Phase 1
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Assessment ◽  
2021 ◽  
Vol 29 (1) ◽  
pp. 34-45
Stephanie N. Mullins-Sweatt ◽  
Marina A. Bornovalova ◽  
Natacha Carragher ◽  
Lee Anna Clark ◽  
Alejandro Corona Espinosa ◽  

This article outlines the Phase 1 efforts of the HiTOP Measure Development group for externalizing constructs, which include disinhibited externalizing, antagonistic externalizing, attention deficit hyperactivity disorder, substance use, and externalizing/maladaptive behaviors. We provide background on the constructs included and the process and issues involved in developing a measure for this diverse range of psychopathology symptoms, traits, and behaviors.

2021 ◽  
Sattiyaraju Sellapan ◽  
M Shahril Majid Allapitchai ◽  
Ahmad Luqman Johan ◽  
El Khalil Mohamed M’Bareck Heboul ◽  
William Sin Yoong Liew ◽  

Abstract Operator's Wells Abandonment & Decommissioning campaign consists of 15 Deepwater subsea wells in Field "C" offshore West Africa. Discovered in 2001, the field is located approximately 80 km west of coastline and about 90 km from Nouakchott, capital of Mauritania. Field "C" is a deepwater field in water depth ranging from 730m to 830m. The field was developed using subsea wells, Hinged Over Subsea Templates (HOST), manifolds, flexible flowlines, umbilicals, and risers tied back to a permanently moored FPSO. In total, the field consists of nine (9) oil producer wells and five (5) water injection wells. During the development stage, one (1) gas injection well was drilled and completed at adjacent Field "B" about 17 km Northeast of Field "C". The water depth at this gas injection well location is approximately 280m. Field "C" reached maturity in 2016. Due to high operating costs, declining production coupled with declining oil prices, the decision was made to cease production, plug and abandon (P&A) and decommission the field. Two phases strategy was engaged by the Operator in order to complete the decommissioning and abandonment of Field "C". In Phase 1, which was executed back in the year of 2017-2018, all the 15 deep water subsea wells were temporarily suspended with two (2) barriers in place. The Floating, Production, Storage and Offloading (FPSO) unit was decommissioned and disconnected. In line with the strategy of dividing the project into two phases, the information on well integrity and conditions acquired during the Phase 1 Temporary Wells Suspension (TWS) was used by the Operator in planning for Phase 2 – Wells Plug and Abandonment (P&A). The operator made full use of temporary well suspension period between Phase 1 and Phase 2 for engineering, procurement, and operations preparation. The same drillship was utilized for the project in both phases. Multiple optimizations and modifications were done on the drillship based on lessons learned in Phase 1 and to cater for the subsea Xmas Tree and subsea structures retrieval in Phase 2. Due to the nature of the remote location and no existing oil & gas operations support base, all equipment required in this project was sent to Mauritania early. Equipment inspection and acceptance were carried out in Mauritania as part of the strategy in ensuring the availability of good quality equipment for offshore operations. The operations on Wells Plug & Abandonment commenced in December 2019. In March 2020, upon declaration of the COVID-19 pandemic, operator was faced with difficulty of continuing operation as the Host Country activated border lockdown. The operator managed to continue operations for remaining well and demobilized drillship and personnel safely. Operator has successfully retrieved three (3) subsea Xmas Trees, P&A three (3) wells and intervened six (6) other wells for tubing cutting before operations was suspended due to COVID-19 pandemic. Operator used the suspension phase to devise a methodology to resume operation in the prevailing COVID-19 pandemic situation. The challenges faced during the COVID-19 pandemic as well as the steps taken for resumption are highlighted in this paper. It is expected that this paper will serve as guidance in highlighting challenges and efforts taken to resume operation in the event of unforeseen suspension due to any reasons. It is also hoped that the details shared in this paper can assist other Operators in better operation planning for remote locations.

2021 ◽  
Vol 2021 (3) ◽  
Abdullah Hamad ◽  
Hany Ezzat ◽  
Tarek Abdel Latif Ghonimi ◽  
Rania Ibrahim ◽  
Fatma Ramadan ◽  

Introduction: Anemia management in dialysis is challenging. Keeping hemoglobin levels within a tight range is difficult. A new program (anemia nurse manager [ANM]) was started for better anemia management. This study aimed to compare traditional anemia management with the new ANM model regarding the achievement of better hemoglobin targets (range, 10–12 g/dL), avoidance of extreme hemoglobin levels ( < 9 or >13 g/dL), and evaluation of the cost-effectiveness of the new model. Methods: This retrospective observational study compared traditional anemia management with management involving our new ANM model. Patients on hemodialysis in all ambulatory dialysis clinics in Qatar were included. The study included three phases: phase 1 (observation): June 2015 to August 2015, 460 patients; phase 2 (pilot): September 2015 to May 2016, 211 patients; and phase 3 (expansion in two phases): June 2016 to February 2017 and October 2017 to June 2018, 610 patients. Hemoglobin, iron saturation, and ferritin were evaluated according to the protocol. Results: In this study, 55% of the patients achieved the target hemoglobin in phase 1 compared with 75% in phase 2 (p = 0.0007). The hemoglobin level within the target range was sustained at 72% ± 5% of patients in phase 3. The achievement rate of the target hemoglobin level increased from 56% (May 2015) to 72% (July 2018) (p < 0.001). The proportion of patients with extreme hemoglobin declined from 10.7% in phase 1 to 6.4% in phase 2 and sustained at 8% afterward. Reducing the doses of erythropoietin stimulating agents, owing to the use of the ANM model, saved costs by approximately 11%. Conclusions: The ANM model was able to achieve and maintain hemoglobin levels within the target range and decrease extreme hemoglobin levels. These outcomes improved patient care by avoiding high hemoglobin (increase thrombosis, cancer recurrence, stroke, and death) and low hemoglobin (weakness, poor quality of life, and need for transfusion) levels. The ANM model was cost effective even after including the salaries of nurses. This model can be considered in other aspects of patient care in dialysis.

2021 ◽  
Vol 2 (3) ◽  
pp. 167-178
Kuspariyah Romelah

ABSTRAK Penyakit jantung koroner adalah penimbunan plak pada pembuluh darah koroner, sehingga menyebabkan arteri koroner menyempit atau tersumbat. Tujuan penelitian ini untuk menganalisis  perbedaan tanda- tanda vital dan ekg sebelum dan sesudah rehabilitasi jantung fase 1 pada pasien penyakit jantung koroner.  Desain penelitian ini one Group Pre dan Post Test Design. Pengambilan sampel menggunakan tehnik purposive sampling dengan jumlah sampel 32 responden pasien. Analisa data menggunakan uji  Pairet T Sample test. Hasil penelitian  yang menunjukkan  normal sebelum   rehabilitasi jantung fase 1  tekanan darah sistole  65,63%, tekanan darah diastole 78,12%,  nadi 78,13%, respirasi 100%, suhu 87,5%, ekg 68,75%. Dan yang menunjukkan normal  sesudah  rehabilitasi jantung fase 1 yaitu   tekanan darah sistole 75% , tekanan darah diastole  93,75%,  nadi 68,75%, respirasi 68,75%, suhu 100% ekg 87,5%. Hasil uji statistik Pairet T Sample Test didapatkan 0,012 (< 0,05).  Kesimpulannya  adalah ada perbedaan tanda- tanda vital dan ekg sebelum dan sesudah  rehabilitasi jantung fase 1 pada pasien penyakit jantung koroner di IPJT RSSA Malang.   Kata kunci : Rehabilitasi, Tanda- tanda vital, Penyakit Jantung Koroner     ABSTRACT Coronary heart disease is the accumulation of plaque in the coronary arteries, causing the coronary arteries to become narrowed or blocked. The purpose of this study was to analyze the differences in vital signs and ECG before and after phase 1 cardiac rehabilitation in patients with coronary heart disease. The design of this research is one group pre and post test design. Sampling using purposive sampling technique with a sample of 32 patient respondents. Analysis of the data using the Pairet T Sample test. The results showed normal before cardiac rehabilitation phase 1 systolic blood pressure 65.63%, diastolic blood pressure 78.12%, pulse 78.13%, respiration 100%, temperature 87.5%, ecg 68.75%. And what showed normal after phase 1 cardiac rehabilitation were systolic blood pressure 75%, diastolic blood pressure 93.75%, pulse 68.75%, respiration 68.75%, temperature 100% ecg 87.5%. The results of the Pairet T Sample Test statistical test obtained 0.012 (<0.05). The conclusion is that there are differences in vital signs and ECG before and after phase 1 cardiac rehabilitation in coronary heart disease patients at IPJT RSSA Malang.   Key words :  Rehabilitation, Vital signs, Coronary Heart Disease

Robert Frank Cornell ◽  
Rachid Baz ◽  
Joshua R. Richter ◽  
Adriana Rossi ◽  
Dan T. Vogl ◽  

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Norikazu Masuda ◽  
Kenji Tamura ◽  
Hiroyuki Yasojima ◽  
Akihiko Shimomura ◽  
Masataka Sawaki ◽  

Abstract Background Entinostat is an oral inhibitor of class I histone deacetylases intended for endocrine therapy-resistant patients with hormone receptor-positive (HR+) advanced or metastatic breast cancer (BC). We examined the safety, efficacy, and pharmacokinetics of entinostat monotherapy and combined entinostat/exemestane in Japanese patients. Methods This phase 1 study (3 + 3 dose-escalation design) enrolled postmenopausal women with advanced/metastatic HR+ BC previously treated with nonsteroidal aromatase inhibitors. Dose-limiting toxicities (DLTs) of entinostat monotherapy (3 mg/qw, 5 mg/qw, or 10 mg/q2w) and entinostat+exemestane (5 mg/qw + 25 mg/qd) were assessed. Pharmacokinetics, lysine acetylation (Ac-K), and T-cell activation markers were measured at multiple time points. Results Twelve patients were enrolled. No DLTs or grade 3–5 adverse events (AEs) occurred. Drug-related AEs (≥ 2 patients) during DLT observation were hypophosphatemia, nausea, and platelet count decreased. Six patients (50%) achieved stable disease (SD) for ≥ 6 months, including one treated for > 19 months. Median progression-free survival was 13.9 months (95% CI 1.9–not calculable); median overall survival was not reached. Area under the plasma concentration-time curve and Ac-K in peripheral blood CD19+ B cells increased dose-proportionally. The changing patterns of entinostat concentrations and Ac-K levels were well correlated. T-cell activation markers increased over time; CD69 increased more in patients with SD ≥ 6 months vs. SD < 6 months. Conclusions Entinostat monotherapy and combined entinostat/exemestane were well tolerated in Japanese patients, with no additional safety concerns compared with previous reports. The correlation between pharmacokinetics and Ac-K in peripheral blood CD19+ B cells, and also T-cell activation markers, merits further investigation. Trial registration JAPIC Clinical Trial Information, JapicCTI-153066. Registered 12 November 2015., NCT02623751. Registered 8 December 2015.

2022 ◽  
Vol 164 ◽  
pp. 29-41
Nan Wang ◽  
Eef Dries ◽  
Ewan D. Fowler ◽  
Stephen C. Harmer ◽  
Jules C. Hancox ◽  

Animals ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 3329
Olivier M. Lepage ◽  
Paola Di Francesco ◽  
Nicolas Moulin ◽  
Monika Gangl ◽  
Gaëtan Texier ◽  

Background: The management of bleeding originating from the guttural pouch (GP) has a high success rate, but the resolution of the macroscopic inflammatory lesions in the case of mycosis (GPM) is highly variable; the resolution of neurological disorders is inconstant and challenging. Objectives: Our aim was to test the feasibility and safety of topical oxygen therapy (TOT) in horses after induction of GPM and in cases with naturally occurring disease. Study design: This study was an in vivo experimental and retrospective two-phase study. Methods: During phase 1, the pilot study, both GPs were inoculated with Aspergillus fumigatus. One GP was randomly assigned to receive one to four TOT 30 min sessions with 100% medical oxygen at 9 L/min. Follow-up endoscopic images were assessed for scoring macroscopic inflammatory lesions of the pharynx and both GPs. In phase 2, the clinical study, TOT was administered for 45 to 60 min at 15 L/min in six horses presenting with GPM. Results: In phase 1, TOT administration was easy to perform in the standing horse with no adverse effects. After more than two administrations, macroscopic inflammatory lesions decreased more quickly in size in the treated GP. In phase 2, horses were treated with TOT only (n = 1) or combined with a transarterial coil embolization (TACE) procedure (n = 5). After TOT and discharge from the hospital, nasal discharge resolved in three horses, and improvement was noted in the fourth one. Between days 2 and 10 after admission, upper respiratory tract endoscopy (URTE) indicated size reduction and alteration in the appearance of all the macroscopic inflammatory lesions. The partial or total recovery of neurological disorders (2/4 laryngeal hemiparesis, 3/5 dysphagia, 1/2 dorsal displacement of the soft palate (DDSP), and 1/1 Horner’s syndrome) was recorded. Main limitations: In phase 1, the small number of horses did not allow for statistically significant conclusions; in phase 2, clinical signs at admission varied between horses, which made comparison difficult. Conclusions: In adult horses, TOT alone or in combination with TACE is feasible and safe with a propensity to reverse the course and the progression of inflammatory lesions without additional local or systemic treatment.

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