The Impact of Sulfate Level Reduction on Seawater Injection Economics: Using Sulfate Scale Precipitation Kinetics to Our Advantage

ADNOC Onshore plans to use seawater as alternative to aquifer water, its source of injection water for over 40 years. However, using seawater for injection introduces a sulfate scaling risk due to incompatibility with formation water. Sulfate in the seawater and cations in the formation water (Ca, Sr) are likely to precipitate, causing scaling and related flow assurance problems and formation damage. Sulfate can be removed from the injection water by means of desulfation, but sulfate removal to well below its scaling concentration is CAPEX intensive and negatively impacts seawater flooding economics. In this paper, the economic benefits of partial sulfate reduction are evaluated, by finding a balance between controllable scaling and costs for inhibition and sulfate removal.

341 Observational multicentre study on effectiveness and tolerability of Alirocumab in real world, the OMERO study: interim data from the first 699 patients

Aims OMERO is a prospective study, aimed to assess the long-term effectiveness, tolerability, and safety of alirocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9-i), in the real life in Italy. The study is planned to include 800 patients, from 40 Italian sites, treated with alirocumab on top of standard lipid lowering therapy. Methods and results This analysis concerns 699 (out of 800) patients with all data available: 65.5% male; mean age 60.6 ± 11.09 years; 29.6% with HeFH in primary prevention; 70.4% in secondary prevention (with/without HeFH). Before ALI administration, 461 patients (66%) were treated with statins while 231 (33%) reported statin intolerance, that resulted in the statin discontinuation. Mean baseline LDL-C was 161.5 ± (53.07) mg/dl. Based on clinical judgement, ALI was initially prescribed at 75 mg Q2W dosing regimen in 60.80% of participants, whereas the remainder received 150 mg Q2W. At V1 57 patients (89.06%) switch from 75 mg Q2W to 150 mg Q2W and 7 patients (10.94%) from 150 mg Q2W to 75 mg Q2W. LDL-C level reduction from baseline (before ALI administration) to 6 months from the study enrolment (V1), was −45% (V1: mean LDL-C was 73.5 ± 45.70 mg/dl). LDL-C levels at V1 by participant category are shown in Figure 1. The rate of patients with at least one adverse event was 25.6% (of which SAE 7.4%); the rate of patients with at least one related adverse reaction to treatment was 3.8% none of them were serious. Conclusions OMERO confirmed in clinical practice the results observed in trials: a significant reduction of LDL-C was observed with ALI 75/150 mg Q2W in participants at high CV risk with or without HeFH. ALI was generally well tolerated.

Safety and efficacy of esaxerenone in Japanese hypertensive patients with heart failure with reduced ejection fraction: A retrospective study

Esaxerenone, a mineralocorticoid receptor blocker (MRB), is a new antihypertensive agent. However, esaxerenone-related data with respect to hypertension with heart failure are limited. We investigated the safety and efficacy of esaxerenone in hypertensive patients with heart failure with reduced ejection fraction (HFrEF). Hypertensive patients with HFrEF treated with esaxerenone were retrospectively analyzed at two timepoints (short-term: 35±15 days; mid-term: 167±45 days). Adverse events including hyperkalemia (K+ >5.5 mEq/L), worsening renal function (WRF; estimated glomerular filtration rate (eGFR) reduction by ≥20%), and hypotension (systolic blood pressure <90 mmHg) were evaluated. eGFR and K+, serum creatinine, and brain natriuretic peptide (BNP) levels at baseline, short-term, and mid-term assessments were compared. Patients administered esaxerenone as their first MRB (first-MRB cohort) and those who converted from another MRB (conversion cohort) were separately analyzed. There were 50 (56±10 years old, 26% female) patients. At the short-term assessment, hyperkalemia or hypotension was not observed at a dose of 2.0±0.9 mg/day. Seven patients (14%) showed WRF. K+ was slightly elevated (4.12±0.41 to 4.25±0.39 mmol/L, p = 0.07) and eGFR was significantly reduced (66.9±19.6 mL/min/1.73 m2 to 62.4±19.7 mL/min/1.73 m2, p = 0.006). In the conversion cohort, significant changes in K+ and eGFR from baseline were not observed at the short-term assessment. BNP levels were consistently improved regardless of the cohorts (first-MRB cohort, 310 [110–370] pg/mL to 137 [47–152] pg/mL, p = 0.001; conversion cohort, 181 [30–203] pg/mL to 108 [26–146] pg/mL, p = 0.028). At the mid-term assessment, there were no significant changes in K+ and eGFR compared with the short-term assessment. In conclusion, esaxerenone was safe for hypertensive patients with HFrEF. Hyperkalemia and hypotension were rarely noted, while eGFR was marginally reduced. Moreover, esaxerenone might be beneficial for HFrEF in terms of BNP level reduction.

Prediction and analysis of sound field in long enclosures with a modal-based method

In this paper, the efficacy of porous ceiling treatment to reduce noise levels inside a typical tunnel is examined with a validated modal-based prediction method. It is found that, for a point source, the effect of increasing porous ceiling thickness on sound pressure level (SPL) attenuation along the tunnel is limited. A porous ceiling with thickness of 0.3 m is comparable with an infinite porous ceiling in middle and high frequency ranges. For a line source, the effect of ceiling thickness on SPL reduc- tion in this typical tunnel is limited. Sound pressure level reduction of 4 dBA is real- ized with 0.3 m porous ceiling, which is the same as infinite ceiling and only 1 dBA smaller than the theoretically optimized value. These results suggest that, in the event only ceiling treatment is considered, 0.3 m porous material is sufficient for noise re- duction in this typical tunnel.

A Survey Study of Audiology Services during the Coronavirus Disease 2019 Pandemic in South Korea

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has severely affected public health and people’s lifestyle. The purpose of this survey study is to investigate audiology services during COVID-19 pandemic to understand the current audiology service situations in Korea and to improve audiology services.Methods: A total of 120 participants (60 audiologists and 60 clients visiting audiologists) were surveyed in this study using online or face-to-face methods. The participants answered 24~25 questions including current status of audiology service, communication difficulties with wearing masks, and the provision of tele-audiology services during COVID-19.Results: The results showed that both audiologists and clients with hearing loss still preferred face-to-face audiology services in COVID-19 situation in spite of 56% of visiting schedule delay and cancellation. The primary audiology services they considered in COVID-19 were hearing aid fitting and maintenance & repair services. Wearing masks has led communication difficulties in both audiologists and clients with hearing loss due to speech level reduction, frequency filtering of sounds, and insufficient visual cues during the conversation. Only 30% of audiologists have provided tele-audiology services, and 4.4% of clients received tele-audiology services during COVID-19.Conclusion: The impacts of COVID-19 in audiology services in South Korea are still progressing. The technical and administrative systems and educational support to improve audiology services in South Korea are necessary.

A dismantling study on imaginal retraining in overweight or obese women

Imaginal retraining is a variant of approach bias modification and transfers the method into one’s own mind. As the technique contains multiple elements, this pilot study aimed to dismantle which of its components is most efficient in reducing craving for high-calorie food. A total of 113 women were randomly allocated to one out of six conditions containing a short intervention to mentally manipulate a picture displaying high-calorie foods. Four of the interventions involved different combinations of elements of the imaginal retraining technique, while the remaining two conditions comprised thought suppression or merely observing a picture. Participants rated their level of craving, as well as three pictures containing healthy and unhealthy foods regarding their pleasantness before and after the interventions took place. Within-group changes were assessed with paired t-tests (in case of non-normal data Wilcoxon paired t-tests) and between-group differences with one-way ANOVAs (non-parametric Kruskal–Wallis tests). A trend level reduction in craving was found in the imaginal retraining condition with and without a movement. A post hoc analysis of both conditions joint together showed a statistically significant reduction in craving. In addition, positive picture appraisal for unhealthy foods was significantly reduced in both imaginal retraining conditions (with and without movement) with medium to large effect sizes. This study demonstrated that imaginal retraining with an arm movement can reduce craving and picture appraisal for high-calorie foods significantly in a one-time application. It is a promising technique to reduce appraisal for unhealthy high-calorie foods. Future studies should repeat the experiment in situations of high craving and allow for a personalized selection of stimuli.

The Effect of Medical Cannabis on Pain Level and Quality of Sleep among Rheumatology Clinic Outpatients

Introduction. Medical cannabis (MC) is becoming increasingly popular for the treatment of chronic pain conditions. In this study, we evaluated the effect of MC treatment on pain level and quality of sleep of patients with different medical conditions at the rheumatology clinic. Methods. Patients licensed for the use of MC at the rheumatology clinics at different settings were located and contacted. Their demographic and clinical parameters were documented, including type of medical cannabis consumed, way of consumption, and current monthly consumed amount. These patients were contacted by phone and asked about the effect on pain level and quality of sleep. Results. A total of 351 patients were located, and 319 completed the questionnaire. Mean age was 46 ± 12 years, 76% were female, 82% had fibromyalgia, ∼9% had mechanical problems, ∼4% had inflammatory problems, ∼4% had neurological problems, and ∼1% had other problems. The average monthly consumed dose of MC was 31, 35, 36, and 32 g, with mean pain level reduction of 77%, 82%, 83%, and 57%, and mean sleep quality improvement of 78%, 71%, 87%, and 76% among patients with fibromyalgia, mechanical, neuropathic, and inflammatory problems, respectively. Mean THC and CBD contents were 18.38% ± 4.96 and 2.62% ± 4.87, respectively. The THC concentration, duration of MC consumption, and MC consumption dose had independent significant correlations with pain reduction while only the duration of MC consumption had an independent significant correlation with sleep quality improvement. Conclusions. MC had a favorable effect on pain level and quality of sleep among all spectrums of problems at the rheumatology clinic.