bluuebunny/crossref_metadata_2025 huggingface dataset:
Avaliação do cumprimento de metas da atenção secundária em saúde bucal no estado de Sergipe
Authors: Santos Júnior Leônidas Marinho dos , Flório Flávia Martão , Zanin Luciane
Published: October 2020

O objetivo do estudo foi avaliar o cumprimento das metas de atenção secundária e o desempenho dos Centros de Especialidades Odontológicas do estado de Sergipe. Este é um estudo quantitativo e exploratório, em que foram coletados dados secundários da produtividade do ano 2015 dos 11 CEO e, calculou-se o cumprimento da atenção secundária e obteve-se o desempenho. Os achados foram associados com: tipo do Centro de especialidade odontológica, tempo de credenciamento, porte populacional, Índice deDesenvolvimento Humano Municipal, cobertura populacional de Equipe Saúde bucal na Estratégia de Saúde da Família, tipo de gestão. Foi realizada análise por meio de distribuição de frequências absolutas e relativas e do teste Exato de Fisher. Observou-se o cumprimento das metas da atenção básica em 81,9% e do subgrupo de especialidade em 54,5% na Periodontia e 45,5% na Cirurgia. Nenhum município cumpriu a meta na Endodontia. Os resultados sugerem a necessidade de reorganizar as práticas e qualificar as ações de monitoramento dos serviços em saúde bucal, com vistas à ampliação da oferta de serviço especializado.
Gestação em tempos de COVID-19: como garantir a segurança e preservar os avanços conquistados?
Authors: Freitas Efigenia Aparecida Maciel de , Souza Silvana Regina Rossi Kissula
Published: October 2020

.
Sistemas de activación y de inhibición de conducta y su relación con el funcionamiento ejecutivo en excombatientes irregulares del conflicto armado colombiano
Authors: Montoya Arenas David Andrés , Pareja Ángela María , Valencia Ana María , Díaz Soto Cecilia María , Trujillo Orrego Natalia , Pineda Salazar David Antonio
Published: October 2020

Objetivo: Explorar la relación entre los sistemas de activación de conducta (SAC) / sistema de inhibición de conducta (SIC) y funciones ejecutivas (FE) en excombatientes del conflicto armado colombiano. Metodología: Estudio observacional, exploratorio, con muestra no aleatoria de 39 excombatientes del programa de la Alta Consejería de la Presidencia para la Reintegración, residentes en Antioquia-Colombia, edad 35±7.6 años, 87.2% hombres, y escolaridad 10±2.8 grados; comparados con un grupo control de 14 no combatientes (edad 33±6.1 años, 71.4% hombres y escolaridad 10±2.7 grados). Se les administró un cuestionario de SAC/SIC, usando la sensibilidad a la recompensa (SR) y la sensibilidad al castigo (SC). Para la FE se aplicó la prueba Ineco Frontal Screening (IFS). Resultados: Hubo alteraciones específicas de la FE: en la ejecución de instrucciones conflictivas (IC), memoria de trabajo verbal (MTV) y control inhibitorio verbal (CIV). Se evidenciaron correlaciones directas, con coeficientes de moderados a altos entre el SAC (SR) y la capacidad de abstracción CA, el control motor inhibitorio (CMI), la MTV, la memoria de trabajo espacial (MTE) y el funcionamiento ejecutivo global (IFSTOT). Conclusiones: Los excombatientes presentaron un rendimiento inferior en la memoria de trabajo verbal y el control inhibitorio verbal, lo que impacta las capacidades de anticipación, establecimiento de metas, diseño de planes, iniciación de conductas voluntarias y el control inhibitorio. Lo anterior puede generar la toma de decisiones equivocadas.
Caracterización del módulo salud del sistema 123: atención de accidentes de tránsito en la ciudad de Medellín
Authors: Zuluaga Ramírez Cindy , Cortés Ballesteros Ana , Medina Rivera Sebastián , Duque Pérez Juan , Upegui Estrada Santiago , Ochoa Franco Mateo , Cohen Cajiao Jorge , Abreo Leal Diego
Published: October 2020

Objetivo: Caracterizar la atención de accidentes de tránsito en la ciudad de Medellín para obtener una imagen general de la situación de salud en este contexto. Metodología: Estudio descriptivo observacional, con intención analítica, de fuentes secundarias de información, en pacientes con edad mayor o igual a 16 años, atendidos por el personal 123, módulo salud, víctimas de accidentes de tránsito en Medellín. Resultados: Un total de 3 829 individuos sufrieron accidente de tránsito entre octubre y diciembre del 2018 según los criterios del estudio. De estos, el 63.1% de sexo masculino, con edad media de 34 años. La zona con mayor demanda de atención prehospitalaria fue la comuna 10 de la ciudad (La Candelaria) y la mayoría de los afectados por los accidentes lo fueron en calidad de conductor, 64%, y en un 75% de los casos, el vehículo involucrado fue una motocicleta. Solo el 26.5% de los pacientes fueron dados de alta en la escena. Las extremidades fueron las zonas corporales de mayor compromiso, en un 78.2% de los episodios, seguidas por el cráneo y la cara, con un 26.8%. Conclusiones: Es evidente la necesidad de la ciudad de implementar y evaluar el impacto de estrategias dinámicas que permitan un manejo eficiente de los recursos, que priorice las zonas y grupos demográficos de mayor riesgo y la articulación de la disposición de pacientes dentro de la cadena de atención, según los tipos más frecuentes de lesiones.
A Case of Petrous Apex Meningocele: Unusual Presentation of Cerebrospinal Fluid Leak Following Adenoidectomy
Authors: Kim Byung Kil , Heo Yujin , Kong Doo-Sik , Hong Sang Duk
Published: October 2020

Cerebrospinal fluid (CSF) leak is possible and can be a cause of recurrent bacterial meningitis. Petrous apex meningocele (PAM) is mostly asymptomatic and is often found during incidental imaging tests. We experienced a case of CSF rhinorrhea with recurrent meningitis in bilateral PAM after adenoidectomy. This report highlights the diagnostic process of CSF leak, identification of leakage site, and surgical approach to petrous apex lesions.
El bosque más allá del capitalismo: un contraste entre sistemas de conocimiento
Authors: González Piñeros Nidia Catherine , Kröger Markus
Published: October 2020

This article compares two knowledge systems: the one of indigenous communities living in the forests, and the one of forest government. We address this issue based on an approach that aims to go beyond the limits of the subjects and objects proper to the classical forest research. This is a critical reflection structured in three parts. After the Introduction and Methodology sections, the power asymmetries between the two knowledge systems are shown. Next, an analysis of the official definitions of forest is done; the ones most frequently used in the scenario of forest government are compared to those coming from the indigenous knowledge system. Finally, this article shows that the reductionism due to rationality in the forest policies during the last century results from a lack of opening to millenary conceptions used by the forest communities. A plural governance requires a dialog focused on rescuing the political impact of the local practices and how they can be the first steps to find alternatives, which will show how the forest management is not only related to reduce emissions but is also closely related to the food safety, agroforestry, and biodiversity protection
Application of electric power accumulators in traction power supply system in order to increase capacity on «bottleneck» sections
Authors:   Omsk State Transport University (OSTU), Nezevak Vladislav Leonidovich , Samolinov Svyatoslav Sergeevich ,   Omsk State Transport University (OSTU)
Published: October 2020

The paper considers issues of increasing capacity on «bottleneck» sections of direct current railways by means of application of electric power accumulators. Selection of electric power accumulators location is carried out with the consideration for grading of track on a section, specific recuperation, dominance of traffic type, rate of electric rolling stops, mode of feeding of intersubstational zones. When determining power consumption and capacity of electric power accumulators a depth of discharge that affects a service life and a state of charge graph that depends on a selected characteristic of charging rate are considered. The procedure of assessing the influence of electric power accumulator operation on capacity is considered on the example of one of the railway sections.
On fastening of freight in cars at action of transverse forces
Authors:   Ural state university of railway transport (USURT), Turanov Khabibulla Turanovich , Ruzmetov Yadgor Ozodovich ,   Tashkent Railway Engineering Institute (TashREI), Molchanova Oksana Viktorovna ,   Ural state university of railway transport (USURT), Shikhnazarov Zhamol Alisherovich ,   Tashkent Railway Engineering Institute (TashREI)
Published: October 2020

On the basis of the research it is proved that the calculations according the existing method don’t provide the strength of freight strapping at action of transverse forces. Firstly, the method doesn’t consider forces of the preliminary lay-up of strapping wires that increase the adhesion force of freight and car floor and, secondly, doesn’t take into consideration freight shifts that occur in transportation process. Forces in wire strapping at action of transverse forces depending on geometry of strapping have the same values, which doesn’t correspond to reality and is one of the main drawbacks of the existing method of calculating freight strapping.
A fuzzy AHP-TOPSIS approach for green logistics instruments ranking
Authors:   Nosov Magnitogorsk State Technical University (NMSTU), Osintsev Nikita Anatolyevich , Rakhmangulov Alexander Nelyevich ,   Nosov Magnitogorsk State Technical University (NMSTU), Sladkowski Alexander Valentinovich ,   Silesian University of Technology
Published: October 2020

The effective concept implementation of sustainable development in logistics and supply chain management is based on the use of management decision-making methods for changing the parameters of logistics flows using the green logistics instruments. Decisions should be made based on the measurement and evaluation of the indicators of these flows. The complexity of managing green supply chains is associated with insufficient knowledge of the system of logistics flows indicators and parameters, as well as methods and instruments for influencing these indicators. In the paper the use of the fuzzy AHP-TOPSIS method for evaluating the performance of logistics flows in green supply chains is considered, as well as ranking of green logistics instruments, taking into account the degree of influence on logistics flows indicators. The work presents a calculation implementation example in the logistics flow control system of the procedure for ranking green logistic instruments.
Determination of basic specific train tractive resistance at analysis of power consumption of electric locomotives
Authors:   Omsk State Transport University (OSTU), Sidorova Elena Anatolyevna , Podgornaya Svetlana Olegovna ,   Omsk State Transport University (OSTU)
Published: October 2020

The paper presents recommendations on determination of basic specific train tractive resistance at analysis of power consumption on traction of trains that plays an important role in the increase of accuracy of standardization and prediction of power consumption with the consideration for assumptions that significantly simplify the necessary calculations.
Application of numerical modelling for assessing electric and thermal operation modes of direct current catenary elements
Authors:   Ural state university of railway transport (USURT), Batrashov Andrey Borisovich , Gushhina Natalya Vladimirovna ,   Ural state university of railway transport (USURT)
Published: October 2020

The paper proposes a method for assessing electric and thermal operation modes of direct current catenary elements that allows determining electric and thermal loads in operation conditions. The main principle is the determination of the most loaded section in the intersubstational zone and calculation of electric and thermal characteristics in conditions of real train schedule. The method is assumed to be used at digitalization of railways as a digital copy of direct current catenary.
Factor analysis of operation of catenary feeders’ distance protection in conditions of heavy-load trains operation
Authors:   Trans-Baikal Institute of Railway Transport (ZabIZhT), Filippov Sergey Anatolyevich , Trifonov Ruslan Sergeevich ,   Trans-Baikal Institute of Railway Transport (ZabIZhT), Solovyeva Oksana Alexandrovna ,   Trans-Baikal Institute of Railway Transport (ZabIZhT)
Published: October 2020

The paper considers a connection of factors that affect the operation of distance protection of catenary feeders. The paper also presents an assessment of this effect on operation quality and selectivity of protection in conditions of operation of heavy-load trains with the weight up to 12,000 tons on example of measurements carried out on the Zabaikal Railway.
Counterparts in life cycle of linear enterprises
Authors:   Ural state university of railway transport (USURT), Akkerman Gennadiy Lvovich , Akkerman Sergey Gennadyevich ,   Ural state university of railway transport (USURT)
Published: October 2020

The paper considers a model of interaction between linear enterprises and counterparts. If a counterpart executes works in summer or winter period, it’s «orbit» may be represented in the form of ellipse or, depending on considered conditions, in the form of one of the half-hyperbola. Distance between the employer and the counterpart in this case characterize their mutual interest. If there are several counterparts, the model allows ranking them from the point of view not only business, but also personal interest of the customer.
Construct and energy reserves improvement of exploitative properties rail friction brake
Authors:   Donetsk Railway Transport Institute (DRTI), Krivosheya Yuriy Vladimirovich , Ripol-Saragosi Tatyana Leonidovna ,   Rostov State Transport University (RSTU)
Published: October 2020

The paper gives an assessment of the design and energy reserves for improving the operational properties of the railway friction brake under the existing mass-dimensional restrictions and the growth of braking energy. The criterion for assessing the operational properties of the friction brake is the friction coefficient and contact energy load. The results of experimental studies of the relationship between the frictional characteristics of the disc brake and the affecting structural and loadspeed factors are presented. Design options for railway friction brakes are proposed that provide improved performance. A comparative analytical assessment of the contact energy load of new friction brake and classic disc brake options has been performed.
Calculation of the speed of movement on the side track for flat grades of switches
Authors:   Russian University of Transport (RUT-MIIT), Loktev Alexey Alexeevich , Korolev Vadim Vadimovich ,   Russian University of Transport (RUT-MIIT), Shishkina Irina Viktorovna ,   Russian University of Transport (RUT-MIIT), Berezovskiy Mikhail Evgenyevich ,   Russian University of Transport (RUT-MIIT)
Published: October 2020

There is a need to speed up the design and implementation of switches on the operated railway network, which can significantly increase the allowed speed of trains, especially on the side track. One of the starting points in the design of switches for high speeds is to provide passengers with a comfortable ride when the train is moving on a side track by limiting the values of the so-called centrifugal acceleration and the increment (change) of the centrifugal acceleration per unit of time (second). If it is necessary to implement the speed of movement on the switch to the side track over 50 km/h, the main factor in determining the radius of the transfer curve under the conditions of driving comfort is to limit the amount of increment (change) of the centrifugal acceleration per unit of time (second). Based on this, when designing switches for high speeds, it is advisable to use curves of variable radius as a translation curve.
Modeling of direct current traction power system with the consideration for earth conductivity
Authors:   Ural state university of railway transport (USURT), Lesnikov Dmitriy Valentinovich
Published: October 2020

Nowadays, one of the main tasks facing the JSC Russian Railways is the increase of volumes of freight transportation. The solution of this task is directly connected with the increase of the load on traction power system devices and their strengthening, which is primarily related to railways electrified with direct current that are characterized by high traction currents. In order to assess the possibility to strengthen a railway section and reveal «bottlenecks» in traction power supply system it is necessary to create a mathematical model of traction power system that must consider parameters of a specific section including earth conductivity that affects the values of skin resistance, potential of railway network and stray currents. The paper proposes a mathematical model of direct current traction power system that represents a combination of a catenary model and a model of railway network. The model considers parameters of traction substations, connection scheme of catenary suspensions and possible influence of rails from adjacent tracks on each other.
NÍVEL DE DESEMPENHO MOTOR E SUA RELAÇÃO COM APTIDÃO FÍSICA, ESTADO NUTRICIONAL E ESTADO MATURACIONAL DE ADOLESCENTES
Authors: da Silva Coêlho Mendonça Eliana
Published: October 2020

Esta pesquisa foi caracterizada como descritiva quantitativa de corte transversal. Durante o processo de desenvolvimento motor ocorre uma série de mudanças físicas e mecânicas, onde os fatores do crescimento físico, da maturação, do desenvolvimento da aptidão física, da atividade física, da idade e da experiência estão inter-relacionados. Objetivo geral deste estudo foi estudar os diferentes efeitos da aptidão física, estado nutricional e estado maturacional sobre o desempenho motor de adolescentes de 13 a 16 anos no município de Itaituba/Pará. Metodologia desenvolvida foi com o n=amostral de102 alunos de ambos os gêneros com idade entre 13 a 16 anos da cidade de Itaituba/PA. Todos os responsáveis assinaram o TCLE e liberados pelo médico para os testes, os instrumentos utilizados foram MABC-2,caminhada/corrida de 6 e 9, protocolo de T.G Lohman, Banco de Wells, Arremesso de Medicinibol, Sargent Jump Test, Teste de Impulsão Horizontal, Balança Antropométrica e o PVC. A estatística utilizada foi descritiva e inferencial através do programa SPSS que avaliou a relação e ou associação dos resultados. Resultados para o Estado Nutricional, na avaliação geral da amostra, 78,4% foram classificadas dentro da normalidade. Quando comparada entre gêneros, os meninos apresentaram o índice de 85,4% e as meninas 72,2% dentro da normalidade. Para a variável Aptidão Física, apenas os valores dos testes de Arremesso de Medicinibol, Impulsão Horizontal e Flexibilidade, apresentaram índices acima da média. Quando comparados entre gêneros, os meninos não superaram as meninas no teste de abdominal, impulsão horizontal e percentual de gordura. Na análise do estado maturacional, realizado através do teste de Pico de Velocidade de Crescimento, as meninas alcançaram este estado por volta dos 12,9 anos de idade, enquanto os meninos aos 14,6 anos. Na análise do desempenho motor, apenas 38,9% das meninas encontram-se na zona verde, apresentando 40,7% com indicativo de TDC, nos meninos, 50% estão na zona verde e apenas 18,8% apresentam indicativo de TDC. Na associação do desempenho motor entre a idade, a aptidão física, o estado nutricional e o estado maturacional, os resultados apontam significância apenas para a associação entre o desempenho motor e um item da aptidão física, a flexibilidade. Concluímos que o processo de aquisição das habilidades motoras emerge em função das influências ambientais e socioeconômicas, claro, sem esquecer, principalmente, da interação entre o genótipo e fenótipo sobre o desempenho motor. Hoje em dia observamos um declínio enorme de oferecimento de oportunidades motoras para crianças e adolescentes, gerando menores estímulos e com isso, poucas experiências motoras.
Productivity of winter maize as affected by varieties and fertilizer levels
Authors: Adhikary Bishnu Hari , Baral Bandhu Raj , Shrestha Jiban
Published: October 2020

Grain yield production of maize is greatly affected by varieties and fertilizer levels. This study was conducted to determine the effects of different rates of fertilizers (nitrogen, phosphorus, potassium fertilizers and farmyard manures) on grain yield and yield attributing traits of different maize varieties during winter seasons of 2009/10 and 2010/011 at the research farm of National Maize Research Program, Rampur, Chitwan, Nepal. Six levels of fertilizers [Control (Zero fertilizer), FYM @ 10 t/ha, FYM@ 10 t/ha plus 60:30 20 kg NPK/ha, FYM@ 10 t/ha plus 120: 60: 40 kg NPK/ha, FYM@ 10 t/ha plus 180: 90: 60 kg NPK/ha, and 120: 60: 40 kg NPK/ha] and four maize varieties (Rampur Composite, Manakamana-4, Across9942 × Across 9944 and S99TLYQ-B) were evaluated in randomized complete block design with three replications. The results showed that grain yield was non-significant for maize genotypes but the fertilizers levels were highly significant for grain yield. Rampur Composite produced the highest grain yield (5195 kg/ha), followed by Manakamana-4 (5074 kg/ha), Across9942 × Across9944 (5052 kg/ha) and S99TLYQ-B (4789 kg/ha) with the application of NPK 180: 90: 60 kg/ha plus FYM 10 t/ha. This information is useful in generating suitable fertilization packages for obtaining higher grain yield of maize varieties.
The Effects of Osteoarthritis on Quality of Life (QoL)
Authors:   Department of Pharmacy, Ziauddin College of Pharmacy, Karachi, Pakistan., Ali Qaim , Aftab Maheen ,   Department of Pharmacy, Ziauddin College of Pharmacy, Karachi, Pakistan., Arshad Sara ,   Department of Pharmacy, Ziauddin College of Pharmacy, Karachi, Pakistan.
Published: October 2020

Abstract: Objective: Functionality and quality of life in patients with osteoarthritis undergoing total arthroplasty of the knee. Materials and Methods: This study was conducted in Ziauddin hospital, Karachi from April 2018 until August 2018, making up 40 individuals who have osteoarthrosis of the knee with an indication for total arthroplasty and not being carriers of any other disease affecting the limbs lower. Two scales of evaluation were applied at two different times: pre and postoperative. Health status questionnaire (SF-36) and Knee injury and osteoarthritis outcome score (KOOS) was applied and answered in the preoperative period (on the day of surgery) and the sixth postoperative week. Results: Regarding the dimensions of activities of daily living and activities, sporting and leisure activities were not statistically significant. Our results go against the conclusions reported by Culliton [1], in a study of 13 patients submitted to TKA. The participants were evaluated before the arthroplasty and four weeks later and the results showed that there was a tendency for pain to decrease in that period. Conclusion: It can be concluded that there was a tendency to decrease pain in this period accompanied by an improvement in the quality of life. Taking into account the results obtained, and stressing the concept that quality of life is related to the state of health of the person and that pain and functional limitation caused by OA negatively influence the well-being and the performance of the activities of the person's daily life, it can be concluded that the TCA contributes to the improvement of the performance of the person. Keywords: Osteoarthritis, Joint, Arthroplasty, Articular cartilage, Osteoarthrosis, Knee injury, QoL.
Infective Endocarditis: A Growing Concern and Treatment Approaches: An Observational Study
Authors:   Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan., Butt Muhammad Daoud , Nawaz Muhammad Sarfraz ,   Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan., Ramazan Basit ,   School of Pharmaceutical Sciences, University Sains Malaysia, Malaysia, Malik Tooba ,   Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan., Sulehri Sidra ,   Department of Pharmacy, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
Published: October 2020

Abstract: Objective: To determine the frequency of prevailing microorganism, treatment approach, different treatment complexities and rationalize the approach for treating Infective Endocarditis (IE) patient. Material and Methods: The retrospective study was conducted from 01st January 2015 to 31st October 2019. Data was collected and after applying exclusion criterion 40 patients were selected and their available record was evaluated. To obtain the conclusive results, frequency and percentages were calculated. Results: The mean age of patient in studied group was 34.02 years with standard deviation (S.D) 13.02 years, and 65% of patients included were male and 35% were female. Staphylococcus aureus (S.aureus) was the prevalent microorganism found in most cases i.e; 60%. Mitral valve was mostly affected; Rheumatic heart disease was the leading factor of IE in patients. Most of the patients complained of shortness of breath and high-grade fever. Benzylpenicillin and aminoglycosides were most commonly prescribed for patients. The medication health care cost was on the higher side at about 1038 PKR/day considering all healthcare facilities provided free by the government. Conclusion: In most of the younger population active infective endocarditis remains the most prevalent disease. Rheumatic heart disease remains to be the most common underlying factor for heart disease. Overall treatment cost of therapy was found to be high due to vigorous antibiotic therapy. Keywords: Infective endocarditis, Microorganism, Rheumatic heart disease, Medication treatment, Vegetation, Staphylococcus aureus
Acute Leukemia of Ambiguous Lineage with a Rare Abnormality Del17p by FISH Analysis
Authors:   Department of Clinical Hematology, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan, Abbas Naeem , Waheed Samra ,   Department of Hematology, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan, Jamal Aisha ,   Department of Clinical Hematology, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan, Saleem Ali ,   Department of Clinical Hematology, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan, Shamsi Tahir Sultan ,   Department of Clinical Hematology, National Institute of Blood Disease & Bone Marrow Transplantation, Karachi, Pakistan
Published: October 2020

Abstract: The World Health Organization (WHO) has categorized acute undifferentiated leukemia (AUL) as a rare subtype of acute leukemia of ambiguous lineage (ALAL). The prognosis of AUL is considered poor and it expresses no known lineage-specific markers. In majority of the cases, AUL has been associated with karyotypic abnormalities, most commonly deletion 5q and complex karyotype. Deletion 17p correlation with acute myeloid leukemia and myelodysplastic syndome has been previously established and is associated with poorer outcomes. Herein we are reporting a case of forty years old male who was referred to National institute of blood diseases and bone marrow transplantation with complains of fever, multiple neck swellings, and early satiety and was diagnosed as Acute Undifferentiated Leukemia along with deletion 17p. This is a rare entity and can aid in further diagnostic and therapeutic approaches. Keywords: Acute undifferentiated leukemia, Deletion 17p, Flourescnece in situ hybridization, Allogeneic haematopoetic stem cell transplantation, Flow cytometry.
Rare Transformation of Chronic Myeloid Leukemia into Acute Lymphoblastic Leukemia in a 14-Year Old Patient
Authors:   Department of Pathology, Pakistan Institute of Medical Science (PIMS), Islamabad, Pakistan, Tariq Javera , Ali Sundas ,   Department of Pathology, Pakistan Institute of Medical Science (PIMS), Islamabad, Pakistan, Jiskani Shahzad Ali ,   Department of Pathology, Pakistan Institute of Medical Science (PIMS), Islamabad, Pakistan, Asghar Rabiah ,   Department of Pathology, Pakistan Institute of Medical Science (PIMS), Islamabad, Pakistan
Published: October 2020

Abstract: Chronic myeloid leukemia is a myeloproliferative neoplasm. It is a common disease of elderly, rarely affecting pediatric, adolescent or young adults. The median age of presentation is 65 years. The incidence is 1‐2 cases per 100,000 adults. Tyrosine kinase inhibitors (TKIs) are highly successful and have good remission rates in the CML treatment; though multiple factors are associated with failure of treatment. We present a patient of 14 years old male who was diagnosed as CML. He was seven months into TKI therapy, transformed into B-Lineage acute lymphoblastic leukemia. Keywords: Chronic myeloid leukemia, Rare, Acute lymphoblastic leukemia, Pediatric, Transformation.
Experimental Investigation of Polymer-Induced Fouling of Heater Tubes in the First-Ever Polymer Flood Pilot on Alaska North Slope
Authors: Dhaliwal Anshul , Zhang Yin , Dandekar Abhijit , Ning Samson , Barnes John , Edwards Reid , Schulpen Walbert , Cercone David , Ciferno Jared
Published: October 2020

Polymer flooding is being pilot tested for the first time in the Schrader Bluff viscous oil reservoir at the Milne Point Field on Alaska North Slope (ANS). One of the major concerns of the operator is the impact of polymer on the oil production system after polymer breakthrough, especially the polymer-induced fouling issues in the heat exchanger. This study investigates the propensity of polymer fouling on the heater tubes as a function of different variables, with the ultimate goal of determining safe and efficient operating conditions. A unique experimental setup was designed and developed in-house to simulate the fouling process on the heating tube. The influence of heating tube skin temperature, tube material, and polymer concentration on fouling tendency was investigated. Each test was run five times with the same tube, and in each run, the freshly prepared synthetic brine and polymer solution was heated from 77°F to 122°F to mimic field-operating conditions. The heating time and fouling amount were recorded for each run. Cloud point measurement has also been conducted to find the critical temperature at which the polymer in solution becomes unstable and precipitates out. The morphology and composition of the deposit samples were analyzed by environmental scanning electron microscopy (ESEM) and X-ray diffraction (XRD), respectively. It was found that the presence of polymer in produced fluids would aggravate the fouling issues on both carbon steel and stainless steel surfaces at all tested skin temperatures. Only higher skin temperatures of 250°F and 350°F could cause polymer-induced fouling issues on the copper tube surface, and the fouling tendency increased with polymer concentration. At the lower skin temperatures of 165°F, no polymer-induced fouling was identified on the copper tube. A critical temperature that is related to the cloud point of the polymer solution was believed to exist, below which polymer-induced fouling would not occur and only mineral scale was deposited but above which the polymer would aggravate the fouling issue. The cloud point of the tested polymer solution was determined to be between 220°F and 230°F. From a practical safer design standpoint, we recommend a value of 220°F for operational purposes on the pilot site. The heating efficiency of the tube would be decreased gradually as more fouling material accumulates on its surface. If polymer precipitated and deposited on the surface, it would bond to the mineral crystals to form a robust three-dimensional network structure, resulting in a rigid polymer-induced fouling. The study results have provided practical guidance to the field operator for the ongoing polymer flooding pilot test on ANS.
Large Perforating Gun System Deployed Using Electric Line: Single 41 m Run of 7 in., 12 spf Deep Penetration Charge
Authors: Sedlacek Ariel , Acosta Jaider , Fernandez Ricardo , DA SILVA Gilmar Ribeiro , DA SILVA André Luís
Published: October 2020

In the ultradeepwater oil and gas market, operators demand reliability and efficiency in all technical disciplines involved during the entire life cycle from exploration through decommissioning stages. In the perforating segment, specifically, recent technological advancements have allowed service companies to increase electric line (e-line) and tubing-conveyed perforating (TCP) gun footage to save rig time. E-line perforating capacity for 7-in. guns has increased from 15 to 41 m/run (49 to 135 ft/run), while the 4 ⅝-in. gun capacity has increased from 20 to 50 m/run (66 to 165 ft/run). This paper discusses how such advancements led to new benchmarks for perforating footage during deployment of a large gun system in Brazilian presalt, changing the perforation technique, and ultimately reducing operational expenses.

During perforating, excessive shock loads are applied on the weak point (WP), so the challenge was to develop a perforating system that could increase the effective perforating footage using 7-in. and 4 ⅝-in. guns without damaging the e-line or dropping the guns because of a pull off. A specially designed WP for high dynamic loading, together with a new 2 ¾-in. outer diameter (OD) cable head was developed. Various software simulations were run to analyze the shock-loading effects on the cable and WP during run in hole (RIH), gun detonation, and pulling out of the hole (POOH).

This paper presents seven field case studies in which this new technology was applied. High-speed memory recordings of pressure and radial/axial accelerations were used to acquire actual downhole data during the perforating event to compare with simulation results and calibrate the models. The WPs were analyzed to validate the overall response of the new perforating system. The actual surface tension and downhole data, such as pressure and acceleration, matched the simulation results.

During the seven field case studies, the new perforating system using e-line deployment helped improve rig-time efficiency, saving more than 130 rig hours compared to performing the operation using the traditional TCP service, representing more than USD 2 million overall savings.

The capability of running long sections of large guns is a significant achievement for wireline-deployed perforating services. During the Brazil operation, the increased efficiency resulted in a reduction of 16 hours of completion phase, which equates to a savings of hundreds of thousands of dollars when compared with TCP operations.
Design and Evaluation of Multifunctional Foaming Agents for Production Enhancement in Oil Wells
Authors: Parra José Ernesto , Soto-Castruita Enrique , Cerón-Camacho Ricardo , Cisneros-Dévora Rodolfo , Pérez-Álvarez Marissa , Servín-Nájera Ana Graciela , Zamudio-Rivera Luis Silvestre , Martínez-Magadan José Manuel , Oviedo-Roa Raúl
Published: October 2020

We developed and investigated the effectiveness of new multifunctional foaming agents (MFAs) for production enhancement in oil wells with gas lift or high gas-oil ratio, high water cuts (>30%), and very high conditions of temperature (180°C), hardness (180,000 ppm), and salinity (400,000 ppm TDS). The efficiency of the MFAs was tested using two laboratory methods, which are conducted at close to wellhead and downhole conditions of temperature and pressure, respectively. These methods were used to optimize the development of the MFAs and their field application design.
Anti-inflammatory effect of the specific carbohydrate diet in children with juvenile idiopathic arthritis
Authors: Berntson Lillemor
Published: October 2020

Background Diet has an effect on the intestinal immune system, which may have consequences for inflammatory diseases. Specific carbohydrate diet (SCD) is an effective anti-inflammatory treatment for inflammatory bowel disease in children. We explored the anti-inflammatory effect of SCD in children with juvenile idiopathic arthritis (JIA). Methods Twenty-two patients with JIA (age 6.3–17.3 years), with stable, low-to-medium disease activity, were included in the study. Seven children dropped out within two weeks from the start of SCD, and fifteen patients, who completed four to five weeks of SCD, were evaluated in the final analyses. A dietician introduced parents and children to SCD with written and verbal instructions, and regular follow-ups were performed during the intervention period. Patients were studied with clinical and laboratory examinations before, during and after the intervention. In addition to conventional JIA laboratory tests, analyses were performed of short chain fatty acids in faecal samples at inclusion and after two and four weeks of SCD. Results SCD significantly decreased morning stiffness (p = 0.003) and pain (p = 0.048), and improved physical function assessed through the child health assessment questionnaire (p = 0.022). Arthritis improved in five of the seven children with arthritis at inclusion. Faecal butyrate increased significantly (p = 0.020). Conclusions SCD has significant positive effect on arthritis activity, morning stiffness, pain and physical function in children with JIA. Our results suggest that change in bacterial activity of the intestinal canal by dietary intervention may provide an effective and feasible complementary treatment for JIA.
Effect of a High Value Care Curriculum on Standardized Patient Exam in the Core Clerkship in Internal Medicine
Authors: Pahwa Amit K , Eaton Kevin , Apfel Ariella , Bertram Amanda , Ridell Rebecca , Cayea Danelle
Published: October 2020

Background: With almost 20% unnecessary spending on healthcare, there has been increasing interest in high value care defined as the best care for the patient, with the optimal result for the circumstances, delivered at the right price. The American Association of Medical Colleges recommend that medical students are proficient in concepts of cost-effective clinical practice by graduation, thus leading to curricula on high value care. However little is published on the effectiveness of these curricula on medical students’ ability to practice high value care.Methods: In addition to the standard curriculum, the intervention group received two classroom sessions and three virtual patients focused on the concepts of high value care. The primary outcome was number of tests and charges for tests on standardized patients.Results: 136 students enrolled in the Core Clerkship in Internal Medicine and 70 completed the high value care curriculum. There were no significant differences in ordering of appropriate tests (3.1 vs. 3.2 tests/students, p = 0.55) and inappropriate tests (1.8 vs. 2.2, p = 0.13) between the intervention and control. Students in the intervention group had significantly lower median Medicare charges ($287.59 vs. $500.86, p = 0.04) and felt their education in high value care was appropriate (81% vs. 56%, p = 0.02).Conclusions: This is the first study to describe the impact of a high value care curriculum on medical students’ ordering practices. While number of inappropriate tests was not significantly different, students in the intervention group refrained from ordering expensive tests.
Potential of resveratrol in enrichment of neural progenitor-like cells induction of human stem cells from apical papilla
Authors: Songsaad Anupong , Gonmanee Thanasup , Ruangsawasdi Nisarat , Phruksaniyom Chareerut , Thonabulsombat Charoensri
Published: October 2020

Introduction: Stem cell transplantation of exogenous neural progenitor cells (NPCs) derived from mesenchymal stem cells (MSCs) has emerged as a promising approach of neurodegenerative disease. Human stem cells from apical papilla (hSCAPs) are derived from migratory neural crest stem cells, and exhibit a potential of neuronal differentiation. However, their neuronal differentiation is low and unpredictable. Resveratrol has been described as a sirtuin 1 (SIRT1) activator which plays an important role in enhancing neuronal differentiation. In this study, we investigate the potential of resveratrol as an enhancer on neuronal differentiation through NPCs induction of hSCAPs.Methods: Stem cells were isolated from human apical papilla, and characterized as MSCs. The cellular toxicity of resveratrol treatment to the characterized hSCAPs was investigated by MTT assay. The non-cellular toxicity concentrations of resveratrol were assessed with various pre-treatment times to select the optimal condition that highly expressed the neural progenitor gene, NES. Consequently, the optimal condition of resveratrol pre-treatment was synergistically performed with a neuronal induction medium to trigger neuronal differentiation. The differentiated cells were visualized, the genes profiling was quantified, and the percentage of neuronal differentiation was calculated. Moreover, the intracellular calcium oscillation was demonstrated. Results: The cellular toxicity of resveratrol was not observed for up to 50 µM for 12 hours. Interestingly, hSCAPs pre-treated with 10 µM resveratrol for 12 hours (RSV-hSCAPs) significantly expressed NES, which is determined as the optimal condition. Under neuronal induction, both of hSCAPs and RSV-hSCAPs were differentiated (d-hSCAPs, and RSV-d-hSCAPs) as they exhibited neuronal-like appearances with Nissl substance staining. The highest expression of NES, and SOX1 was observed in RSV-d-hSCAPs. Additionally, the percentage of neuronal differentiation of RSV-d-hSCAPs was significantly higher than d-hSCAPs for 4 times. Importantly, the neuronal-like cells exhibited slightly increasing pattern of calcium intensity.Conclusion: This study demonstrated that pre-treatment of resveratrol strongly induces neural progenitor marker gene expression which synergistically enhances neural progenitor-like cells’ induction with neuronal induction medium.
L2MXception: An Improved Xception Network for Classification of Peach diseases 
Authors: Yao Na , Ni Fuchuan , Wang Ziyan , Luo Jun , Sung Wing-Kin , Luo Chaoxi , Li Guoliang
Published: October 2020

Background: Peach diseases can cause severe yield reduction and decreased quality for peach production. Rapid and accurate detection and identification of peach diseases is of great importance. Deep learning has been applied to detect peach diseases using imaging data. However, peach disease image data is difficult to collect and samples are imbalance. The popular deep networks perform poor for this issue.Results: This paper proposed an improved Xception network named as L2MXception which ensembles regularization term of L2-norm and mean. With the peach disease image dataset collected, results on seven mainstream deep learning models were compared in details and an improved loss function was integrated with regularization term L2-norm and mean (L2M Loss). Experiments showed that the Xception model with L2M Loss outperformed the current best method for peach disease prediction. Compared to the original Xception model, the validation accuracy of L2MXception was up to 93.85%, increased by 28.48%. Conclusions: The proposed L2MXception network may have great potential in early identification of peach diseases.
Breast Cancer Distant Recurrence Lead Time Interval by Detection Method in an Institutional Cohort
Authors: Kaplan Henry G. , Malmgren Judith , Atwood Mary K.
Published: October 2020

Background: Lead time, the interval between screen detection and when a disease would have become clinically evident, has been cited to explain longer survival times in mammography detected breast cancer cases (BC). Methods: An institutional retrospective cohort study of BC outcomes related to detection method (mammography (MamD) vs. patient (PtD)). Cases were first primary invasive stage I-III BC, age 40-74 years (n = 6603), 1999-2016. Survival time was divided into 1) distant disease-free interval (DDFI) and 2) distant disease-specific survival (DDSS) as two separate time interval outcomes. We measured statistical association between detection method and diagnostic, treatment and outcome variables using bivariate comparisons, Cox proportional hazards analyses and mean comparisons. Outcomes were distant recurrence (n=422), DDFI and DDSS.Results: 39% of cases were PtD (n = 2566) and 61% were MamD (n = 4037). MamD cases had a higher percentage of Stage I tumors [MamD 69% stage I vs. PtD 31%, p<.001]. Rate of distant recurrence was 11% among PtD BC cases (n=289) vs. 3% of MamD (n=133) (p<.001). Order of factor entry into the distant recurrence time interval (DDFI) model was 1) TNM stage (p<.001), 2) HR/HER2 status (p<.001), 3) histologic grade (p=.005) and 4) detection method (p<.001). Unadjusted PtD DDFI mean time was 4.34 years and MamD 5.52 years (p<.001), however when stratified by stage, the most significant factor relative to distant recurrence, there was no significant difference between PtD and MamD BC. Distant disease specific survival time did not differ by detection method.Conclusion: We observed breast cancer distant disease-free interval to be primarily associated with stage at diagnosis and tumor characteristics with less contribution of detection method to the full model. Patient and mammography detected breast cancer mean lead time to distant recurrence differed significantly by detection method for all stages but not significantly within stage with no difference in time from distant recurrence to death. Lead time difference related to detection method appears to be present but may be less influential than other factors in distant disease-free and disease specific survival.
New mutation in PTEN identified in patient with rare bilateral choroidal ganglioneuroma
Authors: Jiang Zhaoxin , Zhang Ting , Chen Chonglin , Sun Limei , Li Songshan , Ding Xiaoyan
Published: October 2020

Background: Choroidal ganglioneuroma is an extremely rare tumor, with little known regarding its pathogenesis. The present study aimed to investigate the phenotype and genetic alterations in one sporadic patient with rare bilateral choroidal ganglioneuroma.Methods: A 6-year-old boy with histological diagnosis of bilateral ganglioneuroma was recruited in this study. Comprehensive ophthalmic examinations were performed in the patient. Genomic DNA was extracted from peripheral blood collected from the patient, the patient's unaffected family members, and from 200 unrelated control subjects from the same population. Whole exome sequencing was carried out and raw reads were aligned to the human genome reference (hg19) using the Burrows Wheeler Aligner. All available family members were subjected to Sanger sequencing for segregation analysis.Results: Bilateral and extensive retinal detachments were observed in OCT. The diffuse thickening of choroid was identified in B scan and MRI. Genetic analysis revealed the presence of a novel heterozygous PTEN frameshift mutation, c.498delA (p.Thr167LeufsTer16), in exon 6. It was identified in the affected individual, but not in any of the unaffected family members. Genetic analysis showed that there was no mutant in neurofibromatosis-related genes. There were no obvious abnormalities in other organs in comprehensive systemic examinations. Conclusions: A novel de novo PTEN mutation was identified in a bilateral choroidal ganglioneuroma case. Although PTEN mutation has been considered to induces multiple abnormalities, choroidal ganglioneuroma can be the first manifestation without abnormalities in other organs. Further studies are needed to confirm this new association between choroidal ganglioneuroma and the PTEN mutation.