bluuebunny/crossref_metadata_2025 huggingface dataset:
Success Story of using an Integrated Subsurface Model for North Kuwait Jurassic Gas Asset Development
Authors: Mahran Ahmed , Grammer Sunday , Emera Mohammed , Sommerauer Gerald , Abbas Ameer Ali , DashtI Qasem
Published: October 2019

The objective of this paper is to show the integrated subsurface reservoir models created for high challengeable HPHT North Kuwait Jurassic (NKJ) Gas Asset. The successful story focuses on the study and modelling achievements that involved applying the appropriate method of upscaling the fine grid static model, calibrating & initializing, history matching with field observation data and finally performing a long-term production forecast. The IPSM (Integrated Production System Modelling) tool has been used to integrate all (six) fields to fill planned facilities and optimize each field forecast to get facilities production target

The new history matched models and base forecast scenarios built by an integrated multi-disciplinary subsurface team of Schlumberger, Shell and KOC staff members. KOC is the focal point and the owner of these models and the asset.

The new Middle Marrat static model is supported as a tool for dynamic simulation, volumetric calculation and other static model applications. Overall the model presents a number of significant improvements over previous models such as the following list of updates:

Updated non-horizontal tilted hydrocarbon contact. Refined zonation and layering to capture vertical heterogeneities observed on porosity / permeability logs Modify the log upscaling method for porosity by removing the bias by facies Update the porosity using the kriging method constrained to IPSOM Correct the log upscaling method for water saturation by using the bulk volume of water Include recent well data Updated fault distribution

Discrete fracture network (DFN) model was built for Middle Marrat reservoirs. The ultimate objective of the fracture modelling work is to provide full field heterogeneous fracture properties to be used in the dynamic simulation as input for history matching and forecasting. The full field DFN which has been calibrated by PTA database.

The models were upscaled and initialized with different approaches such as up-gridding method (SLB workflow) and Reduce ++ application (Shell workflow) on a field by field bases. After the history match and individual development well number and location optimization by reservoir/field, the models were coupled with IPSM tool to predict the production potential of the assets at the per field and reservoir level This tool is the key enabler for asset development planning in order to achieve KOC's gas production target of 1 Bscf/d. The integrated development planning tool allows KOC to determine the number of wells and drilling rigs required to achieve this target. As there are new coming facilities for NJK fields. The integrated development tool was also used to test the gas production plateau length after start-up of the new production facilities and the gas supply of the underlying fields/reservoirs and wells.
Site Preparation & Soil remediation for Kuwait's Largest Environmental Friendly oil Refinery, by Utilizing Dredging & Soil Compaction
Authors: Aljiran Talal , Alkandari Walid
Published: October 2019

Kuwait Integrated Petroleum Industries Company is Constructing a new refinery at AI Zour, Kuwait. The refinery site's native land is low lying and contains areas of loose or poor soils known as Sabkha (soil consisting of deposits which are usually soft and susceptible to salt leaching). The low-lying area is prone to flooding from extreme rainfalls and from extreme high tides. The site of the Al-Zour Refinery requires soil remediation to improve its load bearing properties and it requires to be raised in levels to alleviate the risk of flooding and enabling the underground services to be above the groundwater level, as well as, providing stormwater drainage system of the refinery to be a gravity drained, which will save major capital cost.

KNPC (Former Owner of the Project) has contracted with M/s Van Oord to perform the Ground Remediation and Site Preparation for the project site. The work package is consisting of the preparation, remediation, and filling of the ground in the Al-Zour refinery area to the designed level, including testing and (geotechnical) monitoring. The majority of the fill is imported by dredging; hydraulic transport and disposal of fill materials obtained from selected marine borrow areas. To repopulate the affected marine habitat in the area where the sand was excavated, the crushed rocks are placed on the seabed to create an artificial reef, so that marine habitat can blossom in 5-10 years’ time.

The estimated quantity required to complete the project was 60,000,000 m3. Which is equivalent to 40 times the total volume of Burj Khalifa in Dubai. By using this approach (dredging the sand from the sea) we had prevented the risk of using the public roads to transport around 3.3 million truckloads. Another challenge of the project is the pumping distance for the heavy sand, the closest area is located approximately 5.5 KM from the nearest offshore vessel stand.

This paper will elaborate on the major challenges in this project, where the weak parts of the site are dominant by Sabkha. Therefore, sand was driven in to replace the in-situ soil by placing a layer of sand and dropping heavy concrete blocks. The sand formed columns and a solid base for the material above. Subsequently, another layer of good dredged sand is placed and compacted further. until the final level is reached. This paper will provide insight on how the farsighted vision and planning for major projects from environmentally, safety, logistically and quality point of view has led to a successful execution within the required time period and allocated budget.
Successful Implementation of a Single Well Chemical Tracer SWCT Test for a Giant Sandstone Reservoir in North Kuwait
Authors: Al-Murayri Mohammed T. , Kamal Dawood S. , Al-Abbas Reem S. , Shahin Gordon T. , Chilek Greg A. , Shukla Shunahshep R.
Published: October 2019

A one-spot EOR pilot was successfully completed to demonstrate the efficacy of a lab-optimized ASP formulation to mobilize remaining oil from a giant sandstone reservoir in Kuwait. This one-spot EOR pilot, which also referred to as a Single Well Chemical Tracer (SWCT) test, was a significant milestone in de-risking ASP flooding for multi-well pilot implementation.

The vertical zone of investigation for the Raudhatain Zubair (RAZU) SWCT was chosen to be a confined channel sand with relatively homogeneous and representative properties in a producer near the proposed pilot area. Two SWCT tests were performed and the difference in residual oil saturation from post water flood and post ASP injection tracer tests quantitatively determines the displacement efficiency of the ASP slug. The tracer chemicals for the tests included a hydrolyzing, partitioning tracer (ethyl acetate) and two alcohols (n-propyl alcohol and isopropyl alcohol) that serve as cover tracer and material balance tracer, respectively, to ensure robustness of test interpretation.

The water flood SWCT test showed ideal behavior with well-defined profiles. Interpretation of this test was accomplished using a single layer model and showed that at the end of the water flood, the residual oil saturation to water was 0.24 ± 0.02% in the 23 -ft interval for the SWCT test. The ASP tracer test was complicated due to poor injectivity, well mechanical issues, and dilution from a zone which did not accept any SWCT test injection fluids but contributed substantially to production. Due to the dilution from another zone, the ASP tracer test profiles were more dispersed than the water flood tracer test but were adequately modeled using a two-layer model with irreversible flow. Analysis of the ASP SWCT test showed that the average oil saturation was reduced to 0.06 ± 0.05%, which represents a ~67% reduction in residual oil saturation.

Despite poor injectivity leading to a reduced polymer drive and taper injection and dilution from another zone resulting in a non-idealized tracer response, careful interpretation of the SWCT test measurements resulted in a reliable estimate of the post-ASP oil saturation. The SWCT test results demonstrate the feasibility of applying ASP flooding to increase oil recovery from a giant high-temperature sandstone reservoir in North Kuwait.
Internal Corrosion Severity Ranking of Crude Oil Pipelines
Authors: Jaragh Amer , Al-Ahmad Abdul Wahab , Prakash Surya , Al-Mutairi Adel , Mathew Ashok
Published: October 2019

Internal corrosion is a leading cause of failure of pipelines that transport crude oil. The small amounts of saline water present in crude oil separates over a period due to any stagnancy or low flow conditions. The separated water causes water wetting of the pipe surface and creates corrosive condition along with the presence of carbon dioxide and hydrogen sulfide and bacteria, especially the sulfate reducing bacteria (SRB) and acid producing general anaerobic bacteria (GAnB) that thrive under the anaerobic conditions existing in pipelines. This is the major reason for pitting and leakages of pipelines.

The On-line Corrosion Monitoring (OCM) using corrosion coupons provide early indication of internal corrosion taking place on the pipe wall. The chemical analysis of deposits removed from cleaning pigging provide qualitative information of general corrosion and its possible mechanism, while the microbiological analysis can indicate the involvement of bacteria in the internal corrosion. In-line Inspection (ILI) conducted on a cleaned pipeline measure pit depth on the internal pipe wall.

This paper analyzes the data collected by each of these internal corrosion monitoring techniques and suggests a means for ranking the internal corrosion severity of crude pipelines of the Oil Field Operating Company, based on interpretation of the data. This ranking can help in optimizing the ILI activities by changing to a need-based program from the current schedule-based program.
Big Loop : Capture and Quantity Uncertainty for Accurate Predictions Through Machine Learning Approach
Authors: Agarwal Vikram , Walia Samir
Published: October 2019

Accurate assessments of production forecast of field with time is the ultimate goal of any field operator. To achieve this operators employ a multi-disciplinary team approach and try to obtain a unified representation of the field. The data and the resulting model goes from one team to another after getting the best case or satisfactory results and this has been a standard exercise in the industry till now. In traditional approach, the uncertainties at each stage of the modeling process is not carried over to the next stage and as a result, it is lost at each stage of the process. Big loop addresses this gap in the modeling process where seismic to simulation process is dealt with not just one model at a time, but with ensemble of models and with this approach, the uncertainties are not lost in the process but carried over to the next stage and can be quantified in this process from where they occur to where they matter.

The Big loop workflow is automated and can be run many times and updated with additional information obtained like drilling new wells, as the field passes thru' its lifecycle. With the use of stochastic proxy modeling technique, the stochastic uncertainty in the geological model can be captured. The Big loop workflow gives a geologically consistent history matched model without any local modification in the geological model through the use of machine learning approach and proxy model built by the tool. The model can later be extended to prediction times to capture and quantify uncertainty in the prediction phase of the study. The workflow allows the team to spend more time in analyzing the model to build a common understanding rather than wasting time on manual adjustments or spending time on non-influential uncertain parameters which might not have much influence on the parameters under study.
Building Kuwaiti Researcher Capabilities through DACUM Based S-OJT
Authors: Al-Jasmi Ahmad Kh. , Al-Otaibi Abdullah E. , Al-Qattan Abdullah H. , Thomas Cyril
Published: October 2019

The Innovation & Technology (I&T) group at Kuwait Oil Company (KOC) has been working to build and develop Kuwaiti Researcher capabilities, to be "ready" to execute R&D projects in line with the requirements of the KOC Technology Roadmap. The R&D Planning & Support team has designed and implemented a unique initiative to build this researcher capability, using a DACUM based Structured On-the-Job Training (S-OJT) program. This paper details the capability development program designed by KOC I&T group, to build Kuwaiti Researcher capabilities for the Upstream K-companies.

DACUM is an acronym that stands for "Developing a Curriculum" and involves using a systematic process to analyze and capture a job's duties and tasks, as defined by a group of high-performing incumbent workers. Through the DACUM process, the KOC Junior Researcher job was analyzed and its constituent Duties and Tasks were identified. A detailed training curriculum was defined for each Junior Researcher Task, based on the inputs of Subject Matter Experts. This training curriculum provides information to the trainee, on the Steps that make up each task, resources and trainings required to complete the task, safety information that the trainee must be aware of, and practical learning exercises that the trainee must independently do in order to learn the task.

An implementation process was established to ensure that experienced coaches demonstrated how to perform each task in the actual work setting, while Mentors were assigned to assess and verify trainee learning progress. The advantages in having implemented this program at I&T group included clear evidence-based development, consistency in researcher skill development, and greater trainee motivation.

This process has helped establish a comprehensive and structured training program to develop Junior Researchers in KOC, based on an analysis of their actual work requirements. The training content is developed using internal capabilities, and is delivered by internal coaches and mentors who are well versed with the training curriculum. This Structured On-the-Job Training (S-OJT) program also aligns very strongly with the blended learning principles adopted by K-companies as part of their L&D strategy.
Inclusion of Advanced Completions & Surveillance Data in History Matching and Utility of the Resulting Dynamic Models
Authors: Kasaraneni Pruthviraj , Al-Rashidi Tahani , Al-Zamanan Meshary , Ziyab Khaled , Bahuguna Rakesh
Published: October 2019

Traditionally most Reservoir Engineers give emphasis in matching Water-Cut, GOR, SBHP/FBHP and Cumulative Oil/Water & Gas production. Matching the above said will yield good results at the well level, however what is happening within the layers where the well is completed still remains unclear.

In addition to the conventional production data matching various well surveillance data like Pressure from the RFT data will enhance tracking of the Vertical/Aerial distribution of reservoir fluids. Matching PLT data will result in improving the relative contribution of different layers in the dynamic model. Capturing time-lapse changes of Water/Gas saturation as observed from the TDT/PNC logs in the model will mimic fluid flow and saturation changes in the dynamic model closer to reality. Identifying the amount of water unwantedly being injected in to the reservoir due to casing integrity and simulating its effect during history matching will help in capturing its impact on increasing water saturation and pressure near the well bore.

At the same time due to the complexity and the resultant convergence which arise in modeling advanced completions, typically a positive to skin at the well level is considered to achieve the additional pressure drop which is observed in the constriction (Nozzle) of the ICD. However the effect of flow equalization as a result of implementing ICD is missed in the above approach.

We propose a simplified approach by amalgamating the ICD's into an equivalent acting one. Using Amalgamation it is possible to compute the equivalent length and cross sectional area of an ICD that represents multiple ones. This reduces the number of ICDs in the model, avoids looped flow paths and correctly models annular flow along with great reduction in computational time and convergence.

After thoroughly matching the dynamic model with observed data, well-surveillance data and capturing the flow equalization impact of advanced completions during the long history of 57 years the level of confidence in the history match has increased significantly.

The history matched dynamic model is then used to generate Stream Lines to establish well pair interactions and identify the movement of injected water to optimize injection/production targets. Precisely capturing movement of OWC and tracking the size of Gas-Cap with time has significantly improved the confidence in planning wells. Wells locations thus released on the basis of model results show a good replication of forecasted saturation's and are so far doing well.
Mitigation of Structural Uncertainty in High Angled Dipping Up Middle Marrat Reservoirs With the Help of Deep Electro-Magnetic Inversion Geosteering Technique, Calibrating With Seismic Data- A Case Study, Umm Gudair Field, West Kuwait
Authors: Ray Dipak Singha , Al-Shamali Adnan , Quttainah Riyad , Keot Chandan Jyoti , Noreldeen Salih Abdalla
Published: October 2019

The Umm Gudair field is an elongated doubly plunging anticline which bifurcates into two branches NS elongated West UG and the NE-SW elongated East UG structures with a broad saddle in between Fig1A & 1B. West Umm Gudair structure was formed during the Jurassic time and become reactivated in Cretaceous and Tertiary times. East Umm Gudair was formed during Cretaceous as evident from the thicker deposition of overlying Gotnia sediments and its unique fold geometry.

A total of 28 wells targeting Najmah-Sargelu (NJ/SR) & Marrat reservoirs of Jurassic have been drilled so far in this field including one deep well in South UG in Divided Zone

The Marrat Formation in Umm Gudair field is conventional reservoir with 800ft to 1000ft thick sequence comprising limestone, dolomitic limestone and argillaceous limestone with minor shale and anhydrite. The Jurassic sequence in Kuwait oil fields starts from around 12000ft and is marked by an increase in formation pressure and temperature. Above this lies the Cretaceous sequence where most of the oil field development works have been concentrated in the past. In the last two decades field development has extended to the Jurassic sequence to meet up with increasing production demands. The Jurassic sequence is marked by a series of high pressure and high temperature formations with presence of natural fractures.
Insights on Single Well Chemical Tracer Testing Beyond Oil Saturation Changes
Authors: Al Murayri Mohammed T. , Kamal Dawood S. , Al-Fadhli Atheer A. , Pitts Malcolm , Wyatt Kon , Dean Elio
Published: October 2019

Single Well Chemical Tracer Testing (SWCTT) is traditionally performed to determine oil saturation after waterflooding and after enhanced oil recovery techniques. Raudhatain Lower Burgan (RALB) and Sabriyah Lower Burgan (SALB) SWCTT oil saturation reduction due to injection of surfactant-polymer and alkali-surfactant solutions, respectively, were 7 and 8% OOIP, respectively. During SWCTT, injection rate and surface pressure are routinely measured for each injected solution. Injection rate and surface pressure permit additional determinations to be made as outlined below: Pseudo resistance factor to any fluid "i" can be calculated and, from this, changes in injectivity can be determinedFlowing viscosity of injected fluids relative to waterEffective permeability to injected fluidsInjectivity factors

Pseudo resistance factor for RALB continually increased with seawater injection, from 0.5 to 1.0 indicating a reduction of kwro to approximately half and a twofold loss of injectivity. SALB kwro showed a three-fold loss of injectivity with seawater injection (pseudo resistance factor increased to 1.0 from 0.36). RALB pseudo residual resistance factor was 6.0 indicating a six-fold loss of injectivity due to surfactant-polymer and polymer drive solution injection even though the oil saturation was reduced by 7% OOIP. SALB pseudo resistance factor increased to 1.7 during alkaline-surfactant solution, indicating a loss of injectivity and an increase in flowing viscosity. SALB pseudo residual resistance factors were 0.89 to 1.06 suggesting no damage to reservoir rock and no loss to a slight increase of injectivity or an increase of kwro after an 8% OOIP saturation reduction. RALB surfactant-polymer rheometer viscosity was 0.55 cP while flowing viscosity was 0.21 cP as calculated from pseudo resistance factor data with the comparative polymer drive solution viscosities being 1.9 cP rheometer and 0.16 cP flowing. SALB alkaline-surfactant solution flowing viscosity was calculated to be 0.80 cP compared to water viscosity of 0.50 cP. Calculated SALB kwro values for injection of water, alkaline-surfactant, and water flush after alkaline-surfactant are 0.012, 0.007, and 0.011 to 0.015mD, respectively. Calculated RALB kwro values for injection of seawater and seawater flush after surfactant-polymer/polymer flush are 0.019 and 0.004 mD.
Minimally invasive versus conventional fixation of tracer in robot-assisted pedicle screw insertion surgery: a randomized control trial
Authors: Yongqi Li , Dehua Zhang , Hongzi Wu , Ke Zhang , Rui Yang , Zhou Fang , Shaobo Wang , Liao Yi
Published: October 2019

Background This study evaluated the minimal invasiveness, safety, and accuracy of robot-assisted pedicle screw placement procedure using a modified tracer fixation device. Methods Patients were randomly assigned to conventional fixation group (25 patients) and modified fixation group (27 patients). Results No baseline statistical difference was observed between the groups ( P >0.05). The length of unnecessary incision, amount of bleeding, and fixation duration for tracer fixation respectively were 6.08±1.02 mm, 1.46±0.84 ml, and 1.56±0.32 min in the modified fixation group and 40.28±8.52 mm, 12.02±2.24 ml, and 5.08±1.06 min in the conventional group. The difference between both groups was significant ( P <0.05). However, no significant difference between the two groups was observed in terms of the accuracy of pedicle screw placement ( P >0.05). Conclusions The modified minimally invasive procedure for tracer fixation results in minimal trauma and is simple, reliable, and highly safe. Additionally, the procedure does not compromise the accuracy of pedicle screw placement. Thus, it has great clinical applicable value.
Effects of alternate-day fasting on body weight and dyslipidaemia in patients with non-alcoholic fatty liver disease: a randomised controlled trial
Authors: Cai Hua , Qin Yue-Lan , Shi Ze-Ya , Chen Jin-Hui , Zeng Min-Jie , Zhou Wei , Chen Ru-Qun , Chen Zhi-Yuan
Published: October 2019

Background: Alternate-day fasting (ADF) is a novel diet therapy that may achieve reduction in body weight and improvement of dyslipidaemia, but the impact of this diet on patients with non-alcoholic fatty liver disease (NAFLD) remains unknown. The aim of this study was to evaluate the effects of ADF on the body weight and lipid profile of individuals with NAFLD. Methods: NAFLD patients (n=271) were randomised to the ADF group, time-restricted feeding (TRF) group, or the control group and subjected to the respective diet for 12 weeks. Anthropometric measurements (body weight, fat mass/fat-free mass) were performed, and plasma lipids were analysed enzymatically. Results: Within 4 weeks, the body weight decreased significantly (P<0.001) in the ADF group by 4.56±0.41 kg (6.1 ± 0.5%) and the TRF group by 3.62±0.65 kg (4.83±0.9%) compared to the control group, and it decreased even more after 12 weeks in both groups (ADF: -4.04±0.54 kg, 5.4±0.7%; TRF: -3.25±0.67 kg, 4.3±0.9%). Fat mass was significantly reduced by ADF (-3.49±0.37 kg; 11±1.2%) and TRF (-2.91±0.41 kg; 9.6±1.3%), with ADF leading to a further reduction in fat mass after 12 weeks (-3.48±0.38 kg; 11±1.2%). Total cholesterol was significantly decreased at both time points in the ADF group (-0.91±0.07 mmol/L; 18.5±1.5%) compared to the control and TRF groups. Both ADF (-0.64±0.06 mmol/L; 25±1.9%) and TRF (0.58±0.07 mmol/L; 20±1.7%) achieved a significant reduction in serum triglycerides (P<0.001) after 12 weeks. Changes in fat free mass, HDL, LDL, fasting insulin, glucose, and systolic or diastolic blood pressure did not differ between the groups. Conclusions: ADF appears to be an effective diet therapy for individuals with NAFLD that can achieve weight loss and improvement of dyslipidaemia within a relatively short period of time (4 to 12 weeks). Potential preventive effects of ADF on cardiovascular disease need to be confirmed by future investigations. Trial registration: ChiCTR1900024411, this trial was retrospectively registered on July 10, 2019
Post-hospital medical respite care for homeless people in Denmark: A randomized controlled trial and cost-utility analysis.
Authors: Bring Camilla Nygaard , Kruse Marie , Ankarfeldt Mikkel , Brünés Nina , Pedersen Maja , Petersen Janne , Andersen Ove
Published: October 2019

Background: Being homeless entails higher mortality, morbidity, and prevalence of psychiatric diseases. This can lead to more frequent and expensive use of health care services. Medical respite care enables an opportunity to recuperate after a hospitalization and has shown a positive effect on readmissions, but little is known about the cost-effectiveness of medical respite care for homeless people discharged from acute hospitalization. Therefore, the aim of the present study was to investigate the cost-effectiveness of a 2-week stay in post-hospital medical respite care. Methods: A randomized controlled trial and cost-utility analysis, from a societal perspective, was conducted between April 2014 and December 2015. Homeless people aged >18 years with an acute admission were included from 10 different hospitals in the Capital Region of Denmark. The intervention group (n=53) was offered a 2-week medical respite care stay at a Red Cross facility and the control group (n=43) was discharged without any extra help (usual care), but with the opportunity to seek help in shelters and from street nurses and doctors in the municipalities. The primary outcome was the difference in health care costs 3 months following inclusion in the study. Secondary outcomes were change in health-related quality of life and health care costs 6 months following inclusion in the study. Data were collected through Danish registries, financial management systems in the municipalities and at the Red Cross, and by using the EQ-5D questionnaire. Results: After 3 and 6 months, the intervention group had €4,761 (p=0.10) and €8,515 (p=0.04) lower costs than the control group, respectively. The higher costs in the control group were mainly related to acute admissions. Both groups had minor quality-adjusted life year gains. Conclusions: This is the first randomized controlled trial to investigate the cost-effectiveness of a 2-week medical respite care stay for homeless people after hospitalization. The study showed that a medical respite care stay for homeless people is cost-effective. Furthermore, this study illustrates that it is possible to perform research with satisfying follow-up with a target group that is hard to reach. Trial registration: ClinicalTrials.gov Identifier: NCT02649595
Changing Medical Education Scenario: A wakeup call for reforms in Anatomy Act
Authors: Lalwani Rekha , Kotgirwar Sheetal , Athavale Sunita A.
Published: October 2019

Background Anatomy Act provides legal ambit to medical educationist for the procurement of cadavers. The changing medical education scenario and socio-demographic change has necessitated an urgent review of the concerned legal framework. Suitable amendments addressing the current disparities and deficiencies are long overdue. Methods Anatomy Act in India is a state act and which ensures provision of unclaimed /donated bodies for Medical Education and research. The methodology included three components namely: Comparison of various Anatomy Acts clause by clause; Feedback from anatomist; Formulation of comprehensive model Anatomy Act. Results Various acts studied showed discrepancies in purpose of the act, roles and duties of stake holders, regulation for body donation, procedure to handle unclaimed bodies, disposal of dissected bodies etc. None of the acts defines a donor and neither addresses the issue of transport of anatomical material. Only ten states have a clause for body donation. Acts of only six states have been amended over last 50 years. Three states denied having an act. The whole exercise of review of acts and extensive feedback received from end-users culminated in drafting of a comprehensive model Anatomy act. Conclusion India, with the largest number of medical colleges is not only at forefront but also a hub of medical education in Southeast Asia region. A legal reform can be a torch bearer for other countries of the region with similar socio-demography and shall motivate anatomic fraternity across the globe for critical analysis of their respective anatomy acts. Keywords : Cadaver; Dissection; Medical Education; Southeast Asia.
Steep decline of HPV 6 and genital warts despite low HPV vaccination coverage in young women in Germany: a long-term, population-based cohort study
Authors: Denecke Agnieszka , Iftner Thomas , Iftner Angelika , Riedle Sebastian , Ocak Marion , Luyten Alexander , Üye Isak , Tunc Kübra , Petry Karl Ulrich
Published: October 2019

Background: The introduction of human papilloma virus (HPV) vaccination has resulted in a remarkable decline of genital warts in women and men, but in Germany historical rates of vaccination are relatively low. We report long-term surveillance data on changes in HPV 6 and 11 infection and the prevalence of genital warts in young women in the Wolfsburg HPV epidemiological study (WOLVES).Methods: Women born in 1983/84, 1988/89, and 1993/94 participated in four cohorts between 2009/10 and 2014/15. Vaccination coverage and prevalence of HPV 6/11 and genital warts are reported for participants aged 19−22 years and 24−27 years at the time of analysis. Statistical analyses were done to compare similarly aged participants using 2 x 2 contingency tables (Röhmel-Mansmann unconditional exact test; two-side alpha of 0.05).Results: A total of 2,456 women were recruited. In 2010, vaccination rates were 40/659 (6.1%) in women aged 24−27 years and 142/600 (23.7%) in those aged 19−22 years; 5 years later, vaccination rates had increased to 135/733 (18.4%) and 177/368 (48.1%), respectively. Between 2010 and 2015, there was a statistically significant decrease in the prevalence of HPV 6 among women aged 24−27 years (2.12% versus 0%; P<0.0001) and women aged 19−22 years (2.0% versus 0%; P=0.0056). In total, 52 of 2341 participants were diagnosed with genital warts. There was a statistically significant decrease in the life-time risk of developing genital warts in women aged 24−27 years between 2010 and 2015 (4.7% versus 1.68%, respectively; P=0.0018). The overall life-time risk of developing genital warts in women aged 19−27 years decreased from 3.1% in 2010 to 1.2% in 2015 (P=0.0022).Conclusions: An increase in vaccination coverage was associated with a decreased prevalence of genital warts in young women. A protective effect greater than herd immunity alone was seen despite low vaccination rates. Quadrivalent vaccine had a protective effect on genital HPV 6 positivity and a fully protective effect on the development of genital warts in the youngest population.
Comprehensive Analysis of mRNAs and miRNAs in the Ovarian Follicles of Uniparous and Multiple Goats at Estrus Phase
Authors: Zou Xian , Lu Tingting , Zhao Zhifeng , Liu Guangbin , Lian Zhiquan , Guo Yongqing , Sun Baoli , Liu Dewu , Li Yaokun
Published: October 2019

Background Fertility is an important economic trait in production of meat goat, and follicular development plays an important role in fertility. Despite many mRNAs and microRNAs (miRNAs) have been found in playing critical roles in ovarian biological processes, the interactions between mRNAs and miRNAs in follicular development is not yet completely understood. In addition, less attention has been given to the single follicle (dominant or atretic follicle) in goat. The study was aimed to identify mRNAs, miRNAs and signaling pathways as well as their interaction networks in the ovarian follicles (large follicles and small follicles) of multiple and uniparous goats (Chuanzhong Black Goats) at estrus phase by using a deep RNA-sequencing (RNA-seq) method.Results The result showed that there were more large follicles in multiple than in uniparous goats ( P <0.05), while no difference was observed in small follicles between them ( P >0.05). For the small follicles of multiple and uniparous goats at estrus phase, 289 differentially expressed mRNAs (DEmRNAs) and 16 DEmiRNAs were identified; and for the large follicles, 195 DEmRNAs and 7 DEmiRNAs were identified. Ovarian steroidogenesis and steroid hormone biosynthesis were significantly enriched in small follicles, while ABC transporters and steroid hormone biosynthesis in large follicles. The results of qRT-PCR were generally consistent with the RNA-seq data. The mRNA-miRNA interaction network showed that CD36 (miR-122, miR-200a, miR-141), TNFAIP6 (miR-141, miR-200a, miR-182), CYP11A1 (miR-122), SERPINA5 (miR-1, miR-206, miR-133a-3p, miR-133b) and PTGFR (miR-182, miR-122) might be related to fertility, but need further verification.Conclusion This study provides the first identification of the DEmRNAs and DEmiRNAs as well as their interactions in the follicles of multiple and uniparous goats at estrus phase by using RNA-seq technology. These analyses provide new clues to uncover molecular mechanisms and signaling networks of goat reproduction which could be potentially used to increase ovulation rate and kidding rate in goat.
Accessibility and utilization of modern health care among rural community in Ethiopia: The case of Bako district, Western Oromia: Community based descriptive cross-sectional study
Authors: Abdisa Tadesse Abdisa , Desalegn Zelalem , Cheme Melese Chego
Published: October 2019

Objectives: Knowing determinants of health seeking behaviors of families is significant in assuring access and utilization of health services. Less is known on the seeking behaviors and access of modern health services among populations in rural settings in Ethiopia. The general Objective of the study is to assess health care seeking behavior (Utilization) and associated factors among the community of in Bako Tibe District, Ethiopia. Community based descriptive cross-sectional study design was used on 750 head of the residents of ≥18 years old. Multistage sampling technique was used to get the households and data was collected by interview using structured questionnaire and analyzed using SPSS version 24. Binary and multiple logistic regression analysis were used to identify the factors associated with the health seeking behavior. Results: 495(66%) reported having morbidity and level of health care seeking behavior was 78.6% of which 66% sought care from government facilities. Sex of respondent, residence, family size, educational status, monthly income, disease condition, Perceived severity & access to needed health information were found to be significant associated factors of healthcare seeking behavior of the respondents in multiple logistic regression analysis. Keywords: Health seeking behavior, Access, Bako district, Ethiopia
The effects of protective lung ventilation on regional cerebral oxygen saturation in intracranial tumor operative during dura opening：study protocol for a randomized controlled trial
Authors: Li Jinlu , Wu Xuemei , Liu Hairui , Huang Ying , Liu Yueqin , Xie Hong , Dong Jun
Published: October 2019

Objective:To investigate the effects of protective lung ventilation on regional cerebral oxygen saturation during dura opening, that is from after dura opening (T1a) to before dura closing (T2b), in patients undergoing intracranial tumor surgery. Methods: This is a randomized, controlled trial which will be carried out at the second affiliated hospital of Soochow University. Fifty-four patients undergoing intracranial tumor surgery will be randomly allocated to the control group and the protective lung ventilation group. In the control group, tidal volume (VT) will be set at 8 ml/kg of ideal body weight, but positive end-expiratory pressure (PEEP) and recruitment maneuvers will not be used. In the protective lung ventilation group, VT will be set at 6 ml/kg of ideal body weight combined with individualized PEEP (PEEPx) during intraoperative dura mater opening, but in other periods of general anesthesia, VT will be set at 8 ml/kg of ideal body weight. Titration method of individualized PEEP (PEEPx) [1]: VT and respiratory rate will be fixed at 6ml/kg and 15 beats per minute during PEEP trial. Titration can only begin once the dura is opened. The titration for the individual PEEP can then be initiated by increasing PEEP from 2 to 10cm H2O incrementally. Each PEEP level (2, 3, 4, 5, 6, 7, 8, 9, 10cm H2O) will be maintained for 1 minute, and the pulmonary compliance of the last cycle will be recorded at each PEEP level. At last, the PEEP value at the highest compliance will be selected as the individual PEEP of patient. Regional cerebral oxygen saturation (rSO2), partial pressure of oxygen and carbon dioxide, oxygenation index, lactic acid level in arterial blood, and mean arterial pressure will be compared before anesthesia (T0), before dura opening (T1), after dura closing (T2) and 24 h after surgery (T3). Pulmonary ultrasound scores will be performed at T0 and T3.The degree of brain relaxation before and after protective lung ventilation will be evaluated by the surgeon using the brain relaxation scale. Amount of vasoactive drugs used and blood loss will be recorded during intraoperative dura mater opening. The total duration and secondary rate of surgery also will be recorded. Discussion: This study aims to determine whether intraoperative pulmonary protection strategy can improve regional cerebral oxygen saturation in patients undergoing intracranial tumor surgery, and to investigate whether intraoperative pulmonary protection strategy does not affect the degree of brain tissue swelling and the amount of blood loss during surgery. If our results are positive, this study will show that intraoperative pulmonary protection strategy can be used effectively and safely in neurosurgical patients undergoing craniotomy for tumor resection. Trial registration: chictr.org.cn, ID: ChiCTR1900025632. Registered on 3 September 2019. tudy protocol version 1.0.
Molecular characterization, expression and functional analysis of acyl-CoA-binding protein gene family in maize (Zea mays)
Authors: Zhu Jiantang , Li Weijun , Zhou Yuanyuan , Pei Laming , Liu Jiajia , Xia Xinyao , Che Ronghui , Li Hui
Published: October 2019

Background: Acyl-CoA-binding proteins (ACBPs) have a conserved acyl-CoA-binding (ACB) domain which facilitates binding to the acyl-CoA ester and trafficking in eukaryotic cells. Although the various functions of ACBP have been characterized in several plant species, its structural features, molecular evolution, expression profiling and function in Zea mays L . are still not clear. Results: Genome-wide analysis identified nine ZmACBP genes in Z. mays , which were divided into four groups (class I, class II, class III, and class IV) by a phylogenetic tree constructed with 48 ACBP genes from six plant species. The subcellular localizations of the ZmACBPs were displayed subcellular multi-localization via transient expression of green fluorescence protein (GFP) fusions in tobacco ( Nicotiana tabacum ) epidermal cells. The expression profiles of ZmACBPs are dramatically different in different organs and normal growth, as well as abiotic or biotic stress by Quantitative RT-PCR (qRT-PCR). Eight of nine ZmACBP genes located in metaQTL regions associated with agronomic traits in maize. The heterologous constitutive expression of ZmACBP1 and ZmACBP3 in Arabidopsis enhanced the resistance to salinity and osmotic stress. Conclusion: The ACBP genes family in Z. mays were highly conserved. ZmACBP genes had clear tissue and organ expression preference and were involved in abiotic or biotic stress response, suggesting their roles in plant growth and stress resistance.
Risk of ophthalmic adverse events in patients treated with immune checkpoint inhibitor regimens: A systematic review and meta-analysis
Authors: Hou Yan-li , Wang Di-ya , Tian Ru-yue , Hu Jie-xuan , Wang Wei , Su Qiang , Wang Yan-ling , Burnier Miguel N.
Published: October 2019

Background We performed a systematic review and meta-analysis to evaluate the risks of ophthalmic adverse events (AEs) associated with immune checkpoint inhibitors (ICIs) in patients with solid tumors.Methods Eligible studies were selected after a comprehensive search of multiple databases including phase II/III randomized controlled trials (RCTs) investigating ICIs in patients with the solid tumor. The data was analyzed by R software.Results After exclusion of ineligible studies, 21 RCTs met our strict inclusion criteria for the meta-analysis, included 11930 patients. Compared with chemotherapy, the odds ratio of all-grade ophthalmic treatment-related adverse events (trAEs) were significantly lower for PD-L1 inhibitors (OR: 0.18; 95% CI: 0.08-0.39; p<0.0001) and PD-1 inhibitors (OR 0.44, 95% CI: 0.23-0.83, p<0.050). The combination therapy of PD-1 plus CTLA-4 inhibitors significantly increased the risks of all-grade ophthalmic trAEs (OR 5.29, 95% CI: 1.59-17.57, p<0.05) and all-grade ophthalmic immune-related AEs (irAEs) ( OR: 3.67; 95%CI: 1.08-12.50; p<0.05) compared with PD-1 or CTLA-4 inhibitors monotherapy. The combination therapy of ICIs plus chemotherapy also significantly increased the risks of all-grade ophthalmic trAEs (OR, 3.44; 95%CI, 1.72-6.88; p<0.001) and all-grade ophthalmic irAEs ( OR: 3.69; 95%CI: 1.32-10.32; p<0.05) compared with chemotherapy. The risks of high-grade ophthalmic AEs had no difference in any subgroup compared with control.Conclusions Our meta-analysis demonstrated that compared with chemotherapy, PD-L1/PD-1 inhibitors had lower risks of all-grade ophthalmic trAEs and non-specific ophthalmic trAEs (NS-trAEs) but had the same risk of ophthalmic irAEs. Combination therapy of ICIs plus chemotherapy had higher risks of all-grade ophthalmic trAEs and irAEs. Compared with PD-1 or CTLA-4 inhibitors monotherapy, PD-1 plus CTLA-4 inhibitors combination therapy had significantly higher risks of all-grade ophthalmic trAEs and irAEs.
Determinants of utilization of maternal health care services among mothers in Harare, Zimbabwe
Authors: Mundagowa Paddington Tinashe , Nyarambi Eunice , Chadambuka Elizabeth
Published: October 2019

Background: Provision of quality maternal health care services is an essential component in ensuring a healthy mother-baby dyad both pre- and post-delivery. In Africa, antenatal care, postnatal care, and skilled birth attendances are very low when compared to high-income countries. The continent has a high burden of maternal and infant morbidity as well as mortality rates. According to the Harare Annual Report of 2016, the number of women seeking maternal health care services was gradually declining from 2014 and pregnant women reported various challenges in accessing health care services. Methods: A 1 to 1 case-control study was conducted in Harare West South Western District using pretested interviewer-administered questionnaires. The study was carried out at all three clinics in the district and a total of 73 cases and 73 controls were selected using a systematic random sampling method. Quantitative data were analyzed using Epi Info statistical package and qualitative data was analyzed thematically. Results: The median ages for cases and controls were 29 and 24 years, respectively and the age-group 19 to 24 years constituted the majority of participants (41%). Predictors of utilization of services were young age ( < 24 years), birth order of < 2, maternal and paternal occupation, and religion. Enabling factors included: asking for permission to seek care, absence of transport challenges, a shorter distance to the health facility, affordability of health services, and a higher household income. Besides the shortage of skilled staff at the clinics, mothers endured long waiting hours to be served. The majority of the cases (78.1 %) and controls (72.6%) preferred to be attended by male nurses. Mothers were required to pay a $25 fee for booking and city medical staff rarely visited the clinics. Conclusion: The utilization of maternal health care services in Harare is dependent on the individual, household, and system-related factors. There was a need to articulate policies and design maternal health care programs that target socially and economically marginalized women. Creating women-friendly health facilities with extended hours for the antenatal care, delivery care and post-natal care services for mothers can help to decongest the health facilities.
Cardiac Surgical Outcome Prediction by Blood Pressure Variability Indices Poincaré plot and Coefficient of Variation: an Observational Study
Authors: K Senthil Packiasabapathy , Prasad Varesh , Rangasamy Valluvan , Popok David , Xu Xinling , Novack Victor , Subramaniam Balachundhar
Published: October 2019

Background Recent literature suggests a significant association between blood pressure variability (BPV) and postoperative outcomes after cardiac surgery. However, its outcome prediction ability remains unclear. Current prediction models use static preoperative patient factors. We aimed to test the performance of Poincaré plots and coefficient of variation (CV) independently by measuring intraoperative BP variability.Methods In this retrospective, observational, cohort study, 3687 adult patients undergoing cardiac surgery from 2008 to 2013 were included. Poincaré plots from BP data and descriptors SD1, SD2 by ellipse fitting technique were computed. The outcomes analyzed were the 30-day mortality and postoperative renal failure. Logistic regression models adjusted for preoperative and surgical factors were constructed to evaluate the association between BPV parameters and outcomes. C-statistics were used to analyse the predictive ability.Results Analysis found that, 99 (2.7%) patients died within 30 days and 105 (2.8%) patients suffered from in-hospital renal failure. Logistic regression models including BPV parameters (SD1, SD2 and CV) performed poorly in predicting postoperative 30-day mortality and renal failure. They did not add any significant value to the conventional prediction model.Conclusions We demonstrate the feasibility of applying Poincaré plots for BP variability analysis. Patient comorbid conditions and other preoperative factors are still the gold standard for outcome prediction. Future directions include analysis of dynamic parameters such as complexity of physiological signals in identifying high risk patients and tailoring management accordingly.