bluuebunny/crossref_metadata_2025 huggingface dataset:
Real-Time Classification of Drilled Lithology from Drilling Data Using Deep Learning with Online Calibration
Authors: Arnø Mikkel , Godhavn John-Morten , Aamo Ole Morten
Published: March 2021

Decision making to optimize the drilling operation is based on a variety of factors, among them real-time interpretation of drilled lithology. Since logging while drilling (LWD) tools are placed some meters above the bit, mechanical drilling parameters are the earliest indicators, although difficult to interpret accurately. This paper presents a novel deep learning methodology using mechanical drilling parameters for lithology classification. A cascade of multilayered perceptrons (MLPs) are trained on historical data from wells on a field operated by Equinor. Rather than an end-to-end approach, the drilling parameters are utilized to estimate LWD sensor readings in an intermediate step using the first MLPs. This allows continuous updates of the models during operation using delayed LWD data. The second MLP takes the virtual LWD estimates as input to predict currently drilled lithology, similar to manual expert interpretation of logs. This configuration takes into account case dependent (mud, BHA, wellbore geometry) and time varying (bit-wear, wellbore friction) relationships between drilling parameters and LWD readings, while assuming a constant rule when utilizing LWD data to classify lithology. Upon completion of training and validation, the system is tested on a separate, unseen wellbore, for which results are presented. Visualizations for true lithology alongside the estimates are given, along with confusion matrices and model accuracy. The system achieves high accuracy on the test set and presents low confusion between classes, meaning that it distinguishes well between the lithologies present in the wellbore. It can be seen that the borders between successive layers of lithology are detected rapidly, which is crucial seen from an optimization standpoint, so the driller may adjust accordingly immediately. It shows promise as an advisory system, capable of accurately classifying currently drilled lithology by continuously adapting to changing downhole conditions. Although we cannot expect perfect estimates of lithology purely based on drilling parameters, we can obtain a preliminary map of the subsurface this way. This novel configuration gives a real-time interpretation of the currently drilled lithology, allowing the driller to take proper actions to optimize the drilling operation in terms of rate of penetration (ROP) and best practices for different lithologies.
Evaluation of New Innovative Cement Blend for Enhanced CO2 and H2S Resistance
Authors: Lende Gunnar , Clausen Jill Angelique , Kvassnes Astri Jager
Published: March 2021

Achieving zonal isolation is incumbent upon preventing undesirable flow of hydrocarbons, carbon dioxide, and hydrogen sulfide, as well as other fluids. The risks associated with zonal isolation being compromised come from different mechanisms, such as insufficient displacement efficiency, tubular corrosion, cement cracking, micro-annuli from hydration shrinkage or pressure changes as well as erosion. It is therefore important to understand how CO2, H2S and other factors interact with cement under downhole conditions. The cementing materials are important to the short- and long-term integrity of the well and helping to ensure that no unwanted flow paths are formed that can threaten the safety, health and environment, and also the impact on the profitable life of the well. Thus, pathways for CO2 and H2S as well as other fluids should be avoided and blocked if they occur.

Described herein is the evaluation of a novel cement admixture developed for improving the resistance of the cement matrix to chemical attack from CO2 and H2S, and its incorporation in a tailored cement design. The development of this design focused on applications in wells in the Norwegian Waters where CO2 and H2S are present. A comprehensive test program using customized equipment provided the necessary information to evaluate the performance.

Further discussed are methods developed to test and evaluate the performance of this new design as effectively as possible by using available test equipment in new ways and new combinations.

Test results support the novel cement admixture combined with ordinary Portland cement (OPC) in terms of pumpability, curing time, permeability and mechanical properties is technically and financially viable given that necessary blend optimization is done. Hence, the cement blend can be used without changing the existing cement infrastructure, methods, vetting and procedures that exist for well cementing today.

Finally, the outcome of the first field test on an offshore permanent abandonment plug as part of a mature field plug and abandonment campaign is briefly referenced.
Lessons Learned Using a Next Generation Active Sealing Device for Deepwater MPD Operations
Authors: Johnson Austin , Sundaramoorthy Saravanan , Ameen Kareem , Nichols Jess , MacGregor Alex , Fraczek Justin
Published: March 2021

This paper shares results from the first year of deepwater operations using an active sealing device purpose built for deepwater Managed Pressure Drilling (MPD). The active sealing device is a clean-sheet design approach. The first use of the system was performed in a narrow margin deepwater well in the Black Sea with subsequent wells in the Gulf of Mexico. This paper shares lessons learned from first year of operations.

This paper discusses field operations, lessons learned, and post run evaluation of system performance. An overview of the design introduces system elements and briefly discusses system testing measures taken prior to field deployment. An overview of operations from the first year is provided, highlighting lessons learned, action items taken, and solutions implemented between wells. Analysis of the link between the testing and field results demonstrates the novel approach to testing and validity of assumptions made during the testing phase. Furthermore, methods of evaluating seal performance are discussed.

The paper shares conclusions from the first year of active sealing device deployment. A non-rotating seal sleeve element design eliminates multiple high-wear rotating control device (RCD) components such as bearings and rotary seal as well as their associated failure modes.Redundant, active seal elements ensure wellbore seal quality throughout the seal assembly life.Active seal condition monitoring alerts the rig crew prior to failure to replace the seal assembly.Multi-modal seal control provides crew methods to reach total depth in contingency mode.Full-scale simulated drilling testing included the use of client equipment prior to first use.Testing procedures were designed to simulate drilling to mirror system use in a live well.First MPD well completed in 2019 in the Black Sea with subsequent wells in the Gulf of Mexico.Lessons learned from operations to applied in continuous improvement program.Novel approaches to assessing performance have been developed in order to provide consistent metrics.Learnings have been applied in subsequent wells to improve technology transfer to drilling contractors.

The paper discusses other aspects of the program such as drilling contractor ownership vs. use of third (3rd) party systems, integration of the MPD equipment into the rig, and network architecture. Further, an algorithm has been developed to analyze system performance from electronic drilling recorder data to better characterize the effect of usage patterns of seal wear. These data demonstrate the validity of assumptions made during the development of the test procedures.
Simple but Effective: A Case History Demonstrating Enhanced Performance and Simplified Logistics from New Rotary Steerable
Authors: Aburto Perez Marco A , Yadav Anurag S , Farley Steven R
Published: March 2021

Based on input from key operators in the Middle East region, a new rotary steerable system (RSS) was launched after a compressed development schedule. This paper describes the development and introduction of the larger tool sizes needed for both onshore and offshore hole sections, including hole sizes from 12 in. and up, in the Middle East. It also outlines the deliberate design of the tool for local assembly and repair.

Large diameter (9-1/2 and 11 in.) RSS designs used an existing, smaller design for Middle East applications in both offshore and onshore wells as a basis. When designing these new sizes, engineers took note of lessons learned with smaller sizes of the tool and incorporated design elements for local manufacturing, assembly, and repair. The resulting simple, modular construction enables increased levels of local content and provides for significant reductions in transportation, and therefore associated emissions.

Of course, although local content and sustainability are highly desirable, performance is essential, and this paper describes case histories demonstrating how well the new tool worked in real-world Middle East applications.

In one notable example, the newly introduced 9 1/2-in. diameter RSS was used to drill an offshore section in the Gulf of Arabia. The tool was mobilized after two older generation RSS had become stuck for days. Consisting primarily of argillaceous limestone, the formation had a history of stuck-pipe events. The new RSS was recommended for this application because of a slicker construction, with a fully rotational bias unit, minimal bottom hole assembly (BHA) stabilization, and an optimized junk slot area, which together help to reduce stuck-pipe risks. The tool drilled to the target depth in a single run, thereby achieving all directional requirements. Notably, after reaching the target depth, the assembly was tripped out of the hole without any requirement for backreaming. This seamless exit, in turn, indicated achieving a smooth wellbore.

Other case histories demonstrate results with both new sizes of this tool. The paper also discusses in detail the ability to repair locally and engage the local supply chain.

Specifically with Middle East applications in mind, a new, simple RSS design in large diameter versions has demonstrated success in offshore and onshore applications across the region. The design has also proven capabilities for manufacturing and repair local to operations, which enables maximizing in-country value, optimizing use of the tools, and energizing local supply chains.
Borehole Disposal of Nuclear Waste
Authors: Kristiansen Håvard , Aadnøy Bernt Sigve
Published: March 2021

Approximately 370 000 tons of high-level radioactive waste exists. Some nations have mature projects for disposing of such waste in mined repositories hundreds of meters below ground. Emplacement in boreholes of greater depth could be a cost-efficient and fast alternative, particularly for nations with relatively small amounts of waste. A borehole repository could be developed via an iterative process, which would ultimately end with the completion of a comprehensive safety case and a fully operational disposal facility which would be sealed and decommissioned in a reliable manner. Each design should be adapted to the properties of the waste in question, site-specific geological conditions, and regulatory requirements. This variability causes designs and cost estimates to differ. Overall, borehole disposal of high-level radioactive waste is an opportunity for the drilling industry to expand its service portfolio in a way that is beneficial to the environment and the safety of current and future generations.
When Slick is Not Smooth: Bottom-Hole Assembly Selection and Its Impact on Wellbore Quality
Authors: Willerth Marc , Dodson Briana , McCue Kelton , Farrag Mahmoud
Published: March 2021

Appropriate selection of a bottom-hole assembly (BHA) is critical to the success of a drilling operation. In US Land drilling, these assemblies are often selected using local heuristics rather than rigorous analysis. These heuristics are frequently derived from the incentives of the directional contractor as opposed to incentives for the operator. Large motor bends enable more rotation though the curve and reduce the possibility of tripping for build rates. Unstabilized motors are believed to aid sliding and tool face control. Both of these practices lead to drilling a more tortuous wellbore and may cause problems later in the well’s life. This study quantifies the impact of these practices and proposes alternatives that can balance the needs of directional companies with the desire of operators for high-quality wellbores.

Over 60 conventional motor assemblies used to drill curves in the Eagle Ford and Permian were analyzed for directional performance using commercial drillstring analysis software. The sliding and rotary tendencies were modelled through the curve across a range of potential drilling conditions. Expected build-rate models were validated by comparison to the maximum achieved doglegs in the directional surveys. When available, additional validation was performed using motor yields calculated from slide sheets. The validated models were compared to the dogleg severity requirements for each assembly’s respective well plan. Comparisons of slide ratios and slide/rotate tendencies of the BHAs were used to estimate the impact on wellbore quality using the tortuosity metric proposed by Jamieson (2019).

Typical well plans for both basins had curves of 10 degrees/100ft with no well plan greater than 12 degrees/100ft. Typical bottom hole assemblies were capable of >15 degrees/100ft under normal sliding conditions, with some assemblies capable of >20 degrees/100ft of build. Predicted build rates were validated by slide sheets and observed dogleg severities. Common characteristics among assemblies with excess capacity were high bend angles (>=2 degrees) and minimal stabilization. These slick assemblies also had a strong drop tendency in rotation at low inclinations. The combination of high-build rate with rotary drop greatly increases tortuosity, particularly in the early stages of well. A minority of the assemblies used a lower motor bend angle (<2 degrees) combined with multiple stabilizers. These assemblies had a more consistent directional capability throughout the curve and held angle in rotation. The success of these assemblies confirms that a higher quality wellbore with an improved BHA design is technically achievable.

As increasing attention is afforded to the topic of wellbore quality it is important to have methods available to technically achieve high-quality wellbores. In addition to the management of drilling practices, it is also important to have an appropriate BHA design that can enable those practices
Energy Efficiency and Emissions of a Natural-Draft Wood Pellets Gasifier Compared to Charcoal Cookstoves in Kenya
Authors: Gituku Benjamin Mwondwe , Khisa Kevin , Bogonko Nathan , Mesa Cicilia
Published: March 2021

The conversion of biomass to make charcoal fuel is an inefficient process that leads to immense energy losses along the value chain. We compared the energy efficiency and emissions of Gastov206, a natural draft TLUD gasifier cookstove using two sizes of wood pellets, as an alternative to two contemporary charcoal stoves in Kenya. A laboratory test showed that more energy in the fuel was lost by the charcoal cookstoves (69%) compared to the pellet gasifier cookstove (31%). The pellet gasifier cookstove had high thermal efficiency and cooking power (65–73%, 0.95–1.13 kW) compared to the charcoal cookstoves (27–35%, 0.68–0.89 kW). During the test, Gastov206 converted pellets-to-char at a ratio of 25% and a rate of 3 g/min. These findings indicate that when biomass is converted to pellets rather than charcoal, and cooking continues over the burning char generated by the gasifier cookstove, energy currently being wasted converting wood-to-charcoal can be avoided. Gastov206 using pellets showed lower CO emission (4.46–5.47 g/MJd and 0.27–0.39 g/min) compared to charcoal cookstoves (20.82–24.36 g/MJd and 0.89–1.35 g/min). PM2.5 emission by Gastov206 (52.35–61.50 mg/MJd and 3.21–4.37 mg/min) was not significant different compared to charcoal stoves (40.81–41.13 mg/MJd and 1.69–2.35 mg/min). Laboratory results show that natural-draft gasifier cookstoves using pellets can be studied further in kitchens as an alternative to charcoal cookstoves since they are potentially more energy-efficient.
Knowledge, Attitude and Practice Among Caregivers Towards Pressure Ulcer in Spinal Cord Injury at Rehabilitation Center in Bangladesh
Authors: Tharu Niraj , Alam Monzurul , Bajracharya Shristi , Kabir Mohammad
Published: March 2021

Study design:
A quantitative cross-sectional survey study.
Objective

To determine the knowledge, attitude and practice (KAP) among caregivers regarding prevention and care of pressure ulcer in patients with spinal cord injury and relationship between KAP.
Setting:

Centre for Rehabilitation of Paralysed, Dhaka, Bangladesh.
Methods

A descriptive correlational design with modified semi-structured questionnaire implemented through convenient sampling procedure. McDonald’s standard of learning outcome measured criteria was used to categorize caregivers’ level of knowledge and practice while, the total scores of attitude were categorized into three levels based on mean percentage and standard deviation: negative attitude below (mean ± 1 SD), neutral level (mean ± 1 SD), and positive attitude above (mean ± 1 SD). The pearson product-moment correlation coefficient (r) was used to examine the relationships between caregivers’ KAP and p- value of 0.05 or less was considered as statistically significant.
Results

Our results suggest that caregivers had a moderate level of knowledge (M = 73.68%, SD = 6.43), neutral level of attitude (M = 70.32%, SD = 6.89), and moderate level of practice (M = 74.77%, SD = 9.08). There was a positive correlation between caregivers’ knowledge and attitude (r = 0.30, p < 0.01), and between knowledge and practice (r = 0.37, p < 0.01). However, no correlation existed between attitude and practice (r = 0.12, p > 0.05).
Conclusion

The study findings suggests that caregivers need to develop a positive attitude and increase their knowledge in order to improve their practice.
The causes and frequency of kidney allograft failure in a low-resource setting: Data from Iraqi Kurdistan
Authors: Ali Alaa Abbas , Almukhtar Safaa E , Abd Kais H , Saleem Zana Sidiq M , Sharif Dana A , Hughson Michael D
Published: March 2021

Background
In the developing world, transplantation is the most common long-term treatment for patients with end-stage renal disease, but rates and causes of graft failure are uncertain.
Methods
In 2019, in Iraqi Kurdistan, 301 of 871 renal transplant patients had indicated graft biopsies. Outcomes were followed over the subsequent year of 2020.
Results
The post-transplantation time ranged from one day to 18 years. All donors were living. Approximately 15% of transplants were preemptive. Pretransplant hemodialysis (HD) was twice weekly and less than one year. The median recipient age was 39 (IQR 28 to 48) years. 5.5% of recipients had previous transplants; 3.7% had pretransplant donor-specific antibodies (DSA). The Kaplan-Meier estimated graft failure rates for all-cause, return to HD, and death with functional graft (DWFG) were 9.1%, 6.3%, and 2.9% at one year and 23.8%, 6.3%, and 7.4% at five years. The median death-censored graft survival was 15 years. The most frequent biopsy diagnoses associated with graft failure were interstitial fibrosis and tubular atrophy (IF/TA) (23.1%), transplant glomerulopathy (13.7%), and acquired active antibody-mediated rejection (11.1%). The significant predictors of graft loss were C4d + biopsies (P < 0.01) and advanced IF/TA (P < 0.001).
Conclusions
These Iraqi patients had estimated graft failure rates similar to the United States (US) Renal Data System living-donor outcomes reported for the year 2000. The inability to approach recent US graft survivals may owe to inadequate pretransplant dialysis. Nevertheless, prolonged survival made chronic disorders and acquired DSA the leading causes of graft failure and is creating a need for second transplants.
Acceptability of mentor mother peer support for women living with HIV in North-Central Nigeria: A qualitative study
Authors: Odiachi Angela , Al-Mujtaba Maryam , Torbunde Nguavese , Erekaha Salome , Afe Abayomi J. , Adejuyigbe Ebun , Galadanci Hadiza S. , Jasper Tongdiyen L. , Cornelius Llewellyn J. , Sam-Agudu Nadia A.
Published: March 2021

Background: Mentor mothers provide psychosocial and other support to pregnant and post-partum women living with HIV (WLHIV), which has been shown to enhance maternal-infant outcomes in the prevention of mother-to-child transmission of HIV (PMTCT). Our objective was to assess the acceptability of mentor mothers as a PMTCT intervention, and to explore opinions on mentor mother program composition and delivery among stakeholders in North-Central Nigeria.Methods: We conducted nine focus group discussions and 31 in-depth interviews with 118 participants, including WLHIV, pregnant women, male partners, health workers, traditional birth attendants, community leaders, PMTCT program implementers, and policymakers. Participants were purposively recruited from health facilities and surrounding communities in the Federal Capital Territory and Nasarawa State. Transcripts were manually analysed using a Grounded Theory approach, where theory was derived from the data collected.Results: Most participants were female (n=78, 67%), and married (n=110, 94%). All participant groups found MMs acceptable, as women providing care to pregnant and postpartum women, and as WLHIV supporting other WLHIV. Mentor mothers were uniquely relatable as role models for WLHIV because they were women, living with HIV, and had achieved an HIV-negative status for their HIV-exposed infants. Mentor mothers were recognized as playing major roles in maternal health education, HIV treatment initiation, adherence, and retention, HIV prevention for male partners and infants, and couple HIV disclosure. Most WLHIV preferred to receive mentor mothers’ services at health facilities rather than at home, due to concerns about HIV-related stigma and discrimination through association with mentor mothers. Key mentor mother needs were identified as training, remuneration, and validation as lay health workers.Conclusions: Mentor mothers are an acceptable PMTCT intervention among stakeholders in North-Central Nigeria. However, stigma and discrimination for both mentor mothers and their clients remain a critical challenge, and mentor mother needs such as training, pay, and a sustainably supported niche in health systems require focused attention. Trial registration: Clinicaltrials.gov registration number NCT 01936753, registered on September 3, 2013 (retrospectively registered).
Genomic markers for the biological responses of Triclosan stressed hatchlings of Labeo rohita
Authors: Sharma Sunil , Dar Owias Iqbal , Singh Kirpal , Thakur Sharad , Kesavan Anup Kumar , Kaur Arvinder
Published: March 2021

Triclosan (TCS) used commonly in pharmaceuticals and personal care products has become the most common pollutant in water. Three days old hatchlings of an indegenous fish, Labeo rohita were given 96h exposure to an environmentally relevant (0.06mg/L) and two moderately lethal concentrations (0.067 and 0.097 mg/L) of TCS and kept for 10 days of recovery for recording transcriptomic alterations in antioxidant/detoxification (SOD, GST, CAT, GPx, GR, CYP1a and CYP3a), metabolic (LDH, ALT and AST) and neurological (AchE) genes and DNA damage. The data were subjected to Principal Component Analysis (PCA) for obtaining biomarkers for the toxicity of TCS. Hatchlings were highly sensitive to TCS (96h LC 50 = 0.126mg/L and risk quotient = 40.95), 96h exposure caused significant induction of CYP3a, AChE and ALT but suppression of all other genes. However, expression of all the genes increased significantly (except for a significant decline in ALT) after recovery. Concentration dependent increase was also observed in DNA damage [Tail Length (TL), Tail Moment (TM), Olive Tail Moment (OTM) and Percent Tail DNA (TDNA)] after 96h. The damage declined significantly over 96h values at 0.06 and 0.067 mg/L after recovery, but was still several times more than control. TCS elicited genomic alterations resulted in 5-11% mortality of exposed hatchlings during the recovery period. It is evident that hatchlings of L. rohita are a potential model and PCA shows that OTM, TL, TM, TDNA, SOD and GR (association with PC1 during exposure and recovery) are the biomarkers for the toxicity of TCS.
External Assessment of the EUROMACS Right-Sided Heart Failure Risk Score
Authors: Shah Hirak , Murray Thomas , Schultz Jessica , John Ranjit , Martin Cindy , Thenappan Thenappan , Cogswell Rebecca
Published: March 2021

The EUROMACS Right-Sided Heart Failure Risk Score was developed to predict right ventricular failure (RVF) after left ventricular assist device (LVAD) placement. The predictive ability of the EUROMACS score has not been tested in other cohorts. We performed a single center analysis of a continuous-flow (CF) LVAD cohort (n = 254) where we calculated EUROMACS risk scores and assessed for right ventricular heart failure after LVAD implantation. Thirty-nine percent of patients (100/254) had post-operative RVF, of which 9% (23/254) required prolonged inotropic support and 5% (12/254) required RVAD placement. For patients who developed RVF after LVAD implantation, there was a 45% increase in the hazards of death on LVAD support (HR 1.45, 95 % CI 0.98–2.2, p = 0.066). Two variables in the EUROMACS score (Hemoglobin and Right Atrial Pressure to Pulmonary Capillary Wedge Pressure ratio) were not predictive of RVF in our cohort. Overall, the EUROMACS score had poor external discrimination in our cohort with area under the curve of 58% (95 % CI 52–66%). Further work is necessary to enhance our ability to predict RVF after LVAD implantation.
Effect of Biochar on Transformation of Dissolved Organic Matter and DTPA-Extractable Cu and Cd During Sediment Composting
Authors: Zhao Meihua , Cai Caiyuan , Yu Zhen , Rong Hongwei , Zhang Chaosheng , Zhou Shungui
Published: March 2021

This study investigated the influence of biochar on temperature, pH, organic matter (OM), seed germination (GI), the fluorescent components of dissolved organic matter (DOM), and bioavailability of DTPA-extractable Cu and Cd during composting and analyzed the relation between DTPA-extractable metals with pH, OM, and the fluorescent components of DOM. Results showed that the addition of biochar shortened the thermophilic phase, reduced the pH at maturation period, accelerated the decomposition of OM, and raised GI. Besides, it promoted the formation of components with benzene ring in FA and HyI and the degradation of protein-like organic-matters in FA and HA, which was mainly related with the decrease of DTPA-extractable Cd and the increase of DTPA-extractable Cu. After composting, DTPA-extractable Cd in pile A and pile B were decreased by 37.15% and 27.54%, respectively, while the bioavailability of Cu in pile A and pile B were increased by 65.71% and 68.70%, respectively. All these findings demonstrate positive and negative impact produced by biochar into various heavy metals and the necessary of optimization measures with biochar in sediment composting.
A Study on the Relationship Between Patent Foramen Ovale and White Matter Lesions in Migraine Patients
Authors: Huo Junyan , Wan Mengxia , Li Nan , Wang Juan , Cai Xiao , Fan Dongsheng , Fu Yu
Published: March 2021

Background Migraine is a common clinical primary headache with unclear aetiology. In recent years, studies have shown that migraine is related to patent foramen ovale, and some patients with migraine have white matter lesions. However, the relationship among the three is unclear.Objective To explore the characteristics of white matter lesions (WMLs) in migraine patients with patent foramen ovale and to predict the occurrence of patent foramen ovale through magnetic resonance imaging (MRI) characteristics in patients with migraine.Methods Seventy-seven patients clinically diagnosed with migraine were examined by transcranial Doppler ultrasound (cTCD) and MRI. The patients were grouped according to the presence of WMLs, with matching by age, sex, hypertension, diabetes, PFO and other characteristic data. We observed the MRI fluid attenuation inversion recovery sequence (FLAIR) image and compared and analysed the difference in WMLs between the PFO-positive group and the PFO-negative group.Results There were 42 cases and 35 cases of migraine with and without WMLs, respectively. A statistically significant difference in near-cortical WMLs with PFO in migraine patients was observed (P=0.001). Logistic regression analysis adjusted by age, sex, hypertension and diabetes identified PFO status as the sole determinant for the presence of near-cortical WMLs (OR = 0.14; 95%CI 0.045–0.421; p < 0.001)Conclusion Near-cortical white matter lesions in migraine patients are related to PFO. Transcranial Doppler ultrasonography may reveal more PFO in patients with migraine and near-cortical WMLs.
Spinopelvic sagittal imbalance is risky for development of proximal instrumented fracture after posterior instrumentation.
Authors: Liao Jen-Chung , Chen Wen-Jer
Published: March 2021

Backgrounds:

Postoperative fracture of the upper instrumented vertebrae (UIV) is thought to be as fracture type of proximal junctional failure (PJF), which usually needs revision surgery for salvage. The purpose of this study was to investigate the influences of spinopelvic parameters, such as the pelvic incidence (PI) angles, sacral slope (SS) angles, and pelvic tilt (PT), sagittal vertical axis (SVA), and proximal local kyphosis (PLK) angle on the development of fracture type of proximal junctional failure after posterior instrumentation.
Methods

This was a retrospective 1:3 matched case-control cohort study: 24 patients in the study group and 72 patients in the control group. The weighted Charlson Comorbidity Index (CCI) and bone mineral density (BMD) with T score were recorded. In addition to spinopelvic parameters, PI-LL and spinopelvic realignment score were calculated.
Results

More comorbidities (CCI, p = 0.002), poorer bone density (T score, p = 0.001) were noted in the study group. Before surgery, the study group had significantly lower LL (p = 0.046), SS (p = 0.043), and significantly higher PLK (p < 0.001), PT (p = 0.044) than the control group. Postoperatively, the study group had significantly higher PLK (p < 0.001 ) and lower LL (p = 0.031) than the control group; the degree of PI-LL ( p = 0.007) remained significantly higher in the study group. Both preoperative (p = 0.026) and postoperative (p = 0.045) spinopelvic realignment scores was worse in the study goup.
Conclusions

Preoperative and postoperative lower LL/spinopelvic realignment score, and higher PLK/PI-LL were significantly associated with instrumented fracture at upper instrumented vertebrae. An appropriate LL and a lower PLK should be obtained at surgery to prevent the development of instrumented fracture.
Analysis of bailout procedure in laparoscopic cholecystectomy for acute cholecystitis
Authors: Nagata Shigeyuki , Kai Seiichiro , Korenaga Daisuke , Mori Masaki , Toyota Satoshi , Orita Hiroyuki
Published: March 2021

Background: The Tokyo Guidelines 2018 recommend a bailout procedure consisting of fundus-first cholecystectomy, subtotal cholecystectomy, or open conversion to prevent serious complications in cases of difficult laparoscopic cholecystectomy (LC).Methods: The hospital records of patients with acute cholecystitis who underwent LC from October 2014 to April 2019 were retrospectively analyzed. The clinical data were compared between the standard and bailout groups. A subgroup analysis was performed to compare the fundus-first and subtotal cholecystectomy techniques versus open conversion.Results: In total, 160 of 416 Japanese patients who underwent LC were diagnosed with acute cholecystitis. Standard LC was performed in 125 (78%) patients, and a bailout procedure was performed in 35 (22%). The duration from onset to surgery was significantly longer (P = 0.04) and the C-reactive protein (CRP) concentration was significantly higher (P = 0.001) in the bailout than standard group. The surgical outcomes were worse in the bailout group. In the multivariate analysis, a high CRP concentration at diagnosis was an independent predictor of bailout (P = 0.004). In the subgroup analysis, the open group had a significantly longer duration from onset to surgery (P = 0.04) and a significantly higher incidence of preoperative drainage (P = 0.002). With respect to surgical outcomes, the open group had significantly greater blood loss (P = 0.02) and longer hospital stays (P = 0.002). Conclusion: A high CRP concentration is a risk factor for a bailout procedure. Early LC should be performed for patients with acute cholecystitis and a high CRP concentration.
Health Care Seeking Behavior of Obstetric Danger Signs and its Associated Factors Among Pregnant and Delivered Mothers in Kewot District, North Shoa Zone, Amara Region, Ethiopia: A Cross-Sectional Study
Authors: Tadesse Daniel , Eshete Akine , Mamo Tadesse , Mohammed Sadat
Published: March 2021

Background: Many mothers died due to preventable causes in developing countries like Ethiopia. so, this study aims to assess the healthcare-seeking behavior of obstetric danger signs among pregnant and delivered mothers in 1 year before the study period in Kewot districts. Method: A community-based descriptive cross-sectional study design supplemented by qualitative technique was conducted from April 20 -April 30, 2019, in the Kewot district. Pregnant and delivered mothers were selected by systematic random sampling technique and interviewed with a response rate of 98.2%, Using purposive sampling 3 key-informants and 5 mothers were selected for in-depth interview of a qualitative study. Data were entered into Epi data version 3.1.1 and analyzed using SPSS version 21 and the logistic regressions model was applied to identify the associated factors. Results: A total of 363 participants were involved in the study. Among participants, 211(58.1 %) at (95% CI; CI: 53.7%-63.1%) were sought appropriate health care action. Women who have ANC follow up (AOR=1.735,95%CI:1.107-2.721), knowledgeable about danger sign, (AOR=2.430,95 % CI:1.360-4.342), the decision for own health care seeking (AOR=2.514,95% CI:1.130-5.501), and women who cannot able to judge graveness of condition (AOR=0.509,95% CI:0.302-0.859) were significantly associated with appropriate healthcare-seeking behavior.Conclusion: Having antenatal care follow up, knowledge about danger signs, inability to judge the graveness of conditions and inability to decide alone for own health care were factors that prevent appropriate health care seeking action. So, there should be health information dissemination about danger signs for every pregnant mother in the catchment area and during their visit to health institutions.
Synergistic Effects of Contaminants in Lombardy Waters
Authors: Porta Caterina La , Fumagalli Maria , Gomarasca Stefano , Lionetti Maria , Zapperi Stefano , Bocchi Stefano
Published: March 2021

Quantifying synergistic environmental effects in water contamination is still an open issue. Here, we have analyzed geolocalized data of pollutants recorded in 2018 in surface and groundwater of Lombardia, one of the areas with the highest agricultural production rates, not only in Italy, but also in Europe. Both herbicides and insecticides are present at concentration levels above the legal limit, mainly in surface waters. Geolocalizated analysis allows us to identify interesting areas particularly affected by a combination of multiple pesticides. We thus investigated possible synergistic effects of these compounds on the environment, using the alga C. reinhardtii as a biosensor. Our results show that exposure for 7 days to four compounds, that we found present together at high concentration in surface waters, was able to induce a stress in the algae, as indicated by the presence of palmelloids. Our work results in a pipeline that could easily be exported to monitor other territories in Italy and abroad.
Research and Clinical Significance of the Differentially Expressed Genes TP63 and LMO4 in Human Immunodeficiency Virus-related Penile Squamous Cell Carcinoma
Authors: Xue Wenrui , Zheng Xin , Hu Xiaopeng , Zhang Yu
Published: March 2021

Background: To study the differential gene expression and clinical significance in HIVIIs (human immunodeficiency virus-infected individuals) with penile squamous cell carcinoma.Methods: At our hospital from 2019 to 2020, we selected 6 samples of HIV-related penile squamous cell carcinoma for the experimental group and 6 samples of non-HIV-related penile squamous cell carcinoma for the control group. Transcriptome sequencing of sample mRNAs was performed by high-throughput sequencing. Differential gene expression analysis, differential GO (Gene Ontology) enrichment analysis and differential KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway analysis were carried out, and the RPKM (reads per kilobase per million reads) value was used as a measure of gene expression.Results: A total of 2418 differentially expressed genes were obtained, of which 663 were upregulated and 1755 were downregulated (absolute value of logFC >1.0 and p value<0.05 FDR < 0.05). On the basis of the significance of the GO enrichment analysis, we found that the TP63 (tumor protein p63) gene was significantly upregulated and that the LMO4 (LIM domain only 4) gene was significantly downregulated in the experimental group compared with the control group. KEGG pathway analysis of the differentially expressed genes revealed that DNA replication was the most significant pathway associated with the upregulated genes and CAM (cell adhesion molecule) metabolism was the most significant pathway associated with the downregulated genes.Conclusions: The gene expression profiles of HIV-related penile squamous cell carcinoma and non-HIV-related penile squamous cell carcinoma are significantly different and involve significant GO enrichment and KEGG metabolic pathways, and this is very meaningful for the study of NADCs (non-AIDS-defining cancers). Differential expression of genes may be an important target for the prevention of penile squamous cell carcinoma in HIVIIs.
Cross-sectional and longitudinal associations between quality of first marriage and subjective health assessment in older Chinese residents
Authors: Guan Ming , Guan Hongyi
Published: March 2021

Background: First marriage was vital for a common person in all-life, and there were concerns that marital quality had relationship with self-reported health and quality of life (SRH and SRQoL), health change, and sleep quality. This study aimed to examine longitudinal associations between subjective health assessment and quality of first marriage to characterize the stability and directionality of the trajectory of marriage- health over time.Methods: Data were from the Chinese Longitudinal Healthy Longevity Survey. Chinese elders completed surveys across 3 waves (2008/2009, 2011/2012, and 2014). Using autoregressive cross-lagged models, bidirectional relationships between SRH, SRQoL, health change, sleep quality, and quality of first marriage over time were examined.Results: Cross-sectional analysis confirmed the significant associations between SRH, SRQoL, health change, sleep quality, and quality of first marriage. Autoregressive linear models of SRH, SRQoL, health change, sleep quality, and quality of first marriage were confirmed. Cross-lagged relationship between SRQoL and SRH, between SRQoL and sleep quality, between SRQoL and health change, between SRH and sleep quality, between quality of first marriage and SRQoL, and between sleep quality and health change were confirmed. Conclusions: Subjective health assessment was associated with future subjective health assessment across 3 longitudinal waves. Quality of first marriage might be influenced by SRQoL among older Chinese. Future research needs to examine influencing psychological mechanism of the cross-lagged relationships.
Traumatic Brain Injury in Veterans: Social Determinants, Survival and Costs
Authors: Dismuke-Greer Clara , Gujral Kritee , Egede Leonard
Published: March 2021

BACKGROUND: Traumatic Brain Injury (TBI) is a signature injury from the Iraq and Afghanistan conflicts as well as an important contributor to morbidity and mortality in the United States. Using a cohort of over 400,000 veterans with and without TBI, odds of TBI diagnosis by socio-demographics and clinical factors, along with the association of a TBI diagnosis with veteran survival were estimated for 15 years. Annual Veterans Health Administration (VHA) costs associated with a TBI diagnosis over a 14-year period were estimated per veteran. METHODS: 291,015 veterans without TBI and 181,521 veterans with TBI were followed from FY 2000 through FY2015 for comorbidities and survival. Veterans were followed through FY2014 for costs and adjusted to 2019 for inflation. Logit models were estimated to examine the association of veteran socio-demographics and clinical factors with the odds of a TBI diagnosis. Cox proportional hazard model was estimated to examine the covariate-adjusted association of TBI with survival. Generalized linear and seemingly unrelated regression models were used to estimate the association of TBI with annual per veteran VHA costs. RESULTS: Non-Hispanic Blacks (OR 1.85; 95% CI 1.81:1.88), Hispanic (OR 1.94; 95% CI 1.88:2.00)), and veterans with high numbers of mental (OR 5.83; 95% CI 5.68:5.98) and physical comorbidities (OR 2.47; 95% CI 2.42:2.52) had higher likelihood of having TBI. Veterans with TBI were 1.2 times more likely to die and had higher total annual costs by $19,808 (95% CI $13,900: $25,715), with a similar pattern for all component cost categories. CONCLUSIONS: Racial/Ethnic minorities have a higher likelihood of TBI. TBI is associated with increased death and annual health care costs. These results will inform decision-making by military leaders and policymakers regarding the harmful health impacts and higher health care services burden of TBI that may affect a large portion of military personnel.
Kaempferol reversals retinal ischemia/reperfusion (IR) injury through activating of PI3K/Akt/mTOR signaling pathway
Authors: Sun Da , Shang Fusheng , Chen Dagui , Wang Wenwen , lin lili
Published: March 2021

Purpose

Retinal ischemia/reperfusion (IR) injury is associated with many ocular diseases, including acute glaucoma, diabetic retinopathy, and retinal vascular occlusion. However, currently there are no effective medications to prevent the development ofretinal IR injury.Kaempferol is a kind of plant extract which has showed an excellent ability to inhibit the inflammation..

Materials and Methods

In this study, both in vitro and in vivo retinaloxidative damage models were established.Cell viability was assessed by Cell Counting Kit-8 assay. Apoptosis was examined using flow cytometry analysis.Atherosclerotic lesion analysis was performed using hematoxylin-eosin staining,The expressions of Inflammatory cytokines were detected by quantitative real-time PCR and ELISA respectively.The effect of expression of apoptosis、utophagy and the PI3K/Akt/mTOR signaling pathway related pathway was evaluated by Western blot.

Results

We found kaempferol was able to protect the viability of ARPE-19 cells against oxidative damage by reducing its apoptosis. In addition, it also kept structurally complete epithelium, stroma and endothelium of cornea after oxidative damage. Moreover, it also able to reduce the expression of inflammatory cytokines and increased the expression of anti-inflammatory cytokines.Kaempferol was able to enhanced the expression of anti-apoptotic genes BCL-2, and reduced the expression of autophagy gene Beclin 1 and increased the expression of anti-autophagy gene LC-3,was also able to enhance the expression PI3K and the phosphorylation ofAkt andmTOR.

Conclusion

Kaempferolreversals retinal ischemia/reperfusion (IR) injury through activating of PI3K/Akt/mTOR signaling pathway.
Weight and Abdominal Girth Predict Tidal Volume Requirement During Mechanical Ventilation for General Anaesthesia: A Cross-sectional Study
Authors: Shen Ying-yan , Chen Yan , Zhou Hong-mei , Li Qi
Published: March 2021

Background: Evidence that tidal volume (TV) is related to age, height, weight, chest circumference, and abdominal girth exists. However, it is unclear which of these has the strongest association with TV. This study aimed to investigate the main factors associated with TV and determine a method for accurately predicting TV requirement during mechanical ventilation. Methods: From December 2019 to January 2021, we enrolled 133 patients who were scheduled for surgery. Their age, height, weight, abdominal girth, and chest circumference were recorded. Intraoperatively, at 30 minutes after mechanical ventilation during general anaesthesia, the TV was increased or decreased by 25 ml if the partial pressure of carbon dioxide (PaCO2) was > 45 mmHg or < 35 mmHg, respectively. This was continued until we observed two consecutive PaCO2 values between 35 and 45 mmHg. The TV setting was recorded at this point. Linear regression and multiple regression analyses were performed. Results: The data of 100 patients were analysed. Linear regression analysis showed significant univariate correlations between age, weight, height, abdominal girth, chest circumference, and TV requirement. (all P ≤ 0.049). Multiple linear regression analysis showed that weight and abdominal girth were key determinants of TV requirement (both P < 0.001). The adjusted R2 for the regression equation was 0.813. The regression equation for accurately predicting TV requirement was Y = 312 + 5.717X1 - 2.798X2 (Y, TV requirement; X1, weight; and X2, abdominal girth). Conclusion: TV requirement during mechanical ventilation for general anaesthesia can accurately be set based on weight and abdominal girth.
Quantitative High-resolution Computed tomography Analysis of Antisynthetase Syndrome with Interstitial Pneumonia
Authors: Li Xueren , Peng Shouchun , Wu Qi , Zhang Huarui , Feng Na , Zhang Yuhua
Published: March 2021

Background Non-specific interstitial pneumonia (NSIP) combined with organizing pneumonia (OP) pattern has been confirmed in pathology or radiology. This study is to analyze the correlation between high-resolution computed tomography (HRCT) quantitative indexes (QI) and pulmonary function test parameters (PFTs), and compare differences of HRCT patterns in Antisynthetase Syndrome with interstitial pneumonia (ASS-IP).Methods Data of ASS-IP patients admitted to respiratory department of Ping Jin hospital from January 2014 to December 2019 were retrospectively reviewed.Results 21 ASS-IP patients were enrolled in this study and 3 patients were NSIP, 9 patients were OP and 8 patients were NSIP overlap OP (NSIP/OP) pattern. (1) Volume, Weight percentages of the extracted whole lung volume with attenuation values (V%, W %) and mean lung attenuation (MLA) of non-aerated area is 5.69%, 16.43% and -11.76 Hounsfield unit (Hu). Total MLA of attenuation values(MLAtotal) is -678.97 Hu.(2)FVC and MLA of poorly aerated（r=0.58,P=0.048）, FEV1 and MLA（r=0.79,P=0.001）of poorly aerated, FEV1/FVC（r=0.23,P=0.01） and MLA of normally lung aerated, have linear correlation .(3) DLCO (P=0.049), volume of poorly aerated (Vfibrosis%,P =0.03), and weight of hyper inflated (Whyper%,P=0.02) percentages, and MLAtotal (P=0.01) have significant statistic differences between patients with NSIP/OP or OP patterns, but the therapy improvement time(P=0.41) had no difference. Conclusions QI of HRCT has a good correlation with PFTs and partly reference value to pathological classification of ASS-IP. NSIP/OP may be a common pattern in ASS-IP, fibrosis severity of which is more severe than OP.