All about cellulite: a review of the causes, treatments and new technologies

Cellulite is an aesthetic condition that affects the vast majority of post-pubescent females worldwide. It is difficult to treat, and any results are difficult to maintain. Subcutaneous fibrous septa, anchoring the skin to the underlying tissue and piercing the subcutaneous fat perpendicular to the dermis, lead to the dimpled or wavy topography of the surface. Treatment to improve cellulite must include release of these septa, as well as strengthening of the dermis. As the causes of cellulite are multifactorial, combination treatments, including surgical subcision, lasers, radiofrequency, microfocused ultrasound, acoustic wave therapy and collagenase, are the best option for significant and long-lasting cellulite improvement. Optimum treatment protocols are yet to be determined.

An Efficient Interpretation Method for Matrix Acidizing Evaluation and Optimization in Long Heterogeneous Carbonate Reservoirs

Summary Since its discovery in 1971, numerous matrix stimulations have been performed in South Pars field. However, there are still various challenges surrounding stimulation job design and evaluation methods. To tackle these issues, 16 matrix operations were selected to be analyzed from different phases of the development project of the reservoir. The objective of this study is to introduce an efficient interpretation method to determine optimum treatment volume (gal/ft), compare the effectiveness of diverters, calculate stimulation ratio (SR), and forecast post-acid production behavior from surface treatingdata. The modified inverse injectivity (Iinv) method, which is fully discussed by Safari et al. (2020), is used in this study. The obtained data were analyzed in terms of Iinv decreasing trend, Iinv humps, and pre-/post-acid Iinv during the stimulation process. In addition, pre-/post-stimulation surface testing data are gathered and analyzed. These data are coupled with post-acid Iinv to find a correlation to predict production behavior of treated wells. SR is defined as the ratio of pre-acid Iinv to post-acid Iinv of a treated well. Finally, SR values are validated with available production logging tool (PLT) data from two stimulation operations. First, the obtained results indicated that optimum treatment volume (gal/ft) of acid depends on well conditions. It means that wells with high initial formation damage require more volumes of stimulation fluids. In this regard, wells treated with 27/27 gal/ft treatment volume design [27 gal/ft 28% hydrochloric acid (HCl) and 27 gal/ft 15% viscoelastic surfactant (VES)] were understimulated. Although treatment volume design of 53/53 gal/ft seems to be adequate for low-skin wells, higher treatment volume (gal/ft) would further enhance productivity of highly damaged wells. This result was confirmed by stimulation of a damaged well with treatment volume of 60/60 gal/ft. Finally, the most reliable design applied in the field so far is the 70/70 gal/ft treatment volume. Second, Iinv analyses depicted that better diversion is observed in wells with lower injectivity and higher damage. At the next step, the calculated SR values showed an average deviation of less than 10% from downhole PLT data. Ultimately, the produced results demonstrated that there is a direct relation between the post-acid Iinv and surface drawdown in this field. Therefore, production behavior of treated wells can be correlated by having access to post-acid Iinv. The novelty of this work pertains to use of surface treating data recorded during a stimulation operation to generate Iinv and its associated analysis curves to evaluate performance of matrix stimulation operations. By applying this method, optimum volume of acid and diverter, diversion effectiveness, SR, and an estimation of post-acid surface drawdown can be obtained from the simple surface treating data. The secondary-produced data could lead to a better understanding of carbonate reservoir behavior during matrix stimulations such as in the South Pars field.

What is the optimum systemic treatment for advanced/metastatic renal cell carcinoma of favourable, intermediate and poor risk, respectively? A systematic review and network meta-analysis

PurposeThe optimum systemic therapies for advanced/metastatic renal cell carcinoma (RCC) of favourable, intermediate and poor risk have not been established. We aimed to compare and rank the effects associated with systemic therapies in the first-line setting.MethodsWe searched PubMed, Cochrane databases, Web of Science and ClinicalTrials.gov for randomised controlled trials (RCT) published up to February 2020 of all available treatments for advanced/metastatic RCC. Analysis was done on a Bayesian framework.Results15 unique RCTs including 8995 patients were identified. For advanced/metastatic RCC of favourable risk, avelumab plus axitinib was associated with a significantly higher improvement in progression-free survival (PFS) than sunitinib (HR 0.57, 95% CI 0.34 to 0.96). For intermediate-risk patients, cabozantinib, nivolumab plus ipilimumab, pembrolizumab plus axitinib and avelumab plus axitinib were associated with significantly higher improvement in PFS than sunitinib (HR 0.63, 95% CI 0.44 to 0.97; HR 0.66, 95% CI 0.53 to 0.81; HR 0.58, 95% CI 0.44 to 0.80; HR 0.62, 95% CI 0.47 to 0.83, respectively); pembrolizumab plus axitinib and nivolumab plus ipilimumab were associated with significantly higher improvement in overall survival (OS) than sunitinib (HR 0.53, 95% CI 0.34 to 0.81; HR 0.66, 95% CI 0.50 to 0.87, respectively). For poor-risk patients, nivolumab plus ipilimumab and pembrolizumab plus axitinib were associated with significantly higher improvement in PFS than sunitinib (HR 0.57, 95% CI 0.43 to 0.76; HR 0.48, 95% CI 0.30 to 0.82, respectively); nivolumab plus ipilimumab and pembrolizumab plus axitinib were significantly more efficacious for OS than sunitinib (HR 0.57, 95% CI 0.39 to 0.883; HR 0.43, 95% CI 0.23 to 0.80, respectively). For OS, there were 81% and 78% probabilities that pembrolizumab plus axitinib was the best option for intermediate-risk and poor-risk patients, respectively.ConclusionAvelumab plus axitinib might be the optimum treatment for advanced/metastatic RCC of favourable risk. Pembrolizumab plus axitinib might be the optimum treatment for intermediate-risk and poor-risk patients.

Effect of human urine application on cabbage production and soil characteristics

The aim of this study was to examine the effect of human urine on soil quality and salinity through repeated applications, and compare it with the effects of synthetic fertilizer and non-fertilized treatments. Six different fertilizer mixtures were applied to pots of head cabbage: 100% tap water, 100% urine, 1:1 urine and tap water, 1:2 urine and tap water, 1:3 urine and tap water, and synthetic fertilizer. The study design was completely randomized design (CRD) with three replications of pot-based experiments. The growth and yield parameters of producing head cabbage (Brassica oleracea) among treatments were compared. Soil residual test of the optimum treatment was also conducted for the optimum treatment to examine the effect on its characteristics. The optimum yield was obtained from the application of 1:3 of urine and water, and comparable to the synthetic fertilizer (F = 21.78; p = 0.964). The difference in the electrical conductivity of soil was statistically significant (F = 2.324; p = 0.049) after three rounds of applications which should be considered during urine fertilizer utilization. Generally, urine contains nutrients, which can substitute synthetic fertilizer, at a dilution factor of three. However, education should be delivered to enhance public acceptance and to create awareness on urine collection, storage and application for sustainable utilization.