Selection of EOR Technology in Ultra-Low-Permeability Reservoirs of the Achimov Deposits of the Priobsky Field

To create a technology for selection the optimal RPM method the simulation on a sector hydrodynamic model of the field has performed. Different injection modes (continuous injection, alternating, cyclic), injection agents and completions of injection wells were tried during the modeling. The key factors, which influence the choice of the RPM method, were determined. Pilot industrial works include short-term nitrogen injection, long-term APG injection, and production from pilot wells in various modes. Well research include pressure testing, well testing after gas injection, recording of inflow profiles, laboratory studies of the Priobskoye field's own core. Evaluation of the potential of gas enhanced oil recovery methods shows their significantly higher efficiency compared to stationary waterflooding. The suggested approach can minimize the risks in the transition to previously untested development methods and methods of enhanced oil recovery in ultra-low-permeability reservoirs of the Achimov deposits. The analysis and the results of partially conducted pilot projects (at the moment) have showed a high potential for gas injection in certain areas of the field.

Development of a core evaluation framework of value-added medicines: report 1 on methodology and findings

Background Medicines that are based on known molecules and are further developed to address healthcare needs and deliver relevant improvement for patients, healthcare professionals and/or payers are called value-added medicines (VAMs). The evaluation process of VAMs is heterogeneous across countries, and it has been primarily designed for originator pharmaceuticals with confirmatory evidence collected alongside pivotal clinical trials. There is a mismatch between evidence requirements by public decision-makers and evidence generated by manufacturers of VAMs. Our objective was to develop a core evaluation framework for VAMs. Methods Potential benefits offered by VAMs were collected through a systematic literature review and allocated to separate domains in an iterative process. The draft list of domains and their applicability were validated during two consecutive virtual workshops by health policy experts representing countries with different economic statuses, geographical and decision-making contexts. Results Based on 158 extracted studies, the final consensus on the evaluation framework resulted in 11 value domains in 5 main clusters, including unmet medical needs, health gain (measured by health care professionals), patient-reported outcomes, burden on households, and burden on the health care system. Conclusions The proposed framework could reduce the heterogeneity in value assessment processes across countries and create incentives for manufacturers to invest in incremental innovation. However, some domains may not be equally relevant or accepted in all countries, therefore the core framework needs thorough adaptation in specific jurisdictions.

Development of a core evaluation framework of value-added medicines: report 2 on pharmaceutical policy perspectives

Background A core evaluation framework that captures the health care and societal benefits of value added medicines (VAMs, also often called repurposed medicines) was proposed in Report 1, aiming to reduce the heterogeneity in value assessment processes across countries and to create incentives for manufacturers to invest into incremental innovation. However, this can be impactful only if the framework can be adapted to heterogeneous health care financing systems in different jurisdictions, and the cost of evidence generation necessitated by the framework takes into account the anticipated benefits for the health care system and rewards for the developers. Areas covered The framework could potentially improve the pricing and reimbursement decisions of VAMs by adapting it to different country specific decision-contexts such as deliberative processes, augmented cost-effectiveness frameworks or formal multi-criteria decision analysis (MCDA); alternatively, some of its domains may be added to current general evaluation frameworks of medicines. The proposed evaluation framework may provide a starting point for practices based on which VAMs can be exempted from generic pricing mechanisms or can be integrated into the reimbursement and procurement system, allowing for price differentiation according to their added value. Besides evidence from RCTs, pricing and reimbursement decision processes of VAMs should allow for ex-ante non-RCT evidence for certain domains. Alternatively, relying on ex-post evidence agreements—such as outcome guarantee or coverage with evidence development—can also reduce decision uncertainty. Conclusions The core evaluation framework for VAMs could trigger changes in the existing pricing, reimbursement and procurement practices by improving the appraisal of the added value created by incremental innovation.

EVALUATION OF EQUILIBRIUM CORE OPERATION OF THE RSG-GAS REACTOR

The Indonesian Multipurpose Reactor, RSG-GAS reactor will accomplish its first lifetime in December 2020. The reactor has been operated in safe and reliable manner for about 33 years since it commenced in operation in 1987 to serve radioisotopes production, NAA, neutron beam experiments, material irradiation, and reactor physics experimental activities as well as training. The paper is intended to evaluate its in-core fuel management that is the conformance between the theory and implementation of the equilibrium core. Evaluation of the reactor operation parameter was carried out for core numbers 91 – 100. The data show that excess reactivity, shutdown reactivity and control rod reactivity have no significant difference at each core. The result shows that the BATAN-FUEL accurately determine the equilibrium core and its fuel loading pattern.This in-core fuel management of the RSG-GAS reactor supports the safety of reactor operation.

Geological mapping and stand-up time estimation based on core drill evaluation using RMR89 on Tunnel 3 Sigli Banda Aceh Toll Road

Tunnel 3 of the Sigli Banda Aceh Toll Road has been designed based on several site investigations. The site investigations have not included surface geological investigations. Subsurface geological investigations have been carried out but with less detailed drill core evaluation. This will cause less accuracy on the assessed tunnel stand-up time. This research aims to evaluate the engineering geological conditions at the tunnel construction site by conducting geological mapping with 1:5,000 scale and re-evaluating drill core using RMR89 method more thoroughly so that it can produce more accurate assessment of the tunnel stand-up time. The geological mapping result shows that the research area has three rock units, namely lapili, tuffaceous sandstones, and interbedded sandstone-siltstones, with moderate to fresh weathering degree. The drill core evaluation shows that research area has poor to good rock mass classes (34 – 67). The drill core evaluation results also indicate possible geological structures that may influence subsurface rock mass strength. The tunnel stand-up time obtained from the lowest RMR89 value for each drill core shows a value of 5 - 90 hours, implying immediate application of support system after tunnel excavation.

Microbiological Hygiene Quality of Thermal Muds: A Pilot Study in Pelotherapy Facilities of the Euganean Thermal District (NE Italy)

Evaluation of hygienic aspects of thermal mud microbiology is still neglected. This study evaluates the microbiological hygiene quality of thermal muds, providing a comprehensive assessment of the whole mud cultivation chain. Maturing mud, peloid and used mud samples were collected twice in a year from 30 SPAs of the Euganean Thermal District, NE Italy. Samples were processed with an ad hoc laboratory method. The following indicator parameters were assessed: Total Count at 22, 37 and 55 °C; total coliforms; Escherichia coli; enterococci; Staphylococcus aureus; Pseudomonas aeruginosa; sulfite-reducing clostridia; dermatophytes. Statistical significance of differences between the two sampling campaigns and correlation between temperature and indicator parameters were evaluated. One-hundred eighty samples were analyzed. Widespread presence of environmental species was found, as well as hints of possible microorganism transfer from the patient’s skin to the mud. Proper setting of thermal water temperature resulted critical, in terms of hygienic quality. Although optimal maturation should be granted (thermal water at 30–42 °C), a pasteurization step at 60–65 °C is strongly recommended to sanitize peloids before pelotherapy. Facilities re-using thermal muds should also implement a regeneration step at ≥65 °C. Core evaluation of thermal mud hygienic quality could encompass the following guidelines: absence (i.e., 0 colony forming units (CFU)/g) of E. coli, P. aeruginosa, S. aureus and dermatophytes.

How to Cope with Big Data in Functional Analysis of the Esophagus

<b><i>Introduction:</i></b> Esophageal motility disorders have a severe impact on patients’ quality of life. While high-resolution manometry (HRM) is the gold standard in the diagnosis of esophageal motility disorders, intermittently occurring muscular deficiencies often remain undiscovered if they do not lead to an intense level of discomfort or cause suffering in patients. Ambulatory long-term HRM allows us to study the circadian (dys)function of the esophagus in a unique way. With the prolonged examination period of 24 h, however, there is an immense increase in data which requires personnel and time for evaluation not available in clinical routine. Artificial intelligence (AI) might contribute here by performing an autonomous analysis. <b><i>Methods:</i></b> On the basis of 40 previously performed and manually tagged long-term HRM in patients with suspected temporary esophageal motility disorders, we implemented a supervised machine learning algorithm for automated swallow detection and classification. <b><i>Results:</i></b> For a set of 24 h of long-term HRM by means of this algorithm, the evaluation time could be reduced from 3 days to a core evaluation time of 11 min for automated swallow detection and clustering plus an additional 10–20 min of evaluation time, depending on the complexity and diversity of motility disorders in the examined patient. In 12.5% of patients with suggested esophageal motility disorders, AI-enabled long-term HRM was able to reveal new and relevant findings for subsequent therapy. <b><i>Conclusion:</i></b> This new approach paves the way to the clinical use of long-term HRM in patients with temporary esophageal motility disorders and might serve as an ideal and clinically relevant application of AI.

Simulation Study on the Effect of Grading Diagnosis and Treatment Based on System Dynamics Model in the Context of Medical Alliance——Taking Jiangsu Province as An Example

Abstract: Objective To study the core influencing factor of the implementation of Grading diagnosis and treatment system in the context of Jiangsu medical alliance. Methods By constructing the grading diagnosis and treatment system dynamics model under the background of medical alliance, the number of first-time treatments at the primary level was taken as the core evaluation index. By intervening on different targets, we would study the influence on the core evaluation index. Results The selected six intervention targets had positive effects on graded diagnosis and treatment. Among them, the intervention of medical resource subsidence, the construction of information platform between medical alliances and the technical level of primary level had the greatest impact. Conclusion In order to better promote the development of the grading diagnosis and treatment system, we can focus on the construction of medical alliances: For example, implementing the sinking of high quality medical resources in the medical alliance to strengthen the discipline construction of primary level; breaking the information island in the medical alliance, and strengthening the construction of information platform; building and expanding the green channel for two-way referral, implementing the differentiation of medical insurance policies, and improving the mechanism of benefit sharing in the medical alliances to gradually realize the orderly rationalization of medical treatment.