bluuebunny/crossref_metadata_2025 huggingface dataset:
Wax Removal Procedure Used in Pre-Salt Oil Well
Authors: Andreotti Thiago , Neto José Alberto Rodini , Lorenzeti Jorge Fernando Canato
Published: October 2017

This paper presents a real case of wax deposition in production lines from one Brazil Pre-salt well located at Santos Basin. It also shows a diagnosis of the problem as well as the methods adopted to remove the wax.

An effective wax removal method may imply great costs, not only to implement it but also regarding the production loss involved. The best solution may not always be the one that removes the greatest amount of wax, but the one that implicates lower costs and allows operational continuity.

In order to remove wax from production line, the first method used was pig launching. The second was diesel soaking and the third and final method used was a high velocity viscous flow inducing shear tensions to the walls.

The result of each method allowed us to choose the best one regarding: production continuity, cost and wax removal effectiveness. It was possible to identify that the approach of pig launching was not effective enough. The diesel soaking approach had better result than the pigging, but generated higher costs due to the great length of the production line (9 km). The high velocity viscous flow method was the approach that gave the best results, concerning not only the amount of wax removed but also the reduced "closed well time" and costs. Repeating the high velocity viscous flow approach allowed us to optimize operation total time and the diesel consumption to perform it. The greatest conclusion was to find a method to prevent complete blockage of the production line without wasting long time of well production.

Once this was the first well from Santos Pre-salt to present wax deposition issues, this paper is an important report of good practice in dealing with such a problem.
MPC Advanced Control of an Offshore Gas Compression System
Authors: Plucenio A. , Normey-Rico J. , Vettorazzo C. , Campos M. M. , De Lima M. Lopes
Published: October 2017

This work presents the utilization of Model Predictive Control (MPC) as a tool to help the regulatory control of the compression system of an offshore oil and gas production unit in three importan tasks: to avoid the system to approximate the surge region to increase stability margins and availability and to minimize energy consumption and gas flaring. Although the proposed structure is general, the present work focus on the solution proposed for a particular compression unit of a real off-shore platform. The modeling of the process and the proposed MPC algorithm are discussed and some simulated results illustrate the advantages of the proposed strategy.
Saving Capex on Further Development of Complex Mature Fields with MPD in Deep Water Drilling - Roncador Case
Authors: Campos Otávio
Published: October 2017

At mature field stage, new wells may need to cross reservoirs with different pressure gradient levels. This phenomenon may increase due to the field development strategy. This approach for Roncador development led to a wide range of reservoir pressure at its mature stage. We found that our development of the Managed Pressure Drilling - MPD technique has helped to overcome the problems that arise due to that field development strategy.

At Roncador field we build a trajectory that crosses multiple reservoirs before reaching the objective reservoir, we add to that difficult the occurrence of multiple reservoirs producing by different systems. So at the same region we experience reservoirs with wide gradient pressure levels. The MPD approach is a drilling process that controls the annular pressure profile throughout the wellbore. The objective is to ascertain the downhole pressure and to manage the annular pressure profile. With downhole pressure control in mind, we than developed the well design and project to minimize difficulties that usually arise during drilling and casing setting of new wells at mature fields.

This MPD strategy led to shorter drilling times, thus saving on CAPEX needed to develop a mature filed or early production strategies. When a complex pressure profile arises, it possible to save time and money on sandstone reservoir wells with this MPD variety.
Evaluation of Social and Economic Impacts of Local Content Management in Oil & Gas and Shipbuilding Industry in Brazil: An Ppplication of Input-Output Analysis
Authors: Furtado S. R. , Júnior E. D. , Almeida M. F. L.
Published: October 2017

This paper aims at evaluating the applicability of input-output analysis to local content management practices as a tool to assess the relationship between the Brazilian Government's Local Content Policy and social and economic impacts of implementation of investment projects in the Oil & Gas and Shipbuilding Industry in Brazil.

The methodology comprised literature review on central themes, a field research and a case study focusing on investment projects.

A logical framework was developed, by combining monitoring and evaluation (ME) models identified from the literature review and the conceptual approach of input-output analysis. Based on this framework, a Reference Project concerning the development of an oil field in Brazilian Pre-salt region was defined. From typical information from other similar projects in Brazil, investments associated with "Drilling, Assessment, and Completion System", "Production Collection System" and "Production Unit" was considered.

The main result refers to the creation of a new logical framework which allows measuring the social and economic impacts of Local Content management on investment projects in Oil & Gas and Shipbuilding Industry in Brazil. It can be used as a powerful tool either for crisis management arising from possible reduction of investments in Local Content, subsidizing actions to mitigate negative social impacts that could damage the corporate image of these companies, and for formulation or revision of Local Content public policies that enhance the positive externalities of investment projects in this industry.

The results of the case study demonstrated how the investments of Oil Company could generate positive socioeconomic externalities. The "Social and Economic Impacts Report" for the Reference Project showed the results of direct, indirect, income and total effects for impacts on the Value of Production, GDP and on the generation of job positions, for each of the 55 economic activities in the Brazilian input-output matrix prepared by the Brazilian Institute of Geography and Statistics (IBGE).

Finally, these externalities were correlated with the structure of Local Content requirements established by the Brazilian regulation, to identify competitive advantages for the oil & gas and shipbuilding companies in the country.
Salt Heterogeneities Characterization in Pre-Salt Santos Basin Fields
Authors: Barros P. M. , Fonseca J. S. , Silva L. M. , Maul A. , Yamamoto T. , Meneguim T. , Queiroz L. E. , Toribio T. , Martini A. F. , Gobatto F. , González M.
Published: October 2017

Geomechanical models need to incorporate a more reliable geological model concerning the overburden as well as the underburden sections. These aspects are more important when considering the flow simulation model and the injection and/or production of the field due to the surrounding rocks behavior and their responses against those ratios (injection/producing).

Therefore, a 3D model is needed and the oil industry faces a great challenge: how to build this reliable model without seismic information? Or, how to use seismic properties with all their ambiguity to derive this 3D model?

Special attention is necessary when observing the salt-section above the pre-salt reservoir in Santos Basin, Brazil, since the amplitude response is heavily influenced by the velocity model used for the migration process.

The majority of these velocity models are considered non-geological as the main reasoning for them is only to produce a good image. To build a good seismic image, reproducing the geology is not needed: the only condition imposed on the model is that the migration operators applied using that model will focus the image. In other words, we could see a completely alien model regarding geology that focuses the image, and that model would be considered correct.

In this paper, we will illustrate a way to build plausive velocity models fitting both the geology and the mathematics of the migration for a good seismic image. This allows for the use of the amplitude response for many purposes, including (but not limited to) deriving geomechanical properties, predicting the lithologies inside the evaporitic section and recursively building a new, more realistic velocity model.
A Solution to Optimize the Logistics of a Fleet of Workover Vessels Applied to Offshore Operations in the Gulf of Mexico
Authors: Vasconcelos David , Nogueira Elysio , Sousa Sergio , Charrouf Raed
Published: October 2017

Workover vessel operations in offshore oil fields are crucial to recovering productivity and helping ensure safety. Because of economic constraints, the number of workover vessels is often limited, and logistics optimization has significant relevance. This paper provides a methodology for increasing efficiency with regards to the operational management of these vessels.

The method to address logistics optimization for a fleet of vessels should consider fleet and operational constraints to help determine the most economic routes to perform tasks in different geographic locations. This paper presents a solution to a workover operation routing problem performed by a heterogeneous fleet of vessels with different load capacities and limited abilities to perform different operations. Decisions were necessary to determine which boat should perform each task scheduled for a location at a specific time. The model was developed using operational historical data integrated into an optimization workflow, based on genetic algorithms, to determine which itinerary and tasks each vessel should execute.

This work evaluated two fleet scenarios characterized by vessel capacity and potential ability to perform specific tasks. The results reveal the possibility of a significant reduction in the total time necessary for the fleet to perform the same group of tasks. For both configurations evaluated, the total time reduction was 20 and 40%, respectively. This reduction in total time could result in an increase in tasks performed within a given time period, improved operational economics attributed to reducing downtime, and less production loss caused by the absence of these services. Another benefit provided by this methodology is the capability to generate a new optimized schedule, as necessary.

In the current scenario of high economic variation and uncertainties and reduced oil prices, increasing operational efficiency is a primary challenge. The study results illustrate the importance of an improved method to optimize fleet logistics, thus improving key performance indicators (KPIs) of interest to stakeholders, such as reduced navigation time, improved economics, and improved operator satisfaction. Furthermore, the general methodology presented can be adapted to other routing problems encountered within the petroleum industry.
Temperature Development in Coiled Tubing Cementing Operations in Deepwater Environments
Authors: Calçada Luis Américo , Scheid Claudia Miriam , Hora Paraiso Eduardo Cunha , Filho Leônidas Pereira , Gonçalves Pereira Caroline Eulino , Rocha José Marcelo , Martins André Leibsohn , Filho Leônidas Pereira
Published: October 2017

Coiled tubing cementing has grown as an attractive option for plugging and abandonment (P&A) operations in deepwater environments. Flow through long extension coils generates extra friction which results in relevant pressure and temperature increments in the cement slurry pumping process. Petroleum industries do not have standard procedures to predict these variables that impact slurry properties in deepwater cementing. This fact leads to conservative slurry designs, generating extra costs and eventually affecting its stability.

This work describes the proposition of a mathematical model to predict friction and heat transfer while pumping cement slurries and all the associated fluids through a coiled section. Based on momentum and energy conservation laws, the proposed model aims to generate representative transient pressure and temperature profiles to be coupled to the wellbore thermal model and, finally, provide a reliable schedule for thickening time testing. A broad discussion on initial and boundary conditions allows accounting for fluid-metal-environment heat exchanges. A comparison with different field measurement sets obtained from deepwater cementing operations indicates relative deviations smaller than 10%. The implementation of the methodology leads to the design of optimized slurries, reducing operational costs due to additives and WOC times and risks associated with sedimentation.
Identification of Stresses on Near-Borehole Field Using Cross-Dipole Sonic Tool and Image Logs: Case Study in Deepwater Carbonate
Authors: Tamoto Hugo , Bittencourt Rossi Tiago de , Barroso Fouraux Mateus
Published: October 2017

Near-borehole stress analysis is performed from an integrated interpretation of sonic, imaging, and caliper tools to determine the magnitude and orientation of stresses around the borehole. These stresses can affect the wellbore stability because the tectonic stress field is disturbed during the well drilling. This paper presents a case study in which integrated information from borehole acoustic logs, image logs, and caliper tools were used to identify stresses in the near-borehole region of a deepwater presalt formation, offshore Brazil. The objectives were to extract the maximum (SH) and minimum stress (Sh) orientations in the near-borehole region for a particular zone of interest and identify fractures due to tectonic stresses.

The Sh orientation was determined by the presence of induced fractures and borehole breakouts (both created during drilling), which were observed in the ultrasonic and resistive imaging log data. The SH orientation can be characterized using cross-dipole sonic anisotropy processing when borehole conditions are favorable. Tectonic fractures were identified using ultrasonic and resistive imaging log data information and the Stoneley reflection method was used to support the conductivity interpretation from these image logs.
Improved Ocean Current Estimation using a Seismic Streamer Model
Authors: Grindheim Jan Vidar , Revhaug Inge , Welker Ken
Published: October 2017

A method for determining the ocean current normal to and tangentially to a seismic streamer is introduced. High resolution real time estimation of ocean currents is valuable for optimal lateral steering of seismic streamers. With optimal steering, crossflow noise caused can be reduced. Additionally, improved steering can reduce line-change times. Further, estimated ocean currents can contribute to world current oceanographic models.

A PID controller approach is used in the estimation process. The controller adjusts the ocean current normal to the streamer tangent for minimizing offsets between simulated and measured streamer positions. The streamer model is 3-dimensional and incorporates cable stretch, tension, steering devices and tailbuoy.

The current estimation method has been tested on 50 line-change data from a seismic survey. Especially on line-changes, cable steering, and hence current estimation, contribute to steering efficiency. Line-changes are time consuming, typically 3 or more hours. Efficient lateral steering could reduce this time, resulting in time and cost savings for seismic surveys. Unfortunately, steering wing angles were not available in the study data set; hence the estimation assumes zero wing angles. However, only large currents could account for the magnitude of streamer displacement relative to the zero current model result. This implies that the algorithm is capturing a significant current effect and translating it into current force quite well, as simulations given the estimated currents show good agreement with the actual streamer positions. Computational time of the algorithm is much less than real time. Hence current predictions can be made available to the streamer control system with little delay. Further, streamer prediction can be performed using the simulator with the updated ocean currents. Additionally, the estimated current can be transmitted in near real time to oceanographic research institutes.

To the authors' knowledge the present approach of current estimation has not been attempted previously. Since there exist small scale local variations in current, measuring the current only at the vessel and some stationary positions has limited value. As the current estimation algorithm can be run continuously in real time, it would provide more accurate and higher resolution information to the steering system, facilitating improved steering efficiency.
Analytical and Experimental Analysis of Friction Forces inside Curved Pipes
Authors: de Menezes Eduardo A. W. , Geiger Filipe P. , Basso Eduardo D. , Perondi Eduardo A. , Wildner Fabiano D. , Laranja Rafael A. C. , Becker Tiago , Marenco Javier , Santos Hugo F. L.
Published: October 2017

In-pipe robots are a powerful tool for hydrate plug removal inside ultra-deep water pipes. These robots may operate with energy supplied by umbilical cables immersed in oil. Present work focus on the development of a general strategy for computing the required forces for pulling such cables confined in ducts of generic length and geometry. Based on mathematical models obtained from specialized literature, a computational algorithm was designed to evaluate the static friction force related to the cumulative effects along the arbitrary set of curves present in a generic pipe. This computational routine can calculate the static friction forces associated to a cable inside a given pipe, whose coordinates are fed by the user. To evaluate the simulation performance, the achieved results were compared with that ones obtained through experimental tests performed using a cable with polymeric coating positioned inside ducts. Different geometries, load and lubricating conditions were tested, and the analytical model could estimate with reasonable accuracy the required force to move an umbilical cable inside pipes.
Risk Mitigation on Deepwater Drilling Based on 3D Geomechanics and Fit-For-Purpose Data Acquisition
Authors: Pedroso C. A. , Salies J. B. , Holzberg B. B. , Frydman M. , Pastor J. A. S. C.
Published: October 2017

Drilling horizontal wells in shallow and poorly consolidated reservoirs in deepwater scenarios involves risky operations due to the narrow mud weight window. Risks include severe drilling fluid losses, wellbore instability, and fault reactivation, which, in the worst case, may connect reservoir to the sea floor.

This work presents a case study of risk reduction based on geomechanics, which includes concepts of fault reactivation while drilling, permitted plastified area around the wellbore, and fit-for-purpose data acquisition, which allowed a recalibration of the model and timely changes on the drilling plan.

The study started with a full 3D geomechanical characterization, which is an advanced way to determine stress distribution in a field, in particular, along the faults. Based on this study, it was possible to locate and avoid zones of higher risks of losses and fault reactivation, mitigating drilling risks.

From the study, it was also possible to identify the main uncertainties of the model, which allowed a fit-for-purpose data acquisition plan. The most important missing information was a calibration point for the minimal horizontal stress in the reservoir. Previous drilling experience in the area and geomechanics modelling were not conclusive about losses mechanisms, and the upper limits for horizontal drilling were also not clear. In addition, borehole instability had been shown to be an issue on offset wells; therefore, lower limits for drilling were unclear too.

It was decided to drill a pilot hole down to the reservoir, set a packer in the caprock and perform a series of minifrac tests. The measured minimal horizontal stress in the reservoir was revealed to be lower than initially expected, which implied the need to recalibrate the model and make important adjustments to the drilling plan. The model was recalibrated and the safe mud weight window was found to be even narrower. It was identified that a lower and unprecedented mud weight had to be used in the horizontal section, which was an additional risk. To evaluate this risk, the concept of permitted plastified area around the wellbore was used, and a lower mud weight was selected under a risk analysis manner.

Based on the study, drilling risks were mitigated and horizontal drilling was performed successfully, with minimal losses and controlled wellbore collapse.
Lula Alto - Strategy and Execution of a Megaproject in Deep Water Santos Basin Pre-Salt
Authors: de Abreu Campos Nathalia , da Silva Faria Marcílio José , de Moraes Cruz Rafael Oscar , de Almeida Amaya Caldas Villar , Rebeschini Edson José , Vaz Henrique Paes , João Leonardo Villain , Rosa Marcelo Becher , da Fonseca Tiago Cardoso
Published: October 2017

This article presents the successful history of Lula Alto Project, one of the development modules of Lula giant field, located in Santos Basin pre-salt at southeast Brazil at a 2,120 meters water depth. The project is currently producing at its maximum oil capacity, considering operational performance, achieved only 9 months from first oil. This is the fifth module of Lula field, which modular development allowed drainage plan and subsea layout optimization.

The article will present the reservoir conceptual model, drainage plan optimization, information acquisition strategy and modular development insights; the subsea layout optimization that led to a minimum flowline length per well; twin FPSO construction strategy; project development and fast ramp-up and the challenges faced during the first year of production. It will also address integrity and maintenance management, aiming a secure and sustainable operation, and well construction highlights.

The leased FPSO Cidade de Maricá initiated production in February 2016, and the project strategy was to carbon copy FPSO Cidade de Ilhabela engineering (this FPSO is also producing in pre-salt), reducing design costs and schedule. Construction phase strategy was to build two identical FPSO's in parallel, FPSO's Cidade de Maricá and Cidade de Saquarema, with a planned 2 months schedule delivery gap. Suppliers and construction sites were the same, allowing cost reduction, construction risks mitigation and supply chain optimization. After one year of production, many challenges had to be surpassed, and all lessons learned were important for a solid ramp-up achievement and sustainable peak production.
Lipopolysaccharide Potentiates Insulin-Driven Hypoglycemic Shock
Authors: Hagar Jon A. , Edin Matthew L. , Lih Fred B. , Thurlow Lance R. , Koller Beverly H. , Cairns Bruce A. , Zeldin Darryl C. , Miao Edward A.
Published: October 2017

Critically ill patients typically present with hyperglycemia. Treatment with conventional insulin therapy (targeting 144–180 mg/dl) improves patient survival; however, intensive insulin therapy (IIT) targeting normal blood glucose levels (81–108 mg/dl) increases the incidence of moderate and severe hypoglycemia, and increases mortality. Septic patients are especially prone to IIT-induced hypoglycemia, but the mechanism remains unknown. Here, we show that codelivery of insulin with otherwise sublethal doses of LPS induced hypoglycemic shock in mice within 1–2 h. LPS impaired clearance of insulin, which amplified insulin receptor signaling. These effects were mediated by caspase-11, TLR4, and complement, each of which trigger eicosanoid production that potentiates insulin signaling. Finally, in an animal model of sepsis, we observed that Salmonella typhimurium–infected mice exhibited simultaneous impaired insulin clearance coexisting with insulin resistance. Our results raise the possibility that septic patients have impaired insulin clearance, which could increase their susceptibility to hypoglycemia during IIT, contraindicating its use.
Anti–PD-1 Antibody Treatment Promotes Clearance of Persistent Cryptococcal Lung Infection in Mice
Authors: Roussey Jonathan A. , Viglianti Steven P. , Teitz-Tennenbaum Seagal , Olszewski Michal A. , Osterholzer John J.
Published: October 2017

Activation of immunomodulatory pathways in response to invasive fungi can impair clearance and promote persistent infections. The programmed cell death protein-1 (PD-1) signaling pathway inhibits immune effector responses against tumors, and immune checkpoint inhibitors that block this pathway are being increasingly used as cancer therapy. The objective of this study was to investigate whether this pathway contributes to persistent fungal infection and to determine whether anti–PD-1 Ab treatment improves fungal clearance. Studies were performed using C57BL/6 mice infected with a moderately virulent strain of Cryptococcus neoformans (52D), which resulted in prolonged elevations in fungal burden and histopathologic evidence of chronic lung inflammation. Persistent infection was associated with increased and sustained expression of PD-1 on lung lymphocytes, including a mixed population of CD4+ T cells. In parallel, expression of the PD-1 ligands, PD-1 ligands 1 and 2, was similarly upregulated on specific subsets of resident and recruited lung dendritic cells and macrophages. Treatment of persistently infected mice for 4 wk by repetitive administration of neutralizing anti–PD-1 Ab significantly improved pulmonary fungal clearance. Treatment was well tolerated without evidence of morbidity. Immunophenotyping revealed that anti–PD-1 Ab treatment did not alter immune effector cell numbers or myeloid cell activation. Treatment did reduce gene expression of IL-5 and IL-10 by lung leukocytes and promoted sustained upregulation of OX40 by Th1 and Th17 cells. Collectively, this study demonstrates that PD-1 signaling promotes persistent cryptococcal lung infection and identifies this pathway as a potential target for novel immune-based treatments of chronic fungal disease.
Constitutive Activation of Integrin α9 Augments Self-Directed Hyperplastic and Proinflammatory Properties of Fibroblast-like Synoviocytes of Rheumatoid Arthritis
Authors: Emori Takashi , Hirose Jun , Ise Kotoko , Yomoda Jun-ichiro , Kasahara Michiko , Shinkuma Tadanobu , Yoshitomi Hiroyuki , Ito Hiromu , Hashimoto Motomu , Sugahara Shingo , Fujita Hirotada , Yamamoto Nobuchika , Morita Yoshiaki , Narumiya Shuh , Aramori Ichiro
Published: October 2017

Despite advances in the treatment of rheumatoid arthritis (RA), currently approved medications can have significant side effects due to their direct immunosuppressive activities. Additionally, current therapies do not address residual synovial inflammation. In this study, we evaluated the role of integrin α9 and its ligand, tenascin-C (Tn-C), on the proliferative and inflammatory response of fibroblast-like synoviocytes (FLSs) from RA patients grown in three-dimensional (3D)–micromass culture. FLSs from osteoarthritis patients, when grown in the 3D-culture system, formed self-directed lining-like structures, whereas FLSs from RA tissues (RA-FLSs) developed an abnormal structure of condensed cellular accumulation reflective of the pathogenic features of RA synovial tissues. Additionally, RA-FLSs grown in 3D culture showed autonomous production of proinflammatory mediators. Predominant expression of α9 and Tn-C was observed in the condensed lining, and knockdown of these molecules abrogated the abnormal lining-like structure formation and suppressed the spontaneous expression of matrix metalloproteinases, IL-6, TNFSF11/RANKL, and cadherin-11. Disruption of α9 also inhibited expression of Tn-C, suggesting existence of a positive feedback loop in which the engagement of α9 with Tn-C self-amplifies its own signaling and promotes progression of synovial hyperplasia. Depletion of α9 also suppressed the platelet-derived growth factor–induced hyperplastic response of RA-FLSs and blunted the TNF-α–induced expression of matrix metalloproteinases and IL-6. Finally, α9-blocking Ab also suppressed the formation of the condensed cellular lining by RA-FLSs in 3D cultures in a concentration-related manner. This study demonstrates the central role of α9 in pathogenic behaviors of RA-FLSs and highlights the potential of α9-blocking agents as a nonimmunosuppressive treatment for RA-associated synovitis.
Snapping Pes Anserinus and the Diagnostic Utility of Dynamic Ultrasound
Authors: Shapiro Shane A , Hernandez Lorenzo O , Montero Daniel P
Published: October 2017

Snapping pes anserinus syndrome is an often encountered cause of medial knee snapping. It results from impingement and translation of the gracilis tendon or semitendinosus tendon over the osseous structures of the knee during active flexion and extension. Ultrasonography is often the diagnostic imaging test of choice in cases of mechanical snapping. We report 2 cases of painful snapping pes anserinus and highlight the value of dynamic ultrasound in making an accurate diagnosis so as to direct care.
Massive Left-sided Congestive Colitis Due to Idiopathic Inferior Mesenteric Arteriovenous Malformation
Authors: Gelonch Laura Martí , Enríquez-Navascués Jose Maria , Bonel Tania Pastor , Ansorena Yolanda Saralegui
Published: October 2017

Arteriovenous malformations (AVM) of the inferior mesenteric artery are rare. They may be primary (congenital or idiopathic) or secondary (acquired) after trauma or of iatrogenic origin. Of the abdominal AVM, the inferior mesenteric trunk is the least commonly involved. Most reported cases are of iatrogenic origin, resulting from colon surgery. Only 17 cases have been described and published in the literature. The objective of this work is to make known a case treated in our center. We present a case of 73-year old male, who came to the emergency service with symptoms of abdominal distension, pain lasting 48 hours along with months of diarrhoea. CT scan and an abdominal CT angiography showed a massive left-sided congestive colitis due to idiopathic inferior mesenteric arteriovenous malformation. In our case, the decision was to carry out the treatment in two stages. Embolisation was performed in the first stage in order to decrease the blood flow and the risk of intraoperative bleeding, followed by resective surgery of the affected colon.
Pilot of an Elementary School Cough Etiquette Intervention: Acceptability, Feasibility, and Potential for Sustainability
Authors: Sultana Farhana , Nizame Fosiul A. , Southern Dorothy L. , Unicomb Leanne , Winch Peter J. , Luby Stephen P.
Published: October 2017

Schools convene many people together for a prolonged time, facilitating spread of respiratory pathogens and amplifying epidemics. Crowded Bangladeshi schools lack the infrastructure to support optimal cough etiquette behaviors. We collected formative data on current practices from four elementary schools, and developed and piloted a low-cost cough etiquette intervention, promoting coughing and sneezing into upper sleeves at four additional schools. We trained teachers to lead behavior change sessions during regular hygiene classes for 4 weeks. We evaluated intervention acceptability, feasibility, and potential for sustainability at 1 month and at 14 months after the intervention commenced. At baseline, among 63 observed students, 58 (92%) coughed/sneezed into open air, five (8%) covered coughs/sneezes with their hands, which were not subsequently washed with soap and water as they judged this infeasible. After 4 weeks, among 70 observed students, 27 (39%) coughed/sneezed into upper sleeves, 33 (47%) into open air, and 10 (12%) covered with hands. After 14 months, among 230 observed students, 13 (6%) used upper sleeves, 154 (67%) coughed/sneezed into open air, and 59 (26%) covered with hands. Students reported that coughing/sneezing into upper sleeves was simple and protected them and their classmates from germs. This school-based intervention was acceptable and feasible, and resulted in short-term reductions in coughing/sneezing into open air, but these habits of comparatively new behavior were not sustained as teachers ceased behavior change session delivery. Strategies to support longer-term adoption of habits should be considered.
Resource Use and Costs of Dengue: Analysis of Data from Phase III Efficacy Studies of a Tetravalent Dengue Vaccine
Authors: El Fezzazi Hanna , Branchu Marie , Carrasquilla Gabriel , Pitisuttithum Punnee , Perroud Ana Paula , Frago Carina , Coudeville Laurent
Published: October 2017

A tetravalent dengue vaccine (CYD-TDV) has recently been approved in 12 countries in southeast Asia and Latin America for individuals aged 9–45 years or 9–60 years (age indication approvals vary by country) living in endemic areas. Data on utilization of medical and nonmedical resources as well as time lost from school and work were collected during the active phase of two phase III efficacy studies performed in 10 countries in the Asia-Pacific region and Latin America (NCT01373281; NCT01374516). We compared dengue-related resource utilization and costs among vaccinated and nonvaccinated participants. Country-specific unit costs were derived from available literature. There were 901 virologically confirmed dengue episodes among participants aged ≥ 9 years (N = 25,826): corresponding to 373 episodes in the CYD-TDV group (N = 17,230) and 528 episodes in the control group (N = 8,596). Fewer episodes in the CYD-TDV group resulted in hospitalization than in the control group (7.0% versus 13.3%; P = 0.002), but both had a similar average length of stay of 4 days. Overall, a two-thirds reduction in resource consumption and missed school/work days was observed in the CYD-TDV group relative to the control group. The estimated direct and indirect cost (2014 I$) associated with dengue episodes per participant in the CYD-TDV group was 73% lower than in the control group (I$6.72 versus I$25.08); representing a saving of I$I8.36 (95% confidence interval [CI]:17.05–19.78) per participant with vaccination. This is the first study providing information on dengue costs among vaccinated individuals and direct confirmation that vaccination has the potential to reduce dengue illness costs.
Importance and Contribution of Community, Social, and Healthcare Risk Factors for Hepatitis C Infection in Pakistan
Authors: Trickey Adam , May Margaret T. , Davies Charlotte , Qureshi Huma , Hamid Saeed , Mahmood Hassan , Saeed Quaid , Hickman Matthew , Glass Nancy , Averhoff Francisco , Vickerman Peter
Published: October 2017

Pakistan has a high prevalence of hepatitis C virus (HCV) infection, estimated at 4.9% (2,290/46,843) in the 2007 national HCV seroprevalence survey. We used data from this survey to assess the importance of risk factor associations with HCV prevalence in Pakistan. Exposures were grouped as community (going to the barbers, sharing smoking equipment, having an ear/nose piercing, tattoo, or acupuncture), healthcare (ever having hemodialysis, blood transfusion, or ≥ 5 injections in the last year), demographic (marital status and age), and socio-economic (illiterate or laborer). We used mutually adjusted multivariable regression analysis, stratified by sex, to determine associations with HCV infection, their population attributable fraction, and how risk of infection accumulates with multiple exposures. Strength of associations was assessed using adjusted odds ratios (aOR). Community [aOR females 1.5 (95% confidence interval [CI]: 1.2, 1.8); males 1.2 (1.1, 1.4)] and healthcare [females 1.4 (1.2, 1.6); males 1.2 (1.1, 1.4)] exposures, low socio-economic status [females 1.6 (1.3, 1.80); males 1.3 (1.2, 1.5)], and marriage [females 1.5 (1.2, 1.9); males 1.4 (1.1, 1.8)] were associated with increased HCV infection. Among married women, the number of children was associated with an increase in HCV infection; linear trend aOR per child 1.06 (1.01, 1.11). Fewer infections could be attributed to healthcare exposures (females 13%; males 6%) than to community exposures (females 25%; males 9%). Prevalence increased from 3% to 10% when cumulative exposures increased from 1 to ≥ 4 [aOR per additional exposure for females 1.5 (1.4, 1.6); males 1.2 (1.2, 1.3)]. A combination of community, healthcare, and other factors appear to drive the Pakistan HCV epidemic, highlighting the need for a comprehensive array of prevention strategies.
Effectiveness of the Hydrogen Sulfide Test as a Water Quality Indicator for Diarrhea Risk in Rural Bangladesh
Authors: Islam Mahfuza , Ercumen Ayse , Naser Abu Mohd , Unicomb Leanne , Rahman Mahbubur , Arnold Benjamin F. , Colford, Jr. John M. , Luby Stephen P.
Published: October 2017

Microbiological water quality is usually assessed by the identification of Escherichia coli (E. coli), a fecal indicator. The hydrogen sulfide (H2S) test is an inexpensive, easy-to-use, and portable alternative field-based water quality test. Our study evaluated the H2S test’s effectiveness as a water quality indicator for diarrhea risk. Field workers collected stored drinking water samples for H2S analysis and detection of E. coli by membrane filtration and measured caregiver-reported diarrhea among children < 5 years in the same households 1 month later. We assessed the association between the H2S test (incubated for 24 hours and 48 hours) and diarrhea prevalence, with 2-day and 7-day symptom recall periods (N = 1,348). We determined the sensitivity, specificity, and positive and negative predictive value (PPV, NPV) of the H2S test compared with E. coli (N = 525). Controlling for potentially confounding covariates, H2S-positive water (at 24 or 48 hours) was not associated with 2-day diarrhea prevalence (24-hour prevalence ratio [PR] = 1.03, 95% confidence interval [CI]: 0.63–1.69; 48-hour PR = 0.89, 95% CI: 0.58–1.38) or 7-day diarrhea prevalence (24-hour PR = 1.17, 95% CI: 0.76–1.78; 48-hour PR = 1.21, 95% CI: 0.81–1.80). The sensitivity, PPV, and NPV of the H2S test was significantly higher when the H2S test was incubated for 48 versus 24 hours whereas specificity showed the opposite trend. H2S test sensitivity, PPV, and NPV increased with increasing E. coli levels, consistent with previous evidence that the H2S test is a useful water quality tool in high-contamination settings. However, our results suggest that the H2S test is not an effective indicator for waterborne diarrhea.
Point-of-Care Ultrasound for Extrapulmonary Tuberculosis in India: A Prospective Cohort Study in HIV-Positive and HIV-Negative Presumptive Tuberculosis Patients
Authors: Weber Stefan F. , Saravu Kavitha , Heller Tom , Kadavigere Rajagopal , Vishwanath Shashidhar , Gehring Stephan , Bélard Sabine , _ _
Published: October 2017

Diagnosing extrapulmonary tuberculosis (EPTB) is challenging. Point-of-care ultrasound (POCUS) for human immunodeficiency virus (HIV)-associated EPTB is applied in sub-Saharan Africa. This study aimed at evaluating the applicability of POCUS for diagnosing EPTB in HIV-positive and HIV-negative presumptive tuberculosis (TB) patients in India, a country of moderate relative TB and HIV burden. Presumptive TB patients at Kasturba Hospital, Manipal, India, prospectively underwent POCUS evaluating for pericardial, pleural and ascitic effusion, abdominal lymphadenopathy, and hepatic and splenic microabscesses. Findings were correlated with TB category (confirmed TB, clinical TB, unlikely TB), HIV status, and discharge diagnoses. A total of 425 patients underwent POCUS; 81 (20%) were HIV-positive. POCUS findings were more common in HIV/TB coinfected patients than in HIV-positive patients with unlikely TB (24/40 (60%) versus 9/41 (22%), P < 0.001). Abdominal lymphadenopathy and splenic microabscesses were strongly associated with TB in HIV-positive patients (P = 0.002 and P = 0.001). POCUS findings did not correlate with TB in HIV-negative patients; a third of HIV-negative patients with unlikely TB and POCUS findings had cancer, another third other infectious diseases. Sonographic findings were common in HIV-positive and HIV-negative presumptive TB patients. POCUS was a useful bedside test for the detection of HIV-associated EPTB. In HIV-negative patients, POCUS detected features associated with EPTB but also of malignancy and other infectious diseases.
Use of a Novel Portable Three-Dimensional Imaging System to Measure Limb Volume and Circumference in Patients with Filarial Lymphedema
Authors: Yahathugoda Channa , Weiler Michael J. , Rao Ramakrishna , De Silva Lalindi , Dixon J. Brandon , Weerasooriya Mirani V. , Weil Gary J. , Budge Philip J.
Published: October 2017

The World Health Organization’s Global Program to Eliminate Lymphatic Filariasis (LF) has reduced LF transmission worldwide, but millions remain affected by filarial lymphedema. Tools for clinically monitoring lymphedema in developing nations are limited. We tested a novel, portable, infrared three-dimensional imaging system (3DIS) against water displacement (WD) and tape measurement of limb circumference (TMLC) among patients with filarial leg lymphedema in Galle, Sri Lanka. Outcomes were accuracy and reproducibility of imaging system measurements. In parallel, we also tested the reproducibility of skin thickness ultrasound (STU) measurements. We examined 52 patients (104 limbs) with lymphedema of stages 0–6 (N = 28, 19, 20, 21, 2, 4, and 10, respectively). 3DIS measurements correlated nearly perfectly with WD (r2 = 0.9945) and TMLC values (r2 > 0.9801). The median time required to acquire imaging system measurements for both legs was 2.1 minutes, compared with 17, 7, and 29 minutes, respectively, for WD, TMLC, and STU. Median interexaminer coefficients of variation (CVs) for volume measurements were 1.1% (interquartile range [IQR] 0.5–2.1%) for WD and 1.7% (IQR 1.2–2.4%) for the 3DIS. CVs for circumference measurements were 1.4% (IQR 0.8–2.4%) by TMLC and 1.3% (0.8–1.9%) by 3DIS. Median interexaminer CV for STU was 13.7% (IQR 8.5–21.3%). The portable imaging system noninvasively provided accurate and reproducible limb volume and circumference measurements in approximately 2 minutes per patient. This portable technology has the potential to greatly improve assessment and monitoring of lymphedema in the clinic and in the field.
Three-step in vitro maturation culture of bovine oocytes imitating temporal changes of estradiol-17β and progesterone concentrations in preovulatory follicular fluid
Authors: Matsuo Minami , Sumitomo Kazuma , Ogino Chihiro , Gunji Yosuke , Nishimura Ryo , Hishinuma Mitsugu
Published: October 2017

Abstract. The objective of the article is to evaluate the effect of three-step in vitro maturation (IVM) culture system imitating estradiol-17β (E2) and progesterone (P4) concentrations in preovulatory follicles on in vitro bovine embryo production. The cumulus–oocyte complexes (COCs) were collected from follicles (2 to 8 mm in diameter) of bovine ovaries obtained from a local slaughterhouse. For IVM, the COCs were cultured for 22 h in a three-step system: (1) culture in medium 199, containing 700 ng mL−1 E2 and 50 ng mL−1 P4, for 5 h, followed by the medium containing 150 ng mL−1 E2 and 150 ng mL−1 P4 for 11 h, and then the medium containing 20 ng mL−1 E2 and 300 ng mL−1 P4 for 6 h (EP group); (2) culture in the medium containing 700 ng mL−1 E2 for 5 h, followed by the medium containing 150 ng mL−1 E2 for 11 h, and then the medium containing 20 ng mL−1 E2 for 6 h (E group); or (3) culture in the medium containing 50 ng mL−1 P4 for 5 h, followed by the medium containing 150 ng mL−1 P4 for 11 h, and then the medium containing 300 ng mL−1 P4 for 6 h (P group). The COCs were cultured in the medium containing 1000 ng mL−1 E2 for 22 h (control group). After IVM, the COCs were co-incubated with sperm and further cultured. At 48 h after insemination, the cleavage rate of embryos was not different among the groups. At 192 h after insemination, the blastocyst formation rate of EP group was significantly higher than that of the other groups. The total cell number of blastocysts did not differ among the groups. In conclusion, these results demonstrate that the three-step IVM culture system of bovine oocytes imitating temporal changes of E2 and P4 concentrations in preovulatory follicular fluid improves the developmental potential of embryos in vitro.
Non-methane organic gas emissions from biomass burning:
identification, quantification, and emission factors from PTR-ToF during the FIREX 2016 laboratory experiment
Authors: Koss Abigail R. , Sekimoto Kanako , Gilman Jessica B. , Selimovic Vanessa , Coggon Matthew M. , Zarzana Kyle J. , Yuan Bin , Lerner Brian M. , Brown Steven S. , Jimenez Jose L. , Krechmer Jordan , Roberts James M. , Warneke Carsten , Yokelson Robert J. , de Gouw Joost
Published: October 2017

Abstract. Volatile and intermediate-volatility non-methane organic gases (NMOGs) released from biomass burning were measured during laboratory-simulated wildfires by proton-transfer-reaction time-of-flight mass spectrometry (PTR-ToF). We identified NMOG contributors to more than 150 PTR ion masses using gas chromatography (GC) pre-separation with electron ionization, H3O+ chemical ionization, and NO+ chemical ionziation, an extensive literature review, and time-series correlation, providing higher certainty for ion identifications than has been previously available. Our interpretation of the PTR-ToF mass spectrum accounts for nearly 90 % of NMOG mass detected by PTR-ToF across all fuel types. The relative contributions of different NMOGs to individual exact ion masses are mostly similar across many fires and fuel types. The PTR-ToF measurements are compared to corresponding measurements from open-path Fourier transform infrared spectroscopy (OP-FTIR), broadband cavity enhanced spectroscopy (ACES), and iodide ion chemical ionization mass spectrometry (I-CIMS) where possible. The majority of comparisons have slopes near 1 and values of the linear correlation coefficient, R2, of > 0.8, including compounds that are not frequently reported by PTR-MS such as ammonia, hydrogen cyanide (HCN), nitrous acid (HONO), and propene. The exceptions include methylglyoxal and compounds that are known to be difficult to measure with one or more of the deployed instruments. The fire-integrated emission ratios to CO and emission factors of NMOGs from 18 fuel types are provided. Finally, we provide an overview of the chemical characteristics of detected species. Non-aromatic oxygenated compounds are the most abundant. Furans and aromatics, while less abundant, comprise a large portion of the OH reactivity. The OH reactivity, its major contributors, and the volatility distribution of emissions can change considerably over the course of a fire.