Fluid geochemistry of the Los Humeros geothermal field (LHGF - Puebla, Mexico): New constraints for the conceptual model

Geothermal power in Mexico is mainly produced in four geothermal fields operated by the Comision Federal de Electricidad (CFE): Cerro Prieto, Los Azufres, Los Humeros, and Las Tres Virgenes. The Los Humeros Geothermal Field (LHGF) is ranked third in terms of generated capacity, and in the last decade its installed capacity has doubled (up to 95.0 MW). Further increases in the geothermal power generation capacity in Mexico are planned, and thus the LHGF warrants further examination. The development and growth phases of any geothermal project must start from an awareness of the conceptual model of the natural system studied. The recharge mechanism, feeding zones, and fluid flow-path must be identified, along with the estimation of the temperature at the productive level and of phase separation (liquid - steam). To accomplish this, detailed fluid geochemical surveys were carried out in June 2017 and March 2018, in which 57 and 87 samples were collected, respectively, from cold and thermal springs, water wells and maar lakes located around and inside the LHGF. Samples from fumaroles inside the producing area were also collected for the first time, together with fluid from re-injection wells. The presence of a meteoric component, which plays an important role at the regional scale, is confirmed by the chemical and isotope data, and its contribution in terms of recharge may be higher than previously assumed. The Sierra Madre Oriental, on the west side of the LHGF, is characterized by widespread outcrops of limestone belonging to the same geological formation as those at the bottom of the LHGF. The isotope composition (delta D and delta O-18, respectively -77.3 parts per thousand and -10.50 parts per thousand for the hypothetical Infiltration Water IW) is similar to that observed in cold springs located in the Sierra Madre Oriental, and from this the evolution of isotopes in the liquid-rock-steam system during water-rock interaction and phase separation processes can be modelled. Thus, the experimental data obtained for natural gas emissions (fumarolic condensates) and for geothermal fluids can be reproduced. These findings suggest that geothermal fluids in the LHGF are likely to be derived from meteoric water infiltrating (IW) the limestone outcrops of the Sierra Madre Oriental. During their flow-path, the infiltrating waters exchange isotopes at a high temperature with the crustal rocks, which have a much higher O-18/O-16 ratio, resulting in a shift towards higher delta O-18 (-4.35 parts per thousand +/- 1) as the water O exchanges with rock O. The vapor phase can be separated from this deep water (DW) and it is discharged from the fumarolic effluents of Loma Blanca. Single Step Vapor Separation (SSVS) and Continuous Steam Separation processes (CSS) were modelled using stable isotopes of water. The results of geochemical modeling agree with available data for geothermal liquids discharged from several geothermal wells, suggesting that steam separation may be interpreted either as SSVS or CSS. Other processes can affect the chemistry and isotope composition of geothermal fluids (e.g. phase segregation, gas exchange, contributions from magmatic-volcanic deep fluids and re-injection fluids). The proposed conceptual model is consistent with both the geochemical data and the geological setting, and provides a useful point of reference for examining the fluid flow-path and geochemical processes active in the LHGF, at least at a general level. An involvement of magmatic-volcanic deep fluids in the feeding mechanism of the geothermal system cannot be excluded at priori, but the regional meteoric end-member is supported by the data and it seems the most important component

Mixed-beam approach in locally advanced nasopharyngeal carcinoma: IMRT followed by proton therapy boost versus IMRT-only. Evaluation of toxicity and efficacy

Objective: To compare radiation-induced toxicity and dosimetry parameters in patients with locally advanced nasopharyngeal cancer (LANPC) treated with a mixed-beam (MB) approach (IMRT followed by proton therapy boost) with an historic cohort of patients treated with a full course of IMRT-only. Material and methods: Twenty-seven patients with LANPC treated with the MB approach were compared to a similar cohort of 17 patients treated with IMRT-only. The MB approach consisted in a first phase of IMRT up to 54-60 Gy followed by a second phase delivered with a proton therapy boost up to 70-74 Gy (RBE). The total dose for patients treated with IMRT-only was 69.96 Gy. Induction chemotherapy was administrated to 59 and 88% and concurrent chemoradiotherapy to 88 and 100% of the MB and IMRT-only patients, respectively. The worst toxicity occurring during the entire course of treatment (acute toxicity) and early-late toxicity were registered according to the Common Terminology Criteria Adverse Events V4.03. Results: The two cohorts were comparable. Patients treated with MB received a significantly higher median total dose to target volumes (p = .02). Acute grade 3 mucositis was found in 11 and 76% (p = .0002) of patients treated with MB and IMRT-only approach, respectively, while grade 2 xerostomia was found in 7 and 35% (p = .02) of patients treated with MB and IMRT-only, respectively. There was no statistical difference in late toxicity. Local progression-free survival (PFS) and progression-free survival curves were similar between the two cohorts of patients (p = .17 and p = .40, respectively). Local control rate was 96% and 81% for patients treated with MB approach and IMRT-only, respectively. Conclusions: Sequential MB approach for LANPC patients provides a significantly lower acute toxicity profile compared to full course of IMRT. There were no differences in early-late morbidities and disease-related outcomes (censored at two-years) but a longer follow-up is required to achieve conclusive results

L’attività dei Centri Antifumo italiani tra problematiche e aree da potenziare: i risultati di un’indagine svolta attraverso un questionario on-line

Introduzione. In Italia sono 295 i Servizi per la cessazione dal fumo di tabacco (Centri Antifumo - CA) afferenti al Servizio Sanitario Nazionale (SSN) censiti nel 2011 dall’Osservatorio Fumo, Alcol e Droga (OssFAD) dell’Istituto Superiore di Sanità. La presente indagine, condotta dall’OssFAD in collaborazione con i CA, è stata volta a rilevare alcune delle problematiche con le quali il personale dei CA si confronta per portare avanti la propria attività e le iniziative ritenute utili per migliorarla. Materiali e metodi. L’indagine è stata condotta dal 7 al 21 maggio 2012, mediante un questionario compilabile on-line composto da 5 brevi sezioni di domande con un totale di 38 items da completare. Il link al questionario on-line è stato inviato per e-mail a 322 indirizzi dei CA censiti nel 2011 dall’OssFAD. I dati raccolti sono stati elaborati statisticamente con il programma SPSS 20. Risultati. All’indagine hanno risposto 146 operatori dei CA (45,3%). Sebbene ci siano aspetti ormai consolidati dell’attività dei CA, sono ancora molte le criticità che gli operatori riscontrano nella loro attività. Le principali problematiche che influiscono in modo fondamentale/rilevante per la buona attività del centro sono le “Scarse o nulle risorse economiche” per il 60,7% del personale, “la mancanza di personale dedicato” per il 52,4% del personale; il “riconoscimento/mandato istituzionale del CA” per il 40,9% del personale. Tra le azioni ritenute più efficaci per facilitare l’accesso ai CA sono risultate la sensibilizzazione del personale sanitario (91%), in particolare dei medici di famiglia e l’inserimento delle prestazioni antitabagiche nei LEA (76,8%). Conclusioni. È auspicabile che l’attività dei CA riceva una maggiore attenzione, attraverso la dotazione di strutture, personale e finanziamenti adeguati a svolgere un importante ruolo nella tutela e promozione della salute