Submersible Pump with Line Shaft Pump in Shallow Water, Optimum Selection for Offshore Application in the Oil & Gas Industry

Seawater is an essential fluid used in various process circuits, such as cooling, reinjection into the wells and utilities, etc., in the offshore oil and gas industry. Vertical pumps facilitates with lifting seawater to the platform. This study investigates and compares two pump alternatives that has been widely used in oil and gas industry for seawater lift application: Vertical line-shaft pump and Electrical submersible pump. Existing seawater lift pump operating parameters are used as the basis of this study. The pump that is considered for the study has a flow rate of 3415 US GPM (776 m3/hr.) with a total head of 250 ft. The motor rating is 350 HP. The overall length of the pump is 21 meters. The main methodology used is a Life Cycle Cost Analysis (LCC) where the total cost of ownership of the vertical line-shaft pump and electrical submersible pump were analyzed for a period of 30 years. Furthermore, this research also addresses the operational drawbacks associated with both the pumps. Submersible pumps have higher initial capital investment cost when compared to line-shaft pump of similar capacity and size. The energy consumption cost of submersible pumps are higher mainly owing to lower efficiencies of the motors. The power factor for submersible pumps are lower in relation to line- shaft pumps. One of the main benefits of submersible pumps are their less installation and pump pullout time. Submersible pumps occupies lower space above ground when compared to line-shaft pumps. Additionally, submersible pumps are less noisy and have lower vibration in comparison to line-shaft pumps. This paper aims to provide key information and knowledge for engineers to make prudent decision regarding selection of the most cost effective pump for the seawater lift application with a tangible added cost value to both Capital Expenditures (CAPEX) and Operational Expenditure (OPEX).

Sibelius as a Tool to Improve Student’s Ability of Making Counterpoint Melody

As a subject for music students, counterpoint contributes to the ability to create a melody. The melody in counterpoint usually consists of two or more layers. In order to make a counterpoint melody, students must acknowledge the rules to construct the counterpoint melody. A good counterpoint melody involves two important things: the flow of the melody in a vertical and horizontal in vertical line (interval) and the musical texture of the melody. As a beginner in learning counterpoint, writing a counterpoint melody might be difficult at first. Learning counterpoint investigation was found that students spent a lot of their time following the counterpoint rules. They particularly did not focus on the musical sense of the counterpoint melody causing the melody loses its musical senses. Sibelius was used here as a tool to solve the problem. Sibelius is a music software which commonly used in writing musical scores. This study examined Sibelius in making a counterpoint melody in learning counterpoint. The data were gathered through observation and interviews with students during learning counterpoint course. The result showed that by using Sibelius, making counterpoint melody more efficient, and it helped student not only focused on the counterpoint rules but also the musical senses of the counterpoint melody. Furthermore, students also showed the improvement of their skills in making a counterpoint melody.

1137. Effect of an Antibiotic Stewardship Program on Antibiotic Choice, Dosing, and Duration in Pediatric Urgent Care

Background Many studies have focused on decreasing inappropriate antibiotic prescriptions. In August 2018, our institution implemented an outpatient antibiotic stewardship program (ASP). We describe the impact of an outpatient ASP on the antibiotic choice, dose, and duration for common pediatric infections in a pediatric urgent care (PUC) setting. Methods We reviewed all encounters at 4 freestanding PUC centers within our organization of patients >60 days and < 18 years with a discharge diagnosis of acute otitis media (AOM), group A streptococcal (GAS) pharyngitis, community acquired pneumonia (CAP), urinary tract infection (UTI), cellulitis, abscess, and animal bite who received systemic antibiotics between July 2017 and December 2020. We excluded patients who were transferred, admitted, or had a concomitant diagnosis that required systemic antibiotics. We used established national guidelines to determine appropriateness of antibiotic choice, dose, and duration for each diagnosis (Table 1). Our outpatient ASP efforts included the development of an antibiotic handbook, data sharing, education, quality improvement projects, and commitment letters. Pearson’s chi-square test was used to compare appropriate prescribing (choice, dose, and duration) between pre-implementation (July 2017 – July 2018) and post-implementation (August 2018 -forward). Monthly run charts evaluated improvement over time. Results We included 35,915 encounters. Appropriate antibiotic agent improved in AOM (75.8% to 77.2%; p=0.03), UTI (74.9% to 89.5%; p< 0.001), cellulitis (70.5% to 75.1%; p=0.02) and abscess (53.6% to 67.7%; p< 0.001) following implementation of our ASP (Figure 1). Excluding GAS pharyngitis, all diagnoses had improvement in appropriate duration (p< 0.001) (Figure 2). Appropriate dosing improved for AOM (75.7% to 81.6%; p< 0.001), UTI (34.9% to 42.9%; p=0.01) animal bites (37.1% to 45.6%; p=0.048), and cellulitis (28.0% to 42.3%; p< 0.001) (Figure 3). Figure 1. Appropriate Agent Run chart of percentage of encounters with antibiotic choice consistent with national guideline recommendations by discharge diagnosis. The vertical line indicates the start of outpatient antibiotic stewardship efforts in August 2018. Figure 2. Appropriate Duration Run chart of percentage of encounters with antibiotic duration consistent with national guideline recommendations. The vertical line indicates the start of outpatient antibiotic stewardship efforts in August 2018. Figure 3. Appropriate Dose Run chart of percentage of encounters with antibiotic dose consistent with national guideline recommendations. The vertical line indicates the start of outpatient antibiotic stewardship efforts in August 2018. Conclusion Our outpatient ASP improved prescribing patterns for agent, duration, and dose for many common pediatric infections in the PUC setting. Future work will focus on identifying opportunities to improve prescribing practices when antibiotics are indicated. Disclosures Brian R. Lee, PhD, MPH , Merck (Grant/Research Support)Pfizer (Grant/Research Support)

1141. Effect of the SARS-CoV-2 Pandemic on Staphylococcus aureus Colonization in Healthy Children

Background Staphylococcus aureus is a common colonizer of the skin and mucus membranes. Several investigators have reported reductions in a number of childhood infections temporally associated with social distancing/masking mandates intended to curb the SARS-CoV-2 pandemic. No data are available regarding the impact of these measures on bacterial colonization. We report preliminary results from an ongoing longitudinal S. aureus colonization study initiated just prior to the pandemic. Methods Healthy children < 18 years were recruited from 2 Houston-area primary care clinics from Nov 2019- Feb 2020. Subjects had anterior nares and axillary cultures obtained and completed questionnaires. Additional questionnaires and cultures were performed every three months for 1 year. Identified S. aureus were subjected to antimicrobial susceptibility testing as well as PCR for genes associated with tolerance to antiseptics (qacA/B, smr). Beginning in March 2020, social distancing and masking mandates were initiated. Temporary restrictions on non-essential research activities were enacted and follow-up encounters were not resumed until June 2020; subjects completed follow-up by Feb 2021. Comparison of colonization rates pre- and post-SARS-CoV-2 pandemic were performed. Results 168 children were enrolled and 75.6% completed at least 2 follow-up encounters. 51.2% were colonized at least once by S. aureus and 8.1% had MRSA colonization (Figure 1). Those with MRSA colonization were older than those without (9.6 vs. 5.8 years, p=0.04). The frequency of S. aureus colonization was stable during the study period; however, rates of MRSA colonization declined beginning in summer 2020 (Figure 2 and 3, p=0.04). There was no difference in self-reported masking/social distancing practices or any traditional MRSA risk factors among those with and without MRSA colonization in the 6-12 month follow-up period. The proportion of children colonized at least once during the course of the study period. The proportion of children colonized with S. aureus at each given time point. The dashed vertical line corresponds to initiation of physical distancing/masking mandates in our region The proportion of children colonized with MRSA at each given time point. The dashed vertical line corresponds to initiation of physical distancing/masking mandates in our region Conclusion Overall S. aureus nasal and axillary colonization in children remained relatively constant in the pre- and post-SARS-CoV-2 pandemic. A temporal association with social distancing/masking mandates and reduced MRSA colonization was observed. These findings suggest the potential impacts aggressive infection control practices may have on community MRSA colonization. Disclosures Jonathon C. McNeil, MD, Agency for Healthcare Research and Quality (Research Grant or Support)Allergan (Grant/Research Support)Nabriva (Grant/Research Support, Other Financial or Material Support, Site PI for a multicenter trial) Anthony R. Flores, MD, MPH, PhD, Nothing to disclose

MANAJEMEN SPIRITUAL DI PONDOK PESANTREN AL MUNAWWIR KRAPYAK YOGYAKARTA

This paper aims to analyze the mapping of spiritual management process in Pondok Pesantren Al-Munawwir Kolplek L Krapyak Yogyakarta. The type of research used is qualitatively descriptive with a case study approach. Data collection techniques used are interviews, observations and documentation. Spiritual management makes a bridge to the peak consciousness of human self existence in the vertical line called fitrah awareness, one consciousness that is tawhid. Management concept is understood not only to be empirical-rational by relying on the ability of the five senses and human intellectuality, but more deeply to the values of spirituality that are the main center in success with various aspects of life. The results showed that Pondok Pesantren Al Munawwir Kompleks L implemented a pesantren management system that emphasizes managerial and applies spiritual values in its management through programs realized to achieve more comprehensive and holistic goals, namely through 1) takhalli management; 2) tahalli management; 3) tajalli management.

The compensatory mechanisms for global sagittal balance in degenerative spinal kyphosis patients: a radiological analysis of muscle-skeletal associations

Background The position of the head relative to the spine can be used to evaluate the true global balance in patients with degenerative spinal kyphosis (DSK). However, it is still not clear how the position of the head is related to the spinal-pelvic parameters and lumbar muscles, which are most commonly considered. Methods Sixty-seven patients with DSK admitted in the hospital from January 2017 to January 2019 were retrospectively analyzed. All patients had whole spine X-ray and lumbar MRI. The head position parameters include: the angles of both lines joining the center of acoustic meati (CAM) to the center of the bi-coxofemoral axis (BA) (CAM-BA) and the most superior point of dentiform apophyse of C2 odontoid (OD) to BA (OD-BA) with the vertical line; the distance between the vertical line passing CAM and the posterior upper edge of the S1 (CAM-SVA). The spinal parameters include: C7 sagittal vertical axis (C7-SVA), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), and lumbar lordosis (LL). The pelvic parameters include: pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). The relative cross-sectional area (RCSA) of bilateral multifidus, erector spinae and psoas muscle at L3/4 and L4/5 segments were measured. The correlations between head position parameters and the spinal-pelvic parameters and RCSA of lumbar muscles were analyzed, respectively. Results Significant positive correlations were found between each two of CAM-SVA, C7-SVA, CAM-BA and OD-BA (p < 0.001). SS was found to be significantly positively correlated with CAM-BA (r = 0.377, p = 0.034) and OD-BA (r = 0.402, p = 0.023). CAM-BA was found to be significantly negatively correlated with TK (r = − 0.367, p = 0.039). Significant positive correlations were found between RCSA of multifidus at L3/4 level and CAM-SVA (r = 0.413, p = 0.021), CAM-BA (r = 0.412, p = 0.019) and OD-BA (r = 0.366, p = 0.04). Conclusions Our study showed that the head position relative to the spine were significantly correlated to some spinal-pelvic parameters, and the lower lumbar multifidus muscle. The compensatory mechanisms of the global sagittal balance status should also involve the head position area.

Temporal and spatial relationship between gluteal muscle Surface EMG activity and the vertical component of the ground reaction force during walking

Background Optimized temporal and spatial activation of the gluteal intermuscular functional unit is essential for steady gait and minimized joint loading. Research question To analyze the temporal relationship between spatially resolved surface EMG (SEMG) of the gluteal region and the corresponding ground reaction force (GRF). Methods Healthy adults (29♀; 25♂; age 62.6±7.0 years) walked at their self-selected slow, normal, and fast walking speeds on a 10 m walkway (ten trials/speed). Bilateral paired eight-electrode strips were horizontally aligned at mid-distance of the vertical line between greater trochanter and iliac crest. Concerning the ventral to dorsal direction, the center of each strip was placed on this vertical line. Initially, these signals were monopolarly sampled, but eight vertically oriented bipolar channels covering the whole gluteal region from ventral to dorsal (P1 to P8) were subsequently calculated by subtracting the signals of the corresponding electrodes of each electrode strip for both sides of the body. Three vertical bipolar channels represented the tensor fasciae latae (TFL; P2), gluteus medius (Gmed, SENIAM position; average of P4 and P5), and gluteus maximus muscles (Gmax; P7). To determine the interval between SEMG and corresponding GRF, the time delay (TD) between the respective first amplitude peaks (F1) in SEMG and vertical GRF curves was calculated. Results Throughout the grand averaged SEMG curves, the absolute amplitudes significantly differed among the three walking speeds at all electrode positions, with the amplitude of the F1 peak significantly increasing with increasing speed. In addition, when normalized to slow, the relative SEMG amplitude differences at the individual electrode positions showed an impressively homogeneous pattern. In both vertical GRF and all electrode SEMGs, the F1 peak occurred significantly earlier with increasing speed. Also, the TD between SEMG and vertical GRF F1 peaks significantly decreased with increasing speed. Concerning spatial activation, the TD between the respective F1 peaks in the SEMG and vertical GRF was significantly shorter for the ventral TFL position than the dorsal Gmed and Gmax positions, showing that the SEMG F1 peak during this initial phase of the gait cycle occurred earlier in the dorsal positions, and thus implying that the occurrence of the SEMG F1 peak proceeded from dorsal to ventral. Significance Tightly regulated spatial and temporal activation of the gluteal intermuscular functional unit, which includes both speed- and position-dependent mechanisms, seems to be an essential requirement for a functionally optimized, steady gait.