bluuebunny/crossref_metadata_2025 huggingface dataset:
Removal of Flow Instability Through the Use of Multiple Converging Gas Lift Ports (MCGLP) in Gas Lift Wells
Authors: Gunwant Deepak , Kishore Nand , Gogoi Ranjit , Devshali Sagun , Chanchalni Kuldeep Laxmanbhai , Rajak Himanshu Kumar , Meena Sunil Kumar
Published: October 2023

Conventionally, a cylindrical channel square-edged port is used to transport the gas from the annulus to the tubing. However, insufficient gas injection, incorrect port diameter size, and gas injection rate variation generally result in unstable flow condition with such ports. To overcome these problems, multiple Converging Gas Lift Ports have been designed with an objective to stabilize the gas injection thus minimizing the fluctuation in tubing pressures. This technology has been applied in 13 gas lift wells and has resulted in a liquid production increment of approximately 80 m3/d.

The converging flow geometry of the novel gas lift valve has three directional ports which address the challenges posed by the subcritical flow regime as seen in the conventional valves. By achieving a critical flow regime with a low pressure differential, it offers a potential solution for operating more effectively in gas lift applications. Additionally, the use of Three Pressure Recording provides valuable insights into the performance and stability of the gas lift system. These advancements can be instrumental in maximizing production and addressing issues such as casing heading problems and tubing instability, especially in reservoirs with active water drive or mixed drive mechanisms.

The paper addresses the challenges faced using conventional gas lift valves and details out various benefits of the novel technology. The parent company is the pioneer in implementing this breakthrough technology in one of the highest producing onshore fields which has resulted in substantial liquid and oil gain as brought out in the paper. The technology discussed offers a promising solution for operators aiming to improve production performance and maximize the recovery of hydrocarbon resources in their fields.
Green House Gas Emission Reduction Through Process Improvement at Flaring System in Offshore Gas Production Platform in Malaysia
Authors: Koh Liang Yi , Sia Agnes Hui Bing , Mahmud Nurul Syuhada
Published: October 2023

In supporting PETRONAS Net Zero Carbon Emissions by 2050 (NZCE 2050) goal to achieve Zero Flaring & reduce Green House Gas Emission, a Flare Improvement Study was conducted to reduce the flaring emission at Low Pressure (LP) Flare at an offshore gas platform and avoid value leakage. Root Cause Analysis (RCA) had been initiated using the Fault Tree Analysis method on high LP flaring rate & provide remediation in reducing flare rate. Several findings were identified covering all flaring sources to LP Flare System including LP Knocked Out Drum (KOD), LP Flare Line, LP Flare Tip during normal operation. The operation team investigated the root cause & found changes in flare gas composition that deviated from design. Rerouting of hot glycol vent gas into LP Flare System without being cooled down caused water condensation along flare piping while high moisture content affected flare meter accuracy.

The incomplete modification unable to cool down the 100°C vent gas to at least 50°C before entering LP KOD, which had severely threatened the integrity of LP KOD that operated above its design temperature of 65°C. Other than that, the hot stream fed into LP KOD was unable to knock out liquid before exiting to LP Flare Piping. Condensation along the piping caused rapid corrosion, resulting in LP Flare Piping Line being left with remaining thickness of 1mm (about 0.04 in) before reaching minimum allowable working thickness. From LP KOD, the glycol vent gas contained water vapor + TEG (Tri-ethylene glycol) was sent to flare system. The TEG Thermal Decomposition Temperature is > 404°F or 206.5°C. When exceeded, TEG turned into organic acid & became corrosive which deteriorated flare system physical condition.
Depleted Gas Zone Isolation in Cemented Monobore via Real-Time Coiled Tubing Expandable Steel Patch
Authors: Abd Rahim Mohd Adam , Ibrahim Ahmed Fahmee , Mohd Zain Mohd Nazree , Siew Caleb Jia Lih , Khoo Alan Kwan Hou , Nguyen Thi Huong , Amsidom Amirul Adha , Rashid Ruziean , Choi Xee Yiong , Khairul Anuar Khairina , Chin Pui Ling , Le Pouezard Benjamin , Mohd Noor Ashratul Ashikin , Yong Nigel
Published: October 2023

An operation in Malaysia successfully implemented coiled tubing (CT) expandable steel patches to isolate upper depleted zones so that lower gas zones could be produced. This serves to prove the technique as a method that can be used in top-down gas production isolate & perforate strategy.

A bottom-up isolate & perforate gas production strategy has always been a practice in a cemented monobore with multi-zonal completions. This simple design has the benefit of enabling simple well intervention operations through the well’s production life in the wake of reserve recoveries. Typically, "plug and perf" is used to continue production from the upper zones with undeveloped/ behind casing reserves when the lower zones in the well are depleted to economic limit for them to be isolated. However, some cases require producing from top-to-bottom, which requires isolation of upper zones and perforate the lower zones. Real-time coiled tubing expandable steel patches were proposed as a solution for top-to-bottom production in a well in Malaysia, 5-½" expandable steel patches were installed with the greatest number of overlaps.

The evaluation process prior to installation started with a well information review once the subsurface objective was determined. This thorough analysis identified the new zone to replace the existing depleted zone. Next, a comprehensive study assessed the isolation method, the appropriate conveyance, and the method to be used to validate the isolation integrity. The perforation strategy was then formulated to pass through the validated isolation section.

Following the operation, lessons learned were collected and discussed. The method, results and lessons learned from the application of a real-time coiled tubing expandable steel patch represent a resource for applying the method to future wells with top-to-bottom production.
Prediction of the Maximum Horizontal Principal Stress from Breakout Data Using Generative Adversarial Networks and Backpropagation Neural Network
Authors: Wu Bisheng , Zhang Haoze , Wu Shengshen , Nie Yuanxun , Zhang Xi , Jeffrey Robert G.
Published: October 2023

A good understanding of the magnitude and direction of in-situ stresses is very important for oil and gas exploration. The conventional wellbore breakout method directly uses information about rock strength and wellbore shape (i.e., depth and width of breakout) to predict the in-situ stresses, but it is difficult to accurately describe the relationship between the breakout shape and the in-situ stresses. This paper presents a deep learning model, combining the generative adversarial networks (GAN) and backpropagation neural network (BPNN) to predict the maximum horizontal principal stress (MHPS) from breakout data. First, a GAN is used to effectively improve the quantity and quality of training data by generating a certain number of new training data that approximate the original data. Second, the training data enhanced by the GAN are used to train the BPNN, which predicts the MHPS based on wellbore breakout geometries. The two independent modules, the GAN and BPNN, use the training data to train themselves, respectively. This dual deep learning pattern ensures that the potential relationship between the in-situ stresses and wellbore breakout shape can be found. To examine the reliability of this technique, 86 sets of laboratory data from published literature are used to train the model, and 19 sets of laboratory data from other published literature are used to test the prediction performance of the trained model. The results show that the proposed model has good accuracy with an average relative error of 4.76% when predicting the MHPS. In addition, this deep learning model combining the GAN and BPNN requires only a few seconds to run on a laptop computer, thus providing an effective and efficient tool for predicting the MHPS.
Landscape-scale Epidemiological Dynamics of SARS-CoV-2 in White-tailed Deer
Authors: Hewitt Joshua , Wilson-Henjum Grete , Collins Derek , Linder Timothy , Lenoch Julianna , Heale Jonathon , Quintanal Christopher , Pleszewski Robert , McBride Dillon , Bowman Andrew , Chandler Jeffrey , Shriner Susan , Bevins Sarah , Kohler Dennis , Chipman Richard , Gosser Allen , Bergman David , DeLiberto Thomas , Pepin Kim
Published: October 2023

Understanding pathogen emergence in new host species is fundamental for developing prevention and response plans for human and animal health. We leveraged a large-scale surveillance dataset coordinated by United States Department of Agriculture, Animal and Plant Health Inspection Service and state natural resources agencies to quantify outbreak dynamics of SARS-CoV-2 in North American white-tailed deer (Odocoileus virginianus; WTD) throughout its range in the United States. Local epidemics in WTD were well approximated by a single outbreak peak followed by fade out. Outbreaks peaked earliest in the northeast and mid-Atlantic. Local effective reproduction numbers of SARS-CoV-2 were between 1 and 2.5. Ten percent of variability in peak prevalence was explained by human infection pressure. This, together with the similar peak infection prevalence times across many counties and single-peak outbreak dynamics followed by fade out, suggest that widespread transmission via human-to-deer spillover may have been an important driver of the patterns and persistence. We provide a framework for inferring population-level epidemiological processes through joint analysis of many sparsely-observed local outbreaks (landscape scale surveillance data) and linking epidemiological parameters to ecological risk factors. The framework combines mechanistic and statistical models that can identify and track local outbreaks in long-term infection surveillance monitoring data.
Is Artificial Intelligence Replacing Humans in Systematic Literature Reviews? A Systematic Literature Review
Authors: Queiros Luisa , Mearns Elizabeth S , McCarvil Mary Susan , Alarcão Joana , Garcia Maria João , Abògúnr̀in Ṣẹ̀yẹ
Published: October 2023

Background
Systematic literature reviews (SLRs) seek to answer research questions and form comprehensive, rigorous evidence-based conclusions. However, SLRs are resource-intensive. Multiple SLR applications provide artificial intelligence (AI)-as-a-service capabilities (e.g. EPPI-Reviewer, DistillerSR, Abstrackr) aimed at reducing this workload. The primary objective of our SLR was to assess whether and how researchers employ the AI component of these applications in published SLRs.
Methods
MEDLINE and EMBASE were searched in June 2021 for SLRs that utilized AI. SLRs and scoping reviews were eligible if they addressed human healthcare-related questions and reported the use of AI or AI-as-a-service applications (AIsAPP) in any step. Rayyan was used for abstract and full-text screening. Backwards citation-tracking and hand-searching were completed. Data were abstracted into Google Sheets and used to summarize key characteristics of included studies in frequency tables and figures.
Results
In the fifty-six studies included, the most frequently utilized AIsAPPs were Rayyan (n = 22) DistillerSR (n = 11) and EPPI reviewer (n = 9). Only 16 studies provided details on the automation process; thirteen used AI for semi-automation, two for full-automation, and for one study it was not clear how automation was used. Semi-automation was mainly used for screening (n = 12) and extraction (n = 2). Full automation was used for abstract screening in two studies.
Conclusions
Few SLRs reported utilizing AI in the SLR process. Contrary to recommendations in current PRISMA guidelines, details on automation steps were rarely described. Transparently reporting how AI is used during the conduct of an SLR could aid decision-makers with the adoption of such technologies as standard practice. Further research should evaluate the limitations and barriers to incorporating and reporting the use of AI as standard in SLRs.
Balance chiropractic therapy for cervical spondylotic radiculopathy: a randomized controlled trial
Authors: Li Wenxiong , Chang Yaxin , Feng Qi , Cheng Yan , Yin Jichao , Sun Yindi , Yang Feng
Published: October 2023

Objective. To assess the clinical effectiveness of the balance chiropractic therapy (BCT) compared with traction therapy (TT) for patients with cervical spondylotic radiculopathy.
Methods: Subjects were enrolled from four hospitals. Eligible patients will be randomized to one of the two arms: the treatment group and the control group. In the treatment group, patients received the BCT for 20 days, while patients in the control group received TT. Patients visited the physician at 1- and 3-month follow-up. The primary outcome was pain severity measured with a Visual Analog Scale (VAS). Secondary outcomes included cervical curvature measured using the Borden method, a composite of functional status measured by the Neck Disability Index (NDI), patient health status (evaluated by the SF-36 health survey) and adverse events (AEs) as reported in the trial.
Results: Of the 240 randomly assigned patients, 120 participants were assigned to the BCT and 120 to the TT. 231 (96.3%) provided follow-up data at 1 and 3 months. There were no significant differences in baseline data between the two groups (P > 0.05), indicating good comparability. According to the results, after BCT and TT treatment, the pain VAS score, cervical curvature, NDI scores and SF-36 scores of two groups was significantly improved (P < 0.05). Furthermore, at 20 days of treatment and 1 and 3 months of follow-up, the participants in the BCT group showed superior treatment outcomes on both primary and secondary measures.
Conclusion: The BCT may be a novel strategy for the treatment of the cervical spondylotic radiculopathy.
Trial registration: Clinical Trials.gov Identifier: NCT02705131. Registered on 10 March 2016, https://clinicaltrials.gov/study/NCT02705131?cond=NCT02705131&rank=1&tab=table.
The study was approved by the Ethics Committee of Affiliated Hospital of Shaanxi University of Chinese Medicine (No. SZFYIEC-PJ-2016[01]).
The study of whether acquired Mendelian diseases are the origin of Alzheimer’s disease from viral respiratory diseases.
Authors: Lee Jong hoon
Published: October 2023

We must study viral RNA infection, sustained interferon response, acetylcholine excess, and developing Alzheimer’s disease (AD). We analyzed viral respiratory disease (VRD) (+)/(−) and dapsone (DDS) (+)/(−) groups. ANOVA calculator, logistic regression analysis, and Mann-Whitney U Test Calculator were used to examine the association of VRDs, COPD, and anti-AD drugs (AADs) with AD. A total of 107 subjects from 2005 to 2021 developed COPD. The DDS (+) AAD (-) and DDS (-) AAD (+) groups were strongly positively correlated with all COPD subjects. COPD develops into AD without dapsone, and AAD exacerbates AD through COPD. Ten AD among ninety-three non-COPD patients occurred in 2010 since the endemic. Viral infections set a direct pathway into AD directly without COPD. The endemic causes bronchitis, COPD, and AD. Acquired Mendelian up-regulation might set a direct pathway into AD as an origin.
Even- and odd-numbered fatty acids used as worker arrestant aggregation pheromone components in the Formosan subterranean termite Coptotermes formosanus
Authors: Mitaka Yuki , Matsuura Kenji , Akino Toshiharu
Published: October 2023

Pheromones play a pivotal role in coordinating collective activities. Recent research has demonstrated that workers of the Japanese subterranean termite, Reticulitermes speratus, secrete an aggregation pheromone that induces quick assemble and prolonged stay at the pheromone source for nestmate workers, facilitating efficient dead-wood digestion and colony expansion. The question remains: do other termite species also utilize aggregation pheromones? In this study, we report that workers of the Formosan subterranean termite, Coptotermes formosanus, use a mixture of fatty acids as part of the pheromone components to maintain worker aggregation for extended periods of time. Through bioassays and gas-chromatography mass-spectrometry (GC-MS) analysis, we determined that a mixture of four fatty acids including palmitoleic acid, palmitic acid, (Z)-10-heptadecenoic acid, and stearic acid possesses arrestant activity but little or no attractant activity. Also, the inclusion of cholesterol and cuticular hydrocarbons reinforces only its arrestant activity. Further, GC-MS analysis of extracts of wood and soil, which serve as termite food, indicated that the pheromone components other than palmitic acid are not derived from their food, and GC analysis of extracts from different parts of worker’s body revealed that these components were most likely produced in the midgut and excreted to the outside of the body via the hindgut. These findings suggest that the aggregation pheromone components and their functions in C. formosanus are largely different from those in R. speratus. This research provides insights into the differences among termite species in the development of chemical signals triggering aggregation behavior.
Evaluation of impact of land use and landscape metrics on surface water quality in the Northeastern part along Lake Tanganyika, Africa
Authors: Yu Cheng , Xia Shiyu , Chen Sofia Shuang , Gao Qun , Wang Zhaode , Shen Qiushi , Kimirei Ismael Aaron
Published: October 2023

As the second deepest lake in Africa, Lake Tanganyika plays an important role in supplying fish protein for the catchment’s residents, and is irreplaceable in global biodiversity. However, the lake's water environment is threatened by socio-economic development and rapid population growth along the lake. This study analyzed the spatial scales effects and seasonal dependence of land use types and landscape metrics on water quality in 16 sub-basins along northeastern Lake Tanganyika at different levels of urbanization. The results revealed that land use types had a higher influence on water quality in urban areas than that in rural areas; the explanatory variance in the urban area was 0.74-0.86, while it was 0.21-0.46 in the rural area. The water quality variation was better explained by sub-watershed scale and 500 m buffer scale in urban area in rainy season and dry season, respectively, and artificial surface was the most important factor and had a negative effect on water quality. While the 500 m buffer zone had the highest explained ability in rural area, and this phenomenon was more obvious in dry season than in rainy season. We identified that CONTAG was the key landscape metric in urban area and was positively correlated with nutrient variables, indicating that water quality degraded in less fragmented and highly dispersed landscapes. The sub-watershed scale had the highest explained ability. While in rural area, the 100 m buffer scale had the highest explained ability in the rainy season and IJI had the highest explanatory variance, the contribution rate reached 78.1%, which had a negative effect on water quality. During the dry season, the sub-watershed scale had highest explanatory ability, the IJI and CONTAG had higher explanatory variance, with 40.3% and 38.9%, respectively. And IJI had a positive effect on TN and TP, CONTAG had a negative effect on TN and TP. Thus, we found that the differences in the conﬁguration of artificial surface and forest patches between different locations and areas with differing degrees of connectivity can explain the variability in stream water quality.
Chemical Cocktail: Understanding PSNP and DBP Impact on Testicular Health of Swiss albino mice
Authors: Sharma Kirti , Sharma Anju , Bhatnagar Pradeep
Published: October 2023

The coexposure of nanoplastic (NPs) with other pollutants adsorbed from the environment has gained significant attention in recent years. However, the combined impact of NPs and plasticizers, particularly Di-n-butyl-phthalate (DBP) and Polystyrene nanoplastic particles (PSNP), remains poorly understood. DBP is a widely used plasticizer that has become a major concern due to its pervasive environmental presence and potential endocrine-disrupting properties. This study aimed to assess the reproductive toxicity in male mice resulting from exposures to Di-n-butyl phthalate (DBP), Polystyrene Nanoplastic (PSNP), and their combination (DBP+PSNP). Adult male Swiss albino mice mice (n=24) were divided into four groups, each consisting of six mice. The groups included DBP (900mg/kg bw), PSNP (O.2 mg/ml, 50 nm size), DBP+PSNP (900 mg/kg bw + 0.2 mg/ml, 50 nm size), and a control group (olive oil). The animals were orally administered DBP and PSNP for 60 days, followed by the examination of their testicles and cauda epididymis examined through sperm parameters, biochemical and histological analyses. The study revealed significant decreases in sperm count, motility, viability in treated group as well as in combination group (DBP+PSNP), however sperm abnormality was found to be significantly increased in all the treated groups compared to the control group. Biochemical analysis indicated altered superoxide dismutase, glutathione, and lipid peroxidase activities in the treated groups compared to the control, indicating potential oxidative stress effects on the male reproductive system. Histological studies showed damage to the testis structure and observed rupturing of seminiferous tubule cells, tubular degeneration, intertubular edema, vacuolization, rete testis carcinoma in the exposed groups. These findings suggest that both individual and combined exposure to DBP and PSNP may adversely affect male mice reproductive abilities, with the combination group showing particularly hazardous effects. This investigation aims to shed light on the reproductive effects of these substances, individually and in combination, in male mice and contribute to the understanding of their potential reproductive toxicity. In conclusion, this research highlights the potential reproductive toxicity of DBP and PSNP in male mice and indicates that their combination may lead to exacerbated adverse effects on the reproductive system through oxidative stress and histological damage. These findings underscore the importance of further understanding the reproductive health implications of nanoplastic and plasticizers in environmental and human contexts.
Successful haploidentical stem cell transplantation in a 3-month-old child with reticular dysgenesis using post-transplant cyclophosphamide: A case report & literature review from Pakistan
Authors: GHIAS ZAINAB , JAFRI RABAB ZEHRA , SAMAD SHAFAQ , SIDDIQUI SAIMA , FARZANA TASNEEM , ZAIDI UZMA
Published: October 2023

Reticular dysgenesis is the most severe and rarest form of primary immunodeficiency disorder. Children with severe combined immunodeficiency mainly have lymphopenia. But this rare variant has an additional feature of neutropenia not responding to growth factor. There should be a high index of suspicion for this disease if any infant is presenting with recurrent infections with persistently low myeloid and lymphoid cell lines. A late preterm and low birth weight baby was found to have bi cytopenia incidentally. Presumed sepsis was treated but there was persistent lymphopenia and neutropenia. He had recurrent infections that raised the suspicion of immunodeficiency. He was a product of consanguineous marriage. He was diagnosed with reticular dysgenesis on whole exome sequencing homozygous mutation in mitochondrial AK2 gene variant c.94-2A > G. At 3.5 months of age, he underwent a haploidentical bone marrow transplant using myeloablative conditioning. He had neutrophil and platelet engraftment on post-transplant day + 14 and day + 16 respectively. He maintained full donor chimerism (> 90%) at post-transplant D + 30, + 60 and + 120. Nine months after the transplant his blood counts dropped and he developed severe neutropenia not responding to GCSF. He was given a CD34 booster dose (6.6 x 10^6 cells per kg/recipient body weight). Then eventually his blood count recovered. After, twenty months of transplant, he presented with grade 3 chronic GVHD of nails. At post-transplant 2.5 years both T and B cell immune reconstitution have been achieved with full donor chimerism. Any child with repeated infections and combination of lymphopenia and neutropenia should have high index of suspicion for reticular dysgenesis.
Intrinsically stretchable thermoelectric materials for highly efficient thermal energy conversion
Authors: Kim Heesuk , Jang Doojoon , Lee Byeongmoon , Kang Young Hun , Chung Seungjun , Hong Yongtaek
Published: October 2023

Diversification of heat sources with intense deformation and dynamic changes presents mechanically harsh environments for thermal energy regulation, urging thermoelectric (TE) materials to simultaneously achieve intrinsic stretchability and high TE figure of merit (zT). Nevertheless, the evident trade-off between the two has circumscribed adopting conventional TE materials and technology for mechanically sustainable framework, thereby necessitating fundamental material-oriented breakthroughs. Herein, we develop restructured carbon nanotubes that flawlessly accommodate extreme deformation while harvesting heat with high efficiency. Restructuring the nanotube network with polymeric dopants and ionic liquid can independently promote electrical conductivity by hole-doping and regulating inter-nanotube connectivity. The established nanotube-polymer heterointerfaces instigate phonon scattering to suppress thermal conductivitry and facilitate TE efficiency (zT ≥10-1). Concurrently, such restructuring allocates greater free volume to the network and alleviates nanotube aggregation, thereby imparting extreme intrinsic stretchability (≥180%) with minimal compromise in TE performance. To demonstrate the outstanding advances enabled by such unprecedented pair of exceptional material stretchability and improved energy conversion efficiency, we showcase practical thermal energy regulation applications encompassing stretchable thermoelectric generators and Peltier-induced temperature regulation.
The Efficacy of Low-Intensity Shock Wave Therapy based on the Stratification of Erectile Dysfunction Patients: A Long-term Follow-up
Authors: Elshorbagy Galal , ElSayed Ahmed , ElGhoniemy Mohamed , Rassol Mohamed Abd El , ElKousy mohamed , Gharably Mohamed El
Published: October 2023

Objectives Low intensity extracorporeal shockwave therapy (LIESWT) significantly improves erectile function in patients with vasculogenic erectile dysfunction (ED). We aimed to evaluate the effect of LI-ESWT on different subtypes of ED and to assess through a long-term follow up how long the improvement in erectile function lasts.Methods This was a retrospective review of a prospectively maintained database at the department of urology at Cairo university hospitals. Patients with vasculogenic ED underwent 6–12 sessions of focal LI-ESWT 5000 impulses 0.01 j/mm2 using the electromagnetic Dornier Aries® 1 machine. All patients received at least 6 sessions of LI-ESWT. Then, patients were assessed clinically by using the erection hardness scores (EHS), and erectile function using the international index of erectile function (IIEF-EF) domain score at three months post LI-ESWT and every six months. Also, penile hemodynamics at three months post LI-ESWT and at the last follow up visit.Results 42 patients were identified with mean age 50 ± 12 years, mean ED duration 31 ± 35 months and mean follow up 10 ± 6 months. Overall IIEF-EF was 16 ± 6 and improved to 22 ± 6 at three months and to 21 ± 6 at last follow up (p < 0.01). Minimally important clinical difference was achieved in 69% at three months and in 60% of the whole cohort at last follow up. Risk factors associated with higher MICD at three months were age (p = 0.01), uncontrolled diabetes mellitus ratio (p = 0.04), hypertension (p = 0.24), cardiovascular (p = 0.8), smoker (p = 0.63), and ex-smoker (p = 0.3).Conclusion Li-ESWT have a potential long-term efficacy on different degrees of ED evidenced by the improvement in the penile hemodynamics at the final follow-up particularly in those with controlled diabetes mellitus and advancing age.
Video-based Peer Assessment of Collaborative Teamwork in a large-scale interprofessional learning activity
Authors: Roberts Chris , Jorm Christine , Nisbet Gillian , Gordon Chris , Chen Timothy , Held Fabian , Haq Inam
Published: October 2023

Background
The assessment of team performance in the context of large-scale Interprofessional Learning (IPL) initiatives is an important but underexplored area. It is essential for demonstrating the effectiveness of collaborative learning outcomes in preparing students for professional practice. Using Kane’s validity framework, we investigated whether peer assessment of student-produced videos depicting collaborative teamwork in an IPL activity was sufficiently valid for decision-making about team performance, and where the sources of error might lie to optimize future iterations of the assessment.
Methods
A large cohort of health professional students (n = 1218) of 8 differing professions was divided into teams containing 5–6 students. Each team collaborated on producing a short video to evidence their management of one of 12 complex patient cases. Students from two other teams, who had worked on the same case, individually rated each video using a previously developed assessment scale. A generalisability study quantified sources of error that impacted the reliability of peer assessment of collaborative teamwork. A decision study modeled the impact of differing numbers of raters. A modified Angoff determined the pass/fail mark.
Results
Peer assessment of collaborative teamwork was reliable (G = 0.71) based on scoring by students from two teams (n = 10–12) for each video. The main sources of variation were the stringency and subjectivity of fellow student assessors. Whilst professions marked with differing stringency, and individual student assessors had different views of the quality of a particular video, none of that individual assessor variance was attributable to the assessors’ profession. Teams performed similarly across the 12 cases overall, and no particular professions marked differently on any particular case.
Conclusion
A peer assessment of a student-produced video depicting interprofessional collaborative teamwork around the management of complex patient cases can be valid for decision-making about student team performance. Further refining marking rubrics and student assessor training could potentially modify assessor subjectivity. The impact of professions on assessing individual peers and the case-specificity of team performances in IPL settings need further exploration. This innovative approach to assessment offers a promising avenue for enhancing the measurement of collaborative learning outcomes in large-scale Interprofessional learning initiatives.
The brain-bone marrow axis and its implications for chronic traumatic brain injury
Authors: Ritzel Rodney M. , Li Yun , Jiao Yun , Doran Sarah , Khan Niaz , Henry Rebecca , Brunner Kavitha , Loane David , Faden Alan I. , Szeto Gregory , Wu junfang
Published: October 2023

Traumatic brain injury (TBI) causes acute and chronic alterations in systemic immune function which contribute to posttraumatic neuroinflammation and neurodegeneration. However, how TBI affects bone marrow (BM) hematopoietic stem/progenitor cells chronically and to what extent such changes may negatively impact innate immunity and neurological function has not been examined. To further understand the role of BM cell derivatives on TBI outcome, we generated BM chimeric mice by transplanting BM from chronically injured or sham congenic donor mice into otherwise healthy, age-matched, irradiated hosts. After 8 weeks of reconstitution, peripheral myeloid cells from TBIàWT mice showed significantly higher oxidative stress levels and reduced phagocytic activity. At eight months after reconstitution, TBIàWT chimeric mice were leukopenic, with continued alterations in phagocytosis and oxidative stress responses, as well as persistent neurological deficits. Gene expression analysis revealed BM-driven changes in neuroinflammation and neuropathology after 8 weeks and 8 months of reconstitution, respectively. Chimeric mice subjected to TBI showed that longer reconstitution periods were associated with increased microgliosis and leukocyte infiltration. Thus, TBI causes chronic activation and progressive dysfunction of the BM stem/progenitor cell pool, which drives long-term deficits in innate immunity and neurological function, as well as altered sensitivity to subsequent brain injury.
Retrospective Analysis of Three Posterior Open Surgical Approaches for the Intraoperative and Long-term Outcomes in the Treatment of Thoracolumbar Burst Fractures
Authors: Wang Tianxiong , Zhang Yuheng , Wang Rui , Chen Shizhan , He Yongjie , Wang Bingang
Published: October 2023

ObjectiveEvaluating the Intraoperative and Long-term Clinical Outcomes of Three Posterior Open Surgical Approaches for the Treatment of Thoracolumbar Burst Fractures.MethodsFollow-up observation of 145 patients with thoracolumbar burst fractures treated with three surgical approaches, including “traditional transpedicular four-screw fixation spanning the injured vertebral body (TFSV) (n=38), short-segment transpedicular four-screw fixation through the injured vertebral body (SFTV) (n=53), and six-screw fixation (STV) (n=54)”, at our institution from June 2014 to June 2022. Comparative analysis of perioperative parameters (operative time, intraoperative blood loss, postoperative 24-hour drainage), preoperative and postoperative radiological indices (sagittal plane Cobb angle, Vertebral wedge deformity index), postoperative functional recovery (VAS score, ODI score), and incidence of complications.ResultsThere was no significant difference in general data among the three groups. The SFTV group is superior to the other two groups in perioperative parameters (P＜0.001, P=0.023, P＜0.001). There was significant difference in sagittal plane Cobb angle at each time point among the three groups (P=0.025), but no significant difference in Vertebral wedge deformity index (P=0.299). The improvement of sagittal plane Cobb angle was slightly worse in the group of SFTV. The VAS and ODI scores before and after surgery in each group showed significant improvement (P＜0.001, P＜0.001); however, there were no statistically significant differences between the groups at the same time points (P=0.312, P=0.924). The incisions of all the patients healed at the first stage without any complications. At the end of follow-up, the Cobb angle increased more than 10 degrees in 3 cases (16.67%) in the TFSV group and in 1 case (5.56%) in the SFTV group.ConclusionThe treatment of thoracolumbar burst fracture with STV or SFTV is superior to the TFSV, SFTV is better than STV, but the indication of SFTV is limited.
Advancing Coronary Artery Disease Diagnosis: LncRNA Profiling of Small Extracellular Vesicles Derived from Peripheral Blood Mononuclear Cells
Authors: Liu Xuyang , Xiong Feng , Mao Rui , Zhang Lijuan , Zhao Ruohan , Tan Kunyue , Zhang Tongtong
Published: October 2023

Background
Long noncoding RNAs (lncRNAs) constitute integral components of many physiological processes and exhibit considerable impact on cardiovascular maladies. Nonetheless, the clinical utilization of lncRNAs as serological markers for diagnosing Coronary Artery Disease (CAD) remains unexplored.
Methods
To scrutinize lncRNA expression, we harnessed a lncRNA microarray to probe monocyte small extracellular vesicles (sEVs) derived from three CAD patients and an equivalent number of healthy controls. Differential lncRNA expression in both plasma and monocyte sEVs was corroborated via quantitative real-time PCR (RT-qPCR). A diagnostic prediction model for CAD, integrating lncRNA expression, was fabricated utilizing Random Forest and nomogram analyses.
Results
Data elucidated that 89 lncRNAs were upregulated, while 211 were downregulated in CAD patients compared to controls. Most notable were the upregulation of SNAR-E and downregulation of RPL34-AS1. The expression of SNAR-E correlated with Diabetes Mellitus (DM), Total Cholesterol (TC), High-Density Lipoprotein Cholesterol (HDL-C), and Low-Density Lipoprotein Cholesterol. Conversely, RP34L-AS1 expression corresponded to age alongside DM, TC, HDL-C, and Lipoprotein (a). Additionally, both SNAR-E and RP34L-AS1 displayed elevated diagnostic accuracy for CAD in plasma and sEVs, characterized by high sensitivity and specificity. The prediction model manifested robust diagnostic prowess and consistency.
Conclusion
SNAR-E and RPL34-AS1 in sEVs and plasma have higher sensitivity and specificity in diagnosing CAD than conventional electrocardiogram (ECG), dynamic ECG, or the treadmill exercise tests. The diagnosis model comprising these two molecules showed considerable accuracy and stability, and may assist in the early diagnosis of CAD and support clinical guidance.
Does non-surgical periodontal treatment contribute to rheumatoid arthritis amelioration? Evidence based on an overview and meta-analysis
Authors: Oliveira Sicília Rezende , Arruda José Alcides Almeida , Schneider Ayda Henriques , Ferreira Gilda Aparecida , Calderaro Débora Cerqueira , Costa Fernando Oliveira , Teixeira Antonio Lucio , Oliveira Renê Donizeti Ribeiro , Louzada-Júnior Paulo , Cunha Fernando Queiroz , Abreu Lucas Guimarães , Silva Tarcília Aparecida
Published: October 2023

To perform an overview by analyzing clinical outcomes in individuals with rheumatoid arthritis (RA) who underwent non-surgical periodontal treatment (NSPT). Electronic searches were conducted across four databases and gray literature with no restriction on language or publication date. The study followed the 2020 PRISMA statement. A meta-analysis was performed comprising 18 primary studies from SRs to examine the effects of NSPT (n = 201 subjects in the non-NSPT vs. n = 199 in the NSPT group) on 28-joint Disease Activity Score (DAS28). Nine SRs were analyzed; of these, six with meta-analyses and three without meta-analyses. The main outcomes evaluated were DAS28, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). NSPT resulted in a significant decrease in CRP, ESR and DAS28, both in studies that included a control group (without NSPT) or in those comparing individuals before and after periodontal therapy. Follow-up period after NSPT ranged from 6 to 24 weeks. Despite the heterogeneity of data related to RA and periodontitis status and antirheumatic therapy, NSPT was able to reduce the levels of systemic inflammatory markers and RA activity.
Towards understanding flood risk and coping ability: Persisting gaps, adaptation measures and theoretical perspectives
Authors: Busayo Emmanuel Tolulope
Published: October 2023

Flood risk and coping ability is a major research thrust for appraisal in coastal areas of South Africa considering forecasts of looming flood events. This paper employed literature synthesis of relevant flood risk erudition, theoretical underpinnings of Social Vulnerability Theory (SVT) and Protective Motivation Theory (PMT) in conjunction with a field survey to understand flood risk and coping ability. Methods/models/data for flood risk evaluation in the literature synthesis were broadly classified into 5 types; (1) Approaches utilizing space-based solution (2) human-based solution (3) nature-based solution (4) financial-based solution and (5) Theoretical based approach. However, there is limited knowledge of cognitive, sociocultural, and psychological mechanisms in the flood risk scholarship in line with social responses in a flood event. To understand flood risks and damages on the society and to realise its psychological consequences, this knowledge is important. I surveyed (n = 150), a set of cognitive, and sociocultural key informants from the study area. This study recorded flood as the most predominant hydro-meteorological hazard (n = 118, 81.9%) in East London, coastal city. Findings show that all the nine indicators presented to capture extreme environmental events adaptation measures are extremely lacking. The findings presented in this study are fundamental in reaching the sustainable development goals (SDGs) goal 11: sustainable cities and communities, goal 13: climate action including the seven targets and four priorities for action of the Sendai framework for disaster risk reduction at a local level.
Metabolic Acidosis and Sexual Dysfunction in Chronic Kidney Patients; Who do not Receive Renal Replacement Therapy ,Cross-sectional study in a single center
Authors: Bek Sibel , Ilhan Elif , Sarioglu Irem , Balci Sibel , Tekdemir Ozge , Ergul Metin , Eren Necmi , Dervisoglu Erkan , Kalender Betul
Published: October 2023

In this study, it is aimed to investigate the prevalence of sexual disorders in patients in stage 2–5 stage chronic kidney disease and its relationship with laboratory parameters, including demographic, clinical and especially metabolic acidosis. This is a cross-sectional study consisting of 110 predialysis patients with chronic kidney disease and 110 healthy controls admitted to nephrology out-patient clinics. IIEF (International Index of Erectile Function) and FSFI (Female Sexual Function Index) questionnaire was applied to the patients and control group. The relationship between demographic, clinical and various biochemical parameters, sexual dysfunction in the patient group was assessed. Sexual dysfunction was detected in 76% of the female patients and 31.4% of the control group.FSFI total. Subscale scores of the patients were significantly lower than the control group. In male patients and controls, the frequency of erectile dysfunction was 56.7% and 33.3% respectively. The erectile function, sexual satisfaction and overall satisfaction scores of the IIEF scale were significantly lower than the control group. Female patients reported %40 regular menstrual cycles. Advanced age was associated with loss of libido in female patients, while erectile dysfunction was associated with loss of libido, orgasmic disturbance and sexual dissatisfaction in male patients. Low Glomerular filtration rate(GFR), high calcium(Ca) levels, increased CRP, anemia and metabolic acidosis in both genders. Testosterone deficiency in male patients were associated with sexual dysfunction. In multiple regression analysis, eGFR was the only independent variable associated with sexual dysfunction. The increase in Parathormone (PTH) and Prolactin levels was related to the loss of libido in both genders. Sexual dysfunction is widely observed in male and female patients with chronic kidney disease. There is a need for public awareness of sexual dysfunction, as well as specific studies to better characterize, assess, understand and treat. Clinical Implications:. Despite common neglect,sexual disorders in chronic kidney disease can be optimized with simple precautions Strengths&Limitations: This study contributes to the literature in sexual dysfunction about female CKD patients. Another prospective study should enstrength the findings. Conclusion: Metabolic acidosis and low eGFR seem to be the most important risk factors contributing sexual disorders in CKD patients.
Clinical application of nanopore sequencing for haplotype linkage analysis in preimplantation genetic testing for Duchenne muscular dystrophy
Authors: Xia Qiuping , Chang Tianli , Ding Taoli , Liu Zhen , Liu Jiaqi , Li Yanping , Yao Zhongyuan
Published: October 2023

Background
Duchenne muscular dystrophy (DMD) is an X-linked recessive disease that affects approximately 1 in 5,000 newborn males. Most patients die of cardiac failure and/or respiratory insufficiency at approximately 20–40 years of age. Preimplantation genetic testing for monogenic disorders (PGT-M) has been successfully used to help couples with DMD mutations produce an unaffected offspring. However, the current PGT-M based on next-generation sequencing (NGS) cannot provide an effective PGT technique for DMD that involves de novo mutations or an incomplete pedigree. This study assessed the feasibility of using nanopore sequencing in PGT-M for DMD. The accuracy of the nanopore sequencing results was confirmed using an NGS-based method, which was further validated through amniocentesis.
Results
Using nanopore sequencing, we successfully determined the breakpoints of the DMD mutation and identified a set of informative heterozygous single-nucleotide polymorphisms (SNPs) in the maternal carrier. Subsequently, we conducted a haplotype linkage analysis with embryonic SNPs without the need for additional family members and successfully identified a disease-free euploid embryo. These results were consistent with the findings obtained using NGS and aligned with the results of amniocentesis.
Conclusions
Our results suggest that nanopore sequencing is a potential tool for preimplantation haplotype linkage analysis in PGT-M for DMD, particularly in families lacking probands. This finding is essential for nanopore sequencing to aid in reducing the propagation of DMD in the population.
Defining Clinical Endpoints in Limb Girdle Muscular Dystrophy: A GRASP-LGMD study
Authors: Doody Amy , Alfano Lindsay , Diaz-Manera Jordi , Lowes Linda , Mozaffar Tahseen , Mathews Kathy , Weihl Conrad C. , Wicklund Matthew , Statland Jeffery , Johnson Nicholas E. , Consortium GRASP-LGMD
Published: October 2023

Background
The Limb Girdle Muscular Dystrophies (LGMDs) are characterized by progressive weakness of the shoulder and hip girdle muscles as a result of over 30 different genetic mutations. This study is designed to develop clinical outcome assessments across the group of disorders.
Methods/design:
The primary goal of this study is to evaluate the utility of a set of outcome measures on a wide range of LGMD phenotypes and ability levels to determine if it would be possible to use similar outcomes between individuals with different phenotypes. We will perform a multi-center, 12-month study of 188 LGMD patients within the established Genetic Resolution and Assessments Solving Phenotypes in LGMD (GRASP-LGMD) Research Consortium, which is comprised of 11 sites in the United States and 2 sites in Europe. Enrolled patients will be clinically affected and have mutations in CAPN3 (LGMDR1), ANO5 (LGMDR12), DYSF (LGMDR2), DNAJB6 (LGMDD1), SGCA (LGMDR3), SGCB (LGMDR4), SGCD (LGMDR6), or SGCG (LGMDR5, or FKRP-related (LGMDR9).
Discussion
To the best of our knowledge, this will be the largest consortium organized to prospectively validate clinical outcome assessments (COAs) in LGMD at its completion. These assessments will help clinical trial readiness by identifying reliable, valid, and responsive outcome measures as well as providing data driven clinical trial decision making for future clinical trials on therapeutic agents for LGMD. The results of this study will permit more efficient clinical trial design. All relevant data will be made available for investigators or companies involved in LGMD therapeutic development upon conclusion of this study as applicable.
Trial registration:
clinicaltrials.gov NCT03981289; Date of registration: 6/10/2019