bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors that Influence Teenage Antenatal Care Utilization in John Taolo Gaetsewe (JTG) District of Northern Cape Province, South Africa: Underscoring the Need for Tackling Social Determinants of Health
Authors: Worku, PhD Eshetu Bekele , Woldesenbet, PhD Selamawit Alemu
Published: February 2021

Background and Objectives: In resource-limited settings, the uptake of antenatal care visits among women, especially teenage pregnant women, is disturbingly low. Factors that infl uence the uptake of ANC services among teenage women is largely understudied and poorly understood in John Taolo Gaetsewe (JTG), a predominantly rural and poor district of South Africa. The aim of this study was to determine the factors that infl uence uptake of ANC services among teenage mothers in JTG district.
Methods: A cross-sectional health facility-based study utilising mixed method was conducted in all public health facilities (n=44) at JTG district. Mother-infant pairs (n=383) who brought their infants for six-week first DPT immunisation during the study period were enrolled in the study. Structured questionnaires were used to collect data on demographic, socio-economic and uptake of ANC indicators.
Results: Out of 272 respondent mothers, 18.68% were adolescent mothers (13-19 years). The logistic regression analysis shows that mother’s age (OR=2.11; 95%CI = 1.04 - 4.27); distance to the nearest health facility (OR=3.38; 95%CI = 1.45-7.87); and client service satisfaction (OR=8.58; 95%CI =2.10-34.95 are significantly associated with poor uptake of ANC services.
Conclusion and Global Health Implications: There is a need to improve the quality of adolescent reproductive health services tailored to their health and developmental needs. Moreover, addressing the social determinants of health that affect individual’s healthy life style and health seeking behavior is critical.
 
Copyright © 2016 Worku and Woldesenbet. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.
Pre-Project Selling in A Property Business: The Perspective of Islamic Law
Authors: Sekarmadji Agus , Wiranata Regine , Moechthar Oemar
Published: February 2021

Actors in the real estate market have developed a marketing strategy in the form of pre-project selling. This strategy is conducted to perform a market test for any property a developer intends to market. However, in practice, the system often poses problems, such as misrepresenting the property and inflicting customers' financial losses. From the perspective of Islamic law, this type of transaction is characterized as gharar (uncertainty, deception, and risk), having no exact object, and having forbidden. This article uses a Sharia-based perspective to analyze the characteristics of pre-project selling. This research aims to determine the legality of pre-project selling under Sharia law and prescribe solutions for society. The method used in this article is legal research, using legislation-based, conceptual, and case-based approaches, along with a comparison of national legislation with the written text of the al-Qur’an and hadith. The paper concludes that while pre-project selling should not be legally banned, there need steps taken to reduce its risks. This could be applied, for example, by creating minimum prerequisites for allowing pre-project selling, such as the existence of a plot for construction or the requirement of permits to be obtained before the pre-project sale. This research contributes to the development of legal science in general and Islamic jurisprudence, especially regarding Islamic law agreements' validity.Pelaku usaha dalam bidang properti telah mengembangkan strategi pemasaran berbentuk pre-project selling. Strategi ini dilakukan untuk melakukan tes pasar properti yang hendak dipasarkan oleh pengembang. Namun, dalam praktek, system ini sering menimbulkan masalah, seperti misrepresentasi terhadap properti, yang menimbulkan kerugian finansial pada pembeli. Dari perspektif hukum Islam, transaksi semacam ini merupakan transaksi gharar, yang tidak memiliki obyek yang jelas, dan dengan demikian dilarang. Artikel ini menggunakan perspektif berbasis syariah untuk menganalisa karakteristik dari pre-project selling. Tujuan riset ini adalah untuk menentukan legalitas pre-project selling dalam hukum Syariah dan memberikan solusi bagi masyarakat secara umum. Tulisan ini menyimpulkan bahwa sementara pre-project selling tidak perlu dilarang secara hukum, perlu ada langkah-langkah yang diambil untuk mengurangi risikonya. Hal ini dapat dilakukan, misalnya, dengan membuat prasyarat minimum untuk mengizinkan pre-project selling, seperti keberadaan sebidang tanah untuk konstruksi, atau persyaratan bahwa izin diperoleh sebelum penjualan. Penelitian ini berkontribusi pada pengembangan ilmu hukum pada umumnya dan ilmu hukum islam pada khususnya, terutama terkait keabsahan perjanjian di dalam hukum Islam.
Efficacious Use of Simple and Cost Effective Acoustic Flow Analyzer Measurement to Enhance Recovery and Improve Life Cycle of Wells
Authors: Alaref Omar , Saada Mahmoud , Abdelmoula Mongi , Rourke Marvin
Published: February 2021

Well integrity technologies have been in high demand within the oil and gas industry in the recent years due to two main reasons; Recent incidents and down term in industry. The recent failures and blow out incidents occurring in different parts of the world encouraged new strategies and well integrity management systems to be deployed in order to ensure wells are meeting health, safety and environmental standards. Moreover, the down term in industry caused by relatively low oil price which led oil and gas operators to scale down on exploration and drilling and alternatively work-over existing wells. It is believed that the most economical way to work-over the well is by performing data acquisition first, which enables the work-over team to do an informed decision and tackle the specified problem, saving non-productive time.

One of the fast growing well integrity technologies is leak detection. Unlike conventional data acquisition techniques such as corrosion monitoring, leak detection method traces the fluids entering to the well-bore and gives a dynamic image of what's going on in a producing/injecting well. The leak detection is mainly based on passive acoustic measurement, which is typically based on listening to fluid vibration by moving through different aperture sizes, and recorded in different frequencies and amplitudes. Other measurements are recommended to add such as temperature, pressure and multiphase sensors (in case leak is suspected to be inside the tubing).

The technology has been used in various locations around the world with challenging environments. The typical and most desired ones are firstly the surface casing leaks where fluids of various types enter into the annuli between casings and build up on surface. Moreover, high amounts of undesired fluids contributing to the production and the source would be hard to identify with conventional technologies.
A Preliminary Assessment of the Hydrocarbon Potential of Kerio Valley Basin: Gravity and Magnetic Interpretation
Authors: Masinde Abiud , Simiyu Cleophas , Murunga Innocent , Muia George , Waswa Aaron , Barongo Justus
Published: February 2021

The aim of the study was to assess the hydrocarbon prospectivity of the Kerio Basin in the Kenya Rift. An Isostatically corrected anomaly map produced from a Bouguer anomaly grid was filtered using a Hanning low pass filter of order 2 to remove low wavelengths. Four profiles were extracted from the grid to give 1D interpretation along straight lines. Magnetic grid was corrected for IGRF, diurnal, filtered using a 1 Hz low pass 10km Hanning filter to reduce noise, later, reduced to equator to place all anomalies directly over underlying sources and make anomalies less complicated. Tilt derivative of the magnetic grid was used to estimate depth to basement. The residual analytic signal anomaly map derived from the magnetic grid was used to capture the response of existing near surface magnetic signatures even the reversely magnetized ones.

Kerio basin is characterised by low gravity anomalies ranging between 35mGals to −100mGals related to variations in quantities of sediments deposited. Gravity profiles show that sediment thickness gradually increases to the south where we expect hydrocarbon accumulation. The magnetic anomaly map reveals low susceptibility rocks of between −20nT to −200nT to the south of the basin. Magnetic tilt depth indicates sediment thickness of 2.0-3.5Km above the basement. This corresponds to both gravity and magnetic interpretation of the same area. Integration of these data with seismic and other constraints may help gauge the hydrocarbon potential and reduce exploration uncertainty in the southern area of the Kerio Basin.
Pre-Messinian Petroleum Systems and Trap Style in the Offshore Western of Nile Delta; An Integrated Geological and Geophysical Approach
Authors: Monir Mostafa , Shenkar Omar
Published: February 2021

Exploration in the offshore Nile Delta province has revealed several hydrocarbon plays. Deep marine Turbidites is considered one of the most important plays for hydrocarbon exploration in the Nile Delta. These turbidites vary from submarine turbidite channels to submarine basin floor fans.

An integrated exploration approach was applied for a selected area within West Delta Deep Marine (WDDM)

Concession offshore western Nile Delta using a variety of geophysical, geological and geochemical data to assess the prospectivity of the Pre-Messinian sequences. This paper relies on the integration of several seismic data sets for a new detailed interpretation and characterization of the sub-Messinian structure and stratigraphy based on regional correlation of seismic markers and honoured the well data.

The interpretation focused mainly on the Oligocene and Miocene mega-sequences. The seismic expression of stratigraphic sequences shows a variety of turbidite channel/canyon systems having examples from West Nile delta basin discoveries and failures.

The approach is seismically based focusing on seismic stratigraphic analysis, combination of structure and stratigraphic traps and channels interpretation. Linking the geological and geophysical data together enabled the generation of different sets of geological models to reflect the spatial distribution of the reservoir units.

The variety of tectonic styles and depositional patterns in the West Nile delta provide favourable trapping conditions for hydrocarbon generations and accumulations.

The shallow oil and gas discoveries in the Pliocene sands and the high-grade oils in the Oligo-Miocene and Mesozoic reservoirs indicate the presence of multiple source rocks and an appropriate conditions for hydrocarbon accumulations in both biogenic and thermogenic petroleum systems. The presence of multi-overpressurized intervals in the Pliocene and Oligo-Miocene Nile delta stratigraphic column increase the depth oil window and the peak oil generation due to decrease of the effective stress.

Fluids have the tendency to migrate from high pressure zones toward a lower pressure zones, either laterally or vertically. Also, hydrocarbons might migrate downward if there is a lower pressure in the deeper layers.

Well data and the available geochemical database have been integrated with the interpreted seismic data to identify potential areas of future prospectivity in the study area.
New Insights in the Evaluation of Reserves of Selected wells of the Pletmos Basin Offshore South Africa
Authors: Elamri Samir , Opuwari Mimonitu
Published: February 2021

The area evaluated has similar structural styles and settings as the producing neighboring fields of F-A and E-M in the adjacent Bredasdorp basin Offshore South Africa. The main objective of this study is to create a 3-D-static model and estimate hydrocarbon reserves. Based on log signatures, petrophysical properties and structural configurations, the reservoirs were divided vertically into three reservoir units in order to be properly modelled in 3-D space. The thicknesses of the layers were determined based on the vertical heterogeneity in the reservoir properties. Facies interpretation was performed based on log signatures, core description and previous geological studies. The volume of clay and porosity was used to classify facies into five units of sand, shaly sand, silt, and clay. From petrophysical interpretation, a synthetic permeability log was generated in the wells which ties closely with core data. The J-function water saturation model was adopted because it produced better results in the clean sandstone sections of the reservoirs. A high uncertainty in the basement formation was observed due to very few wells drilled in the area and fault impact and thus resulted in evaluation of uncertainty of each zone separately. The uncertainty workflow was run using 100 trials and the base case P50 estimated 277 Bcf of Gas from the 1At1.
Bottom Hole Pressure Management in a Highly Permeable and Narrow Margin MPD Operation
Authors: Oseme Ugochukwu , Awe Sunday , Amah Obinna , Erinle Adeyemi , Akinfolarin Ayodele , Ibrahim Timothy , Roes Vincent
Published: February 2021

Application of Managed pressure drilling (MPD) technology with other techniques to maintain constant Bottom Hole pressure (BHP) has been found to enhance drilling operations in applications where the margin between the pore pressure and fracture gradient is narrow and the reservoir permeability is high. Classic examples of such applications are deep water drilling, high pressure and high temperature (HPHT) regime and depleted reservoir environments.

In the Niger Delta, HPHT reservoirs can be found in well depths up to 17000 ftss with a drilling window range of 0.4 to1.6ppg. Typical reservoir characteristics are formation permeability of 124 – 204mD and reservoir mobility of 112 – 1000mD/cp. Generally in this type of environment and essentially where there are high uncertainties in the reservoir pressures and formation characteristics, significant process safety incidents have been found to occur during pumps off events as a result of variations in BHP outside the allowable limits of pore pressure (lower limit) and fracture gradient (upper limit). The risks of exceeding the allowable limits are the possibility of taking significant influx volume if BHP falls below the pore pressure and loss of well bore integrity if the BHP exceeds the fracture pressure. Consequences of any of these events are high nonproductive time (NPT), well cost escalation and inability to achieve well objectives.

This paper illustrates how in the recent HPHT exploration campaign carried out in Niger Delta, managing BHP was identified as a critical success factor. Hydrocarbon reserves of the exploratory objectives were successfully and safely unlocked by using MPD to maintain BHP within the allowable limits. The paper also illustrates how MPD application was enhanced by the use of high resolution pressure while drilling (PWD) technology.
Nuclear Magnetic Resonance Logging While Drilling in Complex Lithology – Solution for a Glauconitic Sandstone Reservoir
Authors: Abouzaid Ahmed , Thern Holger , Said Mohamed , ElSaqqa Mohammad , Elbastawesy Mohamed , Ghozlan Sherin
Published: February 2021

The evaluation of logging data in shaly sand reservoirs can be a challenging task, particularly in the presence of accessory minerals such as glauconite. Accessory minerals affect the measurements of conventional logging tools, thus, introducing large uncertainties for estimated petrophysical properties and reservoir characterization. The application of traditional Gamma Ray and Density-Neutron crossover methods can become unreliable even for the simple objective of differentiating reservoir from non-reservoir zones.

This was the situation for many years in the glauconite-rich Upper Bahariya formation, Western Desert, Egypt. Formation evaluation was challenging and the results often questionable. Adding Nuclear Magnetic Resonance (NMR) Logging While Drilling (LWD) data in three wells changed the situation radically. The NMR data unambiguously indicate pay zones and simplify the interpretation for accurate porosity and fluid saturation dramatically. Key to success is NMR total porosity being unaffected by the presence of accessory minerals. NMR moveable fluid directly points to the pay zones in the reservoir, while clay-bound and capillary-bound water volumes reflect variations in rock quality and lithology.

Although the NMR total porosity is lithology independent, the presence of glauconite affects the NMR T2 distribution by shifting the water T2 response to shorter T2 times. This requires an adjustment of the T2 cutoff position for separating bound water from movable hydrocarbons. A varying T2 cutoff was computed by comparing NMR bound water to resistivity-based water saturation. The calibrated T2 cutoff exhibits an increase with depth indicating a decreasing amount of glauconite with depth throughout the Upper Bahariya formation. Based on these volumetrics, an improved NMR permeability log was calculated, now accurately delineating variations in rock quality throughout the different pay zones. In addition, viscosity was estimated from the oil NMR signal. The estimated values match the expected values very well and illustrate the potential of NMR to indicate viscosity variations.

Many of these results are available today already in real-time by transmitting NMR T2 distributions to surface while drilling. Besides the application for formation evaluation, the data can be used to initiate optimized side-tracking and completion decisions directly after finishing the drilling operations.
New synthetic 1H-1,2,3-triazole derivatives of 3-O-acetyl-β-boswellic acid and 3-O-acetyl-11-keto-β-boswellic acid from Boswellia sacra inhibits carbonic anhydrase II in vitro
Authors: Avula Satya Kumar , Rehman Najeeb , Khan Majid , Halim Sobia Ahsan , Khan Ajmal , Rafiq Kashif , Csuk Rene , Das Biswanath , Al-Harrasi Ahmed
Published: February 2021

Boswellic acids are genus specific to Boswellia; they are the principal biologically active compounds holding exceptionally potent anti-inflammatory activity. A series of new 1H-1,2,3-triazole tethered of 3-O-acetyl-β-boswellic acid (ABA, 1) and 3-O-acetyl-11-keto-β-boswellic acid (AKBA, 2) derivatives (10a-d and 11a-d) were synthesized and their carbonic anhydrase II (CA II) inhibitory activity was evaluated in vitro. All compounds were characterized by 1H NMR, 13C NMR, 2D NMR (HMBC, HSQC, COSY and NOESY) experiments, ESI-MS, and when applicable by 19F NMR spectroscopy (10b, 10c and 11b, 11c). This series has displayed a moderate to strong inhibition against CA II with IC50 values of 13.2–60.1 µM. All the active compounds were reported for the first time for their CA II inhibition potential. Kinetics studies on the most active inhibitors (5 and 10b) were carried out to investigate their mode of inhibition and to determine their inhibition constants Ki. Both compounds (5 and 10b) were found to be non-competitive inhibitors with Ki values of 10.40 ± 0.013 and 14.25 ± 0.017 µM, respectively. Molecular docking studies showed that all compounds were well accommodated in the allosteric site of CA II. The current study has demonstrated the usefulness of incorporating a 1H-1,2,3-triazole moiety into the boswellic acids skeleton.
Effects of high-flow oxygen therapy on patients with hypoxemia after extubation and predictors of reintubation: a retrospective study based on the MIMIC-IV database
Authors: Liu Taotao , Zhao Qinyu , Du Bin
Published: February 2021

Purpose: To investigate the indications for high-flow nasal cannula oxygen (HFNC) therapy in patients with hypoxemia during ventilator weaning and to explore the predictors of reintubation when treatment fails.Methods: Adult patients with hypoxemia weaning from mechanical ventilation were identified from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The patients were assigned to the treatment group or control group according to whether they were receiving HFNC or non-invasive ventilation (NIV) after extubation. The 28-day mortality and 28-day reintubation rates were compared between the two groups after Propensity score matching (PSM). The predictor for reintubation was formulated according to the risk factors with the XGBoost algorithm. The areas under the receiver operating characteristic curve (AUC) was calculated for reintubation prediction according to values at 4 hours after extubation, which was compared with the ratio of SpO2/FiO2 to respiratory rate (ROX index).Results: A total of 524520 medical records were screened, and 801 patients with moderate or severe hypoxemia when undergoing mechanical ventilation weaning were included (100<PaO2/FiO2≤300 mmHg), including 358 patients who received HFNC therapy after extubation in the treatment group. There were 315 patients with severe hypoxemia (100<PaO2/FiO2≤200 mmHg) before extubation, and 190 patients remained in the treatment group with median oxygenation index 166[157,180] mmHg after PSM. There were no significant differences in the 28-day reintubation rate or 28-day mortality between the two groups with moderate or severe hypoxemia (all P>0.05). Then HR/SpO2 was formulated as a predictor for 48-hour reintubation according to the important features predicting weaning failure. According to values at 4 hours after extubation, the AUC of HR/SpO2 was 0.657, which was larger than that of ROX index (0.583). When the HR/SpO2 reached 1.2 at 4 hours after extubation, the specificity for 48-hour reintubation prediction was 93%. Conclusions: The treatment effect of HFNC therapy is not inferior to that of NIV, even on patients with oxygenation index from 160 to 180 mmHg when weaning from ventilator. HR/SpO2 is more early and accurate in predicting HFNC failure than ROX index.
Application of the urine-prostate-semen test in accurate diagnosing etiologically in the patients with chronic prostatitis-like symptoms
Authors: Wang Danni , Wang He
Published: February 2021

Background: In diagnosis and differential diagnosis of chronic prostatitis-like symptoms, the prostatic secretion was considered to be the most important and even only specimen, little attention has been paid to other genital organ infections. This may be one of important factors affecting treatment effect of chronic prostatitis. Methods: We used a urine-prostate-semen test (U-EPS-S test) to collect the specimens of urine, prostatic secretion and semen from 200 patients with chronic prostatitis-like symptoms. The specimens were inoculated respectively into a suitable media culture for the bacteriological localization detection and observe the number and their distribution of colonies in each isolation culture. Results: All of the patients had an infection of the internal genital organs (infection rate = 100%). Of these, prostatic secretion positive isolation cultures were obtained in 66 cases (33%), semen positive isolation cultures were obtained in 34 cases (17%), and prostatic secretion and semen positive isolation cultures were obtained in 100 cases (50%).Conclusion: The U-EPS-S test is useful to identify the pathogens and contaminatives in isolation cultures, and accurate diagnose and differential diagnose the multiple microbial infection (MMI) and the multi-organ infection (MOI) in patients with chronic prostatitis-like symptoms.
Integration of Low-Grade Heat from Exhaust Gases into Energy System of the Enterprise
Authors: Kapustenko Petro , Arsenyeva Olga , Fedorenko Olena , Kusakov Sergiy
Published: February 2021

In the paper is presented the way of Process Integration application for waste heat utilisation from exhaust gases streams with partial condensation. It is based on the construction of Hot Composite Curve representing the gaseous mixture cooling with accounting for the gas-liquid equilibrium of condensable vapour part. With Cold Composite Curve for streams requiring heating, the Pinch Point is determined. Then the structure of Heat Exchanger Network (HEN) for utilised Heat Integration into the energy system of the factory is developed accounting for the possible splitting of two-phase flow on gas and liquid streams and selection of plate heat exchanger (PHE) types for specific positions in HEN. The method is illustrated by a case study of heat utilisation from exhaust gases after superheated steam tobacco drying and flue gases from natural gas-fired boiler. The heat transfer areas of PHEs in HEN are optimised with the total annualised cost as an objective function. The payback period of the received solution is less than four months with a substantial saving of energy, reduction of greenhouse gases and other harmful emissions of combustion processes.
Magnitude, Pattern and Management Outcome of Intestinal Obstruction among Non-Traumatic Acute Abdomen Surgical Admissions in Arba Minch General Hospital, Southern Ethiopia
Authors: Atalay Mulatie , Gebremickael Abinet , Demissie Solomon , Derso Yonas
Published: February 2021

Background: Intestinal obstruction is defined as a blockage or partial blockage of the passage of the intestinal contents. It is a potentially risky surgical emergency associated with high morbidity and mortality. Its pattern differs from country to country and even from place to place within a country. Therefore, this study aimed to find out the magnitude, pattern and management outcome of intestinal obstruction in Arba Minch General Hospital.Methods: A retrospective Cross-Sectional study was conducted in Arba Minch General hospital from January 09, 2015, to November 09, 2018. The data collection period was from December 15, 2018, to February 09, 2019. Simple random technique was applied to select 801 study participants. Then, the required data entered into Epi Info version 7.2.1.0 and exported to the statistical package for the social sciences software package version 20 for analysis. Result: This study revealed that the overall magnitude of intestinal obstruction was 40.60% with 95% CI (34.95 - 45.95). The magnitude of unfavorable management outcomes and deaths during the study period were 22.3% with 95% CI (18.00-27.00) and 7.1 % with 95% CI (4.00-10.00) respectively. Small bowel volvulus, sigmoid volvulus and adhesion (bands) accounted for 45.30%, 21.35% and 11.97% of all patterns of intestinal obstructions respectively. Dehydration (p<0.001), persistent tachycardia (p<0.001) and perforated bowl (p<0.001) were highly significantly associated with the management outcome of intestinal obstruction.Conclusion and recommendation: Intestinal obstruction was the most common among all acute abdomen cases and its management outcome highly associated with dehydration. Early resuscitation is recommended to decrease unfavorable management outcomes.
Fever without source as the first manifestation of SARS-CoV-2 infection in infants less than 90 days old.
Authors: Blázquez-Gamero Daniel , Epalza Cristina , Cadenas José Antonio Alonso , Gero Lourdes Calleja , Calvo Cristina , Molino Paula Rodríguez , Méndez María , Santos Mar , Fumadó Victoria , Guzmán María Fernanda , Soriano-Arandes Antoni , Jiménez Ana B. , Penin Maria , Cobo-Vazquez Elvira , León Marta Pareja , Lobato Zulema , Serna Miquel , Delgado Rafael , Moraleda Cinta , Tagarro Alfredo
Published: February 2021

Fever without source (FWS) in infants is a frequent cause of consultation at the emergency department and the emergence of SARS-CoV-2 could affect the approach to those infants. The aim of this study is to define the clinical characteristics and rates of bacterial coinfections of infants < 90 days with FWS as the first manifestation of SARS-CoV-2 infection. This is a cross-sectional study of infants under 90 days of age with FWS and positive SARS-CoV2 PCR in nasopharyngeal swab/aspirate, attended at the emergency departments of 49 Spanish hospitals (EPICO-AEP cohort) from March 1st to June 26th, 2020. Three hundred and thirty-three children with COVID-19 were included in EPICO-AEP. A total of 67/336 (20%) were infants less than 90 days old, and 27/67(40%) presented with FWS. Blood cultures were performed in 24/27(89%) and were negative in all but one (4%) who presented a Streptococcus mitis bacteremia. Urine culture was performed in 26/27(97%) children and was negative in all, except in two (7%) patients. Lumbar puncture was performed in 6/27(22%) cases, with no growth of bacteria. Two children had bacterial coinfections: 1 had UTI and bacteremia, and 1 had UTI. C-reactive was protein over 20 mg/L in two children (one with bacterial coinfection), and procalcitonin was normal in all. One child was admitted to the Pediatric Intensive Care Unit because of apnea episodes. No patients died. Conclusion: FWS was frequent in infants under 90 days of age with SARS-CoV-2 infection. Standardized markers to rule out bacterial infections remain useful in this population, and the outcome is generally good.
Treatment of tibia avulsion fracture of posterior cruciate ligament with total arthroscopic internal fixation with adjustable double loop plate: a retrospective cohort study
Authors: Zhang Fan , Ye Yaping , Yu Wu , Yin Dan , Xu Kai
Published: February 2021

Background We aimed to evaluate the effect of a surgery technique-total arthroscopic internal fixation with adjustable double loop plate in treatment of patients with tibia avulsion fracture of posterior cruciate ligament (PCL). Methods From April 2018 to January 2020, 26 patients with tibia avulsion fracture of PCL treated in the joint surgery of our hospital were enrolled in this retrospective cohort study. According to the way of operation, the patients were divided into the experimental group (receiving total arthroscopic internal fixation with an adjustable double loop plate) and the control group (receiving traditional open surgery). The knee joint X-ray, CT or magnetic resonance imaging (MRI) were used to evaluate the injury or the fixation effect. Results There were no significant differences in baseline patient demographics between the two groups in terms of age, sex, the average time from injury to surgery, type of surgery, preoperative knee range of motion, Lysholm score, IKDC score and KT-1000 score (P>0.05). The average operation time in the experimental group (59.5 ± 10.6 minutes) was significantly shorter than that in the control group (96.8 ± 13.7 minutes) (P < 0.05). Postoperative re-examination of knee CT and X-ray showed that the fracture fragments were well fixed in all patients. The fracture was all healed 2 months after the operation. Post-operative posterior drawer tests were negative in all patients at final follow-up. All patients regained a satisfactory knee range of motion and the flexion and extension function and were satisfied with the results of surgery and rehabilitation. There was significant difference (P < 0.05) in the Lysholm scores, the IKDC scores, the KT1000 scores, and the ROM between preoperative and postoperative values in the control group and the experimental group. However, there were no significant differences in these values between the two groups (p>0.05).Conclusions Total arthroscopic internal fixation with adjustable double loop plate is relatively simple, safe, minimally invasive, and reliable. After taking this operation and rehabilitation training, patients with tibia avulsion fracture of PCL can regain a satisfactory knee range of motion and the flexion and extension function.
More Accurate Estimates of the Accuracy of RT-PCR and Chest CT Tests for COVID-19
Authors: Wang Lu , Liu Xueqing , Xia Chen , Liu Jun , Zhou Xiao-Hua
Published: February 2021

In this article, we propose a novel statistical method for estimating the accuracy of chest computed tomography (CT) and reverse transcription polymerase chain reaction (RT-PCR) tests in the diagnosis of coronavirus disease 2019 (COVID-19), with a correction for imperfect gold standard and verification bias simultaneously. These two types of bias are often involved in estimating the diagnostic accuracy of COVID-19 tests. Imperfect gold standard bias arises when estimating accuracy measures of chest CT while using the RT-PCR test as a gold standard, despite its tendency to produce false negative results. Meanwhile, verification bias occurs in some studies where the results from chest CT are verified by RT-PCR test in a subsample of suspected cases that is not representative of the original population. Consequently, the accuracy estimates of chest CT and RT-PCR tests could be seriously biased and lead to invalid inference. Our proposed method is able to correct these two types of bias in providing unbiased and more accurate estimates of sensitivity and specificity of the two tests. Our results suggest that chest CT has higher sensitivity and lower specificity than RT-PCR, and the accuracy estimates can serve as an important reference for assessing and comparing the performance of these two tests in the diagnosis of COVID-19, and could guide policy recommendations for the implementation of these tests.
A novel recombinant protein vaccine containing the different E7 proteins of the HPV16, 18, 6, 11 E7 linked to the HIV-1 Tat (47-57) improve cytotoxic immune responses
Authors: Mousavi Tahoora , Valadan Reza , Rafiei Alireza , Abbasi Ali , Haghshenas Mohammad Reza
Published: February 2021

Objectives

Human papillomavirus infection (HPV) is the most common viral infection which is causes of cervical, penal, vulvar, anal and, oropharyngeal cancer. E7 protein of HPV is a suitable target for induction of T cell responses and controlling HPV-related cancer. The aim of the current study was to designed and evaluated a novel fusion protein containing the different E7 proteins of the HPV 16, 18, 6 and 11, linked to the cell-penetrating peptide HIV-1 Tat 49-57, in order to improve cytotoxic immune responses in in-vitro and in-vivo.

Results

In this study whole sequence of HPV16,18,6,11 E7-Tat (47-57) and HPV16,18,6,11 E7 cloned into the vector and expressed in E.coli (BL21). The purified protein was confirmed by SDS page and western blotting and then injected into the C57BL/6 mice. The efficiency of the fusion protein vaccine was assessed by antibody response assay, cytokine assay (IL-4 and IFN-γ), CD+8 cytotoxicity assay and tumor challenge experiment. Result showed that fusion proteins containing Adjuvant (IFA,CFA) could express higher titer of antibody. Also, we showed that vaccination with E7-Tat and, E7-Tat-ADJ induced high frequencies of E7-specific CD8+ T cells and CD107a expression as well as IFN-γ level and enhanced long-term survival in the therapeutic animal models.

Conclusion

Our finding suggested that this novel fusion protein vaccine was able to induce therapeutic efficacy and immunogenicity by improving CD8+ T cell in TC-1 tumor bearing mice; so this vaccine may be appreciated for research against HPV and tumor immunotherapies.
Opioid Use in Medical Cannabis Authorization Adult Patients from 2013-2018: Alberta, Canada
Authors: Lee Cerina , Lin Mu , Martins Karen J.B. , Dyck Jason R.B. , Klarenbach Scott , Richer Lawrence , Jess Ed , Hanlon John G. , Hyshka Elaine , Eurich Dean T.
Published: February 2021

Background: The opioid overdose epidemic in Canada and the United States has become a public health crisis - with exponential increases in opioid-related morbidity and mortality. Recently, there has been an increasing body of evidence focusing on the opioid-sparing effects of medical cannabis use (reduction of opioid use and reliance), and medical cannabis as a potential alternative treatment for chronic pain. The objective of this study is to assess the effect of medical cannabis authorization on opioid use (oral morphine equivalent; OME) between 2013-2018 in Alberta, Canada.Methods: All adult patients defined as chronic opioid users who received medical cannabis authorization in the province of Alberta from 2013-2018 were propensity score matched to non-authorized chronic opioid using controls. 5373 medical cannabis patients were matched to controls, who were all chronic opioid users. The change in the weekly average OME of opioid drugs for medical cannabis patients relative to controls was measured. Interrupted time series (ITS) analyses was used to assess the trend change in OME during the 26 weeks (6 months) before and 52 weeks (1 year) after the authorization of medical cannabis among adult chronic opioid users.Results: Average age was 52 years and 54% were female. Patients on low dose opioids (<50 OME) had a slightly increase in their weekly OME per week (absolute increase of 112.1 OME, 95% CI: 104.1 to 120.3); whereas higher dose users (OME >100), showed a significant decrease over 6 months (-435.5, 95% CI: -596.8 to -274.2) compared to controls. Conclusions: This short-term study found that medical cannabis authorization showed intermediate effects on opioid utilization, which was dependent on initial opioid use. Greater observations of changes in OME appear to be in those patients who were on a high dosage of opioids (OME>100); however, continued surveillance of patients utilizing both opioids and medical cannabis – is warranted by clinicians to understand the long-term potential benefits and any harms of ongoing use.
Hydrogen Peroxide Gas and Ozone Gas Synergistically Inactivate Prion Infectivity on Stainless Steel Wire
Authors: Hara Hideyuki , Chida Junji , Pasiana Agriani Dini , Uchiyama Keiji , Kikuchi Yutaka , Naito Tomoko , Takahashi Yuichi , Yamamura Junji , Kuromatsu Hisashi , Sakaguchi Suehiro
Published: February 2021

Prions are infectious agents causing prion diseases, which include Creutzfeldt-Jacob disease (CJD) in humans. Several cases have been reported to be transmitted through medical instruments that were used for preclinical CJD patients, raising public health concerns on iatrogenic transmissions of the disease. Since preclinical CJD patients are currently difficult to identify, medical instruments need to be adequately sterilized not to transmit the disease. In this study, we investigated the sterilizing activity of two oxidizing gases, ozone gas and hydrogen peroxide gas, against prions fixed on stainless steel wires using a mouse bioassay. Mice intracerebrally implanted with prion-contaminated stainless steel wires treated with ozone gas or hydrogen peroxide gas developed prion disease later than those implanted with control prion-contaminated stainless steel wires, indicating that ozone gas and hydrogen peroxide gas could reduce prion infectivity on wires. Incubation times were further elongated in mice implanted with prion-contaminated stainless steel wires treated with ozone and hydrogen peroxide-mixed gas, indicating that ozone-mixed hydrogen peroxide gas inactivates prions on these wires more potently than ozone gas or hydrogen peroxide gas. Taken together, these results suggest that ozone-mixed hydrogen peroxide gas may be useful for prion sterilization of medical instruments.
How to Accelerate Very Early Recovery of Small Incision Lenticular Extraction Formyopia
Authors: Lin Qinghong , Li Qing , Shen Zhengwei
Published: February 2021

Significance: A relatively long period of time is required for visual recovery after small incision lenticule extraction (SMILE), limiting its possible widespread application. The aim of this study was to compare the impact of different defined daily dose systems of 0.1% fluorometholone in the very early phase after SMILE operation.Methods: One hundred and eighty patients (360 eyes) treated with SMILE were divided into three groups. Group A: 60 patients (120 eyes were not given any 0.1% FML; Group B: 60 patients (120 eyes, were given 0.1% fluorometholone once every hour); Group C: 60 patients (120 eyes, were given 0.1% fluorometholone every half an hour). Visual acuity, incidence of subject symptoms and optical quality were assessed at 2, 4 and 24 h postoperatively.Results: The optical quality in group C was significantly higher than the other two groups (p < 0.0001). The incidence of subject symptoms in group C was also notably lower. There were no significant differences between patient groups at 24h.Conclusions: In conclusion, corneal healing, visual and optical quality assessment of patients treated with 0.1% fluorometholone (q1/2h) in the first 2h after SMILE were significantly improved in the very early postoperative phase.
Synovial Fluid Neutrophils in Oligoarticular Juvenile Idiopathic Arthritis Have an Altered Phenotype and Impaired Effector Functions
Authors: Arve-Butler Sabine , Schmidt Tobias , Mossberg Anki , Berthold Elisabet , Gullstrand Birgitta , Bengtsson Anders A , Kahn Fredrik , Kahn Robin
Published: February 2021

BackgroundNeutrophils are the most prevalent immune cells in synovial fluid in inflamed joints of children with oligoarticular juvenile idiopathic arthritis (JIA). Despite this, little is known about neutrophil function at the site of inflammation in JIA and how local neutrophils contribute to disease pathogenesis. This study aimed to characterize phenotype and function of synovial fluid neutrophils in oligoarticular JIA.Methods Neutrophils obtained from paired blood and synovial fluid from patients with active oligoarticular JIA were investigated phenotypically (n=17) and functionally (phagocytosis and oxidative burst, n=13) by flow cytometry. In a subset of patients (n=6), blood samples were also obtained during inactive disease at a follow-up visit. Presence of CD206-expressing neutrophils was investigated in synovial biopsies from four patients by immunofluorescence. ResultsNeutrophils in synovial fluid had an activated phenotype, characterized by increased CD66b and CD11b levels, and most neutrophils had a CD16hi CD62Llow aged phenotype. A large proportion of the synovial fluid neutrophils expressed CD206, a mannose receptor not commonly expressed by neutrophils but by monocytes, macrophages and dendritic cells. CD206 expressing neutrophils were also found in synovial tissue biopsies. The synovial fluid neutrophil phenotype was not dependent on transmigration alone. Functionally, synovial fluid neutrophils had reduced phagocytic capacity and a trend towards impaired oxidative burst compared to blood neutrophils. In addition, the effector functions of the synovial fluid neutrophils correlated negatively with the proportion of CD206+ neutrophils.ConclusionsNeutrophils in the inflamed joint in oligoarticular JIA were altered, both regarding phenotype and function. Neutrophils in the synovial fluid were activated, had an aged phenotype, had gained monocyte-like features and had impaired phagocytic capacity. The impairment in phagocytosis and oxidative burst was associated to the phenotype shift. We speculate that these neutrophil alterations might play a role in the sustained joint inflammation seen in JIA.
Mesoscopic collective dynamics in liquids and the Dual Model
Authors: Peluso Fabio
Published: February 2021

In the present article it is shown how a series of experimental evidences and theoretical developments on liquid modelling, gathered for the first time, can all be framed in a mesoscopic view of liquids that are hypothesized as constituted by a population of wave packets, responsible for the propagation of elastic and thermal perturbations, and of dynamic aggregates of molecules, in continuous re-arrangement, diving in an ocean of amorphous, disordered liquid. This model, dubbed Dual Model of Liquids, is complementary to the Phonon theory of Liquid Thermodynamics, recently proposed by an independent group. The pseudo-crystalline dynamic structures, whose presence in liquids is evidenced by high energy inelastic scattering experiments, interact with a statistical population of harmonic elastic waves and anharmonic wave-packets propagating within and among the structures themselves, respectively. The expression for the interaction term is derived from “first principles” based on general considerations related to the pressure exerted by elastic waves travelling in condensed media. The anharmonic character of the interaction allows the exchange not only of energy but also of momentum between wave packets and clusters, thus determining both the displacement of the latter within the medium, and the redistribution of the energy between external, or translatory degrees of freedom of the clusters, and internal collective, vibratory degrees. Using these concepts it is possible to calculate some dynamic and thermodynamic quantities concerning the dynamics of liquids. Moreover, the interpretation of the relaxation times of the processes involved in momentum and energy transport is given, their Order-of-Magnitude is calculated, and the way in which these times are involved in the different phases of the collective dynamics of liquids is discussed. A comparison is provided with results obtained in the frame of PLT and with the forecasts for the visco-elastic transition regions.
In the last part of the paper, some experiments are suggested that should be performed to provide additional details to the model.
Evaluation and Management Outcomes and Burdens in Patients with Refractory Chronic Cough Referred for Behavioral Cough Suppression Therapy
Authors: Slovarp Laurie , Jette Marie , Gillespie Amanda , Reynolds Jane , Barkmeier-Kraemer Julie
Published: February 2021

Purpose: The purpose of this study was to investigate the typical symptoms and medical management characteristics of adult patients with refractory chronic cough (RCC) who are referred to speech-language pathology (SLP) for behavioral cough suppression therapy (BCST) in order to estimate cost-effectiveness and efficiency of current practice patterns for this population.Methods: One hundred fifty-nine (159) patients with RCC referred for BCST were surveyed. Patients completed an initial survey at BCST onset related to symptom pattern and prior treatment, including the Leicester Cough Questionnaire (LCQ). Every 4-6 weeks patients completed follow-up surveys to assess their response to BCST.Results: Mean age was 58 years (83% women). The majority of participants reported their cough began two or more years prior to BCST. Approximately half reported seeing four or more physicians (49%) and being prescribed four or more medications (55%) prior to BCST. Medications targeting post-nasal drip (71%), reflux (70%), asthma (56%), and allergies (56%) were most commonly prescribed. BCST resulted in a clinically significant improvement in 113 (70.1%) participants. The mean change in LCQ for those who improved with BCST was 6.61. Over half (58%) reported they were quite satisfied to completely satisfied with their treatment response. The average time from enrollment to study completion was 64 days. Conclusion: The results of this study suggest early intervention with BCST may be a more cost-effective and efficient option for patients with RCC.