of Open Access Journals (Sweden)

Gokce A

2013-01-01

Full Text Available Ahmet Gokce, Julie C Wang, Mary K Powers, Wayne JG HellstromDepartment of Urology, Tulane University – School of Medicine, New Orleans, LA, USAAbstract: Peyronie's disease (PD is a condition of the penis, characterized by the presence of localized fibrotic plaque in the tunica albuginea. PD is not an uncommon disorder, with recent epidemiologic studies documenting a prevalence of 3–9% of adult men affected. The actual prevalence of PD may be even higher. It is often associated with penile pain, anatomical deformities in the erect penis, and difficulty with intromission. As the definitive pathophysiology of PD has not been completely elucidated, further basic research is required to make progress in the understanding of this enigmatic condition. Similarly, research on effective therapies is limited. Currently, nonsurgical treatments are used for those men who are in the acute stage of PD, whereas surgical options are reserved for men with established PD who cannot successfully penetrate. Intralesional treatments are growing in clinical popularity as a minimally invasive approach in the initial treatment of PD. A surgical approach should be considered when men with PD do not respond to conservative, medical, or minimally invasive therapies for approximately 1 year and cannot have satisfactory sexual intercourse. As scientific breakthroughs in the understanding of the mechanisms of this disease process evolve, novel treatments for the many men suffering with PD are anticipated.Keywords: oral therapy, intralesional treatment, topical therapy, extracorporeal shockwave therapy, traction devices, plication, incision and grafting, penile prosthesis.

Depression in Parkinson’s disease: Health risks, etiology, and treatment options

Directory of Open Access Journals (Sweden)

Pasquale G Frisina

2008-03-01

Full Text Available Pasquale G Frisina1,2, Joan C Borod3,4, Nancy S Foldi3,5, Harriet R Tenenbaum61Leir Parkinson’s Disease Program, The Jewish Home and Hospital Lifecare System, New York, NY, USA; 2Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY, USA; 3Department of Psychology, Queens College and The Graduate Center of the City University of New York (CUNY, Flushing, NY, USA; 4Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA; 5Department of Medicine, Winthrop-University Hospital, State University of New York, Stony Brook School of Medicine; 6Department of Psychology, Kingston University, Kingston upon Thames, UKAbstract: Depression is found in about 30%–40% of all patients with Parkinson’s disease (PD, but only a small percentage (about 20% receive treatment. As a consequence, many PD patients suffer with reduced health-related quality of life. To address quality of life in depressed PD patients, we reviewed the literature on the health correlates of depression in PD (eg, cognitive function, etiology of depression in PD, and treatment options (ie, antidepressants, electroconvulsive therapy, and psychotherapy. The current review is unique in its focus on psychosocial aspects, as well as neuropathological factors, of depression in PD. Overall, we conclude that neurochemical (eg, serotonin and psychosocial factors (eg, coping style, self-esteem, and social support contribute to the affective disturbances found in this neuropsychiatric population. Therefore, we recommend that a multidisciplinary (eg, pharmacotherapeutic, psychoeducational, and/or psychotherapeutic approach to treatment be taken with depressed PD patients.Keywords: depression, Parkinson’s disease, health outcomes, treatment options

In situ treatment of arsenic contaminated groundwater by aquifer iron coating: Experimental study

Energy Technology Data Exchange (ETDEWEB)

Xie, Xianjun, E-mail: xjxie@cug.edu.cn [State Key Laboratory of Biogeology and Environmental Geology, School of Environmental Studies, China University of Geosciences, 430074 Wuhan (China); Wang, Yanxin, E-mail: yx.wang@cug.edu.cn [State Key Laboratory of Biogeology and Environmental Geology, School of Environmental Studies, China University of Geosciences, 430074 Wuhan (China); Pi, Kunfu [State Key Laboratory of Biogeology and Environmental Geology, School of Environmental Studies, China University of Geosciences, 430074 Wuhan (China); Liu, Chongxuan [State Key Laboratory of Biogeology and Environmental Geology, School of Environmental Studies, China University of Geosciences, 430074 Wuhan (China); Pacific Northwest National Laboratory, Richland, WA 99354 (United States); Li, Junxia; Liu, Yaqing; Wang, Zhiqiang; Duan, Mengyu [State Key Laboratory of Biogeology and Environmental Geology, School of Environmental Studies, China University of Geosciences, 430074 Wuhan (China)

2015-09-15

In situ arsenic removal from groundwater by an aquifer iron coating method has great potential to be a cost effective and simple groundwater remediation technology, especially in rural and remote areas where groundwater is used as the main water source for drinking. The in situ arsenic removal technology was first optimized by simulating arsenic removal in various quartz sand columns under anoxic conditions. The effectiveness was then evaluated in an actual high-arsenic groundwater environment. The arsenic removal mechanism by the coated iron oxide/hydroxide was investigated under different conditions using scanning electron microscopy (SEM)/X-ray absorption spectroscopy, electron probe microanalysis, and Fourier transformation infrared spectroscopy. Aquifer iron coating method was developed via a 4-step alternating injection of oxidant, iron salt and oxygen-free water. A continuous injection of 5.0 mmol/L FeSO{sub 4} and 2.5 mmol/L NaClO for 96 h can form a uniform goethite coating on the surface of quartz sand without causing clogging. At a flow rate of 7.2 mL/min of the injection reagents, arsenic (as Na{sub 2}HAsO{sub 4}) and tracer fluorescein sodium to pass through the iron-coated quartz sand column were approximately at 126 and 7 column pore volumes, respectively. The retardation factor of arsenic was 23.0, and the adsorption capacity was 0.11 mol As per mol Fe. In situ arsenic removal from groundwater in an aquifer was achieved by simultaneous injections of As(V) and Fe(II) reagents. Arsenic fixation resulted from a process of adsorption/co-precipitation with fine goethite particles by way of bidentate binuclear complexes. Therefore, the study results indicate that the high arsenic removal efficiency of the in situ aquifer iron coating technology likely resulted from the expanded specific surface area of the small goethite particles, which enhanced arsenic sorption capability and/or from co-precipitation of arsenic on the surface of goethite particles

In situ treatment of arsenic contaminated groundwater by aquifer iron coating: Experimental study

International Nuclear Information System (INIS)

Xie, Xianjun; Wang, Yanxin; Pi, Kunfu; Liu, Chongxuan; Li, Junxia; Liu, Yaqing; Wang, Zhiqiang; Duan, Mengyu

2015-01-01

In situ arsenic removal from groundwater by an aquifer iron coating method has great potential to be a cost effective and simple groundwater remediation technology, especially in rural and remote areas where groundwater is used as the main water source for drinking. The in situ arsenic removal technology was first optimized by simulating arsenic removal in various quartz sand columns under anoxic conditions. The effectiveness was then evaluated in an actual high-arsenic groundwater environment. The arsenic removal mechanism by the coated iron oxide/hydroxide was investigated under different conditions using scanning electron microscopy (SEM)/X-ray absorption spectroscopy, electron probe microanalysis, and Fourier transformation infrared spectroscopy. Aquifer iron coating method was developed via a 4-step alternating injection of oxidant, iron salt and oxygen-free water. A continuous injection of 5.0 mmol/L FeSO 4 and 2.5 mmol/L NaClO for 96 h can form a uniform goethite coating on the surface of quartz sand without causing clogging. At a flow rate of 7.2 mL/min of the injection reagents, arsenic (as Na 2 HAsO 4 ) and tracer fluorescein sodium to pass through the iron-coated quartz sand column were approximately at 126 and 7 column pore volumes, respectively. The retardation factor of arsenic was 23.0, and the adsorption capacity was 0.11 mol As per mol Fe. In situ arsenic removal from groundwater in an aquifer was achieved by simultaneous injections of As(V) and Fe(II) reagents. Arsenic fixation resulted from a process of adsorption/co-precipitation with fine goethite particles by way of bidentate binuclear complexes. Therefore, the study results indicate that the high arsenic removal efficiency of the in situ aquifer iron coating technology likely resulted from the expanded specific surface area of the small goethite particles, which enhanced arsenic sorption capability and/or from co-precipitation of arsenic on the surface of goethite particles. - Highlights: �

HEMISECTION: A TREATMENT OPTION FOR AN ENDODONTICALLY TREATED MOLAR WITH VERTICAL ROOT FRACTURE

Directory of Open Access Journals (Sweden)

Anitha

2015-05-01

Full Text Available Vertical root fractures in endodontically treated teeth have long been reported and pose diagnostic difficulties. A h emisection/Root resection procedure which removes the fractured fragments completely, and retains a portion of the compromised tooth offers a predictable treatment option. The key to this rests in ideal case selection invol ving balancing all indications and contraindications. The success of the treatment depends on careful case selection based on a firm set of guidelines. This article presents a case with vertical root fracture in an endodontic treated molar. This article de scribes the case of a 60 - year - old man with a vertical root fracture on the mesial root and a healthy periodontium supporting the distal root making it ideal for retention as well as restoration and support of the final prosthesis. Also, the patient was mot ivated to try and save as much of the tooth as possible. Post - operatively no untoward complication was reported making it an alternative treatment option in patients with vertical root fracture in a molar, willing to retain the remaining tooth portion. Wit h all other factors balanced, it allows for retaining the remaining intact portion of the tooth structure.

Electronically Induced Redox Barriers for Treatment of Groundwater

National Research Council Canada - National Science Library

Sale, Tom; Gilbert, David

2006-01-01

...) and Colorado State University (CSU). The focus is an innovative electrolytic approach for managing redox-sensitive contaminants in groundwater, referred to as electrically induced redox barrier (e-barriers...

Pilot plant experiences using physical and biological treatment steps for the remediation of groundwater from a former MGP site

Energy Technology Data Exchange (ETDEWEB)

Wirthensohn, T. [University of Natural Resources and Applied Life Sciences-Vienna, Department of IFA-Tulln, Institute for Environmental Biotechnology, Konrad Lorenz Strasse 20, 3430 Tulln (Austria)], E-mail: thomas.wirthensohn@boku.ac.at; Schoeberl, P. [Wienenergie Gasnetz GmbH, Referat 17-Altlasten, Josefstaedterstrasse 10-12, 1080 Vienna (Austria); Ghosh, U. [Department of Civil and Environmental Engineering, University of Maryland Baltimore County, Baltimore, MD 21250 (United States); Fuchs, W. [University of Natural Resources and Applied Life Sciences-Vienna, Department of IFA-Tulln, Institute for Environmental Biotechnology, Konrad Lorenz Strasse 20, 3430 Tulln (Austria)

2009-04-15

The production of manufactured gas at a site in Vienna, Austria led to the contamination of soil and groundwater with various pollutants including PAHs, hydrocarbons, phenols, BTEX, and cyanide. The site needs to be remediated to alleviate potential impacts to the environment. The chosen remediation concept includes the excavation of the core contaminated site and the setup of a hydraulic barrier to protect the surrounding aquifer. The extracted groundwater will be treated on-site. To design the foreseen pump-and-treat system, a pilot-scale plant was built and operated for 6 months. The scope of the present study was to test the effectiveness of different process steps, which included an aerated sedimentation basin, a submerged fixed film reactor (SFFR), a multi-media filter, and an activated carbon filter. The hydraulic retention time (HRT) was 7.0 h during normal flow conditions and 3.5 h during high flow conditions. The treatment system was effective in reducing the various organic and inorganic pollutants in the pumped groundwater. However, it was also demonstrated that appropriate pre-treatment was essential to overcome problems with clogging due to precipitation of tar and sulfur compounds. The reduction of the typical contaminants, PAHs and BTEX, was more than 99.8%. All water quality parameters after treatment were below the Austrian legal requirements for discharge into public water bodies.

Pilot plant experiences using physical and biological treatment steps for the remediation of groundwater from a former MGP site.

Science.gov (United States)

Wirthensohn, T; Schoeberl, P; Ghosh, U; Fuchs, W

2009-04-15

The production of manufactured gas at a site in Vienna, Austria led to the contamination of soil and groundwater with various pollutants including PAHs, hydrocarbons, phenols, BTEX, and cyanide. The site needs to be remediated to alleviate potential impacts to the environment. The chosen remediation concept includes the excavation of the core contaminated site and the setup of a hydraulic barrier to protect the surrounding aquifer. The extracted groundwater will be treated on-site. To design the foreseen pump-and-treat system, a pilot-scale plant was built and operated for 6 months. The scope of the present study was to test the effectiveness of different process steps, which included an aerated sedimentation basin, a submerged fixed film reactor (SFFR), a multi-media filter, and an activated carbon filter. The hydraulic retention time (HRT) was 7.0 h during normal flow conditions and 3.5h during high flow conditions. The treatment system was effective in reducing the various organic and inorganic pollutants in the pumped groundwater. However, it was also demonstrated that appropriate pre-treatment was essential to overcome problems with clogging due to precipitation of tar and sulfur compounds. The reduction of the typical contaminants, PAHs and BTEX, was more than 99.8%. All water quality parameters after treatment were below the Austrian legal requirements for discharge into public water bodies.

Pilot plant experiences using physical and biological treatment steps for the remediation of groundwater from a former MGP site

International Nuclear Information System (INIS)

Wirthensohn, T.; Schoeberl, P.; Ghosh, U.; Fuchs, W.

2009-01-01

The production of manufactured gas at a site in Vienna, Austria led to the contamination of soil and groundwater with various pollutants including PAHs, hydrocarbons, phenols, BTEX, and cyanide. The site needs to be remediated to alleviate potential impacts to the environment. The chosen remediation concept includes the excavation of the core contaminated site and the setup of a hydraulic barrier to protect the surrounding aquifer. The extracted groundwater will be treated on-site. To design the foreseen pump-and-treat system, a pilot-scale plant was built and operated for 6 months. The scope of the present study was to test the effectiveness of different process steps, which included an aerated sedimentation basin, a submerged fixed film reactor (SFFR), a multi-media filter, and an activated carbon filter. The hydraulic retention time (HRT) was 7.0 h during normal flow conditions and 3.5 h during high flow conditions. The treatment system was effective in reducing the various organic and inorganic pollutants in the pumped groundwater. However, it was also demonstrated that appropriate pre-treatment was essential to overcome problems with clogging due to precipitation of tar and sulfur compounds. The reduction of the typical contaminants, PAHs and BTEX, was more than 99.8%. All water quality parameters after treatment were below the Austrian legal requirements for discharge into public water bodies

Direct measurements of the tile drain and groundwater flow route contributions to surface water contamination: from field-scale concentration patterns in groundwater to catchment-scale surface water quality

NARCIS (Netherlands)

Rozemeijer, J.C.; Velde, van der Y.; Geer, van F.C.; Broers, H.P.; Bierkens, M.F.P.

2010-01-01

Enhanced knowledge of water and solute pathways in catchments would improve the understanding of dynamics in water quality and would support the selection of appropriate water pollution mitigation options. For this study, we physically separated tile drain effluent and groundwater discharge from an

Direct measurements of the tile drain and groundwater flow route contributions to surface water contamination: From field-scale concentration patterns in groundwater to catchment-scale surface water quality

NARCIS (Netherlands)

Rozemeijer, J.C.; Velde, Y. van der; Geer, F.C. van; Bierkens, M.F.P.; Broers, H.P.

2010-01-01

Enhanced knowledge of water and solute pathways in catchments would improve the understanding of dynamics in water quality and would support the selection of appropriate water pollution mitigation options. For this study, we physically separated tile drain effluent and groundwater discharge from an

Prediction of Groundwater Quality Improvement Down-Gradient of In Situ Permeable Treatment Barriers and Fully-Remediated Source Zones. ESTCP Cost and Performance Report

National Research Council Canada - National Science Library

Johnson, Paul C; Carlson, Pamela M; Dahlen, Paul

2008-01-01

In situ permeable treatment barriers (PTB) are designed so that contaminated groundwater flows through an engineered treatment zone within which contaminants are eliminated or the concentrations are significantly reduced...

Bevacizumab as a treatment option for radiation-induced cerebral necrosis

Energy Technology Data Exchange (ETDEWEB)

Matuschek, Christiane; Boelke, Edwin; Budach, Wilfried [Univ. Hospital Duesseldorf (Germany). Dept. of Radiation Oncology; Nawatny, Jens [Univ. Hospital Duesseldorf (Germany). Dept. of Radiology; Hoffmann, Thomas K. [Duisburg-Essen Univ., Essen (Germany). Dept. of Otorhinolaryngology; Peiper, Matthias; Orth, Klaus [Hospital Essen-Sued, Essen (Germany). Dept. of Surgery; Gerber, Peter Arne [Univ. Hospital Duesseldorf (Germany). Dept. of Dermatology; Rusnak, Ethelyn [State Univ. of New York, Buffalo, NY (United States). Dept. of Anesthesiology; Lammering, Guido [Univ. Hospital Duesseldorf (Germany). Dept. of Radiation Oncology; MAASTRO Clinic, Maastricht (Netherlands). Radiation Oncology

2011-02-15

Radiation necrosis of normal CNS tissue represents one of the main risk factors of brain irradiation, occurring more frequently and earlier at higher total doses and higher doses per fraction. At present, it is believed that the necrosis results due to increasing capillary permeability caused by cytokine release leading to extracellular edema. This process is sustained by endothelial dysfunction, tissue hypoxia, and subsequent necrosis. Consequently, blocking the vascular endothelial growth factor (VEGF) at an early stage could be an option to reduce the development of radiation necrosis by decreasing the vascular permeability. This might help to reverse the pathological mechanisms, improve the symptoms and prevent further progression. A patient with radiation-induced necrosis was treated with an anti-VEGF antibody (bevacizumab), in whom neurologic signs and symptoms improved in accordance with a decrease in T1-weighted fluid-attenuated inversion recovery signals. Our case report together with the current literature suggests bevacizumab as a treatment option for patients with symptoms and radiological signs of cerebral necrosis induced by radiotherapy. (orig.)

Bevacizumab as a treatment option for radiation-induced cerebral necrosis

International Nuclear Information System (INIS)

Matuschek, Christiane; Boelke, Edwin; Budach, Wilfried; Nawatny, Jens; Hoffmann, Thomas K.; Peiper, Matthias; Orth, Klaus; Gerber, Peter Arne; Rusnak, Ethelyn; Lammering, Guido; MAASTRO Clinic, Maastricht

2011-01-01

Radiation necrosis of normal CNS tissue represents one of the main risk factors of brain irradiation, occurring more frequently and earlier at higher total doses and higher doses per fraction. At present, it is believed that the necrosis results due to increasing capillary permeability caused by cytokine release leading to extracellular edema. This process is sustained by endothelial dysfunction, tissue hypoxia, and subsequent necrosis. Consequently, blocking the vascular endothelial growth factor (VEGF) at an early stage could be an option to reduce the development of radiation necrosis by decreasing the vascular permeability. This might help to reverse the pathological mechanisms, improve the symptoms and prevent further progression. A patient with radiation-induced necrosis was treated with an anti-VEGF antibody (bevacizumab), in whom neurologic signs and symptoms improved in accordance with a decrease in T1-weighted fluid-attenuated inversion recovery signals. Our case report together with the current literature suggests bevacizumab as a treatment option for patients with symptoms and radiological signs of cerebral necrosis induced by radiotherapy. (orig.)

Assessing quality and quantity of groundwater DOC in relation to plant export from different over-winter green-cover treatments in tillage farming systems

Science.gov (United States)

Premrov, Alina; Coxon, Catherine; Hackett, Richard; Richards, Karl

2010-05-01

The biogeochemistry of nitrogen is often connected to carbon and C/N dynamics. The dissolved organic carbon (DOC) electron donor availability can be related to groundwater denitrification (Buss, et al. 2005). Therefore groundwater nitrate attenuation processes are also frequently linked to carbon availability. In recent years the role of over-winter green cover in tillage farming has been studied extensively. Nevertheless further research on the biogeochemical effect of green cover on soil/sediment and groundwater quality is still needed. In particular plant roots are known to exude different types of organic compounds, but their role in groundwater quality has not been investigated in depth. According to Cannavo et al. (2004a,b), in addition to quantity, the quality of water-extractable soil organic matter (e.g. molecular size/weight) has also an important role for microbial activity. In this study we investigate the effect of over-winter green-cover on potential DOC export to shallow groundwater (2 - 5 m below ground level), located on tillage land in Oak Park, Carlow, Ireland. The experiment includes three over-winter green-cover treatments: natural green-cover, mustard and no-cover (sprayed with herbicide following harvest); and is underlain by a sand and gravel aquifer. The site is equipped with 4 shallow piezometers per treatment (total no. of piezometers is 20, including treatments and surrounding piezometers). In addition to monitoring the quantity of DOC concentrations in shallow groundwater under different green cover treatments over time, an attempt was made to evaluate the quality of dissolved organic matter in shallow groundwater using Excitation Emission Fluorescence Matrix (EEFM) profiles obtained from analyses performed on a Varian Fluorescence Spectrophotometer of a single batch of samples (from all 20 installed piezometers in September 2009). To evaluate the quality of dissolved organic matter in shallow groundwater, computation of the

Environmental analysis of closure options for waste sites at the Savannah River Plant

International Nuclear Information System (INIS)

Gordon, D.E.; King, C.M.; Looney, B.B.; Stephenson, D.E.; Johnson, W.F.

1987-01-01

Previously acceptable waste management practices (e.g., the use of unlined seepage basins) for discarding of wastes from nuclear materials production has resulted in occasional cases of groundwater contamination beneath some disposal sites, mainly in water-table aquifers. Groundwater contaminants include volatile organic compounds, heavy metals, radionuclides, and other chemicals. The closure of active and inactive waste sites that have received hazardous and/or low-level radioactive materials at the Savannah River Plant (SRP) is planned as part of an overall program to protect groundwater quality. DOE developed and submitted to Congress a groundwater protection plan for SRP. This initial plan and subsequent revisions provide the basis for closure of SRP waste sites to comply with applicable groundwater protection requirements. An environmental analysis of the closure options for the criteria waste sites that have received hazardous and/or low-level radioactive wastes was conducted to provide technical support. The several parts of this environmental analysis include description of geohydrologic conditions; determination of waste inventories; definition of closure options; modeling of environmental pathways; assessment of risk; and analysis of project costs. Each of these components of the overall analysis is described in turn in the following paragraphs. Production operations at SRP have generated a variety of solid, hazardous, and low-level radioactive waste materials. Several locations onplant have been used as waste disposal sites for solid and liquid wastes. Seventy-six individual waste sites at 45 distinct geographical locations on SRP have received hazardous, low-level radioactive, or mixed wastes. These waste sites can be categorized into 26 groupings according to the function of the waste disposed. 15 refs., 6 figs., 5 tabs

Generalized Aggressive Periodontitis and Its Treatment Options: Case Reports and Review of the Literature

Directory of Open Access Journals (Sweden)

T. Roshna

2012-01-01

Full Text Available Generalized aggressive periodontitis results in rapid destruction of the periodontium and can lead to early tooth loss in the affected individuals if not diagnosed early and treated appropriately. The diagnostic features of the disease are characteristic, but the clinical presentation and patterns of destructions may vary between patients. Successful management of the disease is challenging especially if diagnosed at advanced stages of the disease, but not impossible with the current therapeutic choices for the disease. A vast array of treatment modalities is available which can be employed in the treatment of generalized aggressive periodontitis with varying success rates, but a definite guideline for the management is yet to be formulated. However, with the exponential rate of developments in periodontal research, regenerative therapy, tissue engineering, and genetic technologies, the future seems promising in regard to options at managing the disease. This paper attempts to describe the clinical and radiographic diagnostic features and the current treatment options along with a suggested protocol for comprehensive management of generalized aggressive periodontitis patients with case reports and a brief review.

Remedial Process Optimization and Green In-Situ Ozone Sparging for Treatment of Groundwater Impacted with Petroleum Hydrocarbons

Science.gov (United States)

Leu, J.

2012-12-01

A former natural gas processing station is impacted with TPH and BTEX in groundwater. Air sparging and soil vapor extraction (AS/AVE) remediation systems had previously been operated at the site. Currently, a groundwater extraction and treatment system is operated to remove the chemicals of concern (COC) and contain the groundwater plume from migrating offsite. A remedial process optimization (RPO) was conducted to evaluate the effectiveness of historic and current remedial activities and recommend an approach to optimize the remedial activities. The RPO concluded that both the AS/SVE system and the groundwater extraction system have reached the practical limits of COC mass removal and COC concentration reduction. The RPO recommended an in-situ chemical oxidation (ISCO) study to evaluate the best ISCO oxidant and approach. An ISCO bench test was conducted to evaluate COC removal efficiency and secondary impacts to recommend an application dosage. Ozone was selected among four oxidants based on implementability, effectiveness, safety, and media impacts. The bench test concluded that ozone demand was 8 to 12 mg ozone/mg TPH and secondary groundwater by-products of ISCO include hexavalent chromium and bromate. The pH also increased moderately during ozone sparging and the TDS increased by approximately 20% after 48 hours of ozone treatment. Prior to the ISCO pilot study, a capture zone analysis (CZA) was conducted to ensure containment of the injected oxidant within the existing groundwater extraction system. The CZA was conducted through a groundwater flow modeling using MODFLOW. The model indicated that 85%, 90%, and 95% of an injected oxidant could be captured when a well pair is injecting and extracting at 2, 5, and 10 gallons per minute, respectively. An ISCO pilot test using ozone was conducted to evaluate operation parameters for ozone delivery. The ozone sparging system consisted of an ozone generator capable of delivering 6 lbs/day ozone through two ozone

[The Probabilistic Efficiency Frontier: A Value Assessment of Treatment Options in Hepatitis C].

Science.gov (United States)

Mühlbacher, Axel C; Sadler, Andrew

2017-06-19

Background The German Institute for Quality and Efficiency in Health Care (IQWiG) recommends the concept of the efficiency frontier to assess health care interventions. The efficiency frontier supports regulatory decisions on reimbursement prices for the appropriate allocation of health care resources. Until today this cost-benefit assessment framework has only been applied on the basis of individual patient-relevant endpoints. This contradicts the reality of a multi-dimensional patient benefit. Objective The objective of this study was to illustrate the operationalization of multi-dimensional benefit considering the uncertainty in clinical effects and preference data in order to calculate the efficiency of different treatment options for hepatitis C (HCV). This case study shows how methodological challenges could be overcome in order to use the efficiency frontier for economic analysis and health care decision-making. Method The operationalization of patient benefit was carried out on several patient-relevant endpoints. Preference data from a discrete choice experiment (DCE) study and clinical data based on clinical trials, which reflected the patient and the clinical perspective, respectively, were used for the aggregation of an overall benefit score. A probabilistic efficiency frontier was constructed in a Monte Carlo simulation with 10000 random draws. Patient-relevant endpoints were modeled with a beta distribution and preference data with a normal distribution. The assessment of overall benefit and costs provided information about the adequacy of the treatment prices. The parameter uncertainty was illustrated by the price-acceptability-curve and the net monetary benefit. Results Based on the clinical and preference data in Germany, the interferon-free treatment options proved to be efficient for the current price level. The interferon-free therapies of the latest generation achieved a positive net cost-benefit. Within the decision model, these therapies

Biological fluidized-bed treatment of groundwater from a manufactured gas plant site

International Nuclear Information System (INIS)

Grey, G.M.; Scheible, O.K.; Maiello, J.A.; Guarini, W.J.; Sutton, P.M.

1995-01-01

Bench- and pilot-scale biological treatability studies were performed as part of a comprehensive study for developing an on-site treatment system for contaminated groundwater at a former manufactured gas plant site. The bench-scale work, which included evaluations of activated sludge and fluidized-bed biological processes, indicated that a carbon-based fluidized-bed process was most appropriate. The process was then demonstrated on a pilot level at the site. The bench and pilot studies demonstrated significant reductions of chemical oxygen demand (COD), and all target organics including polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs)

Field evaluation of a horizontal well recirculation system for groundwater treatment: Field demonstration at X-701B Portsmouth Gaseous Diffusion Plant, Piketon, Ohio

International Nuclear Information System (INIS)

Korte, N.; Muck, M.; Kearl, P.; Siegrist, R.; Schlosser, R.; Zutman, J.; Houk, T.

1998-01-01

This report describes the field-scale demonstration performed as part of the project, In Situ Treatment of Mixed Contaminants in Groundwater. This project was a 3 1/2 year effort comprised of laboratory work performed at Oak Ridge National Laboratory and fieldwork performed at the US Department of Energy (DOE) Portsmouth Gaseous Diffusion Plant (PORTS). The overall goal of the project was to evaluate in situ treatment of groundwater using horizontal recirculation coupled with treatment modules. Specifically, horizontal recirculation was tested because of its application to thin, interbedded aquifer zones. Mixed contaminants were targeted because of their prominence at DOE sites and because they cannot be treated with conventional methods. The project involved several research elements, including treatment process evaluation, hydrodynamic flow and transport modeling, pilot testing at an uncontaminated site, and full-scale testing at a contaminated site. This report presents the results of the work at the contaminated site, X-701B at PORTS. Groundwater contamination at X-701B consists of trichloroethene (TCE) (concentrations up to 1800 mg/L) and technetium-998 (Tc 99 ) (activities up to 926 pCi/L)

Field evaluation of a horizontal well recirculation system for groundwater treatment: Field demonstration at X-701B Portsmouth Gaseous Diffusion Plant, Piketon, Ohio

Energy Technology Data Exchange (ETDEWEB)

Korte, N.; Muck, M.; Kearl, P.; Siegrist, R.; Schlosser, R.; Zutman, J. [Oak Ridge National Lab., TN (United States); Houk, T. [Lockheed Martin Energy Systems, Piketon, OH (United States). Portsmouth Gaseous Diffusion Plant

1998-08-01

This report describes the field-scale demonstration performed as part of the project, In Situ Treatment of Mixed Contaminants in Groundwater. This project was a 3{1/2} year effort comprised of laboratory work performed at Oak Ridge National Laboratory and fieldwork performed at the US Department of Energy (DOE) Portsmouth Gaseous Diffusion Plant (PORTS). The overall goal of the project was to evaluate in situ treatment of groundwater using horizontal recirculation coupled with treatment modules. Specifically, horizontal recirculation was tested because of its application to thin, interbedded aquifer zones. Mixed contaminants were targeted because of their prominence at DOE sites and because they cannot be treated with conventional methods. The project involved several research elements, including treatment process evaluation, hydrodynamic flow and transport modeling, pilot testing at an uncontaminated site, and full-scale testing at a contaminated site. This report presents the results of the work at the contaminated site, X-701B at PORTS. Groundwater contamination at X-701B consists of trichloroethene (TCE) (concentrations up to 1800 mg/L) and technetium-998 (Tc{sup 99}) (activities up to 926 pCi/L).

Sustainable Optimization for Wastewater Treatment System Using PSF-HS

Directory of Open Access Journals (Sweden)

Zong Woo Geem

2016-03-01

Full Text Available The sustainability in a river with respect to water quality is critical because it is highly related with environmental pollution, economic expenditure, and public health. This study proposes a sustainability problem of wastewater treatment system for river ecosystem conservation which helps the healthy survival of the aquatic biota and human beings. This study optimizes the design of a wastewater treatment system using the parameter-setting-free harmony search algorithm, which does not require the existing tedious value-setting process for algorithm parameters. The real-scale system has three different options of wastewater treatment, such as filtration, nitrification, and diverted irrigation (fertilization, as well as two existing treatment processes (settling and biological oxidation. The objective of this system design is to minimize life cycle costs, including initial construction costs of those treatment options, while satisfying minimal dissolved oxygen requirements in the river, maximal nitrate-nitrogen concentration in groundwater, and a minimal nitrogen requirement for crop farming. Results show that the proposed technique could successfully find solutions without requiring a tedious setting process.

Detailing new and emerging groundwater pollutants and their potential risk to groundwater environments

OpenAIRE

Stuart, Marianne; Lapworth, Dan; Manamsa, Katya

2014-01-01

Many different sources and pathways into groundwater: wastewater, biosolids from water treatment and animal wastes are important Frequently detected groups of ECs include antimicrobials, lifestyle compounds, pharmaceuticals Although mostly detected in low ng/L concentrations in groundwater there are many examples of hot spots TPs can be found at concentrations higher than the parent and may be more mobile or polar, and more toxic ECs can be typical of source/landuse Some are re...

Groundwater issues relating to an Alaskan methanol spill

International Nuclear Information System (INIS)

Robertson, S.B.

1992-01-01

This paper reports on a Dec. 1989 methanol spill which resulted from sabotage to three railroad tank cars. Samples taken from nearby drinking-water wells and groundwater-monitoring wells were below the analytical detection limit. Monitoring well data demonstrated that groundwater flow was not toward local residential wells. Dilution by snow and subsequent freezing in the soil limited the downward spread of the methanol, an advantage not found in milder, more temperate conditions. Contaminated material was removed and processed to reclaim the methanol. Volatilization and biodegradation should remove any remaining methanol. Cleanup options were limited by the possible hazardous waste classification of the contaminated soil. The regulatory status of spilled methanol waste should be re-evaluated, especially if use of methanol as a motor fuel increases

Indicators to identify the source of pesticide contamination to groundwater

DEFF Research Database (Denmark)

Thorling, Lærke; Brüsch, Walter; Tuxen, Nina

In Denmark groundwater is synonym with drinking water. The mainstream Danish political approach favors prevention and action at source over advanced treatments of polluted groundwater. The main pollutants are nitrate and pesticides. Pesticides in groundwater can originate from either diffuse or p...

Acupuncture as a therapeutic treatment option for threatened miscarriage

Directory of Open Access Journals (Sweden)

Betts Debra

2012-03-01

Full Text Available Abstract Background Threatened miscarriage involves vaginal bleeding in a pregnancy that remains viable. This is a common early pregnancy complication with increased risk factors for early pregnancy loss, preterm premature rupture of membranes (PPROM, preterm delivery, low birth weight babies and maternal antepartum haemorrhage. Currently there are no recommended medical treatment options, rather women receive advice that centres on a 'wait and see' approach. For women with a history of unexplained recurrent miscarriage providing supportive care in a subsequent pregnancy improves live birthing outcomes, but the provision of supportive care to women experiencing threatened miscarriage has to date not been examined. Discussion While it is known that 50-70% of miscarriages occur due to chromosomal abnormalities, the potential for therapeutic intervention amongst the remaining percentage of women remains unknown. Complementary and alternative medicine (CAM therapies have the potential to provide supportive care for women presenting with threatened miscarriage. Within fertility research, acupuncture demonstrates beneficial hormonal responses with decreased miscarriage rates, raising the possibility acupuncture may promote specific beneficial effects in early pregnancy. With the lack of current medical options for women presenting with threatened miscarriage it is timely to examine the possible treatment benefits of providing CAM therapies such as acupuncture. Summary Despite vaginal bleeding being a common complication of early pregnancy there is often reluctance from practitioners to discuss with women and medical personal how and why CAM may be beneficial. In this debate article, the physiological processes of early pregnancy together with the concept of providing supportive care and acupuncture are examined. The aim is to raise awareness and promote discussion as to the beneficial role CAM may have for women presenting with threatened miscarriage.

Effect of Organic Matter on Cr(VI Removal from Groundwaters by Fe(II Reductive Precipitation for Groundwater Treatment

Directory of Open Access Journals (Sweden)

Anna Gröhlich

2017-06-01

Full Text Available Due to its toxicity, Cr(VI is undesirable in groundwater. Its chemical reduction to Cr(III species, followed by precipitation is the most widely practiced treatment technique for the removal of Cr(VI from polluted waters. The resulting Cr(III species present low solubility, is much less toxic, and can be subsequently removed either by precipitation, or by adsorption onto iron oxy-hydroxides and co-precipitation. The effects of several parameters, such as the pH value of water to be treated, the applied Fe(II dose, and the presence of appropriate mineral surfaces, are well investigated and understood. However, the impact of the presence of humic acids (HAs in this process has only been considered by rather few studies. The main aim of this study was to determine the effect of humic substances on Fe(II reductive precipitation of Cr(VI within a pH range relevant for drinking water treatment. Jar test experiments were performed, using artificial groundwater of defined composition and initial Cr(VI concentration 100 μg/L, ferrous sulphate dosages 0.25–2 mg Fe(II/L, and pH values 6.5–8. It was found that Cr(VI and total chromium (Cr(total can be reliably removed in the absence of HAs in the tested pH range with the addition of Fe(II dosage of 1 mg Fe(II/L. Further on, the results indicated that the reduction of Cr(VI is only slightly affected by the presence of HAs. However, increased residual total Cr concentrations were found at lower Fe(II dosages and/or higher pH values. Additionally, the removal of the Cr(III species formed during Cr(VI reduction was strongly inhibited by the presence of HAs under the examined experimental conditions, since residual concentrations higher than 60 μg/L were determined. The results of this study will have implications to the ongoing discussion of a new, stricter, European Union regulation limit, regarding the presence of total chromium in drinking water.

Analysis and integrated modelling of groundwater infiltration to sewer networks

DEFF Research Database (Denmark)

Thorndahl, Søren Liedtke; Balling, Jonas Dueholm; Larsen, Uffe Bay Bøgh

2016-01-01

Infiltration of groundwater to sewer systems is a problem for the capacity of the system as well as for treatment processes at waste water treatment plants. This paper quantifies the infiltration of groundwater to a sewer system in Frederikshavn Municipality, Denmark, by measurements of sewer flo...

Laboratory evaluation of the in situ chemical treatment approach to soil and groundwater remediation

International Nuclear Information System (INIS)

Thorton, E.C.; Trader, D.E.

1993-10-01

Results of initial proof of principle laboratory testing activities successfully demonstrated the viability of the in situ chemical treatment approach for remediation of soil and groundwater contaminated by hexavalent chromium. Testing activities currently in progress further indicate that soils contaminated with hexavalent chromium and uranium at concentrations of several hundred parts per million can be successfully treated with 100 ppM hydrogen sulfide gas mixtures. Greater than 90% immobilization of hexavalent chromium and 50% immobilization of uranium have been achieved in these tests after a treatment period of one day. Activities associated with further development and implementation of the in situ chemical treatment approach include conducting additional bench scale tests with contaminated geomedia, and undertaking scale-up laboratory tests and a field demonstration. This report discusses the testing and further development of this process

Characterization and comparison of iron oxyhydroxide precipitates from biotic and abiotic groundwater treatments

DEFF Research Database (Denmark)

Arturi, Katarzyna R.; Bender Koch, Christian; Søgaard, Erik G.

2017-01-01

Removal of iron is an important step in groundwater treatment for drinking water production. It is performed to prevent organoleptic issues and clogging in water supply systems. Iron can be eliminated with a purely physico-chemical (abiotic) method or biotically with the help of iron......-oxidizing bacteria (FeOB). Each of the purification methods requires different operating conditions and results in formation of iron oxyhydroxide (FeOOH) precipitates. Knowledge about the differences in composition and properties of the biotic and abiotic precipitates is desirable from a technical, but also...

A/M Area Groundwater Corrective Action Southern Sector Remediation Technology Alternatives Evaluation

International Nuclear Information System (INIS)

Looney, B.B.; Phifer, M.A.

1994-01-01

Several technologies for clean up of solvents such as trichloroethylene, from groundwater were examined to determine the most reasonable strategy for the southern Sector in A/M Area of Savannah River Site. The most promising options identified were: pump and treat technology, airlift recirculation technology, and bioremediation technology. These options range from baseline/traditional methods to more innovative technologies. The traditional methods would be straightforward to implement, while the innovative methods have the potential to improve efficiency and reduce long term costs

Spinal Cord Injury in the Geriatric Population: Risk Factors, Treatment Options, and Long-Term Management.

Science.gov (United States)

Ikpeze, Tochukwu C; Mesfin, Addisu

2017-06-01

Spinal cord injuries (SCIs) are sustained by more than 12 500 patients per year in the United States and more globally. The SCIs disproportionately affect the elderly, especially men. Approximately 60% of these injuries are sustained traumatically through falls, but nontraumatic causes including infections, tumors, and medication-related epidural bleeding have also been documented. Preexisting conditions such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis can render the spine stiff and are risk factors as well as cervical spondylosis and ensuing cervical stenosis. Treatment options vary depending on the severity, location, and complexity of the injury. Surgical management has been growing in popularity over the years and remains an option as it helps reduce spinal cord compression and alleviate pain. Elevating mean arterial pressures to prevent spinal cord ischemia and avoiding the second hit of SCI have become more common as opposed to high dose steroids. Ongoing clinical trials with pharmacological agents such as minocycline and riluzole have shown early, promising results in their ability to reduce cellular damage and facilitate recovery. Though SCI can be life changing, the available treatment options have aimed to reduce pain and minimize complications and maintain quality of life alongside rehabilitative services.

Mixed waste management options

International Nuclear Information System (INIS)

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

1992-01-01

Currently, limited storage and treatment capacity exists for commercial mixed waste streams. No commercial mixed waste disposal is available, and it has been estimated that if and when commercial mixed waste disposal becomes available, the costs will be high. If high disposal fees are imposed, generators may be willing to apply extraordinary treatment or regulatory approaches to properly dispose of their mixed waste. This paper explores the feasibility of several waste management scenarios and management options. Existing data on commercially generated mixed waste streams are used to identify the realm of mixed waste known to be generated. Each waste stream is evaluated from both a regulatory and technical perspective in order to convert the waste into a strictly low-level radioactive or a hazardous waste. Alternative regulatory approaches evaluated in this paper include a delisting petition) no migration petition) and a treatability variance. For each waste stream, potentially available treatment options are identified that could lead to these variances. Waste minimization methodology and storage for decay are also considered. Economic feasibility of each option is discussed broadly. Another option for mixed waste management that is being explored is the feasibility of Department of Energy (DOE) accepting commercial mixed waste for treatment, storage, and disposal. A study has been completed that analyzes DOE treatment capacity in comparison with commercial mixed waste streams. (author)

Nonsurgical and surgical treatment of periodontitis: how many options for one disease?

Science.gov (United States)

Graziani, Filippo; Karapetsa, Dimitra; Alonso, Bettina; Herrera, David

2017-10-01

Treatment of periodontitis aims at preventing further disease progression with the intentions to reduce the risk of tooth loss, minimize symptoms and perception of the disease, possibly restore lost periodontal tissue and provide information on maintaining a healthy periodontium. Therapeutic intervention includes introduction of techniques to change behavior, such as: individually tailored oral-hygiene instructions; a smoking-cessation program; dietary adjustment; subgingival instrumentation to remove plaque and calculus; local and systemic pharmacotherapy; and various types of surgery. No single treatment option has shown superiority, and virtually all types of mechanical periodontal treatment benefit from adjunctive antimicrobial chemotherapy. Periodontal treatment, because of the chronic nature of periodontitis, is a lifelong commitment to intricate oral-hygiene techniques, which, when properly implemented, will minimize the risk of disease initiation and progression. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Antenatal Hydronephrosis: Differential Diagnosis, Evaluation, and Treatment Options

Science.gov (United States)

Herndon, C.D. Anthony

2006-01-01

The diagnosis, evaluation and management of antenatal hydronephrosis has undergone a two stage paradigm shift since the advent of prenatal ultrasonography in the early 1980s. Initially the identification of a large number of asymptomatic infants appeared to afford the surgeon the opportunity for preemptive intervention. However, it has now become apparent that antenatal hydronephrosis (AH) is far more difficult to interpret thanoriginally perceived. The initial enthusiasm for surgery has now been replaced by a much more conservative approach to ureteropelvic junction(UPJ) obstruction, multi-cystic dysplastic kidney(MCDK), vesicoureteral reflux and the non-refluxing megaureter. This review will highlight the postnatal evaluation of AH and include an overview of the Society for Fetal Urology grading system for hydronephrosis. The differential diagnosis and treatment options for UPJ obstruction, vesicoureteral reflux, MCDK, duplication anomalies, megaureter, and posterior urethral valves will be discussed. PMID:17619702

Permeable Reactive Barriers: a multidisciplinary approach of a new emerging sustainable groundwater treatment technology

Energy Technology Data Exchange (ETDEWEB)

Diels, L.; Bastiaens, L. [Vito, Mol (BL); O' Hannessin, S. [EnviroMetal Technologies Inc., Ontario (Canada); Cortina, J.L. [Univ. Politecnica de Catalunya, Barcelona (Spain). Dept. d' Enginyeria Quimica; Alvarez, P.J. [Univ. of Iowa, Iowa-City (United States). Center for Biocatalysis and Bioprocessing; Ebert, M. [Christian-Albrechts Univ. Kiel (Germany). Inst. fuer Geowissenschaften; Schad, H. [I.M.E.S. GmbH, Amtzell (Germany)

2003-07-01

Permeable reactive barriers or zones are becoming an interesting sustainable and cost-effective technology for in situ treatment of contaminated groundwater. The technology is based on chemical processes as the dehalogenating activity of zerovalent iron, biological processes in bioscreens or reactive zones and on sorption technology (e.g. heavy metal adsorption or adsorption on granular activated carbon). Three technical sessions will be devoted to this nowadays becoming mature technology. This special session intends to pay attention to the discussion about some questions related to PRBs. These include the sustainability (e.g. life time and clogging) especially for zerovalent iron barriers, the need and quality of feasibility tests, drawbacks and restrictions of PRBs. Combined with long term performance monitoring os these systems will be discussed. Further attention will be paid to cost evaluation and the relationship between zerovalent barriers and bacterial growth. Also attention will be paid to new reactive materials (e.g. activated carbon for organics and inorganic materials for heavy metals) and consequences (e.g. environmental impact). Finally the session will combine al these approaches in a discussion about combined barriers or multibarriers for treatment of mixed pollution (e.g. landfill leachates contaminated groundwater). Specialists involved in these subjects will introduce these topics and allow for a large and intensive discussion to improve future applications of this technology. (orig.)

Conservative Eulerian-Lagrangian Methods and Mixed Finite Element Methods for Modeling of Groundwater Flow and Transport

National Research Council Canada - National Science Library

Russell, Thomas

2000-01-01

New, improved computational methods for modeling of groundwater flow and transport have been formulated and implemented, with the intention of incorporating them as user options into the DoD Ground...

Transepidermal drug delivery: a new treatment option for areata alopecia?

Science.gov (United States)

Issa, Maria Claudia Almeida; Pires, Marianna; Silveira, Priscilla; Xavier de Brito, Esther; Sasajima, Cristiane

2015-02-01

Transepidermal drug delivery (TED) is a new potential method in dermatology. Permeability alterations induced by ablative fractional resurfacing have been described with the aim to increasing the delivery of different substances into the skin. To evaluate clinical response and side effects of TED in areata alopecia (AA) treatment using ablative fractional methods associated with acoustic pressure ultrasound (US) to deliver triamcinolone solution into the skin. Five cases of AA underwent treatment which comprised of 3 steps: 1) Ablative fractioned RF or CO2 laser 2) topical application of triamcinolone 3) acoustic pressure wave US. The number of sessions varied according to the clinical response, ranging from one to six sessions. All patients had complete recovery of the area treated. Two of them treated with ablative fractional RF + triamcinolone + US had complete response after three and six sessions. The other two treated with ablative fractional CO2 + triamcinolone + US had complete response after one session. Fractioned ablative resurfacing associated with acoustic pressure wave US is a new option to areata alopecia treatment with good clinical result and low incidence of side effects.

Water use and groundwater contamination

International Nuclear Information System (INIS)

Elton, J.J.; Livingstone, B.

1998-01-01

A general review of the groundwater resources in Saskatchewan and their vulnerability to contamination was provided. In particular, the use of water and the effects on water by the oil and gas industry in Saskatchewan were discussed. It was suggested that public concerns over scarcity and contamination of water are gradually changing perceptions about Canada's abundance of water. Saskatchewan's surface water covers 12 per cent of the province. About 90 per cent of the rural populations and 80 per cent of municipalities depend on groundwater supplies. Regulations affecting oil and gas operations that could affect water resources have become more stringent. Techniques used in the detection and monitoring of groundwater affected by salt and petroleum hydrocarbons were described. Electromagnetic surveys are used in detecting salt-affected soils and groundwater. Laboratory analysis of chloride concentrations are needed to define actual chloride concentrations in groundwater. Wells and barriers can be installed to control and recover chloride plumes. Deep well injection and reverse osmosis are other methods, but there is no cheap or simple treatment or disposal method for salt-impacted groundwater. Spills or leaks of petroleum hydrocarbons from various sources can also lead to contamination of groundwater. Various assessment and remediation methods are described. Although there is no scarcity of techniques, all of them are difficult, costly, and may take several years to complete. 11 refs., 1 tab

Regulatory and Technical Issues Concerning the Detection and Treatment of NDMA-Contaminated Groundwater at NASA WSTF

Science.gov (United States)

Wiebe, D. T.; Zigmond, M. J.; Tufts, C. A.

2002-01-01

The National Aeronautics and Space Administration (NASA) White Sands Test Facility (WSTF) was established in 1963 primarily to provide rocket engine testing services for several NASA programs. The groundwater underlying the site has been contaminated as a result of historical operations. Groundwater contaminants include several volatile organic compounds (VOCs) and two semi-volatile compounds: N-nitrosodimethylamine (NDMA) and N-nitrodimethylamine (DMN). This paper discusses some of the technical, analytical, regulatory, and health risk issues associated with the contaminant plume. The plume has moved approximately 2.5 miles downgradient of the facility industrial boundary, with evidence of continued migration. As a result, NASA has proposed a pump and treat system using air strippers and ultraviolet (UV) oxidation to stabilize future movement of the contaminant plume. The system has been designed to treat 1,076 gallons (4,073 liters) per minute, with provisions for future expansion. The UV oxidation process was selected to treat NDMA-contaminated groundwater based on successes at other NDMA-contaminated sites. Bench- and pilot-scale testing of WSTF groundwater confirmed the ability of UV oxidation to destroy NDMA and generated sufficient data to design the proposed full-scale treatment system. NDMA is acutely toxic and is a probable human carcinogen. EPA-recommended health risk criteria for the residential consumption of NDMA/DMN-contaminated groundwater was used to determine that a 1.0 x 10(exp -6) excess cancer risk corresponds to 1.7 parts per trillion (ppt). EPA analytical methods are unable to detect NDMA and DMN in the low ppt range. EPA's current Appendix IX analytical method used to screen for NDMA, Method 8270, can detect NDMA only at levels that are orders of magnitude greater than the recommended health risk level. Additionally, EPA Method 607, the most sensitive EPA approved method, has a detection limit of 150 ppt. This corresponds to an excess cancer

Patellofemoral pain syndrome in female athletes: A review of diagnoses, etiology and treatment options.

Science.gov (United States)

Vora, Molly; Curry, Emily; Chipman, Amanda; Matzkin, Elizabeth; Li, Xinning

2017-12-14

Patellofemoral pain syndrome (PFPS) is one of the most common causes of knee pain and is present in females disproportionately more relative to males. PFPS causes tend to be multifactorial in nature and are described in this review. From a review of the current literature, it is clear that there needs to be further research on PFPS in order to better understand the complex etiology of this disorder in both males and females. It is known that females with patellofemoral pain syndrome demonstrate a decrease in abduction, external rotation and extension strength of the affected side compared with healthy patients. Conservative management, including optimizing muscle balance between the vastus medialis and lateralis around the patella along with formal therapy should be the first line of treatment in patients presenting with PFPS. Surgery should be reserved for patients in which all conservative management options have failed. This review aims to guide physicians in accurate clinicaldecision making regarding conservative and surgical treatment options when specifically faced with PFPS in a female athlete. Furthermore, we will discuss the anatomic variants, incidence and prevalence, etiology, diagnosis and treatment of PFPS.

Patellofemoral pain syndrome in female athletes: A review of diagnoses, etiology and treatment options

Science.gov (United States)

Vora, Molly; Curry, Emily; Chipman, Amanda; Matzkin, Elizabeth; Li, Xinning

2018-01-01

Patellofemoral pain syndrome (PFPS) is one of the most common causes of knee pain and is present in females disproportionately more relative to males. PFPS causes tend to be multifactorial in nature and are described in this review. From a review of the current literature, it is clear that there needs to be further research on PFPS in order to better understand the complex etiology of this disorder in both males and females. It is known that females with patellofemoral pain syndrome demonstrate a decrease in abduction, external rotation and extension strength of the affected side compared with healthy patients. Conservative management, including optimizing muscle balance between the vastus medialis and lateralis around the patella along with formal therapy should be the first line of treatment in patients presenting with PFPS. Surgery should be reserved for patients in which all conservative management options have failed. This review aims to guide physicians in accurate clinicaldecision making regarding conservative and surgical treatment options when specifically faced with PFPS in a female athlete. Furthermore, we will discuss the anatomic variants, incidence and prevalence, etiology, diagnosis and treatment of PFPS. PMID:29564075

Powerful near-surface geothermal energy with vertical groundwater circulation; Leistungsfaehige oberflaechennahe Geothermie mit vertikaler Grundwasserzirkulation

Energy Technology Data Exchange (ETDEWEB)

Viernickel, Michael [Geo-En Energy Technologies GmbH, Berlin (Germany). Bereich Produktentwicklung und Projektierung komplexer Energiesysteme unter Einsatz von Geothermie

2013-03-15

The conversion of energy supply based on renewable energies will be electricity based and the efficient provision of heating and cooling can be done by electric heat pumps. In cities, however, where the open areas for geothermal systems are scarce, groundwater-based systems can be a powerful option. The development of a large heat reservoir via a single bore is possible with vertical groundwater circulation systems and is described here. [German] Der Umbau der Energieversorgung auf erneuerbare Energien wird Strom basiert sein und eine effiziente Bereitstellung von Waerme und Kaelte kann durch elektrische Waermepumpen erfolgen. Innerstaedtisch sind die Freiflaechen fuer Geothermieanlagen allerdings knapp, so dass Grundwasser basierte Anlagen eine leistungsfaehige Option darstellen koennen. Die Erschliessung eines grossen Waerme-Reservoirs ueber nur eine Bohrung ist mit vertikalen Grundwasserzirkulationsanlagen moeglich und wird hier beschrieben.

The treatment of water-conducting features in groundwater flow and transport modelling of the Borrowdale Volcanic Group in Nirex 97

International Nuclear Information System (INIS)

Jackson, C.P.; Norris, S.; Todman, S.J.; Watson, S.P.

1999-01-01

In the Nirex 97 assessment of the post-closure performance of a repository at Sellafield, the potential repository host rock was the Borrowdale Volcanic Group (BVG). The treatment of water-conducting features in groundwater flow and transport modelling of the BVG is discussed. Groundwater flow in the BVG is predominantly through a subset of the total set of discontinuities - the Flowing Features (FFs). FFs can be identified in core samples by the presence of recent calcite. In boreholes, the FFs are clustered, and the clustering appears to be significant hydro-geologically. However, there is uncertainty about the connectivity of the clusters. A range of models is possible, from the case of isolated clusters to the case where the clusters form a well-connected network. The radiological risk from the repository was determined from radionuclide transport calculations based on the groundwater flow fields obtained from the regional-scale flow calculations. For rocks, such as the BVG, in which groundwater flows predominantly through discontinuities, diffusion into immobile water int the rock matrix between the discontinuities was modelled. Data from the site characterization and research programmes could be used to develop and parameterize groundwater flow and transport models for use in repository performance assessments. (author)

Groundwater recharge in the tropics: a pan-African analysis of observations

Science.gov (United States)

Taylor, R. G.

2015-12-01

Groundwater is a vital source of freshwater in sub-Saharan Africa where rainfall and river discharge are unreliable and per-capita reservoir storage is among the lowest in the world. Groundwater is widely considered a distributed, low-cost and climate-resilient option to meet rapidly growing freshwater demand and alleviate endemic poverty by expanding access to safe water and improving food security through irrigation. Recent research indicates that groundwater storage in Africa is about 100 times greater than annual river discharge yet major uncertainties remain in the magnitude and nature of replenishment through recharge as well as the impacts of land-use and climate change. Here, we present newly compiled, multi-decadal observations of groundwater levels from 5 countries (Benin, Burkina Faso, Niger, Tanzania, Uganda) and paired measurements of stable isotope ratios of O and H in precipitation and groundwater at 11 locations. These data reveal both a distinct bias in groundwater recharge to intensive rainfall and rapid recharge pathways (e.g. focused, macropore flow) that are inconsistent with conventional recharge models assuming pore-matrix flow defined by the Darcy-Richards equation. Further the records highlight the substantial influence of land-use change (e.g. conversion of natural, perennial cover to croplands) on groundwater recharge. The compiled observations also provide, for the first time, a pan-African baseline to evaluate the performance of large-scale hydrological models and Land-Surface Models incorporating groundwater in this region. Our results suggest that the intensification of precipitation brought about by global warming favours groundwater replenishment in sub-Saharan Africa. As such, groundwater may prove to be a climate-resilient source of freshwater in the tropics, enabling adaptive strategies such as groundwater-fed irrigation and sustaining domestic and industrial water supplies.

Process and technological options for odorous emissions control in wastewater treatment plants

International Nuclear Information System (INIS)

Cernuschi, S.; Torretta, V.

1996-01-01

The emissions of odorous substances together with noise and issues related to proper architectural design within the existing territorial context, have certainly to be considered one of the most significant environmental effects determined by wastewater treatment plants particularly in the most frequent case of their localization in dense urban areas. Following a brief introduction on the chemical properties of odorous compounds and the corresponding methods for representing their concentration levels in air, present work reports on the main qualitative and quantitative characteristics of odorous emissions originating from single unit operations of typical wastewater treatment plants and on the technological and process options available for their control

Mine Drainage Generation and Control Options.

Science.gov (United States)

Wei, Xinchao; Rodak, Carolyn M; Zhang, Shicheng; Han, Yuexin; Wolfe, F Andrew

2016-10-01

This review provides a snapshot of papers published in 2015 relevant to the topic of mine drainage generation and control options. The review is broken into 3 sections: Generation, Prediction and Prevention, and Treatment Options. The first section, mine drainage generation, focuses on the characterization of mine drainage and the environmental impacts. As such, it is broken into three subsections focused on microbiological characterization, physiochemical characterization, and environmental impacts. The second section of the review is divided into two subsections focused on either the prediction or prevention of acid mine drainage. The final section focuses on treatment options for mine drainage and waste sludge. The third section contains subsections on passive treatment, biological treatment, physiochemical treatment, and a new subsection on beneficial uses for mine drainage and treatment wastes.

A hybrid treatment of ozonation with limestone adsorption processes for the removal of Fe2+ in groundwater: Fixed bed column study

Science.gov (United States)

Akbar, Nor Azliza; Aziz, Hamidi Abdul; Adlan, Mohd Nordin

2017-10-01

During pumping of groundwater to the surface, the reaction between dissolved iron (Fe2+) and oxygen causes oxidation to ferric iron (Fe3+), thereby increasing the concentration of Fe2+. In this research, the potential application of ozonation with limestone adsorption to remove Fe2+ from groundwater was investigated through batch ozonation and fixed-bed-column studies. Groundwater samples were collected from a University Science Malaysia tube well (initial concentration of Fe2+, Co=1.563 mg/L). The effect of varying ozone dosages (10, 12.5, 15, 17.5, 20, 22.5, and 25 g/Nm3) was analyzed to determine the optimum ozone dosage for treatment. The characteristics of the column data and breakthrough curve were analyzed and predicted using mathematical models, such as Adam Bohart, Thomas, and Yoon-Nelson models. The data fitted well to the Thomas and Yoon-Nelson models, with correlation coefficient r2>0.93, but not to the Adam Bohart (r2=0.47). The total Fe2+ removed was 72% (final concentration of Fe2+, Ct=0.426 mg/L) at the maximum dosage of 25 g/Nm3 through ozonation only. However, the efficiency of Fe2+ removal was increased up to 99.5% (Ct=0.008 mg/L) when the hybrid treatment of ozonation with limestone adsorption was applied in this study. Thus, this integrated treatment was considerably more effective in removing Fe2+ than single ozonation treatment.

[Evidence-based therapy for cartilage lesions in the knee - regenerative treatment options].

Science.gov (United States)

Proffen, B; von Keudell, A; Vavken, P

2012-06-01

The treatment of cartilage defects has seen a shift from replacement to regeneration in the last few years. The rationale behind this development is the improvement in the quality-of-care for the growing segment of young patients who are prone to arthroplasty complications because of their specific characteristics - young age, high level of activity, high demand for functionality. These days, two of the most popular regenerative treatments are microfracture and autologous chondrocyte implantation (ACI). Although these new options show promising results, no final algorithm for the treatment of cartilage lesions has been established as yet. The objective of this review is to describe and compare these two treatment options and to present an evidence-based treatment algorithm for focal cartilage defects. Microfracture is a cost-effective, arthroscopic one-stage procedure, in which by drilling of the subchondral plate, mesenchymal stem cells from the bone marrow migrate into the defect and rebuild the cartilage. ACI is a two-stage procedure in which first chondrocytes are harvested, expanded in cell culture and in a second open procedure reimplanted into the cartilage defect. Microfracture is usually used for focal cartilage defects osteophyte, and for the ACI patient, periosteal hypertrophy and the need for two procedures in ACI. Only a few studies provide detailed and evidence-based information on a comparative assessment. These studies, however, are showing widely similar clinical outcomes but better histological results for ACI, which are likely to translate into better long-term outcomes. Although evidence-based studies comparing microfracture and ACI have not found significant differences in the clinical outcome, the literature does show that choosing the treatment based on the size and characteristics of the osteochondral lesion might be beneficial. The American Association of Orthopedic Surgeons suggest that contained lesions < 4 cm2 should be treated by

Cryoablation in fibro-adipose vascular anomaly (FAVA): a minimally invasive treatment option

International Nuclear Information System (INIS)

Shaikh, Raja; Alomari, Ahmad I.; Kerr, Cindy L.; Miller, Patricia; Spencer, Samantha A.

2016-01-01

Fibro-adipose vascular anomaly (FAVA) is a complex vascular malformation that typically presents with persistent pain, discomfort, contracture and other disabling symptoms. There are no minimally invasive treatment options to effectively control these symptoms. Image-guided percutaneous cryoablation, which has been used to control pain in people with cancer, could be used for similar indications in FAVA. To assess the role of image-guided percutaneous cryoablation for control of symptoms in FAVA lesions. We conducted a retrospective cohort study of 20 children and young adults with FAVA who underwent percutaneous cryoablation at 26 sites, from September 2013 to August 2015. The outcome was based on the brief pain inventory scoring (BPI), concurrent symptoms, clinical response and patient satisfaction. After cryoablation there was significant improvement in pain, which dropped by 3 points (pain now) to 3.7 points (pain in the last 24 h). Most patients indicated that pain interfered less in their everyday social life. Concurrent symptoms like swelling, physical limitations and skin hyperesthesia also improved. Clinical response was greatest at 2-5 months follow-up after cryoablation, with acceptable patient satisfaction thereafter. Technical response was 100%. There were no major complications. Image-guided percutaneous cryoablation is a safe and effective option for treatment of symptomatic FAVA lesions. (orig.)

Ozone-augmented percutaneous discectomy: a novel treatment option for refractory discogenic sciatica.

Science.gov (United States)

Crockett, M T; Moynagh, M; Long, N; Kilcoyne, A; Dicker, P; Synnott, K; Eustace, S J

2014-12-01

To assess the short and medium-term efficacy and safety of a novel, minimally invasive therapeutic option combining automated percutaneous lumbar discectomy, intradiscal ozone injection, and caudal epidural: ozone-augmented percutaneous discectomy (OPLD). One hundred and forty-seven patients with a clinical and radiological diagnosis of discogenic sciatica who were refractory to initial therapy were included. Fifty patients underwent OPLD whilst 97 underwent a further caudal epidural. Outcomes were evaluated using McNab's score, improvement in visual analogue score (VAS) pain score, and requirement for further intervention. Follow-up occurred at 1 and 6 months, and comparison was made between groups. OPLD achieved successful outcomes in almost three-quarters of patients in the short and medium term. OPLD achieved superior outcomes at 1 and 6 months compared to caudal epidural. There was a reduced requirement for further intervention in the OPLD group. No significant complications occurred in either group. OPLD is a safe and effective treatment for patients with refractory discogenic sciatica in the short and medium term. OPLD has the potential to offer an alternative second-line minimally invasive treatment option that could reduce the requirement for surgery in this patient cohort. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Economic assessment of preeclampsia : Screening, diagnosis, treatment options, and long term outcomes - A systematic review

NARCIS (Netherlands)

Zakiyah, Neily; Van Asselt, Antoinette D.; Baker, Philip N.; Postma, Maarten J.

OBJECTIVES: Provide a comprehensive overview of the existing evidence on the health economics of screening, diagnosis, and treatment options in preeclampsia. METHODS: A systematic literature search was undertaken using three electronic databases (MEDLINE, Embase, Cochrane) to identify all English

Cachexia and pancreatic cancer: Are there treatment options?

Science.gov (United States)

Mueller, Tara C; Burmeister, Marc A; Bachmann, Jeannine; Martignoni, Marc E

2014-01-01

Cachexia is frequently described in patients with pancreatic ductal adenocarcinoma (PDAC) and is associated with reduced survival and quality of life. Unfortunately, the therapeutic options of this multi-factorial and complex syndrome are limited. This is due to the fact that, despite extensive preclinical and clinical research, the underlying pathological mechanisms leading to PDAC-associated cachexia are still not fully understood. Furthermore, there is still a lack of consensus on the definition of cachexia, which complicates the standardization of diagnosis and treatment as well as the analysis of the current literature. In order to provide an efficient therapy for cachexia, an early and reliable diagnosis and consistent monitoring is required, which can be challenging especially in obese patients. Although many substances have been tested in clinical and preclinical settings, so far none of them have been proven to have a long-term effect in ameliorating cancer-associated cachexia. However, recent studies have demonstrated that multidimensional therapeutic modalities are able to alleviate pancreatic cancer-associated cachexia and ultimately improve patients’ outcome. In this current review, we propose a stepwise and pragmatic approach to facilitate and standardize the treatment of cachexia in pancreatic cancer patients. This strategy consists of nutritional, dietary, pharmacological, physical and psychological methods. PMID:25071331

The genetics of age-related macular degeneration (AMD)--Novel targets for designing treatment options?

Science.gov (United States)

Grassmann, Felix; Fauser, Sascha; Weber, Bernhard H F

2015-09-01

Age-related macular degeneration (AMD) is a progressive disease of the central retina and the main cause of legal blindness in industrialized countries. Risk to develop the disease is conferred by both individual as well as genetic factors with the latter being increasingly deciphered over the last decade. Therapeutically, striking advances have been made for the treatment of the neovascular form of late stage AMD while for the late stage atrophic form of the disease, which accounts for almost half of the visually impaired, there is currently no effective therapy on the market. This review highlights our current knowledge on the genetic architecture of early and late stage AMD and explores its potential for the discovery of novel, target-guided treatment options. We reflect on current clinical and experimental therapies for all forms of AMD and specifically note a persisting lack of efficacy for treatment in atrophic AMD. We further explore the current insight in AMD-associated genes and pathways and critically question whether this knowledge is suited to design novel treatment options. Specifically, we point out that known genetic factors associated with AMD govern the risk to develop disease and thus may not play a role in its severity or progression. Treatments based on such knowledge appear appropriate rather for prevention than treatment of manifest disease. As a consequence, future research in AMD needs to be greatly focused on approaches relevant to the patients and their medical needs. Copyright © 2015 Elsevier B.V. All rights reserved.

An innovative funnel and gate approach to groundwater remediation

International Nuclear Information System (INIS)

Johnson, D.O.; Wilkey, M.L.; Willis, J.M.

1996-01-01

The US Department of Energy, office of Science and Technology (EM-50) sponsored a demonstration project of the Barrier Member Containment Corporation's patented EnviroWall trademark system at the Savannah River site. With this system, contaminated groundwater can be funneled into a treatment system without pumping the contaminated water to the surface. The EnviroWall trademark barrier and pass-through system, an innovative product of sic years of research and development, provides a means to enhance groundwater flow on the upgradient side of an impermeable wall and direct it to an in situ treatment system. The EnviroWall trademark system is adaptable to most site conditions. Remedial applications range form plume containment to more robust designs that incorporate groundwater manipulation coupled with in situ treatment. Several key innovations of the EnviroWall trademark system include the following: a method for guide box installation; a means for using interlocking seals at vertical seams; a down-hole video camera for inspecting seams and panels, installation of horizontal- and vertical-collection systems; installation of vertical monitoring wells and instrumentation on each side of the barrier; site-specific backfill design; and a pass-through system for funneling groundwater into a treatment system

Economic assessment of preeclampsia : Screening, diagnosis, treatment options, and long term outcomes, a systematic review

NARCIS (Netherlands)

Zakiyah, N.; Van Asselt, A.; Baker, P.; Postma, M.J.

2014-01-01

Objectives: To provide a comprehensive overview of the existing evidence on the health economics of screening, diagnosis, and treatment options in preeclampsia. Methods: A systematic literature search was undertaken using three electronic databases (MEDLINE, Embase, Cochrane) to identify all English

24 CFR 35.120 - Options.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Options. 35.120 Section 35.120... and Definitions for All Programs. § 35.120 Options. (a) Standard treatments. Where interim controls are required by this part, the designated party has the option to presume that lead-based paint or...

Edible Oil Barriers for Treatment of Chlorinated Solvent and Perchlorate-Contaminated Groundwater

Science.gov (United States)

2010-02-01

The groundwater potentiometric surface beneath SWMU 17 is relatively flat with some tidal influence resulting in fluctuating groundwater flow...after its application, the pH within most of the aquifer would be expected to vary between background (~5) and 9. A titration experiment determined

Intermediate tree cover can maximize groundwater recharge in the seasonally dry tropics

Science.gov (United States)

Ilstedt, U.; Bargués Tobella, A.; Bazié, H. R.; Bayala, J.; Verbeeten, E.; Nyberg, G.; Sanou, J.; Benegas, L.; Murdiyarso, D.; Laudon, H.; Sheil, D.; Malmer, A.

2016-01-01

Water scarcity contributes to the poverty of around one-third of the world’s people. Despite many benefits, tree planting in dry regions is often discouraged by concerns that trees reduce water availability. Yet relevant studies from the tropics are scarce, and the impacts of intermediate tree cover remain unexplored. We developed and tested an optimum tree cover theory in which groundwater recharge is maximized at an intermediate tree density. Below this optimal tree density the benefits from any additional trees on water percolation exceed their extra water use, leading to increased groundwater recharge, while above the optimum the opposite occurs. Our results, based on groundwater budgets calibrated with measurements of drainage and transpiration in a cultivated woodland in West Africa, demonstrate that groundwater recharge was maximised at intermediate tree densities. In contrast to the prevailing view, we therefore find that moderate tree cover can increase groundwater recharge, and that tree planting and various tree management options can improve groundwater resources. We evaluate the necessary conditions for these results to hold and suggest that they are likely to be common in the seasonally dry tropics, offering potential for widespread tree establishment and increased benefits for hundreds of millions of people. PMID:26908158

As(III) oxidation by MnO2 during groundwater treatment.

Science.gov (United States)

Gude, J C J; Rietveld, L C; van Halem, D

2017-03-15

The top layer of natural rapid sand filtration was found to effectively oxidise arsenite (As(III)) in groundwater treatment. However, the oxidation pathway has not yet been identified. The aim of this study was to investigate whether naturally formed manganese oxide (MnO 2 ), present on filter grains, could abiotically be responsible for As(III) oxidation in the top of a rapid sand filter. For this purpose As(III) oxidation with two MnO 2 containing powders was investigated in aerobic water containing manganese(II) (Mn(II)), iron(II) (Fe(II)) and/or iron(III) (Fe(III)). The first MnO 2 powder was a very pure - commercially available - natural MnO 2 powder. The second originated from a filter sand coating, produced over 22 years in a rapid filter during aeration and filtration. Jar test experiments showed that both powders oxidised As(III). However, when applying the MnO 2 in aerated, raw groundwater, As(III) removal was not enhanced compared to aeration alone. It was found that the presence of Fe(II)) and Mn(II) inhibited As(III) oxidation, as Fe(II) and Mn(II) adsorption and oxidation were preferred over As(III) on the MnO 2 surface (at pH 7). Therefore it is concluded that just because MnO 2 is present in a filter bed, it does not necessarily mean that MnO 2 will be available to oxidise As(III). However, unlike Fe(II), the addition of Fe(III) did not hinder As(III) oxidation on the MnO 2 surface; resulting in subsequent effective As(V) removal by the flocculating hydrous ferric oxides. Copyright © 2016 Elsevier Ltd. All rights reserved.

Provision of Desalinated Irrigation Water by the Desalination of Groundwater within a Saline Aquifer

Directory of Open Access Journals (Sweden)

David D. J. Antia

2016-12-01

Full Text Available Irrigated land accounts for 70% of global water usage and 30% of global agricultural production. Forty percent of this water is derived from groundwater. Approximately 20%–30% of the groundwater sources are saline and 20%–50% of global irrigation water is salinized. Salinization reduces crop yields and the number of crop varieties which can be grown on an arable holding. Structured ZVI (zero valent iron, Fe0 pellets desalinate water by storing the removed ions as halite (NaCl within their porosity. This allows an “Aquifer Treatment Zone” to be created within an aquifer, (penetrated by a number of wells (containing ZVI pellets. This zone is used to supply partially desalinated water directly from a saline aquifer. A modeled reconfigured aquifer producing a continuous flow (e.g., 20 m3/day, 7300 m3/a of partially desalinated irrigation water is used to illustrate the impact of porosity, permeability, aquifer heterogeneity, abstraction rate, Aquifer Treatment Zone size, aquifer thickness, optional reinjection, leakage and flow by-pass on the product water salinity. This desalination approach has no operating costs (other than abstraction costs (and ZVI regeneration and may potentially be able to deliver a continuous flow of partially desalinated water (30%–80% NaCl reduction for $0.05–0.5/m3.

Groundwater-level trends and implications for sustainable water use in the Kabul Basin, Afghanistan

Science.gov (United States)

Mack, Thomas J.; Chornack, Michael P.; Taher, Mohammad R.

2013-01-01

The Kabul Basin, which includes the city of Kabul, Afghanistan, with a population of approximately 4 million, has several Afghan, United States, and international military installations that depend on groundwater resources for a potable water supply. This study examined groundwater levels in the Kabul Basin from 2004 to 2012. Groundwater levels have increased slightly in rural areas of the Kabul Basin as a result of normal precipitation after the drought of the early 2000s. However, groundwater levels have decreased in the city of Kabul due to increasing water use in an area with limited recharge. The rate of groundwater-level decrease in the city is greater for the 2008–2012 period (1.5 meters per year (m/yr) on average) than for the 2004–2008 period (0–0.7 m/yr on average). The analysis, which is corroborated by groundwater-flow modeling and a non-governmental organization decision-support model, identified groundwater-level decreases and associated implications for groundwater sustainability in the city of Kabul. Military installations in the city of Kabul (the Central Kabul subbasin) are likely to face water management challenges resulting from long-term groundwater sustainability concerns, such as the potential drying of shallow water-supply wells. Installations in the northern part of the Kabul Basin may have fewer issues with long-term water sustainability. Groundwater-level monitoring and groundwater-flow simulation can be valuable tools for assessing groundwater management options to improve the sustainability of water resources in the Kabul Basin.

Ex situ treatment of N-nitrosodimethylamine (NDMA) in groundwater using a fluidized bed reactor.

Science.gov (United States)

Webster, Todd S; Condee, Charles; Hatzinger, Paul B

2013-02-01

N-nitrosodimethylamine (NDMA) is a suspected human carcinogen that has traditionally been treated in water using ultraviolet irradiation (UV). The objective of this research was to examine the application of a laboratory-scale fluidized bed reactor (FBR) as an alternative technology for treating NDMA to part-per-trillion (ng/L) concentrations in groundwater. Previous studies have shown that the bacterium Rhodococcus ruber ENV425 is capable of cometabolizing NDMA during growth on propane as a primary substrate in batch culture (Fournier et al., 2009) and in a bench-scale membrane bioreactor (Hatzinger et al., 2011) to low ng/L concentrations. R. ruber ENV425 was inoculated into the FBR during this study. With a hydraulic residence time (HRT) of 20 min, the FBR was found to be an effective means to treat 10-20 μg/L of NDMA to effluent concentrations less than 100 ng/L. When the HRT was increased to 30 min and oxygen and propane addition rates were optimized, the FBR system demonstrated treatment of the NDMA to effluent concentrations of less than 10 ng/L. Short-term shutdowns and the presence of trichloroethene (TCE) at 6 μg/L as a co-contaminant had minimal effect on the treatment of NDMA in the FBR. The data suggest that the FBR technology can be a viable alternative to UV for removing NDMA from groundwater. Copyright © 2012 Elsevier Ltd. All rights reserved.

Cocaine Addiction Treatments to improve Control and reduce Harm (CATCH): new pharmacological treatment options for crack-cocaine dependence in the Netherlands

NARCIS (Netherlands)

Nuijten, Mascha; Blanken, Peter; van den Brink, Wim; Hendriks, Vincent

2011-01-01

Cocaine, particularly in its base form ('crack'), has become one of the drugs of most concern in the Netherlands, being associated with a wide range of medical, psychiatric and social problems for the individual, and with significant public order consequences for society. Available treatment options

Isotopic Survey of Lake Davis and the Local Groundwater

Energy Technology Data Exchange (ETDEWEB)

Ridley, M N; Moran, J E; Singleton, M J

2007-08-21

In September 2007, California Fish and Game (CAFG) plans to eradicate the northern pike from Lake Davis. As a result of the eradication treatment, local residents have concerns that the treatment might impact the local groundwater quality. To address the concerns of the residents, Lawrence Livermore National Laboratory (LLNL) recommended measuring the naturally occurring stable oxygen isotopes in local groundwater wells, Lake Davis, and the Lake Davis tributaries. The purpose of these measurements is to determine if the source of the local groundwater is either rain/snowmelt, Lake Davis/Big Grizzly Creek water or a mixture of Lake Davis/Big Grizzly Creek and rain/snowmelt. As a result of natural evaporation, Lake Davis and the water flowing into Big Grizzly Creek are naturally enriched in {sup 18}oxygen ({sup 18}O), and if a source of a well's water is Lake Davis or Big Grizzly Creek, the well water will contain a much higher concentration of {sup 18}O. This survey will allow for the identification of groundwater wells whose water source is Lake Davis or Big Grizzly Creek. The results of this survey will be useful in the development of a water-quality monitoring program for the upcoming Lake Davis treatment. LLNL analyzed 167 groundwater wells (Table 1), 12 monthly samples from Lake Davis (Table 2), 3 samples from Lake Davis tributaries (Table 2), and 8 Big Grizzly Creek samples (Table 2). Of the 167 groundwater wells sampled and analyzed, only 2 wells contained a significant component of evaporated water, with an isotope composition similar to Lake Davis water. The other 163 groundwater wells have isotope compositions which indicate that their water source is rain/snowmelt.

[Novel current and future therapy options for treatment of dry eye disease].

Science.gov (United States)

Messmer, E M

2018-02-01

Dry eye disease was redefined by the dry eye workshop (DEWS II) in May 2017. According to the new definition "dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms". The current definition encompasses etiological factors, such as instability and hyperosmolarity of the tear film, ocular surface inflammation and damage as well as a new aspect compared to the former definition, neurosensory abnormalities. Recent and future therapeutic options for dry eye focus on treatment of the aforementioned pathogenetic events. New tear substitutes, medications and devices to stimulate tear production, innovative anti-inflammatory treatment, medications to influence corneal innervation and new methods for treatment of Meibomian gland dysfunction are already available or will be available in the near future.

A socio-ecological investigation of options to manage groundwater degradation in the Western Desert, Egypt.

Science.gov (United States)

King, Caroline; Salem, Boshra

2012-07-01

Under increasing water scarcity, collective groundwater management is a global concern. This article presents an interdisciplinary analysis of this challenge drawing on a survey including 50 large and small farms and gardens in a village in an agricultural land reclamation area on the edge of the Western Desert of Egypt. Findings revealed that smallholders rely on a practice of shallow groundwater use, through which drainage water from adjacent irrigation areas is effectively recycled within the surface aquifer. Expanding agroindustrial activities in the surrounding area are socio-economically important, but by mining non-renewable water in the surrounding area, they set in motion a degradation process with social and ecological consequences for all users in the multi-layered aquifer system. Based on the findings of our investigation, we identify opportunities for local authorities to more systematically connect available environmental information sources and common pool resource management precedents, to counterbalance the degradation threat.

End-stage renal disease treatment options education: What matters most to patients and families.

Science.gov (United States)

St Clair Russell, Jennifer; Boulware, L Ebony

2018-03-01

Treatment modality education can offer many important benefits to patients and their families. Evidence suggests such education can increase use of home dialysis, reduce catheter use, decrease 90-day mortality, and increase transplantation. While these benefits are encouraging, not all patients are offered options education and when they are, it may not be presented in a way that is immediately applicable to them and their lives. Furthermore, little is known regarding specific characteristics (e.g. format such as group or individual or in-person or online, duration, teaching methods, location, content) of educational programs that are most successful. No single approach has emerged as a best practice. In the absence of such evidence, adult learning principles, such as involving patients and families in the development programs and materials, can serve as a guide for educational development. Adult learning principles can enhance options education, evolving them from information delivery to a person-centered, values-based endeavor that helps match treatment to values and lifestyle. © 2018 Wiley Periodicals, Inc.

Treatment Options

Science.gov (United States)

... one that is tailored to your symptoms. article Protecting your eyesight when taking Plaquenil Some lupus treatments have the potential for eye health side-effects. Know the warning signs. article ​ ...

Cost-effectiveness analysis of Option B+ for HIV prevention and treatment of mothers and children in Malawi.

Science.gov (United States)

Fasawe, Olufunke; Avila, Carlos; Shaffer, Nathan; Schouten, Erik; Chimbwandira, Frank; Hoos, David; Nakakeeto, Olive; De Lay, Paul

2013-01-01

The Ministry of Health in Malawi is implementing a pragmatic and innovative approach for the management of all HIV-infected pregnant women, termed Option B+, which consists of providing life-long antiretroviral treatment, regardless of their CD4 count or clinical stage. Our objective was to determine if Option B+ represents a cost-effective option. A decision model simulates the disease progression of a cohort of HIV-infected pregnant women receiving prophylaxis and antiretroviral therapy, and estimates the number of paediatric infections averted and maternal life years gained over a ten-year time horizon. We assess the cost-effectiveness from the Ministry of Health perspective while taking into account the practical realities of implementing ART services in Malawi. If implemented as recommended by the World Health Organization, options A, B and B+ are equivalent in preventing new infant infections, yielding cost effectiveness ratios between US$ 37 and US$ 69 per disability adjusted life year averted in children. However, when the three options are compared to the current practice, the provision of antiretroviral therapy to all mothers (Option B+) not only prevents infant infections, but also improves the ten-year survival in mothers more than four-fold. This translates into saving more than 250,000 maternal life years, as compared to mothers receiving only Option A or B, with savings of 153,000 and 172,000 life years respectively. Option B+ also yields favourable incremental cost effectiveness ratios (ICER) of US$ 455 per life year gained over the current practice. In Malawi, Option B+ represents a favorable policy option from a cost-effectiveness perspective to prevent future infant infections, save mothers' lives and reduce orphanhood. Although Option B+ would require more financial resources initially, it would save societal resources in the long-term and represents a strategic option to simplify and integrate HIV services into maternal, newborn and child

Ecotoxicity assessment of artificial groundwater recharge with reclaimed water: a pilot-scale study.

Science.gov (United States)

Zhang, Xue; Zhao, Xuan

2013-11-01

A demonstration of artificial groundwater recharge with tertiary effluent was evaluated using a set of bioassays (acute toxicity to Daphnia, genotoxicity, estrogenic and antiestrogenic toxicity). Around 95 % genotoxicity and 53 % antiestrogenicity were removed from the feed water by ozonation, whereas significant reduction of acute toxicity to Daphnia magna was achieved during a 3 days vadose soil treatment. The toxicity was further removed to the same level as the local groundwater during a 20 days aquifer soil treatment. The pilot study has shown that ozonation and soil treatments can improve the quality of municipal wastewater treatment plant effluents for possible groundwater recharge purposes.

Evaluating Nitrogen Management Options for Reducing Nitrate Leaching from Northeast U.S. Pastures

Directory of Open Access Journals (Sweden)

William L. Stout

2001-01-01

Full Text Available Substantial amounts of nitrate nitrogen NO3-N can leach from intensively grazed pasture in the northeast U.S. where there is about 30 cm of groundwater recharge, annually. Management options for reducing NO3-N leaching were evaluated for this environment using the Cornell Net Carbohydrate and Protein System Model and a recently developed nitrogen leaching index. Management options utilizing energy supplementation of grazing dairy cows could improve nitrogen efficiency within the cow, but would not necessarily reduce NO3-N leaching at the pasture scale if stocking rate was not controlled. The management option of using white clover to supply nitrogen to the pasture decreased NO3-N leaching, but produced less dry matter yield, which in turn reduced stocking rate. The economic returns of reducing NO3-N with these options need to be evaluated in light of milk prices and commodity and fertilizer nitrogen costs. At current prices and costs, the economic benefit from the energy supplementation options is substantial.

Hanford statewide groundwater flow and transport model calibration report

International Nuclear Information System (INIS)

Law, A.; Panday, S.; Denslow, C.; Fecht, K.; Knepp, A.

1996-04-01

This report presents the results of the development and calibration of a three-dimensional, finite element model (VAM3DCG) for the unconfined groundwater flow system at the Hanford Site. This flow system is the largest radioactively contaminated groundwater system in the United States. Eleven groundwater plumes have been identified containing organics, inorganics, and radionuclides. Because groundwater from the unconfined groundwater system flows into the Columbia River, the development of a groundwater flow model is essential to the long-term management of these plumes. Cost effective decision making requires the capability to predict the effectiveness of various remediation approaches. Some of the alternatives available to remediate groundwater include: pumping contaminated water from the ground for treatment with reinjection or to other disposal facilities; containment of plumes by means of impermeable walls, physical barriers, and hydraulic control measures; and, in some cases, management of groundwater via planned recharge and withdrawals. Implementation of these methods requires a knowledge of the groundwater flow system and how it responds to remedial actions

An estimation of US horse-owner/caregiver willingness-to-pay for daily use and infectious upper respiratory disease treatment options.

Science.gov (United States)

Kibler, M L; Pendell, D L; Costanigro, M; Traub-Dargatz, J

2018-07-01

Equine injury and disease cause two types of costs for those financially responsible for treating and caring for the infected horse(s); direct costs of treating the horse and indirect cost of lost use of the horse for a period of time to the user of the horse (daily horse use). Indirect costs are more difficult to estimate but pose significant financial implications for equine-owners/caregivers. Additionally, there exists a gap in existing research regarding the valuation of infectious treatment options in horses. To estimate the value a US horse-owner/caregiver places on daily horse use and describe respondents' willingness-to-pay for various attributes of equine treatment options. Online questionnaire survey. An online questionnaire was provided to equine-owners and caretakers, and owner demographic, horse care and horse use information from respondents were requested. Additionally, respondents were presented with hypothetical disease treatment options with the following attributes: daily dosage, number of days of rest required, route of administration and out-of-pocket cost to the owner/caretaker through a choice experiment. Data were analysed using a rank-ordered logit analysis and willingness-to-pay estimates for daily use and treatment options were calculated. Results suggest that the average horse-owner with an uninsured and insured horse is willing to pay $12.07 (95% confidence interval: -$15.01, -$9.69) and $17.95 (95% confidence interval: -$25.30, -$11.20) per day to reduce lost use days required (due to need for rest) respectively. Respondents showed preferences for oral administration over treatments requiring i.m. injections. As this study employed an online survey it was subjected to self-selection bias and a sample size calculation was not performed. Veterinarians and pharmaceutical companies may use these results when promoting various treatment options to horse-owners/caregivers and in product development. Additionally, promotion efforts may be

Split high-dose oral levothyroxine treatment as a successful therapy option in myxedema coma.

Science.gov (United States)

Charoensri, Suranut; Sriphrapradang, Chutintorn; Nimitphong, Hataikarn

2017-10-01

High-dose intravenous thyroxine (T4) is the preferable treatment for myxedema coma. We describe the clinical course of a 69-year-old man who presented with myxedema coma and received oral levothyroxine (LT4) therapy (1 mg) in a split dose. This suggests split high-dose oral LT4 as a therapeutic option in myxedema coma.

Atypical antipsychotics as a possible treatment option for irritable bowel syndrome.

Science.gov (United States)

Pae, Chi-Un; Lee, Soo-Jung; Han, Changsu; Patkar, Ashwin A; Masand, Prakash S

2013-05-01

Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder (FGID) that is characterised by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits. Although the pathophysiology of IBS is not fully understood, it is believed that psychiatric comorbidities are highly common in such patients. A variety of psychotropic medications are widely used in the treatment of IBS, particularly older antidepressants such as tricyclic antidepressants (TCAs). With the advent of newer antidepressant classes with better safety and tolerability compared with TCAs, such as serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), clinicians now have more advanced treatment options for treating IBS. Additionally, some atypical antipsychotics (AAs) have recently received approval for treatment of major depressive disorder (MDD). Some AAs may have potentials based on their pharmacodynamic profile and proven benefit for mood symptoms, pain, anxiety and sleep disturbances. This article describes the potential rationale, clinical data and practical aspects involved in the use of AAs for patients with IBS. Atypical antipsychotics (AAs) may have a role in the treatment of irritable bowel syndrome (IBS) based on the currently available findings, although there is no clear evidence, and a number of clinical issues to be addressed in the use of AAs for the treatment of IBS.

Tadalafil once daily: Narrative review of a treatment option for female sexual dysfunctions (FSD in midlife and older women

Directory of Open Access Journals (Sweden)

Chiara Borghi

2017-03-01

Full Text Available Female Sexual Disorders (FSD include a complex, multidimensional, individual experience that can change as an individual age, suggesting that these problems are caused by multiple factors including psychosocial factors, personal relationships, pathologic changes caused by diseases, and pharmacologic influences. Menopause is an important time for middle aged women and postmenopausal physiological changes could have a significant role in the development of FSD. Few is still known about their correct definition and treatment. Their incidence, prevalence and risk factors are difficult to define because of a high level of overlap in the experience of problems with desire, arousal, and orgasm. Little evidences are known about the best therapeutic approach, and both non-pharmacological and pharmacological treatment options have been described. Among these, phosphodiesterase type 5 inhibitors could be an effective option for many subtypes of female sexual disorders, with an improvement in different aspects of sexual function, such as desire, arousal, orgasm and sexual satisfaction. In this paper authors reviewed what is already known about the use of these vasoactive agents, particularly tadalafil, as a treatment option for female sexual disturbances.

Maturity onset diabetes of the young: Diagnosis and treatment options

Directory of Open Access Journals (Sweden)

Serghei Covanțev

2016-12-01

Full Text Available Diabetes is a complicated disease, so multiple factors are involved in its development. Nevertheless some of the patients with type 1 and 2 diabetes mellitus have a monogenic form of this disease which has different treatment options and usually fewer complications. It is estimated that about 5% of patients with type 2 diabetes melitus (T2DM and about 10% of type 1 diabetes melitus (T1DM are misdiagnosed and have maturity onset diabetes of the young (MODY. We present a review study of the management of most frequent monogenic forms of diabetes such as MODY 1, 2 and 3 and the possibilities of their diagnosis including in resource limited situations.

Laryngeal manifestations of relapsing polychondritis and a novel treatment option.

Science.gov (United States)

Childs, Lesley F; Rickert, Scott; Wengerman, Oscar C; Lebovics, Robert; Blitzer, Andrew

2012-09-01

Laryngotracheal involvement in relapsing polychondritis (RP) is rare. However, it is one of the most common causes of death in this patient population. We present three patients who primarily presented with laryngeal manifestations of RP and a novel treatment option for bamboo nodules. Retrospective chart review and comprehensive review of the literature. Two patients first presented to an otolaryngologist because of hoarseness and chronic cough that eventually progressed to dyspnea upon exertion. Laryngeal examination revealed subglottic stenoses. Upon rheumatologic workup both were diagnosed with RP. After treatment with steroids and immunosuppressive drugs, one of the patient's laryngeal symptoms improved, whereas the other required dilation procedures. Neither patient had classic auricular or nasal symptoms upon initial presentation. The third patient was being treated for spasmodic dysphonia and was noted to have bamboo nodules with accompanying dysphonia. Rheumatologic workup revealed RP and systemic treatment ensued. Unfortunately, her symptoms of hoarseness persisted despite systemic treatment. A pulsed-potassium-titanyl-phosphate (KTP) laser was applied to the bilateral bamboo nodules, which eventually caused resolution of her vocal fold lesions and dysphonia. We present three patients with RP, all of whom sought health care by an otolaryngologist primarily. Awareness of this disease entity and the possibility for early laryngeal involvement is crucial for proper care of those with this life-threatening disease. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Composite use of numerical groundwater flow modeling and geoinformatics techniques for monitoring Indus Basin aquifer, Pakistan.

Science.gov (United States)

Ahmad, Zulfiqar; Ashraf, Arshad; Fryar, Alan; Akhter, Gulraiz

2011-02-01

The integration of the Geographic Information System (GIS) with groundwater modeling and satellite remote sensing capabilities has provided an efficient way of analyzing and monitoring groundwater behavior and its associated land conditions. A 3-dimensional finite element model (Feflow) has been used for regional groundwater flow modeling of Upper Chaj Doab in Indus Basin, Pakistan. The approach of using GIS techniques that partially fulfill the data requirements and define the parameters of existing hydrologic models was adopted. The numerical groundwater flow model is developed to configure the groundwater equipotential surface, hydraulic head gradient, and estimation of the groundwater budget of the aquifer. GIS is used for spatial database development, integration with a remote sensing, and numerical groundwater flow modeling capabilities. The thematic layers of soils, land use, hydrology, infrastructure, and climate were developed using GIS. The Arcview GIS software is used as additive tool to develop supportive data for numerical groundwater flow modeling and integration and presentation of image processing and modeling results. The groundwater flow model was calibrated to simulate future changes in piezometric heads from the period 2006 to 2020. Different scenarios were developed to study the impact of extreme climatic conditions (drought/flood) and variable groundwater abstraction on the regional groundwater system. The model results indicated a significant response in watertable due to external influential factors. The developed model provides an effective tool for evaluating better management options for monitoring future groundwater development in the study area.

Treatment of co-mingled benzene, toluene and TCE in groundwater.

Science.gov (United States)

Chen, Liang; Liu, Yulong; Liu, Fei; Jin, Song

2014-06-30

This work addressed a hypothetical but practical scenario that includes biological oxidation and reductive dechlorination in treating groundwater containing co-mingled plume of trichloroethene (TCE), benzene and toluene. Groundwater immediately downgradient from the commonly used zero-valent iron (ZVI) has shown alkaline pH (up to 10.7). The elevated pH may influence BTEX compounds (i.e., benzene, toluene, ethyl benzene, and xylenes) biodegradation, which could also be inhibited by elevated concentrations of TCE. Data from this work suggests that the inhibition coefficients (IC) value for 100 μg/L and 500 μg/L of TCE on benzene and toluene degradation are 2.1-2.8 at pH 7.9, and 3.5-6.1 at pH 10.5. For a co-mingled plume, it appears to be more effective to reduce TCE by ZVI before addressing benzene and toluene biodegradation. The ample buffering capacity of most groundwater and the adaptation of benzene and toluene-degrading microbes are likely able to eliminate the adverse influence of pH shifts downgradient from a ZVI-PRB. Copyright © 2014 Elsevier B.V. All rights reserved.

Rapidly changing treatment options adding burden to the management of typhoid fever

Directory of Open Access Journals (Sweden)

Jaspal Kaur

2015-01-01

Full Text Available Typhoid fever continues to be a global public health problem. It is caused by the facultative intracellular organisms Salmonella enteric serotype Typhi and Salmonella paratyphi. Antimicrobial therapy is the mainstay for treatment of typhoid fever. Chloramphenicol, ampicillin, and cotrimoxazole had been in use for decades for treating enteric fever. But the emergence and rapid spread of drug resistance has resulted in rapid shift of treatment options from chloramphenicol to fluoroquinolones to third generation cephalosporins to azithromycin with tigecycline and carbapenems in line, thus adding burden to the health-care sector in developing countries. Rational and judicious antibiotic prescribing practices by health professionals are necessary to prevent further development of drug resistance and help in re-emergence of sensitive strains.

ALTERNATIVE REMEDIATION TECHNOLOGY STUDY FOR GROUNDWATER TREATMENT AT 200-PO-1 OPERABLE UNIT AT HANFORD SITE

Energy Technology Data Exchange (ETDEWEB)

DADO MA

2008-07-31

This study focuses on the remediation methods and technologies applicable for use at 200-PO-I Groundwater Operable Unit (OU) at the Hanford Site. The 200-PO-I Groundwater au requires groundwater remediation because of the existence of contaminants of potential concern (COPC). A screening was conducted on alternative technologies and methods of remediation to determine which show the most potential for remediation of groundwater contaminants. The possible technologies were screened to determine which would be suggested for further study and which were not applicable for groundwater remediation. COPCs determined by the Hanford Site groundwater monitoring were grouped into categories based on properties linking them by remediation methods applicable to each COPC group. The screening considered the following criteria. (1) Determine if the suggested method or technology can be used for the specific contaminants found in groundwater and if the technology can be applied at the 200-PO-I Groundwater au, based on physical characteristics such as geology and depth to groundwater. (2) Evaluate screened technologies based on testing and development stages, effectiveness, implementability, cost, and time. This report documents the results of an intern research project conducted by Mathew Dado for Central Plateau Remediation in the Soil and Groundwater Remediation Project. The study was conducted under the technical supervision of Gloria Cummins and management supervision of Theresa Bergman and Becky Austin.

Tracing freshwater nitrate sources in pre-alpine groundwater catchments using environmental tracers

Science.gov (United States)

Stoewer, M. M.; Knöller, K.; Stumpp, C.

2015-05-01

Groundwater is one of the main resources for drinking water. Its quality is still threatened by the widespread contaminant nitrate (NO3-). In order to manage groundwater resources in a sustainable manner, we need to find options of lowering nitrate input. Particularly, a comprehensive knowledge of nitrate sources is required in areas which are important current and future drinking water reservoirs such as pre-alpine aquifers covered with permanent grassland. The objective of the present study was to identify major sources of nitrate in groundwater with low mean nitrate concentrations (8 ± 2 mg/L). To achieve the objective, we used environmental tracer approaches in four pre-alpine groundwater catchments. The stable isotope composition and tritium content of water were used to study the hydrogeology and transit times. Furthermore, nitrate stable isotope methods were applied to trace nitrogen from its sources to groundwater. The results of the nitrate isotope analysis showed that groundwater nitrate was derived from nitrification of a variety of ammonium sources such as atmospheric deposition, mineral and organic fertilizers and soil organic matter. A direct influence of mineral fertilizer, atmospheric deposition and sewage was excluded. Since temporal variation in stable isotopes of nitrate were detected only in surface water and locally at one groundwater monitoring well, aquifers appeared to be well mixed and influenced by a continuous nitrate input mainly from soil derived nitrogen. Hydrogeological analysis supported that the investigated aquifers were less vulnerable to rapid impacts due to long average transit times, ranging from 5 to 21 years. Our study revealed the importance of combining environmental tracer approaches and a comprehensive sampling campaign (local sources of nitrate, soil water, river water, and groundwater) to identify the nitrate sources in groundwater and its vulnerability. In future, the achieved results will help develop targeted

Appraising options to reduce shallow groundwater tables and enhance flow conditions over regional scales in an irrigated alluvial aquifer system

Science.gov (United States)

Morway, Eric D.; Gates, Timothy K.; Niswonger, Richard G.

2013-01-01

Some of the world’s key agricultural production systems face big challenges to both water quantity and quality due to shallow groundwater that results from long-term intensive irrigation, namely waterlogging and salinity, water losses, and environmental problems. This paper focuses on water quantity issues, presenting finite-difference groundwater models developed to describe shallow water table levels, non-beneficial groundwater consumptive use, and return flows to streams across two regions within an irrigated alluvial river valley in southeastern Colorado, USA. The models are calibrated and applied to simulate current baseline conditions in the alluvial aquifer system and to examine actions for potentially improving these conditions. The models provide a detailed description of regional-scale subsurface unsaturated and saturated flow processes, thereby enabling detailed spatiotemporal description of groundwater levels, recharge to infiltration ratios, partitioning of ET originating from the unsaturated and saturated zones, and groundwater flows, among other variables. Hybrid automated and manual calibration of the models is achieved using extensive observations of groundwater hydraulic head, groundwater return flow to streams, aquifer stratigraphy, canal seepage, total evapotranspiration, the portion of evapotranspiration supplied by upflux from the shallow water table, and irrigation flows. Baseline results from the two regional-scale models are compared to model predictions under variations of four alternative management schemes: (1) reduced seepage from earthen canals, (2) reduced irrigation applications, (3) rotational lease fallowing (irrigation water leased to municipalities, resulting in temporary dry-up of fields), and (4) combinations of these. The potential for increasing the average water table depth by up to 1.1 and 0.7 m in the two respective modeled regions, thereby reducing the threat of waterlogging and lowering non-beneficial consumptive use

Treatment options for renal cell carcinoma in renal allografts: a case series from a single institution.

Science.gov (United States)

Swords, Darden C; Al-Geizawi, Samer M; Farney, Alan C; Rogers, Jeffrey; Burkart, John M; Assimos, Dean G; Stratta, Robert J

2013-01-01

Renal cell carcinoma (RCC) is more common in renal transplant and dialysis patients than the general population. However, RCC in transplanted kidneys is rare, and treatment has previously consisted of nephrectomy with a return to dialysis. There has been recent interest in nephron-sparing procedures as a treatment option for RCC in allograft kidneys in an effort to retain allograft function. Four patients with RCC in allograft kidneys were treated with nephrectomy, partial nephrectomy, or radiofrequency ablation. All of the patients are without evidence of recurrence of RCC after treatment. We found nephron-sparing procedures to be reasonable initial options in managing incidental RCCs diagnosed in functioning allografts to maintain an improved quality of life and avoid immediate dialysis compared with radical nephrectomy of a functioning allograft. However, in non-functioning renal allografts, radical nephrectomy may allow for a higher chance of cure without the loss of transplant function. Consequently, radical nephrectomy should be utilized whenever the allograft is non-functioning and the patient's surgical risk is not prohibitive. © 2013 John Wiley & Sons A/S.

Current and potential treatment options for hyperphosphatemia.

Science.gov (United States)

Carfagna, Fabio; Del Vecchio, Lucia; Pontoriero, Giuseppe; Locatelli, Francesco

2018-05-21

Hyperphosphatemia is common in late stages of chronic kidney disease and is often associated with elevated parathormone levels, abnormal bone mineralization, extra-osseous calcification, and increased risk of cardiovascular events and death. Several classes of oral phosphate binders are available to help control plasma phosphorus levels. Although effective at lowering serum phosphorus, they all have safety, tolerability, and compliance issues that need to be considered when selecting which one to use. Areas covered: This paper reviews the most established treatment options for hyperphosphatemia, in patients with chronic kidney disease, focusing on the new inhibitors of active phosphate absorption. Expert opinion: The prevention and the treatment of hyperphosphatemia is today far to be satisfactory. Nonetheless, an extending range of phosphate binders are now available. Aluminum has potentially serious toxic risks. Calcium-based binders are very effective but can lead to hypercalcemia and/or positive calcium balance and progression of cardiovascular calcification. No long-term data are available for the new calcium acetate/magnesium combination product. Lanthanum is an effective phosphate binder, and long-term effects of tissue deposition seem clinically irrelevant. Sevelamer, appear to have profiles that would lead to pleiotropic effects and reduced progression of vascular calcification, and the main adverse events seen with these agents are gastrointestinal. Iron has a powerful capability of binding phosphate, thus numerous preparations are available, both with and without significant systemic absorption of the iron component. The inhibitors of active intestinal phosphate transport, with their very selective mechanism of action and low pill burden seem the most interesting approach; however, do not seem at present to be effective alone, in reducing serum phosphorus levels.

Application of optimization modeling to groundwater remediation at US Department of Energy facilities

International Nuclear Information System (INIS)

Bakr, A.A.; Dal Santo, D.J.; Smalley, R.C.; Phillips, E.C.

1988-01-01

This paper outlines and explores the fundamentals of the current strategies for groundwater hydraulic and quality management modeling and presents a scheme for the application of such strategies to DOE facilities. The discussion focuses on the DOE-Savannah River Operations (DOE-SR) facility. Remediation of contaminated groundwater at active and abandoned waste disposal sites has become a major element of environmental programs. Traditional groundwater remediation programs (e.g., pumping and treatment) may not represent optimal water quality management strategies at sites to be remediated. Complex, interrelated environmental (geologic/geohydrologic), institutional, engineering, and economic conditions at a site may require a more comprehensive management strategy. Groundwater management models based on the principles of operations research have been developed and used to determine optimal management strategies for water resources needs and for hypothetical remediation programs. Strategies for groundwater remediation programs have ranged from the simple removal of groundwater to complex, hydraulic gradient control programs involving groundwater removal, treatment, and recharge

Integrating groundwater stress in life-cycle assessments – An evaluation of water abstraction

DEFF Research Database (Denmark)

Gejl, Ryle Nørskov; Bjerg, Poul Løgstrup; Henriksen, H. J.

2018-01-01

Understanding groundwater abstraction effects is vital for holistic impact assessments in areas depending on groundwater resources. The objective of our study was to modify the state-of-the-art AWaRe (available water remaining), freshwater impact assessment specifically for use in LCAs in areas...... and adjusts demarcations in order to improve the representation of the heterogeneity of groundwater catchments. The applicability of AGWaRe was demonstrated on three groundwater systems producing 5 million m3 water for the city of Copenhagen, namely Advanced Treatment of Groundwater, Simple Treatment...... of Groundwater and Infiltration of Reclaimed water. Results were normalised to compare with other effects of supplying water to an average Danish person. The normalised impacts for drinking water for one person ranged between 0.1 and 39 PE (person equivalent) for the three systems, which indicates that effects...

Soil, groundwater cleanup takes the gamble out of casino operation

International Nuclear Information System (INIS)

Anon.

1993-01-01

Colorado's rich stores of gold and silver sparked development of towns like Black Hawk and Central City in the 1890s. Today, these communities are the homes of limited-stakes gaming operations. However casino operators are discovering that having gold and silver underground in the form of tailings is not as desirable as collecting it aboveground in slot machines. A unique environmental engineering approach allowed construction of two new casinos and reclamation of the tailings, as well as cleanup of petroleum-saturated soils and groundwater. A treatment system was designed and constructed to treat groundwater at the Black Hawk site. The most economical alternative for disposing treated groundwater was to discharge it into nearby North Clear Creek. An NPDES permit was obtained requiring treatment of the groundwater for petroleum, heavy metals and pH before discharging it

Degradation of sucralose in groundwater and implications for age dating contaminated groundwater.

Science.gov (United States)

Robertson, W D; Van Stempvoort, D R; Spoelstra, J; Brown, S J; Schiff, S L

2016-01-01

The artificial sweetener sucralose has been in use in Canada and the US since about 2000 and in the EU since 2003, and is now ubiquitous in sanitary wastewater in many parts of the world. It persists during sewage treatment and in surface water environments and as such, has been suggested as a powerful tracer of wastewater. In this study, longer-term persistence of sucralose was examined in groundwater by undertaking a series of three sampling snapshots of a well constrained wastewater plume in Canada (Long Point septic system) over a 6-year period from 2008 to 2014. A shrinking sucralose plume in 2014, compared to earlier sampling, during this period when sucralose use was likely increasing, provides clear evidence of degradation. However, depletion of sucralose from a mean of 40 μg/L in the proximal plume zone, occurred at a relatively slow rate over a period of several months to several years. Furthermore, examination of septic tank effluent and impacted groundwater at six other sites in Canada, revealed that sucralose was present in all samples of septic tank effluent (6-98 μg/L, n = 32) and in all groundwater samples (0.7-77 μg/L, n = 64). Even though sucralose degradation is noted in the Long Point plume, its ubiquitous presence in the groundwater plumes at all seven sites implies a relatively slow rate of decay in many groundwater septic plume environments. Thus, sucralose has the potential to be used as an indicator of 'recent' wastewater contamination. The presence of sucralose identifies groundwater that was recharged after 2000 in Canada and the US and after 2003 in the EU and many Asian countries. Copyright © 2015 Elsevier Ltd. All rights reserved.

Kansas City plant ultraviolet/ozone/hydrogen peroxide groundwater treatment system overview

International Nuclear Information System (INIS)

Stites, M.E.; Hughes, R.F.

1992-01-01

The Kansas City Plant (KCP) has committed to the utilization of a groundwater treatment system, for removal of volatile organic compounds (VOCs), that discharges a minimal amount of pollutants to the environment. An advanced oxidation process (AOP) system utilizing ozone, ultraviolet radiation, and hydrogen peroxide serves in this capacity. Packed tower aeration and activated carbon filtration are listed as best available technologies (BATs) by the Environmental Protection Agency (EPA) for the removal of VOCs in water. The disadvantage to these BATs is that they transfer the VOCs from the water medium to the air or carbon media respectively. Operation of the system began in May 1988 at a flow rate of 22.7 liters per minute (lpm) (6 gallons per minute (gpm)). An additional 102.2 lpm (27 gpm) of flow were added in October 1990. Various efforts to optimize and track the treatment unites efficiency have been carried out. A maximum influent reading of 26,590 parts per billion (ppb) of total VOCs has been recorded. Following the addition of flows, removal efficiency has averaged approximately 95%. Both air and water effluents are factored into this calculation. (author)

Surgical options for lumbosacral fusion: biomechanical stability, advantage, disadvantage and affecting factors in selecting options.

Science.gov (United States)

Yoshihara, Hiroyuki

2014-07-01

Numerous surgical procedures and instrumentation techniques for lumbosacral fusion (LSF) have been developed. This is probably because of its high mechanical demand and unique anatomy. Surgical options include anterior column support (ACS) and posterior stabilization procedures. Biomechanical studies have been performed to verify the stability of those options. The options have their own advantage but also disadvantage aspects. This review article reports the surgical options for lumbosacral fusion, their biomechanical stability, advantages/disadvantages, and affecting factors in option selection. Review of literature. LSF has lots of options both for ACS and posterior stabilization procedures. Combination of posterior stabilization procedures is an option. Furthermore, combinations of ACS and posterior stabilization procedures are other options. It is difficult to make a recommendation or treatment algorithm of LSF from the current literature. However, it is important to know all aspects of the options and decision-making of surgical options for LSF needs to be tailored for each patient, considering factors such as biomechanical stress and osteoporosis.

Split high‐dose oral levothyroxine treatment as a successful therapy option in myxedema coma

OpenAIRE

Charoensri, Suranut; Sriphrapradang, Chutintorn; Nimitphong, Hataikarn

2017-01-01

Key Clinical Message High‐dose intravenous thyroxine (T4) is the preferable treatment for myxedema coma. We describe the clinical course of a 69‐year‐old man who presented with myxedema coma and received oral levothyroxine (LT4) therapy (1 mg) in a split dose. This suggests split high‐dose oral LT4 as a therapeutic option in myxedema coma.

Environmental Sciences Division Groundwater Program Office report for fiscal years 1995-1997

International Nuclear Information System (INIS)

Huff, D.D.

1998-03-01

The purpose of this report is to summarize the activities of the Groundwater Program Office in fiscal years 1995--1997 and document technical results achieved. One of the first contributions of the project was development and publication of a conceptual hydrologic framework for the Oak Ridge Reservation. This framework then served to guide research to fill important gaps in knowledge and suggest the most cost-effective approaches to site characterization and remediation. Examples of major goals include: quantitative characterization of the role of matrix diffusion in slowing transport of contaminants and impacting the practicality of pump and treat options for aquifer restoration; the importance of geologic structure and preferred flow pathways in the near surface zone (including the role of stormflow); evaluation of the importance of the deep groundwater system in contaminant migration; and acquisition of three-dimensional groundwater flow and contaminant transport simulation capability for fractured porous media

An overview of seasonal affective disorder and its treatment options.

Science.gov (United States)

Howland, Robert H

2009-12-01

Seasonal affective disorder (SAD) is defined as a history of major depressive episodes that recur regularly at a particular time of year. Depending on the diagnostic instruments and criteria available, the reported prevalence (1%-10%) varies. Neurotransmitter abnormalities have been implicated in the pathophysiology, but they do not necessarily explain the seasonal pattern or the known chronobiological abnormalities in SAD compared with nonseasonal depression. Circadian rhythm abnormalies have been hypothesized to account for these aspects of SAD, and they provide a rationale for the therapeutic use of light therapy. Family history, twin, and molecular genetics studies suggest that hereditary factors are also involved. Light therapy and antidepressant medication are effective treatment options, with limited evidence for the efficacy of psychotherapy. Some studies demonstrate that narrow-band short wavelength "blue" light, naturalistic dawn simulation, and high-density negative air ionization are effective. Patients should be informed of the benefits of diet and exercise. Light therapy should be clinically monitored in the same manner, as it is done for other antidepressant treatments.

TIE for cyanides in groundwater at a former coal gasification plant

Energy Technology Data Exchange (ETDEWEB)

McLeay, M.; Cameron, M. [Hemmeram, Vancouver, BC (Canada); Elphick, J. [Nautilus Environmental Co., Burnaby, BC (Canada)

2010-07-01

Groundwater remediation efforts are underway at a former coal gasification plant site in British Columbia because the concentrations of cyanide and other substances were found to exceed aquatic life guidelines. Hemmera and Nautilus Environmental examined whether that groundwater was toxic to a variety of sensitive marine aquatic life species, and whether cyanide was the primary toxicant. Untreated groundwater containing cyanide, weak acid dissociable cyanide and free cyanide was tested for toxicity on bivalve larval survival, kelp zoospore germination, sea urchin gamete fertilization, and larval topsmelt survival and growth. The untreated groundwater was found to be toxic to kelp zoospores and sea urchin gametes, but relatively non-toxic to bivalve larvae and topsmelt. The following 4 toxicity identification evaluation (TIE) treatments were conducted on site groundwater: (1) acidification/aeration of the sample, (2) filtration of the sample through anion exchange media, (3) filtration of the sample through activated carbon, and (4) exposure of the sample to UV light. Both the cyanide concentration and the toxicity to kelp decreased considerably when the anion exchange treatment was applied. The results suggest that the toxicity may be attributed to cyanides in the groundwater. The information obtained from this study will be used to plan excavation water treatment strategies during site remediation as part of an ecological risk assessment for the site.

TIE for cyanides in groundwater at a former coal gasification plant

International Nuclear Information System (INIS)

McLeay, M.; Cameron, M.; Elphick, J.

2010-01-01

Groundwater remediation efforts are underway at a former coal gasification plant site in British Columbia because the concentrations of cyanide and other substances were found to exceed aquatic life guidelines. Hemmera and Nautilus Environmental examined whether that groundwater was toxic to a variety of sensitive marine aquatic life species, and whether cyanide was the primary toxicant. Untreated groundwater containing cyanide, weak acid dissociable cyanide and free cyanide was tested for toxicity on bivalve larval survival, kelp zoospore germination, sea urchin gamete fertilization, and larval topsmelt survival and growth. The untreated groundwater was found to be toxic to kelp zoospores and sea urchin gametes, but relatively non-toxic to bivalve larvae and topsmelt. The following 4 toxicity identification evaluation (TIE) treatments were conducted on site groundwater: (1) acidification/aeration of the sample, (2) filtration of the sample through anion exchange media, (3) filtration of the sample through activated carbon, and (4) exposure of the sample to UV light. Both the cyanide concentration and the toxicity to kelp decreased considerably when the anion exchange treatment was applied. The results suggest that the toxicity may be attributed to cyanides in the groundwater. The information obtained from this study will be used to plan excavation water treatment strategies during site remediation as part of an ecological risk assessment for the site.

Online flow cytometry reveals microbial dynamics influenced by concurrent natural and operational events in groundwater used for drinking water treatment.

Science.gov (United States)

Besmer, Michael D; Epting, Jannis; Page, Rebecca M; Sigrist, Jürg A; Huggenberger, Peter; Hammes, Frederik

2016-12-07

Detailed measurements of physical, chemical and biological dynamics in groundwater are key to understanding the important processes in place and their influence on water quality - particularly when used for drinking water. Measuring temporal bacterial dynamics at high frequency is challenging due to the limitations in automation of sampling and detection of the conventional, cultivation-based microbial methods. In this study, fully automated online flow cytometry was applied in a groundwater system for the first time in order to monitor microbial dynamics in a groundwater extraction well. Measurements of bacterial concentrations every 15 minutes during 14 days revealed both aperiodic and periodic dynamics that could not be detected previously, resulting in total cell concentration (TCC) fluctuations between 120 and 280 cells μL -1 . The aperiodic dynamic was linked to river water contamination following precipitation events, while the (diurnal) periodic dynamic was attributed to changes in hydrological conditions as a consequence of intermittent groundwater extraction. Based on the high number of measurements, the two patterns could be disentangled and quantified separately. This study i) increases the understanding of system performance, ii) helps to optimize monitoring strategies, and iii) opens the possibility for more sophisticated (quantitative) microbial risk assessment of drinking water treatment systems.

In situ remediation of uranium contaminated groundwater

International Nuclear Information System (INIS)

Dwyer, B.P.; Marozas, D.C.

1997-01-01

In an effort to develop cost-efficient techniques for remediating uranium contaminated groundwater at DOE Uranium Mill Tailing Remedial Action (UMTRA) sites nationwide, Sandia National Laboratories (SNL) deployed a pilot scale research project at an UMTRA site in Durango, CO. Implementation included design, construction, and subsequent monitoring of an in situ passive reactive barrier to remove Uranium from the tailings pile effluent. A reactive subsurface barrier is produced by emplacing a reactant material (in this experiment various forms of metallic iron) in the flow path of the contaminated groundwater. Conceptually the iron media reduces and/or adsorbs uranium in situ to acceptable regulatory levels. In addition, other metals such as Se, Mo, and As have been removed by the reductive/adsorptive process. The primary objective of the experiment was to eliminate the need for surface treatment of tailing pile effluent. Experimental design, and laboratory and field results are discussed with regard to other potential contaminated groundwater treatment applications

Finding Balance Between Biological Groundwater Treatment and Treated Injection Water

Energy Technology Data Exchange (ETDEWEB)

Carlson, Mark A.; Nielsen, Kellin R.; Byrnes, Mark E.; Simmons, Sally A.; Morse, John J.; Geiger, James B.; Watkins, Louis E.; McFee, Phillip M.; Martins, K.

2015-01-14

At the U.S. Department of Energy’s Hanford Site, CH2M HILL Plateau Remediation Company operates the 200 West Pump and Treat which was engineered to treat radiological and chemical contaminants in groundwater as a result of the site’s former plutonium production years. Fluidized bed bioreactors (FBRs) are used to remove nitrate, metals, and volatile organic compounds. Increasing nitrate concentrations in the treatment plant effluent and the presence of a slimy biomass (a typical microorganism response to stress) in the FBRs triggered an investigation of nutrient levels in the system. Little, if any, micronutrient feed was coming into the bioreactors. Additionally, carbon substrate (used to promote biological growth) was passing through to the injection wells, causing biological fouling of the wells and reduced specific injectivity. Adjustments to the micronutrient feed improved microorganism health, but the micronutrients were being overfed (particularly manganese) plugging the injection wells further. Injection well rehabilitation to restore specific injectivity required repeated treatments to remove the biological fouling and precipitated metal oxides. A combination of sulfamic and citric acids worked well to dissolve metal oxides and sodium hypochlorite effectively removed the biological growth. Intensive surging and development techniques successfully removed clogging material from the injection wells. Ultimately, the investigation and nutrient adjustments took months to restore proper balance to the microbial system and over a year to stabilize injection well capacities. Carefully tracking and managing the FBRs and well performance monitoring are critical to balancing the needs of the treatment system while reducing fouling mechanisms in the injection wells.

A review of treatment options for Graves' disease: why total thyroidectomy is a viable option in selected patients.

Science.gov (United States)

Mohan, Vinuta; Lind, Robert

2016-01-01

Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I(131)iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves' disease.

Future research needs involving pathogens in groundwater

Science.gov (United States)

Bradford, Scott A.; Harvey, Ronald W.

2017-01-01

Contamination of groundwater by enteric pathogens has commonly been associated with disease outbreaks. Proper management and treatment of pathogen sources are important prerequisites for preventing groundwater contamination. However, non-point sources of pathogen contamination are frequently difficult to identify, and existing approaches for pathogen detection are costly and only provide semi-quantitative information. Microbial indicators that are readily quantified often do not correlate with the presence of pathogens. Pathogens of emerging concern and increasing detections of antibiotic resistance among bacterial pathogens in groundwater are topics of growing concern. Adequate removal of pathogens during soil passage is therefore critical for safe groundwater extraction. Processes that enhance pathogen transport (e.g., high velocity zones and preferential flow) and diminish pathogen removal (e.g., reversible retention and enhanced survival) are of special concern because they increase the risk of groundwater contamination, but are still incompletely understood. Improved theory and modeling tools are needed to analyze experimental data, test hypotheses, understand coupled processes and controlling mechanisms, predict spatial and/or temporal variability in model parameters and uncertainty in pathogen concentrations, assess risk, and develop mitigation and best management approaches to protect groundwater.

Future research needs involving pathogens in groundwater

Science.gov (United States)

Bradford, Scott A.; Harvey, Ronald W.

2017-06-01

Contamination of groundwater by enteric pathogens has commonly been associated with disease outbreaks. Proper management and treatment of pathogen sources are important prerequisites for preventing groundwater contamination. However, non-point sources of pathogen contamination are frequently difficult to identify, and existing approaches for pathogen detection are costly and only provide semi-quantitative information. Microbial indicators that are readily quantified often do not correlate with the presence of pathogens. Pathogens of emerging concern and increasing detections of antibiotic resistance among bacterial pathogens in groundwater are topics of growing concern. Adequate removal of pathogens during soil passage is therefore critical for safe groundwater extraction. Processes that enhance pathogen transport (e.g., high velocity zones and preferential flow) and diminish pathogen removal (e.g., reversible retention and enhanced survival) are of special concern because they increase the risk of groundwater contamination, but are still incompletely understood. Improved theory and modeling tools are needed to analyze experimental data, test hypotheses, understand coupled processes and controlling mechanisms, predict spatial and/or temporal variability in model parameters and uncertainty in pathogen concentrations, assess risk, and develop mitigation and best management approaches to protect groundwater.

Groundwater Engineering in an Environmentally Sensitive Urban Area: Assessment, Landuse Change/Infrastructure Impacts and Mitigation Measures

Directory of Open Access Journals (Sweden)

Yohannes Yihdego

2017-07-01

Full Text Available A rise in the shallow unconfined groundwater at a site in Australia is causing water logging of the underground facility in the affected area. Realizing this problem, a study was conducted to identify the source of water that is causing the rise and to develop an implementation and operation plan of the mitigation (dewatering system. Modelling was undertaken using MODFLOW-SURFACT code, within the framework of Visual MODFLOW, to assess the spatial and temporal groundwater level at the site. The study undertaken incorporates compilation and assessment of available data, including a list of factual information reviewed, development of a conceptual groundwater model for the site and modelling of the pre and post development conditions. The outcomes of the assessment indicate water level rises due to the construction of the embankment are likely less than 0.12 m and changes in land, such as affected area burial, may change aquifer characteristics more significantly than the embankment. It is concluded that the elevated groundwater levels in the affected area are most likely a result of above average rainfall since 2007 and long term cumulative land use changes. The embankment construction is just one of many land use changes that have occurred both within and surrounding the affected area and likely only a minor contributor to the elevated water levels. Greater contribution may be attributed to re-direction of the natural flow paths the railway culvert weir reducing the overland flow gradient and ongoing changes (burial within the affected area and including the embankment. The model findings gives answers on what factors may be/are causing/contributing to, the higher than usual groundwater levels in the study area. A combination of drainage and/or pumping (dewatering system is suggested as a solution to overcome the problem of rising groundwater levels at the site. Further, the model output can aid in assessing mitigation options, including

Management of patients with hormone receptor–positive breast cancer with visceral disease: challenges and treatment options

International Nuclear Information System (INIS)

Harb, Wael A

2015-01-01

Endocrine therapy is an important treatment option for women with hormone receptor–positive (HR+) advanced breast cancer (ABC), yet many tumors are either intrinsically resistant or develop resistance to these therapies. Treatment of patients with ABC presenting with visceral metastases, which is associated with a poor prognosis, is also problematic. There is an unmet need for effective treatments for this patient population. Although chemotherapy is commonly perceived to be more effective than endocrine therapy in managing visceral metastases, patients who are not in visceral crisis might benefit from endocrine therapy, avoiding chemotherapy-associated toxicities that might affect quality of life. To improve outcomes, several targeted therapies are being investigated in combination with endocrine therapy for patients with endocrine-resistant, HR+ ABC. Although available data have considered patients with HR+ ABC as a whole, there are promising data from a prespecified analysis of a Phase III study of everolimus (Afinitor ® ), a mammalian target of rapamycin (mTOR) inhibitor, in combination with exemestane (Aromasin ® ) in patients with visceral disease progressing after nonsteroidal aromatase inhibitor therapy. In this review, challenges and treatment options for management of HR+ ABC with visceral disease, including consideration of therapeutic approaches undergoing clinical investigation, will be assessed

Management of stage IV rectal cancer: Palliative options

Science.gov (United States)

Ronnekleiv-Kelly, Sean M; Kennedy, Gregory D

2011-01-01

Approximately 30% of patients with rectal cancer present with metastatic disease. Many of these patients have symptoms of bleeding or obstruction. Several treatment options are available to deal with the various complications that may afflict these patients. Endorectal stenting, laser ablation, and operative resection are a few of the options available to the patient with a malignant large bowel obstruction. A thorough understanding of treatment options will ensure the patient is offered the most effective therapy with the least amount of associated morbidity. In this review, we describe various options for palliation of symptoms in patients with metastatic rectal cancer. Additionally, we briefly discuss treatment for asymptomatic patients with metastatic disease. PMID:21412493

Bioremediation of Uranium-Contaminated Groundwater using Engineered Injection and Extraction

Science.gov (United States)

Greene, J. A.; Neupauer, R.; Ye, M.; Kasprzyk, J. R.; Mays, D. C.; Curtis, G. P.

2017-12-01

During in-situ remediation of contaminated groundwater, a treatment chemical is injected into the contaminated groundwater to react with and degrade the contaminant, with reactions occurring where the treatment chemical contacts the contaminant. Traditional in-situ groundwater remediation relies on background groundwater flow for spreading of treatment chemicals into contaminant plumes. Engineered Injection and Extraction (EIE), in which time-varying induced flow fields are used to actively spread the treatment chemical into the contaminant plume, has been developed to increase contact between the contaminant and treatment chemical, thereby enhancing contaminant degradation. EIE has been investigated for contaminants that degrade through irreversible bimolecular reaction with a treatment chemical, but has not been investigated for a contaminant governed by reversible reactions. Uranium primarily occurs in its aqueous, mobile form, U(VI), in the environment but can be bioreduced to its sparingly soluble, immobile form, U(IV), by iron reducing bacteria stimulated by an acetate amendment. In this study, we investigate the ability of EIE to facilitate and sustain favorable conditions to immobilize uranium during remediation, and to prevent re-mobilization of uranium into the aqueous phase after active remediation has ended. Simulations in this investigation are conducted using a semi-synthetic model based on physical and chemical conditions at the Naturita Uranium Mill Tailings Remedial Action (UMTRA) site in southwestern Colorado and the Old Rifle UMTRA site in western Colorado. The EIE design is optimized for the synthetic model using the Borg multi-objective evolutionary algorithm.

A subagging regression method for estimating the qualitative and quantitative state of groundwater

Science.gov (United States)

Jeong, Jina; Park, Eungyu; Han, Weon Shik; Kim, Kue-Young

2017-08-01

A subsample aggregating (subagging) regression (SBR) method for the analysis of groundwater data pertaining to trend-estimation-associated uncertainty is proposed. The SBR method is validated against synthetic data competitively with other conventional robust and non-robust methods. From the results, it is verified that the estimation accuracies of the SBR method are consistent and superior to those of other methods, and the uncertainties are reasonably estimated; the others have no uncertainty analysis option. To validate further, actual groundwater data are employed and analyzed comparatively with Gaussian process regression (GPR). For all cases, the trend and the associated uncertainties are reasonably estimated by both SBR and GPR regardless of Gaussian or non-Gaussian skewed data. However, it is expected that GPR has a limitation in applications to severely corrupted data by outliers owing to its non-robustness. From the implementations, it is determined that the SBR method has the potential to be further developed as an effective tool of anomaly detection or outlier identification in groundwater state data such as the groundwater level and contaminant concentration.

Management options of varicoceles

Directory of Open Access Journals (Sweden)

Peter Chan

2011-01-01

Full Text Available Varicocele is one of the most common causes of male infertility. Treatment options for varicoceles includes open varicocelectomy performed at various anatomical levels. Laparoscopic varicocelectomy has been established to be a safe and effective treatment for varicoceles. Robotic surgery has been introduced recently as an alternative surgical option for varicocelectomy. Microsurgical varicocelectomy has gained increasing popularity among experts in male reproductive medicine as the treatment of choice for varicocele because of its superior surgical outcomes. There is a growing volume of literature in the recent years on minimal invasive varicocele treatment with percutaneous retrograde and anterograde venous embolization/sclerotherapy. In this review, we will discuss the advantages and limitations associated with each treatment modality for varicoceles. Employment of these advanced techniques of varicocelectomy can provide a safe and effective approach aiming to eliminate varicocele, preserve testicular function and, in a substantial number of men, increase semen quality and the likelihood of pregnancy.

Proceedings of the fifth international groundwater conference on the assessment and management of groundwater resources in hard rock systems with special reference to basaltic terrain

International Nuclear Information System (INIS)

Thangarajan, M.; Mayilswami, C.; Kulkarni, P.S.; Singh, V.P.

2012-01-01

many contaminant processes, a precautionary approach should generally be adopted for the groundwater resources. Such an approach is always aimed to avert danger or at least minimize the risk of groundwater pollution and promote protection of its quality. The main emphasis of the conference was on the groundwater shortage and quality deterioration and the main topics discussed were: resources assessment and aquifer characterisation; recharge estimation process and augmentation; agricultural stress and water management; water and environment; models and its application in groundwater management; and groundwater management issues/options and policies. Papers relevant to INIS are indexed separately

Pre-eclampsia Diagnosis and Treatment Options: A Review of Published Economic Assessments.

Science.gov (United States)

Zakiyah, Neily; Postma, Maarten J; Baker, Philip N; van Asselt, Antoinette D I

2015-10-01

Pre-eclampsia is a pregnancy complication affecting both mother and fetus. Although there is no proven effective method to prevent pre-eclampsia, early identification of women at risk of pre-eclampsia could enhance appropriate application of antenatal care, management and treatment. Very little is known about the cost effectiveness of these and other tests for pre-eclampsia, mainly because there is no clear treatment path. The aim of this study was to provide a comprehensive overview of the existing evidence on the health economics of screening, diagnosis and treatment options in pre-eclampsia. We searched three electronic databases (PubMed, EMBASE and the Cochrane Library) for studies on screening, diagnosis, treatment or prevention of pre-eclampsia, published between 1994 and 2014. Only full papers written in English containing complete economic assessments in pre-eclampsia were included. From an initial total of 138 references, six papers fulfilled the inclusion criteria. Three studies were on the cost effectiveness of treatment of pre-eclampsia, two of which evaluated magnesium sulphate for prevention of seizures and the third evaluated the cost effectiveness of induction of labour versus expectant monitoring. The other three studies were aimed at screening and diagnosis, in combination with subsequent preventive measures. The two studies on magnesium sulphate were equivocal on the cost effectiveness in non-severe cases, and the other study suggested that induction of labour in term pre-eclampsia was more cost effective than expectant monitoring. The screening studies were quite diverse in their objectives as well as in their conclusions. One study concluded that screening is probably not worthwhile, while two other studies stated that in certain scenarios it may be cost effective to screen all pregnant women and prophylactically treat those who are found to be at high risk of developing pre-eclampsia. This study is the first to provide a comprehensive overview

Fluorine geochemistry in bedrock groundwater of South Korea

International Nuclear Information System (INIS)

Chae, Gi-Tak; Yun, Seong-Taek; Mayer, Bernhard; Kim, Kyoung-Ho; Kim, Seong-Yong; Kwon, Jang-Soon; Kim, Kangjoo; Koh, Yong-Kwon

2007-01-01

High fluoride concentrations (median = 4.4 mg/L) in deep bedrock groundwater of South Korea prevent the usage of it as a drinking water source. The hydrogeochemistry of deep thermal groundwaters (N = 377) in diverse bedrocks has been studied in order to evaluate the geologic and geochemical controls on fluoride concentrations in groundwater. The groundwater samples were clustered geologically, and the average and median concentrations of fluoride were compared by the Mann-Whitney U test. The order of median fluoride concentration with respect to geology is as follows: metamorphic rocks ≥ granitoids ≥ complex rock >> volcanic rocks ≥ sedimentary rocks. This result indicates that the geological source of fluoride in groundwater is related to the mineral composition of metamorphic rocks and granitoids. With respect to groundwater chemistry, the fluoride concentration was highest in Na-HCO 3 type groundwater and lowest in Ca-HCO 3 type groundwater. Ionic relationships also imply that the geochemical behavior of fluoride in groundwater is related to the geochemical process releasing Na and removing Ca ions. The thermodynamic relationship between the activities of Ca and F indicates that fluoride concentration is controlled by the equilibrium of fluorite (CaF 2 ). In other words, the upper limits of fluoride concentration are determined by the Ca ion; i.e., Ca concentrations play a crucial role in fluoride behavior in deep thermal groundwater. The result of this study suggests that the high fluoride in groundwater originates from geological sources and fluoride can be removed by fluorite precipitation when high Ca concentration is maintained. This provides a basis for a proper management plan to develop the deep thermal groundwater and for treatment of high fluoride groundwater frequently found in South Korea

Groundwater Treatment at SRS: An Innovative Approach

International Nuclear Information System (INIS)

Jorque, M.A.; Golshir, G.H.; Davis, B.

1998-03-01

The SRS is located in southwestern South Carolina, occupying an almost circular area of approximately 800 km2 within Aiken, Barnwell, and Allendale counties. The site lies approximately 36 km southeast of Augusta, Georgia, and is bounded by the Savannah River along its southwestern border. Prior to the establishment of the SRS in 1952, the area was largely a rural agricultural community. As part of the defense complex, the SRS produced special nuclear materials for the national defense.From 1955 until 1988, unlined earthen basins were used to dispose of wastewater from the SRS separations facilities located in the F and H areas. Approximately 300 million liters of wastewater was transported annually from the process area through underground piping to the basins. The wastewater was allowed to evaporate and to seep into the underlying formations. There were three basins in the F-Area covering a total of about 3 hectares; while the H-Area was served by four basins covering about 6 hectares. The seepage basins closure was started in 1989 and SCDHEC certified the closures as completed in 1991.Groundwater monitoring conducted in accordance with the provisions of the RCRA Permits determined that the underlying hydrogeologic units were contaminated by tritium, radioactive metals (primarily Cesium 137, Strontium 90, and Uranium 235), nitrate and heavy metals, some of which are defined as hazardous by RCRA. Under the terms and conditions of the RCRA Post- Closure Permits, it was necessary to remediate the contaminated groundwater plumes

Ground-water heat pumps: an examination of hydrogeologic, environmental, legal, and economic factors affecting their use

Energy Technology Data Exchange (ETDEWEB)

Armitage, D M; Bacon, D J; Massey-Norton, J T; Miller, J D

1980-11-12

Groundwater is attractive as a potential low-temperature energy source in residential space-conditioning applications. When used in conjuncton with a heat pump, ground water can serve as both a heat source (for heating) and a heat sink (for cooling). Major hydrogeologic aspects that affect system use include groundwater temperature and availability at shallow depths as these factors influence operational efficiency. Ground-water quality is considered as it affects the performance and life-expectancy of the water-side heat exchanger. Environmental impacts related to groundwater heat pump system use are most influenced by water use and disposal methods. In general, recharge to the subsurface (usually via injection wells) is recommended. Legal restrictions on system use are often stricter at the municipal and county levels than at state and Federal levels. Although Federal regulations currently exist, the agencies are not equipped to regulate individual, domestic installations. Computer smulations indicate that under a variety of climatologic conditions, groundwater heat pumps use less energy than conventional heating and cooling equipment. Life-cycle cost comparisons with conventional equipment depend on alternative system choices and well cost options included in the groundwater heat pump system.

Comparative study of the efficacy of different treatment options in patients with chronic blepharitis.

Science.gov (United States)

Arrúa, M; Samudio, M; Fariña, N; Cibils, D; Laspina, F; Sanabria, R; Carpinelli, L; Mino de Kaspar, H

2015-03-01

To compare the efficacy of 3 treatment options in patients with chronic blepharitis. An experimental, randomized, controlled study was conducted on 45 patients (female 67%; Mean age: 40.5 years) diagnosed with chronic blepharitis, in order to compare the effectiveness of three treatment options. Group 1: eyelid hygiene with neutral shampoo three times/day; group 2: neutral shampoo eyelid hygiene plus topical metronidazole gel 0.75% twice/day; group 3: neutral eyelid hygiene with shampoo plus neomycin 3.5% and polymyxin 10% antibiotic ointment with 0.5% dexamethasone 3 times/day. The symptoms and signs were assessed by assigning scores from 0: no symptoms and/or signs; 1: mild symptoms and/or signs, 2: moderate symptoms and/or signs; and 3: severe symptoms and/or signs. A significant improvement was observed in the signs and symptoms in all 3 treatment groups. While groups 1 and 2 had more improvement in all variables studied (P<.05), Group 3 showed no clinical improvement for itching (P=.16), dry eye (P=.29), eyelashes falling (P=.16), and erythema at the eyelid margin (P=.29). Shampoo eyelid hygiene neutral and neutral shampoo combined with the use of metronidazole gel reported better hygiene results than neutral shampoo lid with antibiotic ointment and neomycin and polymyxin dexamethasone. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Solidification of radioactive liquid wastes. A comparison of treatment options for spent resins and concentrates

International Nuclear Information System (INIS)

Roth, A.; Willmann, F.; Ebata, M.; Wendt, S.

2008-01-01

Ion exchange is one of the most common and effective treatment methods for liquid radioactive waste. However, spent ion exchange resins are considered to be problematic waste that in many cases require special approaches and pre-conditioning during its immobilization to meet the acceptance criteria for disposal. Because of the function that they fulfill, spent ion exchange resins often contain high concentrations of radioactivity and pose special handling and treatment problems. Another very common method of liquid radioactive waste treatment and water cleaning is the evaporation or diaphragm filtration. Both treatment options offer a high volume reduction of the total volume of liquids treated but generate concentrates which contain high concentrations of radioactivity. Both mentioned waste streams, spent resins as well as concentrates, resulting from first step liquid radioactive waste treatment systems have to be conditioned in a suitable manner to achieve stable waste products for final disposal. The most common method of treatment of such waste streams is the solidification in a solid matrix with additional inactive material like cement, polymer etc. In the past good results have been achieved and the high concentration of radioactivity can be reduced by adding the inactive material. On the other hand, under the environment of limited space for interim storage and the absence of a final repository site, the built-up of additional volume has to be considered as very critical. Moreover, corrosive effects on cemented drums during long-term interim storage at the surface have raised doubts about the long-term stability of such waste products. In order to avoid such disadvantages solidification methods have been improved in order to get a well-defined product with a better load factor of wastes in the matrix. In a complete different approach, other technologies solidify the liquid radioactive wastes without adding of any inactive material by means of drying

Arsenic pollution of groundwater in Vietnam exacerbated by deep aquifer exploitation for more than a century

Science.gov (United States)

Winkel, Lenny H. E.; Trang, Pham Thi Kim; Lan, Vi Mai; Stengel, Caroline; Amini, Manouchehr; Ha, Nguyen Thi; Viet, Pham Hung; Berg, Michael

2011-01-01

Arsenic contamination of shallow groundwater is among the biggest health threats in the developing world. Targeting uncontaminated deep aquifers is a popular mitigation option although its long-term impact remains unknown. Here we present the alarming results of a large-scale groundwater survey covering the entire Red River Delta and a unique probability model based on three-dimensional Quaternary geology. Our unprecedented dataset reveals that ∼7 million delta inhabitants use groundwater contaminated with toxic elements, including manganese, selenium, and barium. Depth-resolved probabilities and arsenic concentrations indicate drawdown of arsenic-enriched waters from Holocene aquifers to naturally uncontaminated Pleistocene aquifers as a result of > 100 years of groundwater abstraction. Vertical arsenic migration induced by large-scale pumping from deep aquifers has been discussed to occur elsewhere, but has never been shown to occur at the scale seen here. The present situation in the Red River Delta is a warning for other As-affected regions where groundwater is extensively pumped from uncontaminated aquifers underlying high arsenic aquifers or zones. PMID:21245347

Renal Artery Embolization - A First Line Treatment Option For End-Stage Hydronephrosis

International Nuclear Information System (INIS)

Mitra, Kakali; Prabhudesai, Vikramaditya; James, R. Lester; Jones, Robert W. A.; French, Michael E.; Cowling, Mark; West, David J.

2004-01-01

Conventionally poorly functioning hydronephrotic kidneys have been removed if they are symptomatic. In our unit, patients are offered renal artery embolization as an alternative treatment option. Patients and Methods: Fifteen patients (11 male, 4 female) with a mean age of 32.9 yr (20-51 yrs) have undergone renal artery embolization for symptomatic hydronephrosis with poor function. Mean follow-up was 64.13 weeks (range 14-200). All patients had loin pain and hydronephrosis. Twelve patients had primary pelvi-ureteric junction obstruction (PUJO). Two patients had poorly functioning hydronephrotic kidneys secondary to chronic calculous obstruction. One patient had chronic pain in an obstructed but reasonably functioning kidney following a previous pyeloplasty for PUJO which demanded intervention. Mean split function on renography was 11% (range 0-46%). Selective renal artery embolization was carried out under antibiotic cover using a 7 Fr balloon occlusion catheter and absolute alcohol, steel coils, and polyvinyl alcohol particles.Results: Nine patients developed post-embolization syndrome of self-limiting pain and pyrexia with no evidence of sepsis. One patient required readmission with this condition. One patient developed a hematoma at the puncture site. Mean hospital stay was 2.3 days. Fourteen patients are happy with the result and are completely pain free. One patient has minor discomfort but is delighted with the result. Nine patients have had follow-up ultrasound confirming resolution of the hydronephrosis. Conclusion: Renal artery embolization is an effective, safe, well-tolerated minimally invasive treatment option in end-stage hydronephrosis and we routinely offer it as an alternative to nephrectomy

Emerging treatment options for refractory angina pectoris: ranolazine, shock wave treatment, and cell-based therapies.

Science.gov (United States)

Gennari, Marco; Gambini, Elisa; Bassetti, Beatrice; Capogrossi, Maurizio; Pompilio, Giulio

2014-01-01

A challenge of modern cardiovascular medicine is to find new, effective treatments for patients with refractory angina pectoris, a clinical condition characterized by severe angina despite optimal medical therapy. These patients are not candidates for surgical or percutaneous revascularization. Herein we review the most up-to-date information regarding the modern approach to the patient with refractory angina pectoris, from conventional medical management to new medications and shock wave therapy, focusing on the use of endothelial precursor cells (EPCs) in the treatment of this condition. Clinical limitations of the efficiency of conventional approaches justify the search for new therapeutic options. Regenerative medicine is considered the next step in the evolution of organ replacement therapy. It is driven largely by the same health needs as transplantation and replacement therapies, but it aims further than traditional approaches, such as cell-based therapy. Increasing knowledge of the role of circulating cells derived from bone marrow (EPCs) on cardiovascular homeostasis in physiologic and pathologic conditions has prompted the clinical use of these cells to relieve ischemia. The current state of therapeutic angiogenesis still leaves many questions unanswered. It is of paramount importance that the treatment is delivered safely. Direct intramyocardial and intracoronary administration has demonstrated acceptable safety profiles in early trials, and may represent a major advance over surgical thoracotomy. The combined efforts of bench and clinical researchers will ultimately answer the question of whether cell therapy is a suitable strategy for treatment of patients with refractory angina.

Options for Steam Generator Decommissioning

International Nuclear Information System (INIS)

Krause, Gregor; Amcoff, Bjoern; Robinson, Joe

2016-01-01

Selecting the best option for decommissioning steam generators is a key consideration in preparing for decommissioning PWR nuclear power plants. Steam Generators represent a discrete waste stream of large, complex items that can lend themselves to a variety of options for handling, treatment, recycling and disposal. Studsvik has significant experience in processing full size Steam Generators at its metal recycling facility in Sweden, and this paper will introduce the Studsvik steam generator treatment concept and the results achieved to date across a number of projects. The paper will outline the important parameters needed at an early stage to assess options and to help consider the balance between off-site and on-site treatment solutions, and the role of prior decontamination techniques. The paper also outlines the use of feasibility studies and demonstration projects that have been used to help customers prepare for decommissioning. The paper discusses physical, radiological and operational history data, Pro and Contra factors for on- and off-site treatment, the role of chemical decontamination prior to treatment, planning for off-site shipments as well as Studsvik experience This paper has an original focus upon the coming challenges of steam generator decommissioning and potential external treatment capacity constraints in the medium term. It also focuses on the potential during operations or initial shut-down to develop robust plans for steam generator management. (authors)

Biofeedback as complementary treatment in patients with epilepsy – an underestimated therapeutic option? Review, results, discussion

Directory of Open Access Journals (Sweden)

Uhlmann Carmen

2016-12-01

Full Text Available Background. Biofeedback methods represent side effect free complementary options in the treatment of epilepsy. In this paper we review the current status of these methods in terms of clinical study results and their evaluation by systematic review papers. Possible mechanisms of action in biofeedback methods are discussed.

Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence

Science.gov (United States)

Hill, Jonathan C.; Foster, Nadine E.; Protheroe, Joanne

2017-01-01

Background & aims Musculoskeletal pain, the most common cause of disability globally, is most frequently managed in primary care. People with musculoskeletal pain in different body regions share similar characteristics, prognosis, and may respond to similar treatments. This overview aims to summarise current best evidence on currently available treatment options for the five most common musculoskeletal pain presentations (back, neck, shoulder, knee and multi-site pain) in primary care. Methods A systematic search was conducted. Initial searches identified clinical guidelines, clinical pathways and systematic reviews. Additional searches found recently published trials and those addressing gaps in the evidence base. Data on study populations, interventions, and outcomes of intervention on pain and function were extracted. Quality of systematic reviews was assessed using AMSTAR, and strength of evidence rated using a modified GRADE approach. Results Moderate to strong evidence suggests that exercise therapy and psychosocial interventions are effective for relieving pain and improving function for musculoskeletal pain. NSAIDs and opioids reduce pain in the short-term, but the effect size is modest and the potential for adverse effects need careful consideration. Corticosteroid injections were found to be beneficial for short-term pain relief among patients with knee and shoulder pain. However, current evidence remains equivocal on optimal dose, intensity and frequency, or mode of application for most treatment options. Conclusion This review presents a comprehensive summary and critical assessment of current evidence for the treatment of pain presentations in primary care. The evidence synthesis of interventions for common musculoskeletal pain presentations shows moderate-strong evidence for exercise therapy and psychosocial interventions, with short-term benefits only from pharmacological treatments. Future research into optimal dose and application of the most

Treatment of Chlorinated Solvents in Groundwater Beneath an Occupied Building at the Young-Rainey STAR Center, Pinellas, FL

Energy Technology Data Exchange (ETDEWEB)

Daniel, Joe [Navarro Research and Engineering; Surovchak, Scott [Dept. of Energy (DOE), Legacy Management; Tabor, Charles [Navarro Research and Engineering

2016-03-01

Groundwater contamination, consisting of two dissolved-phase plumes originating from chlorinated solvent source areas, in the southeastern portion of the Young- Rainey Star Center (also known as the Pinellas County, Florida, Site) in Largo, Florida, has migrated beyond the property boundary, beneath the roadways, and beneath adjacent properties to the south and east. Groundwater contamination will persist as long as the onsite contaminant source remains. The origin of the contamination appears to be multiple long-term point sources beneath Building 100, a 4.5 ha (11 acre) building that housed manufacturing facilities during US DOE operations at the site. The site is now owned by Pinellas County, and most of the space inside the building is leased to private companies, so DOE chose not to conduct characterization or remediation through the floor of the building, instead choosing to conduct all work from outside the building. Injection of emulsified soybean oil and a microbial culture has been used at other areas of the site to accelerate naturally occurring bacterial processes that degrade groundwater contaminants to harmless compounds, and that same approach was chosen for this task. The technical approach consisted of installing horizontal wells from outside the building footprint, extending through and around the identified subsurface treatment areas, and terminating beneath the building. Two 107 m (350 ft) long wells, two 122 m (400 ft) long wells, and four 137 m (450 ft) long wells have been installed to intersect the inferred source areas and confirmed contaminant plumes beneath the building. DOE then injected emulsified vegetable oil and a microbial culture into the horizontal wells at each of several target areas beneath the building where the highest groundwater contaminant concentrations have been detected. The target areas are the northwest corner of the building between the old drum storage pad locations and monitoring well PIN12-S35B, the vicinity of

Low-grade MALT lymphoma of the stomach: a review of treatment options

International Nuclear Information System (INIS)

Schechter, Naomi R.; Yahalom, Joachim

2000-01-01

Purpose: Low-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach (MLS) is often associated with the presence of Helicobacter pylori (H. pylori) bacteria. Eradication of the infection with antibiotic therapy may result in regression of the lymphoma. But when antibiotic treatment fails to reverse the malignant process or if H. pylori is absent, other treatment options should be considered. Because MLS is often confined to the stomach and regional lymph nodes, it is potentially curable with local therapy. Endoscopy and improved imaging, with endoscopic ultrasound (EUS) and computerized tomography (CT), have reduced the prior dependence on surgery for diagnosis and staging of gastric lymphomas. Methods and Results: This review details the advances in the diagnosis, classification, and imaging of MLS. We also describe the experience that supports the use of radiation therapy as the preferred treatment of MLS in patients who have not responded to antibiotic therapy or have not had evidence for H. pylori infection. Conclusions: Radiation therapy for MLS is not only effective and safe, but offers the significant advantage of low morbidity and gastric function preservation

Geophysical and hydrogeological characterisation of the impacts of on-site wastewater treatment discharge to groundwater in a poorly productive bedrock aquifer

Energy Technology Data Exchange (ETDEWEB)

Donohue, Shane [School of Planning, Architecture and Civil Engineering, Queen' s University Belfast, David Keir Building, Stranmillis Road, Belfast BT9 5AG, Northern Ireland (United Kingdom); McCarthy, Valerie; Rafferty, Patrick [Department of Applied Sciences, Dundalk Institute of Technology, Dublin Road, Dundalk (Ireland); Orr, Alison; Flynn, Raymond [School of Planning, Architecture and Civil Engineering, Queen' s University Belfast, David Keir Building, Stranmillis Road, Belfast BT9 5AG, Northern Ireland (United Kingdom)

2015-08-01

Contaminants discharging from on-site wastewater treatment systems (OSWTSs) can impact groundwater quality, threatening human health and surface water ecosystems. Risk of negative impacts becomes elevated in areas of extreme vulnerability with high water tables, where thin unsaturated intervals limit vadose zone attenuation. A combined geophysical/hydrogeological investigation into the effects of an OSWTS, located over a poorly productive aquifer (PPA) with thin subsoil cover, aimed to characterise effluent impacts on groundwater. Groundwater, sampled from piezometers down-gradient of the OSWTS percolation area displayed spatially erratic, yet temporally consistent, contaminant distributions. Electrical resistivity tomography identified an area of gross groundwater contamination close to the percolation area and, when combined with seismic refraction and water quality data, indicated that infiltrating effluent reaching the water table discharged to a deeper more permeable zone of weathered shale resting on more competent bedrock. Subsurface structure, defined by geophysics, indicated that elevated chemical and microbiological contaminant levels encountered in groundwater samples collected from piezometers, down-gradient of sampling points with lower contaminant levels, corresponded to those locations where piezometers were screened close to the weathered shale/competent rock interface; those immediately up-gradient were too shallow to intercept this interval, and thus the more impacted zone of the contaminant plume. Intermittent occurrence of faecal indicator bacteria more than 100 m down gradient of the percolation area suggested relatively short travel times. Study findings highlight the utility of geophysics as part of multidisciplinary investigations for OSWTS contaminant plume characterisation, while also demonstrating the capacity of effluent discharging to PPAs to impact groundwater quality at distance. Comparable geophysical responses observed in similar

Geophysical and hydrogeological characterisation of the impacts of on-site wastewater treatment discharge to groundwater in a poorly productive bedrock aquifer

International Nuclear Information System (INIS)

Donohue, Shane; McCarthy, Valerie; Rafferty, Patrick; Orr, Alison; Flynn, Raymond

2015-01-01

Contaminants discharging from on-site wastewater treatment systems (OSWTSs) can impact groundwater quality, threatening human health and surface water ecosystems. Risk of negative impacts becomes elevated in areas of extreme vulnerability with high water tables, where thin unsaturated intervals limit vadose zone attenuation. A combined geophysical/hydrogeological investigation into the effects of an OSWTS, located over a poorly productive aquifer (PPA) with thin subsoil cover, aimed to characterise effluent impacts on groundwater. Groundwater, sampled from piezometers down-gradient of the OSWTS percolation area displayed spatially erratic, yet temporally consistent, contaminant distributions. Electrical resistivity tomography identified an area of gross groundwater contamination close to the percolation area and, when combined with seismic refraction and water quality data, indicated that infiltrating effluent reaching the water table discharged to a deeper more permeable zone of weathered shale resting on more competent bedrock. Subsurface structure, defined by geophysics, indicated that elevated chemical and microbiological contaminant levels encountered in groundwater samples collected from piezometers, down-gradient of sampling points with lower contaminant levels, corresponded to those locations where piezometers were screened close to the weathered shale/competent rock interface; those immediately up-gradient were too shallow to intercept this interval, and thus the more impacted zone of the contaminant plume. Intermittent occurrence of faecal indicator bacteria more than 100 m down gradient of the percolation area suggested relatively short travel times. Study findings highlight the utility of geophysics as part of multidisciplinary investigations for OSWTS contaminant plume characterisation, while also demonstrating the capacity of effluent discharging to PPAs to impact groundwater quality at distance. Comparable geophysical responses observed in similar

The Role of Transdisciplinary Approach and Community Participation in Village Scale Groundwater Management: Insights from Gujarat and Rajasthan, India

Directory of Open Access Journals (Sweden)

Basant Maheshwari

2014-11-01

Full Text Available Sustainable use of groundwater is becoming critical in India and requires effective participation from local communities along with technical, social, economic, policy and political inputs. Access to groundwater for farming communities is also an emotional and complex issue as their livelihood and survival depends on it. In this article, we report on transdisciplinary approaches to understanding the issues, challenges and options for improving sustainability of groundwater use in States of Gujarat and Rajasthan, India. In this project, called Managed Aquifer Recharge through Village level Intervention (MARVI, the research is focused on developing a suitable participatory approach and methodology with associated tools that will assist in improving supply and demand management of groundwater. The study was conducted in the Meghraj watershed in Aravalli district, Gujarat, and the Dharta watershed in Udaipur district, Rajasthan, India. The study involved the collection of hydrologic, agronomic and socio-economic data and engagement of local village and school communities through their role in groundwater monitoring, field trials, photovoice activities and education campaigns. The study revealed that availability of relevant and reliable data related to the various aspects of groundwater and developing trust and support between local communities, NGOs and government agencies are the key to moving towards a dialogue to decide on what to do to achieve sustainable use of groundwater. The analysis of long-term water table data indicated considerable fluctuation in groundwater levels from year to year or a net lowering of the water table, but the levels tend to recover during wet years. This provides hope that by improving management of recharge structures and groundwater pumping, we can assist in stabilizing the local water table. Our interventions through Bhujal Jankaars (BJs, (a Hindi word meaning “groundwater informed” volunteers, schools

Quality-assurance plan for groundwater activities, U.S. Geological Survey, Washington Water Science Center

Science.gov (United States)

Kozar, Mark D.; Kahle, Sue C.

2013-01-01

This report documents the standard procedures, policies, and field methods used by the U.S. Geological Survey’s (USGS) Washington Water Science Center staff for activities related to the collection, processing, analysis, storage, and publication of groundwater data. This groundwater quality-assurance plan changes through time to accommodate new methods and requirements developed by the Washington Water Science Center and the USGS Office of Groundwater. The plan is based largely on requirements and guidelines provided by the USGS Office of Groundwater, or the USGS Water Mission Area. Regular updates to this plan represent an integral part of the quality-assurance process. Because numerous policy memoranda have been issued by the Office of Groundwater since the previous groundwater quality assurance plan was written, this report is a substantial revision of the previous report, supplants it, and contains significant additional policies not covered in the previous report. This updated plan includes information related to the organization and responsibilities of USGS Washington Water Science Center staff, training, safety, project proposal development, project review procedures, data collection activities, data processing activities, report review procedures, and archiving of field data and interpretative information pertaining to groundwater flow models, borehole aquifer tests, and aquifer tests. Important updates from the previous groundwater quality assurance plan include: (1) procedures for documenting and archiving of groundwater flow models; (2) revisions to procedures and policies for the creation of sites in the Groundwater Site Inventory database; (3) adoption of new water-level forms to be used within the USGS Washington Water Science Center; (4) procedures for future creation of borehole geophysics, surface geophysics, and aquifer-test archives; and (5) use of the USGS Multi Optional Network Key Entry System software for entry of routine water-level data

Metals and metalloids treatment in contaminated neutral effluents using modified materials.

Science.gov (United States)

Calugaru, Iuliana Laura; Neculita, Carmen Mihaela; Genty, Thomas; Zagury, Gérald J

2018-04-15

Circumneutral surface water and groundwater can contain hazardous concentrations of metals and metalloids that can threaten organisms in surrounding ecosystems. Extensive research has been conducted over the past two decades to prevent, limit, and treat water pollution. Among the currently available treatment options is the use of natural and residual materials, which is generally regarded as effective and inexpensive. The modification of such materials enhances the removal capacity of metals and metalloids, as well as the physical and chemical stability of the materials and resulting sludge (after treatment). This paper reviews several modified materials that have produced and evaluated in the past twenty years to treat various contaminants in water under specific conditions. Important factors on performance improvement following the modifications are emphasized. Sorption capacity and kinetics, and element removal mechanisms are also discussed. Element recovery, material regeneration, water reuse, evaluation of treatment efficiency for real effluents are also considered, as well as the applicability of these materials in both active and passive treatment systems. Modified natural and residual materials are a promising option for the treatment of metals and metalloids in circumneutral contaminated waters. However, further research is necessary to evaluate their field-scale performance and to properly assess treatment costs. Copyright © 2018 Elsevier Ltd. All rights reserved.

Groundwater Molybdenum from Emerging Industries in Taiwan.

Science.gov (United States)

Tsai, Kuo-Sheng; Chang, Yu-Min; Kao, Jimmy C M; Lin, Kae-Long

2016-01-01

This study determined the influence of emerging industries development on molybdenum (Mo) groundwater contamination. A total of 537 groundwater samples were collected for Mo determination, including 295 samples from potentially contaminated areas of 3 industrial parks in Taiwan and 242 samples from non-potentially contaminated areas during 2008-2014. Most of the high Mo samples are located downstream from a thin film transistor-liquid crystal display (TFT-LCD) panel factory. Mean groundwater Mo concentrations from potentially contaminated areas (0.0058 mg/L) were significantly higher (p industry and following wastewater batch treatment were 0.788 and 0.0326 mg/L, respectively. This indicates that wastewater containing Mo is a possible source of both groundwater and surface water contamination. Nine samples of groundwater exceed the World Health Organization's suggested drinking water guideline of 0.07 mg/L. A non-carcinogenic risk assessment for Mo in adults and children using the Mo concentration of 0.07 mg/L yielded risks of 0.546 and 0.215, respectively. These results indicate the importance of the development of a national drinking water quality standard for Mo in Taiwan to ensure safe groundwater for use. According to the human health risk calculation, the groundwater Mo standard is suggested as 0.07 mg/L. Reduction the discharge of Mo-contaminated wastewater from factories in the industrial parks is also the important task in the future.

Groundwater quota versus tiered groundwater pricing : two cases of groundwater management in north-west China

NARCIS (Netherlands)

Aarnoudse, Eefje; Qu, Wei; Bluemling, B.; Herzfeld, Thomas

2017-01-01

Difficulties in monitoring groundwater extraction cause groundwater regulations to fail worldwide. In two counties in north-west China local water authorities have installed smart card machines to monitor and regulate farmers’ groundwater use. Data from a household survey and in-depth interviews are

Comparison of a Conceptual Groundwater Model and Physically Based Groundwater Mode

Science.gov (United States)

Yang, J.; Zammit, C.; Griffiths, J.; Moore, C.; Woods, R. A.

2017-12-01

Groundwater is a vital resource for human activities including agricultural practice and urban water demand. Hydrologic modelling is an important way to study groundwater recharge, movement and discharge, and its response to both human activity and climate change. To understand the groundwater hydrologic processes nationally in New Zealand, we have developed a conceptually based groundwater flow model, which is fully integrated into a national surface-water model (TopNet), and able to simulate groundwater recharge, movement, and interaction with surface water. To demonstrate the capability of this groundwater model (TopNet-GW), we applied the model to an irrigated area with water shortage and pollution problems in the upper Ruamahanga catchment in Great Wellington Region, New Zealand, and compared its performance with a physically-based groundwater model (MODFLOW). The comparison includes river flow at flow gauging sites, and interaction between groundwater and river. Results showed that the TopNet-GW produced similar flow and groundwater interaction patterns as the MODFLOW model, but took less computation time. This shows the conceptually-based groundwater model has the potential to simulate national groundwater process, and could be used as a surrogate for the more physically based model.

Expediting Groundwater Sampling at Hanford and Making It Safer

International Nuclear Information System (INIS)

Connell, Carl W. Jr.; Carr, Jennifer S.; Hildebrand, R. Douglas; Schatz, Aaron L.; Conley, S. F.; Brown, W. L.

2013-01-01

The CH2M HILL Plateau Remediation Company (CHPRC) manages the groundwater monitoring programs at the Department of Energy's 586-square-mile Hanford site in southeastern Washington state. These programs are regulated by the Resource Conservation and Recovery Act (RCRA), the Comprehensive Environmental Response Compensation and Liability Act (CERCLA), and the Atomic Energy Act (AEA). The purpose of monitoring is to track existing groundwater contamination from past practices, as well as other potential contamination that might originate from RCRA treatment, storage, and disposal (TSD) facilities. An integral part of the groundwater-monitoring program involves taking samples of the groundwater and measuring the water levels in wells scattered across the site. Each year, more than 1,500 wells are accessed for a variety of reasons

Enhancing aerobic biodegradation of 1,2-dibromoethane in groundwater using ethane or propane and inorganic nutrients.

Science.gov (United States)

Hatzinger, Paul B; Streger, Sheryl H; Begley, James F

2015-01-01

1,2-Dibromoethane (ethylene dibromide; EDB) is a probable human carcinogen that was previously used as both a soil fumigant and a scavenger in leaded gasoline. EDB has been observed to persist in soils and groundwater, particularly under oxic conditions. The objective of this study was to evaluate options to enhance the aerobic degradation of EDB in groundwater, with a particular focus on possible in situ remediation strategies. Propane gas and ethane gas were observed to significantly stimulate the biodegradation of EDB in microcosms constructed with aquifer solids and groundwater from the FS-12 EDB plume at Joint Base Cape Cod (Cape Cod, MA), but only after inorganic nutrients were added. Ethene gas was also effective, but rates were appreciably slower than for ethane and propane. EDB was reduced to ethane gas and inorganic nutrients. An enrichment culture (BE-3R) that grew on ethane or propane gas but not EDB was obtained from the site materials. The degradation of EDB by this culture was inhibited by acetylene gas, suggesting that degradation is catalyzed by a monooxygenase enzyme. The BE-3R culture was also observed to biodegrade 1,2-dichloroethane (DCA), a compound commonly used in conjunction with EDB as a lead scavenger in gasoline. The data suggest that addition of ethane or propane gas with inorganic nutrients may be a viable option to enhance degradation of EDB in groundwater aquifers to below current state or federal MCL values. Copyright © 2014 Elsevier B.V. All rights reserved.

Influence of groundwater composition on subsurface iron and arsenic removal

KAUST Repository

Moed, David H.; Van Halem, Doris; Verberk, J. Q J C; Amy, Gary L.; Van Dijk, Johannis C.

2012-01-01

Subsurface arsenic and iron removal (SAR/SIR) is a novel technology to remove arsenic, iron and other groundwater components by using the subsoil. This research project investigated the influence of the groundwater composition on subsurface treatment. In anoxic sand column experiments, with synthetic groundwater and virgin sand, it was found that several dissolved substances in groundwater compete for adsorption sites with arsenic and iron. The presence of 0.01 mmol L -1phosphate, 0.2 mmol L -1 silicate, and 1 mmol L -1 nitrate greatly reduced the efficiency of SAR, illustrating the vulnerability of this technology in diverse geochemical settings. SIR was not as sensitive to other inorganic groundwater compounds, though iron retardation was limited by 1.2 mmol L -1 calcium and 0.06 mmol L -1 manganese. © IWA Publishing 2012.

Influence of groundwater composition on subsurface iron and arsenic removal

KAUST Repository

Moed, David H.

2012-06-01

Subsurface arsenic and iron removal (SAR/SIR) is a novel technology to remove arsenic, iron and other groundwater components by using the subsoil. This research project investigated the influence of the groundwater composition on subsurface treatment. In anoxic sand column experiments, with synthetic groundwater and virgin sand, it was found that several dissolved substances in groundwater compete for adsorption sites with arsenic and iron. The presence of 0.01 mmol L -1phosphate, 0.2 mmol L -1 silicate, and 1 mmol L -1 nitrate greatly reduced the efficiency of SAR, illustrating the vulnerability of this technology in diverse geochemical settings. SIR was not as sensitive to other inorganic groundwater compounds, though iron retardation was limited by 1.2 mmol L -1 calcium and 0.06 mmol L -1 manganese. © IWA Publishing 2012.

Installation of reactive metals groundwater collection and treatment systems

International Nuclear Information System (INIS)

Hopkins, J.K.; Primrose, A.L.; Uhland, J.

1998-01-01

Three groundwater plumes contaminated with volatile organic compounds (VOCs) and radionuclides at the Rocky Flats Environmental Technology Site are scheduled for remediation by 1999 based on the Rocky Flats Cleanup Agreement (RFCA) (DOE, 1996). These three plumes are among the top 20 environmental cleanup sites at Rocky Flats. One of these plumes, the Mound Site Plume, is derived from a previous drum storage area, and daylights as seeps near the South Walnut Creek drainage. Final design for remediation of the Mound Site Plume has been completed based on use of reactive metals to treat the contaminated groundwater, and construction is scheduled for early 1998. The two other plumes, the 903 Pad/Ryan's Pit and the East Trenches Plumes, are derived from VOCs either from drums that leaked or that were disposed of in trenches. These two plumes are undergoing characterization and conceptual design in 1998 and construction is scheduled in 1999. The contaminants of concern in these plumes are tetrachloroethene, trichloroethene, carbon tetrachloride and low levels of uranium and americium

Simulation of Groundwater Flow, Denpasar-Tabanan Groundwater Basin, Bali Province

Directory of Open Access Journals (Sweden)

Heryadi Tirtomihardjo

2014-06-01

Full Text Available DOI: 10.17014/ijog.v6i3.123Due to the complex structure of the aquifer systems and its hydrogeological units related with the space in which groundwater occurs, groundwater flows were calculated in three-dimensional method (3D Calculation. The geometrical descritization and iteration procedures were based on an integrated finite difference method. In this paper, all figures and graphs represent the results of the calibrated model. Hence, the model results were simulated by using the actual input data which were calibrated during the simulation runs. Groundwater flow simulation of the model area of the Denpasar-Tabanan Groundwater Basin (Denpasar-Tabanan GB comprises steady state run, transient runs using groundwater abstraction in the period of 1989 (Qabs-1989 and period of 2009 (Qabs-2009, and prognosis run as well. Simulation results show, in general, the differences of calculated groundwater heads and observed groundwater heads at steady and transient states (Qabs-1989 and Qabs-2009 are relatively small. So, the groundwater heads situation simulated by the prognosis run (scenario Qabs-2012 are considerably valid and can properly be used for controlling the plan of groundwater utilization in Denpasar-Tabanan GB.

Carbon footprint assessment of Western Australian Groundwater Recycling Scheme

Science.gov (United States)

Simms, Andrew; Hamilton, Stacey; Biswas, Wahidul K.

2017-04-01

This research has determined the carbon footprint or the carbon dioxide equivalent (CO2 eq) of potable water production from a groundwater recycling scheme, consisting of the Beenyup wastewater treatment plant, the Beenyup groundwater replenishment trial plant and the Wanneroo groundwater treatment plant in Western Australia, using a life cycle assessment approach. It was found that the scheme produces 1300 tonnes of CO2 eq per gigalitre (GL) of water produced, which is 933 tonnes of CO2 eq higher than the desalination plant at Binningup in Western Australia powered by 100% renewable energy generated electricity. A Monte Carlo Simulation uncertainty analysis calculated a Coefficient of Variation value of 5.4%, thus confirming the accuracy of the simulation. Electricity input accounts for 83% of the carbon dioxide equivalent produced during the production of potable water. The chosen mitigation strategy was to consider the use of renewable energy to generate electricity for carbon intensive groundwater replenishment trial plant. Depending on the local situation, a maximum of 93% and a minimum of 21% greenhouse gas saving from electricity use can be attained at groundwater replenishment trial plant by replacing grid electricity with renewable electricity. In addition, the consideration of vibrational separation (V-Sep) that helps reduce wastes generation and chemical use resulted in a 4.03 tonne of CO2 eq saving per GL of water produced by the plant.

Carbon footprint assessment of Western Australian Groundwater Recycling Scheme.

Science.gov (United States)

Simms, Andrew; Hamilton, Stacey; Biswas, Wahidul K

2017-04-01

This research has determined the carbon footprint or the carbon dioxide equivalent (CO 2 eq) of potable water production from a groundwater recycling scheme, consisting of the Beenyup wastewater treatment plant, the Beenyup groundwater replenishment trial plant and the Wanneroo groundwater treatment plant in Western Australia, using a life cycle assessment approach. It was found that the scheme produces 1300 tonnes of CO 2 eq per gigalitre (GL) of water produced, which is 933 tonnes of CO 2 eq higher than the desalination plant at Binningup in Western Australia powered by 100% renewable energy generated electricity. A Monte Carlo Simulation uncertainty analysis calculated a Coefficient of Variation value of 5.4%, thus confirming the accuracy of the simulation. Electricity input accounts for 83% of the carbon dioxide equivalent produced during the production of potable water. The chosen mitigation strategy was to consider the use of renewable energy to generate electricity for carbon intensive groundwater replenishment trial plant. Depending on the local situation, a maximum of 93% and a minimum of 21% greenhouse gas saving from electricity use can be attained at groundwater replenishment trial plant by replacing grid electricity with renewable electricity. In addition, the consideration of vibrational separation (V-Sep) that helps reduce wastes generation and chemical use resulted in a 4.03 tonne of CO 2 eq saving per GL of water produced by the plant.

Estimating Groundwater Development area in Jianan Plain using Standardized Groundwater Index

Science.gov (United States)

Yu, Chang Hsiang; Haw, Lee Cheng

2017-04-01

Taiwan has been facing severe water crises in recent years owing to the effects of extreme weather conditions. Changes in precipitation patterns have also made the drought phenomenon increasingly prominent, which has indirectly affected groundwater recharge. Hence, in the present study, long-term monitoring data were collected from the study area of the Jianan plain. The standardized groundwater index (SGI) and was then used to analyse the region's drought characteristics. To analyse the groundwater level by using SGI, making SGI180 groundwater level be the medium water crises, and SGI360 groundwater level be the extreme water crises. Through the different water crises signal in SGI180 and SGI360, we divide groundwater in Jianan plain into two sections. Thereby the water crises indicators establishing groundwater level standard line in Jianan Plain, then using the groundwater level standard line to find the study area where could be groundwater development area in Jianan plain. Taking into account relatively more water scarcity in dry season, so the study screen out another emergency backup groundwater development area, but the long-term groundwater development area is still as a priority development area. After finding suitable locations, groundwater modeling systems(GMS) software is used to simulate our sites to evaluate development volume. Finally, the result of study will help the government to grasp the water shortage situation immediately and solve the problem of water resources deployment.

Tank Space Options Report

International Nuclear Information System (INIS)

BOYLES, V.C.

2001-01-01

A risk-based priority for the retrieval of Hanford Site waste from the 149 single-shell tanks (SSTs) has been adopted as a result of changes to the Hanford Federal Facility Agreement and Consent Order (HFFACO) (Ecology et al. 1997) negotiated in 2000. Retrieval of the first three tanks in the retrieval sequence fills available capacity in the double-shell tanks (DSTs) by 2007. As a result, the HFFACO change established a milestone (M-45-12-TO1) requiring the determination of options that could increase waste storage capacity for single-shell tank waste retrieval. The information will be considered in future negotiations. This document fulfills the milestone requirement. This study presents options that were reviewed for the purpose of increasing waste storage capacity. Eight options are identified that have the potential for increasing capacity from 5 to 10 million gallons, thus allowing uninterrupted single-shell tank retrieval until the planned Waste Treatment Plant begins processing substantial volumes of waste from the double-shell tanks in 2009. The cost of implementing these options is estimated to range from less than $1 per gallon to more than $14 per gallon. Construction of new double-shell tanks is estimated to cost about $63 per gallon. Providing 5 to 10 million gallons of available double-shell tank space could enable early retrieval of 5 to 9 high-risk single-shell tanks beyond those identified for retrieval by 2007. These tanks are A-101, AX-101, AX-103, BY-102, C-107, S-105, S-106, S-108, and S-109 (Garfield et al. 2000). This represents a potential to retrieve approximately 14 million total curies, including 3,200 curies of long-lived mobile radionuclides. The results of the study reflect qualitative analyses conducted to identify promising options. The estimated costs are rough-order-of magnitude and, therefore, subject to change. Implementing some of the options would represent a departure from the current baseline and may adversely impact the

Sacral electrical neuromodulation as an alternative treatment option for lower urinary tract dysfunction.

Science.gov (United States)

Grünewald, Volker; Höfner, Klaus; Thon, Walter F.; Kuczyk, Markus A.; Jonas, Udo

1999-01-01

Temporary electrical stimulation using anal or vaginal electrodes and an external pulse generator has been a treatment modality for urinary urge incontinence for nearly three decades. In 1981 Tanagho and Schmidt introduced chronic electrical stimulation of the sacral spinal nerves using a permanently implanted sacral foramen electrode and a battery powered pulse generator for treatment of different kinds of lower urinary tract dysfunction, refractory to conservative treatment. At our department chronic unilateral electrical stimulation of the S3 sacral spinal nerve has been used for treatment of vesi-courethral dysfunction in 43 patients with a mean postoperative follow up of 43,6 months. Lasting symptomatic improvement by more than 50 % could be achieved in 13 of 18 patients with motor urge incontinence (72,2 %) and in 18 of the 21 patients with urinary retention (85,7 %). Implants offer a sustained therapeutic effect to treatment responders, which is not achieved by temporary neuromodulation. Chronic neuromodulation should be predominantly considered in patients with urinary retention. Furthermore in patients with motor urge incontinence, refusing temporary techniques or in those requiring too much effort to achieve a sustained clinical effect. Despite high initial costs chronic sacral neuromodulation is an economically reasonable treatment option in the long run, when comparing it to the more invasive remaining therapeutic alternatives.

Nonsurgical Treatments of Patellar Tendinopathy: Multiple Injections of Platelet-Rich Plasma Are a Suitable Option: A Systematic Review and Meta-analysis.

Science.gov (United States)

Andriolo, Luca; Altamura, Sante Alessandro; Reale, Davide; Candrian, Christian; Zaffagnini, Stefano; Filardo, Giuseppe

2018-03-01

Patellar tendinopathy is a condition characterized by anterior knee activity-related pain. It has a high incidence among athletes engaged in jumping sports and may become a chronic condition. Nonoperative management is the first choice in these patients, and several nonsurgical treatment options have been proposed. Nonetheless, clear indications on the most effective approach to address patellar tendinopathy are still lacking. To analyze the evidence on nonoperative options to treat chronic patellar tendinopathy through a systematic review of the literature and to perform a meta-analysis to identify the most effective nonsurgical option. Systematic review and meta-analysis. The search was conducted with the PubMed and Cochrane databases on January 4, 2017. All clinical English-language reports of any level of evidence on nonsurgical treatment of patellar tendinopathy were included. The quality of each article was assessed by use of the Coleman score. A meta-analysis was performed on all articles reporting the Victorian Institute of Sport Assessment scale for patellar tendinopathy to evaluate the results of the most described treatments. A total of 70 studies involving 2530 patients were included in the qualitative data synthesis. The Coleman score showed an overall poor study quality. The most described treatment groups that could be included in the meta-analysis were reported in 22 studies on eccentric exercise, extracorporeal shockwave therapy (ESWT), and platelet-rich plasma (PRP). Single and multiple PRP injections were evaluated separately. Eccentric exercise therapies obtained the best results ( P patellar tendinopathy with important limitations in terms of study quality. The available evidence showed an overall positive outcome, but some differences have been highlighted. Eccentric exercises may seem the strategy of choice in the short-term, but multiple PRP injections may offer more satisfactory results at long-term follow-up and can be therefore considered

Comparative efficacy and safety of treatment options for MDR and XDR Acinetobacter baumannii infections: a systematic review and network meta-analysis.

Science.gov (United States)

Kengkla, Kirati; Kongpakwattana, Khachen; Saokaew, Surasak; Apisarnthanarak, Anucha; Chaiyakunapruk, Nathorn

2018-01-01

To comprehensively compare and rank the efficacy and safety of available treatment options for patients with MDR and XDR Acinetobacter baumannii (AB) infection. We searched PubMed, Embase and the Cochrane register of trials systematically for studies that examined treatment options for patients with MDR- and XDR-AB infections until April 2016. Network meta-analysis (NMA) was performed to estimate the risk ratio (RR) and 95% CI from both direct and indirect evidence. Primary outcomes were clinical cure and microbiological cure. Secondary outcomes were all-cause mortality and nephrotoxic and non-nephrotoxic adverse events. A total of 29 studies with 2529 patients (median age 60 years; 65% male; median APACHE II score 19.0) were included. Although there were no statistically significant differences between treatment options, triple therapy with colistin, sulbactam and tigecycline had the highest clinical cure rate. Colistin in combination with sulbactam was associated with a significantly higher microbiological cure rate compared with colistin in combination with tigecycline (RR 1.23; 95% CI 1.03-1.47) and colistin monotherapy (RR 1.21; 95% CI 1.06-1.38). No significant differences in all-cause mortality were noted between treatment options. Tigecycline-based therapy also appeared less effective for achieving a microbiological cure and is not appropriate for treating bloodstream MDR- and XDR-AB infections. Combination therapy of colistin with sulbactam demonstrates superiority in terms of microbiological cure with a safety profile similar to that of colistin monotherapy. Thus, our findings support the use of this combination as a treatment for MDR- and XDR-AB infections. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Technological Options to Ameliorate Waste Treatment of Intensive Pig Production in China：An Analysis Based on Bio-Economic Model

Institute of Scientific and Technical Information of China (English)

LU Wen-cong; MA Yong-xi; Holger Bergmann

2014-01-01

Ameliorating waste treatment by technological improvements affects the economic and the ecological-environment beneifts of intensive pig production. The objective of the research was to develop and test a method to determine the technical optimization to ameliorate waste treatment methods and gain insight into the relationship between technological options and the economic and ecological effects. We developed an integrated bio-economic model which incorporates the farming production and waste disposal systems to simulate the impact of technological improvements in pig manure treatment on economic and environmental benefits for the case of a pilot farm in Beijing, China. Based on different waste treatment technology options, three scenarios are applied for the simulation analysis of the model. The simulation results reveal that the economic-environmental beneifts of the livestock farm could be improved by reducing the cropland manure application and increasing the composting production with the current technologies. Nevertheless, the technical efifciency, the waste treatment capacity and the economic beneifts could be further improved by the introduction of new technologies. It implies that technological and economic support policies should be implemented comprehensively on waste disposal and resource utilization to promote sustainable development in intensive livestock production in China.

Evidence-Based Treatment Options in Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck

Directory of Open Access Journals (Sweden)

Athanassios Argiris

2017-05-01

Full Text Available The major development of the past decade in the first-line treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN was the introduction of cetuximab in combination with platinum plus 5-fluorouracil chemotherapy (CT, followed by maintenance cetuximab (the “EXTREME” regimen. This regimen is supported by a phase 3 randomized trial and subsequent observational studies, and it confers well-documented survival benefits, with median survival ranging between approximately 10 and 14 months, overall response rates between 36 and 44%, and disease control rates of over 80%. Furthermore, as indicated by patient-reported outcome measures, the addition of cetuximab to platinum-based CT leads to a significant reduction in pain and problems with social eating and speech. Conversely, until very recently, there has been a lack of evidence-based second-line treatment options, and the therapies that have been available have shown low response rates and poor survival outcomes. Presently, a promising new treatment option in R/M SCCHN has emerged: immune checkpoint inhibitors (ICIs, which have demonstrated favorable results in second-line clinical trials. Nivolumab and pembrolizumab are the first two ICIs that were approved by the US Food and Drug Administration. We note that the trials that showed benefit with ICIs included not only patients who previously received ≥1 platinum-based regimens for R/M SCCHN but also patients who experienced recurrence within 6 months after combined modality therapy with a platinum agent for locally advanced disease. In this review, we outline the available clinical and observational evidence for the EXTREME regimen and the initial results from clinical trials for ICIs in patients with R/M SCCHN. We propose that these treatment options can be integrated into a new continuum of care paradigm, with first-line EXTREME regimen followed by second-line ICIs. A number of ongoing clinical trials

Biological drinking water treatment of anaerobic groundwater in trickling filters

NARCIS (Netherlands)

De Vet, W.W.J.M.

2011-01-01

Drinking water production from anaerobic groundwater is usually achieved by so called conventional techniques such as aeration and sand filtration. The notion conventional implies a long history and general acceptation of the application, but doesn’t necessarily mean a thorough understanding of the

Liquid effluent retention facility final-status groundwater monitoring plan

International Nuclear Information System (INIS)

Sweeney, M.D.; Chou, C.J.; Bjornstad, B.N.

1997-09-01

The following sections describe the groundwater-monitoring program for the Liquid Effluent Retention Facility (LERF). The LERF is regulated under the Resource Conservation and Recovery Act of 1976 (RCRA). The LERF is included in the open-quotes Dangerous Waste Portion of the Resource Conservation and Recovery Act Permit for the Treatment, Storage, and Disposal of Dangerous Waste, Permit WA890008967close quotes, (referred to herein as the Permit) (Ecology 1994) and is subject to final-status requirements for groundwater monitoring (WAC 173-303-645). This document describes a RCRA/WAC groundwater detection-monitoring program for groundwater in the uppermost aquifer system at the LERF. This plan describes the LERF monitoring network, constituent list, sampling schedule, statistical methods, and sampling and analysis protocols that will be employed for the LERF. This plan will be used to meet the groundwater monitoring requirements from the time the LERF becomes part of the Permit and through the post-closure care period, until certification of final closure

Immunotoxin – a new treatment option in patients with relapsed and refractory Hodgkin lymphoma

Science.gov (United States)

Novakovic, Barbara Jezersek

2015-01-01

Background Even though Hodgkin lymphoma is a highly curable disease, some of the patients have either a refractory disease or experience a relapse following a successful primary therapy. Durable responses and remissions in patients with relapsed or refractory disease may be achieved in approximately one-half with salvage chemotherapy followed by high dose chemotherapy (HDT) and autologous hematopoietic cell rescue (SCT). On the other hand, patients who relapse after HDT and autologous SCT or those who have failed at least two prior multi-agent chemotherapy regimens and are not candidates for HDT have limited treatment options. Conclusions A new treatment option in this population is an immunotoxin Brentuximab vedotin composed of a CD30 directed antibody linked to the antitubulin agent monomethyl auristatin E. It has demonstrated a substantial effectiveness and an acceptable toxicity. In the pivotal study, the overall response rate was 75% with 34% of complete remissions. The median durations of response were 20.5 and 6.7 months for those with complete remission and all responding patients, respectively. The median overall survival was 40.5 months (3-years overall survival 54%) and the median progression-free survival 9.3 months. The most common non-hematologic toxicities were peripheral sensory neuropathy, nausea, and fatigue while the most common severe side effects were neutropenia, thrombocytopenia, anemia, and peripheral sensory neuropathy. PMID:26834516

Treatment of highly polluted groundwater by novel iron removal process.

Science.gov (United States)

Sim, S J; Kang, C D; Lee, J W; Kim, W S

2001-01-01

The removal of ferrous iron (Fe(II)) in groundwater has been generally achieved by simple aeration, or the addition of an oxidizing agent. Aeration has been shown to be very efficient in insolubilization ferrous iron at a pH level greater than 6.5. In this study, pH was maintained over 6.5 using limestone granules under constant aeration to oxidize ferrous iron in groundwater in a limestone packed column. A sedimentation unit coupled with a membrane filtration was also developed to precipitate and filtrate the oxidized ferric compound simultaneously. Several bench-scale studies, including the effects of the limestone granule sizes, amounts and hydraulic retention time on iron removal in the limestone packed column were investigated. It was found that 550 g/L of the 7-8 mesh size limestone granules, and 20 min of hydraulic retention time in the limestone packed column, were necessary for the sufficient oxidation of 40 mg/L of iron(II) in groundwater. Long-term operation was successfully achieved in contaminated waters by removing the iron deposits on the surface of the limestone granule by continuous aeration from the bottom of the column. Periodic reverse flow helped to remove caking and fouling of membrane surface caused by the continuous filtration. Recycling of the treated water from the membrane right after reverse flow operation made possible an admissible limit of iron concentration of the treated water for drinking. The pilot-scale process was constructed and has been tested in the rural area of Korea.

Anastomotic leakage after esophageal resection: new treatment options by endoluminal vacuum therapy.

Science.gov (United States)

Weidenhagen, Rolf; Hartl, Wolfgang H; Gruetzner, Klaus U; Eichhorn, Martin E; Spelsberg, Fritz; Jauch, Karl W

2010-11-01

Anastomotic leakage after esophagectomy is an important determinant of early and late morbidity and mortality. Control of the septic focus is essential when treating patients with anastomotic leakages. Surgical and endoscopic treatment options are limited. Between 2005 and 2009, we treated 6 patients who experienced an intrathoracic anastomotic leakage after esophageal resection. After all established therapeutic measures had failed, we explored the feasibility of an endoscopically assisted mediastinal vacuum therapy. We were able to heal intrathoracic esophageal leakages in all 6 patients without any local complications and without the need for reoperation. One patient died because of a progressive pneumonia. Endoscopic vacuum-assisted closure of anastomotic leakages may help to overcome the limitations that are associated with intermittent endoscopic treatment and conventional drainage therapy. Our preliminary results suggest that this new concept may be suitable for those patients. Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Assessing groundwater policy with coupled economic-groundwater hydrologic modeling

Science.gov (United States)

Mulligan, Kevin B.; Brown, Casey; Yang, Yi-Chen E.; Ahlfeld, David P.

2014-03-01

This study explores groundwater management policies and the effect of modeling assumptions on the projected performance of those policies. The study compares an optimal economic allocation for groundwater use subject to streamflow constraints, achieved by a central planner with perfect foresight, with a uniform tax on groundwater use and a uniform quota on groundwater use. The policies are compared with two modeling approaches, the Optimal Control Model (OCM) and the Multi-Agent System Simulation (MASS). The economic decision models are coupled with a physically based representation of the aquifer using a calibrated MODFLOW groundwater model. The results indicate that uniformly applied policies perform poorly when simulated with more realistic, heterogeneous, myopic, and self-interested agents. In particular, the effects of the physical heterogeneity of the basin and the agents undercut the perceived benefits of policy instruments assessed with simple, single-cell groundwater modeling. This study demonstrates the results of coupling realistic hydrogeology and human behavior models to assess groundwater management policies. The Republican River Basin, which overlies a portion of the Ogallala aquifer in the High Plains of the United States, is used as a case study for this analysis.

Direct visual internal urethrotomy: Is it a durable treatment option?