bluuebunny/crossref_metadata_2025 huggingface dataset:
Decommissioning of Splitter Wellhead Wells
Authors: Ishak Siti Nadiah , M Garib Nurul Iffah , Damasena Edwin , Dahasry Daeng Dhamiry
Published: March 2022

Drilling keeper wells with an open-sea concept by suspending a 36″ conductor to a jackup drilling rig as a temporary structure induced several criticalities in plugging and abandoning the wells. The severity amplified with the two (2) wells are cemented inside the conductor and completed with a splitter wellhead. As per the Malaysia local regulatory, any abandoned wells are to be free from any structure protruding from seabed. This is paramount in confirming the drilled location is free from potential hazards. This splitter design confirmed that conventional cut-and-pull approach is not feasible and multistring cutter is the only solution available. This paper covers the approach and result in performing eccentric cut of fully cemented 2 × 9-5/8″, 2 × 13-3/8″ and a 1.0″ wall thickness 36″ conductor including decommission of a splitter wellhead. In achieving the objective to P&A the keeper wells, an Abrasive Water Jet Cutter (AWJC) is deployed to perform an internal eccentric cut that able to penetrate five (5) cemented casing simultaneously. The cutter is paired up with Drilling Wire Saw (DWS) and Dual Drilling Machine (DDM) as a surface cutter and a "hole-borer" in cutting the retrieved multistring into shorter sections that eliminated the needs to dismantle the splitter wellhead into individual component. Meanwhile, for surface lifting and suspending, an engineered pad eyes, H-beam and lifting frame with pins were required to guarantee a successful operation. AWJC is designed to penetrate structures with extreme pressure, coupled with optimized pre-planned nozzle rotation speed to establish a complete 360° clean cut downhole. The jetting mechanism using the right mixture of water and garnet is crucial in providing sufficient capability to penetrate the conductor size in an eccentric condition considering the worst-case position of the cutter downhole. The significant finding from this P&A operation is understanding the type of garnet and fluid less environment around nozzle cutter head as main contributors for an efficient cutting process. Actual pick-up weight to pull free the pipe was 37% higher than the calculated weight for a complete cut. Hence, the surface capability shall be designed with some marginal tolerance to provide additional lifting capability in case an unsmoothed cut is experienced. Overall, the operation managed to overcome the challenges and uncertainties experienced and mark as a great milestone for the first ever decommission splitter well design in Malaysia.
Integrated Approach in Implementing Hydrate Management Strategies in Deepwater Gas Developments
Authors: Anuar Astriyana , M Norpiah Rohaizad
Published: March 2022

Hydrates have been a constant threat to subsea deepwater operations. Partial or total hydrate blockages usually occur after shutdown of a host facility, which invariably affects the resumption of production. The complexities of subsea production systems and extensiveness of deepwater fields present challenges in implementing hydrate management strategies. In the past, erroneous and ad-hoc strategies were implemented due to a lack of flow assurance (FA) awareness and understanding, resulting in production deferment caused by frequent hydrate formation/ blockages. Hydrate inhibition based on Mono-Ethylene Glycol (MEG) and Methanol (MeOH), if not properly understood and managed may lead to significant increases in a field's annual operating expenditure (OPEX). PETRONAS has gained a fair amount of experience in dealing with hydrates. The approaches taken in mitigating hydrate related issues in subsea developments have been exemplary and it is beneficial to be shared across the fraternities. These approaches will be discussed in detail throughout the article based on case studies from two subsea field developments: Field D Deepwater Gas Development and BG Gas Flowline at Field C
The Deployment of Deep Learning Models for Performance Optimization and Failure Prevention of Electric Submersible Pumps
Authors: Dachanuwattana Silpakorn , Ratanatanyong Suwitcha , Wasanapradit Tawan , Vimolsubsin Pojana , Kulchanyavivat Sawin
Published: March 2022

Real-time sensors are crucial for monitoring electrical submersible pump (ESP) operation. However, manually analyzing the whole data from these sensors is virtually impossible due to its overwhelming volume. Artificial intelligence (AI) is a game-changing tool that can leverage the big data from ESP sensors more efficiently. Coupled with ESP knowledge, AI could reveal insights into ESP behaviors, well performances, and reservoirs dynamics, leading to ESP life extension and better production optimization.

In this paper, we present the development and deployment of an AI workflow to enhance ESP surveillance. The workflow is developed in-house using the Python programming language and consists of the following four main modules:

Data ingestion – to ingest all ESP-relevant databases Data preprocess – to transform the databases in the format ready for AI modelling AI modelling – to experiment several AI models, e.g., to detect ESP critical events, and predict ESP run life. Deployment – To automatically notify ESP critical events and visualize insight from the AI models

The application of a hierarchical clustering algorithm reveals that the ESP run life in our fields are most influenced by gas production. Then, after more than 1000 runs of experiments, we achieve a deep learning model to predict whether an ESP will fail within the next 90 days. We also develop a module to automate nodal analysis as part of the AI workflow. Combining this physics-based model with a data-driven approach, the resulting AI models can accurately detect ESP critical events, such as ESP degradation, imminent gas lock, and sand production.

To deploy the AI workflow, we build a dashboard to effectively visualize actionable insights from the AI models on our local server. The workflow sends notifications of ESP critical events to users for prompt troubleshooting actions and collects user feedbacks for improvement of the AI models in the next model development cycle.

This paper demonstrates a holistic approach to develop a closed-loop ESP surveillance workflow that integrates the powers of AI, automation, and ESP knowledge including nodal analysis. The AI workflow potentially creates value of several million dollars or higher per year by extending ESP run lives and optimizing production. The lessons learnt from this AI workflow development are shared to assist the development and deploying of similar AI methods throughout the oil and gas industry.
Electromagnetic Measurement While Drilling System Enabled the Operator to Reach Beyond the Limits in a Multiphase Foam Drilling Medium
Authors: Ashraf Qasim , Khalid Ali , Hussain Syed Ahrar
Published: March 2022

In this era of low oil price, it is vital for the operators to deliver low cost wells with enhanced production. A continuous technological advancement in the oil and gas industry has played a pivotal role in establishing high returns on investments. Many techniques have been developed so far in this aspiration to improve the quality of the reservoirs, enhanced production mechanisms and efficient drilling operations.

Situated in Sulaiman fold belt of Pakistan a large Gas field was discovered by one of the NOCs in 2011. It was a carbonate reservoir, laterally extended on a large portion resulting in a big volumetric reservoir. When discovered it was observed that being naturally fractured and having low reservoir pressure it was plagued with massive loss of circulation and associated drilling challenges. Conventional drilling technique has also resulted in immense reservoir damage. To overcome the challenges of overbalanced drilling the operator started drilling with underbalanced drilling methodology in this formation, which resulted in efficient drilling, saving time and cost.

In order to improve the field economics, the operator decided to drill horizontally into this formation to maximize the production potential of each well. As a pilot project a well was designed to drill a horizontal leg of almost 504 m into this carbonate reservoir. It was obvious that this formation could not be drilled with conventional overbalanced mud system so it would be drilled with underbalanced multiphase foam drilling system. The biggest challenge in this gaseous foam drilling medium is to control the trajectory of the well as the measurement while drilling (MWD) system works through mud pulse telemetry that could only be done in an incompressible drilling fluid.

To address this major glitch an electromagnetic (EM) MWD system was suggested that can transmit the signals via electromagnetic waves and is independent of the drilling medium being used. Based on the resistivity analysis of the formations laying above this reservoir, modeling was performed to design the most suitable measuring system. As the lateral was long and deep so the requirement of extended range antenna system was also incorporated so that signal transmission remain uninterrupted throughout the drilling operation.

Through the application of this unconventional MWD technique the operator was able to drill the longest horizontal well in this block. The well was completed without any NPT in an excellent fashion and tested to evaluate the maximum flow potential of this reservoir. This application has shown the operators how to reach beyond the limits in such troublesome formations.
Analytical Modelling of Gas Hydrates in Porous Media
Authors: Rabbani Harris Sajjad , Khan Muhammad Saad , Qureshi M. Fahed Aziz , Rahman Mohammad Azizur , Seers Thomas , Lal Bhajan
Published: March 2022

A mathematical model is presented to predict the formation of gas hydrates in porous media under various boundary conditions. The new mathematical modeling framework is based on coupling the analytical pore network approach (APNA) and equation proposed by De La Fuente et al. [1]. Further, we also integrate thermodynamic models to capture the phase boundary at which the formation of gas hydrates takes place. The proposed analytical framework is a set of equations that are computationally inexpensive to solve, allowing us to predict the formation of gas hydrates in complex porous media. Complete governing equations are provided, and the method is described in detail to permit readers to replicate all results. To demonstrate the formation of hydrates in porous media, we analyzed the saturation of hydrates in porous media with different properties. Our model shows that the hydrate formation rate is positively related to the porous media's pore size. The hydrates were found to be preferably formed in the porous media composed of relatively larger pores, which could be attributed to the weak capillary forces resisting the formation of hydrates in porous media. The novelty of the new analytical model is the ability to predict the gas hydrates formation in porous media in a reasonable time using standard engineering computers. Furthermore, the model can aid in the estimation of natural gas hydrate reservoirs, which offer the avenue for effective methane recovery from the vast natural gas hydrate reserves in continental margins.
Challenges in Planning and Designing for the Sea Transportation of Heavy Modules of a Modularized Plant, an EPC Contractor's Perspective
Authors: Ahmad Nazari Zunaidi , Mashari Madada , Kumar Mukesh , Paul Eldho
Published: March 2022

The ocean transportation of heavy modules on heavy transportation vessels (HTV) has a large influence on the design and construction of modularized plants. In some instances, it governs structural design loads and influences the layout and commissioning plan of modules. Proper selection of transportation routes, seasons, and vessels will reduce the impact of transportation loads and constraints on the overall module design. Details presented in this paper are based on an EPC Modularization project involving the sea transportation of 5 mega modules weighing between 5000MT to 9000MT, totaling 34000MT, which took place between November 2020 and February 2021. A summary of planning and execution strategy together with key solutions to deal with challenges faced during this project can serve as a guide for future projects.
A Comprehensive Approach in Managing the Aftermath of Non-Conformance Seam Welded Linepipes
Authors: Aziz M. Faisal , Desa M. Anuar , Jaafar Azamsyah , Hussien Hayati
Published: March 2022

PETRONAS had been notified by its pipe mill that some of the linepipe supplied by the mill were found to be non-compliance with agreed manufacturing process specification (MPS) and inspection & test plan (ITP). The non-conformances happened during longitudinal weld seam repair at the manufacturing stage. The notification has put PETRONAS on high alert as the affected linepipes have already been installed and commissioned as part of gas pipelines i.e. Pipeline 1 and Pipeline 2 supplying to onshore customer. This paper will discuss the investigation strategies implemented by PETRONAS' investigation team which include 1) multidisciplined investigation team, 2) Technical Safety Review, 3) Desktop Review and 4) Repair Simulation and Material Verification Testing. The paper also details out the type of non-conformance and associated hazards with corresponding action plan to address them. Engineering Criticality Assessment (ECA) was one of the critical processes in the investigation where simulated longitudinal weld samples from the linepipe underwent Crack Tip Opening Displacement (CTOD) test. The test provided fracture toughness value of the weld sample and became the main input in the ECA study. The objective of the ECA is to provide defect/ crack acceptance criteria based on methodology specified by BS7910. During ECA, the respective weld sample was analyzed against pipeline operating parameters coupled with fatigue stress mainly contributed by pressure variations. Crack growth was studied and compared against defect/ crack critical dimensions i.e. height, and length. Given all the investigations carried out combined with ECA experts review, the pipelines were proven safe and reliable to operate. The investigation outcomes have saved PETRONAS commercially while maintaining good safety record.
Selection of a Flocculant to Assist in Divalent Cation Removal in a MEG Pre-Treatment Process
Authors: Fisher Nicholas , Lehmann Marc , Brunt Steve , Gloyn Mark
Published: March 2022

When monoethylene glycol (MEG) is used to provide hydrate protection for gas condensate production, MEG pre-treatment, reconcentration and reclamation systems are generally employed to recover and reuse the MEG. Prior to reconcentration, low solubility salts of divalent cations such as calcium, iron, strontium and magnesium, that may be present in the Rich MEG, are removed in a MEG pre-treatment process. This process involves the addition of a base, such as NaOH or KOH, to the Rich MEG at elevated temperatures to convert dissolved carbon dioxide to carbonate ions and so precipitate the cations, as their respective insoluble carbonate or hydroxide salts. When enough residence time is available within the process these precipitated salts are removed from the Rich MEG stream through physical separation. For onshore based MEG systems, this is usually accomplished via settling tanks. However, in offshore systems the residence time for crystallization and settling becomes limited due to vessel sizes imposed by facility space limitations so precipitated salts are actively removed using mechanical equipment such as centrifuges. Centrifuges are only effective when crystals reach threshold particle sizes. Contaminants in MEG such as dissolved hydrocarbons and magnesium ions can inhibit crystal growth of calcium and iron carbonate. This study details the development of testing methodologies to screen chemistries to assist in particle agglomeration and led to the identification of a promising class of chemistries that could be applied in MEG Pre-treatment for the flocculation of cation salts.
Burnout in and Commission of Medical Errors by Secondary School Athletic Trainers
Authors: Oglesby Leslie W. , Gallucci Andrew R. , Porter Anna K. , Vineyard Ashlyne Paige
Published: March 2022

Context

Commission of medical errors by health care providers can be costly and potentially fatal for their patients. Previous researchers found a correlation between burnout and the commission of medical errors by physicians. The Smith Cognitive-Affective Model of Athletic Burnout suggests that emotional exhaustion and decreased personal accomplishment in athletic trainers (ATs) may be associated with behavioral outcomes such as commission of medical errors, but this association has not been examined.

Objective

To explore the association between burnout in and commission of medical errors by ATs.

Design

Cross-sectional study.

Setting

Web-based survey.

Patients or Other Participants

A total of 403 certified ATs working in the secondary school setting were recruited via multiple social media pages and the National Athletic Trainers' Association Research Survey Service.

Main Outcome Measure(s)

An online questionnaire that consisted of 97 items from previously used scales was distributed to participants. A logistic regression model with personal accomplishment and emotional exhaustion as independent variables and a dichotomous variable for commission of medical errors (yes or no) as a dependent variable was calculated. A Poisson regression model with personal accomplishment and emotional exhaustion as independent variables and number of medical errors committed as a dependent variable was also calculated.

Results

Approximately 18.4% of our sample admitted to committing at least 1 medical error in the last 30 days. Both personal accomplishment (odds ratio = 1.06, P = .005) and emotional exhaustion (odds ratio = 1.02, P = .037) were significantly associated with commission of at least 1 medical error. Emotional exhaustion (B = .02, P = .002) was significantly associated with the number of medical errors committed.

Conclusions

Athletic trainers committed medical errors at a rate comparable with that of other health care professionals. Burnout was directly associated with both the likelihood of an AT committing a medical error and the number of errors an AT committed.
Psychological Impact of Overweight/Obesity among Pediatric Age Group Before and During COVID-19 Lockdown in Saudi Arabia
Authors: AlNowaiser Maha Walid , Harakati Amal Maher , Bakraa Reem Medhat , Alamoudi Malak Mohammed , Nour Remaz Zuhair , Alhuthayli Reema Sulaiman , Banjer Aisha Yaseen , AlAgha Abdulmoein Eid
Published: March 2022

Objectives:

Obesity is a primary public health concern in Saudi Arabia. The COVID-19 pandemic has profoundly affected people's lives, putting considerable pressure on children and adolescents, leading to psychological problems. Therefore, we aimed to assess obesity's psychological and behavioral impact among children and adolescents before and during the COVID-19 lockdown in Jeddah.

Materials and Methods:

A cross-sectional study was conducted in the pediatric endocrine outpatient clinic at King Abdulaziz University Hospital(KAUH). The sample included 360 participants. Data were collected through clinical interviews by telecommunication from April to June 2020. Demographic factors and answers to questions about behavior, feelings, and daily life (pre and during home quarantine) were assessed against the participants’ body mass index (BMI) and reported daily life difficulties. The BMI standard deviation was calculated based on the Center of Disease Control and Prevention standards.

Results:

Compared to other groups, a significantly higher percentage of overweight/obese participants reported low self-confidence (22.1%), 61.7% reported that their friends or family rarely bullied or picked on them and 66.4% reported that the people who they lived with rarely made fun of or bullied them due to their weight before home quarantine.

Conclusion:

Children with a higher BMI reported lower self-confidence than their average weight peers before home quarantine. However, a higher BMI did not increase the risk of being bullied by family members and friends. The majority of the participants changed for the worse in every research aspect during quarantine.
Update on First African Clinical trial on EarPopper for the Treatment of Otitis Media with Effusion [FCT/UATH/HREC/PR/330]
Authors: Ibekwe Titus Sunday , Dahilo Enoch Auta , Folorunso David , Uzochukwu Tochukwu , Egbe Bosa I. , Quadri Oladeji Raheem , Fred Damtong , Etukumana Iboro , Nwankwo Basil C. , Gbujie Ibeneche Onyemuchechi
Published: March 2022

Background:

Otitis media with effusion (OME) is a middle ear condition characterized by the accumulation of serous fluid. It is common, though not exclusive; among children with its attendant developmental consequence if missed or untreated in early life. OME could be managed surgically, pharmacologically, or physiologically. EarPopper is a medical device developed for physiologic management of OME, Eustachian tube dysfunction, and related problems. We aim to ascertain the suitability/efficiency of EarPopper® device for the treatment of OME in our setting.

Methodology:

This is a prospective interventional study of volunteers diagnosed with OME from four (4) medical centers in Abuja. Pneumatic otoscopy, video-otoscopy, tympanometry, and pure-tone audiometry were done to confirm the diagnosis. Serial EarPopper sessions were performed twice weekly for 2–12 weeks, and outcome was assessed using patients’ reports. The reports include the EarPopper scoring system (ESS) and audiometric parameters (before and after therapy).

Results:

Forty-five patients (17 males and 28 females) aged between 3–56 years were enrolled. Thirty-five were diagnosed with bilateral OME and 10 unilateral. All patients had Type-B tympanometry tracing with mild-to-moderate conductive hearing losses and ESS of between 2.45% and 84%. Out of the 45 participants, 32 (71.1%) completed the treatment, whereas 13 (28.9%) were lost to follow-up. Duration of EarPopper treatment ranged from 2 to 12 weeks. The outcome revealed improvement in 26/32 (81.3%) with significant reduction in ESS (1% to 9.8%). Six patients 6/32 (18.9%) had persistence symptoms. These 18.9% had the propensity to progress to chronic OME.

Conclusion:

This study highly suggests good prospect in using EarPopper for the management of OME among Africans.
The Association of Extreme Body Weight with Bone Mineral Density in Saudi Children
Authors: Milyani Asmaa A. , Kabli Yousof O. , Al-Agha Abdulmoein E.
Published: March 2022

Objective:

The objective to investigate the effect of extreme body weight; obesity and undernutrition, on bone mineral density (BMD).

Methodology:

This study is a descriptive cross-sectional study carried between January and June of 2019, and included 224 children and adolescents without any comorbidities or chronic disease. Important data collected included anthropometrics, past medical and surgical history, history of medication intake, level of physical activity and pubertal assessment. Data entry and analysis were conducted using Statistical Package for Social Sciences version 24.

Results:

Gender distribution showed 48.2% were male and 51.8% were female. The mean age was 9.98 ± 3.5 years. Mean weight was 34.89 ± 18.2 kg. Mean BMD z-score was − 1.64 ± 1.4. Weight was considered to significantly correlate with BMD stature at a P = 0.014. Subjects who were underweight showed a lower mean BMD z-score of <−2 than those who were overweight/obese (mean BMD z-score = −1.60).

Conclusion:

Both extremes of weight are considered a significant risk factor for the development of low BMD in children. We recommend the early recognition of weight aberrations and consequent aggressive intervention with strict lifestyle modifications to promote the development of maximum peak bone mass.
Treatment Outcomes of Graded Dose of Empagliflozin in Type-2 Diabetes
Authors: Dutta Deep , Sharma Meha , Aggarwal Sameer , Agarwal Anshita , Dhall Anil
Published: March 2022

Background:

Costs are important cause of therapeutic noncompliance in type-2 diabetes mellitus (T2DM). Half-tablet empagliflozin (EMPA)-25 mg has lowest monthly cost among all EMPA preparations; data is unavailable on efficacy of half EMPA-25. This study compared real world weight loss and glycaemic outcomes of 10 mg versus 12.5 mg versus 25 mg of EMPA.

Methods:

Data, retrospectively captured from records of 2 different centresfor patients > 35 years-age having T2DM on EMPA as part of standard pharmacotherapy for T2DM, having > 6 months follow-up data available was analysed. Patients were in 3-groups depending on EMPA dosage: Group 1 on EMPA 10 mg/day (1-tablet EMPA-10), Group-2 on EMPA 12.5 mg/day (half-tablet EMPA-25), and Group 3 on EMPA 25 mg/day (1-tablet EMPA-25). Primary endpoints were glycaemic efficacy and weight-loss.

Results:

Of 3601 records screened, data from 599 patients (184, 239 and 176 in Group-1, 2 and 3 respectively) was analysed. All 3 groups were comparable with regards to sex, blood pressure, haemoglobin, renal function, medications use. Group-3 were significantly older, had longest diabetes duration, highest HbA1c and lowest body mass index. Glycaemic efficacy was comparable among groups (ΔHbA1c Groups 1-3: −0.9 (−1.9 – 0.0), −1.0 (−1.8 – 0.5) and − 1.0 (−1.5 – 0.22], respectively; P = 0.363). Patients on EMPA 12.5 or 25 mg/d had significantly higher total (−1.4 [−3.0 –0.2] vs. −0.3 [−2.4 – 1.32] kg; P = 0.028) and percent weight-loss (−1.75% [−4.15 – 0.26] vs. −0.44% [−3.11 – 1.39]; P = 0.039), and significantly higherfraction achieving HbA1c < 5.7% (12% vs. 0; P = 0.021), compared to EMPA-10.

Conclusion:

Half EMPA-25 is the most cost effective way of using EMPA in clinical practice.
Dengue Seropositivity among Blood Donors in a Tertiary Hospital in Kerala, Southern India
Authors: Raj A. R. Rahul , Shashindran Nandita , Shenoy Veena , Kumar Anil
Published: March 2022

Aim:

The aim of this study was to screen blood donors in a tertiary hospital in Kerala for dengue during the period of peak dengue transmission.

Materials and Methods:

One hundred and seventy-eight continuous serum samples obtained from asymptomatic blood donors during the monsoon season were subjected to ELISA for Dengue NS1 antigen and dengue immunoglobulin M (IgM) antibodies.

Results:

Dengue IgM antibodies were positive in 20 (11.23%) donors and NS1 antigen was positive in 1 (0.56%) donor. The presence of these markers in asymptomatic blood donors showed that they may have had active or subclinical dengue infection at the time of donation or in the recent past. The presence of NS1 in particular raises the possibility that the donor may have been viremic at the time of donation.

Conclusion:

The findings of this study suggest the risk of transfusion transmission of dengue during the monsoon in Kerala and strengthen the case for dengue screening among blood donors during this period of high incidence.
COVID-19
Authors: Omidiji Olubukola A. T. , Atalabi Omolola Mojisola , Idowu Elizabeth A. , Ishola Aderemi , Olowoyeye Omodele A. , Omisore Adeleye Dorcas , Eze K. C. , Ahmadu Muhammad S. , Dim Ngozi R. , Anas Ismail , Ilo Adaobi C. , Ayodele Sidikat A. , Daji Feyisayo Yvonne , Yidi Abdulsalam M. , Ajiboye Olubukola Khadija , Jimoh Kamaldeen O. , Toyobo Oluyemisi O. , Onuwaje Ayesan M. , Irurhe Nicholas Kayode , Adeyomoye Adekunle O. , Akinola Rachael A. , Arogundade Rasheed Ajani
Published: March 2022

Context:

COVID-19 came suddenly, bringing to the fore the challenges inherent in the health system. In a developing country, such as Nigeria, which already had myriad problems with funds and equipment in the health sector.

Aims:

This study aims to examine the challenges encountered by the staff in Radiology facilities and how they combated the challenges.

Settings and Design:

A descriptive cross-sectional study of radiology facilities in Nigeria.

Subjects and Methods:

Radiologists from nine government and four private facilities who attended to COVID-19 patients were asked to fill questionnaires on challenges faced and their coping strategies. Responses were sent through E-mail.

Statistical Analysis Used:

Data from the responses were analyzed using Microsoft excel for Mac 2011 and presented as figures and tables.

Results:

Majority of the government 7 (77.8%) and private facilities 4 (100%) had no equipment dedicated only to COVID-19 patients. Seven (77.8%) government facilities complained of inadequate staff, poor availability of personal protective equipment (PPEs) 8 (88.9%), and lack of technology for remote viewing 7 (77.8%). Fear of cross-infection was a challenge in one of the facilities 1 (11.1%). Coping strategies adopted include ensuring less traffic in the department by discouraging walk-in patients and canceling non-emergent cases, booking suspected/confirmed cases for lighter times, using old film for face shields and cloth for facemasks, staff education on COVID-19 and preventive measures, and sending reports to physicians through E-mail.

Conclusions:

There were a lot of challenges during the COVID-19 crisis, with government hospitals experiencing more challenges than private facilities. The challenges included among others inadequate staff strength and lack of technology for remote viewing. Some were overcome using education and by production of facemasks/shields production using recycled materials.
Role of cartridge-based nucleic acid amplification test in diagnosing extrapulmonary tuberculosis
Authors: Kannuri Sriram , Mirza Shahzad , Misra Rabindra N. , Vyawahare R. Chanda , Das Nikunja Kumar , Gandham Nageswari R. , Khan Sameena , Bhaumik Shalini , Mukhida Sahjid S.
Published: March 2022

Background:

Tuberculosis (TB) is a major health concern globally. Extrapulmonary tuberculosis (EPTB) accounts for around 20% of the total (EPTB) cases which are difficult to diagnose due to the lack of availability of diagnostic tools. Although pulmonary TB is most common presentation, EPTB is also an important problem clinically. Cartridge-based nucleic acid amplification (CBNAAT) test has a well-documented role in diagnosing pulmonary tuberculosis. The potency of CBNAAT in the diagnosis of EPTB cases is still debated.

Aim:

To establish the importance and role of diagnosing EPTB by CBNAAT.

Settings:

Conducted in Dr. D Y Patil Medical College Hospital and Research Centre, Dr. D Y Patil Vidyapeeth, Pimpri, Pune-411018.

Design:

Retrospective cross-sectional study of suspected EPTB patients in a tertiary care center area from April 2020 to September 2020.

Materials and Methods:

Data of suspected EPTB patients were retrieved. Potency of CBNAAT in diagnosing EPTB was assessed.

Statistical Analysis:

All the statistical analyses were carried out using the Statistical Package for the Social Sciences (SPSS) version 20.

Results:

Samples collected from 556 suspected EPTB patients were subjected to CBNAAT. The collected samples included pus, pleural fluid, cerebrospinal fluid, gastric aspirate, peritoneal fluid, tissue biopsy, pericardial fluid, ascitic fluid, synovial fluid, drain fluid, para-spinal fluid. In CBNAAT results, 67 cases were positive for TB bacilli, rifampicin resistance detected in 4 samples.

Conclusion:

Xpert®MTB/RIF assay is a rapid and effective method for early detection of EPTB and can be used in conjunction with routine culture methods for detection of the same.
Combined pericapsular nerve group and lateral femoral cutaneous nerve blocks for hip fracture in a polytraumatized patient—A case report
Authors: Valoriani Juri , Conti Duccio , Gianesello Lara , Pavoni Vittorio
Published: March 2022

Locoregional anesthetic techniques in hip fracture are significant in order to control pain, reduce postoperative opioid use, and perioperative adverse events. Pericapsular nerve group (PENG) block has been described and proved as an effective analgesic method for hip surgery as an alternative to other regional nerve blocks. The association of PENG and lateral femoral cutaneous nerve (LCFN) block can be performed to achieve skin and subcutaneous tissues analgesia or anesthesia. Direct anterior approach PENG block is considered a safe and effective anesthesia technique for total hip arthroplasty surgery. In this paper, we aim to describe a case report of a PENG and LFCN block successful association for anesthesia in a major trauma patient who undergone surgical percutaneous fixation of femoral neck fracture.
Extremely low bispectral index value during robotic-assisted laparoscopic prostatectomy
Authors: Hoshi Takuo
Published: March 2022

The steep Trendelenburg position and pneumoperitoneum during surgery may affect intracranial pressure and cerebral oxygenation, which in turn may affect the values of the bispectral index (BIS). Prolonged maintenance of the Trendelenburg position and pneumoperitoneum may impair cerebrovascular autoregulation. We present a case of a patient with an extremely low BIS value during robotic-assisted laparoscopic prostatectomy (RALP). We managed the patient under general anesthesia and he showed a prominent decrease in BIS values 6 h after the start of surgery. Suppression ratio (SR) of electroencephalography (EEG) is also decreased, suggesting that the brain activity decreased. The BIS value increased quickly after the Trendelenburg position was released and the anesthesia was terminated. The patient recovered without any neurological deficits and was discharged. Steep Trendelenburg position and pneumoperitoneum can cause EEG abnormalities.
Non-intubated general anesthesia in prone position for advanced biliopancreatic therapeutic endoscopy
Authors: Melis Valentina , Aldo Cristalli , Dioscoridi Lorenzo , Arlati Sergio , Molinari Pietro , Cintolo Marcello , Pugliese Francesco , Bonato Giulia , Forti Edoardo , Massimiliano Mutignani
Published: March 2022

Background and Study Aim:

Advance biliopancreatic endoscopies are nowadays performed in non-operating room anesthesia (NORA) under general anesthesia (GA). We evaluate the outcomes of non-intubated patients in prone position who received GA for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) in a tertiary referral center for digestive endoscopy.

Patients and Methods:

Anesthesiological records, anamnestic, and intraoperative data of patients who underwent advanced therapeutic biliopancreatic endoscopies at our tertiary referral center from January 2019 until January 2020 were collected in the present observational study.

Results:

One hundred fifty-three patients (93 M; median age: 68-year-old; mean ASA status: 2) were considered eligible for a procedure in the prone position with GA in spontaneous breathing. Prone position was always the initial setting. Propofol administration through a target-controlled infusion (TCI) pump was the choice to achieve GA. In our experience, desaturation appears to be the most frequent adverse event, accounting for 35% of cases (55/153). Treatment foresaw additional oxygen through a nasopharyngeal catheter, which proved to be a sufficient measure in almost all patients (52/55). Other adverse events (i.e., inadequate sedative plan, pain, and bradycardia) accounted for 2.6% of cases (4/153).

Conclusions:

Non-intubated GA in the prone position may be regarded as a safe procedure, as long as the anesthesiological criteria of exclusion are respected and the anesthesiological team has become acquainted with the peculiar NORA setting and familiar with the management of possible adverse events.
Can ACS-NSQIP score be used to predict postoperative mortality in Saudi population?
Authors: Huda Anwar U. , Yasir Mohammad , Sheikh Nasrullah , Khan Asad Z.
Published: March 2022

Background:

Various scoring systems help in classifying the patient's risk preoperatively and hence to decide the best available treatment option. ACS-NSQIP score has been introduced in clinical practice for few years. This study was done to find out whether there is any difference between predicted mortality from ACS-NSQIP score and observed mortality in Saudi population.

Methods:

This prospective observational study was conducted at Security Forces Hospital, Riyadh, Kingdom of Saudi Arabia. We included patients undergoing elective and emergency surgical procedures in our hospital. Thirty days mortality data was collected and then observed to expected (O/E) mortality ratio was calculated. The sample size for our study was nine hundred and three (903) patients.

Results:

The mean ACS-NSQIP mortality risk score (%) for the study was 0.49. Expected number of mortalities was 4.42 while observed mortalities were 11, yielding an O/E ratio of 2.48 (p-value 0.000). We did not find a significant difference between expected and observed mortalities except for ASA class 3 and 4 patients where expected numbers of mortalities were lower than observed (p-value < 0.05).

Conclusion:

ACS-NSQIP can be reliably used for postoperative mortality prediction especially in lower risk groups.
The use of mandibular nerve block in unilateral mandibular fracture to evaluate the mouth opening for assessment of airway
Authors: Prasad Mukesh Kumar , Jain Payal , Alam Alauddin , Varshnay Rohit Kumar , Rani Kanchan , Chaudhary Amit Kumar
Published: March 2022

Background:

Facial area is one of the most frequently injured area of the body, accounting for 23–97% of all facial fractures. Treatments under general anesthesia as those for maxillofacial fractures or infections is a highly complicated and a major challenging task in trismus associated patients. The main culprit in trismus is the increase muscle tone of masticatory muscles which are supplied via the mandibular nerve, blocking which could help increase the mouth opening thus, changing the whole of airway management.

Material and Method:

A prospective study was done on 50 patients of ASA grade I-II with unilateral mandibular fracture with trismus posted for maxillofacial surgery. Mandibular nerve block was given via extraoral approach with 5 ml of 0.5% bupivacaine using peripheral nerve stimulator to determine the difference in Pre block and Post block mouth opening and the VAS score at 2, 5, 10, 15, 20, 25, and 30 minutes.

Results:

The Interincisor distance measured Pre block was 1.20 ± 0.32 mm and was significantly increased after 5 mins onwards from the block (P < 0.005). The VAS score determined Pre block was 5.14 ± 1.37 which significantly decreased just 2 minutes after the application of block (P < 0.005).

Conclusion:

Mandibular nerve block decreases the pain and will aid in the decision making by an anesthetist regarding airway management as it helps in increasing the inter incisor distance significantly. Moreover, given the feasibility and effectiveness of the block it could be included in standard of care protocol for mandibular fracture patients.
Tourism SME’s Adoption of Social Media Analytics Tools and Technology
Authors: Madila Shadrack Stephen , Dida Mussa Ally , Kaijage Shubi
Published: March 2022

The study analysed the current state of the adoption of social media analytics (SMA) technology and tools to tourism small and medium enterprises (SME) in Tanzania and to understand the factors which influence the adoption of SMA tools to tourism SMEs. SMA became the basic technology in understanding and getting insight into social media data. Tourism SMEs are among the users of social media platforms. The researcher carried out the survey in Arusha and Kilimanjaro regions to determine the current state of the adoption of SMA to tourism SMEs. The technology, organization and environment (TOE) framework has been used to determine the factors that contribute to the adoption of SMA. The study finding shows that many tourism SMEs are using social media in their business activities however the adoption of SMA is very low, majority of the SMA are not adopting and using SMA. Technology, organization and environmental factors seem to allow the adoption of SMA to tourism SMEs. The study contributes to the research body of knowledge on the current status of adoption of SMA to tourism SMEs and managerial contribution on the factors to determine when tourism SMEs wants to adopt SMA.
Establishing Ethical Relationships through Care Education
Authors: Kim Min-Young , Kim Mu-Young
Published: March 2022

This thesis begins by acknowledging that there are more suffering and more discriminating people, as Zizek said, that the fear of Pandemic is more clearly revealing the widespread discrimination in our society. From this idea, I would like to answer the question of what the relationship with the other should be in this era. In particular, modern society seems to regard rationality as the only tool in solving social problems and establishing ethical relationships in the community. is rationality truly the one and only tool at our disposal to help us solve the problems of modern society? In response to this question, we focus on the ethics of caring as a means to solve the problem in a ‘different’ way. In particular, we will examine how the ethics of caring, which begins with Gilligan, shows a critical view of the existing rationality-oriented ethical attitude. We then outline how Noddings, who followed, laid the foundation for ethical education through this perspective. The ethics of caring plays a role in making care lead from natural care to ethical care, and making the ethics of caring no longer remain in the private domain of intimacy. The necessity of caring education is being discussed not only in the realm of ethics but also in the realm of politics. In addition to Noddings, it should be understood that Tronto and Engster want to establish a community as a more essential relationship by systematizing and theorizing caring education. Through this discussion, we will show that Noddings' ethics of caring can indeed be extended beyond a feminine perspective to that of an ethics of caring for others. Morevover, we will show that an ethics of caring implies a perspective that is actually centered on others in that the first caring begins by responding to the call of others, rather than caring for others from the standpoint of the subject based on identity.
A Case Study of Applying ‘Notion’ when Reading Classics of Great Literature
Authors: Oh Jinnyoung
Published: March 2022

The purpose of smart learning and self-directed learning is to make learners realize that they can cultivate the ability to process various types of informative knowledge and then create new knowledge in a singular fashion. This is also the purpose of learner-centered lesson design. This study aims to provide a case that will determine the effects of the ‘Notion’ application when used as a smart-learning tool and when applying question-based learning in a program which makes use of smart learning and self-directed learning. Namely, the Reading Classics of Great Literature course. ‘Notion’ application is a new tool that has not been dealt with in previous studies in the field of smart learning and learner-centered lesson design. The reason why I introduced ‘Notion’ into the course is because I consider it to be the best application to date for the implementation of learner-centered lesson design. In fact, ‘Notion’ has a more diverse user interface than other smart learning online applications. It helps learners to better understand problematic phenomena structurally and to solve problems creatively. This in turn allows them to go beyond simply memorizing or utilizing information. Furthermore, this study identifies the utility of ‘Notion’ through three cases of 1) the access of data 2) interaction 3) self-designing question-based learning, and then concentrates on the analysis of these use cases in regards to its to educational implications. This analysis is crucial to analyze the characteristics and components of the program on Reading Classics of Great Literature. Therefore, this case study will explore effective ways to implement smart learning and self-directed learning in the field General Education.
Students’ Perceptions of L1 Use in Online EFL Classes－A Case Study of Beginner-Level Korean College Students
Authors: Franzese John , Cho Youngsang
Published: March 2022

The purpose of this case study is to investigate Korean college students’ perceptions about the use of L1 in a general English class conducted entirely online amid the COVID-19 pandemic situation. More specifically, the current study aims to better understand the perceptions students held about the language choices made by the instructor, including the advantages and/or disadvantages of using L1, as well as their perceptions on how the use of L1 should be implemented in the online EFL class. The language choices engineered by the instructor for this class were designated into three forms; English and Korean pre-recorded video lectures, English-only Zoom classes, and Korean-only feedback via Zoom and email. The main source of data was a survey questionnaire consisting of multiple choice questions, the Likert-scale, and open-ended questions. A total of 69 mostly first-year college students taking the course during the fall semester of 2021 responded. Descriptive statistics were used to analyze responses to the multiple-choice questions and the Likert scale ratings. Responses to open-ended questions were analyzed using the content analysis method. Analysis of data showed that students hold a prevailingly positive view of L1 inclusion in the online English classroom for academic, managerial, and affective purposes. Students believed that the use of Korean was especially helpful for managerial and academic purposes, for it assisted them in developing a strong understanding of the content delivered and in following the flow of the online lectures. Students also showed a strong desire to include Korean for affective purposes, such as to help ease anxiety and to help them cope with low confidence due to their feelings of possessing inadequate language skills to clearly articulate themselves in English. In regard to the social benefits of L1, students also viewed this positively. However, views were not as high as shown in the other cases of the benefits they perceived, likely due to the complexity of online social interactions. To the question about what languages should be utilized as mediums of instruction in the online English class, the students commonly agreed that English should be the primary language, but that L1 should be allowed to be used to some extent. Their reasons for needing L1 particularly in the online English learning environment were also discussed, some of which were the lack of nonverbal cues to understand the instructor’s lectures and the absence of immediate help when faced with difficulties. The results of this study indicate that L1 certainly holds a positive role in the minds of beginner-level EFL students. The findings also suggest that inclusion of L1, when used prudently, can act as a valuable scaffolding tool to help beginner-level students achieve the goals of the class in an online setting.