Providing a comprehensive approach to oil well blowout risk assessment.

Drilling is one of the most dangerous activities in the oil and gas process industries. Therefore, a holistic approach was presented to prevent and control risks and reduce the uncertainty of blowouts, kick scenarios, and control layers based on the Fuzzy Bayesian Network (FBN). Four independent protection layers (IPLs) were used to evaluate the blowout outcome, and the failure probabilities of IPL1 and IPL2 were calculated with Fault Tree Analysis (FTA). Then, different events were transferred to the Bayesian Network (BN) in GeNIe software, and updated the probabilities. The Fuzzy Fault Tree (FFT) results reveal that the failure probabilities for IPL1 and IPL2 amount to 8.94×10-4 and 4.97×10-21, respectively. Also, the blowout probability results based on FFT were larger than FBN. According to FBN, the probability of the kick event was equal to 6.60×10-34. Sensitivity analysis showed that X1 (Mud volume/flow change) had the highest degree of importance in the blowout of oil wells. The results of this study can be used in both a preventive and reactive approach. Deductive and inductive reasoning, the dynamic nature and conditional dependencies, and causal relationships between events can make the model more realistic.

Multidisciplinary Cognitive Function Assessment of Good versus Poor Performance in Children with Cochlear Implants: An Observational Cross-Sectional Study

Abstract Introduction Despite the developing technology of cochlear implants (CIs), implanted prelingual hearing-impaired children exhibit variable speech processing outcomes. When these children match in personal and implant-related criteria, the CI outcome variability could be related to higher-order cognitive impairment. Objectives To evaluate different domains of cognitive function in good versus poor CI performers using a multidisciplinary approach and to find the relationship between these functions and different levels of speech processing. Methods This observational, cross-sectional study used the word recognition score (WRS) test to categorize 40 children with CIs into 20 good (WRS/65%) and 20 poor performers (WRS < 65%). All participants were examined for speech processing at different levels (auditory processing and spoken language) and cognitive functioning using (1) verbal tests (verbal component of Stanford-Binet intelligence [SBIS], auditory memory, auditory vigilance, and P300); and (2) performance tasks (performance components of SBIS, and trail making test). Results The outcomes of speech processing at different functional levels and both domains of cognitive function were analyzed and correlated. Speech processing was impaired significantly in poor CI performers. This group also showed a significant cognitive function deficit, in which the verbal abilities were more affected (in 93.5%) than in the good performers (in 69.5%). Moreover, cognitive function revealed a significant correlation and predictive effect on the CI speech outcomes. Conclusion Cognitive function impairment represented an important factor that underlies the variable speech proficiency in cochlear-implanted children. A multidisciplinary evaluation of cognitive function would provide a comprehensive overview to improve training strategies.

Multidisciplinary Cognitive Function Assessment of Good versus Poor Performance in Children with Cochlear Implants: An Observational Cross-Sectional Study.

Introduction Despite the developing technology of cochlear implants (CIs), implanted prelingual hearing-impaired children exhibit variable speech processing outcomes. When these children match in personal and implant-related criteria, the CI outcome variability could be related to higher-order cognitive impairment. Objectives To evaluate different domains of cognitive function in good versus poor CI performers using a multidisciplinary approach and to find the relationship between these functions and different levels of speech processing. Methods This observational, cross-sectional study used the word recognition score (WRS) test to categorize 40 children with CIs into 20 good (WRS/65%) and 20 poor performers (WRS < 65%). All participants were examined for speech processing at different levels (auditory processing and spoken language) and cognitive functioning using (1) verbal tests (verbal component of Stanford-Binet intelligence [SBIS], auditory memory, auditory vigilance, and P300); and (2) performance tasks (performance components of SBIS, and trail making test). Results The outcomes of speech processing at different functional levels and both domains of cognitive function were analyzed and correlated. Speech processing was impaired significantly in poor CI performers. This group also showed a significant cognitive function deficit, in which the verbal abilities were more affected (in 93.5%) than in the good performers (in 69.5%). Moreover, cognitive function revealed a significant correlation and predictive effect on the CI speech outcomes. Conclusion Cognitive function impairment represented an important factor that underlies the variable speech proficiency in cochlear-implanted children. A multidisciplinary evaluation of cognitive function would provide a comprehensive overview to improve training strategies.

Current insight into enteropathogens in flare-up ulcerative colitis. An observational study.

OBJECTIVE: Incidence of ulcerative colitis is globally increased. Enteric infections and their role in ulcerative colitis flares present a common health problem and a unique clinical challenge. We aimed to identify enteropathogens in flared ulcerative colitis patients and their antimicrobial susceptibilities and relation with the disease activity. METHODS: Stool samples were collected from 95 patients with ulcerative colitis (17 inactive cases and 78 active cases) according to the Mayo score assessment of ulcerative colitis severity. Enteropathogens were examined using an automated VITEK2 system and FilmArray gastrointestinal pathogen panel. RESULTS: Enteric infections were found in 81 patients (85.3%) with a significantly higher percentage in active ulcerative colitis (96.2% vs. 35.3%, P  < 0.001). In 78 symptomatic patients, (78.7%) of bacteria as enteroaggregative and enteropathogenic E. coli , (11.5%) parasitic as Cryptosporidium and (7.7%) viral as Norovirus were the most detected microbial pathogens. Mixed, multidrug-resistant organisms (MDROs) and opportunistic infections were reported in 70.7%, 52.9% and 46.7% respectively. Raoultella ornithinolytica was reported for the first time as an enteropathogen in ulcerative colitis flare. Multiple organisms, MDROs, extended-spectrum beta-lactamases-producing and AmpC-resistant bacteria were significantly associated with disease severity. CONCLUSION: Identifying enteropathogens especially opportunistic and MDR organisms as a cause of ulcerative colitis flare-ups is a matter of worry increasing their diagnostic and therapeutic burden. Periodic studies evaluating changes in microbial profiles and their antimicrobial susceptibilities are needed to achieve antibiotic stewardship and improve management.

Biphasic calcium phosphate doped with zirconia nanoparticles for reconstruction of induced mandibular defects in dogs: cone-beam computed tomographic and histopathologic evaluation.

The present study aimed to evaluate osteogenic potential and biocompatibility of combining biphasic calcium phosphate with zirconia nanoparticles (4Zr TCP/HA) compared to biphasic calcium phosphate (TCP/HA) for reconstruction of induced mandibular defects in dog model. TCP/HA and 4Zr TCP/HA scaffolds were prepared. Morphological, physicochemical, antibacterial, cytocompatibility characterization were tested. In vivo application was performed in 12 dogs where three critical-sized mandibular defects were created in each dog. Bone defects were randomly allocated into: control, TCP/HA, and 4Zr TCP/HA groups. Bone density and bone area percentage were evaluated at 12 weeks using cone-beam computed tomographic, histopathologic, histomorphometric examination. Bone area density was statistically increased (p < 0.001) in TCP/HA and 4Zr TCP/HA groups compared to control group both in sagittal and coronal views. Comparing TCP/HA and 4Zr TCP/HA groups, the increase in bone area density was statistically significant in coronal view (p = 0.002) and sagittal view (p = 0.05). Histopathologic sections of TCP/HA group demonstrated incomplete filling of the defect with osteoid tissue. Doping with zirconia (4Zr TCP/HA group), resulted in statistically significant increase (p < 0.001) in bone formation (as indicated by bone area percentage) and maturation (as confirmed by Masson trichrome staining) compared to TCP/HA group. The newly formed bone was mature and organized with more trabecular thickness and less trabecular space in between. Physicochemical, morphological and bactericidal properties of combining zirconia and TCP/HA were improved. Combining zirconia and TCP/HA resulted in synergistic action with effective osteoinduction, osteoconduction and osteointegration suggesting its suitability to restore damaged bone in clinical practice.

Ultrasonographic and histopathologic features associated with common ocular diseases in donkeys (Equus asinus).

There is a lack of reports describing ultrasonographic and histopathologic features of ocular diseases in donkeys. The present study aimed to document ultrasonographic and histopathologic changes associated with common ocular diseases in donkeys. The study included 45 donkeys (64 eyes) with ocular diseases that had reached the end of their working lives and requested to be used for educational and research purposes. Complete clinical, ophthalmic, ultrasonographic, gross pathologic and histopathologic examinations were included. Ocular abnormalities were documented, tabulated, and analyzed. Seventy-five ocular abnormalities were diagnosed with multiple involvements within the same eye including anterior uveitis (n = 13; 22.8%), cataract (n = 57; 76%), retinal detachment (n = 3; 4%), lens and phthisis bulbi (n = 2; 2.6%). Descriptive ultrasonographic findings of ocular abnormalities were included. Gross pathologic and histopathology findings confirmed the ultrasonography findings. Ultrasonography provided a clinically useful tool offering insight into detailed intraocular structures especially with opacification of the dioptric structures of the eye.

Effect of laser acupuncture on pain and density of bone in osteoporotic postmenopausal women: a randomized controlled trial.

OBJECTIVE: This study aimed to evaluate the value of laser acupuncture (LA) on forearm bone mineral density (BMD) and wrist pain in osteoporotic postmenopausal women. METHODS: Sixty-eight postmenopausal women diagnosed with osteoporosis were randomly allocated equally to one of two sets. The drug-only group received calcium and vitamin D 3 supplement containing fluoride daily for 12 weeks, whereas the drug/LA group received LA therapy for 20 minutes per session, three sessions weekly, in addition to the same supplementation. The primary outcome parameter was assessment of BMD of the nondominant arm. Other outcomes included wrist pain. RESULTS: There was a highly significant improvement in the T-score of forearm BMD in both groups (-2.844 ± 0.476 to -2.597 ± 0.478 and -2.944 ± 0.486 to -1.652 ± 0.728 in the drug-only and drug/LA groups, respectively; P < 0.0001) and visual analog scale score (7.50 ± 0.79 to 4.24 ± 1.07 and 7.24 ± 0.82 to 3.09 ± 0.75 in the drug-only and drug/LA group, respectively; P < 0.0001). The improvement of both BMD and pain score was significantly higher in the drug/LA group (-1.303 and 4.15) compared with the drug-only group (-0.247 and 3.26; P < 0.0001). CONCLUSIONS: LA in combination with calcium and vitamin D supplementation containing fluoride is an effective modality in improving forearm BMD and reducing pain in osteoporotic postmenopausal women.

The effect of various types of COVID-19 vaccines on the retinal microvasculature.

PURPOSE: To detect the effect of various types of COVID-19 vaccine on macular and optic disc microvasculature. METHOD: One hundred subjects receiving various types of COVID-19 vaccine (AstraZeneca, Sinopharm, Sinovac, Pfizer, and Moderna) were included in this study. A complete ophthalmic examination was done which included best-corrected visual acuity measurement, slit-lamp biomicroscopy, intraocular pressure measurement with Goldmann applanation tonometry, and fundus examination. Optical coherence tomography angiography (OCT-A) was done before and 1 week after receiving the vaccine. Superficial and deep macular capillary densities were measured in the form of the whole image, fovea, parafoveal, and perifoveal capillary density. Optic disc vessel density in the form of the whole disc, inside disc, and peripapillary were also measured. RESULTS: The superficial macular vessel densities, (whole image, fovea, parafoveal, and perifoveal) showed statistically non-significant changes with P-values (0.269, 0.167, 0.346, and 0.476) respectively. Also, the deep macular vessel densities showed statistically non-significant changes with P-values (0.491, 0.096, 0.724, and 0.386) for the whole image, fovea, parafoveal, and perifoveal respectively. Moreover, RPC (radial peripapillary capillary) density showed no significant changes either (the whole disc, inside disc, or peripapillary) with P-values (0.807, 0.141, 0.883) respectively. CONCLUSION: Various types of COVID-19 vaccines had no statistically significant effects on macular or optic disc microvasculature.

Bioactivity of Trigonella foenum (Fenugreek) oil on immunological and biochemical response of Schistosoma mansoni infected mice.

The effect of fenugreek oil (FO) on some parasitological, immunological, and biochemical parameters in mice infected with Schistosoma mansoni were investigated. Chromatography mass spectrometry (GC/MS) analysis of FO revealed that linoleic acid, (E,E)-4-decadienal, and isopropyl myristate are the major constituents of FO. The results showed that treatment of S. mansoni-infected mice with 0.15 ml of FO daily for 10 successive days exhibited a significant reduction in the number of S. mansoni male worms, and coupled worms as compared to an infected control group (p < 0.05). Regarding total egg counts and oogram patterns, FO effectively reduced the percentage of hepatic and intestinal egg counts, and elevated immature and dead eggs in ratios closely to praziquantel (PZQ) treated mice. Meanwhile, FO significantly elevated the levels of glutathione and co-enzyme Q-10 (COQ-10) up to 0.33±0.02 ng/ml and 0.28±0.02 ng/ml, respectively. However, when accompanied with PZQ, COQ-10 level was closer to that of the normal control group (0.37 ± 0.021 ng/ml). The result also showed that FO significantly reduced levels of lipid per-oxidation (0.165±0.01 ng/ml) and vascular endothelial growth factor (0.25±0.02 pg/ml) as compared to the PZQ-treated group (0.234±0.02 ng/ml and 0.31±0.008 pg/ml, respectively). Moreover, FO recovered normal values of caspase-7, and when accompanied with PZQ, annexin-V was also significantly reduced. However, treatment of S. mansoni-infected mice with PZQ led to a significant increase in the level of annexin-V as compared to S. mansoni-infected mice group (p < 0.05). It can be concluded that FO may have a potential anti-schistosomal, antioxidant and anti-inflammatory activities. Also, it may have a recovering effect on apoptotic parameters toward the normal values.

Impact of Sarcopenia on Short-Term Complications and Survival After Liver Transplant.

OBJECTIVES: Sarcopenia is a common entity in cirrhosis with significant morbidity and mortality. However,the effects of sarcopenia on the risk of complications and survival after liver transplant remain controversial.We aimed to evaluate the effect of sarcopenia on survival and complications after liver transplant. MATERIALS AND METHODS: Our study cohort included 61 adult patients with hepatitis C-related cirrhosis who underwent living donor liver transplant. Pretransplant clinical and anthropometric assessments included body mass index, hand grip, mid-arm circumference, triceps skin fold thickness, and gait speed. Sarcopenia was determined by computed tomography using the skeletal muscle index at the third lumbar vertebra cut-off value of <38.5 cm2/m2 for women and <52.4 cm2/m2 for men; these patients were then followed up for 6 months after transplant to determine survival and complications. RESULTS: At time of liver transplant, sarcopenia was present in 27/61 patients (44.3%). At follow-up after transplant, sarcopenia was found in 14 patients (30.4%) among 46 survivors; all patients who survived were male patients. Among patients with sarcopenia posttransplant, 12 had sarcopenia before transplant and 2 developed sarcopenia after transplant. Liver dysfunction, lower triceps skin fold thickness, recent infections, and sarcopenia pretransplant were associatedwithposttransplant complications, especially infection(42.8%) and prolonged intensive careunit stay. Age and pretransplant sarcopenia were found to be independent predictors of posttransplant mortality. CONCLUSIONS: Sarcopenia is a common entity in patients with cirrhosis who are on liver transplant wait lists and may continue after liver transplant. De novo sarcopenia after liver transplant is also a common finding. Sarcopenia can affect patient outcomes, including prolonged intensive care unit stay and poor short-term survival.