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Nurses in the radiation oncology (RO) clinic have a critical role in the management of patients receiving radiation therapy. However, limited data exist regarding the exposure of nurses to RO during training and the current educational needs of practicing RO nurses. This study assesses nurses’ prior RO education, participation in national training efforts, and perceived educational needs.
Natural organic matter (NOM) in water can cause the formation of disinfection byproducts (DBPs) when NOM reacts with a disinfectant such as chlorine. Nanofiltration (NF) and reverse osmosis (RO) are effective treatment methods to remove NOM. However, the simultaneous presence of both NOM and divalent cations such as Ca 2+ can enhance fouling in NF and RO. Therefore, an appropriate pretreatment to remove such cations before NF or RO would delay fouling and perhaps improve water recovery and NOM removal efficiency. Electrodialysis (ED) is potentially an excellent pretreatment method because it separates inorganic ions well using ion exchange membranes (IEMs) but does not separate NOM well because of its size and consequent low diffusivity. This research focused on ion and NOM separation with ED using three different types of commercially available IEM pairs, two different commercially available NOM sources, and six different influents at 500 mg/L total dissolved solids in the presence or absence of both hardness (Ca 2+ and Mg 2+ ) and NOM. The target waters of interest in this research were drinking water supplies that require little or no desalination but substantial removal of NOM; after NOM separation in NF or RO, some or all of the ED concentrate can be added to the NF/RO permeate to create the finished water prior to disinfection. The results indicate that ED can effectively separate alkaline earth metal ions without separation of NOM. Cation exchange membranes with high exchange capacity, high selectivity for divalent cations are desirable, and both anion and cation exchange membranes should have low affinity for organic adsorption. As a result, the process would work particularly well for NOM with relatively low hydrophobicity, since NOM adsorption to most surfaces increases with hydrophobicity.
Electromagnetic field (EMF) treatment has emerged as a promising approach for scaling control due to its cost-effectiveness, simplicity, and low energy consumption. However, there is a limited understanding of the mechanisms by which applied EMF impacts mineral scaling in reverse osmosis (RO) systems. This has led to inconclusive and varied results and uncertainties regarding its effectiveness. This study elucidates the impacts of EMF on homogenous and heterogeneous nucleation and membrane performance during RO desalination of different feedwaters. Our results reveal that EMF exhibits greater efficacy in treating near-saturated water (SI∼0), especially when coupled with extended hydraulic flushing (HF). For saturated brackish water desalination, heterogeneous scaling predominantly occurs on membrane surfaces, with the effectiveness of EMF in inhibiting scaling primarily attributed to the hydration effect. In supersaturated solutions, EMF promotes bulk precipitation due to the magnetohydrodynamic effect, quickly blocking membrane pores. Thus, when the saturation reaches a certain high level during RO desalination, magnetohydrodynamic EMF effects can accelerate flux decline caused by homogeneous scaling. In conclusion, this work provides an efficient method for predicting EMF efficiency, emphasizing the importance of saturation conditions and HF cleaning duration in determining membrane performance, suggesting these show promise for improving undersaturated or near-saturated feedwater desalination via RO.
Integrated elemental, spectroscopic (infrared spectroscopy and X-ray absorption near-edge structure), and gas intrusion (helium pycnometry and nitrogen adsorption) analyses are used to characterize the bulk chemical, molecular, and physical microstructures of kerogen spanning a thermal maturity transect (vitrinite reflectance, Ro, from 0.5% to 2.6%) across the Woodford Shale of the Anadarko Basin, Oklahoma. The integration takes advantage of novel procedures to prepare kerogen isolates that preserve both the chemical and physical properties of the organic matter in the bulk shale. The Woodford kerogens follow the expected trends in H/C and O/C coordinates during thermal maturation for type II kerogen. Infrared spectra show that loss of hydrogen from kerogen is related to cracking of hydrogen-rich aliphatic (alkyl) carbon structures from aromatic carbons. Within the range of Ro values < 1.5%, peripheral aromatic carbons remain highly substituted with alkyl (methyl and methylene) and probably heteroatom functional groups. At Ro values > 1.5%, these substitutions are substantially removed and replaced by hydrogen. The evolution of carbon structures inferred from the IR spectra is supported by known carbon bond dissociation energies for carbonaceous materials. Total organic sulfur and sulfur-XANES data show that sulfur in Woodford kerogens is dominated by aromatic sulfur (thiophene) and that reactive, aliphatic sulfur (sulfide) is eliminated at low degrees of thermal stress (Ro ≤ 0.9%). At higher thermal stress, sulfur speciation is stable and dominated by thermally stable thiophene. The physical properties of Woodford kerogens evolve during thermal maturation in a manner consistent with their molecular characteristics. Skeletal density of kerogen increases during maturation in a manner that is linearly correlated to its atomic H/C ratio and inferred aromatic carbon content. The specific surface area of kerogen also increases during maturation, reflecting the development of internal pores within the kerogen skeletal framework as aliphatic carbon structures are preferentially cracked and expelled from solid kerogen. The quantitative chemical and structural changes expressed by the Woodford kerogens during thermal maturation, including their hydrogen and carbon content, carbon speciation, and skeletal density, are shown by comparison to not be measurably different for other type II kerogens from numerous oil- and gas-producing shale plays, indicating that thermal stress acts to drive maturation of type II kerogen in a similar way globally.
Electromagnetic field (EMF) is a cost-effective, simple, and energy-efficient method for scale control in reverse osmosis (RO) systems. However, its effects on gypsum and silica scaling, as well as the underlying mechanisms, remain poorly understood. This study systematically investigates the effects of EMF treatment on gypsum and silica scaling in RO systems, utilizing synthetic brackish water and natural RO concentrate (ROC) from a desalination facility. For gypsum, EMF changes the crystal morphology, resulting in the formation of a porous, less compact scaling layer. It is more readily removed through hydraulic flushing (HF), enhancing scaling reversibility and water recovery. In the case of silica scaling, EMF promotes homogeneous polymerization in the bulk solution, producing larger silica particles that inhibit the formation of a dense, cross-linked gel layer on the membrane surface, mitigating flux decline. This study thus demonstrates EMF’s effectiveness in controlling gypsum scaling in undersaturated feedwaters when combined with HF and in mitigating silica scaling under both HF and non-HF conditions for supersaturated feedwaters. These findings underscore EMF’s versatility as a nonchemical approach for scale control in RO desalination and show its substantial potential to enhance membrane performance and operational efficiency in real-world water treatment applications.
Ethylene-forming enzyme (EFE) is an ambifunctional iron(II)- and 2-oxoglutarate-dependent (Fe/2OG) oxygenase. In its major (EF) reaction, it converts carbons 1, 2, and 5 of 2OG to CO 2 and carbons 3 and 4 to ethylene, a four-electron oxidation drastically different from the simpler decarboxylation of 2OG to succinate mediated by all other Fe/2OG enzymes. EFE also catalyzes a minor reaction, in which the normal decarboxylation is coupled to oxidation of L-arginine (a required activator for the EF pathway), resulting in its conversion to L-glutamate semialdehyde and guanidine. Here we show that, consistent with precedent, the L-Arg-oxidation (RO) pathway proceeds via an iron(IV)-oxo (ferryl) intermediate. Use of 5,5-[ 2 H 2 ]-L-Arg slows decay of the ferryl complex by >16-fold, implying that RO is initiated by hydrogen-atom transfer (HAT) from C5. That this large substrate deuterium kinetic isotope effect has no impact on the EF:RO partition ratio implies that the same ferryl intermediate cannot be on the EF pathway; the pathways must diverge earlier. Consistent with this conclusion, the variant enzyme bearing the Asp191Glu ligand substitution accumulates ~ four times as much of the ferryl complex as the wild-type enzyme and exhibits a ~ 40-fold diminished EF:RO partition ratio. Here, the selective detriment of this nearly conservative substitution to the EF pathway implies that it has unusually stringent stereoelectronic requirements. An active-site, like-charge guanidium pair, which involves the L-Arg substrate/activator and is unique to EFE among four crystallographically characterized L-Arg modifying Fe/2OG oxygenases, may serve to selectively stabilize the transition state leading to the unique EF branch.
Different cloud types are generated over Antarctica as a result of various synoptic conditions. The cloud characteristics affect their impact on the surface energy budget. In this study, the dominating synoptic regimes over Antarctica (centered on the Ross Ice Shelf) are classified using self-organizing map (SOM) analysis, applied over long-term ERA-Interim 700 hPa geopotential height data. The corresponding cloud properties over McMurdo Station (measured as part of the AWARE campaign) are described and discussed with respect to the synoptic settings and sea-ice extent conditions. Cloud radiative forcing calculations are performed as well, and a particular focus is given to the net longwave “radiatively cloudy/opaque” (RO) regime. These results are compared with measurements performed at the West Antarctic Ice Sheet (WAIS) Divide to examine their variability and applicability to other Antarctic locations. It is found that the McMurdo cloud properties are strongly affected by the regional mesoscale cyclonic activity, which counterweights the larger-scale synoptic regime influence, while the WAIS clouds are more susceptible to the varying synoptic settings. In addition, it is suggested that the positive trend in the (frequent) cyclonic activity near the Antarctic coastal regions makes ice-clouds an increasing prominent contributor for the RO cases, especially during freeze-up and maximum sea-ice conditions.
The El Niño–Southern Oscillation (ENSO) is one of the most‐well understood climate phenomena, and the Recharge Oscillator (RO) theory is widely used to conceptualize its physics in observations and models. ENSO‐associated equatorial zonal wind anomalies shift southward in boreal winter, contributing to ENSO termination. Thus far, this effect has not been explicitly described in the RO framework. Here we derive a new form of the RO under the low‐frequency limit that incorporates the seasonal migration of zonal wind anomalies. In our theory, the Bjerknes feedback depends on the central latitude of zonal wind anomalies, decaying exponentially as winds shift away from the equator. Meanwhile, wind anomalies centered off the equator induce equatorial wave adjustment and thereby have a delayed effect on sea surface temperature anomalies. A stochastic RO simulation with a prescribed wind shift reproduces about half the amplitude of ENSO seasonal synchronization as well as ENSO combination tones.
The MUSASHI (MSI) family of RNA binding proteins (MSI1 and MSI2) contribute to a wide spectrum of cancers including acute myeloid leukemia. We find that the small molecule Ro 08–2750 (Ro) binds directly and selectively to MSI2 and competes for its RNA binding in biochemical assays. Ro treatment in mouse and human myeloid leukemia cells results in an increase in differentiation and apoptosis, inhibition of known MSI-targets, and a shared global gene expression signature similar to shRNA depletion of MSI2. Ro demonstrates in vivo inhibition of c-MYC and reduces disease burden in a murine AML leukemia model. Thus, we identify a small molecule that targets MSI’s oncogenic activity. Our study provides a framework for targeting RNA binding proteins in cancer.
In this study, we present a class of thin-film crosslinked (TFX) composite reverse osmosis (RO) membranes that resist physical compaction at ultrahigh pressures (up to 200 bar). Since RO membranes experience compaction at virtually all pressure ranges, the ability to resist compaction has widespread implications for RO membrane technology. The process described herein involves crosslinking a phase inverted porous polyimide (PI) support membrane followed by interfacial polymerization of a polyamide layer, thereby forming a fully thermoset composite membrane structure. We explore a range of phase inversion membrane formation parameters such as PI concentration, solvent-cosolvent ratios, coagulation bath composition, and crosslinking methods in addition to interfacial polymerization reaction chemistry and conditions. Overall, TFX membranes exhibit significantly less compaction compared to hand-cast and commercial high-pressure RO membranes, experiencing less than 10% decline in water permeance and maintaining salt rejection over 99% for NaCl solutions up to 180,000 mg/L with 200 bar applied pressure.
The present study was carried out to determine levels of inorganic compounds contained in the ground water and Reverse Osmosis (RO) water filtration result. The data in groundwater samples was collected from Bekasi, Tangerang and Jakarta in Indonesia. A total of 30 samples were collected and analyzed for the determine Cadmium (Cd), Chromium (Cr), Manganese (Mn), Cyanide (CN) and Lead (Pb). The results of the study revealed that in groundwater, the average of Cd 0.0058 mg / l, Mn 1.5233 mg / l, Cr 0.0127 mg/l, Pb 0.0060 mg / l, and CN 0.0040 mg / l. The level of RO result were: Cd 0.0027 mg / l, Mn 0.1767 mg / l, Cr 0.0024 mg / l, Pb 0.0021 mg / l, and CN 0.0023 mg / l . This means that Cd and Mn in ground water were higher than the values recommended by PAK-EPA and WHO or the standard of Indonesian Ministry of Health. But after filtration Reverse Osmosis (RO) Mn and Cd levels decreased to levels below the standardized value. By comparing of mean in MANOVA and nonparametric MANOVA in α=5%, there are differences in average levels of inorganic substances Mn, Cr, Cd, Pb, and CN between before and after RO filtration.
Quasi-classical trajectory (QCT) calculations are used to study state-specific ro-vibrational energy exchange and dissociation in the O{sub 2} + O system. Atom-diatom collisions with energy between 0.1 and 20 eV are calculated with a double many body expansion potential energy surface by Varandas and Pais [Mol. Phys. 65, 843 (1988)]. Inelastic collisions favor mono-quantum vibrational transitions at translational energies above 1.3 eV although multi-quantum transitions are also important. Post-collision vibrational favoring decreases first exponentially and then linearly as Δv increases. Vibrationally elastic collisions (Δv = 0) favor small ΔJ transitions while vibrationally inelastic collisions have equilibrium post-collision rotational distributions. Dissociation exhibits both vibrational and rotational favoring. New vibrational-translational (VT), vibrational-rotational-translational (VRT) energy exchange, and dissociation models are developed based on QCT observations and maximum entropy considerations. Full set of parameters for state-to-state modeling of oxygen is presented. The VT energy exchange model describes 22 000 state-to-state vibrational cross sections using 11 parameters and reproduces vibrational relaxation rates within 30% in the 2500–20 000 K temperature range. The VRT model captures 80 × 10{sup 6} state-to-state ro-vibrational cross sections using 19 parameters and reproduces vibrational relaxation rates within 60% in the 5000–15 000 K temperature range. The developed dissociation model reproduces state-specific and equilibrium dissociation rates within 25% using just 48 parameters. The maximum entropy framework makes it feasible to upscale ab initio simulation to full nonequilibrium flow calculations.
Scarcity of freshwater is becoming a world crisis. In a recent annual risk report, the World Economic Forum lists it in their greatest global risk category. Currently, about four billion people live under conditions of severe water scarcity for at least one month out of the year [1]. Increasing water use efficiency is thus essential. However, this alone will not be able to provide adequate drinking water to meet the world’s needs. The process of preparing drinking water from seawater and brackish water involves many stages, the final and most expensive of which is typically reverse osmosis (RO). Reverse osmosis processes operate by forcing water across a semi-permeable membrane by applying a pressure greater than the osmotic pressure of the feed solution (seawater, Π ≈ 28 bar = 400 psi), thereby separating the water from any dissolved ions and impurities (rejection > 99%). The flux of water through the membrane is directly proportional to the amount of pressure applied above the osmotic pressure; however, the energy consumption is related to the total pressure. According to the American Membrane Technology Association, the amount of energy required to desalinate seawater with current technologies is 2.5 to 3.5 kWh/m 3 of water. RO materials have been tuned, modified, and optimized extensively since their initial discovery through an Edisonian approach. Despite immense technological progress [2, 3], many basic scientific questions remain on the molecular structure of RO membranes. Overall, in this report, we demonstrate that synchrotron X-ray scattering methods offer the possibility of improving our fundamental understanding of RO materials.
Purpose: Advancement in Radiation Oncology (RO) practice develops through evidence based medicine and clinical trial. Knowledge usable for treatment planning, decision support and research is contained in our clinical data, stored in an Oncospace database. This data store and the tools for populating and analyzing it are compatible with standard RO practice and are shared with collaborating institutions. The question is - what protocol for system development and data sharing within an Oncospace Consortium? We focus our example on the technology and data meaning necessary to share across the Consortium. Methods: Oncospace consists of a database schema, planning and outcome data import and web based analysis tools.1) Database: The Consortium implements a federated data store; each member collects and maintains its own data within an Oncospace schema. For privacy, PHI is contained within a single table, accessible to the database owner.2) Import: Spatial dose data from treatment plans (Pinnacle or DICOM) is imported via Oncolink. Treatment outcomes are imported from an OIS (MOSAIQ).3) Analysis: JHU has built a number of webpages to answer analysis questions. Oncospace data can also be analyzed via MATLAB or SAS queries.These materials are available to Consortium members, who contribute enhancements and improvements. Results: 1) The Oncospace Consortium now consists of RO centers at JHU, UVA, UW and the University of Toronto. These members have successfully installed and populated Oncospace databases with over 1000 patients collectively.2) Members contributing code and getting updates via SVN repository. Errors are reported and tracked via Redmine. Teleconferences include strategizing design and code reviews.3) Successfully remotely queried federated databases to combine multiple institutions’ DVH data for dose-toxicity analysis (see below – data combined from JHU and UW Oncospace). Conclusion: RO data sharing can and has been effected according to the Oncospace Consortium model: http://oncospace.radonc.jhmi.edu/ . John Wong - SRA from Elekta; Todd McNutt - SRA from Elekta; Michael Bowers - funded by Elekta.
Purpose: The robustness-optimized intensity modulated proton therapy (RO-IMPT) plans takes into account the setup errors to eliminate the hot/cold spots caused by setup errors at the junction for craniospinal (CSI) irradiation fields. The RO-IMPT requires a large area for the junction of two fields. This work is to verify the treatment planning system calculated dose with introduction of setup errors by two-dimensional (2D) dose measurement. Two fields of total lengths of 45 cm with junctions of 21 cm were measured. Methods: 2D dose distributions in the coronal plane were measured by a commercial 2D ion-chamber-array detector in a cubic solid water phantom. A total spine field consisting of an upper and a lower spine field was measured at the depths of 5.4 and 6.9 cm. The active area for the measurement was 24×24 cm{sup 2}2. The junction and the area outside the junction of the spine fields were measured separately to complete the verification for the total field. Six different amounts of set-up errors along the superior-inferior direction up to 1.4 cm were intentionally applied. The measured dose with and without set-up errors were compared with the calculated dose with and without set-up errors using Gamma-index analysis. 3%/3mm and 2%/2mm dose/distance agreement criteria were used. The point dose at the center of the junction was also compared. Results: For all fields with various introduced setup errors, 100 % of pixels passed the 3%/3mm criteria and on average 96% of pixels passed 2%/2mm criteria. Differences in the measured and calculated doses were within 1.1%. Conclusion: The efficacy of the robustness for the CSI RO-IMPT plans were verified by measurement. The measurement method can be used for patient treatment field specific QA for CSI RO-IMPT plans in our institution in the near future.
It has long been standard practice in radiation oncology to report internally when a patient’s treatment has not gone as planned and to report events to regulatory agencies when legally required. Most potential errors are caught early and never affect the patient. Quality assurance steps routinely prevent errors from reaching the patient, and these “near misses” are much more frequent than treatment errors. A growing number of radiation oncology facilities have implemented incident learning systems to report and analyze both errors and near misses. Using the term “incident learning” instead of “event reporting” emphasizes the need to use these experiences to change the practice and make future errors less likely and promote an educational, non-punitive environment. There are challenges in making such a system practical and effective. Speakers from institutions of different sizes and practice environments will share their experiences on how to make such a system work and what benefits their clinics have accrued. Questions that will be addressed include: How to create a system that is easy for front line staff to access How to motivate staff to report How to promote the system as positive and educational and not punitive or demeaning How to organize the team for reviewing and responding to reports How to prioritize which reports to discuss in depth How not to dismiss the rest How to identify underlying causes How to design corrective actions and implement change How to develop useful statistics and analysis tools How to coordinate a departmental system with a larger risk management system How to do this without a dedicated quality manager Some speakers’ experience is with in-house systems and some will share experience with the AAPM/ASTRO national Radiation Oncology Incident Learning System (RO-ILS). Reports intended to be of value nationally need to be comprehensible to outsiders; examples of useful reports will be shown. There will be ample time set aside for audience members to contribute to the discussion. Learning Objectives: Learn how to promote the use of an incident learning system in a clinic. Learn how to convert “event reporting” into “incident learning”. See examples of practice changes that have come out of learning systems. Learn how the RO-ILS system can be used as a primary internal learning system. Learn how to create succinct, meaningful reports useful to outside readers. Gary Ezzell chairs the AAPM committee overseeing RO-ILS and has received an honorarium from ASTRO for working on the committee reviewing RO-ILS reports. Derek Brown is a director of http://TreatSafely.org . Brett Miller has previously received travel expenses and an honorarium from Varian. Phillip Beron has nothing to report.
It has long been standard practice in radiation oncology to report internally when a patient’s treatment has not gone as planned and to report events to regulatory agencies when legally required. Most potential errors are caught early and never affect the patient. Quality assurance steps routinely prevent errors from reaching the patient, and these “near misses” are much more frequent than treatment errors. A growing number of radiation oncology facilities have implemented incident learning systems to report and analyze both errors and near misses. Using the term “incident learning” instead of “event reporting” emphasizes the need to use these experiences to change the practice and make future errors less likely and promote an educational, non-punitive environment. There are challenges in making such a system practical and effective. Speakers from institutions of different sizes and practice environments will share their experiences on how to make such a system work and what benefits their clinics have accrued. Questions that will be addressed include: How to create a system that is easy for front line staff to access How to motivate staff to report How to promote the system as positive and educational and not punitive or demeaning How to organize the team for reviewing and responding to reports How to prioritize which reports to discuss in depth How not to dismiss the rest How to identify underlying causes How to design corrective actions and implement change How to develop useful statistics and analysis tools How to coordinate a departmental system with a larger risk management system How to do this without a dedicated quality manager Some speakers’ experience is with in-house systems and some will share experience with the AAPM/ASTRO national Radiation Oncology Incident Learning System (RO-ILS). Reports intended to be of value nationally need to be comprehensible to outsiders; examples of useful reports will be shown. There will be ample time set aside for audience members to contribute to the discussion. Learning Objectives: Learn how to promote the use of an incident learning system in a clinic. Learn how to convert “event reporting” into “incident learning”. See examples of practice changes that have come out of learning systems. Learn how the RO-ILS system can be used as a primary internal learning system. Learn how to create succinct, meaningful reports useful to outside readers. Gary Ezzell chairs the AAPM committee overseeing RO-ILS and has received an honorarium from ASTRO for working on the committee reviewing RO-ILS reports. Derek Brown is a director of http://TreatSafely.org . Brett Miller has previously received travel expenses and an honorarium from Varian. Phillip Beron has nothing to report.