Intravascular Imaging-Guided Versus Coronary Angiography-Guided Complex PCI: A Meta-analysis of Randomized Controlled Trials

INTRODUCTION

Trials evaluating the role of intravascular imaging in percutaneous coronary intervention (PCI) for complex coronary artery disease have yielded mixed results. This study aimed to compare the outcomes of intravascular imaging specifically intravascular ultrasound (IVUS) with those from conventional coronary angiography in complex PCI.

METHODS

Comprehensive electronic search of MEDLINE, EMBASE, and Cochrane databases was performed until March 2023 for randomized clinical trials (RCTs) comparing intravascular imaging with coronary angiography in patients undergoing complex PCI. Complex PCI was defined per each study, and included PCI for American College of Cardiology/American Heart Association (ACC/AHA) type B2/C lesions, unprotected left main coronary artery disease, or multivessel stenting. The primary study outcome was major adverse clinical events (MACE).

RESULTS

The meta-analysis included 10 RCTs with a total of 6615 patients (3576 in the intravascular imaging group and 3039 in the coronary angiography group). The weighted mean-follow up was 28.9 months. Compared with coronary angiography, intravascular imaging reduced MACE (8% vs. 13.3%; relative risk [RR] 0.63; 95% confidence interval [CI] 0.54-0.73), cardiac death (RR 0.47; 95% CI 0.31-0.73), definite/probable stent thrombosis (RR 0.48; 95% CI 0.24-0.97), target vessel revascularization (RR 0.62; 95% CI 0.46-0.83), and target lesion revascularization (RR 0.61; 95% CI 0.47-0.79). There was no difference between both groups in all-cause death (RR 0.79; 95% CI 0.53-1.18) and myocardial infarction (RR 0.80; 95% CI 0.61-1.04).

CONCLUSION

In patients undergoing complex PCI, intravascular imaging-specifically IVUS-reduced MACE by decreasing the incidence of cardiac death, stent thrombosis, and target vessel and target lesion revascularization.

Degradation of levofloxacin using electro coagulation residuals-alginate beads as a novel heterogeneous electro-fenton composite

The presence of levofloxacin (LEV) in aqueous solutions can pose health risks to humans, have adverse effects on aquatic organisms and ecosystems, and contribute to the development of antibiotic-resistant bacteria. This study aims to investigate the feasibility of using electrocoagulation residuals (ECRs) as a heterogeneous catalyst in the electro-Fenton process for degrading LEV. By combining electrocoagulation residuals with sodium alginate, ECRs-alginate beads were synthesized as a heterogeneous electro-Fenton composite. The response surface method was employed to investigate the optimization and influence of various operating parameters such as the initial concentration of LEV (10-50 mg/L), voltage (15-35 V), pH (3-9), and catalyst dose (1-9 g/L). The successful incorporation of iron and other metals into the ECRs-alginate beads was confirmed by characterization tests such as EDX and FTIR. By conducting a batch reaction under optimal conditions (initial LEV concentration = 20 mg/L, pH = 4.5, voltage = 30V, and catalyst dose = 7 g/L), a remarkable degradation of 99% for LEV was achieved. Additionally, under these optimal conditions, a high removal efficiency of 92.3% for total organic carbon (TOC) could be attained within 120 min and these findings are remarkable compared to previous studies. The results further indicated that the degradation of levofloxacin (LEV) could be accurately quantified by utilizing the first-order kinetic reaction with a 0.03 min-1 rate constant. The synthesized beads offered notable advantages in terms of being eco-friendly, simple to use, highly efficient, and easily recoverable from the liquid medium after use.

Near-infrared Absorption and Emission Probes with Optimal Connection Bridges for Live Monitoring of NAD(P)H Dynamics in Living Systems

Two NAD(P)H-biosensing probes consisting of 1,3,3-trimethyl-3H-indolium and 3-quinolinium acceptors, linked by thiophene, A, and 3,4-ethylenedioxythiophene, B, bridges are detailed. We synthesized probes C and D, replacing the thiophene connection in probe A with phenyl and 2,1,3-benzothiadiazole units, respectively. Probe E was prepared by substituting probe A's 3-quinolinium unit with a 1-methylquinoxalin-1-ium unit. Solutions are non-fluorescent but in the presence of NADH, exhibit near-infrared fluorescence at 742.1 nm and 727.2 nm for probes A and B, respectively, and generate absorbance signals at 690.6 nm and 685.9 nm. In contrast, probes C and D displayed pronounced interference from NADH fluorescence at 450 nm, whereas probe E exhibited minimal fluorescence alterations in response to NAD(P)H. Pre-treatment of A549 cells with glucose in the presence of probe A led to a significant increase in fluorescence intensity. Additionally, subjecting probe A to lactate and pyruvate molecules resulted in opposite changes in NAD(P)H levels, with lactate causing a substantial increase in fluorescence intensity, conversely, pyruvate resulted in a sharp decrease. Treatment of A549 cells with varying concentrations of the drugs cisplatin, gemcitabine, and camptothecin (5, 10, and 20 μM) led to a concentration-dependent increase in intracellular fluorescence intensity, signifying a rise in NAD(P)H levels. Finally, fruit fly larvae were treated with different concentrations of NADH and cisplatin illustrating applicability to live organisms. The results demonstrated a direct correlation between fluorescence intensity and the concentration of NADH and cisplatin, respectively, further confirming the efficacy of probe A in sensing changes in NAD(P)H levels within a whole organism.

Utility of long-read sequencing for All of Us

The All of Us (AoU) initiative aims to sequence the genomes of over one million Americans from diverse ethnic backgrounds to improve personalized medical care. In a recent technical pilot, we compare the performance of traditional short-read sequencing with long-read sequencing in a small cohort of samples from the HapMap project and two AoU control samples representing eight datasets. Our analysis reveals substantial differences in the ability of these technologies to accurately sequence complex medically relevant genes, particularly in terms of gene coverage and pathogenic variant identification. We also consider the advantages and challenges of using low coverage sequencing to increase sample numbers in large cohort analysis. Our results show that HiFi reads produce the most accurate results for both small and large variants. Further, we present a cloud-based pipeline to optimize SNV, indel and SV calling at scale for long-reads analysis. These results lead to widespread improvements across AoU.

Conv3D-Based Video Violence Detection Network Using Optical Flow and RGB Data

Detecting violent behavior in videos to ensure public safety and security poses a significant challenge. Precisely identifying and categorizing instances of violence in real-life closed-circuit television, which vary across specifications and locations, requires comprehensive understanding and processing of the sequential information embedded in these videos. This study aims to introduce a model that adeptly grasps the spatiotemporal context of videos within diverse settings and specifications of violent scenarios. We propose a method to accurately capture spatiotemporal features linked to violent behaviors using optical flow and RGB data. The approach leverages a Conv3D-based ResNet-3D model as the foundational network, capable of handling high-dimensional video data. The efficiency and accuracy of violence detection are enhanced by integrating an attention mechanism, which assigns greater weight to the most crucial frames within the RGB and optical-flow sequences during instances of violence. Our model was evaluated on the UBI-Fight, Hockey, Crowd, and Movie-Fights datasets; the proposed method outperformed existing state-of-the-art techniques, achieving area under the curve scores of 95.4, 98.1, 94.5, and 100.0 on the respective datasets. Moreover, this research not only has the potential to be applied in real-time surveillance systems but also promises to contribute to a broader spectrum of research in video analysis and understanding.

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

BACKGROUND

Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.

METHODS

This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.

RESULTS

The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (β coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.

CONCLUSION

Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely.

Insights on hexavalent chromium(VI) remediation strategies in abiotic and biotic dual chamber microbial fuel cells: electrochemical, physical, and metagenomics characterizations

Hexavalent chromium [Cr(VI)] is one of the most carcinogenic and mutagenic toxins, and is commonly released into the environemt from different industries, including leather tanning, pulp and paper manufacturing, and metal finishing. This study aimed to investigate the performance of dual chamber microbial fuel cells (DMFCs) equipped with a biocathode as alternative promising remediation approaches for the biological reduction of hexavalent chromium [Cr(VI)] with instantaneous power generation. A succession batch under preliminary diverse concentrations of Cr(VI) (from 5 to 60 mg L-1) was conducted to investigate the reduction mechanism of DMFCs. Compared to abiotic-cathode DMFC, biotic-cathode DMFC exhibited a much higher power density, Cr(VI) reduction, and coulombic efficiency over a wide range of Cr(VI) concentrations (i.e., 5-60 mg L-1). Furthermore, the X-ray photoelectron spectroscopy (XPS) revealed that the chemical functional groups on the surface of biotic cathode DMFC were mainly trivalent chromium (Cr(III)). Additionally, high throughput sequencing showed that the predominant anodic bacterial phyla were Firmicutes, Proteobacteria, and Deinococcota with the dominance of Clostridiumsensu strict 1, Enterobacter, Pseudomonas, Clostridiumsensu strict 11 and Lysinibacillus in the cathodic microbial community. Collectively, our results showed that the Cr(VI) removal occurred through two different mechanisms: biosorption and bioelectrochemical reduction. These findings confirmed that the DMFC could be used as a bioremediation approach for the removal of Cr(VI) commonly found in different industrial wastewater, such as tannery effluents. with simultaneous bioenergy production.

Lightweight Multi-Class Support Vector Machine-Based Medical Diagnosis System with Privacy Preservation

Machine learning, powered by cloud servers, has found application in medical diagnosis, enhancing the capabilities of smart healthcare services. Research literature demonstrates that the support vector machine (SVM) consistently demonstrates remarkable accuracy in medical diagnosis. Nonetheless, safeguarding patients' health data privacy and preserving the intellectual property of diagnosis models is of paramount importance. This concern arises from the common practice of outsourcing these models to third-party cloud servers that may not be entirely trustworthy. Few studies in the literature have delved into addressing these issues within SVM-based diagnosis systems. These studies, however, typically demand substantial communication and computational resources and may fail to conceal classification results and protect model intellectual property. This paper aims to tackle these limitations within a multi-class SVM medical diagnosis system. To achieve this, we have introduced modifications to an inner product encryption cryptosystem and incorporated it into our medical diagnosis framework. Notably, our cryptosystem proves to be more efficient than the Paillier and multi-party computation cryptography methods employed in previous research. Although we focus on a medical application in this paper, our approach can also be used for other applications that need the evaluation of machine learning models in a privacy-preserving way such as electricity theft detection in the smart grid, electric vehicle charging coordination, and vehicular social networks. To assess the performance and security of our approach, we conducted comprehensive analyses and experiments. Our findings demonstrate that our proposed method successfully fulfills our security and privacy objectives while maintaining high classification accuracy and minimizing communication and computational overhead.

Enhanced degradation of ibuprofen in an integrated constructed wetland-microbial fuel cell: treatment efficiency, electrochemical characterization, and microbial community dynamics

Over the past few decades, there has been a growing concern regarding the fate and transport of pharmaceuticals, particularly antibiotics, as emerging contaminants in the environment. It has been proposed that the presence of antibiotics at concentrations typically found in wastewater can impact the dynamics of bacterial populations and facilitate the spread of antibiotic resistance. The efficiency of currently-used wastewater treatment technologies in eliminating pharmaceuticals is often insufficient, resulting in the release of low concentrations of these compounds into the environment. In this study, we addressed these challenges by evaluating how different influent ibuprofen (IBU) concentrations influenced the efficiency of a laboratory-scale, integrated constructed wetland-microbial fuel cell (CW-MFC) system seeded with Eichhornia crassipes, in terms of organic matter removal, electricity generation, and change of bacterial community structure compared to unplanted, sediment MFC (S-MFC) and abiotic S-MFC (AS-MFC). We observed that the addition of IBU (5 mg L-1) resulted in a notable decrease in chemical oxygen demand (COD) and electricity generation, suggesting that high influent IBU concentrations caused partial inhibition for the electroactive microbial community due to its complexity and aromaticity. However, CW-MFC could recover from IBU inhibition after an acclimation period compared to unplanted S-MFC, even though the influent IBU level was increased up to 20 mg L-1, suggesting that plants in CW-MFCs have a beneficial role in relieving the inhibition of anode respiration due to the presence of high levels of IBU; thus, promoting the metabolic activity of the electroactive microbial community. Similarly, IBU removal efficiency for CW-MFC (i.e., 49-62%) was much higher compared to SMFC (i.e., 29-42%), and AS-MFC (i.e., 20-22%) during all experimental phases. In addition, our high throughput sequencing revealed that the high performance of CW-MFCs compared to S-MFC was associated with increasing the relative abundances of several microbial groups that are closely affiliated with anode respiration and organic matter fermentation. In summary, our results show that the CW-MFC system demonstrates suitability for high removal efficiency of IBU and effective electricity generation.

A Federated Learning Model Based on Hardware Acceleration for the Early Detection of Alzheimer's Disease

Alzheimer's disease (AD) is a progressive illness with a slow start that lasts many years; the disease's consequences are devastating to the patient and the patient's family. If detected early, the disease's impact and prognosis can be altered significantly. Blood biosamples are often employed in simple medical testing since they are cost-effective and easy to collect and analyze. This research provides a diagnostic model for Alzheimer's disease based on federated learning (FL) and hardware acceleration using blood biosamples. We used blood biosample datasets provided by the ADNI website to compare and evaluate the performance of our models. FL has been used to train a shared model without sharing local devices' raw data with a central server to preserve privacy. We developed a hardware acceleration approach for building our FL model so that we could speed up the training and testing procedures. The VHDL hardware description language and an Altera 10 GX FPGA are utilized to construct the hardware-accelerator approach. The results of the simulations reveal that the proposed methods achieve accuracy and sensitivity for early detection of 89% and 87%, respectively, while simultaneously requiring less time to train than other algorithms considered to be state-of-the-art. The proposed algorithms have a power consumption ranging from 35 to 39 mW, which qualifies them for use in limited devices. Furthermore, the result shows that the proposed method has a lower inference latency (61 ms) than the existing methods with fewer resources.

Sand consolidation using enzyme-induced carbonate precipitation: new insights on temperature and particle size effects

Sand production is a major issue in the oil and gas industry. Unconsolidated sand can be produced with the oil or gas a cause many issues to the production facilities. Enzyme-induced carbonate precipitation (EICP) is a promising method for sand consolidation and is characterized by its environment friendliness. Numerous studies have shown its effectiveness in ambient conditions. However, oil and gas downhole well operations are high pressure and high-temperature conditions. The objective of this study is to investigate effect of high temperature on EICP reaction and its efficiency in terms of uniformity to consolidate different types of sand samples. In this paper, the behavior of EICP solutions is examined in high temperatures from 25 to 90 °C. The study shows that high temperature environment doesn't handicap efficiency but in contrast it can favor the reaction if optimum concentration of reactants has been selected. The temperature effect is also discussed in terms of controllability of reaction which can favor application of reaction. Qualitive analysis shows when EICP solutions containing more than 50,000 ppm of metal ions and stoichiometrically surplus urea requires exposure to heat for reaction progress. The effect of sand particle size and its implication on the consolidation process was examined. Particle size of fine and medium sand ranged from 125 to 250 µm and 250 to 425 µm respectively while for coarse sand 70% sand particle size was between 425 and 700 µm. Designed EICP solutions achieve 9,000 psi for medium and almost 5,000 psi intrinsic specific energy for coarse sand samples. However, treated samples were subject to non-uniform distribution of strength of which can be up to 8,000 psi difference between top and bottom half of the samples.

A new promising approach to urodynamic stress urinary incontinence care can help menopausal women

Introduction

The goal of this study is to evaluate the effectiveness of single-incision mini-sling in the surgical treatment of postmenopausal urodynamic stress urinary incontinence (SUI) compared to the standard trans-obturator mid-urethral sling.

Material and methods

This prospective study was carried out in two tertiary centres; Al-Azhar University Maternity & Urology Hospitals. A total of 120 postmenopausal women with urodynamic SUI were randomized to undergo either single-incision mini-sling (n = 60) or standard trans-obturator mid-urethral sling procedure (n = 60) from May 2019 until Oct 2021. Main outcome measures: efficacy was evaluated utilizing objective cure rate (cough stress test) and subjective cure rate (Sandvik incontinence severity index and International Consultations on Incontinence Questionnaire - Short Form), intraoperative and postoperative complications, and postoperative pain (using a visual analogue scale).

Results

The single-incision mini-sling (SIMS) and transobturator tape (TOT) groups had no statistically significant difference in subjective and objective cure rates (p > 0.05). Compared with the transvaginal tape O group, patients in the SIMS group had significantly less postoperative pain, shorter operative duration, and less intraoperative blood loss (all p-values < 0.05). No significant difference in perioperative complications was observed between both groups.

Conclusions

Single-incision mini-sling was superior to TOT in postmenopausal as SIMS is of similar effectiveness, more safe and minimally invasive with earlier ambulance.

A Guide for Selection of Aging Time and Temperature for Wettability Alteration in Various Rock-Oil Systems

Wettability alteration has been identified to be one of the important mechanisms to improve the microscopic recovery in many of the enhanced oil recovery (EOR) methods including polymer flood, surfactant flood, low salinity flood, microbial flood, alkaline flood, etc. Ensuring the oil-wet nature of the formation before flooding in the laboratory is necessary to study the efficiency of the EOR process, which targets microscopic recovery through wettability alteration. Nevertheless, altering the wettability depends on several parameters, such as aging time, aging temperature, core nature, oil properties, etc. Although several researchers investigated the effect of individual parameters on wettability alteration, the literature is scarce, and the question of what is the shortest and yet the most reliable aging time for ensuring wettability alteration for the specific rock-oil system at different temperatures remains unclear. This paper attempts to seek an answer to this question by compiling the relevant literature to find the effect of individual parameters such as different aging times, temperatures, oil compositions, and rock lithologies on wettability alteration. Results observed from data analysis showed different windows for aging conditions depending on the core sample lithology, initial wettability, and type of oil used. It was noticed that the higher the asphaltene content in the crude oil used, the lower the time and temperature that it takes to alter the sample wettability. Aging a sandstone core under 80 °C using crude oil with 11 wt % % asphaltene took 7 days to shift the core from strongly water-wet to neutral-wet. The same wettability alteration was achieved in 14 days when aging the sandstone sample at 90 °C using crude oil with 0.85 wt % asphaltene content. Generally, it was observed that the aging time decreased as the temperature increased. Moreover, as the sample has a lower initial water wettability condition, the time that it needs to be aged becomes higher. Results indicated that carbonates in general require less aging time to alter their wettability condition to oil-wet, around 1-7 days, compared with sandstones, around 14-21 days.

Highly Sensitive Cyanine Dyes for Rapid Sensing of NAD(P)H in Mitochondria and First-Instar Larvae of Drosophila melanogaster

We have developed two highly sensitive cyanine dyes, which we refer to as probes A and B. These dyes are capable of quick and sensitive sensing of NAD(P)H. The dyes were fabricated by connecting benzothiazolium and 2,3-dimethylnaphtho[1,2-d]thiazol-3-ium units to 3-quinolinium through a vinyl bond. In the absence of NAD(P)H, both probes have low fluorescence and absorption peaks at 370 and 400 nm, correspondingly. This is because of their two electron-withdrawing acceptor systems with high charge densities. However, when NAD(P)H reduces the probes' electron-withdrawing 3-quinolinium units to electron-donating 1,4-dihydroquinoline units, the probes absorb at 533 and 535 nm and fluoresce at 572 and 586 nm for A and B correspondingly. This creates well-defined donor-π-acceptor cyanine dyes. We successfully used probe A to monitor NAD(P)H levels in live cells during glycolysis, under hypoxic conditions induced by CoCl2 treatment and after treatment with cancer drugs, including cisplatin, camptothecin, and gemcitabine. Probe A was also employed to visualize NAD(P)H in Drosophila melanogaster first-instar larvae. We observed an increase in NAD(P)H levels in A549 cancer cells both under hypoxic conditions and after treatment with cancer drugs, including cisplatin, camptothecin, and gemcitabine.

GANMasker: A Two-Stage Generative Adversarial Network for High-Quality Face Mask Removal

Deep-learning-based image inpainting methods have made remarkable advancements, particularly in object removal tasks. The removal of face masks has gained significant attention, especially in the wake of the COVID-19 pandemic, and while numerous methods have successfully addressed the removal of small objects, removing large and complex masks from faces remains demanding. This paper presents a novel two-stage network for unmasking faces considering the intricate facial features typically concealed by masks, such as noses, mouths, and chins. Additionally, the scarcity of paired datasets comprising masked and unmasked face images poses an additional challenge. In the first stage of our proposed model, we employ an autoencoder-based network for binary segmentation of the face mask. Subsequently, in the second stage, we introduce a generative adversarial network (GAN)-based network enhanced with attention and Masked-Unmasked Region Fusion (MURF) mechanisms to focus on the masked region. Our network generates realistic and accurate unmasked faces that resemble the original faces. We train our model on paired unmasked and masked face images sourced from CelebA, a large public dataset, and evaluate its performance on multi-scale masked faces. The experimental results illustrate that the proposed method surpasses the current state-of-the-art techniques in both qualitative and quantitative metrics. It achieves a Peak Signal-to-Noise Ratio (PSNR) improvement of 4.18 dB over the second-best method, with the PSNR reaching 30.96. Additionally, it exhibits a 1% increase in the Structural Similarity Index Measure (SSIM), achieving a value of 0.95.

Thiophene-based organic dye with large Stokes shift and deep red emission for live cell NAD(P)H detection under varying chemical stimuli

We report a novel method for synthesizing red and deep red cyanine dyes with large Stokes shifts, probes A and B, for live cell NAD(P)H detection. The probes were prepared using thiophene-based organic dyes featuring a π-conjugated bridge of thiophene and 3,4-ethylenedioxythiophene units linking the 1-methylquinolinium acceptor and formyl acceptor, respectively. These probes display weak absorption peaks at 315 nm (A) and 334 nm (B) and negligible fluorescence in the absence of NADH. However, upon the presence of NADH, new absorption and fluorescence peaks appear at 477 nm and 619 nm for probe A and at 486 nm and 576 nm for probe B, respectively. This is due to the NADH-facilitated reduction of the 1-methylquinolinium unit into 1-methyl-1,4-dihydroquinoline, which then acts as the electron donor for the probes, leading to the formation of well-defined electron donor-acceptor dye systems. Probe A has a large Stokes shift of 144 nm, which allows for better separation between the excitation and emission spectra, reducing spectral overlap and improving the accuracy of fluorescence measurements. The probes are highly selective for NAD(P)H, water-soluble, biocompatible, and easily permeable to cells. They are also photostable and were successfully used to monitor changes in NADH concentration in live cells during glycolysis in the presence of glucose, lactate, and pyruvate, treatment of FCCP and cancer drug cisplatin, and under hypoxia triggered by CoCl2. Furthermore, the probes were able to image NAD(P)H in Drosophila melanogaster larvae. Notably, cisplatin treatment increased the NAD(P)H concentration in A459 cells over time. Overall, this work presents a significant advancement in the field of live cell imaging by providing a simple and cost-effective method for detecting changes in NAD(P)H concentration under varying chemical stimuli.

A randomized clinical trial evaluating the effects of administration of acidogenic boluses at dry-off on rumination and activity behavior in the 14 subsequent days

Elevated milk production at dry-off can lead to increased udder pressure and, in turn, increased stress due to pain and discomfort, affecting natural behaviors. Administering acidogenic boluses at dry-off acts by inducing temporary and mild decreases in blood pH. This decreases dry matter intake, reduces milk yield, and increases cow comfort by lessening udder pressure. The objective of this study was to assess the effect of oral administration of acidogenic boluses at dry-off on total daily activity (TDA) and total daily rumination (TDR) behaviors in the first 2 wk of the dry period. This randomized clinical trial was conducted on a single farm and cows were randomly assigned to either treatment (TRT; n = 30) or control (CON; n = 34). The TRT group received 2 acidogenic boluses at dry-off and the CON group received no intervention. All cows received dry-cow therapy (intramammary antibiotic and internal teat sealant). The TDA and TDR data from 7 d before to 14 d after dry-off were measured using ear-mounted activity monitors. Analyses were performed using linear mixed-effects models with repeated measures. We observed a similar TDA in both groups throughout the study follow-up period. Overall, cows in the TRT group spent 17 min/d less time active than cows in the CON group in the first 2 wk after dry-off with the greatest difference observed on the second day of the dry period (TRT = 395 min/d; 95% CI: 370 to 420 vs. CON = 428 min/d; 95% CI: 404 to 451). The TRT group had lower TDR in the first 24 h after bolus administration (TRT = 437 min/d; 95% CI: 414 to 461 vs. CON = 488 min/d; 95% CI: 466 to 510) when compared with the CON group, but no differences were observed when comparing both groups in the 13 subsequent days. Our results indicate that administering acidogenic boluses at dry-off slightly decreased TDA during the first 2 wk of the dry period and decreased TDR on the first day after administration.

Does Vitamin K2 Influence the Interplay between Diabetes Mellitus and Intervertebral Disc Degeneration in a Rat Model?

Intervertebral disc (IVD) degeneration is a common cause of low back pain in diabetes mellitus type 2 (T2DM) patients. Its pathogenesis and the vitamin (vit.) K2 influence on this disease remain unclear. Lumbar motion segments of male Zucker Diabetes Fatty (ZDF) rats (non-diabetic [control] and diabetic; fed without or with vit. K2) were used. Femur lengths and vertebral epiphyseal cross-section areas were measured. IVDs were histopathologically examined. Protein synthesis and gene expression of isolated IVD fibrochondrocytes were analyzed. T2DM rats showed histopathological IVD degeneration. Femur lengths and epiphyseal areas were smaller in T2DM rats regardless of vit. K2 feeding. Fibrochondrocytes synthesized interleukin (IL)-24 and IL-10 with no major differences between groups. Alpha smooth muscle actin (αSMA) was strongly expressed, especially in cells of vit. K2-treated animals. Gene expression of aggrecan was low, and that of collagen type 2 was high in IVD cells of diabetic animals, whether treated with vit. K2 or not. Suppressor of cytokine signaling (Socs)3 and heme oxygenase (Hmox)1 gene expression was highest in the cells of diabetic animals treated with vit. K2. Vit. K2 influenced the expression of some stress-associated markers in IVD cells of diabetic rats, but not that of IL-10 and IL-24.

Comparative study between oxytocin and combination of tranexamic acid and ethamsylate in reducing intra-operative bleeding during emergency and elective cesarean section after 38 weeks of normal pregnancy

OBJECTIVE

Cesarean Section (CS) is associated with an increased risk of hemorrhage. Many drugs are used to decrease this risk. We aim to compare the combination of ethamsylate and tranexamic acid, oxytocin, and placebo in women undergoing CS.

METHODS

We conducted a double-blinded, randomized, placebo-controlled trial between October and December 2020 in four university hospitals in Egypt. The study included all pregnant women in labor without any complications who accepted to participate in the study between October and December 2020. The participants were divided into three groups. The subjects were randomly allocated to receive either oxytocin (30 IU in 500 ml normal saline during cesarean section), combined one gram of tranexamic acid with 250 mg of ethamsylate once before skin incision, or distilled water. Our main outcome was the amount of blood loss during the operation. The secondary outcomes were the need for blood transfusion, hemoglobin and hematocrit changes, hospital stay, operative complications, and the need for a hysterectomy. The one-way ANCOVA test was used to compare the quantitative variables between the three groups while the Chi-square test was used to compare the qualitative variables. Post hoc analysis then was performed to compare the difference between every two groups regarding the quantitative variables.

RESULTS

Our study included 300 patients who were divided equally into three groups. Tranexamic acid with ethamsylate showed the least intra-operative blood loss (605.34 ± 158.8 ml) compared to oxytocin (625.26 ± 144.06) and placebo (669.73 ± 170.69), P = 0.015. In post hoc analysis, only tranexamic acid with ethamsylate was effective in decreasing the blood loss compared to placebo (P = 0.013); however, oxytocin did not reduce blood loss compared to saline (P = 0.211) nor to tranexamic acid with ethamsylate (P = 1). Other outcomes and CS complications showed no significant difference between the three groups except for post-operative thrombosis which was significantly higher in the tranexamic and ethamsylate group, P < 0.00001 and the need for a hysterectomy which was significantly increased in the placebo group, P = 0.017.

CONCLUSION

The combination of tranexamic acid and ethamsylate was significantly associated with the least amount of blood loss. However, in pairwise comparisons, only tranexamic acid with ethamsylate was significantly better than saline but not with oxytocin. Both oxytocin and tranexamic acid with ethamsylate were equally effective in reducing intra-operative blood loss and the risk of hysterectomy; however, tranexamic acid with ethamsylate increased the risk of thrombotic events. Further research with a larger number of participants is needed.

TRIAL REGISTRATION

The study was registered on Pan African Clinical Trials Registry with the following number: PACTR202009736186159 and was approved on 04/09/2020.

Identification of allele-specific KIV-2 repeats and impact on Lp(a) measurements for cardiovascular disease risk

The abundance of Lp(a) protein holds significant implications for the risk of cardiovascular disease (CVD), which is directly impacted by the copy number (CN) of KIV-2, a 5.5 kbp sub-region. KIV-2 is highly polymorphic in the population and accurate analysis is challenging. In this study, we present the DRAGEN KIV-2 CN caller, which utilizes short reads. Data across 166 WGS show that the caller has high accuracy, compared to optical mapping and can further phase ~50% of the samples. We compared KIV-2 CN numbers to 24 previously postulated KIV-2 relevant SNVs, revealing that many are ineffective predictors of KIV-2 copy number. Population studies, including USA-based cohorts, showed distinct KIV-2 CN, distributions for European-, African-, and Hispanic-American populations and further underscored the limitations of SNV predictors. We demonstrate that the CN estimates correlate significantly with the available Lp(a) protein levels and that phasing is highly important.

Investigation of the Coupled Effect of IFT Reduction and Wettability Alteration for Oil Recovery: New Insights

Interfacial tension (IFT) reduction and wettability alteration (WA) are both important enhanced oil recovery (EOR) mechanisms. In oil-wet formations, IFT reduction reduces the magnitude of negative capillary pressure, releasing trapped oil. WA changes the negative capillary pressure to positive conditions, helping the entrance of the aqueous phase, and the displacement of the oil phase. In most cases, IFT reduction and WA happen at the same time. However, studies regarding the coupled effect provided different, sometimes conflicting observations. It requires further study and better understanding. In our study, oil-aged Indiana limestone samples were chosen to represent oil-wet carbonate rocks. Static contact angle and spinning drop method were adopted for wettability assessment and IFT measurement, respectively. Spontaneous imbibition was adopted to reflect on the oil recovery mechanisms in different cases. The impact of IFT reduction, WA, and permeability on the coupled effect was discussed by choosing four pairs of comparison tests. Results showed that when the coupled effect took place, both a higher IFT value and a stronger WA performance resulted in faster and higher oil recoveries. The importance of IFT reduction was enhanced in the higher-permeability condition, while the importance of WA was enhanced in the lower-permeability condition.

Thermally Activated Nitrogen/Heat Generating Reaction: A Kinetic Study

Sodium nitrite and ammonium chloride are the most widely used thermochemicals in the oil and gas industry. The kinetics of this reaction when activated with acids or acid precursors were the subject of extensive research by several researchers. The activation of such a highly spontaneous/vigorous reaction by heat is considered a promising reaction control. In this work, a kinetic study was carried out for the reaction of sodium nitrite and ammonium chloride salt activated by heat at 1-5 M and temperatures of 50-90 °C. The study was carried out in both closed and open systems, with the monitoring of gas evolution and generated pressure. The study showed a relatively higher order for ammonium chloride than sodium nitrite. The excess amount of ammonium chloride, a weak acid, enhanced the reaction as it could be catalyzed by both heat and acid. The obtained kinetics of the nitrogen generating reaction is given as dc/dt = -7.66 × 10¹¹ C _o ^2.45 e ^{(-91.44 kJ/mol)/RT} . The reaction kinetics in this study differs from what is reported in the literature regarding the order of NH₄Cl, which was reported to be higher than that of NaNO₂ under examined conditions. This study has practical significance for controlling the reactivity of the NH₄Cl/NaNO₂ nitrogen/heat generating system and calculating/optimizing nitrogen generation for a specific field application.

Narratives of Abd Al-Rahman bin Harmala in the Nine Books (Chapter on Naming when Ablution, as an Example ) - An Analytical Study -

ABSTRACT                                       There is no doubt that the science of the Prophet’s hadith is one of the highest and most beneficial sciences. Allah Almighty has guided me to write this science , so my choice fell on one of its topics, which is (The Narratives of Abd Al-Rahman bin Harmala in the Nine Books – An Analytical Study -) .After researching the nine books and what the authors of these books brought out for him we found that Abd Al-Rahman bin Harmala had forty-five narrations, and after deleting the repeated ones, we found them to be twenty-one narrations. We will put them in your hands, divided according to the  jurisprudential chapters .We do not find any thing that enables us to identify the date of the narrators birth who is Abd Al-Rahman bin Harmala. However, one can that from the peers who lived with him, and through the sheikhs from whom Abd Al-Rahman bin Harmala was taken so, his birth may have been between 60 AH to 70 AH. Allah  knows.

Prediction of Total Organic Carbon in Organic-Rich Shale Rocks Using Thermal Neutron Parameters

Total organic carbon (TOC) content is one of the crucial parameters that determine the value of the source rock. The TOC content gives important indications about the source rocks and hydrocarbon volume. Various techniques have been utilized for TOC quantification, either by geochemical analysis of source rocks in laboratories or using well logs to develop mathematical correlations and advanced machine learning models. Laboratory methods require intense sampling intervals to have an accurate understanding of the reservoir, and depending on the thickness of the interested formation, it can be time-consuming and costly. Empirical correlations based on well logs (e.g., density, sonic, gamma ray, and resistivity) showed fast predictions and very reasonable accuracies. However, other important parameters such as thermal neutron logs have not been studied yet as a potential input for providing reliable TOC predictions. Also, different studies estimate the TOC based on the well-logging data for various formations; however, limited studies were reported to predict the TOC for the Horn River Formation. Therefore, the objective of this study is to estimate the TOC variations based on the thermal neutron logs using one of the largest source rocks in Canada: The Horn River Formation. More than 150 data sets were collected and used in this work. The parameters of the artificial neural network (ANN) model were fine-tuned in order to improve the model's prediction performance. Furthermore, an empirical correlation was developed utilizing the optimized ANN model to allow fast and direct application for the developed model. The developed correlation can predict the TOC with an average absolute error of 0.52 wt %. The proposed TOC model was able to outperform the previous models, and the coefficient of determination was increased from 0.28 to 0.73. Overall, the proposed TOC model can provide high accuracy for TOC ranges from 0.3 to 6.44 wt %. The developed model can provide a real-time quantification for the organic matter maturity, helping to allocate the zones of mature organic matter within the drilled formations.

Effect of Seawater Ions on Polymer Hydration in the Presence of a Chelating Agent: Application to Hydraulic Fracturing

Seawater (SW) and produced water (PW) could replace freshwater in hydraulic fracturing operations, but their high salinity impacts the fluid stability and results in formation damage. Few researchers investigated SW and PW individual ions' impact on polymer hydration and rheology. This research examines the rheology of carboxy methyl hydroxy propyl guar (CMHPG) polymer hydrated in salt ions in the presence of a chelating agent. The effect of various molar concentrations of SW and PW salt ions on the rheology of CMHPG polymer solution was examined. The tested salt ions included calcium chloride, magnesium chloride, sodium chloride, and sodium sulfate, which were compared to SW and deionized water (DI) solutions. The solutions were tested at 70 °C temperature, 500 psi pressure, and 100 1/s shear rate. A GLDA chelating agent was utilized at different concentrations to examine their impact on stabilizing the solution viscosity. We found that adding the GLDA to magnesium and calcium chloride solutions increased the viscosity. Results showed that sulfate ions control the rheology of seawater due to their similar rheological response to the addition of GLDA. The results help to understand how the SW and PW ions impact the rheology of fracturing fluids.

Purification and biochemical characterization of two laccase isoenzymes isolated from Trichoderma harzianum S7113 and its application for bisphenol A degradation

Two laccase isoenzymes (LacA and LacB) were isolated from a novel Trichoderma harzianum S7113 isolate employing ammonium sulfate precipitation, Sephadex G100, and DEAE Sepharose ion exchange chromatography. The molecular weights of the purified LacA and LacB laccases were estimated to be 63 and 48 kDa, respectively. The two isoenzymes had their optimum activities at the same temperature (50 °C), but at slightly different pH values (pH 3.0 for LacA and pH 2.5 for LacB). LacA and LacB had the same thermal stability at 40 °C and pH stability at pH 9.0. The two isoenzymes also showed a high level of specific activity toward ABTS, where the K_m values of LacA and LacB were 0.100 and 0.065 mM, whereas their V_max values were 0.603 and 0.182 µmol min^-1, respectively. LacA and LacB catalytic activity was stimulated by Mg²⁺, Zn²⁺, K⁺, and Ni²⁺, whereas it was inhibited by Hg²⁺ and Pb²⁺, β-mercaptoethanol, EDTA, and SDS, and completely inhibited by sodium azide. Our findings indicate that purified laccase has a promising capacity for bisphenol A (BPA) bioremediation across a broad pH range. This finding opens up new opportunities for the commercialization of this technique in a variety of biotechnology-based applications, particularly for removing endocrine chemicals from the environment.

A novel injection technique for ilioinguinal nerve block for post-operative pain relief in caesarean delivery - a randomized, double-blind, placebo-controlled trial

AIM

To determine whether the novel method is successful in blocking both ilioinguinal nerves to lessen postoperative pain following caesarean surgery.

MATERIALS AND METHODS

Between January 2022 and January 2023, 300 patients were enrolled in this study at the Obstetrics and Gynaecology Departments of the Faculty of Medicine at Al-Azhar University. About 150 of these patients received bupivacaine infiltration on both sides close to the anterior superior iliac spine, and 150 received a normal saline injection at the same locations.

RESULTS

The study compared the two groups and discovered significant differences in the timing of analgesic requests, interval before the patient's first ambulation, length of hospital stay, postoperative pain score, and incidence of postoperative nausea and vomiting, with group A performing better.

CONCLUSION

After a caesarean section, the local anaesthetic "bupivacaine" injection used to block the ilioinguinal nerves bilaterally is an efficient way to lessen postoperative discomfort and analgesic use.

Optimization of calcium carbonate precipitation during alpha-amylase enzyme-induced calcite precipitation (EICP)

The sand production during oil and gas extraction poses a severe challenge to the oil and gas companies as it causes erosion of pipelines and valves, damages the pumps, and ultimately decreases production. There are several solutions implemented to contain sand production including chemical and mechanical means. In recent times, extensive work has been done in geotechnical engineering on the application of enzyme-induced calcite precipitation (EICP) techniques for consolidating and increasing the shear strength of sandy soil. In this technique, calcite is precipitated in the loose sand through enzymatic activity to provide stiffness and strength to the loose sand. In this research, we investigated the process of EICP using a new enzyme named alpha-amylase. Different parameters were investigated to get the maximum calcite precipitation. The investigated parameters include enzyme concentration, enzyme volume, calcium chloride (CaCl₂) concentration, temperature, the synergistic impact of magnesium chloride (MgCl₂) and CaCl₂, Xanthan Gum, and solution pH. The generated precipitate characteristics were evaluated using a variety of methods, including Thermogravimetric analysis (TGA), Fourier-transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD). It was observed that the pH, temperature, and concentrations of salts significantly impact the precipitation. The precipitation was observed to be enzyme concentration-dependent and increase with an increase in enzyme concentration as long as a high salt concentration was available. Adding more volume of enzyme brought a slight change in precipitation% due to excessive enzymes with little or no substrate available. The optimum precipitation (87%) was yielded at 12 pH and with 2.5 g/L of Xanthan Gum as a stabilizer at a temperature of 75°C. The synergistic effect of both CaCl₂ and MgCl₂ yielded the highest CaCO₃ precipitation (32.2%) at (0.6:0.4) molar ratio. The findings of this research exhibited the significant advantages and insights of alpha-amylase enzyme in EICP, enabling further investigation of two precipitation mechanisms (calcite precipitation and dolomite precipitation).

Machine Learning-Based Accelerated Approaches to Infer Breakdown Pressure of Several Unconventional Rock Types

Unconventional oil and gas reservoirs are usually classified by extremely low porosity and permeability values. The most economical way to produce hydrocarbons from such reservoirs is by creating artificially induced channels. To effectively design hydraulic fracturing jobs, accurate values of rock breakdown pressure are needed. Conducting hydraulic fracturing experiments in the laboratory is a very expensive and time-consuming process. Therefore, in this study, different machine learning (ML) models were efficiently utilized to predict the breakdown pressure of tight rocks. In the first part of the study, to measure the breakdown pressures, a comprehensive hydraulic fracturing experimental study was conducted on various rock specimens. A total of 130 experiments were conducted on different rock types such as shales, sandstone, tight carbonates, and synthetic samples. Rock mechanical properties such as Young's modulus (E), Poisson's ratio (ν), unconfined compressive strength, and indirect tensile strength (σ_t) were measured before conducting hydraulic fracturing tests. ML models were used to correlate the breakdown pressure of the rock as a function of fracturing experimental conditions and rock properties. In the ML model, we considered experimental conditions, including the injection rate, overburden pressures, and fracturing fluid viscosity, and rock properties including Young's modulus (E), Poisson's ratio (ν), UCS, and indirect tensile strength (σ_t), porosity, permeability, and bulk density. ML models include artificial neural networks (ANNs), random forests, decision trees, and the K-nearest neighbor. During training of ML models, the model hyperparameters were optimized by the grid-search optimization approach. With the optimal setting of the ML models, the breakdown pressure of the unconventional formation was predicted with an accuracy of 95%. The accuracy of all ML techniques was quite similar; however, an explicit empirical correlation from the ANN technique is proposed. The empirical correlation is the function of all input features and can be used as a standalone package in any software. The proposed methodology to predict the breakdown pressure of unconventional rocks can minimize the laboratory experimental cost of measuring fracture parameters and can be used as a quick assessment tool to evaluate the development prospect of unconventional tight rocks.

H2, CO2, and CH4 Adsorption Potential of Kerogen as a Function of Pressure, Temperature, and Maturity

We performed molecular dynamics simulation to elucidate the adsorption behavior of hydrogen (H2), carbon dioxide (CO2), and methane (CH4) on four sub-models of type II kerogens (organic matter) of varying thermal maturities over a wide range of pressures (2.75 to 20 MPa) and temperatures (323 to 423 K). The adsorption capacity was directly correlated with pressure but indirectly correlated with temperature, regardless of the kerogen or gas type. The maximum adsorption capacity was 10.6 mmol/g for the CO2, 7.5 mmol/g for CH4, and 3.7 mmol/g for the H2 in overmature kerogen at 20 MPa and 323 K. In all kerogens, adsorption followed the trend CO2 > CH4 > H2 attributed to the larger molecular size of CO2, which increased its affinity toward the kerogen. In addition, the adsorption capacity was directly associated with maturity and carbon content. This behavior can be attributed to a specific functional group, i.e., H, O, N, or S, and an increase in the effective pore volume, as both are correlated with organic matter maturity, which is directly proportional to the adsorption capacity. With the increase in carbon content from 40% to 80%, the adsorption capacity increased from 2.4 to 3.0 mmol/g for H2, 7.7 to 9.5 mmol/g for CO2, and 4.7 to 6.3 mmol/g for CH4 at 15 MPa and 323 K. With the increase in micropores, the porosity increased, and thus II-D offered the maximum adsorption capacity and the minimum II-A kerogen. For example, at a fixed pressure (20 MPa) and temperature (373 K), the CO2 adsorption capacity for type II-A kerogen was 7.3 mmol/g, while type II-D adsorbed 8.9 mmol/g at the same conditions. Kerogen porosity and the respective adsorption capacities of all gases followed the order II-D > II-C > II-B > II-A, suggesting a direct correlation between the adsorption capacity and kerogen porosity. These findings thus serve as a preliminary dataset on the gas adsorption affinity of the organic-rich shale reservoirs and have potential implications for CO2 and H2 storage in organic-rich formations.

Geomechanics of Organic Matters Contained in Shales: A Molecular-Level Investigation

Petrophysical and mechanical properties of kerogen are difficult to obtain through conventional techniques due to length scale limitations. Characterization of kerogen requires the isolation of organic materials from the rock matrix, which is associated with a high probability of mechanical damage or chemical alteration of the properties. Alternatively, computational modeling and molecular representation of kerogens can be used to simulate the outcomes of the experimental work. Volumetric and thermodynamics modeling of kerogens has provided the means for recreating nanoscale structures virtually. This research implements existing three-dimensional (3D) kerogen macromolecules to form kerogen structures that can be analyzed for the mechanical behavior of type II organic matters, mainly found in shales, at different maturity levels. Additionally, the underlying factors that could control the mechanical behavior, such as the density and porosity, were investigated. The results are compared against those reported following a similar methodology or other advanced fine-scale experimental work. The results revealed an elastomer-like mechanical behavior of kerogen with comparable elastic moduli regardless of maturity level. Moreover, the mechanical behavior of kerogen was sensitive to the type of fluid contained within the structure. Such observations can help shed more light on the macroscopic mechanical properties of shales, especially for formations with high organic contents.

Intracranial wide neck aneurysms: clinical and angiographic outcomes of endovascular management

Background

The treatment of intracranial wide neck aneurysms (WNAs) is usually difficult, hence several endovascular techniques were developed. This study aims to assess the clinical and angiographic imaging outcome of endovascular management of intracranial wide neck aneurysm. Forty patients were referred to the neuro-endovascular unit, at our hospital, each with a wide neck aneurysm. They were assessed regarding clinical presentation, aneurysm size, the character of the aneurysm, and the age and sex of the patient. Post-procedural, clinical, and angiographic outcomes of the patients who underwent endovascular intervention were reviewed.

Results

In this study, the mean aneurysmal neck was 5.4 ± 1.6 mm (mm). Endovascular intervention was carried out in all 40 patients in the form of simple coiling in 3 patients, double-catheter technique in 5 patients, balloon-assisted coiling (BAC) in 16 patients, stent-assisted coiling (SAC) in 13 patients, and flow diverter (FD) in 3 patients. Regarding clinical outcome, 4 patients had unfavorable outcome (the modified Rankin Scale, mRS > 2) at presentation and 3 patients at discharge. There was no unfavorable clinical outcome at 6- and 12-month follow-ups. Overall angiographic outcome at 1-year follow-up, 37/40 aneurysms (92.5%) had complete occlusion while two aneurysms had neck recurrence and one aneurysm had neck recanalization.

Conclusion

The current endovascular techniques in the treatment of WNAs are considered effective, feasible, and safe.

Rheological Study of Seawater-Based Fracturing Fluid Containing Polymer, Crosslinker, and Chelating Agent

Freshwater is usually used in hydraulic fracturing as it is less damaging to the formation and is compatible with the chemical additives. In recent years, seawater has been the subject of extensive research to reduce freshwater consumption. The study aims to optimize the rheology of seawater-based fracturing fluid with chemical additives that reduce the formation damage. The studied formulation consists of a polymer, a crosslinker, and a chelating agent to reduce seawater hardness. We used a standard industry rheometer to perform the rheology tests. By comparing five distinct grades [hydroxypropyl guar (HPG) and carboxymethyl hydroxypropyl guar (CMHPG)], we selected the guar derivative with the best rheological performance in seawater. Five different polymers (0.6 wt %) were hydrated with seawater and freshwater to select the suitable one. Then, the best performing polymer was chosen to be tested with (1.6, 4, and 8 wt %) N, N-dicarboxymethyl glutamic acid GLDA chelating agent and 1 wt % zirconium crosslinker. In the first part, the testing parameters were 120 °C temperature, 500 psi pressure, and 100 1/s shear rate. Then, the same formulations were tested at a ramped temperature between 25 and 120 °C. We observed that higher and more stable viscosity levels can be achieved by adding the GLDA after polymer hydration. In seawater, an instantaneous crosslinking occurs once the crosslinker is added even at room temperature, while in freshwater, the crosslinker is activated by ramping the temperature. We noted that, in the presence of a crosslinker, small changes in the chelating agent concentration have a considerable impact on the fluid rheology, as demonstrated in ramped temperature results. It is observed that the viscosities are higher and more persistent at lower concentrations of GLDA than at higher concentrations. The study shows the rheological response when different chemical additives are mixed in saline water for hydraulic fracturing applications.

Separation of Different Blogs from Skin Disease Data using Artificial Intelligence

A combination of environmental conditions may cause skin illness everywhere on the earth, and it is one of the most dangerous diseases that can develop as a result. A major goal in the selection of characteristics is to produce predictions about skin disease instances in connection with influencing variables, which is one of the most important tasks. As a consequence of the widespread usage of sensors, the amount of data collected in the health industry is disproportionately large when compared to data collected in other sectors. In the past, researchers have used a variety of machine learning algorithms to determine the relationship between illnesses and other disorders. Forecasting is a procedure that involves many steps, the most important of which are the preprocessing of any scenario and the selection of forecasting features. A major disadvantage of doing business in the health industry is a lack of data availability, which is particularly problematic when data is provided in an unstructured format. Filling in missing numbers and converting between various types of data take somewhat more than 70% of the total time. When dealing with missing data in machine learning applications, the mean, average, and median, as well as the stand mechanism, may all be employed to solve the problem. Previous research has shown that the characteristics chosen for a model's overall performance may have an influence on the overall performance of the model's overall performance. One of the primary goals of this study is to develop an intelligent algorithm for identifying relevant traits in models while simultaneously eliminating nonsignificant attributes that have an impact on model performance. To present a full view of the data, artificial intelligence techniques such as SVM, decision tree, and logistic regression models were used in conjunction with three separate feature combination methodologies, each of which was developed independently. As a consequence of this, their accuracy, F-measure, and precision are all raised by a factor of ten, respectively. We then have a list of the most important features, together with the weights that have been allocated to each of them.

Myocardial Infarction As the Initial Presentation of Rituximab-Induced Interstitial Lung Disease: A Case Report

Rituximab has been widely used alone or in combination therapy to treat B-cell non-Hodgkin lymphoma, chronic lymphocytic leukemia, and various autoimmune diseases. Although it is a relatively safe drug, rare rituximab-induced interstitial lung disease (RTX-ILD) has been reported and can be potentially fatal.

Here, we report a patient with stage 4 mantle cell lymphoma on rituximab who presented with non-ST segment elevation myocardial infarction in the setting of severe respiratory distress. He underwent left heart catheterization that revealed no new obstructive lesions and patent grafts. Extensive Infectious and autoimmune workup was negative except for Stenotrophomonas maltophilia pneumonia. The patient was diagnosed later with probable RTX-ILD after exclusion of other etiologies, and he did not show any signs of clinical improvement despite antibiotics and steroid therapy. The patient was then discharged to a long-term acute care hospital, where he eventually passed away.

Effect of Sulfate-Based Scales on Calcite Mineral Surface Chemistry: Insights from Zeta-Potential Experiments and Their Implications on Wettability

Scale formation and deposition in the subsurface and surface facilities have been recognized as a major cause of flow assurance issues in the oil and gas industry. Sulfate-based scales such as sulfates of calcium (anhydrite and gypsum) and barium (barite) are some of the commonly encountered scales during hydrocarbon production operations. Oilfield scales are a well-known flow assurance problem, which occurs mainly due to the mixing of incompatible brines. Researchers have largely focused on the rocks' petrophysical property modifications (permeability and porosity damage) caused by scale precipitation and deposition. Little or no attention has been paid to their influence on the surface charge and wettability of calcite minerals. Thus, this study investigates the effect of anhydrite and barite scales' presence on the calcite mineral surface charge and their propensity to alter the wetting state of calcite minerals. This was achieved vis-à-vis zeta-potential (ζ-potential) measurement. Furthermore, two modes of the scale control (slug and continuous injections) using ethylenediaminetetraacetic acid (EDTA) were examined to determine the optimal control strategy as well as the optimal inhibitor dosage. Results showed that the presence of anhydrite and barite scales in a calcite reservoir affects the colloidal stability of the system, thus posing a threat of precipitation, which would result in permeability and porosity damage. Also, the calcite mineral surface charge is affected by the presence of calcium and barium sulfate scales; however, the magnitude of change in the surface charge via ζ-potential measurement is insignificant to cause wettability alteration by the mineral scales. Slug and continuous injections of EDTA were implemented, with the optimal scale control strategy being the continuous injection of EDTA solutions. The optimal dosage of EDTA for anhydrite scale control is 5 and 1 wt % for the formation water and seawater environments, respectively. In the case of barite, in both environments, an EDTA dosage of 1 wt % suffices. Findings from this study not only further the understanding of the scale effects on calcite mineral systems but also provide critical insights into the potential of scale formation and their mechanisms of interactions for better injection planning and the development of a scale control strategy.

Environmental Performance Assessment of a Novel Process Concept for Propanol Production from Widely Available and Wasted Methane Sources

Currently, propanol production highly depends on conventional fossil resources. Therefore, an alternative production process, denoted as “C123”, is proposed and evaluated in which underutilized and methane-rich feedstocks such as biogas (scenario BG), marginal gas (scenario MG), and associated gas (scenario AG) are converted into propanol. A first modular-scale process concept was constructed in Aspen Plus, based on experimental data and know-how of the C123 consortium partners. The environmental performance of the considered scenarios was compared at the life cycle level by calculating key performance indicators (KPIs), such as the global warming burden. The results showed that scenario BG is the least dependent on fossil fuels for energy use. Scenario AG seems the most promising one based on almost all selected KPIs when taking into account the avoided gas flaring emissions. The performance of the C123 process concept could be improved by applying heat integration in the process concept.

Iron Sulfide Scale Inhibition in Carbonate Reservoirs

Hydrocarbon production operations include water injection, varying stimulation approaches, and enhanced oil recovery techniques. These treatments often affect reservoir formation, production, and injection facilities. Such sorts of well operations cause the formation of organic and inorganic scales in the near-wellbore region and various production and injection structures. Downhole squeeze treatment is commonly used as a control measure to prevent scale precipitation. A scale inhibitor solution is introduced into a formation by applying a squeeze treatment. The method allows scale inhibitors to adsorb on the internal rock surface to avoid settling down the scale precipitates. Thus, the study of adsorption of different types of inhibitors to prevent scale formation on the reservoir rock through the execution of downhole squeeze treatment is becoming necessary. This study incorporated different experimental techniques, including dynamic adsorption experiments of chelating agents employing a coreflooding setup, inductively coupled plasma-optical emission spectrometry (ICP-OES) to inhibit the formation of iron-containing scales in limestone rocks, and ζ-potential measurements targeting determination of iron precipitation in varying pH environments on calcite minerals. The influence of the inhibitor soaking time and salt existence in the system on chelating agent adsorption was also evaluated in the coreflooding experiments. The findings based on the coreflooding tests reveal that the concentration of chelating agents plays a significant role in their adsorption on carbonate rocks. The treatments with 20 wt % ethylenediaminetetraacetic acid (EDTA) and 20 wt % diethylenetriaminepentaacetic acid produced the highest adsorption capacity in limestone rock samples by inhibiting 84 and 85% of iron(III) ions, respectively. Moreover, the presence of the salts (CaCl₂ and MgCl₂) considerably decreased the adsorption of 10 wt % EDTA to 56% (CaCl₂) and 52% (MgCl₂) and caused nearly 20% more permeability reduction, while more inhibitor soaking time resulted in comparably higher adsorption and lesser permeability diminution. The results of ζ-potential measurements showed that the pH environment controls iron(II) and (III) precipitation, and iron(III) starts to deposit from a low pH region, whereas iron(II) precipitates in increased pH environments in calcite minerals.

A Review of Enzyme-Induced Calcium Carbonate Precipitation Applicability in the Oil and Gas Industry

Enzyme-induced calcium carbonate precipitation (EICP) techniques are used in several disciplines and for a wide range of applications. In the oil and gas industry, EICP is a relatively new technique and is actively used for enhanced oil recovery applications, removal of undesired chemicals and generating desired chemicals in situ, and plugging of fractures, lost circulation, and sand consolidation. Many oil- and gas-bearing formations encounter the problem of the flow of sand grains into the wellbore along with the reservoir fluids. This study offers a detailed review of sand consolidation using EICP to solve and prevent sand production issues in oil and gas wells. Interest in bio-cementation techniques has gained a sharp increase recently due to their sustainable and environmentally friendly nature. An overview of the factors affecting the EICP technique is discussed with an emphasis on the in situ reactions, leading to sand consolidation. Furthermore, this study provides a guideline to assess sand consolidation performance and the applicability of EICP to mitigate sand production issues in oil and gas wells.

Single step calcium sulfate scale removal at high temperature using tetrapotassium ethylenediaminetetraacetate with potassium carbonate

Calcium sulfate (CaSO₄) scale has been identified as one of the most common scales contributing to several serious operating problems in oil and gas wells and water injectors. Removing this scale is considered an economically feasible process in most cases as it enhances the productivity of wells and prevents potential severe equipment damage. In this study, a single-step method utilizing potassium carbonate and tetrapotassium ethylenediaminetetraacetate (K4-EDTA) at high temperature (200 °F) has been used to remove CaSO₄ scale. The CaSO₄ scale was converted to calcium carbonate (CaCO₃) and potassium sulfate (K₂SO₄) using a conversion agent, potassium carbonate (K₂CO₃), at a high temperature (200 °F) and under various pH conditions. Various parameters were investigated to obtain a dissolver composition at which the optimum dissolution efficiency is achieved including the effect of dissolver pH, soaking time, the concentration of K4-EDTA, the concentration of potassium carbonate (K₂CO₃), temperature impact and agitation effect. Fourier transform infrared, X-ray crystallography, ion chromatography, stability tests and corrosion tests were carried out to test the end product of the process and showcase the stability of the dissolver at high temperature conditions. A reaction product (K₂SO₄) was obtained in most of the tests with different quantities and was soluble in both water and HCl. It was observed that the dissolver solution was effective at low pH (7) and resulted in a negligible amount of reaction product with 3 wt% CaSO₄ dissolution. The 10.5-pH dissolver was effective in most of the cases and provided highest dissolution efficiency. The reaction product has been characterized and showed it is not corrosive. Both 7-pH and 10.5-pH dissolvers showed high stability at high temperature and minimum corrosion rates. The single step dissolution process showed its effectiveness and could potentially save significant pumping time if implemented in operation.

Integration of microbial electrochemical systems and photocatalysis for sustainable treatment of organic recalcitrant wastewaters: Main mechanisms, recent advances, and present prospects

In recent years, microbial electrochemical systems (MESs) have demonstrated to be an environmentally friendly technology for wastewater treatment and simultaneous production of value-added products or energy. However, practical applications of MESs for the treatment of recalcitrant wastewater are limited by their low power output and slow rates of pollutant biodegradation. As a novel technology, hybrid MESs integrating biodegradation and photocatalysis have shown great potential to accelerate the degradation of bio-recalcitrant pollutants and increase the system output. In this review, we summarize recent advances of photo-assisted MESs for enhanced removal of recalcitrant pollutants, and present further discussion about the synergistic effect of biodegradation and photocatalysis. In addition, we analyse in detail different set-up configurations, discuss mechanisms of photo-enhanced extracellular electron transfer, and briefly present ongoing research cases. Finally, we highlight the current limitations and corresponding research gaps, and propose insights for future research.

The impact of virtual reality on pain management during normal labor: A systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

To evaluate the impact of virtual reality on pain management during normal labor.

METHODS

A systematic search was performed in September 2021 through PubMed, Cochrane Library, Scopus, and ISI web of science. We selected randomized clinical trials (RCTs) that compared virtual reality in the intervention group versus placebo or no intervention in the control group among laboring women during their normal delivery. Revman software was used for performing our meta-analysis. Our primary outcome was the pain score evaluated during the labor process by the Visual Analog Scale (VAS). Our secondary outcomes were anxiety and satisfaction scores during childbirth in addition to the duration of the first and second stages of labor.

RESULTS

Eight RCTs met our inclusion criteria with a total number of 466 patients. We found virtual reality was linked to a significant reduction in the VAS pain score during labor compared to the control group (MD = -1.40, 95% CI [-1.83, -0.96], p < 0.001). The anxiety score during labor was significantly reduced among the virtual reality group (SMD = -1.15, 95% CI [-2.18, -0.12], p = 0.03). Moreover, virtual reality significantly improved the satisfaction score during labor (MD = 15.58, 95% CI [4.93, 26.22], p = 0.004). However, there were no significant differences between virtual reality and control groups regarding the duration of the first and second stages of labor.

CONCLUSIONS

Virtual reality is an effective technique for reducing anxiety, increasing satisfaction, and improving pain management during normal labor.

Minimizing the Barite Scale in Carbonate Formations during the Filter Cake Removal Process

The barite scale is one of the most common scales in the oil and gas industry. It can form in the reservoir or precipitate in different production equipment. The formation of such a scale will significantly minimize the capillary diameter of the flow channels and consequently shrink the well productivity. On the other hand, the production of movable barite particles causes severe erosion for the installed equipment. There are several sources of the barite scale such as mixing of incompatible brines and solid invasion of the barite weighted during drilling. In addition, the barite scale could be produced during the interaction of the chelating agent solutions with the reservoir formation during the filter cake removal process (secondary damage). The main focus of this study is to prevent the barite scale inside the carbonate formations during filter cake removal. The capability of a solution consisting of both diethylenetriamine pentaacetic acid (DTPA) and ethylenediamine tetraacetic acid (EDTA) as a novel solution to prevent barite scale formation in carbonate formations after the removal of the barite filter cake was evaluated. A series of laboratory experiments were accomplished to characterize the barite scale and evaluate the performance of the proposed solution. In particular, particle size distribution, scanning electron microscopy, X-ray diffraction, core flooding, NMR spectroscopy, solubility test, and inductively coupled plasma (ICP) spectroscopy tests were conducted for this aim. The experiments were performed using carbonate core samples. The results showed that the proposed solution was able to load 35 000 ppm barium in the presence of calcite ions. The addition of EDTA tended to inhibit the barite deposition and improve the rate of the calcite reaction. NMR results showed that a mixture of DTPA and EDTA (20%) can stimulate the macropores, resulting in an increase in the return permeability by 1.4-1.8 times of the initial value, while the precipitation that occurred in the micropores could be ignored with respect to the overall porosity improvements.

Evaluation of the Dynamic Interfacial Tension between Viscoelastic Surfactant Solutions and Oil Using Porous Micromodels

Interfacial tension (IFT) is a crucial parameter in many natural and industrial processes, such as enhanced oil recovery and subsurface energy storage. IFT determines how easy the fluids can pass through pore throats and hence will decide how much residual fluids will be left behind. Here, we use a porous glass micromodel to investigate the dynamic IFT between oil and Armovis viscoelastic surfactant (VES) solution based on the concept of drop deformation while passing through a pore throat. Three different concentrations of VES, that is, 0.5, 0.75, and 1.25% vol% prepared using 57 K ppm synthetic seawater, were used in this study. The rheology obtained using a rheometer at ambient temperature showed zero shear viscosity of 325, 1101, and 1953 cP for 0.5%, 0.75%, and 1.25% VES, respectively, with a power-law region between 2 and 50 1/s. The dynamic IFT increases with the shear rate and then reaches a plateau. The results of IFT were compared with those obtained from the spinning drop method, which shows 97% accuracy for 1.25% VES, whereas the accuracy decreased to 65% for 0.75 VES and 51% for 0.5% VES. The findings indicate that we can reliably estimate the IFT of VES at higher concentrations directly during multiphase flow in porous micromodels without the need to perform separate experiments and wait for a long time to reach equilibrium.

P204 FRACTIONAL EXCRETION OF ALBUMIN DURING ACS AS A PREDICTOR OF THE VERY LONG–TERM MORTALITY AND CAUSES OF DEATH. RESULTS FROM 22 YEARS OF FOLLOW–UP OF THE ABC STUDY ON HEART DISEASE

Introduction

Several clinical risk predictors have been used to stratify risk in acute coronary syndromes (ACS) patients. Yet, few have been tested or demonstrated usefulness in the very long–term follow–up.

Purpose

To investigate the association between baseline albumin fractional excretion (AlbFE) and the long–term mortality and causes of death after ACS.

Methods

This prospective analysis included 579 patients admitted with ACS to 3 hospitals and discharged alive. Clinical and laboratory data were gathered within the first 7 days of hospitalization. Baseline AlbFE calculated as ((Serum Cr*Urine Alb) / (Serum Alb*UCr)) %, Patients were followed–up for 22 years.

Results

All except three patients completed the follow–up, and by its end 449(78%) patients were dead. Causes of death were sudden cardiac death (SCD) in 85(15%), non–sudden cardiac death (non–SCD) in 176(30%), non–cardiac death (non–CD) in 166 (29%). Baseline AlbFE median (IQR) values were: 4.1% (1.5–12.4), 1.7% (0.8–5.3), 1.3% (0.6–3.5) at 1st,3rd, and 7th hospitalization, respectively. At cox regression analysis, 3rd day AlbFE was associated to all–cause mortality: (HR = 1.4, 95%CI=1.3–1.5; p &lt; 0.0001). It was also associated to the risk of non–SCD (HR = 1.6, 95%CI=1.4–1.7; p &lt; 0.0001), SCD (HR = 1.3, 95%CI=1.2–1.5; p &lt; 0.0001), and to non–CD (HR = 1.3, 95%CI=1.1–1.4; p &lt; 0.0001). Using a cox regression model adjusted for age, gender diabetes and baseline left ventricular ejection fraction: the 3rd day AlbFE was associated to all–cause mortality (HR = 1.1, 95%CI=1.1–1.2; p &lt; 0.0001), and to non–SCD risk (HR = 1.2, 95%CI=1.1–1.4; p &lt; 0.0001) but not to the risk of SCD or non–CD (HR = 1.1, 95%CI=0.9–1.2; p = 0.45), and (HR = 1.1, 95% CI=1.0–1.2; p = 0.06), respectively. Same results were obtained with 1st an 7th day AlbFE values. Of relevance, a sub–analysis showed that the association between the 3rd day AlbFE and all–cause mortality kept true both in the 1st (1–11 years) and the 2nd (12–22 years) half of follow up period; (HR = 1.5, 95%CI=1.4–1.6; p &lt; 0.0001) and (HR = 1.2, 95%CI=1.1–1.4; p = 0.001) in the unadjusted model and (HR = 1.3, 95%CI=1.2–1.4; p &lt; 0.0001) and (HR = 1.1, 95%CI=1.0–1.3; p = 0.02) in age and gender–adjusted model for the 1st and the second half respectively.

Conclusion

The present results showed that baseline AlbFE is an independent predictor of mortality up to 22 years after ACS, chiefly for non–SCD.