PETMiner - A visual analysis tool for petrophysical properties of core sample data

The aim of the PETMiner software is to reduce the time and monetary cost of analysing petrophysical data that is obtained from reservoir sample cores. Analysis of these data requires tacit knowledge to fill ‘gaps’ so that predictions can be made for incomplete data. Through discussions with 30 industry and academic specialists, we identified three analysis use cases that exemplified the limitations of current petrophysics analysis tools. We used those use cases to develop nine core requirements for PETMiner, which is innovative because of its ability to display detailed images of the samples as data points, directly plot multiple sample properties and derived measures for comparison, and substantially reduce interaction cost. An 11-month evaluation demonstrated benefits across all three use cases by allowing a consultant to: (1) generate more accurate reservoir flow models, (2) discover a previously unknown relationship between one easy-to-measure property and another that is costly, and (3) make a 100-fold reduction in the time required to produce plots for a report

Mass Drug Administration and beyond: how can we strengthen health systems to deliver complex interventions to eliminate neglected tropical diseases?

Achieving the 2020 goals for Neglected Tropical Diseases (NTDs) requires scale-up of Mass Drug Administration (MDA) which will require long-term commitment of national and global financing partners, strengthening national capacity and, at the community level, systems to monitor and evaluate activities and impact. For some settings and diseases, MDA is not appropriate and alternative interventions are required. Operational research is necessary to identify how existing MDA networks can deliver this more complex range of interventions equitably. The final stages of the different global programmes to eliminate NTDs require eliminating foci of transmission which are likely to persist in complex and remote rural settings. Operational research is required to identify how current tools and practices might be adapted to locate and eliminate these hard-to-reach foci. Chronic disabilities caused by NTDs will persist after transmission of pathogens ceases. Development and delivery of sustainable services to reduce the NTD-related disability is an urgent public health priority. LSTM and its partners are world leaders in developing and delivering interventions to control vector-borne NTDs and malaria, particularly in hard-to-reach settings in Africa. Our experience, partnerships and research capacity allows us to serve as a hub for developing, supporting, monitoring and evaluating global programmes to eliminate NTDs

Comparison of Primary Open Angle Glaucoma Patients in Rural and Urban Ghana

Purpose: To compare the clinical features of glaucoma patients who present at a rural hospital in North Eastern Ghana and an urban hospital in the capital city of Accra.Methods: This is a multi-center retrospective case series involving records of newly diagnosed glaucoma patients with emphasis on primary open angle glaucoma (POAG). Information collected included basic demographic data, intraocular pressures and optic disc measurements.Results: A total of 949 patients (437 rural; 512 urban; 1868 eyes) were included. Rural vs. urban comparisons, respectively: mean age, 53.2 ± 16.3 vs. 54.5 ± 16.4 years; male: female ratio, 3:2 vs. 1:1; POAG, 78.1% vs. 50.6%; POAG suspect, 10.3% vs. 41.9%; IOP, 39.2 ± 7.1 vs. 31.8 ± 7.3 mmHg; bilateral blindness, 34.1% vs. 17.5%; uniocular blindness, 52.2% vs. 32.9%. Females at the rural hospital were twice as likely to present blind in at least one eye (OR 2.04, CI 1.36 - 3.07, p<0.001).Conclusions: Patients with POAG at the rural hospital present with more advanced disease characteristics.Keywords: glaucoma, open angle,Ghana, Urban, rura

Can feedback approaches reduce unwarranted clinical variation? A systematic rapid evidence synthesis.

BACKGROUND:Assessment of clinical variation has attracted increasing interest in health systems internationally due to growing awareness about better value and appropriate health care as a mechanism for enhancing efficient, effective and timely care. Feedback using administrative databases to provide benchmarking data has been utilised in several countries to explore clinical care variation and to enhance guideline adherent care. Whilst methods for detecting variation are well-established, methods for determining variation that is unwarranted and addressing this are strongly debated. This study aimed to synthesize published evidence of the use of feedback approaches to address unwarranted clinical variation (UCV). METHODS:A rapid review and narrative evidence synthesis was undertaken as a policy-focused review to understand how feedback approaches have been applied to address UCV specifically. Key words, synonyms and subject headings were used to search the major electronic databases Medline and PubMed between 2000 and 2018. Titles and abstracts of publications were screened by two reviewers and independently checked by a third reviewer. Full text articles were screened against the eligibility criteria. Key findings were extracted and integrated in a narrative synthesis. RESULTS:Feedback approaches that occurred over a duration of 1 month to 9 years to address clinical variation emerged from 27 publications with quantitative (20), theoretical/conceptual/descriptive work (4) and mixed or multi-method studies (3). Approaches ranged from presenting evidence to individuals, teams and organisations, to providing facilitated tailored feedback supported by a process of ongoing dialogue to enable change. Feedback approaches identified primarily focused on changing clinician decision-making and behaviour. Providing feedback to clinicians was identified, in a range of a settings, as associated with changes in variation such as reducing overuse of tests and treatments, reducing variations in optimal patient clinical outcomes and increasing guideline or protocol adherence. CONCLUSIONS:The review findings suggest value in the use of feedback approaches to respond to clinical variation and understand when action is warranted. Evaluation of the effectiveness of particular feedback approaches is now required to determine if there is an optimal approach to create change where needed

Early Clinical and Subclinical Visual Evoked Potential and Humphrey's Visual Field Defects in Cryptococcal Meningitis.

Cryptococcal induced visual loss is a devastating complication in survivors of cryptococcal meningitis (CM). Early detection is paramount in prevention and treatment. Subclinical optic nerve dysfunction in CM has not hitherto been investigated by electrophysiological means. We undertook a prospective study on 90 HIV sero-positive patients with culture confirmed CM. Seventy-four patients underwent visual evoked potential (VEP) testing and 47 patients underwent Humphrey's visual field (HVF) testing. Decreased best corrected visual acuity (BCVA) was detected in 46.5% of patients. VEP was abnormal in 51/74 (68.9%) right eyes and 50/74 (67.6%) left eyes. VEP P100 latency was the main abnormality with mean latency values of 118.9 (±16.5) ms and 119.8 (±15.7) ms for the right and left eyes respectively, mildly prolonged when compared to our laboratory references of 104 (±10) ms (p<0.001). Subclinical VEP abnormality was detected in 56.5% of normal eyes and constituted mostly latency abnormality. VEP amplitude was also significantly reduced in this cohort but minimally so in the visually unimpaired. HVF was abnormal in 36/47 (76.6%) right eyes and 32/45 (71.1%) left eyes. The predominant field defect was peripheral constriction with an enlarged blind spot suggesting the greater impact by raised intracranial pressure over that of optic neuritis. Whether this was due to papilloedema or a compartment syndrome is open to further investigation. Subclinical HVF abnormalities were minimal and therefore a poor screening test for early optic nerve dysfunction. However, early optic nerve dysfunction can be detected by testing of VEP P100 latency, which may precede the onset of visual loss in CM

Isolation and characterization of renin-like aspartic-proteases from Echis ocellatus venom

Three aspartic proteases (SVAPs) have been isolated from venom of the saw-scaled viper, Echis ocellatus. In confirmation of prior transcriptomic predictions, all three forms match to sequences of either of the two SVAP transcripts (EOC00051 and EOC00123), have a molecular weight of 42 kDa and possess a single N-glycan. The SVAPs act in a renin-like manner, specifically cleaving human and porcine angiotensinogen into angiotensin-1 and possess no general protease activity. Their activity is completely inhibited by the aspartyl protease inhibitor Pepstatin A

Mountain rock glaciers contain globally significant water stores

This is the author accepted manuscript. The final version is available from Springer Nature via the DOI in this recordGlacier- and snowpack-derived meltwaters are threatened by climate change. Features such as rock glaciers (RGs) are climatically more resilient than glaciers and potentially contain hydrologically valuable ice volumes. However, while the distribution and hydrological significance of glaciers is well studied, RGs have received comparatively little attention. Here, we present the first near-global RG database (RGDB) through an analysis of current inventories and this contains >73,000 RGs. Using the RGDB, we identify key data-deficient regions as research priorities (e.g., Central Asia). We provide the first approximation of near-global RG water volume equivalent and this is 83.72 ± 16.74 Gt. Excluding the Antarctic and Subantarctic, Greenland, and regions lacking data, we estimate a near-global RG to glacier water volume equivalent ratio of 1:456. Significant RG water stores occur in arid and semi-arid regions (e.g., South Asia East, 1:57). These results represent a first-order approximation. Uncertainty in the water storage estimates includes errors within the RGDB, inherent flaws in the meta-analysis methodology, and RG thickness estimation. Here, only errors associated with the assumption of RG ice content are quantified and overall uncertainty is likely larger than that quantified. We suggest that RG water stores will become increasingly important under future climate warming.This work was supported by the Natural Environment Research Council (grant number NE/L002434/1 to D.B.J.). S.H. and R.A.B. received funding from the European Union Seventh Framework Programme FP7/2007-2013 under grant agreement no 603864 (HELIX: High-End cLimate Impacts and eXtremes; www.helixclimate.eu). The work of R.A.B. forms part of the BEIS/Defra Met Office Hadley Centre Climate Programme GA01101

Why Some Interfaces Cannot be Sharp

A central goal of modern materials physics and nanoscience is control of materials and their interfaces to atomic dimensions. For interfaces between polar and non-polar layers, this goal is thwarted by a polar catastrophe that forces an interfacial reconstruction. In traditional semiconductors this reconstruction is achieved by an atomic disordering and stoichiometry change at the interface, but in multivalent oxides a new option is available: if the electrons can move, the atoms don`t have to. Using atomic-scale electron energy loss spectroscopy we find that there is a fundamental asymmetry between ionically and electronically compensated interfaces, both in interfacial sharpness and carrier density. This suggests a general strategy to design sharp interfaces, remove interfacial screening charges, control the band offset, and hence dramatically improving the performance of oxide devices.Comment: 12 pages of text, 6 figure

Social problems in oncology

A study was undertaken to describe, evaluate and categorise the social problems experienced by cancer patients. Ninety-six adult cancer patients at all stages of disease participated in either a telephone focus group discussion, a face to face focus group or an individual interview which were tape recorded and transcribed. Six experts analysed the transcripts. A total of 32 social problems were identified categorized under eight headings plus four single items. The categories were: problems with (1) managing in the home, (2) health and welfare services, (3) finances, (4) employment, (5) legal matters, (6) relationships, (7) sexuality and body image and (8) recreation. Problems with relationships and communication were the most frequently reported with financial, employment, body image and domestic problems also being widely endorsed. Female groups, younger patient groups and groups where the aim of treatment was palliative reported more social problems than other groups. Social problems are common and important to cancer patients. The social problems identified in this study will contribute to an item pool generated for developing a Social Problems Inventory that may be included in patient centred assessment as part of routine oncology practice