Decline In Pressure Research Articles

Relationship between oral hypofunction and salivary biomarkers in older adults: a cross-sectional study

BackgroundOral health problems have increased among older adults. Oral hypofunction is characterized by seven signs and symptoms: oral uncleanness, oral dryness, decline in occlusal force, decline in the movement function of the tongue and lips, decline in tongue pressure, decline in masticatory function, and decline in swallowing function, the latter being a significant risk factors for oral frailty. Recent research has suggested that salivary biomarkers can be used to assess not only oral diseases, including dental caries and periodontitis, but also systemic diseases, such as cancer and diabetes mellitus. This cross-sectional study investigated the relationship between oral hypofunction and the levels of salivary biomarkers.MethodsIn total, 116 patients, aged 65 years or older, were included in this cross-sectional study. If three or more signs or symptoms in seven kinds of tests met the criteria of each test, oral hypofunction was diagnosed. The levels of biomarkers in the saliva collected from the patients were analyzed using an enzyme-linked immunosorbent assay.ResultsIn total, 63.8% of patients were diagnosed with oral hypofunction. Multivariable linear regression analysis showed that calprotectin levels in the saliva were significantly related to oral moisture and masticatory function. Furthermore, 8-OHdG levels in saliva were associated with the movement function of the tongue and lips and oral hygiene level, and salivary AGE correlated only with the movement function of the tongue and lips. Multiple logistic regression analysis revealed that calprotectin levels in the saliva were significantly correlated with the prevalence of oral hypofunction, even after adjusting for age, sex, and periodontal status. However, none of the biomarker levels in the saliva had a significant relationship with the number of examinations outside the reference range.ConclusionsCalprotectin, 8-OHdG, and AGE levels are associated with oral hypofunction in older adults.

Downhole Hydrogen-Generation System Stimulates Challenging Formations in Kuwait

_ This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper OTC 34832, “Successful Trial of Innovative Downhole Hydrogen-Generator System To Stimulate Hard-to-Recover Formations: First in Onshore Kuwait,” by Mustafa Al-Hussaini, Hamad S. Al-Rashedi, and Nada Al-Saleh, SPE, Kuwait Oil Company, et al. The paper has not been peer reviewed. Copyright 2024 Offshore Technology Conference. _ The objective of the pilot trial described in the complete paper was to provide an economic solution to develop tight and hard-to-recover formations within the operator’s fields. These assets represent a major challenge because of their low recovery factor (1–3%), the high cost of available conventional stimulation technologies, low revenue, and inability to sustain production rates. Introduction To establish an integrated stimulation solution for tight and heavy oil formations, the concept of using active single-atom hydrogen power to enhance near-wellbore permeability was evolved. This technology is based on downhole hydrogen generation from an in-situ exothermic multistage chemical reaction between two unique hydroreacting agents (HRAs). This reaction generates a huge amount of thermal energy, active hydrogen, and other hot active gases and acid vapors. The selection of HRA compounds, and their amount and concentration, is customized for each field. Development of Business Cases West Kuwait (WK) Business Case. The M formation in the WK region is a carbonate, multifractured tight reservoir that had been producing for years but had begun experiencing a low recovery factor. Some of its wells had low-productivity issues related to tight formation characteristics and low pressure. Production could not be sustained for long periods of time even after conventional acid stimulation. The reservoir featured a carbonate reservoir thickness of 300 ft, with 70% of oil in place at the top section. The reservoir is classified as tight (less than 0.1–10 md average permeability and 10–25% porosity), with 10 fractured multilayers. Only 1–3% recovery could be achieved despite many vertical, horizontal, and multilateral wells having been drilled in the M formation. Oil is considered nonviscous (28 cp, 21 °API). Current stimulation approaches included conventional acid stimulation, which elicited a poor response, and multistage fracturing, which encountered mixed results at best. North Kuwait (NK) Business Case. The tight T formation in this region featured poor reservoir connectivity. Minimal aquifer support led to a rapid decline in reservoir pressure. In general, low mobility of oil, poor API gravity, and low permeability were the main obstacles in draining oil from the T formation, in addition to reservoir heterogeneities such as facies distribution, fracture patterns, and pressure regimes. The formation consisted of tight limestone deposited on a carbonate ramp. The reservoir is divided into three main stratigraphic units (Upper, of approximately 110 ft; Middle, of approximately 60 ft; and Lower, of approximately 16 ft). The reservoir exhibits porosity of approximately 14% and permeability of approximately 14 md and is filled with relatively-low-API hydrocarbon (19–22 °API).

Microbiota based personalized nutrition improves hyperglycaemia and hypertension parameters and reduces inflammation: a prospective, open label, controlled, randomized, comparative, proof of concept study.

Recent studies suggest that gut microbiota composition, abundance and diversity can influence many chronic diseases such as type 2 diabetes. Modulating gut microbiota through targeted nutrition can provide beneficial effects leading to the concept of personalized nutrition for health improvement. In this prospective clinical trial, we evaluated the impact of a microbiome-based targeted personalized diet on hyperglycaemic and hyperlipidaemic individuals. Specifically, BugSpeaks®-a microbiome profile test that profiles microbiota using next generation sequencing and provides personalized nutritional recommendation based on the individual microbiota profile was evaluated. A total of 30 participants with type 2 diabetes and hyperlipidaemia were recruited for this study. The microbiome profile of the 15 participants (test arm) was evaluated using whole genome shotgun metagenomics and personalized nutritional recommendations based on their microbiota profile were provided. The remaining 15 participants (control arm) were provided with diabetic nutritional guidance for 3 months. Clinical and anthropometric parameters such as HbA1c, systolic/diastolic pressure, c-reactive protein levels and microbiota composition were measured and compared during the study. The test arm (microbiome-based nutrition) showed a statistically significant decrease in HbA1c level from 8.30 (95% confidence interval (CI), [7.74-8.85]) to 6.67 (95% CI [6.2-7.05]), p < 0.001 after 90 days. The test arm also showed a 5% decline in the systolic pressure whereas the control arm showed a 7% increase. Incidentally, a sub-cohort of the test arm of patients with >130 mm Hg systolic pressure showed a statistically significant decrease of systolic pressure by 14%. Interestingly, CRP level was also found to drop by 19.5%. Alpha diversity measures showed a significant increase in Shannon diversity measure (p < 0.05), after the microbiome-based personalized dietary intervention. The intervention led to a minimum two-fold (Log2 fold change increase in species like Phascolarctobacterium succinatutens, Bifidobacterium angulatum, and Levilactobacillus brevis which might have a beneficial role in the current context and a similar decrease in species like Alistipes finegoldii, and Sutterella faecalis which have been earlier shown to have some negative effects in the host. Overall, the study indicated a net positive impact of the microbiota based personalized dietary regime on the gut microbiome and correlated clinical parameters.

Impact of the blockage ratio and void fraction of porous obstacle on gas explosion characteristics in semi-confined channel

This study conducted various explosion experiments under different porous obstacle conditions of blockage ratio (BR) and void fraction (Φf). The impact of porous obstacle on flame propagation velocity (v) and peak overpressure (Pop) were analyzed. The results indicate that an increase in the BR enhances explosion pressure near the blockage area for both porous and non-porous obstacles. However, it also increases the downstream pressure decline gradient. An increase in the Φf weakens the hindrance of porous obstacle on the flame propagation, allowing more flame to pass through the internal void channels of obstacles, thus delaying the downstream pressure decay. Compared to non-porous obstacles, gas explosions disturbed by porous obstacles with both high BR (BR＞75%) and high Φf (Φf＞0.55) exhibit a lower downstream pressure decline gradient and a longer positive pressure duration. As a result, the explosion can produce a broader range of destruction.

Correlation of the Size of Adenoids With Impedance Audiometry Findings.

Introduction Adenoid tissue is part of the first line of immunity of the upper aero-digestive tract. It is located in the postero-superior wall of the nasopharynx behind the choana.Adenoid hypertrophy, a common childhood disorder, significantly contributes to the pathogenesis of otitis media with effusion (OME), which is the leading cause of hearing impairment in young children. This condition can result in delayed speech, poor academic performance, and language development issues. Assessing the size of the adenoids and their correlation with OME is crucial, as undiagnosed cases can lead to complications such as atelectasis of the tympanic membrane and cholesteatoma. Clinical examination of the nose alone is often insufficient, and children do not cooperate for nasal endoscopy. Therefore, a lateral radiograph of the skull is considered the most reliable method for assessing the adenoid size. The size of the adenoids can affect Eustachian tube patency, which is reflected in the results of impedance audiometry. This study aimed to correlate the size of adenoids with impedance audiometry findings. Methods This cross-sectional observational study was conducted in the Department of Otorhinolaryngology of a tertiary care hospital from October 1, 2022, to March 31, 2024. A sample size of 50 patients was taken for the study. The inclusion criterion of selection of the patients included patients aged 3 to 15 years, who suffered from recurrent attacks of upper respiratory tract infections,particularly those with adenoid facies confirmed by X-ray with a non-perforated tympanic membrane. Exclusion criteria encompassed patients below 3 or above 15 years, and those with acute or chronic suppurative otitis media, craniofacial anomalies, or nasal pathologies like polyps.Adenoids were graded using X-ray imaging of the nasopharynx, and correlations between the adenoid size and impedance audiometry findings, such as middle ear pressure and compliance, were analyzed. Results The study assessed the relationship between the adenoid size and impedance audiometry findings, focusing on middle ear pressure and compliance, as well as the occurrence of OME. The results indicated a significant decline in middle ear pressure with increasing adenoid grades. Specifically, adenoid grade 1 had an average pressure of -3.50 daPa, while grade 4 had the lowest average pressure at -119.72 daPa. This trend was statistically significant with a p-value of 0.00042. Similarly, compliance values also decreased with higher adenoid grades. Grade 1 had an average compliance of 0.64 ml, whereas grade 4 had the lowest average compliance at 0.28 ml. This relationship was statistically significant, as indicated by a p-value of 0.0048. Additionally, the analysis showed that a significant majority of patients with enlarged adenoids also presented with OME, highlighting a strong association between adenoid hypertrophy and this condition. Conclusion The study concluded that larger adenoids wereassociated with lower middle ear pressure and reduced compliance. Additionally, a significant majority of patients with enlarged adenoids also had OME. This underscores the importance of evaluating adenoid hypertrophy in the context of OME due to its potential impact on childhood hearing and development.

#50 The relationship between pre-dialysis plasma endothelin-1 and the intradialytic decline in blood pressure

Abstract Background and Aims Endothelin-1 (ET-1), a potent vasoconstrictor, may play an important role in the blood pressure (BP) response to hemodialysis (HD). Patients receiving maintenance HD have higher concentrations of plasma endothelin-1 than non-HD patients with advanced chronic kidney disease or patients receiving peritoneal dialysis. We wished to examine the association between the pre-HD level of ET-1 and the magnitude of intradialytic systolic BP decline. Methods Data was collected in a prospective study of 50 patients receiving maintenance HD admitted to Brigham and Women's Hospital in Boston, MA, USA. BP was measured before and every 15 min during a single HD session using an automated BP cuff. The systolic BP decline was calculated as the pre-HD minus the lowest intradialytic systolic BP. Blood samples were collected pre-HD. Patients with missing data, HD &amp;lt;3 h, or pre-dialysis BP &amp;lt;85/55 mmHg were excluded from the analysis (n = 8). Spearman's rho (ρ) was used to assess the correlation between pre-HD ET-1 and intradialytic systolic BP decline. Results Of the 42 included patients, 17 were females, median age 62 [25th, 75th percentile: 50, 70] years. The median HD duration was 232 [210, 242] min and median ultrafiltration was 2.1 [2, 3] L. Before HD, the median ET-1 was 2.4 [1.9, 3.0] pg/mL, the median systolic BP was 141 [119, 167] mmHg, and the median diastolic BP was 68 [63, 84] mmHg. A moderate negative correlation was observed between the baseline ET-1 and the intradialytic decline in systolic BP (ρ = –0.34, P = 0.03). This correlation was stronger in patients with baseline systolic BP &amp;gt;120 mmHg (ρ = –0.51, P = 0.004, n = 30) and much stronger in patients with baseline systolic BP &amp;gt;140 mmHg (ρ = –0.66, P = 0.001, n = 21). Almost all cases (8 out of 9) with an intradialytic decline in systolic BP of &amp;gt;50 mmHg occurred in patients with baseline ET-1 below the pre-HD median level. Conclusions Our results suggest that hospitalized patients with pre-HD systolic BP &amp;gt;140 mmHg and lower baseline ET-1 may be more likely to experience larger intradialytic declines in systolic BP. Whether measurement of pre-HD ET-1 could help identify hypotensive-prone patients requires further investigation in larger studies.

Amiloride lowers plasma TNF and interleukin-6 but not interleukin-17A in patients with hypertension and type 2 diabetes.

Interleukin (IL)-17A contributes to hypertension in preclinical models. T helper 17 and dendritic cells are activated by NaCl, which could involve the epithelial Na+ channel (ENaC). We hypothesized that the ENaC blocker amiloride reduces plasma IL-17A and related cytokines in patients with hypertension. Concentrations of IL-17A, IFN-γ, TNF, IL-6, IL-1β, and IL-10 were determined by immunoassays in plasma from two patient cohorts before and after amiloride treatment: 1) patients with type 2 diabetes mellitus (T2DM) and treatment-resistant hypertension (n = 69, amiloride 5-10 mg/day for 8 wk) and 2) patients with hypertension and type 1 diabetes mellitus (T1DM) (n = 29) on standardized salt intake (amiloride 20-40 mg/day, 2 days). Plasma and tissue from ANG II-hypertensive mice with T1DM treated with amiloride (2 mg/kg/day, 4 days) were analyzed. The effect of amiloride and benzamil on macrophage cytokines was determined in vitro. Plasma cytokines showed higher concentrations (IL-17A ∼40-fold) in patients with T2DM compared with T1DM. In patients with T2DM, amiloride had no effect on IL-17A but lowered TNF and IL-6. In patients with T1DM, amiloride had no effect on IL-17A but increased TNF. In both cohorts, blood pressure decline and plasma K+ increase did not relate to plasma cytokine changes. In mice, amiloride exerted no effect on IL-17A in the plasma, kidney, aorta, or left cardiac ventricle but increased TNF in cardiac and kidney tissues. In lipopolysaccharide-stimulated human THP-1 macrophages, amiloride and benzamil (from 1 nmol/L) decreased TNF, IL-6, IL-10, and IL-1β. In conclusion, inhibition of ENaC by amiloride reduces proinflammatory cytokines TNF and IL-6 but not IL-17A in patients with T2DM, potentially by a direct action on macrophages.NEW & NOTEWORTHY ENaC activity may contribute to macrophage-derived cytokine release, since amiloride exerts anti-inflammatory effects by suppression of TNF and IL-6 cytokines in patients with resistant hypertension and type 2 diabetes and in THP-1-derived macrophages in vitro.

Haar wavelet collocation technique for numerical solution of porous media equations

This paper focuses on using efficient Haar wavelet collocation method to nonlinear parabolic differential equations in order to solve steady state pore-scale creeping fluid flow in porous medium, substituting finite Haar series for space derivatives, incontrast forward difference approach is used to estimate the time derivative for porous media equation. These equations has vast number of application in engineering and various other fields such as, in petroleum engineering, there are often situations where fluids are near critical conditions. As oil pressure reduces below the bubble point when gas forms liquid condensations, or when the surface tension become very low i.e, transition from miscibility to immiscibility. To model gas production by pressure decline requires an accurate description of physical mechanism involved in the appearance of the gas bubbles. The observed stability with theoretical convergence assertion, the conservation law of mass and energy are stated. This supports the convergence of the preferred paradigm. A convergent approximation to the porous media equation is obtained by suggested approach. By calculating the maximum error norm and the experimental rate of convergence for various problems, the method efficiency and dependability are demonstrated. The method is accurate, easily applicable, and efficient.

Management and Outcomes of Kidney Transplant Candidates With Severe Pulmonary Hypertension: A Single-center Strategy and Experience.

Severe pulmonary hypertension (PH) is associated with high mortality posttransplant and thus is considered a contraindication to kidney transplantation. In this study, we describe the pretransplant management and posttransplant outcomes in patients with severe PH using a multidisciplinary approach. Between 11 of 2013 and 8 of 2022, we identified all patients with severe PH on initial pretransplant workup who underwent ultrafiltration (UF) or medical therapy for PH before transplant. Posttransplant we evaluated the perioperative course, renal function, graft, and patient survival. We compared survival to those who remained waitlisted or were delisted. Three-two patients (mean age = 55.03 ± 10.22 y) diagnosed with severe PH on pretransplant screening echocardiogram. Thirty patients (94%) were subjected to a median of 4 (range, 3-8) UF sessions with an average weight loss of 4.33 ± 2.6 kg. Repeat assessment of PH revealed a decline in mean pulmonary artery systolic pressure from 67 ± 12 mm Hg to 43 ± 13 mm Hg (P < 0.0001). Seventeen patients (53%) received a kidney transplant. The mean estimated Glomerular Filtration Rate at 3, 6, 9, and 12 mo was 72 ± 27, 72 ± 28, 75 ± 29, and 75 ± 29 mL/min/1.73 m2. Among, those who underwent transplantation both graft and patient survival was 100% at 1-y posttransplant. Overall, since the UF intervention, at a median follow-up of 88 ± 12 mo those transplanted had a patient survival of 88% while those who remained on dialysis had a survival of 53% (P = 0.0003). In this single-center study, we report postcapillary PH can be a significant contributor to elevations in pulmonary artery systolic pressure. Using a multidisciplinary approach, PH can improve with volume removal and phosphodiesterase 5 inhibitors therapy leading to a successful posttransplant outcome.

Semi-supervised approach using Transductive SVM for internal leakage detection in two-stage hydraulic cylinder

Abstract Hydraulic cylinders with higher stages of extraction are extensively used in earthmoving and heavy machines due to their longer stroke, shorter retracted length and high-end performance. The rigorous and long hours of operations make cylinders prone to internal leakage, which visually remains unnoticeable This manuscript presents the conceptualization and realization of a newly developed 210 bar high-pressure hydraulic test rig actuated by a two-stage hydraulic cylinder. Experiments have been carried out to acquire pressure signals for two different leakage conditions (3 and 5% for moderate and severe leakage respectively) in the ramp wave motion of the cylinder. A decline in the working pressure and the piston velocity by approximately 10 and 45% for these leakage conditions respectively is noted. The time-frequency analysis infers these signals contain low-frequency components. For the automated leakage detection, a new iterative probability-based, transductive semi-supervised Support Vector Machine (TS-SVM) is proposed capable of learning with limited datasets in several iterations. TS-SVM classifies the internal leakage with 100% accuracy in 4 iterations and utilises only 64% of the total training data.

Sublingual sufentanil does not decrease tolerance to progressive central hypovolemia

Hemorrhage is a leading cause of death in both civilian and battlefield settings. Since pain often accompanies a hemorrhagic insult, the administered pain medication must not interfere with critical autonomic responses beneficial to maintaining arterial blood pressure and thus organ perfusion. Sublingual sufentanil is currently available for administration on the battlefield, but its effect on hemorrhage tolerance is unknown. This study tested the hypothesis that sufentanil impairs tolerance to progressive central hypovolemia in awake humans. METHODS: 29 participants, 15 males and 14 females (aged: 29 ± 5, weight: 74 ± 8 kg, BMI: 25 ± 2 kg/m2) participated in this double-blinded, randomized, placebo-controlled trial. Following sublingual administration of sufentanil (30 μg) or placebo, participants completed a progressive lower-body negative pressure (LBNP) protocol starting at 40 mmHg that was further reduced by 10 mmHg every three minutes until presyncope. Presyncope was defined as: continued reports of feeling faint and/or nauseous, a rapid decline in blood pressure resulting in systolic blood pressure &lt;80 mmHg, and/or relative bradycardia accompanied by a narrowing of pulse pressure. Tolerance to LBNP, quantified as cumulative stress index (mmHg*min), was compared between sufentanil and placebo trials using a Wilcoxon Signed rank test. Arterial blood pressure, heart rate, and plasma catecholamine concentrations were compared using mixed effects models (LBNP stage x Drug). RESULTS: Tolerance to LBNP was not different between trials (sufentanil: 518 ± 203 vs. placebo: 594 ± 267, p = 0.495). Mean blood pressure decreased similarly between the two trials during LBNP (sufentanil: -23 ± 9 mmHg vs. placebo: -22 ± 10 mmHg, p&lt; 0.001), with no main effect of drug (p = 0.498) or interaction (p = 0.935). Increases in heart rate with LBNP were similar between the two trials (sufentanil: 44 ± 25 bpm vs. placebo: 52 ± 23 bpm, time: p &lt; 0.001) with no main effect of drug (p=0.626) or interaction (p = 0.424). Epinephrine (drug: p = 0.004, time: p &lt; 0.001, interaction: p = 0.031) and norepinephrine (drug: p = 0.017, time: p &lt; 0.001, interaction: p = 0.161), concentrations increased to LBNP, with post hoc analysis revealing that epinephrine concentrations were higher at LBNP 50 and presyncope (p ≤ 0.05) with sufentanil. CONCLUSION: These data demonstrate that sublingual sufentanil does not impair tolerance to simulated hemorrhage or alter the assessed mechanisms responsible for maintaining arterial blood pressure. W81XWH-22-C-0004. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Transient numerical investigation on thermochemical erosion of C/C nozzles in hybrid rocket motors

Nozzle erosion is a vital important issue that impacts the performance of hybrid rocket motors. Serious nozzle erosion may significantly decrease the combustion chamber pressure and thrust, which increases the difficulty in designing flight control systems. This paper aims to reveal erosion mechanism systematically. In this paper, transient numerical simulations of thermochemical erosion in hybrid rocket motors are conducted, and combustion flow and thermochemical erosion are coupled calculated. The numerical computation of combustion flow is based on the chemical reactions of propellants and regression rate model, and that of thermochemical erosion is based on the surface reactions between oxidizing species and carbon. The movement of burning surface and nozzle inner surface is simulated through dynamic mesh method. The hybrid rocket motor adopts 90% hydrogen peroxide and hydroxyl-terminated polybutadiene. Distributions of flow field parameters and fuel regression rate are given. The spatial developing process of nozzle surface is presented, and it is found that the roughness of nozzle profile increases with time. The nozzle wall temperature and wall pressure decline with time. Erosion by different species is calculated. OH and H2O make a major contribution to the nozzle thermochemical erosion, while nozzle erosion contributed by CO2 and O2 are quite low. Time-varying characteristics of the erosion rate are unveiled. At the first 1.5 s, the total erosion rate remains almost constant, and then it reduces over time.

Low-Salinity Waterflooding for EOR in Field A of Western Offshore Basin: A Pilot Study Analysis with Laboratory and Simulation Studies—Early Observations

Carbonate reservoirs hold vast oil reserves, but their complex properties make traditional enhanced oil recovery (EOR) methods challenging. This study explores the application of low-salinity water flooding (LSWF) as a novel EOR method for India’s largest offshore carbonate oil field. Conventional EOR techniques were deemed unsuitable due to reservoir heterogeneity, pressure decline, high temperature, and the offshore location. Favorable factors for LSWF included successful seawater flooding history, medium-weight crude oil, and existing infrastructure. Following core flooding experiments demonstrating a 6–16% increase in oil recovery, a multi-pronged evaluation process was implemented. Single-well chemical tracer tests (SWCTT) and reservoir simulations confirmed the potential of LSWF. A specific target area was chosen based on reservoir characteristics, production data, and available facilities. Simulations predicted a 1.5% incremental oil recovery using diluted seawater (25% salinity) at 30% pore volume injection. After a positive techno-economic analysis, the first offshore LSWF project in India was completed within 3 years. Initial monitoring results are encouraging. This study highlights the successful journey of LSWF from concept to field deployment in a challenging carbonate reservoir, showcasing its potential for revitalizing such fields. Furthermore, this work provides valuable data relevant to Indian offshore environments, where factors like salinity, mineralogy, and crude oil composition pose unique challenges compared to other LSWF applications. These detailed data fill a critical gap in the existing literature.

Flowback Rates for Pump-In/Flowback Test

Summary The pump-in/flowback test (PIFT), often referred to as the diagnostic fracture injection test (DFIT) with flowback, offers notable advantages in terms of time efficiency and accuracy, particularly in the context of low-permeability formations. The key to the success of this test lies in the careful selection of an optimal flowback rate to yield meaningful results. The fundamental assumption underlying the pressure analysis of these tests is the uniform closure of fractures during the flowback phase, which is considered the default fracture closure mode in current analyses. In this study, we present evidence that challenges the validity of this assumption, highlighting instances where unsuitable flowback rates can lead to nonuniform fracture closure and result in abnormal pressure data. To address this challenge, we identify different closure modes through the signature of fracture closure in the excessive bottomhole pressure decline curve. Subsequently, we propose an optimal range of flowback rates using a scaling analysis approach to obtain a uniform closure mode in an extended openhole section of a vertical well. Our method has been rigorously validated through 3D numerical simulations and field studies, enhancing its reliability and applicability. This approach helps operators to conduct effective tests in complex situations, overcoming a barrier to widespread test application.

White matter lessions are associated with increases in blood pressure and global cognitive decline

White matter lessions are associated with increases in blood pressure and global cognitive decline

Biogeochemical dynamics in a marine storm demonstrates differences between natural and anthropogenic impacts

This study explores the impact of a wind storm on sediment resuspension and marine biogeochemical dynamics. Additionally, the storm took place during an expedition researching bottom trawling, enabling the direct comparison of certain natural and fisheries-related disturbances. The storm was initiated by a decline in atmospheric pressure and a 2 h period of gale force winds, which was followed by over 40 h of elevated bottom currents. Storm induced turbidity, potentially a cumulative post-fishing impact, was remarkably higher compared to what was observed in a recent trawling event. Storm-induced mixing and movement of water masses led to decreased silicate and increased phosphate concentrations in the water column, accompanied by lower salinity and higher fluorescence. The erosion depth of the seabed averaged around 0.3 cm during the peak turbidity period. Trawl-induced erosion in the area has been measured at over twice that depth, and has been linked to intermittent reductions in near-bed oxygen levels. In contrast, storm-induced turbidity coincided with increased oxygen due to wave mixing, suggesting inherent differences in how trawling and storms can oxidize reduced substances. These findings suggest that storms have a greater regional impact, whereas the local impacts of bottom trawling on biogeochemistry can be more significant.

Wettability evaluation of shale oil reservoirs and its impact on the post-fracturing shut-in duration of horizontal wells: a quantitative study for Ordos Basin, NW China

Shale oil development in Ordos Basin, China, primarily relies on the displacement of crude oil during the post-fracturing shut-in stage (PFSIS) of horizontal wells. Reservoir wettability significantly influences the shut-in duration and even the development approach. However, due to strong heterogeneity and super tight characteristics, the reservoir usually shows an mixed wettability, and it was usually hard to differentiate the wettability in different pore sizes. With this in mind, this study focuses on core samples from shale oil reservoir in the Longdong region of the Ordos basin to quantitatively analyze the reservoir wettability. Amott method combined with nuclear magnetic resonance is adopted in the paper to meed this end. And the optimal post-fracturing shut-in duration for Huachi and Heshui areas in the Longdong region are determined based on both wettability and field practice analysis as well as numerical simulations. Qualitative wettability evaluation reveals that the reservoir in the Longdong region is weakly oil-wet (oil-wet pores account for 58.9% and water-wet pores for 41.1%), and that larger pores are more water-wet, while smaller pores are more oil-wet. Field practice observes a noticeable two-stage decline in wellhead pressure, with pressure drop rates and water content decline rates following the order of neutral reservoir > weakly oil-wet reservoir > oil-wet reservoir during the post-fracturing shut-in stage. Numerical simulations indicate that the determination of the optimal post-fracturing shut-in duration for horizontal wells should consider reservoir properties, wettability, and injection volume. The final optimal shut-in durations for the Huachi and Heshui areas in the reservoir are determined to be 36 days and 43 days, respectively. Our study qualitatively distinguishes the wettability in different pores sizes and thus determines reasonable post-fracturing shut-in durations in different areas in Longdong region. The research has major implication for building a realistic method of wettability analysis in shale or tight oil reservoir.

Tongue Pressure Resistance Training for Post-Stroke Dysphagia: A Case Study

Introduction: Swallowing outcomes regarding lingual resistance training have been mixed due to variability in methods, leading to ambiguity concerning the utility of this intervention. The purpose of this study was to explore the effect of a lingual resistance training protocol on the swallowing function of an individual presenting with dysphagia and reduced tongue pressure following a supratentorial ischemic stroke. Methods: A study involving a lingual resistance training protocol with videofluoroscopy to measure outcomes comparing different parameters to ASPEKT normative reference values at three timepoints: baseline (videofluoroscopic swallowing study [VFSS] A), following a 4-week lead-in period to control for spontaneous recovery (VFSS B), and at the 8-week endpoint of treatment (VFSS C). The study was interrupted due to the COVID-19 pandemic after 1 participant enrollment and is presented as a single case study. Results: Isometric tongue pressures: Following the 4-week lead-in, a decline in maximum isometric anterior tongue pressure (MAIP) and regular effort saliva swallow pressures (RESS) was noted; however, there was no change in maximum posterior isometric tongue pressures (MPIP). Isometric tongue pressures improved post-treatment, with increases in MAIP, MPIP, and to a lesser degree RESS. Swallowing function: Impairments in swallowing safety continued between the baseline VFSS A (Penetration-Aspiration Scale score [PAS] = 8) and lead-in VFSS B (PAS = 5). Swallowing safety improved following the intervention, with PAS scores = 1 at the endpoint VFSS C. Pixel-based measures of swallowing efficiency revealed a reduced frequency of post-swallow total pharyngeal residue following the treatment. Improvements were found in two other swallowing parameters, laryngeal vestibule closure integrity and pharyngeal area at maximum pharyngeal constriction, at the endpoint VFSS. Conclusion: These pilot data suggest improvements in some swallowing parameters as an outcome of intervention.

Natto (fermented soybeans)-induced anaphylaxis in a surfer with the possibility of sensitization to poly(γ-glutamic acid) from cutaneous exposure to jellyfish sting: a case report

BackgroundWe report a case of anaphylaxis induced by natto (fermented soybeans) allergy that occurred following dermal sensitization from a jellyfish sting.Case presentationA 49-year-old male presented to the emergency room complaining of an acute onset of erythema with pruritis that appeared while he was surfing. Given that his heart rate dropped to ~ 40 bpm without a decline in blood pressure or oxygen saturation, we suspected anaphylaxis and administered 0.5 mg of adrenaline intramuscularly. Immediately after the muscular adrenaline injection, his heart rate recovered to ~ 60–70 bpm.ConclusionsThe major allergen that induces natto allergy is poly(γ-glutamic acid) (PGA), which is present in its mucilage. Given that PGA is also produced by jellyfish tentacles, it can be inferred that the PGA sensitization occurred via dermal exposure to jellyfish PGA. This is an example of a food allergy induced by animal stings. As PGA is a high-molecular-weight polymer, natto allergy, despite being IgE-mediated, often presents with late-onset anaphylaxis, which typically develops half a day after digestion. PGA has a wide range of applications in pharmaceuticals, cosmetics, and foods. Patients may develop allergic symptoms and experience repeated anaphylaxis with no known cause. Therefore, it is important to obtain a detailed medical history and individually instruct patients suspected of being allergic to PGA to avoid PGA-containing products.

A blunted nocturnal blood pressure decline is associated with all-cause and cardiovascular mortality.

It has been suggested that a blunted nocturnal blood pressure (BP) decline is associated with a poor prognosis. Nevertheless, it remains unclear if an abnormal dipping is deleterious per se or it merely reflects an elevated BP during sleep. We aimed to assess the prognostic value of nocturnal BP decline, with or without concomitant elevated nocturnal BP. Vital status and cause of death were obtained from death certificates in 59 124 patients, enrolled in the Spanish ABPM Registry between 2004 and 2014 (median follow-up: 10 years). The association between night-to-day ratio (NDR) and dipping patterns (extreme dippers, dippers, reduced dippers, and risers) with all-cause and cardiovascular mortality were evaluated by Cox-proportional models adjusted for clinical confounders and 24 h blood pressure. NDR was associated with all-cause mortality [hazard ratio for 1SD change: 1.15; 95% confidence interval (CI) 1.13-1.17]. Reduced dippers (1.13; 1.06-1.20) and risers (1.41; 1.32-1.51) were associated with an increased risk of all-cause death, whereas extreme dippers (0.90; 0.79-1.02) were not. Elevated NDR (≥0.9) in the absence of elevated night SBP (<120 mmHg) was associated with an increased risk of death (1.13; 1.04-1.22), as well as elevated night SBP but normal NDR (1.38; 1.26-1.50), and the combination of both abnormalities (1.56; 1.46-1.66). Similar results were obtained for cardiovascular mortality. Abnormalities in the circadian pattern are associated with an increased risk of all-cause and cardiovascular mortality. This is maintained even in the absence of nocturnal BP elevation.