bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers and Facilitators to Accessing Health Care Services among Married Women in Ethiopia: a Multi-level Analysis of the Ethiopia Demographic and Health Survey
Authors: Zegeye Betregiorgis , Adjei Nicholas Kofi , Ahinkorah Bright Opoku , Ameyaw Edward Kwabena , Budu Eugene , Seidu Abdul-Aziz , Idriss-Wheeler Dina , Yaya Sanni
Published: October 2021

Background and Objective: Access to health care services is a major challenge to women and children in many developing countries such as Ethiopia. In this study, we investigated the individual- and community-level factors associated with barriers to accessing health care services among married women in Ethiopia.
Methods: Data from the 2016 Ethiopia demographic and health survey on 9,824 married women of reproductive age (15-49 years) were analyzed. Multilevel logistic regression models were used to assess individual- and community-level factors associated with barriers to access health care services. Regression analysis results revealed adjusted odds ratios at 95% confidence intervals.
Results: Over two-thirds (71.8%) of married women in Ethiopia reported barriers to accessing health care services. Some of the individual-level factors that were associated with lower odds of reporting barriers to access health care services include: having secondary education (aOR=0.49, 95% CI: 0.32-0.77), being in the richest quintile (aOR=0.34, 95% CI: 0.22-0.54), and indicating wife-beating as unjustified (aOR=0.66, 95% CI:0.55-0.81). Among the community-level factors, high community-level literacy (aOR=0.56, 95% CI: 0.34-0.92) and moderate community socioeconomic status (aOR=0.62, 95% CI: 0.45-0.85) were significantly associated with lower odds of reporting barriers to access health care services.
Conclusion and Implications for Translation: The findings revealed high barriers to access health care services, and both individual- and community-level factors were significant contributing predictors. Therefore, it is important to consider multidimensional strategies and interventions to facilitate access to health care services in Ethiopia.
 
Copyright © Zegeye et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.
Racial/Ethnic Disparities in Temporal Trends of Myocardial Infarction Hospitalizations Among Pregnant Women in the United States: 2009-2018
Authors: Dongarwar Deepa , Garcia Brisa , Jacob Nisha , Salihu Hamisu
Published: October 2021

There has been an increase in the incidence of Myocardial Infarction (MI) among pregnant women in the United States. There have been no studies examining the trends in the rates of gestational MI hospitalizations by race/ethnicity;and therefore, we undertook this study. No prior studies have examined the trends in the rates of gestational MI hospitalizations by race and ethnicity. In this study, we examined temporal trends of MI-related hospitalizations among pregnant women using the Nationwide Inpatient Sample (NIS) dataset from 2009 to 2018. We performed joinpoint regression analyses to assess trends in the rates of MI by race/ethnicity during the study period. Overall, there was an increase in the rates of MI among pregnant women during the study period (from 9.7 per 100,000 hospitalizations in 2009 to 18.1 per 100,000 hospitalizations in 2018) with an average annual percentage change (AAPC) of 7.2, (95% Confidence Interval (CI)=[4.0, 10.5]. The overall rate of MI was highest in non-Hispanic (NH)-Blacks and the greatest increments in rates of MI-related hospitalizations were noted in NH-Blacks during 2013-2018, and in Hispanics during the entire study period (2009-2018). NH-Blacks and Hispanics bear a disproportionately high burden of MI among pregnant women in the US. More worrisome is the first-ever reported finding in this study of a widening Black-White disparity in MI-related hospitalizations over the past decade.
 
Copyright © Dongarwar et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.
Experimental Investigation of Trapped Oil Mobilization with Ferrofluid
Authors: Wang Ningyu , Liu Yifei , Cha Luming , Balhoff Matthew T. , Prodanovic Maša
Published: October 2021

Nanoparticles have great potential to mobilize trapped oil in reservoirs because of their chemical, thermal, and interfacial properties. However, the direct application of magnetic forces on superparamagnetic nanoparticles in reservoir engineering applications has not been extensively investigated. We demonstrate the enhanced oil recovery (EOR) potential of hydrophilic superparamagnetic nanoparticles in oil production by direct observation using microfluidics. We studied the mobilization of oil blobs by a ferrofluid (a suspension of hydrophilic superparamagnetic nanoparticles in water) both in a converging/diverging micromodel channel and in a foot-long pore network micromodel, both with varying depth (so-called 2.5D micromodels). The water-based ferrofluid in all cases was the wetting fluid.

Initial ferrofluid flooding experiments in single channels were performed without and then with a static magnetic field. This magnetic field caused oil droplet deformation, dynamic breakup into smaller droplets, and subsequent residual oil saturation reduction. During the flooding, after the magnetic field was applied, significant oil displacement was observed within 2 hours [6 pore volumes injected (PVI)], and 86.2% of the oil that was not mobilized without a magnetic field was mobilized within 64 hours (192 PVI). Then, in experiments in the micromodel and in a Hele-Shaw cell without flooding, we observed self-assembly of oil droplets, indicating the formation of the hydrophilic magnetic nanoparticle microstructures (chains under the magnetic field) and their interaction with the oil blobs. Further ferrofluid flooding experiments were performed in a foot-long micromodel under a rotating magnetic field. The oil saturation was reduced from 44.6 to 33.3% after 17 hours (8.5 PVI) of ferrofluid flooding after the rotating magnetic field was applied. Finally, a discussion of field application of ferrofluid flooding is presented.
Practical Quantification of Sand Distribution from Perforation Erosion Measurements, An Example from Marcellus Shale
Authors: Floyd Gabin Oliver , Rivera Gerardo , Pichon Stephane , Jacot Henry , Archuleta Jason , Chirinos Jose , Rechkemer Daniel
Published: October 2021

Unconventional wells require hydraulic fracturing to be economic. Several levers for improving well productivity are available including stage spacing, cluster spacing, and sand loading however much of the recent focus has been on perforation design as well as a more uniform distribution of sand and water. This paper proposes to evaluate how optimizing the perforation strategy might enhance stimulation distribution along the lateral, in the Marcellus shale.

Three different perforation designs were tested for better understanding of perforation efficiency, when considering design options such as perforation diameter, tapered perforating, and Extreme Limited Entry (XLE). A combination of step down tests, downhole perforation imaging and modeling are used to compare the different designs and support the conclusions.

Downhole ultrasonic perforation imaging, even if it only captures an end-of-job snapshot, provides valuable insight to the dynamics of limited entry perforating and sand distribution. The pre-fracture diameter is identified as a key uncertainty, while post-fracture measurements show variations from the specifications of the shape charge and, in some instances smaller perforation diameters when compared to the expected value. The current dataset allows for a better understanding on the concept of erosion and how to correlate erosion with actionable design parameters such as perforation diameter or rate per perf.

Downhole ultrasonic measurement of the perforation exit diameter, along with the corresponding erosion assumptions, are combined with modeling to recreate the rate and pressure evolution along the fracture stage., In addition, one can infer the actual volume of sand placed in each cluster in order to provide a quantitative assessment for future performance evaluation.
Methane and other Volatile HC Gasses in Produced-Water
Authors: Lahoti Raj
Published: October 2021

Getting correct estimates for Volatile Organic Compounds (VOCs) and greenhouse gases (GHGs) from water storage tanks is not only important for maintaining emission compliance for state and national regulatory authorities, but also crucial in designing the capital-intensive systems for economic use of methane and other Natural Gas Liquid (NGL) gasses. This paper highlights the significance of gas liberated from produced water tanks in the fields. The paper presents a laboratory method to estimate such emissions from produced-water storage tanks by virtue of the in-situ water getting depressurized and releasing VOCs, and other emission gasses such as Hydrogen Sulfide (H2S) and Carbon Dioxide (CO2). Further, the paper provides qualitative and quantitative assessment of the gas liberated from produced-water by analyzing the gas liberated from produced-water from gas-condensate reservoir wells from the Marcellus region.
OCTG Connection Testing Aiding in the Integrity of Multi-Fractured Horizontal Wells
Authors: Blanc Carlos , Santi Nestor , Perello Leandro Abel , Ichim Adonis , Zestran Alexandru Adrian , Rodriguez Jordan Gonzalo
Published: October 2021

With the increase in shale oil and gas activity and complexity, companies deploy new solutions to safely and efficiently drill, complete, and produce wells in unconventional plays. These include Oil Country Tubular Goods (OCTG) connections, which must withstand installation, stimulation, and production loads specific to this application. Industry available standards provide manufacturers and operators a framework for quality founded on best practices and testing.

In some instances, existing testing protocols may not be adequate (e.g. insufficient or overconservative) to assess connections’ performance for this application. For this reason, the American Petroleum Institute established an expert working group to develop Technical Report 5SF (TR 5SF) intended to evaluate casing connections performance in multi-fractured horizontal wells.

The objective of this paper is to present a set of verified testing protocols applicable to casing connections used in the most common shale plays, complementing the existing body of knowledge.

We discuss testing elements and parameters tailored to the conditions of various shale plays. Based on the operations planned for the life of a well, the testing procedure is adjusted to resemble the expected conditions and loads in the correct order. This includes make-up, high-cycle fatigue associated with the casing string installation, thread compound degradation under temperature and time, and mechanical load cycles generated by stimulation. Specimen sealability is confirmed under production loads, after which failure testing is performed. Some of the inputs to build the testing protocol are: maximum internal pressure, axial load, dogleg severity, number of cycles, temperature, and fluid type.

Since connections play a crucial role in the integrity of a well, a testing procedure to ensure their performance is shown. Testing protocols for Multi-fractured Horizontal Wells (MFHW) applied to two connection types are presented, highlighting how tailored testing protocols and robust engineering improve product reliability and well integrity assurance.

We compile a set of testing inputs for the most relevant shale plays worldwide, together with the testing elements, sequence, and acceptance criteria. This should help end users validate and benchmark products’ performance while improving industry knowledge of connections capabilities.
Paying it Forward: How an Emerging Unconventional Play can Hit the Ground Running
Authors: Koperna George J , Murray Brett L , Riestenberg David E , Carpenter Steven M
Published: October 2021

While every tight oil play is unique, there are lessons that can be transferred from one play to another to improve the efficiency and pace of production operations and development. These improvements may not fit precisely in every basin or play but generally hold to themes that can be tested against and built upon. Themes such as the quantity of proppant, longer lateral length, or the number of stages can be directly tied to increased productivity. However, there are diminishing returns on these investment activities for which each operator, within a given play, will be required to identify and mitigate against.

This is especially true as the industry steps in and begins developing new tight oil plays. In their nascent stages, these plays may have limited well penetrations and, as a result, limited geological and performance data from which to extrapolate. Pulling together an understanding of where the industry currently resides in terms of how to exploit these resources can provide a boost in terms of working towards greatly improved well completions.

In 2019, the US EIA estimated that nearly 8 million barrels of oil per day were produced from tight oil reservoirs in the United States (US EIA, 2020). This represents over 60% of the domestic crude production, originating from multiple reservoirs in the Permian Basin (TX) as well as the Bakken (MT, ND), Eagle Ford (TX), Niobrara (CO, WY), and Anadarko Basin (OK) formations, among others. As such, there are 1,000s of wells across these numerous tight oil plays that can relate an informative story. To build this story, the interplay of geology, well spacing, lateral length, and stimulation, all critical to economic success, will be explored.

This paper proposes to look back at these mature tight oil (and gas) basins and bring forth an understanding of what lessons can be applied to the emerging Powder River Basin tight oil reservoirs (Mowry and the Turner/Frontier). The authors will delve into the four broad topics of geology, well spacing, lateral length, and stimulation, highlighting case studies to demonstrate those lessons from established tight oil plays that will underpin planned activities at a Field Laboratory Test Site in the southern Powder River Basin.
A New Nonlinear Two-Point Flux Approximation Method for Solving the Anisotropic Diffusion Equation with Reduced Violations of the Discrete Maximum/Minimum Principle
Authors: Zhang Wenjuan , Al Kobaisi Mohammed
Published: October 2021

A class of monotone cell-centered nonlinear finite-volume methods has been proposed in the past decade to solve the anisotropic diffusion equation. The nonlinear two-point flux approximation (TPFA) (NTPFA) method preserves the nonnegativity of the solution values but can violate the discrete maximum/minimum principle (DMP). To enforce DMP, the nonlinear multipoint flux approximation (NMPFA) method ought to be used. In this work, we propose a novel NTPFA method that can reduce the severity of DMP violations significantly compared with the standard NTPFA method. The new formulation uses conormal decomposition for the construction of the one-sided fluxes. To define the unique flux through a connection between two cells, we choose a convex combination of the two one-sided fluxes such that the absolute differences of the magnitudes of the two transmissibility terms associated with the two neighboring cells are minimized, thus bringing the discrete coefficient matrix closer to having the zero row-sum property. Numerical experiments are conducted to test the performance of the new NTPFA method. The results demonstrate that the new scheme has comparable convergence order for both the solution and the flux compared with the standard NTPFA method or the classical multi-point flux approximation (MPFA-O) method. Moreover, the new NTPFA formulation shows marked improvements over the standard NTPFA in terms of reducing DMP violations. However, depending on the specific problem configuration, our new NTPFA formulation can lead to a system of nonlinear equations that is more difficult to solve.
Estuarine Gradients Dictate Spatiotemporal Variations of Microbiome Networks in the Chesapeake Bay
Authors: Wang Hualong , Chen Feng , Zhang Chuanlun , Wang Min , Kan Jinjun
Published: October 2021

Background: Annually reoccurring microbial populations with strong spatial and temporal variations have been identified in estuarine environments, especially in those with long residence time such as the Chesapeake Bay (CB). However, it is unclear how microbial taxa cooccurrence with each other and how the inter-taxa networks respond to the strong environmental gradients in the estuaries. Results: Here, we constructed co-occurrence networks on prokaryotic microbial communities in the CB, which included seasonal samples from seven spatial stations along the salinity gradients for three consecutive years. Our results showed that spatiotemporal variations of planktonic microbiomes promoted differentiations of the characteristics and stability of prokaryotic microbial networks in the CB estuary. Prokaryotic microbial networks exhibited a clear seasonal pattern where microbes were more closely connected during warm season compared to the associations during cold season. In addition, microbial networks were more stable in the lower Bay (ocean side) than those in the upper Bay (freshwater side). Multivariate regression tree (MRT) analysis and piecewise structural equation modeling (SEM) indicated that temperature, salinity and total suspended substances along with nutrient availability, particulate carbon and Chl a, affected the distribution and co-occurrence of microbial groups, such as Actinobacteria, Bacteroidetes, Cyanobacteria, Planctomycetes, Proteobacteria, and Verrucomicrobia. Interestingly, compared to the abundant groups (such as SAR11, Saprospiraceae and Actinomarinaceae), the rare taxa including OM60(NOR5) clade (Gammaproteobacteria), Micrococcales (Actinobacteria), and NS11-12 marine group (Bacteroidetes) contributed greatly to the stability of microbial co-occurrence in the Bay. Modularity and cluster structures of microbial networks varied spatiotemporally, which provided valuable insights into the ‘small world’ (a group of more interconnected species), network stability, and habitat partitioning/preferences.Conclusion: Our results shed light on how estuarine gradients alter the spatiotemporal variations of prokaryotic microbial networks in the estuarine ecosystem, as well as their adaptability to environmental disturbances and co-occurrence network complexity and stability.
Teriparatide Administration By The Omnipod Pump: A Self-Managed Therapeutic Option for Refractory Hypoparathyroidism
Authors: Aouchiche Karine , Reynaud Rachel , Amodru Vincent , Brue Thierry , Cuny Thomas
Published: October 2021

Context

: Hypoparathyroidism (hypoPTH) in adults is mainly due to total thyroidectomy. Conventional therapies (calcium, active vitamin D) can fail to normalize calcemia, expose the patient to hypercalciuria and impact quality-of-life. Human parathormone (hPTH) replacement therapy is a suitable option in these cases, although few clinical reports have been published so far.
Methods

we describe two cases of refractory postsurgical hypoPTH for which subcutaneous infusion of recombinant parathormone (teriparatide) through the Omnipod® pump was started after failure of all other therapeutic options. Besides, we performed a review of literature of hypoPTH cases treated by continuous infusion of teriparatide.
Results

two women aged 46 and 61yo failed to normalize calcemia either with conventional treatments (calcium 8g/d + calcitriol 9µg/d and calcium 5g/d + calcitriol 12µg/d) or with thrice-daily subcutaneous injections of teriparatide. As a last resort, teriparatide infusion via Omnipod® device normalized their calcemia and allowed calcium/vitamin D withdrawal, with average teriparatide dose of 23 and 32 µg/day, respectively. Notably, a dedicated protocol currently allow each patient to be autonomous with its pump without adverse dyscalcemia until now. In the literature, 15 adult cases (13 women, mean age 44.5 ± 5.2 yo) are reported. HypoPTH was consecutive to surgery in all of them. Mean dose of teriparatide administered was 25 ± 6 µg/d with improvement of calcemia level and quality-of-life in all patients.
Conclusion

Continuous administration of teriparatide through Omnipod® is a safe and efficient therapeutic option in refractory hypoPTH, which can, furthermore, be safely self-managed by the patient.
ACE2/ANG-(1-7)/Mas Receptor Axis Activation Prevents Inflammation, Glial Activation And Cognitive Decline In a Rat Model of STZ Induced Impairment of Learning and Memory
Authors: Tiwari Virendra , Singh Jitendra , Tiwari Priya , Chaturvedi Swati , Gupta Shivangi , Mishra Akanksha , Singh Sonu , Wahajuddin Muhammad , Hanif Kashif , Shukla Shubha
Published: October 2021

Activation of the renin-angiotensin system (RAS), mediated by Angiotensin converting enzyme/Angiotensin II/Angiotensin receptor-1 (ACE/Ang II/AT1 R) axis elicits amyloid pathology, induces neurodegeneration and cognitive impairment leading to Alzheimer's disease (AD). On the contrary, Angiotensin converting enzyme2 (ACE2) produces Ang -(1-7) which binds with the Mas receptor and counters ACE/Ang II/AT1 axis. To date, the involvement of ACE2/Ang-(1–7)/MasR axis in etiology and progression of AD largely remains to be elucidated. Hence, the present study is aimed to determine the role of ACE2/Ang-(1–7)/MasR axis in STZ induced model of neurodegeneration using Diminazene aceturate (DIZE), an ACE2 activator in both in vitro/in vivo experimental conditions. Interestingly, ROS content and oxidative stress burden in N2A cells were found to be attenuated along with a decrease in enzymatic activity of AChE following DIZE treatment. In contrast, activation of this axis led to altered mitochondrial membrane potential (MMP) in addition to ablated intracellular Ca2+ influx. ACE2/Ang-(1–7)/MasR axis activation further resulted in reduction of astrogliosis as indicated by decreased intensity of NFκB and dwindled expression of its downstream NLRP3 cascade signaling molecules. These results were confirmed by using a selective inhibitor of ACE-2, MLN-4760, which reversed the protective effects of ACE2 activation by DIZE. Subsequently, treatment with DIZE in STZ induced rat model of AD prevented cognitive impairment and progression of amyloid pathology. Therefore, the involvement of ACE2/Ang-(1–7)/Mas axis suggests that it could be further explored as a potential pathway in AD, owing to its inhibitory effect on inflammation/astrogliosis and restoring cognitive functions.
Impact of a Clinical Pharmacist in a Neurology Clinic Treating Patients with Myasthenia Gravis and Multiple Sclerosis
Authors: Bejjani Andrea , Hwang Stephanie , Fudzie Seyram , Iyer Stephanie
Published: October 2021

Background: Myasthenia gravis (MG) and multiple sclerosis (MS) are treated with complex pharmacological agents. Pharmacists play a vital role by optimizing care, providing medication counseling, and assisting with medication access. Currently, there are no published studies assessing the impact of a clinical pharmacist on MG management and limited studies evaluating impact in MS.Aim: The objective is to evaluate the impact of a clinical pharmacist in interdisciplinary MG and MS clinics by identifying pharmacist-led direct and indirect services. Methods: A retrospective chart review was conducted of MG or MS patients who had a clinical pharmacist visit between December 1, 2019 and August 31, 2020 to identify pharmacist interventions. Clinic-based pharmacist reports were used to identify indirect services provided by the pharmacist.Results: A total of 137 encounters were analyzed. For direct patient care, the most common intervention was evaluating monitoring parameters of the medications, which occurred at 129 encounters (94.2%). Within these encounters, an average of 2.79 parameters were evaluated. Other common interventions included evaluating laboratory findings (77.4%), identifying medication discrepancies (77.4%), and providing medication counseling (76.6%). Regarding indirect patient care, a total of 1280 services were identified. The most common service was telephone encounters, with a total of 598 encounters over 9 months.Conclusion: A clinical pharmacist improved the quality of care in the MS and MG management through direct and indirect services when integrated into a neurology clinic. This supports the role of pharmacists in specialty clinics by showing their impact on quality of care and medication management.
Predictive Supervised Learning Model for Classification of Type 2 Diabetes Mellitus
Authors: Roobini M.S , Lakshmi M
Published: October 2021

There is a tremendous increase in severe cases of type 2 diabetes in the day today's life. Therefore, proper assessment of the disease is critical to saving society. Many prediction models help identify type 2 diabetes. At the same time, every model varies based on the performance measures. Various kinds of algorithms such as Decision Tree, Logistic Regression, KNN, Random Forest algorithm are applied to identify type 2 diabetes. At this juncture, used the implementation of type 2 Classification by AdaBoost algorithms, an ensemble approach. Here, the proposed methodology of the paper is to implement an ensemble approach of machine learning to receive a better efficiency compared to other existing algorithms for the classification of type 2 diabetes. When compared to all different algorithms, this ensemble approach shows an efficiency of 83%. The accuracy is calculated based on various performance measures.
Effect of Graphene additives on the structure and the optical parameters of the pure sodium borate glass
Authors: Gomaa Hosam Mohamed , Saudi H. A. , Yahia I.S. , Zahran H.Y.
Published: October 2021

This work has been performed to knowledge the effect of insertion of pure graphene which is an organic two-dimensional material throughout the structural matrix of the pure sodium borate glass according to the chemical formula; 1mol. [Na2B4O7. 10H2O] + x g Graphene, where 0 ≤ x ≤ 3g. A set of four solid samples have been prepared using the fast cooling method from their melts at 1000±20oC. The prepared solids have been characterized using the XRD technique, which indicates the amorphous nature of all four samples, as well as showing an increase in the count rate as the content of graphene increases. FTIR spectral analysis clarified that the increase in the graphene content caused an increase in BO4 concentration with respect to BO3, as well as an amount of graphene that has been oxidized was shared as glass network formers. The measured values of both bulk density and the microhardness showed a slight increase as the graphene content increased. Optical measurement showed an increase in the optical absorbance, direct bandgap, indirect bandgap, and optical bandage. Also, the values of optoelectronic parameters increased when the graphene content increased, to be larger than that of the pure ZnO, and CO-ZnO which make the studied glass to be good candidates for nonlinear optical applications. Both the metallization factor and Urbach's energy showed that the crystallinity degree increased when the content of graphene increased.
Psychological Impact of Covid-19 Pandemic: Lockdown Induced Anxiety and Its Impact on Sleep Quality in Adults Between 18-50 Years of Age
Authors: Kasat Radhika , Walimbe Vaibhavi
Published: October 2021

BACKGROUND:- COVID 19 pandemic is the global health emergency and most critical health calamity of the century4.The COVID-19 belongs to the family of virus that causes illness such as common cold to severe infection causing Middle East respiratory syndrome (MERS)-CoV and severe acute respiratory distress syndrome (SARS)CoV1. RESULTS:- 30 questions were asked combining of 5 components of which 4 were demographic questions and 1 willingness to participate. Total 196 subjects were chosen randomly between the age group of 18 years to 50 years from all over the Maharashtra. The subjects were both male and female. CONCLUSION :- In Our study the total sample size was 196. Population was significantly affected in all the components. Out of 196, 49% population was affected in sleep quality, and 57 % population was affected in anxiety.
Impact of nasogastric decompression on gastric tube size after McKeown minimally invasive esophagectomy: A retrospective controlled cohort study
Authors: Jiang Duo , Liu Xian-Ben , Xing Wen-Qun , Chen Pei-Nan , Feng Shao-Kang , Liu Jun-Xiao , Sun Hai-Bo
Published: October 2021

Purpose: This retrospective study evaluated the impact of nasogastric decompression (NGD) on gastric tube size to optimize the Enhanced Recovery After Surgery protocol after McKeown minimally invasive esophagectomy (MIE). Methods: Overall, 640 patients were divided into two groups according to nasogastric tube (NGT) placement intraoperatively. Using propensity score matching, 203 pairs of individuals were identified for gastric tube size comparisons on postoperative days (PODs) 1 and 5. Results: Gastric tubes were larger in the non-NGD group than the NGD group on POD 1 (vertical distance from the right edge of the gastric tube to the right edge of the thoracic vertebra, 22.2 [0–34.7] vs. 0 [0–22.5] mm, p <0.001). No difference was noted between the groups on POD 5 (18.5 [0–31.7] vs. 18.0 [0–25.4] mm, p =0.070). Univariate and multivariate analyses showed that non-NGD was an independent risk factor for gastric tube distention on POD 1. No difference in the incidence of complications (Clavien–Dindo（CD）≥2) (40 (23.0%) vs. 46 (19,8%), p =0.440), pneumonia (CD≥2) (29 [16.8%] vs. 30 [12.9%], p =0.280) or anastomotic leakage (CD≥3) (3 [1.7%] vs. 6 [2.6%], p =0.738) were noted between the without gastric tube distention group and with gastric tube distention group. Conclusion: Intraoperative NGT placement reduces gastric tube distention rates after McKeown MIE on POD 1, but the complications are similar to those of unconventional NGT placement. This finding is based on NGT placement or replacement at the appropriate time postoperatively through bedside chest X-ray examination.
Improvement In Colorectal Cancer Outcomes Over Time is Limited To Patients With Left-Sided Disease
Authors: Rumpold Holger , Hackl Monika , Petzer Andreas , Wolf Dominik
Published: October 2021

Purpose: Incidence and mortality of colorectal cancer (CRC) declined over the last decades. However, survival depends on the primary tumor location. It is unknown if all progress in outcomes vary depending on left-sided (LCRC) versus right sided (RCC) colorectal cancer. We compare incidence and mortality rates over time according to the primary tumor location. Methods: Data from the Austrian National Cancer Registry spanning from 1983 to 2018 were used to calculate annual incidence and mortality rates and survival stratified by primary tumor localization and stage. Joinpoint regression with linear regression models were used on different subgroups to identify significant changes of incidence- and mortality slopes.Results: A total of 168,260 (incidence-data set) and 87,355 cases (mortality data-set) were identified. Survival of disseminated RCC was worse compared to LCRC (HR 1.14; CI 1.106 – 1.169). Total and LCRC incidence- and mortality-rates declined steadily over time, whereas the rates of RCC did not. Incidence of disseminated RCC declined significantly less (slope -0.07; CI -0.086; -0.055) than in LCRC (slope -0.159; CI -0.183; -0.136); mortality rate of RCC was unchanged over time. Incidence and mortality of localized RCC remained unchanged over time, whereas both rates declined independently of stage in LCRC. Conclusion: Colorectal cancer outcomes during the last 35 years have preferentially improved in LCRC but not in RCC, indicating that the progress made is limited to LCRC. It is necessary to define RCC as a distinct form of CRC and to focus on specific strategies for its early detection and treatment.
Aortic Hypoplasia in Young Adult Patients with Sudden Intrinsic Cardiopulmonary Arrest: An Observational Study
Authors: Bando Misaki , Yoshioka Yuki , Akagawa Yoko
Published: October 2021

Background: The leading cause of sudden cardiac death in adults over 40 is ischemic heart disease due to vascular atherosclerosis. In contrast, sudden cardiac death in adults younger than 40 (young adults) may be caused by aortic hypoplasia (AH). To date, few detailed studies of AH exist. This study evaluated AH patients in our hospital for sudden cardiopulmonary arrest in young adults. Methods: We selected young adult patients who transferred to our center with cardiopulmonary arrest status between April 2010 and March 2020. Their cause of death was supposed to be cardiac or unknown. In the chart review, sex, age, rate of computed tomography (CT) being performed, and outcome were described. For patients with CT being performed, we assessed the diameters of the aortic root, ascending, descending and abdominal aorta, and right femoral artery.Results: There were 1268 cardiopulmonary arrest cases during the study period. Thirteen young adults died of intrinsic diseases, such as sudden cardiac death or unknown cause of death. Twelve patients underwent CT scans, and eight (61.5%) had AH.Conclusions: For a decade, 61.5% of young adults who died of intrinsic diseases had AH. Further studies should be conducted to reveal AH’s clinical significance in young adults.
Towards an Effective Collaboration Between South Western Sydney Local Health District and Local Councils: Insights from the Qualitative Study
Authors: Kovai Vilas , Mahjabeen Zeenat , Jalaludin Bin
Published: October 2021

Background

Urban planning is of fundamental use in promoting a healthy urban environment, prompting increased collaboration between public health and local government planning authorities. A major challenge to the success of this co-operation, however, is the difficulty of ensuring that the views of the health sector are, ultimately, reflected in planning policy. To facilitate this, a qualitative study was designed by Population Health, South Western Sydney Local Health District (SWSLHD) in 2016.
Objective

The aim of the study was to understand and help improving the effectiveness of collaboration between local governments and public health sector.
Methods

Qualitative data was collected from 14 in-depth interviews with staff representing five local councils: Bankstown, Camden, Liverpool, Campbelltown, and Fairfield. The data was thematically analysed using inductive and deductive reasoning by applying NVivo software.
Results

While councils recognise the potential value of consultation (and partnership) with SWSLHD, the fact is that the status quo is one of limited communication and the absence of any clearly defined process for collaboration. Councils perceive knowledge gaps in relation to basic issues such as who provides what services to whom and how to access services from health experts related to evidence based local government level data.
Implications:

The study demonstrated that a shift in provision of public health evidence that has local applicability in a timely manner on issues of mutual concern, and proactive and ongoing consultations between SWSLHD and councils would enable effective engagement, coordinated and sustained actions. As the concerns raised in this study about the need for practical information on effective interventions and impact of social determinants of health echo the findings from studies that were conducted in other local government settings of Victoria, South Australia and New South Wales, the study findings may be applied to other councils beyond the SWSLHD.
Contribution of TREM2 Signaling to the Development of Painful Diabetic Neuropathy by Mediating Microglial Polarization in Mice
Authors: chen xin , Le Yue , Tang Si-qi , He Wan-you , He Jian , Wang Yun-hua , Wang Hanbing
Published: October 2021

Background: Painful diabetic neuropathy (PDN) is a common and intractable complication of diabetes mellitus, with little effective treatment. PDN has been associated with spinal neuroinflammation characterized by microglial activation. Recently, the triggering receptor expressed on myeloid cells 2 (TREM2), specifically localized on microglia, has been identified as a vital factor in modulating neuroinflammation and microglial phenotypes in neural diseases. Therefore, we hypothesized that spinal TREM2 might contribute to PDN and neuroinflammation by regulating microglial activity and phenotypes.Methods：Type I diabetes mellitus was elicited by a single intraperitoneal administration of streptozotocin (STZ) in mice. The pain behaviors were reflected by paw mechanical withdrawal thresholds (PMWT) and thermal withdrawal latency (PTWL). Results：We demonstrated that up-regulation of microglial TREM2 and amplification of both microglial M1 and M2 response was along with the presence of diabetes-related mechanical allodynia and thermal hypersensitivity. Moreover, we found that overexpression of TREM2 in microglia aggravated the symptom of PDN, amplified microglia M1 response, and suppressed microglia M2 polarization in the lumbar spinal cord of diabetic mice. However, inhibition of TREM2 with anti-TREM2 neutralizing antibodies attenuated mechanical allodynia and thermal hyperalgesia in diabetic mice. Besides, we identified Galectin-3 (GLT-3) as the potential ligand of the TREM2 receptor in facilitating the progression of PDN.Conclusions: TREM2 could be a critical microglial membrane molecule that modulates microglial phenotypes pain hypersensitivity in PDN. GLT-3 might act as a specific ligand to trigger TREM2 signaling in PDN or other neuropathic pain.
Research of Assessment Model Framework of Rainwater Resource Utilization and Driving Force in Arid and Semi-Arid Areas
Authors: Zhang Xingyuan , Li Fawen , Yuan Ximin
Published: October 2021

The arid and semi-arid areas generally face the degradation of natural resources, poor vegetation conditions, and serious soil erosion. In this paper, a spatio-temporal assessment model for the rainwater resources utilization and its driving forces is studied and constructed, and a typical watershed is selected for application and verification. The model is based on SWAT (Soil & Water Assessment Tool) and GTWR (Geographically Temporal Weighted Regression) for secondary development. Two indicators are proposed to characterize the utilization of rainwater: rainwater resources utilization quantity (RRU) and rainwater resources utilization rate (RRUR). To further verify the performance of the model, the scenarios of different watershed management measures were simulated and evaluated. The results show that the model can accurately evaluate the RRU, RRUR, and driving force. The annual average value of the RRUR in the typical watershed is 0.44, and the utilization rate of the middle reaches is higher than that of the upper and lower reaches. Meanwhile, the model can evaluate the RRUR and driving force of different land management scenarios. The driving effects of meteorological, topographical, vegetation, and other factors on the regional RRUR exhibits certain spatiotemporal differences, among which the leaf area index (LAI) is the key driving factor. The framework can provide scientific guidance for improving the rainwater resources utilization rate (RRUR) and alleviating ecological problems.
Chemerin Promotes The Proliferation And Migration of Breast Cancer Cells Through JNK And ERK1/2 Signaling pathways
Authors: Zeng Fanyu , Zhang Jie , Liu Qianqian , Yang Shuya , Zhou Xueqing , Luo Naixiang
Published: October 2021

Breast cancer is the most common invasive malignancy. In 2020, the number of new cases of breast cancer worldwide has replaced lung cancer as the No.1 cancer in the global. Breast cancer is the leading cause of cancer death among women worldwide. Mammary tumorigenesis is severely linked to obesity, one potential connection is chemerin. Chemerin is a chemoattractant protein secreted by adipocytes, which contributes to the progression of breast cancer. Cell proliferation, migration, and invasion are cellular processes associated with various stages of metastasis. These processes are associated with mitogen-activated protein kinase (MAPK) signaling pathway. In this study, human breast cancer cell lines MCF-7 and MDA-MB-231were utilized to determine the effect of chemerin on cell proliferation, migration, and key proteins of MAPK signaling pathway. We found that chemerin promoted cell proliferation and migration in a concentration-dependent manner. Interestingly, these effects of chemerin were through promoting the proteins phosphorylation of ATF2 and ERK1/2 but not p38, in MAPK signaling pathway. Specific inhibitors of JNK and ERK1/2 pathway showed that the effect exerted by chemerin in cell proliferation and migration in breast cancer cells was dependent on these proteins. Our findings suggest that chemerin promotes the development of mammary cancer cells through JNK and ERK signaling pathways.
COVID-19 and Neurosurgery: A Comprehensive Review of Literature
Authors: Albastaki Aysha , Aljawder Abdulaziz Isa
Published: October 2021

The 2019 Coronavirus Infection (COVID-19) first appeared in Wuhan, Hubei Province, China, in December 2019 and has disseminated rapidly to almost every region of the world to become a pandemic. COVID-19 is initiated by severe acute respiratory syndrome CoV-2. The principal signs and symptoms are related to the respiratory and cardiovascular systems; however, the nervous system is another primary target of this devastating disease, according to numerous case reports and some reviews that have been published. Moreover, neurosurgical issues have also been dramatically affected. This comprehensive review aims to summarize the impact of COVID-19 on neurosurgical issues. In addition, we aim to serve as a reference for neurosurgeons dealing with neurosurgical cases of the disease. The article emphasized neurological display of COVID-19, neurosurgical practice, contagion control and precautions, residency, and education in neurosurgery, neurosurgeons' mental health. In addition to that, the article also provides some recommendations.
Prenatal Diagnosis on Ultrasound, Management and Prognosis of Umbilical Artery Thrombosis: A Retrospective Study of 11 Cases
Authors: Wu Suqing , Chen Hui , Wang Yin , Hong Tingting , Luo Siwei , Liu Yanying , Huang Chunwang
Published: October 2021

Background Umbilical artery thrombosis (UAT) is a rare occurrence during pregnancy and is responsible for most of the fetal demises. It is usually difficult to diagnose and easy to be missed or misdiagnosed. The purpose of this study is to investigate the prenatal ultrasonographic and clinical features of UAT.Methods The UAT cases from January 2015 to June 2021 in Guangdong Provincial People’s Hospital were collected, and their ultrasonographic and clinical data were analyzed retrospectively.Results 11 cases were diagnosed as UAT by intrapartum and postpartum findings. 8 cases (Case 1-8) were diagnosed as UAT by prenatal ultrasound, in which one umbilical vein (UV) and two umbilical arteries (UAs) were detected in the cross and longitudinal sections of the umbilical cord (UC) and thrombi were found in one UA with the obstructed blood flow in the third trimester; however, two UAs with normal blood flow on both sides of fetal bladder were detected during the second trimester. UC punctures were performed before thrombi appeared in 2 cases (Case 7-8). 3 cases (Case 9-11) were misdiagnosed as single umbilical artery (SUA) until delivery. When UAT was diagnosed, the systolic to diastolic ratio (S/D) values of UA were < the 25th percentile and the pulsatility index (PI) values of UA were < the 5th percentile in all cases. Doppler measurements of middle cerebral artery (MCA) were measured in 3 cases. Among them, PI values of MCA of 2 cases were < the 5th percentile, and the cerebroplacental ratios of all 3 cases were > the 25th percentile. 8 pregnancies were terminated by cesarean section. 2 women gave birth spontaneously. 1 woman underwent vaginal forceps delivery. 8 neonates were transferred to neonatal intensive care unit. All the newborns had good prognosis.Conclusions When the ultrasound shows only one UA in the level of fetal bladder for the first time in the third trimester, both sonologists and obstetricians should be highly alert to UAT. Thorough confirm of the previous examination results is necessary to exclude SUA. Intensive fetal monitoring and emergency cesarean section are necessary to avoid adverse perinatal outcomes.
High Disease Activity Influences the Presence of Vertebral Fractures in Rheumatoid Arthritis
Authors: Sakane Hideo , Okamura Koichi , Iizuka Yoichi , Honda Akira , Takasawa Eiji , Mieda Tokue , Ishiwata Sho , Ito Syunsuke , Inomata Kazuhiro , Yonemoto Yukio , Suto Takahito , Kaneko Tetsuya , Chikuda Hirotaka
Published: October 2021

Background: To investigate the prevalence and risk factors for vertebral fractures in patients with rheumatoid arthritis (RA) during an era of tight management.Methods: We retrospectively reviewed 426 RA patients who had visited our outpatient RA clinic between July 2017 and June 2020. Among them, we included 107 patients (19 males and 88 females) who had undergone lateral X-ray of the thoracolumbar spine and dual-energy X-ray absorption spectroscopy for the assessment of osteoporosis. We assessed the disease activity score for 28 joints (DAS28), the history of medication for RA and osteoporosis, the number and location of vertebral fractures, and the bone mineral density (BMD). Two board-certified specialists determined osteoporotic vertebral fractures on a lateral X-ray of the thoracolumbar spine.Results: The mean age, average disease duration, and average DAS28 of the analyzed patients were 67.9 years, 14.9 years, and 2.8, respectively. Vertebral fractures were found in 33 patients (30.8%). In this population, 84.8% of patients with vertebral fractures and 59.5% of those without vertebral fractures were treated for osteoporosis with active vitamin D3, bisphosphonate, and/or denosumab. RA patients with vertebral fractures had significantly higher DAS28 values, a higher rate of patients with a history of glucocorticoid use, and lower BMD in comparison to those than without vertebral fractures (p = 0.009, p = 0.004, and p = 0.01, respectively). Logistic regression analysis showed DAS28 (p = 0.038) and BMD (p = 0.004) were independent factors associated with the presence of vertebral fractures. The ordered logistic regression analysis also showed DAS28 (p = 0.043) and BMD (p = 0.024) were independent factors that explained the number of vertebral fractures.Conclusions: Vertebral fractures were frequently observed in RA patients, even when patients were treated the recommended anti-osteoporotic agents. A high disease activity score and low BMD were associated with the presence and number of vertebral fractures in patients with RA.
Effect of Copper On Bioconcentration of Benzotriazole Ultraviolet Stabilizers (BUVSs) in Common Carp (Cyprinus Carpio)
Authors: Zhao Dandan , Bekele Tadiyose Girma , Zhao Hongxia
Published: October 2021

Benzotriazole ultraviolet stabilizers (BUVSs) have received increasing attention due to their widespread usage, ubiquitous detection and their adverse ecological effect. However, information about the bioaccumulation potential of BUVSs and their joint exposure with heavy metals remains scarce. In this study, we investigated the bioaccumulation kinetics of 6 frequently reported BUVSs in common carp under different Cu concentration for 48 d, and their tissue-specific distribution patterns (liver, kidney, gill, and muscle tissues) were also evaluated. The bioconcentration factors (BCFs) and half-lives (t1/2) in the tissues ranged from 5.73 (UV-PS) to 1076 (UV-327), and 2.19 (UV-PS) to 31.5 (UV-320) days, respectively. The tissue-specific concentration and BCF values followed the order of liver > kidney > gill > muscle with or without Cu exposure. An increase in BCF with rising Cu concentration was observed, which is caused by the decreased depuration rate (k2) in more than half of treatment groups. These results indicated that BUVSs accumulated in fish and provides important insight into the risk assessment of this group of chemicals.