Interfacial Tension-Temperature-Pressure-Salinity Relationship for the Hydrogen-Brine System under Reservoir Conditions: Integration of Molecular Dynamics and Machine Learning.

Hydrogen (H2) underground storage has attracted considerable attention as a potentially efficient strategy for the large-scale storage of H2. Nevertheless, successful execution and long-term storage and withdrawal of H2 necessitate a thorough understanding of the physical and chemical properties of H2 in contact with the resident fluids. As capillary forces control H2 migration and trapping in a subsurface environment, quantifying the interfacial tension (IFT) between H2 and the resident fluids in the subsurface is important. In this study, molecular dynamics (MD) simulation was employed to develop a data set for the IFT of H2-brine systems under a wide range of thermodynamic conditions (298-373 K temperatures and 1-30 MPa pressures) and NaCl salinities (0-5.02 mol·kg-1). For the first time to our knowledge, a comprehensive assessment was carried out to introduce the most accurate force field combination for H2-brine systems in predicting interfacial properties with an absolute relative deviation (ARD) of less than 3% compared with the experimental data. In addition, the effect of the cation type was investigated for brines containing NaCl, KCl, CaCl2, and MgCl2. Our results show that H2-brine IFT decreases with increasing temperature under any pressure condition, while higher NaCl salinity increases the IFT. A slight decrease in IFT occurs when the pressure increases. Under the impact of cation type, Ca2+ can increase IFT values more than others, i.e., up to 12% with respect to KCl. In the last step, the predicted IFT data set was used to provide a reliable correlation using machine learning (ML). Three white-box ML approaches of the group method of data handling (GMDH), gene expression programming (GEP), and genetic programming (GP) were applied. GP demonstrates the most accurate correlation with a coefficient of determination (R2) and absolute average relative deviation (AARD) of 0.9783 and 0.9767%, respectively.

Spirituality as a Neglected Core in Occupational Therapy Practice: An Iranian Exploratory Survey.

Spirituality has received more attention in recent decades from different health disciplines. Occupational Therapy (OT), as a health discipline, believes that all aspects of human experience, including physical, psychological, social, and spiritual, are considered essential aspects of health. OT supports the fact that incorporating spirituality can promote health, well-being, and quality of life. Various researchers have attempted to investigate and explain occupational therapists' views on spirituality. In Iran's OT curriculum, spirituality has not been incorporated directly. The purpose of this study is to acquire information about the knowledge and opinions of Iranian occupational therapists about spirituality. This is a cross-sectional exploratory descriptive survey study in which 125 occupational therapists participated through convenience sampling. Inclusion criteria were, namely (a) at least one-year clinical experience of OT, (b) being educated in Iran, and (c) working in Iran. The Occupational Therapy Assessment of Spirituality (OTAS) questionnaire was used for data collection. The answers to the quantitative questions were analyzed through descriptive statistics. Most of the participants believed that spirituality should be incorporated by occupational therapists, but more than half of the participants disagreed that formal education prepared them to pay any attention to spirituality in their practice. Analyzing qualitative data by frequencies of their repetitions, led to four categories and sixteen subcategories, accordingly. The four categories are (1) the barriers to applying spirituality in OT, (2) the need to acquire knowledge and apply spirituality in OT, (3) the benefits of incorporating spirituality for a client, and (4) the benefits of incorporating spirituality for the occupational therapist. The findings indicate that academic education has failed to prepare Iranian occupational therapists to meet spiritual needs of their clients. However, OTs tend to get information about spirituality from other sources and find it helpful for themselves and their clients. There are also barriers to applying spirituality; therefore, an educational package is needed to address these problems.

Resection of pancreatic cancer in Europe and USA: an international large-scale study highlighting large variations.

OBJECTIVE: Resection can potentially cure resectable pancreatic cancer (PaC) and significantly prolong survival in some patients. This large-scale international study aimed to investigate variations in resection for PaC in Europe and USA and determinants for its utilisation. DESIGN: Data from six European population-based cancer registries and the US Surveillance, Epidemiology, and End Results Program database during 2003-2016 were analysed. Age-standardised resection rates for overall and stage I-II PaCs were computed. Associations between resection and demographic and clinical parameters were assessed using multivariable logistic regression models. RESULTS: A total of 153 698 records were analysed. In population-based registries in 2012-2014, resection rates ranged from 13.2% (Estonia) to 21.2% (Slovenia) overall and from 34.8% (Norway) to 68.7% (Denmark) for stage I-II tumours, with great international variations. During 2003-2014, resection rates only increased in USA, the Netherlands and Denmark. Resection was significantly less frequently performed with more advanced tumour stage (ORs for stage III and IV versus stage I-II tumours: 0.05-0.18 and 0.01-0.06 across countries) and increasing age (ORs for patients 70-79 and ≥80 versus those <60 years: 0.37-0.63 and 0.03-0.16 across countries). Patients with advanced-stage tumours (stage III-IV: 63.8%-81.2%) and at older ages (≥70 years: 52.6%-59.5%) receiving less frequently resection comprised the majority of diagnosed cases. Patient performance status, tumour location and size were also associated with resection application. CONCLUSION: Rates of PaC resection remain low in Europe and USA with great international variations. Further studies are warranted to explore reasons for these variations.

Administration of adjuvant chemotherapy for stage II-III colon cancer patients: An European population-based study.

The advantage of adjuvant chemotherapy (ACT) for treating Stage III colon cancer patients is well established and widely accepted. However, many patients with Stage III colon cancer do not receive ACT. Moreover, there are controversies around the effectiveness of ACT for Stage II patients. We investigated the administration of ACT and its association with overall survival in resected Stage II (overall and stratified by low-/high-risk) and Stage III colon cancer patients in three European countries including The Netherlands (2009-2014), Belgium (2009-2013) and Sweden (2009-2014). Hazard ratios (HR) for death were obtained by Cox regression models adjusted for potential confounders. A total of 60244 resected colon cancer patients with pathological Stages II and III were analyzed. A small proportion (range 9-24%) of Stage II and over half (range 55-68%) of Stage III patients received ACT. Administration of ACT in Stages II and III tumors decreased with higher age of patients. Administration of ACT was significantly associated with higher overall survival in high-risk Stage II patients (in The Netherlands (HR; 95%CI = 0.82 (0.67-0.99), Belgium (0.73; 0.59-0.90) and Sweden (0.58; 0.44-0.75)), and in Stage III patients (in The Netherlands (0.47; 0.43-0.50), Belgium (0.46; 0.41-0.50) and Sweden (0.48; 0.43-0.54)). In Stage III, results were consistent across subgroups including elderly patients. Our results show an association of ACT with higher survival among Stage III and high-risk Stage II colon cancer patients. Further investigations are needed on the selection criteria of Stages II and III colon cancer patients for ACT.

Stratified survival of resected and overall pancreatic cancer patients in Europe and the USA in the early twenty-first century: a large, international population-based study.

BACKGROUND: The prognosis of pancreatic cancer (PaC) strongly varies across different stages and age groups, which has unfortunately not been well recorded in the literature. This international population-based study aimed to provide tumor-node-metastasis (TNM) stage- and age-specific survival estimates and trends in resected and overall (resected and unresected) PaC in the early twenty-first century. METHODS: Using data from the US Surveillance, Epidemiology, and End Results-18 Program and the national cancer registries of the Netherlands, Belgium, Norway, and Slovenia, short-term and long-term overall survival results stratified by TNM stage and age in resected and overall primary PaC, irrespective of being microscopically confirmed or not, in 2003-2014 were computed using the Kaplan-Meier method. The temporal survival trends over three predefined periods (2003-2005, 2006-2008, and 2009-2011) were further examined using the log-rank test. RESULTS: In total, data for 125,183 patients were analyzed. Overall, age-stratified 3-year survival was 20-34% (< 60 years), 14-25% (60-69 years), and 9-13% (≥ 70 years) in stages I-II PaC; and 2-5% (< 60 years), 1-2% (60-69 years), and < 1-1% (≥ 70 years) in stages III-IV cancer. Patients who underwent operation had higher 3-year survival in each stage and age group (stages I-II: 23-39% (< 60 years), 16-31% (60-69 years), and 17-30% (≥ 70 years); stages III-IV: 5-19% (< 70 years) and 2-14% (≥ 70 years)). Perioperative survival also decreased with advancing stage and older age (stages I-II: 98-100% (< 60 years), 97-99% (60-69 years), and 94-99% (≥ 70 years); stages III-IV: 94-99% (< 70 years) and 81-96% (≥ 70 years)). Between 2003 and 2005 and 2009-2011, for overall PaC, both short-term and long-term survival improvements were observed in all countries except Belgium; for resected disease, short-term improvements were present only in the USA and Slovenia, but long-term improvements were observed in all countries except Slovenia, with stage-specific variations. CONCLUSIONS: Our large international study provides TNM stage- and age-specific population-based survival in overall and resected PaC that will facilitate clinical counseling. While the survival expectations for patients with resected PaC are substantially higher than the widely available and known dismal survival predictions for overall patients, conclusions on the benefits of resection cannot be made from this observational study. Patients with advanced-stage disease and/or older age should undergo careful risk assessment before treatment. Limited but inspiring improvement in survival is observed.

A form of the metabolic syndrome associated with mutations in DYRK1B.

BACKGROUND: Genetic analysis has been successful in identifying causative mutations for individual cardiovascular risk factors. Success has been more limited in mapping susceptibility genes for clusters of cardiovascular risk traits, such as those in the metabolic syndrome. METHODS: We identified three large families with coinheritance of early-onset coronary artery disease, central obesity, hypertension, and diabetes. We used linkage analysis and whole-exome sequencing to identify the disease-causing gene. RESULTS: A founder mutation was identified in DYRK1B, substituting cysteine for arginine at position 102 in the highly conserved kinase-like domain. The mutation precisely cosegregated with the clinical syndrome in all the affected family members and was absent in unaffected family members and unrelated controls. Functional characterization of the disease gene revealed that nonmutant protein encoded by DYRK1B inhibits the SHH (sonic hedgehog) and Wnt signaling pathways and consequently enhances adipogenesis. Furthermore, DYRK1B promoted the expression of the key gluconeogenic enzyme glucose-6-phosphatase. The R102C allele showed gain-of-function activities by potentiating these effects. A second mutation, substituting proline for histidine 90, was found to cosegregate with a similar clinical syndrome in an ethnically distinct family. CONCLUSIONS: These findings indicate a role for DYRK1B in adipogenesis and glucose homeostasis and associate its altered function with an inherited form of the metabolic syndrome. (Funded by the National Institutes of Health.).

Critical Role of the Immobile Zone in Non-Fickian Two-Phase Transport: A New Paradigm.

Using a visualization setup, we characterized the solute transport in a micromodel filled with two fluid phases using direct, real-time imaging. By processing the time series of images of solute transport (dispersion) in a two fluid-phase filled micromodel, we directly delineated the change of transport hydrodynamics as a result of fluid-phase occupancy. We found that, in the water saturation range of 0.6-0.8, the macroscopic dispersion coefficient reaches its maximum value and the coefficient was 1 order of magnitude larger than that in single fluid-phase flow in the same micromodel. The experimental results indicate that this non-monotonic, non-Fickian transport is saturation- and flow-rate-dependent. Using real-time visualization of the resident concentration (averaged concentration over a representative elementary volume of the pore network), we directly estimated the hydrodynamically stagnant (immobile) zones and the mass transfer between mobile and immobile zones. We identified (a) the nonlinear contribution of the immobile zones to the non-Fickian transport under transient transport conditions and (b) the non-monotonic fate of immobile zones with respect to saturation under single and two fluid-phase conditions in a micromodel. These two findings highlight the serious flaws in the assumptions of the conventional mobile-immobile model (MIM), which is commonly used to characterize the transport under two fluid-phase conditions.

Neglected role of hookah and opium in gastric carcinogenesis: a cohort study on risk factors and attributable fractions.

A recent study showed an association between hookah/opium use and gastric cancer but no study has investigated the relationship with gastric precancerous lesions. We examined the association between hookah/opium and gastric precancerous lesions and subsequent gastric cancer. In a population-based cohort study, 928 randomly selected, healthy, Helicobacter pylori-infected subjects in Ardabil Province, Iran, were followed for 10 years. The association between baseline precancerous lesions and lifestyle risk factors (including hookah/opium) was analyzed using logistic regression and presented as odds ratios (ORs) and 95% confidence intervals (CIs). We also calculated hazard ratios (HRs) and 95% CIs for the associations of lifestyle risk factors and endoscopic and histological parameters with incident gastric cancers using Cox regression models. Additionally, the proportion of cancers attributable to modifiable risk factors was calculated. During 9,096 person-years of follow-up, 36 new cases of gastric cancer were observed (incidence rate: 3.96/1,000 persons-years). Opium consumption was strongly associated with baseline antral (OR: 3.2; 95% CI: 1.2-9.1) and body intestinal metaplasia (OR: 7.3; 95% CI: 2.5-21.5). Opium (HR: 3.2; 95% CI: 1.4-7.7), hookah (HR: 3.4; 95% CI: 1.7-7.1) and cigarette use (HR: 3.2; 95% CI: 1.4-7.5), as well as high salt intake, family history of gastric cancer, gastric ulcer and histological atrophic gastritis and intestinal metaplasia of body were associated with higher risk of gastric cancer. The fraction of cancers attributable jointly to high salt, low fruit intake, smoking (including hookah) and opium was 93% (95% CI: 83-98). Hookah and opium use are risk factors for gastric cancer as well as for precancerous lesions. Hookah, opium, cigarette and high salt intake are important modifiable risk factors in this high-incidence gastric cancer area.

Geomechanics contribution to CO2 storage containment and trapping mechanisms in tight sandstone complexes: A case study on Mae Moh Basin.

Recognized as a not-an-option approach to mitigate the climate crisis, carbon dioxide capture and storage (CCS) has a potential as much as gigaton of CO2 to sequestrate permanently and securely. Recent attention has been paid to store highly concentrated point-source CO2 into saline formation, of which Thailand considers one onshore case in the north located in Lampang - the Mae Moh coal-fired power plant matched with its own coal mine of Mae Moh Basin. Despite a large basin and short transport route from the source, target sandstone reservoir buried at deeper than 1000 m is of tight nature and limited data, while question on storing possibility has thereafter risen. The current study is thus aimed to examine the influence of reservoir geomechanics on CO2 storage containment and trapping mechanisms, with co-contributions from geochemistry and reservoir heterogeneity, using reservoir simulator - CMG-GEM. With the injection rate designed for 30-year injection, reservoir pressure build-ups were ∼77 % of fracture pressure but increased to ∼80 % when geomechanics excluded. Such pressure responses imply that storage security is associated with the geomechanics. Dominated by viscous force, CO2 plume migrated more laterally while geomechanics clearly contributed to lesser migration due to reservoir rock strength constraint. Reservoir geomechanics contributed to less plume traveling into more constrained spaces while leakage was secured, highlighting a significant and neglected influence of geomechanical factor. Spatiotemporal development of CO2 plume also confirms the geomechanics-dominant storage containment. Reservoir geomechanics as attributed to its respective reservoir fluid pressure controls development of trapping mechanisms, especially into residual and solubility traps. More secured storage containment after the injection was found with higher pressure, while less development into solubility trap was observed with lower pressure. The findings reveal the possibility of CO2 storage in tight sandstone formations, where geomechanics govern greatly the plume migration and the development of trapping mechanisms.

Automated segmentation and morphological characterization of placental intervillous space based on a single labeled image.

In this study, a novel method of data augmentation has been presented for the segmentation of placental histological images when the labeled data are scarce. This method generates new realizations of the placenta intervillous morphology while maintaining the general textures and orientations. As a result, a diversified artificial dataset of images is generated that can be used for training deep learning segmentation models. We have observed that on average the presented method of data augmentation led to a 42% decrease in the binary cross-entropy loss of the validation dataset compared to the common approach in the literature. Additionally, the morphology of the intervillous space is studied under the effect of the proposed image reconstruction technique, and the diversity of the artificially generated population is quantified. We have demonstrated that the proposed method results in a more accurate morphological characterization of the placental intervillous space with an average feature relative error of 6.5%, which is significantly lower than the 11.5% error observed with conventional augmentation techniques. Due to the high resemblance of the generated images to the real ones, applications of the proposed method may not be limited to placental histological images, and it is recommended that other types of tissue be investigated in future studies.

A rare case of mycotic aortic aneurysm with Clostridium perfringens culture.

Key Clinical Message: As only early diagnosis, prompt surgical intervention, and appropriate antibiotic therapy can decrease clostridial MAA mortality rate; keeping in mind a broad differential diagnosis in a patient with sepsis and unusual vascular symptoms is important. Abstract: Mycotic aortic aneurysm (MAA) is an infrequent but very consequential condition characterized by the pathological disruption of the aorta due to infection. Clostridium perfringens is a bacterium that falls under the taxonomic classification of the genus Clostridium. Although mycotic aneurysm is often not commonly linked with this infection, there are instances when it may function as a causative agent for MAA. Timely diagnosis and thorough therapeutic techniques, including surgical intervention and quick administration of appropriate antibiotics, can potentially reduce the mortality rate associated with clostridial MAA. In this study, we presented a clinical report detailing the diagnosis of a mycotic aneurysm caused by C. perfringens in the thoracic aorta in a 66-year-old male patient with a history of diabetes mellitus and a recent prostate biopsy. Furthermore, we discussed the surgical approach and overall management strategy to address this case.

Dissolution and remobilization of NAPL in surfactant-enhanced aquifer remediation from microscopic scale simulations.

In this paper, the dissolution and mobilization of non-aqueous phase liquid (NAPL) blobs in the Surfactant-Enhanced Aquifer Remediation (SEAR) process were upscaled using dynamic pore network modeling (PNM) of three-dimensional and unstructured networks. We considered corner flow and micro-flow mechanisms including snap-off and piston-like movement for two-phase flow. Moreover, NAPL entrapment and remobilization were evaluated using force analysis to develop the capillary desaturation curve (CDC) and predict the onset of remobilization. The corner diffusion mechanism was also applied in the modeling of interphase mass transfer to represent NAPL dissolution as the dominant mass transfer process. In addition, the effect of pore-scale heterogeneity on mass transfer rate coefficient and recovered residual NAPL was considered in the simulations. Sodium dodecyl sulfate (SDS) and Triton X-100 were used as the surfactant for the SEAR process. The results indicate that although surfactants enhance NAPL recovery during two-phase flow, surfactant-enhanced remediation of residual NAPL through dissolution is highly dependent on surfactant type. When SDS ─as a surfactant with high critical micelle concentration (CMC) and low micelle partition coefficient (Km)─ was injected into a NAPL contaminated site, the mass transfer rate coefficient decreased (due to considerable changes in interface chemical potentials) which leads to a significant reduction in NAPL recovery after the end of two-phase flow. In contrast, Triton X-100 (with low CMC and high Km) improved NAPL recovery, by enhancing solubility at surfactant concentrations greater than CMC which overcompensates the interphase mass transfer reduction.

Nanoparticle transport within non-Newtonian fluid flow in porous media.

Control over dispersion of nanoparticles in polymer solutions through porous media is important for subsurface applications such as soil remediation and enhanced oil recovery. Dispersion is affected by the spatial heterogeneity of porous media, the non-Newtonian behavior of polymer solutions, and the Brownian motion of nanoparticles. Here, we use the Euler-Lagrangian method to simulate the flow of nanoparticles and inelastic non-Newtonian fluids (described by Meter model) in a range of porous media samples and injection rates. In one case, we use a fine mesh of more than 3 million mesh points to model nanoparticles transport in a sandstone sample. The results show that the velocity distribution of nanoparticles in the porous medium is non-Gaussian, which leads to the non-Fickian behavior of nanoparticles dispersion. Due to pore-space confinement, the long-time mean-square displacement of nanoparticles depends nonlinearly on time. Additionally, the gradient of shear stress in the pore space of the porous medium dictates the transport behavior of nanoparticles in the porous medium. Furthermore, the Brownian motion of nanoparticles increases the dispersion of nanoparticles along the longitudinal and transverse direction.

Functional requirements of a mobile-based application for stroke self-management: A Delphi study.

This study aimed to determine the functional requirements of a self-management mobile application for stroke survivors. For extracting the initial functional requirements, a literature review as well as interviews with 17 patients and caregivers were done. The results were analyzed using the content analysis method. The initial extracted requirements were then provided to the specialists by the Delphi technique to determine the final functional requirements. Content validity ratio (CVR) and content validity index (CVI) were calculated according to the Lawshe model. Criteria for item approval included CVR > 0.49 and CVI > 0.79. Finally, the approved items were turned into a five-point Likert scale questionnaire and were then provided to 53 experts and items with a mean score higher than 3.75 were approved. Functional requirements including creating a user account, educational material, support services, providing reminders and alerts for drugs administration and physician appointments, and rehabilitation exercises (to improve balance, upper and lower extremities rehabilitation, and activities of daily living (ADLs)) were approved. Most of the approved functional requirements were related to rehabilitation exercises for improving upper limb motor function. The experts did not approve the requirements for using splints and slings or the recommendation to take some medications.

Pore network and Darcy scale modelling of DNAPL remediation using ethanol flushing: Study of physical properties in DNAPL remediation.

Co-solvent flushing into contaminated soils is one of the most effective techniques for Dense Non-Aqueous Phase Liquid (DNAPL) remediation. In addition to the increase of DNAPL solubility, co-solvents (e.g. ethanol) can alter the viscosity and density of aqueous phase and diffusion coefficient of solute. Any changes in these parameters can change the flow behaviour and alter the upscaled DNAPL mass transfer coefficient which is a key parameter controlling soil and groundwater remediation at Darcy-scale. While numerous studies have investigated DNAPL remediation using co-solvents at the Darcy scale, pore-scale modelling of co-solvent enhanced DNAPL remediation has not been well investigated. In this work, a three-dimensional pore-network model was developed to simulate the 1,2-dichlorobenzene (DCB) remediation experiments using ethanol-water flushing solution. The model simulates the effect of changes in solubility, viscosity, density, and diffusion coefficient during co-solvent flushing of the DNAPL. The results of pore network modelling for ethanol-water flushing for the DCB remediation were also validated using the experimental data. In addition to pore-scale modelling, a continuum scale modelling (Darcy-scale) was used for the DCB remediation using ethanol-water flushing. The results of both pore network and continuum scale modelling demonstrated that the ethanol content and flushing velocity influence the interphase mass transfer and DNAPL dissolution process. The results indicated while the mass transfer coefficient decreased in the presence of ethanol, the process of NAPL remediation was improved due to the substantial increase of solubility in the presence of co-solvent. The large scale modelling showed that NAPL bank can be formed in the front of ethanol-water mixture flushing.

Comparison of breast cancer survival in two populations: Ardabil, Iran and British Columbia, Canada.

BACKGROUND: Patterns in survival can provide information about the burden and severity of cancer, help uncover gaps in systemic policy and program delivery, and support the planning of enhanced cancer control systems. The aim of this paper is to describe the one-year survival rates for breast cancer in two populations using population-based cancer registries: Ardabil, Iran, and British Columbia (BC), Canada. METHODS: All newly diagnosed cases of female breast cancer were identified in the Ardabil cancer registry from 2003 to 2005 and the BC cancer registry for 2003. The International Classification of Disease for Oncology (ICDO) was used for coding cancer morphology and topography. Survival time was determined from cancer diagnosis to death. Age-specific one-year survival rates, relative survival rates and weighted standard errors were calculated using life-tables for each country. RESULTS: Breast cancer patients in BC had greater one-year survival rates than patients in Ardabil overall and for each age group under 60. CONCLUSION: These findings support the need for breast cancer screening programs (including regular clinical breast examinations and mammography), public education and awareness regarding early detection of breast cancer, and education of health care providers.

Numerical modelling of the impact of surfactant partitioning on surfactant-enhanced aquifer remediation.

The partitioning of surfactants into non-aqueous phase liquids (NAPLs) during Surfactant-Enhanced Aquifer Remediation (SEAR) is potentially an important and non-negligible phenomenon that can strongly impact remediation efficiency. This paper numerically investigates the impact of surfactant partitioning on the enhanced NAPL dissolution and mobilization mechanisms and the overall NAPL removal from the subsurface. For demonstration, a multiphase model is used to simulate a hypothetical SEAR consisting of Triton X100 surfactant solution for the removal of perchloroethylene (PCE) entrapped in contaminated porous medium at the core/column scale. The simulations are conducted for two-dimensional homogenous and three-dimensional heterogeneous systems. By simultaneously incorporating spatial heterogeneity of porous media, injection rate, and endpoint mobility ratio into the model, we delineate the interplay of surfactant partitioning with flow and transport dynamics. Our results show that surfactant partitioning from the aqueous phase across the interface to the NAPL phase can undermine both efficiency of the enhanced dissolution and mobilization of NAPL species. This undermining is more pronounced for when aqueous phase mobility is less than the mobility of the NAPL phase. For such conditions interfacial tension between the two phases is reduced less for partitioning than non-partitioning cases (due to loss of surfactant into NAPL phase) and a secondary water front is formed due to partitioning that makes aqueous phase breaks through earlier.

Experiments and sensitivity coefficients analysis for multiphase flow model calibration of enhanced DNAPL dissolution.

Multiphase flow modeling is often used for the comparison and optimization of subsurface nonaqueous phase liquid (NAPL) remediation schemes. The calibration of such models is a challenging task due to the lack of detailed data describing the initial NAPL spatial distribution and the processes governing the fate and transport of NAPLs in porous media. In this study laboratory scale experiments were conducted to evaluate reagent-enhanced dense nonaqueous phase liquid (DNAPL) solubilization in saturated heterogeneous media. The DNAPL consisted of both pooled and residual saturation forms. To gain insight into the influence of various input parameters on effluent concentrations, the multiphase flow program was used to compute the sensitivity coefficients of key parameters, relating to the flow, flushing solution properties, soil parameters, NAPL distribution and mass transfer coefficient. The sensitivity coefficients were, in turn, used to aid in the model calibration and to underline the difficulties associated with the calibration of multiphase flow models, most notably the non-uniqueness of the calibration process when complete information is lacking. To alleviate this uncertainty and provide additional constraints, the conducted flushing experiments were jointly used to calibrate the multiphase flow model. The results of the model calibration suggest that the interphase mass transfer coefficient is dependent on the properties of the reagent aqueous solution used for DNAPL remediation, most notably the viscosity and interfacial tension.

Importance of tumor location and histology in familial risk of upper gastrointestinal cancers: a nationwide cohort study.

BACKGROUND: Familial clustering of upper gastrointestinal (UGI) cancers and the significance of family history has been addressed previously. We aimed to elucidate the familial risk based on the specified tumor location and histology. METHOD: In the Swedish Family-Cancer Database, we determined the familial risk of UGI cancer patients diagnosed (1958-2015) with esophageal and gastric cancer by tumor location using standardized incidence ratios (SIRs). RESULTS: Risk of esophageal cancer in first-degree relatives (FDRs) of patients with esophageal cancer increased 2.4-fold (SIR 95% CI 2.0-2.8), whereas risk of esophageal cancer in cases with family history of cancer in the middle third of the esophagus increased 3.4-fold (SIR 95% CI 2.1-5.1). Risk of gastric cancer in FDRs increased 1.6-fold (SIR 95% CI 1.5-1.7), occurrence of concordant subsite gastric cancer in the antrum, body, and cardia was 5.5-fold (SIR 95% CI 2.4-11), 4.6-fold (SIR 95% CI 2.6-7.4), and 1.7-fold (SIR 95% CI 1.1-2.5), respectively. Familial risk of concordant histological subtype in esophageal cancer was 4.1-fold for squamous cell carcinoma (SIR 95% CI 3.2-5.2) and 3.6-fold for adenocarcinoma (SIR 95% CI 2.5-5.1). The risk of concordant gastric adenocarcinoma was 1.6-fold for one affected FDR (SIR 95% CI 1.5-1.7), 6.1-fold for two FDRs (SIR 95% CI 4.4-8.4), and 8.6-fold among twins (SIR 95% CI 2.3-22). CONCLUSION: Family history of cancer in the lower third of the esophagus and stomach cancer in specific locations such as the antrum, body, and cardia can be considered as important predictive evidence for cancer in the same location in relatives. Our findings might guide endoscopy-based surveillance by introducing subgroups of populations with a higher risk for UGI cancer with particular attention to concordance of location of lesions, which could be a reasonable strategy for early detection, and thus help save more lives.

Neoadjuvant Therapy in Rectal Cancer Patients With Clinical Stage II to III Across European Countries: Variations and Outcomes.

BACKGROUND: Neoadjuvant therapy improves survival of patients with clinical stage II and III rectal cancer in clinical trials. In this study, we investigated the administration of neoadjuvant radiotherapy (neo-RT) and neoadjuvant chemoradiotherapy (neo-CRT) and its association with survival in resected patients in 2 European countries (The Netherlands and Sweden) and at 3 specialist centers. MATERIALS AND METHODS: Administration of neoadjuvant treatment (all registries) and overall survival after surgery in The Netherlands and Sweden were assessed. Hazard ratios (HRs) were obtained using Cox regression adjusted for potential confounders. RESULTS: A total of 16,095 rectal cancer patients with clinical stage II and III were eligible for analyses. Large variations in administration of neo-RT and neo-CRT were observed. Elderly patients less often received neo-RT and neo-CRT. Patients with stage III disease received neo-CRT more frequently than neo-RT. Administration of neo-RT versus surgery without neoadjuvant treatment was significantly associated with improved survival in The Netherlands (HR, 0.62; 95% confidence interval [CI], 0.53-0.73) as well as in Sweden (HR, 0.79; 95% CI, 0.69-0.90). Administration of neo-CRT was associated with enhanced survival in The Netherlands (HR, 0.62; 95% CI, 0.50-0.78) but not in Sweden (HR, 0.97; 95% CI, 0.80-1.18). The mortality of patients treated with neo-CRT compared with neo-RT showed inconsistent results in population-based centers. CONCLUSIONS: Our results support an association of neo-RT with enhanced survival among stage II and III rectal cancer patients. Comparing neo-CRT with neo-RT, larger variations and inconsistent results with respect to survival were observed across centers.