Search results for: water treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15147

Search results for: water treatment

6687 Effect of Climate Changing Pattern on Aquatic Biodiversity of Bhimtal Lake at Kumaun Himalaya (India)

Authors: Davendra S. Malik

Abstract:

Bhimtal lake is located between 290 21’ N latitude and 790 24’ E longitude, at an elevation of 1332m above mean sea level in the Kumaun region of Uttarakhand of Indian subcontinent. The lake surface area is decreasing in water area, depth level in relation to ecological and biological characteristics due to climatic variations, invasive land use pattern, degraded forest zones and changed agriculture pattern in lake catchment basin. The present study is focused on long and short term effects of climate change on aquatic biodiversity and productivity of Bhimtal lake. The meteorological data of last fifteen years of Bhimtal lake catchment basin revealed that air temperature has been increased 1.5 to 2.1oC in summer, 0.2 to 0.8 C in winter, relative humidity increased 4 to 6% in summer and rainfall pattern changed erratically in rainy seasons. The surface water temperature of Bhimtal lake showed an increasing pattern as 0.8 to 2.6 C, pH value decreased 0.5 to 0.2 in winter and increased 0.4 to 0.6 in summer. Dissolved oxygen level in lake showed a decreasing trend as 0.7 to 0.4mg/l in winter months. The mesotrophic nature of Bhimtal lake is changing towards eutrophic conditions and contributed for decreasing biodiversity. The aquatic biodiversity of Bhimtal lake consisted mainly phytoplankton, zooplankton, benthos and fish species. In the present study, a total of 5 groups of phytoplankton, 3 groups of zooplankton, 11 groups of benthos and 15 fish species were recorded from Bhimtal lake. The comparative data of biodiversity of Bhimtal lake since January, 2000 indicated the changing pattern of phytoplankton biomass were decreasing as 1.99 and 1.08% of Chlorophyceae and Bacilleriophyceae families respectively. The biomass of Cynophyceae was increasing as 0.45% and contributing the algal blooms during summer season in lake. The biomass of zooplankton and benthos were found decreasing in winter season and increasing during summer season. The endemic fish species (18 no.) were found in year 2000-05, as while the fish species (15 no.) were recorded in present study. The relative fecundity of major fish species were observed decreasing trends during their breeding periods in lake. The natural and anthropogenic factors were identified as ecological threats for existing aquatic biodiversity of Bhimtal lake. The present research paper emphasized on the effect of changing pattern of different climatic variables on species composition, biomass of phytoplankton, zooplankton, benthos, and fishes in Bhimtal lake of Kumaun region. The present research data will be contributed significantly to assess the changing pattern of aquatic biodiversity and productivity of Bhimtal lake with different time scale.

Keywords: aquatic biodiversity, Bhimtal lake, climate change, lake ecology

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6686 Modeling of Sand Boil near the Danube River

Authors: Edina Koch, Károly Gombás, Márton Maller

Abstract:

The Little Plain is located along the Danube river, and this area is a “hotbed” of sand boil formation. This is due to the combination of a 100-250 m thick gravel layer beneath the Little Plain with a relatively thin blanket of poor soil spreading the gravel with variable thickness. Sand boils have a tradition and history in this area. It was possible to know which sand boil started and stopped working at what water level, and some of them even have names. The authors present a 2D finite element model of groundwater flow through a selected cross-section of the Danube river, which observed activation of piping phenomena during the 2013 flood event. Soil parametrization is based on a complex site investigation program conducted along the Danube River in the Little Plain.

Keywords: site characterization, groundwater flow, numerical modeling, sand boil

Procedia PDF Downloads 90
6685 Fast Algorithm to Determine Initial Tsunami Wave Shape at Source

Authors: Alexander P. Vazhenin, Mikhail M. Lavrentiev, Alexey A. Romanenko, Pavel V. Tatarintsev

Abstract:

One of the problems obstructing effective tsunami modelling is the lack of information about initial wave shape at source. The existing methods; geological, sea radars, satellite images, contain an important part of uncertainty. Therefore, direct measurement of tsunami waves obtained at the deep water bottom peruse recorders is also used. In this paper we propose a new method to reconstruct the initial sea surface displacement at tsunami source by the measured signal (marigram) approximation with the help of linear combination of synthetic marigrams from the selected set of unit sources, calculated in advance. This method has demonstrated good precision and very high performance. The mathematical model and results of numerical tests are here described.

Keywords: numerical tests, orthogonal decomposition, Tsunami Initial Sea Surface Displacement

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6684 A Holistic Study of the Beta Lyrae Systems V0487 Lac, V0566 Hya and V0666 Lac

Authors: Moqbil S. Alenazi, Magdy. M. Elkhateeb

Abstract:

A comprehensive photometric study and evolutionary state for the newly discovered Beta Lyr systems V0487 Lac, V0566 Hya, and V0666 Lac were carried out by means of their first photometric observations. New times of minima were estimated from the observed light curves, and first (O-C) curves were established for all systems. A windows interface version of the Wilson and Devinney code (W-D) based on model atmospheres and a pass band prescription have been used for the radiative treatment. The accepted models reveal some absolute parameters for the studied systems, which are used in adopting the spectral type of the system's components and their evolutionary status. Distances to each system were calculated, and physical properties were estimated. Locations of the systems on the theoreticalmass–luminosity and mass–radius relations revealed a good fit for all systems components except for the secondary component of the system V0487 Lac.

Keywords: eclipsing binaries, light curve modelling, evolutionary state

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6683 An Investigation on Ultrasonic Pulse Velocity of Hybrid Fiber Reinforced Concretes

Authors: Soner Guler, Demet Yavuz, Refik Burak Taymuş, Fuat Korkut

Abstract:

Because of the easy applying and not costing too much, ultrasonic pulse velocity (UPV) is one of the most used non-destructive techniques to determine concrete characteristics along with impact-echo, Schmidt rebound hammer (SRH) and pulse-echo. This article investigates the relationship between UPV and compressive strength of hybrid fiber reinforced concretes. Water/cement ratio (w/c) was kept at 0.4 for all concrete mixes. Compressive strength of concrete was targeted at 35 MPa. UPV testing and compressive strength tests were carried out at the curing age of 28 days. The UPV of concrete containing steel fibers has been found to be higher than plain concrete for all the testing groups. It is decided that there is not a certain relationship between fiber addition and strength.

Keywords: ultrasonic pulse velocity, hybrid fiber, compressive strength, fiber

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6682 Modelling and Simulation of Biomass Pyrolysis

Authors: P. Ahuja, K. S. S. Sai Krishna

Abstract:

There is a concern over the energy shortage in the modern societies as it is one of the primary necessities. Renewable energy, mainly biomass, is found to be one feasible solution as it is inexhaustible and clean energy source all over the world. Out of various methods, thermo chemical conversion is considered to be the most common and convenient method to extract energy from biomass. The thermo-chemical methods that are employed are gasification, liquefaction and combustion. On gasification biomass yields biogas, on liquefaction biomass yields bio-oil and on combustion biomass yields bio-char. Any attempt to biomass gasification, liquefaction or combustion calls for a good understanding of biomass pyrolysis. So, Irrespective of the method used the first step towards the thermo-chemical treatment of biomass is pyrolysis. Pyrolysis mainly converts the solid mass into liquid with gas and residual char as the byproducts. Liquid is used for the production of heat, power and many other chemicals whereas the gas and char can be used as fuels to generate heat.

Keywords: biomass, fluidisation, pyrolysis, simulation

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6681 Existential Affordances and Psychopathology: A Gibsonian Analysis of Dissociative Identity Disorder

Authors: S. Alina Wang

Abstract:

A Gibsonian approach is used to understand the existential dimensions of the human ecological niche. Then, this existential-Gibsonian framework is applied to rethinking Hacking’s historical analysis of multiple personality disorder. This research culminates in a generalized account of psychiatric illness from an enactivist lens. In conclusion, reflections on the implications of this account on approaches to psychiatric treatment are mentioned. J.J. Gibson’s theory of affordances centered on affordances of sensorimotor varieties, which guide basic behaviors relative to organisms’ vital needs and physiological capacities (1979). Later theorists, notably Neisser (1988) and Rietveld (2014), expanded on the theory of affordances to account for uniquely human activities relative to the emotional, intersubjective, cultural, and narrative aspects of the human ecological niche. This research shows that these affordances are structured by what Haugeland (1998) calls existential commitments, which draws on Heidegger’s notion of dasein (1927) and Merleau-Ponty’s account of existential freedom (1945). These commitments organize the existential affordances that fill an individual’s environment and guide their thoughts, emotions, and behaviors. This system of a priori existential commitments and a posteriori affordances is called existential enactivism. For humans, affordances do not only elicit motor responses and appear as objects with instrumental significance. Affordances also, and possibly primarily, determine so-called affective and cognitive activities and structure the wide range of kinds (e.g., instrumental, aesthetic, ethical) of significances of objects found in the world. Then existential enactivism is applied to understanding the psychiatric phenomenon of multiple personality disorder (precursor of the current diagnosis of dissociative identity disorder). A reinterpretation of Hacking’s (1998) insights into the history of this particular disorder and his generalizations on the constructed nature of most psychiatric illness is taken on. Enactivist approaches sensitive to existential phenomenology can provide a deeper understanding of these matters. Conceptualizing psychiatric illness as strictly a disorder in the head (whether parsed as a disorder of brain chemicals or meaning-making capacities encoded in psychological modules) is incomplete. Rather, psychiatric illness must also be understood as a disorder in the world, or in the interconnected networks of existential affordances that regulate one’s emotional, intersubjective, and narrative capacities. All of this suggests that an adequate account of psychiatric illness must involve (1) the affordances that are the sources of existential hindrance, (2) the existential commitments structuring these affordances, and (3) the conditions of these existential commitments. Approaches to treatment of psychiatric illness would be more effective by centering on the interruption of normalized behaviors corresponding to affordances targeted as sources of hindrance, the development of new existential commitments, and the practice of new behaviors that erect affordances relative to these reformed commitments.

Keywords: affordance, enaction, phenomenology, psychiatry, psychopathology

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6680 Biomedical Application of Green Biosynthesis Magnetic Iron Oxide (Fe3O4) Nanoparticles Using Seaweed (Sargassum muticum) Aqueous Extract

Authors: Farideh Namvar, Rosfarizan Mohamed

Abstract:

In the field of nanotechnology, the use of various biological units instead of toxic chemicals for the reduction and stabilization of nanoparticles, has received extensive attention. This use of biological entities to create nanoparticles has designated as “Green” synthesis and it is considered to be far more beneficial due to being economical, eco-friendly and applicable for large-scale synthesis as it operates on low pressure, less input of energy and low temperatures. The lack of toxic byproducts and consequent decrease in degradation of the product renders this technique more preferable over physical and classical chemical methods. The variety of biomass having reduction properties to produce nanoparticles makes them an ideal candidate for fabrication. Metal oxide nanoparticles have been said to represent a "fundamental cornerstone of nanoscience and nanotechnology" due to their variety of properties and potential applications. However, this also provides evidence of the fact that metal oxides include many diverse types of nanoparticles with large differences in chemical composition and behaviour. In this study, iron oxide nanoparticles (Fe3O4-NPs) were synthesized using a rapid, single step and completely green biosynthetic method by reduction of ferric chloride solution with brown seaweed (Sargassum muticum) water extract containing polysaccharides as a main factor which acts as reducing agent and efficient stabilizer. Antimicrobial activity against six microorganisms was tested using well diffusion method. The resulting S-IONPs are crystalline in nature, with a cubic shape. The average particle diameter, as determined by TEM, was found to be 18.01 nm. The S-IONPs were efficiently inhibited the growth of Listeria monocytogenes, Escherichia coli and Candida species. Our favorable results suggest that S-IONPs could be a promising candidate for development of future antimicrobial therapies. The nature of biosynthesis and the therapeutic potential by S-IONPs could pave the way for further research on design of green synthesis therapeutic agents, particularly nanomedicine, to deal with treatment of infections. Further studies are needed to fully characterize the toxicity and the mechanisms involved with the antimicrobial activity of these particles. Antioxidant activity of S-IONPs synthesized by green method was measured by ABTS (2, 2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (IC50= 1000µg) radical scavenging activity. Also, with the increasing concentration of S-IONPs, catalase gene expression compared to control gene GAPDH increased. For anti-angiogenesis study the Ross fertilized eggs were divided into four groups; the control and three experimental groups. The gelatin sponges containing albumin were placed on the chorioalantoic membrane and soaked with different concentrations of S-IONPs. All the cases were photographed using a photo stereomicroscope. The number and the lengths of the vessels were measured using Image J software. The crown rump (CR) and weight of the embryo were also recorded. According to the data analysis, the number and length of the blood vessels, as well as the CR and weight of the embryos reduced significantly compared to the control (p < 0.05), dose dependently. The total hemoglobin was quantified as an indicator of the blood vessel formation, and in the treated samples decreased, which showed its inhibitory effect on angiogenesis.

Keywords: anti-angiogenesis, antimicrobial, antioxidant, biosynthesis, iron oxide (fe3o4) nanoparticles, sargassum muticum, seaweed

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6679 Medical and Surgical Nursing Care

Authors: Nassim Salmi

Abstract:

Postoperative mobilization is an important part of fundamental care. Increased mobilization has a positive effect on recovery, but immobilization is still a challenge in postoperative care. Aims: To report how the establishment of a national nursing database was used to measure postoperative mobilization in patients undergoing surgery for ovarian cancer. Mobilization was defined as at least 3 hours out of bed on postoperative day 1, with the goal set at achieving this in 60% of patients. Clinical nurses on 4400 patients with ovarian cancer performed data entry. Findings: 46.7% of patients met the goal for mobilization on the first postoperative day, but variations in duration and type of mobilization were observed. Of those mobilized, 51.8% had been walking in the hallway. A national nursing database creates opportunities to optimize fundamental care. By comparing nursing data with oncological, surgical, and pathology data, it became possible to study mobilization in relation to cancer stage, comorbidity, treatment, and extent of surgery.

Keywords: postoperative care, gynecology, nursing documentation, database

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6678 Dys-Regulation of Immune and Inflammatory Response in in vitro Fertilization Implantation Failure Patients under Ovarian Stimulation

Authors: Amruta D. S. Pathare, Indira Hinduja, Kusum Zaveri

Abstract:

Implantation failure (IF) even after the good-quality embryo transfer (ET) in the physiologically normal endometrium is the main obstacle in in vitro fertilization (IVF). Various microarray studies have been performed worldwide to elucidate the genes requisite for endometrial receptivity. These studies have included the population based on different phases of menstrual cycle during natural cycle and stimulated cycle in normal fertile women. Additionally, the literature is also available in recurrent implantation failure patients versus oocyte donors in natural cycle. However, for the first time, we aim to study the genomics of endometrial receptivity in IF patients under controlled ovarian stimulation (COS) during which ET is generally practised in IVF. Endometrial gene expression profiling in IF patients (n=10) and oocyte donors (n=8) were compared during window of implantation under COS by whole genome microarray (using Illumina platform). Enrichment analysis of microarray data was performed to determine dys-regulated biological functions and pathways using Database for Annotation, Visualization and Integrated Discovery, v6.8 (DAVID). The enrichment mapping was performed with the help of Cytoscape software. Microarray results were validated by real-time PCR. Localization of genes related to immune response (Progestagen-Associated Endometrial Protein (PAEP), Leukaemia Inhibitory Factor (LIF), Interleukin-6 Signal Transducer (IL6ST) was detected by immunohistochemistry. The study revealed 418 genes downregulated and 519 genes upregulated in IF patients compared to healthy fertile controls. The gene ontology, pathway analysis and enrichment mapping revealed significant downregulation in activation and regulation of immune and inflammation response in IF patients under COS. The lower expression of Progestagen Associated Endometrial Protein (PAEP), Leukemia Inhibitory Factor (LIF) and Interleukin 6 Signal Transducer (IL6ST) in cases compared to controls by real time and immunohistochemistry suggests the functional importance of these genes. The study was proved useful to uncover the probable reason of implantation failure being imbalance of immune and inflammatory regulation in our group of subjects. Based on the present study findings, a panel of significant dysregulated genes related to immune and inflammatory pathways needs to be further substantiated in larger cohort in natural as well as stimulated cycle. Upon which these genes could be screened in IF patients during window of implantation (WOI) before going for embryo transfer or any other immunological treatment. This would help to estimate the regulation of specific immune response during WOI in a patient. The appropriate treatment of either activation of immune response or suppression of immune response can be then attempted in IF patients to enhance the receptivity of endometrium.

Keywords: endometrial receptivity, immune and inflammatory response, gene expression microarray, window of implantation

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6677 Preparation and Chemical Characterization of Eco-Friendly Activated Carbon Produced from Apricot Stones

Authors: Sabolč Pap, Srđana Kolaković, Jelena Radonić, Ivana Mihajlović, Dragan Adamović, Mirjana Vojinović Miloradov, Maja Turk Sekulić

Abstract:

Activated carbon is one of the most used and tested adsorbents in the removal of industrial organic compounds, heavy metals, pharmaceuticals and dyes. Different types of lignocellulosic materials were used as potential precursors in the production of low cost activated carbon. There are, two different processes for the preparation and production of activated carbon: physical and chemical. Chemical activation includes impregnating the lignocellulosic raw materials with chemical agents (H3PO4, HNO3, H2SO4 and NaOH). After impregnation, the materials are carbonized and washed to eliminate the residues. The chemical activation, which was used in this study, has two important advantages when compared to the physical activation. The first advantage is the lower temperature at which the process is conducted, and the second is that the yield (mass efficiency of activation) of the chemical activation tends to be greater. Preparation of activated carbon included the following steps: apricot stones were crushed in a mill and washed with distilled water. Later, the fruit stones were impregnated with a solution of 50% H3PO4. After impregnation, the solution was filtered to remove the residual acid. Subsequently impregnated samples were air dried at room temperature. The samples were placed in a furnace and heated (10 °C/min) to the final carbonization temperature of 500 °C for 2 h without the use of nitrogen. After cooling, the adsorbent was washed with distilled water to achieve acid free conditions and its pH was monitored until the filtrate pH value exceeded 4. Chemical characterizations of the prepared activated carbon were analyzed by FTIR spectroscopy. FTIR spectra were recorded with a (Thermo Nicolet Nexus 670 FTIR) spectrometer, from 400 to 4000 cm-1 wavenumbers, identifying the functional groups on the surface of the activated carbon. The FTIR spectra of adsorbent showed a broad band at 3405.91 cm-1 due to O–H stretching vibration and a peak at 489.00 cm-1 due to O–H bending vibration. Peaks between the range of 3700 and 3200 cm−1 represent the overlapping peaks of stretching vibrations of O–H and N–H groups. The distinct absorption peaks at 2919.86 cm−1 and 2848.24 cm−1 could be assigned to -CH stretching vibrations of –CH2 and –CH3 functional groups. The adsorption peak at 1566.38 cm−1 could be characterized by primary and secondary amide bands. The sharp bond within 1164.76 – 987.86 cm−1 is attributed to the C–O groups, which confirms the lignin structure of the activated carbon. The present study has shown that the activated carbons prepared from apricot stone have a functional group on their surface, which can positively affect the adsorption characteristics with this material.

Keywords: activated carbon, FTIR, H3PO4, lignocellulosic raw materials

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6676 Synthesize of Cobalt Oxide Nanoballs/Carbon Aerogel Nanostructures: Towards High-Performance Materials for Supercapacitors

Authors: A. Bahadoran, M. Zomorodian

Abstract:

The synthesizer of cobalt oxide nanoballs (length 3−4 μm, width 250−400 nm) was achieved by a simple high-temperature supercritical solution method. Multiwalled carbon aerogels are a step towards high-density nanometer-scale nanostructures. Cobalt oxide nanoballs were prepared by supercritical solution method. Synthesis in an aqueous solution containing cobalt hydroxide at ∼80 °C without any further heat treatment at high temperature. The formation of cobalt oxide nanoballs on carbon aerogel was confirmed by X-ray diffraction and Raman spectroscopy. The FE-SEM images showed the presence of cobalt oxide nanoballs. The reaction mechanism of the ultrasound-assisted synthesis of cobalt oxide nanostructures was proposed on the basis of the XRD, X-ray absorption spectroscopy analysis and FE-SEM observation of the reaction products taken during the course of the synthesis.

Keywords: cobalt oxide nano balls, carbon aerogel, synthesize, nanostructure

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6675 Fly ash Contamination in Groundwater and its Implications on Local Climate Change

Authors: Rajkumar Ghosh

Abstract:

Fly ash, a byproduct of coal combustion, has become a prevalent environmental concern due to its potential impact on both groundwater quality and local climate change. This study aims to provide an in-depth analysis of the various mechanisms through which fly ash contaminates groundwater, as well as the possible consequences of this contamination on local climate change. The presence of fly ash in groundwater not only poses a risk to human health but also has the potential to influence local climate change through complex interactions. Although fly ash has various applications in construction and other industries, improper disposal and lack of containment measures have led to its infiltration into groundwater systems. Through a comprehensive review of existing literature and case studies, the interactions between fly ash and groundwater systems, assess the effects on hydrology, and discuss the implications for the broader climate. This section reviews the pathways through which fly ash enters groundwater, including leaching from disposal sites, infiltration through soil, and migration from surface water bodies. The physical and chemical characteristics of fly ash that contribute to its mobility and persistence in groundwater. The introduction of fly ash into groundwater can alter its chemical composition, leading to an increase in the concentration of heavy metals, metalloids, and other potentially toxic elements. The mechanisms of contaminant transport and highlight the potential risks to human health and ecosystems. Fly ash contamination in groundwater may influence the hydrological cycle through changes in groundwater recharge, discharge, and flow dynamics. This section examines the implications of altered hydrology on local water availability, aquatic habitats, and overall ecosystem health. The presence of fly ash in groundwater may have direct and indirect effects on local climate change. The role of fly ash as a potent greenhouse gas absorber and its contribution to radiative forcing. Additionally, investigation of the possible feedback mechanisms between groundwater contamination and climate change, such as altered vegetation patterns and changes in local temperature and precipitation patterns. In this section, potential mitigation and remediation techniques to minimize fly ash contamination in groundwater are analyzed. These may include improved waste management practices, engineered barriers, groundwater remediation technologies, and sustainable fly ash utilization. This paper highlights the critical link between fly ash contamination in groundwater and its potential contribution to local climate change. It emphasizes the importance of addressing this issue promptly through a combination of preventive measures, effective management strategies, and continuous monitoring. By understanding the interconnections between fly ash contamination, groundwater quality, and local climate, towards creating a more resilient and sustainable environment for future generations. The findings of this research can assist policymakers and environmental managers in formulating sustainable strategies to mitigate fly ash contamination and minimize its contribution to climate change.

Keywords: groundwater, climate, sustainable environment, fly ash contamination

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6674 Reduction of Content of Lead and Zinc from Wastewater by Using of Metallurgical Waste

Authors: L. Rozumová, J. Seidlerová

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The aim of this paper was to study the sorption properties of a blast furnace sludge used as the sorbent. The sorbent was utilized for reduction of content of lead and zinc ions. Sorbent utilized in this work was obtained from metallurgical industry from process of wet gas treatment in iron production. The blast furnace sludge was characterized by X-Ray diffraction, scanning electron microscopy, and XRFS spectroscopy. Sorption experiments were conducted in batch mode. The sorption of metal ions in the sludge was determined by correlation of adsorption isotherm models. The adsorption of lead and zinc ions was best fitted with Langmuir adsorption isotherms. The adsorption capacity of lead and zinc ions was 53.8 mg.g-1 and 10.7 mg.g-1, respectively. The results indicated that blast furnace sludge could be effectively used as secondary material and could be also employed as a low-cost alternative for the removal of heavy metals ions from wastewater.

Keywords: blast furnace sludge, lead, zinc, sorption

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6673 The Effect of Type of Nanoparticles on the Quenching Process

Authors: Dogan Ciloglu, Abdurrahim Bolukbasi, Harun Cifci

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In this study, the experiments were carried out to determine the best coolant for the quenching process among water-based silica, alumina, titania and copper oxide nanofluids (0.1 vol%). A sphere made up off brass material was used in the experiments. After the spherical test specimen was heated at high temperatures, it was suddenly plunged into the nanofluid suspensions. All experiments were performed at saturated conditions and under atmospheric pressure. Using the temperature-time data of the specimen, the cooling curves were obtained. The experimental results showed that the cooling performance of test specimen depended on the type of nanofluids. The silica nanoparticles enhanced the performance of boiling heat transfer and it is the best coolant for the quenching among other nanoparticles.

Keywords: quenching, nanofluid, pool boiling, heat transfer

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6672 A Case of Myelofibrosis-Related Arthropathy: A Rare and Underrecognized Entity

Authors: Geum Yeon Sim, Jasal Patel, Anand Kumthekar, Stanley Wainapel

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A 65-year-old right-hand dominant African-American man, formerly employed as a security guard, was referred to Rehabilitation Medicine with bilateral hand stiffness and weakness. His past medical history was only significant for myelofibrosis, diagnosed 4 years earlier, for which he was receiving scheduled blood transfusions. Approximately 2 years ago, he began to notice stiffness and swelling in his non-dominant hand that progressed to pain and decreased strength, limiting his hand function. Similar but milder symptoms developed in his right hand several months later. There was no history of prior injury or exposure to cold. Physical examination showed enlargement of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints with finger flexion contractures, Swan-neck and Boutonniere deformities, and associated joint tenderness. Changes were more prominent in the left hand. X-rays showed mild osteoarthritis of several bilateral PIP joints. Anti-nuclear antibodies, rheumatoid factor, and cyclic citrullinated peptide antibodies were negative. MRI of the hand showed no erosions or synovitis. A rheumatology consultation was obtained, and the cause of his symptoms was attributed to myelofibrosis-related arthropathy with secondary osteoarthritis. The patient was tried on diclofenac cream and received a few courses of Occupational Therapy with limited functional improvement. Primary myelofibrosis (PMF) is a rare myeloproliferative neoplasm characterized by clonal proliferation of myeloid cells with variable morphologic maturity and hematopoietic efficiency. Rheumatic manifestations of malignancies include direct invasion, paraneoplastic presentations, secondary gout, or hypertrophic osteoarthropathy. PMF causes gradual bone marrow fibrosis with extramedullary metaplastic hematopoiesis in the liver, spleen, or lymph nodes. Musculoskeletal symptoms are not common and are not well described in the literature. The first reported case of myelofibrosis related arthritis was seronegative arthritis due to synovial invasion of myeloproliferative elements. Myelofibrosis has been associated with autoimmune diseases such as systemic lupus erythematosus, progressive systemic sclerosis, and rheumatoid arthritis. Gout has been reported in patients with myelofibrosis, and the underlying mechanism is thought to be related to the high turnover of nucleic acids that is greatly augmented in this disease. X-ray findings in these patients usually include erosive arthritis with synovitis. Treatment of underlying PMF is the treatment of choice, along with anti-inflammatory medications. Physicians should be cognizant of recognizing this rare entity in patients with PMF while maintaining clinical suspicion for more common causes of joint deformities, such as rheumatic diseases.

Keywords: myelofibrosis, arthritis, arthralgia, malignancy

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6671 Screening of Osteoporosis in Aging Populations

Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi

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Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.

Keywords: osteoporosis, prevention, public health, screening

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6670 Effect of Fermented Orange Juice Intake on Urinary 6‑Sulfatoxymelatonin in Healthy Volunteers

Authors: I. Cerrillo, A. Carrillo-Vico, M. A. Ortega, B. Escudero-López, N. Álvarez-Sánchez, F. Martín, M. S. Fernández-Pachón

Abstract:

Melatonin is a bioactive compound involved in multiple biological activities such as glucose tolerance, circadian rhythm regulation, antioxidant defense or immune system action. In elderly subjects the intake of foods and drinks rich in melatonin is very important due to its endogenous level decreases with age. Alcoholic fermentation is a process carried out in fruits, vegetables and legumes to obtain new products with improved bioactive compounds profile in relation to original substrates. Alcoholic fermentation process carried out by Saccharomycetaceae var. Pichia kluyveri induces an important synthesis of melatonin in orange juice. A novel beverage derived of fermented orange juice could be a promising source of this bioactive compound. The aim of the present study was to determine whether the acute intake of fermented orange juice increase the levels of urinary 6-sulfatoxymelatonin in healthy humans. Nine healthy volunteers (7 women and 2 men), aged between 20 and 25 years old and BMI of 21.1  2.4 kg/m2, were recruited. On the study day, participants ingested 500 mL of fermented orange juice. The first urine collection was made before fermented orange juice consumption (basal). The rest of urine collections were made in the following time intervals after fermented orange juice consumption: 0-2, 2-5, 5-10, 10- 15 and 15-24 hours. During the experimental period only the consumption of water was allowed. At lunch time a meal was provided (60 g of white bread, two slices of ham, a slice of cheese, 125 g of sweetened natural yoghurt and water). The subjects repeated the protocol with orange juice following a 2-wk washout period between both types of beverages. The levels of 6-sulfatoxymelatonin (6-SMT) were measured in urine recollected at different time points using the Melatonin-Sulfate Urine ELISA (IBL International GMBH, Hamburg, Germany). Levels of 6-SMT were corrected to those of creatinine for each sample. A significant (p < 0.05) increase in urinary 6-SMT levels was observed between 2-5 hours after fermented orange juice ingestion with respect to basal values (increase of 67,8 %). The consumption of orange juice did not induce any significant change in urinary 6-SMT levels. In addition, urinary 6-SMT levels obtained between 2-5 hours after fermented orange juice ingestion (115,6 ng/mg) were significantly different (p < 0.05) from those of orange juice (42,4 ng/mg). The enhancement of urinary 6-SMT after the ingestion of 500 mL of fermented orange juice in healthy humans compared to orange juice could be an important advantage of this novel product as an excellent source of melatonin. Fermented orange juice could be a new functional food, and its consumption could exert a potentially positive effect on health in both the maintenance of health status and the prevention of chronic diseases.

Keywords: fermented orange juice, functional beverage, healthy human, melatonin

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6669 The Renewed Constitutional Roots of Agricultural Law in Hungary in Line with Sustainability

Authors: Gergely Horvath

Abstract:

The study analyzes the special provisions of the highest level of national agricultural legislation in the Fundamental Law of Hungary (25 April 2011) with descriptive, analytic and comparative methods. The agriculturally relevant articles of the constitution are very important, because –in spite of their high level of abstraction– they can determine and serve the practice comprehensively and effectively. That is why the objective of the research is to interpret the concrete sentences and phrases in connection with agriculture compared with the methods of some other relevant constitutions (historical-grammatical interpretation). The major findings of the study focus on searching for the appropriate provisions and approach capable of solving the problems of sustainable food production. The real challenge agricultural law must face with in the future is protecting or conserving its background and subjects: the environment, the ecosystem services and all the 'roots' of food production. In effect, agricultural law is the legal aspect of the production of 'our daily bread' from farm to table. However, it also must guarantee the safe daily food for our children and for all our descendants. In connection with sustainability, this unique, value-oriented constitution of an agrarian country even deals with uncustomary questions in this level of legislation like GMOs (by banning the production of genetically modified crops). The starting point is that the principle of public good (principium boni communis) must be the leading notion of the norm, which is an idea partly outside the law. The public interest is reflected by the agricultural law mainly in the concept of public health (in connection with food security) and the security of supply with healthy food. The construed Article P claims the general protection of our natural resources as a requirement. The enumeration of the specific natural resources 'which all form part of the common national heritage' also means the conservation of the grounds of sustainable agriculture. The reference of the arable land represents the subfield of law of the protection of land (and soil conservation), that of the water resources represents the subfield of water protection, the reference of forests and the biological diversity visualize the specialty of nature conservation, which is an essential support for agrobiodiversity. The mentioned protected objects constituting the nation's common heritage metonymically melt with their protective regimes, strengthening them and forming constitutional references of law. This regimes also mean the protection of the natural foundations of the life of the living and also the future generations, in the name of intra- and intergenerational equity.

Keywords: agricultural law, constitutional values, natural resources, sustainability

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6668 Bone Mineralization in Children with Wilson’s Disease

Authors: Shiamaa Eltantawy, Gihan Sobhy, Alif Alaam

Abstract:

Wilson disease, or hepatolenticular degeneration, is an autosomal recessive disease that results in excess copper buildup in the body. It primarily affects the liver and basal ganglia of the brain, but it can affect other organ systems. Musculoskeletal abnormalities, including premature osteoarthritis, skeletal deformity, and pathological bone fractures, can occasionally be found in WD patients with a hepatic or neurologic type. The aim was to assess the prevalence of osteoporosis and osteopenia in Wilson’s disease patients. This case-control study was conducted on ninety children recruited from the inpatient ward and outpatient clinic of the Paediatric Hepatology, Gastroenterology, and Nutrition department of the National Liver Institute at Menofia University, aged from 1 to 18 years. Males were 49, and females were 41. Children were divided into three groups: (Group I) consisted of thirty patients with WD; (Group II) consisted of thirty patients with chronic liver disease other than WD; (Group III) consisted of thirty age- and sex-matched healthy The exclusion criteria were patients with hyperparathyroidism, hyperthyroidism, renal failure, Cushing's syndrome, and patients on certain drugs such as chemotherapy, anticonvulsants, or steroids. All patients were subjected to the following: 1- Full history-taking and clinical examination. 2-Laboratory investigations: (FBC,ALT,AST,serum albumin, total protein, total serum bilirubin,direct bilirubin,alkaline phosphatase, prothrombin time, serum critine,parathyroid hormone, serum calcium, serum phosphrus). 3-Bone mineral density (BMD, gm/cm2) values were measured by dual-energy X-ray absorptiometry (DEXA). The results revealed that there was a highly statistically significant difference between the three groups regarding the DEXA scan, and there was no statistically significant difference between groups I and II, but the WD group had the lowest bone mineral density. The WD group had a large number of cases of osteopenia and osteoporosis, but there was no statistically significant difference with the group II mean, while a high statistically significant difference was found when compared to group III. In the WD group, there were 20 patients with osteopenia, 4 patients with osteoporosis, and 6 patients who were normal. The percentages were 66.7%, 13.3%, and 20%, respectively. Therefore, the largest number of cases in the WD group had osteopenia. There was no statistically significant difference found between WD patients on different treatment regimens regarding DEXA scan results (Z-Score). There was no statistically significant difference found between patients in the WD group (normal, osteopenic, or osteoporotic) regarding phosphorus (mg/dL), but there was a highly statistically significant difference found between them regarding ionised Ca (mmol/L). Therefore, there was a decrease in bone mineral density when the Ca level was decreased. In summary, Wilson disease is associated with bone demineralization. The largest number of cases in the WD group in our study had osteopenia (66.7%). Different treatment regimens (zinc monotherapy, Artamin, and zinc) as well as different laboratory parameters have no effect on bone mineralization in WD cases. Decreased ionised Ca is associated with low BMD in WD patients. Children with WD should be investigated for BMD.

Keywords: wilson disease, Bone mineral density, liver disease, osteoporosis

Procedia PDF Downloads 53
6667 The Method for Synthesis of Chromium Oxide Nano Particles as Increasing Color Intensity on Industrial Ceramics

Authors: Bagher Aziz Kalantari, Javad Rafiei, Mohamad Reza Talei Bavil Olyai

Abstract:

Disclosed is a method of preparing a pigmentary chromium oxide nano particles having 50 percent particle size less than about 100nm. According to the disclosed method, a substantially dry solid composition of potassium dichromate and carbon active is heated in CO2 atmosphere to a temperature of about 600ºc for 1hr. Thereafter, the solid Cr2O3 product was washed twice with distilled water. The other aim of this study is to assess both the colouring performance and the potential of nano-pigments in the ceramic tile decoration. The rationable consists in nano-pigment application in several ceramics, including a comparison of colour performance with conventional micro-pigments.

Keywords: green chromium oxide, nano particles, colour performances, particle size

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6666 Degradation of Endosulfan in Different Soils by Indigenous and Adapted Microorganisms

Authors: A. Özyer, N. G. Turan, Y. Ardalı

Abstract:

The environmental fate of organic contaminants in soils is influenced significantly by the pH, texture of soil, water content and also presence of organic matter. In this study, biodegradation of endosulfan isomers was studied in two different soils (Soil A and Soil B) that have contrasting properties in terms of their texture, pH, organic content, etc. Two Nocardia sp., which were isolated from soil, were used for degradation of endosulfan. Soils were contaminated with commercial endosulfan. Six sets were maintained from two different soils, contaminated with different endosulfan concentrations for degradation experiments. Inoculated and uninoculated mineral media with Nocardia isolates were added to the soils and mixed. Soils were incubated at a certain temperature (30 °C) during ten weeks. Residue endosulfan and its metabolites’ concentrations were determined weekly during the incubation period. The changes of the soil microorganisms were investigated weekly.

Keywords: endosulfan, biodegradation, Nocardia sp. soil, organochlorine pesticide

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6665 Addiction Counseling Resources: A Qualitative Study

Authors: Cailyn Green

Abstract:

Substance use counselors have a variety of fast-paced tasks and responsibilities. Professional resources are designed to support professionals in making their job duties easier and less stressful. The purpose of this research was to identify what types of resources would support addiction counselors in performing their job duties. Counselors often must jump in and facilitate a group counseling session with little to no time for prep. This causes stress and creates pressure to come up with a clinical group activity in little time. The researcher utilized qualitative interviews focused on identifying what types of resources would support addiction counselors in doing their jobs easier and effectively. The researcher visited 23 different addiction counseling facilities seeking participants for the interviews. Altogether 15 interviews were collected across six different substance-use counseling facilities. The interviews guided the researcher toward creating an open education resource (OER) of group activities for addiction counselors to utilize.

Keywords: addiction, counseling, resources, OER, treatment

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6664 Strategic Interventions to Combat Socio-economic Impacts of Drought in Thar - A Case Study of Nagarparkar

Authors: Anila Hayat

Abstract:

Pakistan is one of those developing countries that are least involved in emissions but has the most vulnerable environmental conditions. Pakistan is ranked 8th in most affected countries by climate change on the climate risk index 1992-2011. Pakistan is facing severe water shortages and flooding as a result of changes in rainfall patterns, specifically in the least developed areas such as Tharparkar. Nagarparkar, once an attractive tourist spot located in Tharparkar because of its tropical desert climate, is now facing severe drought conditions for the last few decades. This study investigates the present socio-economic situation of local communities, major impacts of droughts and their underlying causes and current mitigation strategies adopted by local communities. The study uses both secondary (quantitative in nature) and primary (qualitative in nature) methods to understand the impacts and explore causes on the socio-economic life of local communities of the study area. The relevant data has been collected through household surveys using structured questionnaires, focus groups and in-depth interviews of key personnel from local and international NGOs to explore the sensitivity of impacts and adaptation to droughts in the study area. This investigation is limited to four rural communities of union council Pilu of Nagarparkar district, including Bheel, BhojaBhoon, Mohd Rahan Ji Dhani and Yaqub Ji Dhani villages. The results indicate that drought has caused significant economic and social hardships for the local communities as more than 60% of the overall population is dependent on rainfall which has been disturbed by irregular rainfall patterns. The decline in Crop yields has forced the local community to migrate to nearby areas in search of livelihood opportunities. Communities have not undertaken any appropriate adaptive actions to counteract the adverse effect of drought; they are completely dependent on support from the government and external aid for survival. Respondents also reported that poverty is a major cause of their vulnerability to drought. An increase in population, limited livelihood opportunities, caste system, lack of interest from the government sector, unawareness shaped their vulnerability to drought and other social issues. Based on the findings of this study, it is recommended that the local authorities shall create awareness about drought hazards and improve the resilience of communities against drought. It is further suggested to develop, introduce and implement water harvesting practices at the community level to promote drought-resistant crops.

Keywords: migration, vulnerability, awareness, Drought

Procedia PDF Downloads 127
6663 Broad Survey of Fine Root Traits to Investigate the Root Economic Spectrum Hypothesis and Plant-Fire Dynamics Worldwide

Authors: Jacob Lewis Watts, Adam F. A. Pellegrini

Abstract:

Prairies, grasslands, and forests cover an expansive portion of the world’s surface and contribute significantly to Earth’s carbon cycle. The largest driver of carbon dynamics in some of these ecosystems is fire. As the global climate changes, most fire-dominated ecosystems will experience increased fire frequency and intensity, leading to increased carbon flux into the atmosphere and soil nutrient depletion. The plant communities associated with different fire regimes are important for reassimilation of carbon lost during fire and soil recovery. More frequent fires promote conservative plant functional traits aboveground; however, belowground fine root traits are poorly explored and arguably more important drivers of ecosystem function as the primary interface between the soil and plant. The root economic spectrum (RES) hypothesis describes single-dimensional covariation between important fine-root traits along a range of plant strategies from acquisitive to conservative – parallel to the well-established leaf economic spectrum (LES). However, because of the paucity of root trait data, the complex nature of the rhizosphere, and the phylogenetic conservatism of root traits, it is unknown whether the RES hypothesis accurately describes plant nutrient and water acquisition strategies. This project utilizesplants grown in common garden conditions in the Cambridge University Botanic Garden and a meta-analysis of long-term fire manipulation experiments to examine the belowground physiological traits of fire-adapted and non-fire-adapted herbaceous species to 1) test the RES hypothesis and 2) describe the effect of fire regimes on fine root functional traits – which in turn affect carbon and nutrient cycling. A suite of morphological, chemical, and biological root traits (e.g. root diameter, specific root length, percent N, percent mycorrhizal colonization, etc.) of 50 herbaceous species were measuredand tested for phylogenetic conservatism and RES dimensionality. Fire-adapted and non-fire-adapted plants traits were compared using phylogenetic PCA techniques. Preliminary evidence suggests that phylogenetic conservatism may weaken the single-dimensionality of the RES, suggesting that there may not be a single way that plants optimize nutrient and water acquisition and storage in the complex rhizosphere; additionally, fire-adapted species are expected to be more conservative than non-fire-adapted species, which may be indicative of slower carbon cycling with increasing fire frequency and intensity.

Keywords: climate change, fire regimes, root economic spectrum, fine roots

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6662 Synchronous Carcinoma Cervix with Vulvar Carcinoma in situ: A Case Report

Authors: Bhushan Bhalgat, Suresh Singh, Phanindra Swain, Kamal Kishore Lakhera

Abstract:

Carcinoma of cervix and carcinoma of vulva have been associated with common predisposing factors like human papillomavirus and smoking. Skip metastases and metachronous appearance of both these tumours have been reported. There is no case report showing synchronous appearance of these tumours in English literature. We herewith report a case report of a middle aged female patient who presented with per vaginal bleeding, and on examination, a cervical mass was palpable. Also, a proliferative growth was seen over her left vulva. Biopsy of both lesions came out to be squamous cell carcinoma and carcinoma in situ, respectively. A radical hysterectomy and bilateral pelvic and paraaortic lymph nodal dissection was performed along with left simple vulvectomy. This thereby underscores that any lesion over vulva appearing during or after treatment of cervical carcinoma should be biopsied to rule out vulvar carcinoma.

Keywords: carcinoma of cervix, carcinoma of vulva, synchronous tumours, gynecological oncology

Procedia PDF Downloads 164
6661 Moisture Variations in Unbound Layers in an Instrumented Pavement Section

Authors: R. Islam, Rafiqul A. Tarefder

Abstract:

This study presents the moisture variations of unbound layers from April 2012 to January 2014 in the Interstate 40 (I-40) pavement section in New Mexico. Three moisture probes were installed at different layers inside the pavement which measure the continuous moisture variations of the pavement. Data show that the moisture contents of unbound layers are typically constant throughout the day and month unless there is rainfall. Moisture contents of all unbound layers change with rainfall. Change in ground water table may affect the moisture content of unbound layers which has not investigated in this study. In addition, the Level 3 predictions of moisture contents using the Pavement Mechanistic-Empirical (ME) Design software are compared and found quite reasonable. However, results presented in the current study may not be applicable for pavement in other regions.

Keywords: asphalt pavement, moisture probes, resilient modulus, climate model

Procedia PDF Downloads 486
6660 Clinical Case Report of Fulminating Leptospirosis in a 4-Months Old Caucasian Dog: Public Health Significance and Ramifications

Authors: N. N. Pilau, M. S. Abubakar, A. Danmaigoro, P. C. Mshelia, Y. Sani

Abstract:

A severely debilitated 4months old Caucasian male dog presented dehydration, emaciation, vomiting, icteric ocular and oral mucous membranes, generalized lymphadenopathy, hematuria, anorexia and prolonged recumbency. Clinical workup was done in established protocols for diagnosis based on history, clinical signs and selected laboratory tests. Treatment course were administered over 48hours during which the patient died of overwhelming hepatopathy, nephropathy and pneumonia. Postmortem findings supported by ante mortem laboratory test results tentatively diagnosed leptospirosis, a disease endemic and presenting potentially fatal epidemics and zoonoses in some countries amongst the developing regions of the world. This disease is reviewed and a call for attention on the public health significance of the disease is hereby presented through this case report.

Keywords: canine, endemic, leptospirosis, prevalence

Procedia PDF Downloads 509
6659 Construction of Green Aggregates from Waste Processing

Authors: Fahad K. Alqahtani

Abstract:

Nowadays construction industry is developing means to incorporate waste products in concrete to ensure sustainability. To meet the need of construction industry, a synthetic aggregate was developed using optimized technique called compression moulding press technique. The manufactured aggregate comprises mixture of plastic, waste which acts as binder, together with by-product waste which acts as fillers. The physical properties and microstructures of the inert materials and the manufactured aggregate were examined and compared with the conventional available aggregates. The outcomes suggest that the developed aggregate has potential to be used as substitution of conventional aggregate due to its less weight and water absorption. The microstructure analysis confirmed the efficiency of the manufacturing process where the final product has the same mixture of binder and filler.

Keywords: fly ash, plastic waste, quarry fine, red sand, synthetic aggregate

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6658 Progress Towards Optimizing and Standardizing Fiducial Placement Geometry in Prostate, Renal, and Pancreatic Cancer

Authors: Shiva Naidoo, Kristena Yossef, Grimm Jimm, Mirza Wasique, Eric Kemmerer, Joshua Obuch, Anand Mahadevan

Abstract:

Background: Fiducial markers effectively enhance tumor target visibility prior to Stereotactic Body Radiation Therapy or Proton therapy. To streamline clinical practice, fiducial placement guidelines from a robotic radiosurgery vendor were examined with the goals of optimizing and standardizing feasible geometries for each treatment indication. Clinical examples of prostate, renal, and pancreatic cases are presented. Methods: Vendor guidelines (Accuray, Sunnyvale, Ca) suggest implantation of 4–6 fiducials at least 20 mm apart, with at least a 15-degree angular difference between fiducials, within 50 mm or less from the target centroid, to ensure that any potential fiducial motion (e.g., from respiration or abdominal/pelvic pressures) will mimic target motion. Also recommended is that all fiducials can be seen in 45-degree oblique views with no overlap to coincide with the robotic radiosurgery imaging planes. For the prostate, a standardized geometry that meets all these objectives is a 2 cm-by-2 cm square in the coronal plane. The transperineal implant of two pairs of preloaded tandem fiducials makes the 2 cm-by-2 cm square geometry clinically feasible. This technique may be applied for renal cancer, except repositioned in a sagittal plane, with the retroperitoneal placement of the fiducials into the tumor. Pancreatic fiducial placement via endoscopic ultrasound (EUS) is technically more challenging, as fiducial placement is operator-dependent, and lesion access may be limited by adjacent vasculature, tumor location, or restricted mobility of the EUS probe in the duodenum. Fluoroscopically assisted fiducial placement during EUS can help ensure fiducial markers are deployed with optimal geometry and visualization. Results: Among the first 22 fiducial cases on a newly installed robotic radiosurgery system, live x-ray images for all nine prostatic cases had excellent fiducial visualization at the treatment console. Renal and pancreatic fiducials were not as clearly visible due to difficult target access and smaller caliber insertion needle/fiducial usage. The geometry of the first prostate case was used to ensure accurate geometric marker placement for the remaining 8 cases. Initially, some of the renal and pancreatic fiducials were closer than the 20 mm recommendation, and interactive feedback with the proceduralists led to subsequent fiducials being too far to the edge of the tumor. Further feedback and discussion of all cases are being used to help guide standardized geometries and achieve ideal fiducial placement. Conclusion: The ideal tradeoffs of fiducial visibility versus the thinnest possible gauge needle to avoid complications needs to be systematically optimized among all patients, particularly in regards to body habitus. Multidisciplinary collaboration among proceduralists and radiation oncologists can lead to improved outcomes.

Keywords: fiducial, prostate cancer, renal cancer, pancreatic cancer, radiotherapy

Procedia PDF Downloads 88