bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Multizone Water Injection Downhole Flow Control Completions with Fibre-Optic Surveillance in Soft Sand Reservoirs
Authors: Nguyen Dzu , Macleod Innis , Taylor Donald , Murray Laurence , Zavyalov Denis , Booth Dave , Robertson Neil , Smith Robert , Joubran Jonathon , Allen Clifford , Shafei Sharil Mohd
Published: September 2019

The multiple zone water injection project (MZWIP) was initiated to deliver the following key objectives: deliver zonal injection with conformance control and reliable sand management across the major layered sands of the Balakhany unconsolidated reservoirs in the BP operated Azeri-Chirag-Gunashli (ACG) fields in Azerbaijan sector of the Caspian Sea.

Three years after MZWIP implementation, six wells with a total of 14 zones are injecting at required rates with zonal rate live-reporting. To achieve this multizone injection facility, the requirement for a standard ACG sand-control injector design was discounted and a non-standard sand management control technique developed using a cased & perforated (C&P) and downhole flow-control system (DHFC). During this program, BP ACG has successfully installed the world's first 10kpsi three-zone inline variable-choke DHFC wells with distributed temperature sensors (DTS) across all target injection zones.

The choking DHFC provides flexibility in operations and delivers the right rates to the right zones. The DTS provides conformance surveillance, fracture assessment, caprock integrity and sand ingress monitoring capability. A customized topside logic control system provides an automatic shutin of interval control valves (ICVs) during planned or unplanned shutins to stop crossflow and sand ingress and is the primary method of effectively managing sanded annuli.

The development of this MZWI solution has significantly changed the Balakhany development plan and has been quickly expanded across five ACG platforms. Accessing 2nd and 3rd zones in the same wellbore, this C&P DHFC well design is accelerating major oil volumes and will significantly reduce future development costs, maximizing wellbore utility in a slot-constrained platform.
Casing Rotation for Improved Cement Quality in Unconventional Horizontal Wellbores
Authors: Turner William , Adam Derek , Cowan Kenneth Mike , Tellez Diego , Willis John
Published: September 2019

Results from a long-term field study to improve zonal isolation show that rotating production casing in unconventional well laterals is possible and that it delivers excellent cement quality. This paper reports the results of the study. To date, 44 production strings have been rotated during cement jobs.

Specific details covered are cement bond evaluation results, methods used for modeling casing running, torque and drag forces for floated and rotated strings, torque estimation for casing connection selection, operational procedures, mud conversion cement additive, and best practices. Evaluation of cement bond is based on ultrasonic cement logs acquired in casing strings cemented with and without casing rotation. Advanced azimuthal ultrasonic logs were used to measure cement placement and quality. Trials with a mud conversion cement additive evaluated whether the cement quality could be achieved with additives instead of rotation. Both 6¾ in. and 8½ in. hole sizes in 10,000 ft lateral lengths were evaluated.

Prior studies demonstrated that casing movement is crucial for efficient mud removal (Hyatt et al. 1984; Gai et al. 1996), yet it is not a common practice on long horizontal sections in our company. The casing rotation initiative reported here was enabled by the availability of reliable high torque casing connections. The results shared in this paper demonstrate that it is necessary to rotate casing while cementing horizontal wells with 10,000 ft lateral lengths for effective cement isolation in the annulus. The cement bond resulting from rotated cement jobs is near-perfect. Long-term study is needed to evaluate the effect of optimal cement on hydraulic fracturing effectiveness, production, and the long-term health of the well.

Results reported include log data and modeled torque and drag values paired with operational data to validate the models. Log data is available for eight lateral wellbores evaluated during the base case and trial period. It is unique in that log data was acquired for both the base case and trial wells.

This paper supports well-known cementing best practices (McLean et al. 1967; Zurdo et al. 1986; Reiley 1987; Wilson et al. 1988; Sabins 1990; Torsvoll et al. 1991; Kettl 1993; McPherson 2000; Nelson et al. 2006; Al-Baiyat et al. 2019) with undisputable log data. The operational practices can be applied to many unconventional operations to implement casing rotating into their cementing programs. The method shared to estimate torque can be implemented by any drilling engineer with access to torque and drag software, enabling them to choose the right casing connection for their application.
Development and Application of Firebag SAGD Reservoir Simulation Platform
Authors: Xu Jinze , Wang Jin , Aghabarati Hossein , Zamani Amir , Cheung Kathy
Published: September 2019

Suncor's Firebag Project is one of the largest steam-assisted gravity drainage (SAGD) projects in the world. As a powerful tool for decision-making in the field, the Firebag SAGD reservoir simulation platform is based on an in-depth understanding of physics that controls thermal recovery process and meets the need for a practical solution. In this platform, standardized inputs and workflows are developed, and a good agreement with field data is achieved for all Firebag SAGD operating pads with production history. The Firebag SAGD reservoir simulation platform promotes the capacity to address existing Firebag SAGD challenges, capture unique Firebag reservoir features, and support reservoir management and future pad development.
Gas Relative Permeability and its Evolution During Water Imbibition in Unconventional Reservoir Rocks: Direct Laboratory Measurement and a Conceptual Model
Authors: Peng Sheng
Published: September 2019

Relative permeability has a significant impact on gas or oil and water production, and is one of the most complicated properties in unconventional reservoirs. Current understanding of relative permeability for unconventional reservoir rocks is limited, mainly because of a lack of direct measurement of relative permeability for rocks that have a matrix permeability at the submicrodarcy level. Because of the difficulties related to direct measurement, most studies on relative permeability in unconventional reservoirs are based on indirect or modeling methods. In this paper, a modified gas–expansion method for shale matrix–permeability measurement (Peng et al. 2019) was adopted to measure gas relative permeability directly under the scenario of water imbibition for samples from different unconventional reservoir formations. Evolution of gas permeability, along with gas porosity and fracture/matrix interaction, during the process of water redistribution (which mimics what occurs in the shut–in period in real production) was also closely measured. Results show that gas relative permeability in the matrix decreases during water redistribution because of water imbibition from fractures to the matrix coupled with a water–block effect. The water–block effect is more significant at low water saturations than at higher water saturations, leading to a rapid–to–gradual drop of gas relative permeability with increasing water saturation.

A conceptual model on water redistribution in a fracture/matrix system and the change of gas and water relative permeability is proposed on the basis of experimental results and observations. Influencing factors including pore size, shape, connectivity, and wettability are taken into account in this conceptual model. The combined effect of these four influencing factors determines the level of residual gas saturation, which is the most important parameter in defining the shape of relative permeability curves. Water relative permeability is predicted on the basis of the conceptual model and the measured gas relative permeability using modified Brooks–Corey equations. Deducing the oil/water relative permeability is also discussed. The implications of relative permeability for gas or oil and water production and potential strategies for optimal production are also discussed in the paper. The hysteresis effect is not included in this study but will be addressed in future work.
Orientation of Hydraulic Fracture Initiation from Perforated Horizontal Wellbores
Authors: Michael Andreas
Published: September 2019

The orientation of hydraulic fractures controls the productivity from hydrocarbon reservoirs. Productivity from low permeability formations is greatly improved having multiple fractures oriented transversely rather than longitudinally, relative to a horizontal wellbore. Analytical approximations from the literature for the longitudinal and transverse fracturing stresses are modified to incorporate pore pressure effects and then used to develop a criterion for the orientation of fractures initiating from perforated wells. The validity of this criterion is assessed numerically and is found to overestimate transverse fracture initiation, which occurs under a narrow range of conditions; when the formation tensile strength is below a critical value and the breakdown pressure within a "window."

In horizontal wells, it is easier to achieve longitudinal fracture initiation, as transverse fracture initiation only occurs over a narrow wellbore pressure-at-breakdown window, while longitudinal fracture initiation occurs at comparatively higher wellbore pressures. The numerical study shows that in contradiction with existing analytical approximations, the tangential stress which induces transverse fracture initiation, is a stronger function of wellbore pressure just as the stress inducing longitudinal fracture initiation is. This reduces the breakdown pressure window for transverse fracture initiation compared to what the derived analytical approximations predict. Furthermore, this creates an additional constraint for transverse fracture initiation; the critical tensile strength value, which determines the maximum tensile strength for which transverse fracture initiation is possible for a given stress state.

The range of the in-situ stress states where transverse fracture initiation is promoted can be visualized in dimensionless plots for perforated wells. This is useful for completion engineers; when targeting low permeability formations, wells must be made to induce multiple transverse fractures. A numerical simulation scheme performed on several stress states demonstrates frequent occurrence of longitudinal fracture initiation, implying that the propagating fracture re-orients in the near-wellbore region to become aligned perpendicular to the least compressive in-situ principal stress. This is the cause of near-wellbore tortuosity, which in turn is a cause completions and production-related problems, such as early screenouts and post-stimulation well underperformance.
Efficient Simulation and Analysis of the Effects of Permeability on the In-Situ Combustion of Heavy Oils
Authors: Aounallah Khaled
Published: September 2019

The simulation of the In Situ Combustion (ISC) process is a very challenging process due to the complexity and non-linear nature of the problem. In this work, we propose an efficient technique to simulate experimental procedures for the ISC process including heterogeneity. The effects of permeability on mass flow and heat transfer were studied through a series of numerical frameworks. Different approaches to model the reactions occurring during combustion were attempted and simulation results were validated using experimental results. We focus on two different key areas: the integration of chemical reaction kinetics obtained through kinetic cell experiments, and the analysis of efficient simulations of combustion tube experiments that account for the flow element. After establishing a robust framework that accurately matches lab-scale results, combustion tube simulation results using a commercial simulator were analyzed to corroborate conclusions. Through observing the propagation of the combustion front and the oil bank in heterogeneous zones, assessments around the effects of permeability on the ISC process were performed. This work provides valuable information that would be instrumental in understanding experimental behavior of in-situ combustion and upgrading results to field scale after matching numerical results with experimental data collected in our future work.
Polymer Viscosity: Understanding of Changes Through Time in the Reservoir and a Way to Predict Them
Authors: Katz Marquez Román E.
Published: September 2019

Polymer rheological behavior in an Enhanced Oil Recovery (EOR) project is one of the critical factors to determine whether the polymer injection would be effective to increase the oil production in a field. Due to complications on the measurement of this parameter and its variation within the reservoir, the challenge of understanding viscosity behavior relies on lab and field tests that become key factors to solve this issue.

This study was conducted during an injectivity test for an EOR project in Los Perales field (Santa Cruz, Argentina) in three wells with different operational and subsurface conditions, and tests were performed twice a day for 30 days each in order to obtain sufficient time span of data.

From lab rheology tests performed at reservoir conditions, where the main objective was to analyze viscosity changes through time, two different tendencies were observed: one that affects in early times and another that becomes preeminent at late times. With these results, a describing equation was developed to predict viscosity evolution over time. The equation consists of three terms including thermal variation, chemical degradation and the final viscosity towards which the polymer tends.

Although the equation properly describes both lab and field polymer solution, there is a considerable difference, especially when the effects mentioned become preponderant. This difference is attributed to both the water used for the mixture and the possible impurities that may be incorporated during the maturation or transfer of the polymer. Since most of the data used was obtained from field tests, this emphasizes the appliance of the equation on the field.

Impurities turn out to be crucial, specially oxygen (O2) and hydrogen sulfide (H2S) combined. Their presence highly impacts the asymptotic viscosity, so a correlation between H2S content and final viscosity was also developed.

Finally, an analysis of the temperature influence on the viscosity was conducted. A correlation between the final viscosity and temperature was found and used to incorporate temperature variations in the predictions and therefore to relate measurements performed at different conditions.

The primary advantage of this study is that the equation and correlations enable the prediction of the polymer solution viscosity at any time. This allows the estimation of actual polymer viscosity in the reservoir from a routine measurement at any temperature and impurities content. The versatility of this equation is what makes it novel and useful in an industry going towards EOR projects.
MiR-190a Potentially Ameliorates Postoperative Cognitive Dysfunction by Regulating Tiam1
Authors: Liu Qiang , Hou Aisheng , Zhang Yongyi , Guo Ying , Li Jingjing , Yao Yinghao , Niu Kaimeng , Li Hao , Ma Yunlong , Cao Jiangbei
Published: September 2019

Postoperative cognitive dysfunction (POCD) affects a large number of post-surgery patients, especially for the elderly. However, the etiology of this neurocognitive disorder is largely unknown. Even if several studies have reported a small number of miRNAs as the essential modulatory factors in POCD, these findings are still rather limited. In this study, we used two miRNA microarray datasets to perform differential expression analyses of miRNAs in the hippocampus of POCD model mice. We found that nine miRNAs showed significant associations with POCD in both datasets. Among these miRNAs, mmu-miR-190a-3p was the most significant one. By performing weighted gene co-expression network analysis, we found 25 co-expression modules, of which mmu-miR-190a-3p was significantly anti-correlated with the red module. Moreover, in this red module, 314 genes were significantly enriched in four pathways such as axon guidance and calcium signaling pathway, which are well-documented to be associated with psychiatric disorders and brain development. Also, 169 of the 314 genes were highly correlated with mmu-miR-190a-3p, and four genes (Sphkap, Arhgef25, Tiam1, and Ntrk3) had putative binding sites at 3'-UTR of mmu-miR-190a-3p. Based on protein-protein network analysis, we detected that Tiam1 was a central gene regulated by the mmu-miR-190a-3p. Taken together, we conclude that mmu-miR-190a-3p is involved in the etiology of POCD and may serve as a novel predictive indicator for POCD.
A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial
Authors: Lin Wendong , Sun Jiehao , Fu Shuying
Published: September 2019

Background: Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia.
Methods: This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total of 100 patients undergoing elective surgery under general anesthesia were enrolled, and at last 84 patients were included and randomly allocated into two equal size groups (n=42): Patients in the Remifentanil group (R group) received an intravenous infusion of remifentanil 0.3 µg/kg (diluted to 2 ml) 1 minute before sufentanil injection; patients in the Control group (C group) received 2 ml of normal saline (NS) at the same time point. Injections of patients in both groups were completed within 5 seconds. Then, sufentanil 0.5 µg/kg was injected within 5 seconds and the number of coughs that occurred within 1 minute after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 minutes after administration (T1), 1 minute after intubation (T2), and 3 minutes after intubation (T3) were recorded.
Results: The incidence of cough in patients in the R group and C group was 4.8% and 31%, respectively. Compared with group C, the incidence and severity of cough in group R was significantly lower (P <0.01). No significant differences were observed in MAP and HR at the time of general anesthesia induction between the two groups (P> 0.05).
Conclusion: Pretreatment with a small dose of remifentanil effectively and safely reduced the incidence and severity of cough induced by sufentanil during anesthesia induction and can be used as an alternative treatment to inhibit coughing caused by sufentanil.
Exploring transcriptomic landscapes in red blood cells, in their extracellular vesicles and on a single-cell level
Authors: Kerkelä Erja , Lahtela Jenni , Larjo Antti , Impola Ulla , Mäenpää Laura , Mattila Pirkko
Published: September 2019

Background Circulating human red blood cells (RBCs) consist of mature erythrocytes and immature reticulocytes. Being anucleated, RBCs lack typical transcriptomes, but are known to contain small amounts of diverse long transcripts and microRNAs. However, the exact role and importance of these RNAs is lacking. Results To study this further, we explored the transcriptomes of RBCs and extracellular vesicles (EVs) of RBCs using next-generation sequencing. Furthermore, to understand the dynamics of the RBC transcriptome, we performed single-cell RNA sequencing on RBCs. An analysis of the single-cell transcriptomes revealed that approximately 10% of the cells contained detectable levels of mRNA and fell into three subpopulations based on their transcriptomes. Decrease in the mRNA quantity was observed across the populations. Qualitative changes included the differences in the globin transcripts and changes in the expression of ribosomal genes. A specific short splice form of a long non-coding RNA, Metastasis Associated Lung Adenocarcinoma Transcript 1 (MALAT1), was the most enriched marker in one subpopulation of RBCs, co-expressing with ribosomal structural transcripts. MALAT1 expression was confirmed by qPCR in CD71-enriched reticulocytes, which were also characterized with imaging flow cytometry at single cell level. Conclusions Analysis of the RBC transcriptome shows enrichment of pathways and functional categories required for the maturation of reticulocytes and erythrocyte functions. The RBC transcriptome was detected in their EVs, proposing vesiculation as a mechanism to remove the cellular contents from RBCs throughout their life cycle. Our experiments on single cell level revealed that lncRNA MALAT1 is the marker for one of the three RBC populations co-expressing with a group of ribosomal protein transcripts.
Comparative analysis of RNA-sequencing in intraocular tumors
Authors: Yang Yang , Mei Qi
Published: September 2019

Background: Intraocular tumors are a class of serious diseases which may cause blindness and disability. This study aims to explore the underlying mechanisms of gene regulation in intraocular tumors.Methods: In this study, we firstly adopted RNA-sequencing technology to screen the differentially expressed genes in OCM-1 and Y79 cells compared with HRECs.Results: We found 8424 differentially expressed genes (4665 downregulated and 3759 upregulated) in OCM-1 cells compared with HRECs cells, and 7486 differentially expressed genes (4250 downregulated and 3236 upregulated) in Y79 cells compared with HRECs cells. In addition, the GO (Gene Ontology) terms was used to predict the potential functions of these differentially expressed genes and KEGG (Kyoto Encyclopedia of Genes and Genomes) was used to analyze the potential functions of these genes in the pathways. Furthermore, we identified the Top differentially expressed genes by using qRT-PCR assay in intraocular tumors. Conclusions: Here, we fully exposed the differentially expressed genes in intraocular tumor cell lines, which will improve understanding for gene regulation in intraocular tumors.
Diagnostic accuracy of history taking, physical examination and imaging for phalangeal, metacarpal and carpal fractures: a systematic review update.
Authors: Krastman Patrick , Mathijssen Nina M. , Bierma-Zeinstra Sita M.A. , Kraan Gerald , Runhaar Jos
Published: September 2019

Background The standard diagnostic work-up for hand and wrist fractures consists of history taking, physical examination and imaging if needed, but the supporting evidence for this work-up is limited. The purpose of this study was to systematically examine the diagnostic accuracy of tests for hand and wrist fractures. Methods A systematic search for relevant studies was performed. Methodological quality was assessed and sensitivity (Se), specificity (Sp), accuracy, positive predictive value (PPV) and negative predictive value (NPV) were extracted from the eligible studies. Results Of the 35 eligible studies, one described the diagnostic accuracy of history taking for hand and wrist fractures. Physical examination with or without radiological examination for diagnosing scaphoid fractures (five studies) showed Se, Sp, accuracy, PPV and NPV ranging from 15-100%, 13-98%, 55-73%, 14-73% and 75-100%, respectively. Physical examination with radiological examination for diagnosing other carpal bone fractures (one study) showed a Se of 100%, with the exception of the triquetrum (75%). Physical examination for diagnosing phalangeal and metacarpal fractures (one study) showed Se, Sp, accuracy, PPV and NPV ranging from 26-55%, 13-89%, 45-76%, 41-77% and 63-75%, respectively. Imaging modalities of scaphoid fractures showed predominantly low values for PPV and the highest values for Sp and NPV (24 studies). Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Ultrasonography (US) and Bone Scintigraphy (BS) were comparable in diagnostic accuracy for diagnosing a scaphoid fracture, with an accuracy ranging from 85-100%, 79-100%, 49-100% and 86-97%, respectively. Imaging for metacarpal and finger fractures showed Se, Sp, accuracy, PPV and NPV ranging from 73-100%, 78-100%, 70-100%, 79-100% and 70-100%, respectively. Conclusions Only one study was found on the diagnostic accuracy of history taking for hand and wrist fractures in the current review. Physical examination was of moderate use for diagnosing a scaphoid fracture and of limited use for diagnosing phalangeal, metacarpal and remaining carpal fractures. MRI, CT and BS were found to be moderately accurate for the definitive diagnosis of clinically suspected carpal fractures.
Prevalence and Associated Factors of Low Back Pain Among Hairdressers in Female Beauty Salons of Mekelle City, Tigray, Ethiopia; Cross-Sectional Study.
Authors: Tsegay Gebrerufael Solomon , Gebremeskel Berihu Fisseha , Gezahegn Selam Desalegn , Teklemichael Desalegn Massa
Published: September 2019

Abstract Background: Low back pain is one of the most prevalent musculoskeletal conditions and the most common cause of disability. Hairdressers are one of the high-risk professionals for work-related musculoskeletal disorders like low back pain. However, studies on the prevalence and associated factors of low back pain among hairdressers are scarce. The objective of the current study is to assess the prevalence and associated factors of low back pain among hairdressers in female beauty salons of the Mekelle City, Tigray, Ethiopia. Method: An institutional-based cross-sectional study was employed from January 05 up to February 28, 2018. The sample (n=344) hairdressers were selected randomly from all-female beauty salons of Mekelle city. A structured questionnaire adapted from a standardized Nordic questionnaire and other similar studies was used. Binary logistic regression analysis was performed to identify factors associated with low back pain. The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was estimated to show the strength of association. A p-value of < 0.05 was used to declare statistical significance. Result: A total of 314 hairdressers participated, with a 91.3% response rate. The study found that the self-reported 12 months prevalence of low back pain was (47.5 %) with 95%CI (41.8- 53.1). Awkward way working posture [AOR: 2.6, 95%CI (1.41- 4.62)], working greater than 4 days in a week [AOR: 7.98, 95%CI (2.54-25.09], hair washing job category [AOR: 4.35, 95%CI (1.87-10.12)], having adjustable washing basin [AOR: 0.30, 95%CI (0.151-0.587)] and job stress [AOR: 2.75, 95%CI (1.61-4.72)] were factors that shows a statically significant association with low back pain. Conclusion: This study found that almost half of the hairdressers developed work-related low back pain in the last 12 months. Awkward posture, working days per week, hair washing job category, adjustable height washing basin and job stress show a significant association with low back pain. To address the problem responsible body needed to promote health and prevent low back pain among hairdressers by paying great attention to the prevalent problem and the identified risk factors. Keywords : Low back pain, Hairdresser, Musculoskeletal disorder.
Whether Evacuation surgery should be the first step for Postoperative Delayed Lumbar Epidural Hematomas?A Retrospective Comparative Study
Authors: Cao Liangliang , Liu Yumei , Guo Rundong , Xu Jianguang , Mei Wei , Yang Erzhu , Lian Xiaofeng
Published: September 2019

Background To analyze the efficacy and necessity of multiple lumbar punctures for postoperative delayed lumbar epidural hematoma(PDLEH).Methods Patients who underwent lumbar spinal surgeries between 2012 and 2016 at our institution, were reviewed through their medical records. For patients with PDLEH, the therapies, duration to onset(DO), duration from onset to intervention (DOI), symptoms (ASIA grade), neurological outcomes, VAS before and after treatment were examined. Only patients that received evacuation surgery(Group A) or mutiple lumbar punctures(MLP)(Group B) were included. We compared ASIA grade and VAS before and after treatment, DOI between the two therapies, and analyzed the correlation among the parameters.Results 15 cases(Group A) were performed with emergent surgical evacuation of the hematoma, and 16 cases(Group B) were treated with lumbar MLP at surgical site. The DOIs were 10.87±6.14h in group A and 2.05±5.33 in group B(P=0,P<0.05.). Preoperative neurological status in Group A were slighter than that in Group B.(P=0,P<0.05.). There was significant difference on VAS after treatment (P=0,P<0.05). Correlation analysis revealed that DOI were significantly positively correlated with neurological state before interventions (r=0.672, p=0,). In Group A, neurological outcomes at 2 years follow-up were correlated significantly with DOI (r=0.594, p=002) and neurological state before reoperation (r=0.665,p=0.007,). And in Group B, the correlation coefficient of neurological state and neurological outcomes at 2 years follow-up was r=o.584 (p=0.02),while there was no correlation between neurological outcomes and DOI(r=0.158,p=0.558).Conclusions In addition to serving as a timely, minimally invasive treatment, MLP could also serve as a preliminary measure during preoperative preparation before surgical evacuation.
Using propensity for pre-diagnosis behavior as a predictor of cancer survival time: an example in esophageal cancer.
Authors: Fahey Paul Patrick , Page Andrew , Stone Glenn , Astell-Burt Thomas
Published: September 2019

Background: Information on the associations between pre-diagnosis health behavior and post-diagnosis survival time in esophageal cancer could assist in choosing treatments and planning health services but can be difficult to obtain using established study designs. We postulated that, with a large data set, using estimated propensity for a behavior as a predictor of survival times could provide useful insight as to the impact of actual behavior. Methods: Data from a national health survey and logistic regression were used to calculate the propensity of selected health behaviors from participant’s demographic characteristics for each esophageal cancer case within a large cancer registry data base. The associations between survival time and the propensity of the health behaviors were investigated using Cox regression. Results: Observed associations include: a 0.1 increase in the probability of smoking one year prior to diagnosis was detrimental to survival (Hazard Ratio (HR) 1.21, 95% CI 1.19,1.23); a 0.1 increase in the probability of hazardous alcohol consumption 10 years prior to diagnosis was associated with decreased survival in squamous cell cancer (HR 1.29, 95% CI 1.07, 1.56) but not adenocarcinoma (HR 1.08, 95% CI 0.94,1.25); a 0.1 increase in the probability of physical activity outside the workplace is protective (HR 0.83, 95% CI 0.81,0.84). Conclusions: We conclude that propensity for health behavior estimated from demographic characteristics can assist in determining existence of the association between pre-diagnosis health behavior and post-diagnosis health outcomes, allowing some sharing information across otherwise unrelated data collections.
True and False Positive Rates for Different Criteria of Evaluating Statistical Evidence from Clinical Trials
Authors: Ravenzwaaij Don van , Ioannidis John P A
Published: September 2019

Background: Until recently a typical rule that has often been often used for the endorsement of new medications by the Food and Drug Administration has been the existence of at least two statistically significant clinical trials favoring the new medication. This rule has consequences for the true positive (endorsement of an effective treatment) and false positive (endorsement of an ineffective treatment) rates. Methods: In this paper, we compare true positive and false positive rates for different evaluation criteria through simulations that rely on (1) conventional p -values; (2) confidence intervals based on meta-analyses assuming fixed or random effects; and (3) Bayes factors. We varied threshold levels for statistical evidence, and thresholds for what constitutes a clinically meaningful treatment effect. Results: Our results show that Bayes factors, meta-analytic confidence intervals, and p-values often have similar performance. Bayes factors may perform better when trials have small sample sizes and clinically meaningful effects are not small, particularly in fields where the number of non-zero effects is relatively large. Conclusions: Thinking about realistic effect sizes in conjunction with desirable levels of statistical evidence, as well as quantifying statistical evidence with Bayes factors may help improve decision-making in some circumstances.
The Utility of Multi-Stack Alignment and 3D Longitudinal Image Registration to Assess Bone Remodeling in Rheumatoid Arthritis Patients from Second Generation HR-pQCT Scans
Authors: Brunet Scott C , Kuczynski Michael T , Bhatla Jennifer L , Lemay Sophie , Pauchard Yves , Salat Peter , Barnabe Cheryl , Manske Sarah Lynn
Published: September 2019

Background: Medical imaging plays an important role in determining the progression of joint damage in rheumatoid arthritis (RA). High resolution peripheral quantitative computed tomography (HR-pQCT) is a sensitive tool capable of evaluating bone microarchitecture and erosions, and 3D rigid image registration can be used to visualize and quantify bone remodeling over time. However, patient motion during image acquisition can cause a “stack shift” artifact resulting in loss of information and reducing the number of erosions that can be analyzed using HR-pQCT. The purpose of this study was to use image registration to improve the number of useable HR-pQCT scans and to apply image-based bone remodeling assessment to the metacarpophalangeal (MCP) joints of RA patients. Methods: Ten participants with RA completed HR-pQCT scans of the 2 nd and 3 rd MCP joints at enrolment to the study and at a 6-month follow-up interval. At 6-months, an additional repeat scan was acquired to evaluate reliability. HR-pQCT images were acquired in three individual 1 cm acquisitions (stacks) with a 25% overlap. We completed analysis first using standard evaluation methods, and second with multi-stack registration. We assessed whether additional erosions could be evaluated after multi-stack registration. Bone remodeling analysis was completed using registration and transformation of baseline and follow-up images. We calculated the bone formation and resorption volume fractions with 6-month follow-up, and same-day repositioning as a negative control. Results: 13/57 (23%) of erosions could not be analyzed from raw images due to a stack shift artifact. All erosions could be volumetrically assessed after multi-stack registration. We observed that there was a median bone formation fraction of 2.1% and resorption fraction of 3.8% in RA patients over the course of 6 months. In contrast to the same-day rescan negative control, we observed median bone formation and resorption fractions of 0%. Conclusions: Multi-stack image registration is a useful tool to improve the number of useable scans when analyzing erosions using HR-pQCT. Further, image registration can be used to longitudinally assess bone remodeling. These methods could be implemented in future studies to provide important pathophysiological information on the progression of bone damage.
Factors associated with the self-management practices of Type 2 diabetes among the middle-aged population of rural area of Pakistan
Authors: Ansari Rashid M , Harris Mark , Hosseinzadeh Hassan , Zwar Nicholas
Published: September 2019

Background: This study is aimed at identifying the factors associated with the self-management practices of type 2 diabetes among the middle-aged population of rural area of Pakistan.Methods: The sample of participants was purposively recruited from the medical clinic of rural area of Pakistan. The participants (n=200) recruited were asked to complete the questionnaire following their informed consents. The study questionnaire consisted of three main sections: socio-demographics, the Urdu-version of Summary of Diabetes Self-care Activities (U-SDSCA), and the extended version of U-SDSCA. In addition, glycosylated hemoglobin (HbA1c) level results were obtained from the medical clinic. The study explored the factors associated with the self-management practices of type 2 diabetes among the middle-aged population of rural area of Pakistan.Results: The current study has demonstrated that self-management activities level among the patients of type 2 diabetes in the rural area of Pakistan was not achieved in majority of patients, and that glycemic control was unsatisfactory. The medications sub-scale mean (Mean: 6.17 ± 1.18 SD) was the highest among all the U-SDSCA instrument sub-scales. The results of blood glucose monitoring subscale revealed that longer duration of diabetes ≥8 years) was associated significantly with poor glycemic control (Diff= -.299; p = .120).The multivariate regression analysis revealed that the participants’ characteristics accounted for 21% of the variability in the total self-management score (R²=0.211). In addition, women were more inclined to undertake appropriate diabetes self-management activities (β .302; p = .001). Conclusion: This study has identified the factors associated with the self-management activities among the patients with type 2 diabetes in rural area of Pakistan. In order to overcome the influence of these factors, healthcare professionals should pay special attention to the patients of middle-aged population of rural area of Pakistan and provide them educational programme that emphasizes lifestyle modification with importance of adherence to treatment and encourage them to make diabetes self-management activities as part of their day to day life.
Down-regulated miR-145 rescues insulin resistance in endothelial cells
Authors: Wang Jing , Dong Zhichun , Lou Liying
Published: September 2019

Background: MiR-145 is involved in insulin resistance (IR) in liver cells, but its effects in human umbilical vein endothelial cells (HUVECs) induced by IR remains unclear. This study took this as the starting point, aiming to find a potential target for the treatment of related disease.
Methods: HUVECs were respectively treated with glucose of 15, 30, 45 mmol/L, or insulin of 1, 2, 3, 4, 5 μmol/L on the basis of high-glucose (33.3 mmol/L). MiR-145 mimics and miR-145 inhibitor were severally transfected into HUVECs with or without IR (4 μmol/L insulin + high-glucose). Quantitative real-time polymerase chain reaction (qRT-PCR) assay determined the miR-145 expression in HUVECs after treatment and transfection. The glucose consumption and glycogen contents of cells were appraised by glucose oxidase-peroxidase and anthranone-sulfuric acid methods, respectively. The apoptotic rates were ascertained using the flow cytometry. The expressions of apoptosis-related indicators Bcl-2 and Bax were analyzed by western blot (WB) and qRT-PCR assays.
Results: The expression of miR-145 was increased in IR models and incremental glucose concentrations. The glucose consumption and glycogen content were down-regulated in IR-induced HUVECs, which were enhanced by over-expressed miR-145 but reversed by down-regulation. Moreover, over-expression of miR-145 aggravated the apoptosis of IR-induced HUVECs, while the inhibition of miR-145 had a completely opposite effect. Accordingly, up-regulated miR-145 obviously reduced Bcl-2 level and enhanced Bax expression in IR models, which was contrary to the down-regulated miR-145.
Conclusion: Down-regulated miR-145 rescued IR in endothelial cells, which might be a conceivable treatment for IR of endothelial cells.
Serum platelet-derived growth factor is a novel biomarker for the prediction of vulnerable plaque in patients with NSTE-ACS
Authors: Zhang Hong , Zhang Ying , Liu Yujie , Ma Kejing , Zhou Jia , Guan Jingjing
Published: September 2019

Objective: To investigate the relationship between serum platelet-derived growth factor (PDGF) and vulnerable plaque in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).Methods: A total of 65 patients with NSTE-ACS were divided into vulnerable plaque group (n=46) and vulnerable plaque and stable plaque group (n=19) according to intravascular ultrasound (IVUS) examinations. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and serum PDGF were measured. Plaque characteristics and components were analyzed using gray-scale and iMap-IVUS. Correlation was performed between plaque characteristics and ACS markers. Logistic regression analysis was applied to determine risk factors. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value.Results: Patients in vulnerable plaque group had visible higher levels of TG, LDL-C and PDGF (P < 0.05). There were significant differences in minimal lumen area (MLA), plaque area, plaque burden, fibrotic (FI), clipidic (LI) and necrotic core (NC) between the two groups (P < 0.05). PDGF was weakly correlated with plaque burden (R=0.428, P < 0.05), as well as moderately correlated with NC (R=0.669, P < 0.05). Multivariate analysis showed that serum PDGF (OR 4.751, [95% CI 1.534-29.543], P=0.05) was an independent risk factor of vulnerable plaque. The area under the curve (AUC) was 0.876 (95% CI 0.804-0.948, P=0.001).Conclusion: Serum PDGF could be used as a novel biomarker for the prediction of vulnerable plaque in patients with NSTE-ACS.
BRD9 controls Oxytocin signal pathway in gastric cancer via CACNA2D4 and CALML6
Authors: Wang Yuan , Jiang Xue-Yan , Zheng Guo-Dong , Xu Chuan-Shan , Liang Lu , Lin Zhong-Xiao , Yu Xi-Yong
Published: September 2019

Background: First-line chemotherapeutic agents have great activation treatment in cancers, but the side effect of these kind drugs also hurt the healthy cells, in some cases, cancer cells are induced drug resistance to chemotherapeutic agents. The molecular mechanisms underlying such side effect have been studied in a range of cancer types, yet little is known in depressing the adverse effect of chemotherapeutic drugs by targeting BRD9 in gastric cancers. Methods: We used two gastric cancer cell lines (MGC-803 and AGS) for comparison. We applied molecular and cellular techniques to measure cell survival, mRNA expression, investigated clinical data in the consensus of The Cancer Genome Atlas, and combined with the High-Throughput Sequencing approach in MGC-803 cells and AGS cells, for global gene expression analysis in inhibiting BRD9 conditions. Results: Our studies have shown that cancer cells with BRD9 over-expression, MGC-803 cells, are more sensitive to BRD9 inhibitors, BI9564 or BI7273, than AGS cells. Its mechanism is related to the regulation of CACNA2D4 and CALML6 oncogenes in the Oxytocin signaling pathway. And BRD9 inhibitors can enhance the sensitivity of gastric cancer MGC-803 cells to adriamycin and cisplatin, so we may reduce the dosage of chemotherapeutic agents in curing gastric cancers with BRD9 over-expression by combining BI9564 or BI7273 with adriamycin or cisplatin. Conclusions: Our study elucidates the feasibility and effectiveness of inhibiting BRD9 to reduce the adverse effect of first-line chemotherapeutic agents in treating over-expressed BRD9 gastric cancer, providing a scientific theoretical basis on chemotherapy regimen in over-expressed BRD9 gastric cancer.
A systematic review of parental vaccine hesitancy and refusal in childhood vaccination
Authors: Dyda Amalie , King Catherine , Dey Aditi , Leask Julie , Dunn Adam
Published: September 2019

Background Acceptance of vaccines is an important predictor of vaccine uptake. This has public health implications as those who are not vaccinated are at a higher risk of infection from vaccine preventable diseases. We aimed to systematically review studies of parental attitudes and beliefs in childhood vaccination, with a focus on the methods used to measure hesitancy and refusal.Methods We identified and reviewed primary research studies using quantitative methods and investigating vaccine attitudes and beliefs published between January 2012 and May 2018. Studies were included if they involved a quantitative survey of the attitudes and beliefs of parents about vaccinations recommended for children. We undertook a narrative synthesis of the results with a focus on evaluating variation in the use of behavioural theories, validated survey instruments, and localisation and adaptation of questions to suit local context.Results A total of 116 studies met the inclusion criteria; 99 used a cross sectional study design, 5 used a case control study design, 4 used a pre-post study design and 8 used mixed methods study designs. Sample sizes of included studies ranged from 49 to 12,259. Thirty-six countries were represented in the included studies. The most commonly used tool was the Parent Attitudes about Childhood Vaccines (PACV) Survey. Questions eliciting vaccination attitudes and beliefs varied widely.Conclusions There was heterogeneity in the types of measures used in studies investigating attitudes and beliefs about vaccination in parents. Broader and more consistent use of validated survey instruments for measuring parental attitudes and beliefs about childhood vaccination would help to better understand localised differences in the reasons for vaccine hesitancy and refusal.
The Sydney Triage to Admission Risk Tool (START) to improve patient flow in an Emergency Department: A model of care implementation pilot study
Authors: Ebker-White Anja , Bein Kendall , Russell Saartje Berendsen , Dinh Michael
Published: September 2019

Background The Sydney Triage to Admission Risk Tool (START) is a validated clinical analytics tool designed to estimate the probability of in-patient admission based on Emergency Department triage characteristics.Methods This was a single centre pilot implementation study using a matched case control sample of patients assessed at ED triage. Patients in the intervention group were identified at triage by the START tool as likely requiring in-patient admission and briefly assessed by an ED Consultant. Bed management were notified of these patients and their likely admitting team based on senior early assessment. Matched controls were identified on the same day of presentation if they were admitted to the same in-patient teams as patients in the intervention group and same START score category. Outcomes were ED length of stay and proportion of patients correctly classified as an in-patient admission by the START tool.Results One hundred and thirteen patients were assessed using the START-based model of care. When compared with matched control patients, this intervention model of care was associated with a significant reduction in ED length of stay [301 minutes (IQR 225-397) versus 423 minutes (IQR 297-587) p<0.001] and proportion of patients meeting four hour length of stay thresholds increased from 24% to 45% (p<0.001).Conclusion In this small pilot implementation study, the START tool, when used in conjunction with senior early assessment was associated with a reduction in ED length of stay. Further controlled studies are now underway to further examine its utility across other ED settings.