bluuebunny/crossref_metadata_2025 huggingface dataset:
Soft Computing Predictions of Relative Energy Dissipation for Vertical Drops Equipped with a Horizontal Screen
Authors: Norouzi Reza , Daneshfaraz Rasoul , Abraham John , Sihag Parveen
Published: October 2020

Drops are the most important and most common energy dissipator in irrigation networks and erodible canals and consequently, their performance must be well understood. This study was designed to evaluate the capability of Artificial Intelligence (AI) methods including ANN, ANFIS, GRNN, SVM, GP, MLR, and LR to predict the relative energy dissipation (∆E/E0) in vertical drops equipped with a horizontal screen. For this study, 108 experiments were carried out to investigate energy dissipation with variable discharge, varying drop height, and porosity of the horizontal screens. Parameters yc/h, yd/yc, and p are considered as input variables and ∆E/E0 is the output variable. The efficiency of models was compared using Taylor's diagram, Box Plot of the applied error distribution, correlation coefficient (CC), mean absolute error (MAE) and root-mean-square error (RMSE). Results indicate that the performance of the ANFIS_gbellmf based model with CC value of 0.9953, RMSE value of 0.0069 and MAE value of 0.0042 was superior to other applied models. Also, the linear regression model with CC=0.9933, RMSE=0.0083, and MAE= 0.0067performs better than the multiple linear regression model in this study. Results of a sensitivity study suggest that yc/h is the most effective parameter for predicting ∆E/E0.
Shale Compaction Kinetics
Authors: Smith James , Smith-Rowland Edward
Published: October 2020

1 Abstract The grain-to-grain stress vertically in sediments is given by the overburden less the pore fluid pressure, σ, divided by the fraction of the horizontal area which is the supporting matrix , (1 − φ), φ being the porosity. It is proposed that the fractional reduction of this ratio, Λ, with time is given by the product of φ 4m/3) , (1 − φ) 4n/3 , and one or more Arrhenius functions A exp(−E/RT ) with m and n close to 1. This proposal is tested for shale sections in six wells from around the world for which porosity-depth data are available. Good agreement is obtained above 30-40 C. A single activation energy of 23+-5 kJ/mole, indicating pressure solution of quartz, 24 kJ/mol, was obtained. The average value of m is 1, indicating fractal pore-matrix spaces and water-wet interfaces. Grain-to -grain interfaces may be fractal with m close to 1, but can have lower values suggesting smooth surfaces and even grain-to-grain welding. Results are independent of over- or under-pressure of pore water. This model explains shale compaction quantitatively.
The Genetic Basis of Obesity and Related Metabolic Diseases in Humans and Companion Animals
Authors: Wallis Natalie , Raffan Eleanor
Published: October 2020

Obesity is one of the most prevalent health conditions in humans and companion animals across the world. Obesity is associated with multiple health conditions across species including premature mortality. It is therefore of importance across the fields of medicine and veterinary medicine. The regulation of body weight is a homeostatic process vulnerable to disruption by genetic and environmental factors. It is well established that the heritability of obesity is high in humans and laboratory animals, with ample evidence that the same is true in companion animals. In this review, we provide an overview of how genes link to obesity in humans, drawing on a wealth of information from laboratory animal models, and summarising the mechanisms by which obesity causes related disease. Throughout, we focus on how large-scale human studies and niche investigations of rare mutations in severely affected patients have improved our understanding of obesity biology and can inform our ability to interpret results of animal studies. For dogs, cats and horses, we review the similarities in obesity pathophysiology to humans and review those genetic studies that have been done to investigate them. Finally, we discuss how veterinary genetics may learn from humans about studying precise, nuanced phenotypes and implementing large-scale studies, but also how veterinary studies may be able to look past clinical findings to mechanistic ones and demonstrate translational benefits to human research.
A Novel Earwax Method to Measure Acute and Chronic Glucose Levels
Authors: Herane-Vives Andres , Espinoza Susana , Sandoval Rodrigo , Ortega Lorena , Alameda Luis , Young Allan H , Arnone Danilo , Hayes Alexander , Benohr Jan
Published: October 2020

Increased chronic glucose is associated with pandemic diseases. To date, there is not a practical, as well as accurate sample for reflecting that level. We measured earwax glucose in 37 controls. They provided standard serum samples, Glycated Haemoglobin (HbA1c) and earwax samples on two time-points, one month a part. The specimens measured baseline fasting glucose, a follow-up postprandial glucose level and a between sample chronic glucose, calculated using the average level on the two occasions. The baseline earwax sample was obtained using a clinical method and the follow-up using a novel self-sampling earwax device. The earwax analytic time was significantly faster using the novel device in comparison to the clinical use of the syringe. Earwax accurately reflected glucose at both assessments with stronger correlations than HbA1c. Follow-up postprandial concentrations were more significant than their respective fasting baseline concentrations, reflecting differences in fasting and postprandial glycaemia and more efficient standardisation at follow up. Earwax demonstrated to be more predictable than HbA1c in reflecting systemic fasting, postprandial and long-term glucose levels and immune by confounders. Earwax glucose was approximately 60% more predictable than HbA1c in reflecting glycaemia over a month. The self-sampling device provided a sample that might accurately reflect chronic glycaemia.
Case History of Conformance Solutions for West Sak Wormhole/Void Space Conduit with a New Reassembling Pre-formed Particle Gel RPPG
Authors: Targac Gary , Gallo Courtney , Smith David , Huang Chung-Kan , Autry Sydney , Peirce John , Baohong Li
Published: October 2020

Waterflood conformance is a significant problem in the West Sak field of Alaska. Re-assembling Pre-Formed Particle Gels (RPPG) have been used to treat Void Space Conduits (VSC) and repair the "short-circuited" waterflood. These VSC’s are typically formed by sand producing wormholes. Several dozen VSC solutions have been implemented since 2006, including molten wax, cement blends, and pre-formed particle gels. To date, all the solutions have been faced with various limitations due to the low reservoir temperature and poor sand consolidation.

A good percentage of the pre-formed particle gel (PPG) solutions have been successful in sealing off VSCs, but often show limited longevity that can range from as little as several weeks to several years. An effort was undertaken to develop a product that would provide enhanced stability in the VSC and extend solution life beyond the current range. A cost-effective conformance solution was developed with increased mechanical strength through a re-crosslinking process known as RPPG. The goal of the RPPG solution is to provide a longer-term repair to a VSC and restore the primary water flood characteristics.

This paper will present the results of the seventeen RPPG solutions that have been pumped between 2017 and 2019 in the West Sak field on the North Slope of Alaska. RPPG treatments have shown a 23% improvement over traditional PPG treatments at the economic payout during the field trial. There have been some significant learnings through this time period. The focus of this paper will be to review the VSC problem understanding and the reason for the RPPG product development, detail the evolution of RPPG job design over time and provide results and operational knowledge from the field trial efforts.

The latest advancements in conformance engineering will be of interest to Reservoir and Production Engineers who are focused on supporting and optimizing conventional waterflooded assets, particularly when faced with conformance issues in an unconsolidated reservoir. In addition, the field results will be useful to those seeking to implement RPPG solutions in their area of operation.
A New Machine Learning Procedure to Generate Highly Accurate Synthetic Shear Sonic Logs in Unconventional Reservoirs
Authors: Chaikine Ilia Alexandrovich , Gates Ian Donald
Published: October 2020

Shear sonic travel time (DTS), along with compressional sonic travel time and bulk density are required in order to estimate rock mechanical properties which play an important role in fracture propagation and the success of hydraulic fracture treatments in horizontal wells. DTS logs are often missing from the log suite due to their costs and time to process. The following study presents a machine learning procedure capable of generating highly accurate synthetic DTS curves. A hybrid convolutional-recurrent neural network (c-RNN) was chosen in the development of this procedure as it can learn sequential data which a traditional neural network (ANN) cannot. The accuracy of the c-RNN was superior when compared to that of the ANN, simple baselines and empirical correlations. This procedure is a cost effective and fast alternative to running DTS logs and with further development, has the potential to be used for predicting production performance from unconventional reservoirs.
10,000 RPM ESP Pump Slurry Test With In situ Performance Measurement
Authors: Ye Zheng , Forsberg Michael , Rutter Risa , Smith Spencer , Najmi Kamyar , Lack Ryan , Hoines Jason , Gunter Shawn
Published: October 2020

Affinity law teaches that when the rotating speed of the electric submersible pump (ESP) pump is tripled, the flow rate triples and the head increases to nine times the original pump. Thus, a high-speed ESP has the potential of delivering increased production at deeper setting depths and opportunity for shorter equipment allowing operators to land the equipment in shorter tangent sections. Operation at high-speed also presents additional challenges with one of the most significant being increased potential for abrasive and erosive wear. This study compares pump performance from slurry testing to help evaluate the potential trade-offs system performance versus wear when operating at higher speeds.

When deploying ESPs in sandy applications, sand particles can enter the seal clearance between impeller and diffuser creating 3-body abrasion wear. Meanwhile, the 2-body erosion wear in stage flow path reshapes the hydraulic geometry and causes additional losses. Both abrasion and erosion cause pump head reduction, efficiency deterioration, and thrust increase. Data was collected during slurry testing for comparison of performance over the test period. The in situ head change and thrust change were monitored during the slurry test. Pre and posttest stage dimensional data were gathered for comparison. Sand samples were gathered and analyzed to ensure similar slurry conditions applied to all the tested pumps.

Slurry testing and analysis for the evaluation of ESP pump stage performance deterioration for a stage operated at 10,000 RPM as compared to a stage operated at 3,500 RPM will be provided. The pump performance degradation and dimensional wear were compared. This demonstrates higher speed ESP pump components can be created that show similar abrasive wear performance to current ESP pump.

A 10,000 rpm ESP pump completed slurry testing while measuring pressure, temperature, flow and thrust. The results provide pump performance deterioration trend in a sand application and helps to understand physics of stage wear mechanism. This is the first of this type of testing apparatus to authors’ knowledge. It also serves as a backbone in high-speed pump validation program.
A Quick and Rigorous Approach for Estimating Reservoir Permeability from DFITs
Authors: Cai Yuzhe , Dahi Taleghani Arash , Hawkes Robert
Published: October 2020

Diagnostic fracture injection tests (DFITs) have been widely studied and implemented in unconventional reservoirs to derive properties such as closure stress, pore pressure, and permeability. During a DFIT, a small volume of water is pumped into a formation to create a small-sized crack. Formation permeability is typically obtained by means of modeling fluid leakoff during the shut-in period. Early studies have assumed a constant fluid pressure boundary condition on the fracture walls or a constant leakoff rate into the formation. However, the results deduced based on these assumptions may introduce significant errors because the fluid pressure inside a fracture dissipates quickly as the fluid leaks off into the formation. In this study, we propose a material balance approach to obtain formation permeability using DFIT data. The proposed analysis takes into account fluid leakoff during both fracture propagation and well shut-in periods. To model fluid leakoff during fracture propagation, we adopt the superposition principle to decompose the problem into two separate problems; we then obtain the analytical solution. Two synthetic cases are presented to validate the proposed analysis. The results suggest that the proposed approach provides a good estimation of formation permeability. This approach has broad field application potential, as it can be used even when pressure data contains significant levels of noise. In addition, the solution is more accurate than those provided in available studies of formation permeability estimation using DFITs data, especially when formation permeability is not extremely tight.
Stranger Things: Pairing Cementing Fluid Technologies to Overcome Challenging Isolation Requirements
Authors: Shine Joseph , Qasmi Urooj
Published: October 2020

Exploration wells tend to produce challenging cement placement conditions with varying design elements to achieve the isolation requirements such as avoiding lost circulation and exhibiting high mud removal efficiencies. To satisfy both of these design elements, development of a cementing fluid (spacer) has paired multiple technologies helping overcome these requirements. The cementing fluid combines a lost circulation spacer, shown to be a cement placement aid, and a scrubbing or scouring additive, demonstrating support for high mud removal efficiencies. Thorough function-based assurance testing helped mitigate the identified deployment risks, due to their plugging natures, in combining these technologies.

The paper will document applications where the cementing fluid helped achieve the isolation requirements when faced with wellbore instability during placement as well as the associated mud removal challenges from these limitations. The use of the cementing fluid may help others achieve success when faced with similar challenges.
Mechanistic Model Validation of Decline Curve Analysis for Unconventional Reservoirs
Authors: Gorditsa Mikhail , Bryan Eric , Moridis George J. , Blasingame Thomas A.
Published: October 2020

The motivation for this work is straight-forward — simply put, there is need in the upstream oil and gas industry to properly forecast production rate performance in unconventional reservoirs. At present, this need is being met by an ever-growing inventory of time-rate (decline curve analysis (or, DCA)) relations of various constructs and purposes — this has led to inconsistent and somewhat contradictory results. The overall purpose of this work is to put forth an examination of the validity of the most common of these time-rate models via the use of high-resolution reservoir simulation.

As such, this work is constructed in 2 parts. The first part of this work is focused on the creation of a very high precision reservoir simulation model that is of sufficient accuracy and flexibility to model the well performance for the primary types of unconventional reservoirs (e.g., gas-water and oil-gas-water systems). The reservoir simulation model is validated against analytical models for the single-phase case (to ensure validity), then tested with numerous synthetic field cases (to ensure applicability to most types of unconventional reservoir systems).

The second part of this work focuses on the use of the common DCA relations (Arp's Modified Hyperbolic model, the stretched/power law exponential model, the Duong model, and the Logistical Growth model (a population model)) to correlate against reservoir simulation results to establish the "most appropriate" model(s) for which to history match actual field cases.

Based on the synthetic performance cases considered in the first portion of this work, a new time-rate (DCA) model is proposed based on the K1(x) Bessel Function (i.e., the Modified Bessel Function of the second kind). In form, this result is quite compact and has the general performance characteristics of the modified-hyperbolic model at early times and the stretched/power law exponential model(s) at intermediate and late times — that is, the rate and the decline parameters D(t) and b(t) for the K1X model closely match these functions for the aforementioned DCA models and the reservoir simulation performance results. In this sense, the K1X model is a sort of "hybrid" which represents the combined behavior of the modified-hyperbolic model and the stretched/power law exponential model(s).
Estimating Reservoir and Fracture Properties from Stage-By-Stage Pressure Decline Analysis in Horizontal Wells
Authors: Wang HanYi , Elliott Brendan , Sharma Mukul
Published: October 2020

The pressure decline data after the end of a hydraulic fracture stage is sometimes monitored for an extended period of time (30 minutes to hours). However, this data is not analyzed and often ignored or underappreciated due to a lack of suitable models for closure of propped fractures. In this study, we present a new approach to model and analyze pressure decline data that is available at the end of each plug and perf stage in horizontal wells. The new model, interpretation method and specialized plots presented in this study allow us to quantify closure stress, average pore pressure inside the stimulated reservoir volume (SRV) and normalized fracture stiffness/compliance evolution along the entire horizontal wellbore without additional data acquisition costs. Analysis of field stage-by-stage pressure decline data shows that the interpreted results are consistent with the analysis of DFIT data from an offset well for the same formation. We found that the early-time stage-by-stage pressure decline trend is controlled by progressive hydraulic fracture closure on the proppant pack, while late-time pressure decline reflects linear flow. Thus, the pressure decline rate alone is not a reliable indicator of the productivity or stimulation efficiency of a certain stage. When DFIT data is not available, pressure decline analysis of a main hydraulic fracturing stage can be used even if it can be monitored for a relatively short period of time (1 hour). Most important of all, we show that the slope of pressure derivative on a log-log plot and the normalized fracture stiffness plot can be used to infer the uniformity of proppant distribution.
An Intelligent Artificial Lift Technology and its Trial in Middle East: Integration of Remote Wireless Control and Artificial Automation for Zonal Water Injection
Authors: Fu Jin , Wang Xi , Yang Guobin , Zhang Shunyuan , Liu Bingshan , Chen Chen
Published: October 2020

High water cut is a serious problem for mature oilfields in China. Water injection paths are intersected with each other, injectors and producers are distributed in a more and more complicated pattern, while low-productivity layers are more focused. Conventional zonal water injection technologies require repetitive operation with wirelines and cables, causing extensive tests and low efficiency. However, an intelligent zonal water injection string consisting of several preset cable packers, water injection pressure gauges, formation pressure gauges and downhole flow meters has simply optimized water injection parameters and efficiently developed all reservoirs in some China's mature oilfields.

Horizontal drilling and extended reach well drilling technologies are developing by high speed, we are faced by more critical borehole conditions, which has brought more challenges to water adsorption testing of horizontal intervals and deployment of zonal water injection instruments. Compared with vertical wells, the water adsorption test and string running are more challenging for horizontal wells, in which we are faced by many a problem during zonal water injection, such as competitive slack off and tight pull, excessive or inadequate water injection, complicated operation process, etc.

There are several common challenges arising from zonal water injection, such as tight pull, slack off and repetitive operation. A full set of wireless intelligent water injection string for horizontal wells has been proposed. Based on pressure pulse water distribution technique, the water injection string is eligible for multi-stage adjustment, so it is possible to finalize testing, adjusting, injection, measurement, downhole data collection as well as automatic error correction in one run during water injection. A dedicated trial shows that integration of remote wireless control and artificial automation may is applicable, as packers are set securely and released easily, in order to adjust opening of each water injection nozzle on the ground. Therefore, this completion and water zonal water injection string enables precise water injection by means of data remote control. The first trial was accomplished in Ghawar Oilfield, Saudi Arabia, showing acceptable results.

Integration of remote wireless control and artificial automation requires a wireless water injection string that combines testing, adjusting, injection, measuring and data collection in one trip, providing us with adequate downhole data. Thus, the complete water injection process for each zone is precisely monitored and controlled on the ground.
Assessment of the Efficacy of the Far Cortical Locking Technique in Proximal Humeral Fractures: A Comparison with the Conventional Bi-cortical Locking Technique 
Authors: seo joongbae , Kim Yoenjun , Kim Kyubeom , Yoo Jae-Sung
Published: October 2020

Background Locking plate fixation is one of the treatment strategies for the management of proximal humeral fractures. However, stiffness after locking plate fixation is a clinical concern. The mechanical stiffness of the standard locking plate system may suppress the interfragmentary motion necessary to promote secondary bone healing by callus formation. The far cortical locking (FCL) technique was developed to address this limitation in 2005. FCL increases construct flexibility and promotes callus formation. Our study aimed to evaluate the clinical and radiological outcomes of the FCL technique when implemented in proximal humeral fracture management. Furthermore, we compared the surgical outcomes of FCL with those of the conventional bicortical locking (BCL) screw fixation technique.Methods Forty-five consecutive patients who had undergone locking fixation for proximal humeral fractures were included in this study. A proximal humeral locking plate (PHILOS) system with BCL screw fixation was used in the first 27 cases, and the periarticular proximal humeral locking plate with FCL screw fixation was used in the final 18 consecutive cases. Functional capacity was assessed using the constant score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion. Radiographic outcomes were evaluated using the Paavolainen method of measuring the neck-shaft angle (NSA).Results No significant differences in clinical outcomes (ASES score, constant score, and range of motion)were found between the two groups. The union rate at 12 weeks was significantly higher in the FCL group (94.4%) than in the BCL group (66.7%, p=0.006). No significant differences in NSA were found between the two treatment strategies. The complication rate was not significantly different between the two groups.Conclusions When implemented in proximal humeral fractures, the FCL technique showed satisfactory clinical and radiological outcomes as compared with the conventional BCL technique. The bone union rate at 12 weeks after surgery was significantly higher in the FCL group than in the BCL group. However, no significant difference in the final bone union rate was found between the two groups.Level of evidence: Level III-2, Retrospective study
WITHDRAWN: Age-related changes of neutrophil characteristics, potential of activation, DNA release and NET formation
Authors: Krall Moritz , Mauracher Lisa-Marie , Roiss Johanna , Hell Lena , Ondracek Anna S , Gebhart Johanna , Brostjan Christine , Ay Cihan , Pabinger Ingrid
Published: October 2020

Background: Neutrophils are a heterogeneous population of leukocytes, which can be subdivided into high and low density neutrophils (HDNs/LDNs). They are known to fight intruders with different mechanisms, including the release of neutrophil extracellular traps (NETs), which have also been associated with thrombosis. Risks of infection and thrombosis increase with age. Differences in neutrophil subpopulations and functionality have been shown in various disease states, but investigations in healthy subjects and their dependence on age are lacking. The aim of this study was to investigate age-related changes in neutrophils regarding neutrophil subpopulations, their potential of activation, DNA release and NET formation.Methods: Neutrophil subpopulations (HDNs and LDNs) were isolated from 25 healthy individuals subdivided into 3 groups (<45 years, n=8; 45-54, n=9; >54, n=8). Neutrophil characteristics, potential of activation and the ability of NET formation was investigated using flow cytometry. Externalisation of DNA was detected by a DNA release assay.Results: HDN and LDN counts did not differ between age-groups. However, with increasing age we observed a shift in neutrophil subpopulations towards a lower amount of mature LDNs, characterized by their expression of membrane receptors CD62L and CD16. Upon stimulation, neutrophils of older individuals showed significantly higher release of DNA. HDNs of younger participants increased activation markers (CD66b and CD11b) to a higher extent compared to those of older individualsConclusion: Neutrophils and their ability of activation, DNA release and NET formation change with age and this might contribute to the higher risk of infection and thrombosis at advanced age. Furthermore, these results highlight the importance and necessity of age-matching in studies that focus on neutrophil characteristics.
Long-term radiographic outcomes and functional evaluation of ulnar shortening osteotomy in patients with ulnar impaction syndrome and reverse oblique sigmoid notch
Authors: Huang Hui-Kuang , Lee Steve K. , Huang Yi-Chao , Yin Cheng-Yu , Chang Ming-Chau , Wang Jung-Pan
Published: October 2020

Background: Ulnar shortening osteotomy (USO) is an effective treatment for ulnar impaction syndrome. However, there has been a concern of osteoarthritis (OA) developing at the distal radioulnar joint (DRUJ) if USO is performed on patients with a reverse oblique sigmoid notch. This study aimed to evaluate the radiographic and functional outcomes following USO in patients with a reverse oblique sigmoid notch.Methods: We retrospectively reviewed our patients with a reverse oblique sigmoid notch who underwent USO to treat ulnar impaction syndrome between 2002 and 2013. We evaluated the radiographic changes of the DRUJ and the patients’ functional outcomes.Results: We enrolled 22 patients (22 wrists) with an average age at operation of 49.6 years and mean follow-up of 93.2 (range, 36 - 179; SD 38.2) months. We found that there were changes in the inclination angle of the sigmoid notch, from an average of reverse oblique 14.9o (range, 11o - 23o; SD 3.4o) preoperatively to a more parallel 5.1o (range, 0o - 11o; SD 3.2o) at the final follow-ups. The functional results at the final follow-ups were good with a mean VAS for pain of 0.2 (range, 0 - 1; SD 0.4) at rest and 1.3 (range, 0 - 3; SD 0.9) during activity, QuickDASH of 15.1 (range, 2.3 - 34.1; SD 8.8), and modified Mayo Wrist Score of 91.6 (range, 70-100; SD 6.4). Seven wrists (31.8%) were noted to have OA changes, but the wrists did not exhibit a significantly worse function when compared to wrists without OA changes, except for supination motion and grip strength.Conclusions: For those patients with a reverse oblique sigmoid inclination following USO, the inclination angle would have a tendency to become more parallel and some patients would develop OA changes at the DRUJ, but the functional outcomes could still be good in the long term. The reverse oblique sigmoid inclination seems not to be an absolute contraindication for USO.
Accessing health services in India: Experiences of seasonal migrants returning to Nepal.
Authors: Adhikary Pratik , Aryal Nirmal , Dhungana Raja Ram , KC Radheyshyam Krishna , Regmi Pramod Raj , Wickramage Kolitha Prabhash , Duigan Patrick , Inkochasan Montira , Sharma Guna Nidhi , Devkota Bikash , Teijlingen Edwin van , Simkhada Padam
Published: October 2020

Background: Migration to India is a common livelihood strategy for poor people in remote Western Nepal. To date, little research has explored the degree and nature of healthcare access among Nepali migrant workers in India. This study explores the experiences of returnee Nepali migrants with regard to accessing healthcare and the perspectives of stakeholders in the government, support organizations, and health providers working with migrant workers in India. Methods: Six focus group discussions (FGDs) and 12 in-depth interviews with returnee migrants were conducted by trained moderators in six districts in Western Nepal in late 2017. A further nother 12 key persons working in the health and education sector were also interviewed. With the consent of the participants, FGDs and interviews were audio-recorded. They were then transcribed and translated into English and the data w ere as analysed thematically. Results: The interviewed returnee migrants worked in 15 of India’s 29 states, most as daily wage labourers. Most were from among the lowest castes so called-Dalits. Most migrants had had difficulty accessing healthcare services in India. The major barriers to access were the lack of insurance, low wages, not having an Indian identification card tied to individual biometrics so called: Aadhaar card. Other barriers were unsupportive employers, discrimination at healthcare facilities and limited information about the locations of healthcare services. Conclusions: Nepali migrants experience difficulties in accessing healthcare in India. Partnerships between the Nepali and Indian governments, migrant support organizations and relevant stakeholders such as healthcare providers, government agencies and employers should be strengthened so that this vulnerable population can access the healthcare they are entitled to. Keywords: Migrants, Returnees, Healthcare access, Qualitative research, Nepal, South Asia
Air sampling for detection of infectious laryngotracheitis (ILT) in commercial poultry flocks.
Authors: Brown Lauren , Premaratna Dilhani , Segal Yonatan , Beddoe Travis
Published: October 2020

Objective Infectious laryngotracheitis (ILT) is an acute and highly contagious viral respiratory disease of poultry, caused by gallid herpesvirus 1 (ILTV), which causes significant economic losses. Due to recent outbreaks of ILT in Australia, it has been proposed that ILT could be transmitted between poultry sheds by airborne transmission; however, there has never been direct detection of gallid herpesvirus 1 from air samples. We aimed to optimize a sampling system for the detection of airborne gallid herpesvirus 1 in poultry sheds.Results Poultry farms with a known clinical outbreaks of ILT were used as a test case for detection of airborne ILTV. Infected chickens were verified by detection of ILTV nucleic acid in feather shafts with all farms being positive. Using a liquid cyclonic impinging device, it was found that recovery and detection of airborne ILTV was possible in alkaline PEG buffer. Additional sampling was performed at different heights to determine the presence of ILTV in the air. In farm 3, all three air samples at both heights were positive for ILVT while at farm 2 only one sample at 45cm was positive. We envisaged in the future air sampling will be able to detect and track potential transmission of gallid herpesvirus 1 both inside and outside of the poultry shed.
Tsetse fly distribution and occurrence of Trypanosoma species among cattle and goats around Queen Elizabeth National park, Uganda
Authors: Kangume Mallion , Muhangi Denis , Byaruhanga Joseph , Agaba Aggrey , Sserunkuma Joachim , Kisembo Stallon Justus , Bogere Paul , Vudriko Patrick , Rwego Innocent Bidason
Published: October 2020

Background: African Animal Trypanosomiasis (AAT) is an infectious disease of economic and veterinary importance in Sub-Saharan Africa. The current study aimed at providing baseline information on tsetse fly distribution and occurrence of Trypanosoma species in cattle and goats within and around Queen Elizabeth National Park (QENP), in western Uganda. A minimal entomological survey was conducted in April 2017 while blood samples collected from cattle (n = 576) and goats (n = 319) in June 2015 and May 2017 were subjected to Polymerase Chain Reaction (PCR) to determine the occurrence of Trypanosoma species.Results: Glossina pallidipes and G. fuscipes were the only tsetse fly species trapped in the study area with apparent density of 20.6. The overall prevalence of Trypanosoma spp. was 27% for goats and approximately 38% for cattle. The most prevalent Trypanosoma spp. in goats was T. brucei (n = 60, 18.8%) while the most prevalent in cattle was T. congolense (n = 102, 27.1%). In both cattle and goats, a dual infection of T. brucei + T. congolense was most encountered. In goats a triple infection of T. brucei + T. congolense + T. vivax was higher than that in cattle. Conclusions: Current findings show that there are two species of tsetse flies, and three species of Trypanosoma, important in transmission of AAT in both cattle and goats. Control efforts of AAT have mainly focused on cattle and this study proves that prevention and control efforts should also involve goat farmers.
Facilitating equal access to primary care for all: work experiences of health mediators in a primary health care model program in Hungary
Authors: Katona Cintia , Gutási Éva , Papp Magor , Varga Orsolya , Kósa Karolina
Published: October 2020

Background: A Primary Care Model Programme was implemented in Hungary between 2013 and 2017 in order to increase access of disadvantaged population groups to primary care and to offer new preventive services for all clients. In a country with single-handed practices, four group practices or GP clusters were created in the Programme. Six GPs comprised one cluster who together employed nonmedical health professionals and nonprofessional health mediators, the latter recruited from the serviced communities, many of them of Roma ethnicity. Health mediators were tasked by improving access of the local communities – including its vulnerable Roma members – to existing and new services. Health mediators were interviewed about their work experiences, motivation, and overall opinion as members of the clusters as part of the Programme evaluation. Methods: As part of the Programme evaluation, structured interviews were conducted with all 40 health mediators employed at the time in the Programme. Interviews were transcribed and content analysis was carried out. Results: Three themes emerged from the transcripts. The first focused on the health mediators’ personal characteristics such as motivation to join the Programme, the way their job increased their self-esteem, social status and health consciousness. Domains of the second theme of their work included importance of on-the-job training and of their insider knowledge of local communities, as well as their pride to have become members of the primary care team. The third theme covered overall functioning of the Programme of which they had mostly positive opinions, notwithstanding some criticism regarding procurement. Conclusions: Health mediators had earlier worked in various European countries specifically to improve access of Roma ethnic groups to health services but the Hungarian Model Programme was globally the first in which health mediators as non-professional workers became equal members of the primary care team as employees. Their contribution and overwhelmingly positive experiences, along with their useful insights for improvement call for the establishment and funding of health mediator positions in primary care especially in areas with large numbers of disadvantaged Roma populations.
A Finite Element Analysis of Sacroiliac Joint Displacements and Ligament Strains in Response to Three Manipulations
Authors: Xu Zhun , Li Yikai , Zhang Shaoqun , Liao Liqing , Wu Kai , Feng Ziyu , Liu Dan
Published: October 2020

Background: Clinical studies have found that manipulations have a good clinical effect on sacroiliac joint (SIJ) pain without specific causes. However, the specific mechanisms of manipulations are still unclear. The purpose of this study was to investigate the effects of three common manipulations on the pressures and displacements of SIJ, and the strains of the surrounding ligaments. Methods: A three-dimensional finite element model of the pelvis-femur was developed. The manipulation of hip and knee flexion (MHKF), the manipulation of oblique pulling (MOP), and the manipulation of lower limb hyperextension (MLLH) were simulated. The pressures and displacements of SIJs, and the strains of the surrounding ligaments were analyzed under the three manipulations. Results: The MOP produced the greatest pressure on the left SIJ, at 6.6 MPa, while the MHKF could produce the lowest pressure on the right SIJ, at 1.5 MPa. The displacements of SIJs were all less than 1mm in the three manipulations. The three manipulations could cause different degrees of the strains of ligaments around the SIJs, and the MOP could produce the largest strain of ligaments. Conclusion: The three manipulations all produced small displacements of SIJs, while they caused different degrees of ligament strains, which might be the reason for relieving the SIJ pain. The MOP may be a more effective manual therapy. Key words: Manipulation, Sacroiliac joint, Displacement, Ligament strain, Finite element analysis.
Analysis of sagittal profile and radiographic parameters in symptomatic thoracolumbar disc herniation patients
Authors: Gao Ang , Yu Miao , Wang Yongqiang , Liu Xiaoguang
Published: October 2020

Background Few studies describe thoracolumbar disc herniation (TLDH) as an isolated category, it is frequently classified as the lower thoracic spine or upper lumbar spine. Thus, less is known about the morphology and aetiology of TLDH compared to lumbar disc herniation (LDH). The aim of study is to investigate sagittal alignment in TLDH and analyze sagittal profile with radiographic parameters.Methods Data from 70 patients diagnosed with TLDH were retrospectively reviewed. The thoracic-lumbar alignment was depicted by description of curvatures (the apex of lumbar curvature, the apex of thoracic curvature, and inflexion point of the two curvatures) and radiographic parameters from complete standing long-cassette spine radiographs. The rank sum test was utilised to compare radiographic parameter values in each subtype. Results We found two subtypes differentiated by the apex of thoracic kyphotic curves. The apex of the thoracic kyphotic curve located in the middle thoracic spine in type I, and the apex of the thoracic kyphotic curve located in the thoracolumbar region in type II patients. Thirty-six patients were classified as type I, and 34 patients were classified as type II. The mean sagittal vertical axis, T1 pelvic angle and L1 pelvic angle were 27.9±24.8°, 8.2±7.3° and 6.2±4.9°, respectively. There was significant difference (p<0.001) of thoracolumbar angle between type I (14.9±7.9°) and type II patients (29.1±13.7°).Conclusions We presented two distinctive sagittal profiles in TLDH patients, and a regional kyphotic deformity with a balanced spine was validated in both subtypes. In view of the different curvatures, different aetiologies were discovered in each subtype. Mismatch between shape and sacral slope value was observed, and better agreement was found in Type II patients.
Computer-Assisted femoral head reduction osteotomies: An approach for anatomic reconstruction of severely deformed Legg-Calvé-Perthes hips. A pilot study of six patients
Authors: Fürnstahl Philipp , Casari Fabio A. , Ackermann Joëlle , Marcon Magda , Leunig Michael , Ganz Reinhold
Published: October 2020

Background Legg–Calvé–Perthes (LCP) is a common orthopedic childhood disease that causes a deformity of the femoral head and to an adaptive deformity of the acetabulum. The altered joint biomechanics can result in early joint degeneration that requires total hip arthroplasty. In 2002, Ganz et al. introduced the femoral head reduction osteotomy (FHRO) as a direct joint-preserving treatment. The procedure remains one of the most challenging in hip surgery. Computer-based 3D preoperative planning and patient-specific navigation instruments have been successfully used to reduce technical complexity in other anatomies. The purpose of this study was to report the first results in the treatment of 6 patients to investigate whether our approach is feasible and safe.Methods In this retrospective pilot study, 6 LCP patients were treated with FHRO in multiple centers between May 2017 and June 2019. Based on patient-specific 3D-models of the hips, the surgeries were simulated in a step-wise fashion. Patient-specific instruments tailored for FHRO were designed, 3D-printed and used in the surgeries for navigating the osteotomies. The results were assessed radiographically [diameter index, sphericity index, Stulberg classification, extrusion index, LCE-, Tönnis-, CCD-angle and Shenton line] and the time and costs were recorded. Radiologic values were tested for normal distribution using the Shapiro–Wilk test and for significance using Wilcoxon signed-rank test.Results The sphericity index improved postoperatively by 20% (p = 0.028). The postoperative diameter of the femoral head differed by only 1.8% (p = 0.043) from the contralateral side and Stulberg grading improved from poor coxarthrosis outcome to good outcome (p = 0.026). All patients underwent acetabular reorientation by periacetabular osteotomy. The average time (in minutes) for preliminary analysis, computer simulation and patient-specific instrument design was 63 (±48), 156 (±64) and 105 (±68.5), respectively.Conclusion The clinical feasibility of our approach to FHRO has been demonstrated. The results showed significant improvement compared to the preoperative situation. All operations were performed by experienced surgeons; nevertheless, three complications occurred, showing that FHRO remains one of the most complex hip surgeries even with computer assistance. However, none of the complications were directly related to the simulation or the navigation technique.
Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus weighing ≥ 1kg
Authors: Wang Xiaojuan , LI Junwei , Hua Keqin , Chen Yisong
Published: October 2020

Background: The transvaginal natural orifice transluminal endoscopic surgery (vNOTES) applied in gynecology has been developed recent years and been evolving. In this study, we aimed to evaluate the feasibility and effect of the vNOTES hysterectomy for uterus ≥ 1 kilogram (kg).Methods: From January 2019 to March 2020, patients with benign indications in cases of uterus weighing ≥ 1kg, underwent vNOTES hysterectomy were studied retrospectively. The patients’ demographics, indications for surgery, operation outcomes and follow-up details were recorded. Results: 39 patients were performed vNOTES hysterectomy for large uterus (mean weight 1141.8 gram, range from 1000 to 1720), indications for surgery included bulky uterine myomas or adenomysosis. The mean age was 48 years (range 42-66) and mean BMI was 24 kg/m2 (range 18.4-38). Mean operating time was 123.3 minutes (rang 40-400) and the mean estimated blood loss was 206.7 milliliters (range 10-1300). The mean pain assessment was 2.1 (range 0-5). The mean length of stay was 2.4 nights (1-11). 1 patient experienced ureteral injury and was performed ureteral anastomosis. 3 patients were converted to vaginal-assisted trans-umbilicus single-port laparoscopy. The learning curve was analyzed to show that 20 cases were needed to achieve proficiency in vNOTES hysterectomy for large uterus ≥ 1 kg.Conclusion: Our preliminary experience suggested that vNOTES hysterectomy for large uterus weighing ≥ 1kg was feasible and safe, meanwhile this procedure had the advantages of all the minimal invasive approach such as fast recovery and aesthetic advantage.
A Tripartite Analysis of Online Healthcare Platforms: Evidence from Spring Rain Doctor in China
Authors: Cao Xia , Zhang Lanting , Lv Dan , Li Weijia , Xing Zeyu
Published: October 2020

Background: Online healthcare platform (OHP) is a new form of medical treatment, which solves the problems of unbalanced distribution of medical resources and expensive medical treatment in China. Especially under the epidemic of COVID-19, OHP has greatly reduced the medical pressure of the hospital and the risk of cross infection. Methods: This paper uses evolutionary game theory to analyze behavioral strategies and their dynamic evolution in the promotion of OHP, and then numerical simulations are carried out with the help of program compilation. Results: The results demonstrate that: (1) both the stricter qualification inspection of doctors and the more investment in information protection promote the participation of doctors and the use of patients; (2) with a higher initial probability of doctors joining, the possibility for patients in using OHP and platforms to provide standardized online healthcare services becomes higher; (3) if the initial probability of patients using is higher, the possibility for doctors to join OHP and platforms to provide standardized online healthcare services raises; (4) the trend of doctors joining the platform is affected by factors, such as registration cost, time cost, reputation loss ; (5) the tendency of patients in using online healthcare is mainly decided by the cost.Conclusions: Based on theoretical analysis, this article takes the Spring Rain Doctor OHP as an example to verify the game results. Therefore, OHP should attach importance to the inspection of doctors and the protection of privacy information, and strengthen the publicity in remote places. At the same time OHP can promote the active participation of grassroots doctors, and set a reasonable evaluation mechanism, so as to popularize online medical treatment among patients further.