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Polymers are often used to increase oil recovery by improving sweeping efficiency. The screening was carried out as a first step in evaluating the test parameters of several polymers of the Hydrolyzed Polyacrylamide (HPAM) type in fluid and sandstone reservoir rocks. The test was carried out using a reservoir fluid classified as light oil (35°API) and at a reservoir temperature (60°C). The HPAM polymers used are A1, F1, F2, F3, and P1 polymers. The test parameters carried out on these 5 types of polymer (A1, F1, F2, F3 dan P1) include a compatibility test for formation water. The rheology polymer test includes concentration vs Tres, and shear rate vs viscosity which aims to determine the type of polymer solution being tested is a non-Newtonian or pseudoplastic fluid group. Thermal stability test of polymer for 60 days to determine the stability of the polymer solution and whether it is degraded or stable. Filtration testing with criteria FR value 1.2, screen factor test, and adsorption testing using the static method with a standard limit of adsorption value 400 µg/gr and polymer injectivity test. From these tests, scoring (range 0-100) was carried out to determine polymer candidates in polymer flooding testing. The F1 polymer candidate for the sandstone reservoir was obtained with a score of 82.25. From the scoring results, the selected F1 polymer candidate has a concentration value of 2000 ppm. For thermal degradation, the polymer F1 2000 ppm experienced degradation of 15.5%. The results of the F1 2000 ppm polymer static adsorption test were 54.8 µg/gr. With the RRF = 1 value indicating rock permeability after injection of polymer F1 2000 ppm, it tends not to experience plugging due to injection of polymer solution.

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This study carry out a content analysis on the features of School Heads Development Program (SHDP) project outputs of school heads in the DepEd Schools Division of Sorsogon Province, Philippines. As part of the content analysis, the SHDP project outputs were categorized for instructional leadership. Also, the management beliefs and practices of school heads on instructional leadership along two-dimensional contracts were out in this study. The statistical tool used were Spearman and computed through the SPSS software program. The results were presented by frequencies in a descriptive way. The date collection technique was survey questionnaire and interview. The results indicated that the features were done, generative, systematic, standard-based and shared manner. School heads’ beliefs are strongly they frequently practiced instructional leadership. It can be concluded also that the management beliefs and practices of school heads on instructional leadership have significant relationship on communicating the school goals to conflict management as leadership process likewise, maintain high visibility to change process, meaning that school heads make use of leadership processes to perform well the instructional leadership function of an instructional leader.

The block of voltage-dependent sodium channels by saxitoxin (STX) and tetrodotoxin (TTX) was investigated in voltage-clamped squid giant axons internally perfused with a variety of permeant monovalent cations. Substitution of internal Na+ by either NH4+ or N2H5+ resulted in a reduction of outward current through sodium channels under control conditions. In contrast, anomalous increases in both inward and outward currents were seen for the same ions if some of the channels were blocked by STX or TTX, suggesting a relief of block by these internal cations. External NH4+ was without effect on the apparent magnitude of toxin block. Likewise, internal inorganic monovalent cations were without effect, suggesting that proton donation by NH4+ might be involved in reducing toxin block. Consistent with this hypothesis, decreases in internal pH mimicked internal perfusion with NH4+ in reducing toxin block. The interaction between internally applied protons and externally applied toxin molecules appears to be competitive, as transient increases in sodium channel current were observed during step increases in intracellular pH in the presence of a fixed STX concentration. In addition to these effects on toxin block, low internal pH produced a voltage-dependent block of sodium channels and enhanced steady-state inactivation. Elevation of external buffer capacity only marginally diminished the modulation of STX block by internal NH4+, suggesting that alkalinization of the periaxonal space and a resultant decrease in the cationic STX concentration during NH4+ perfusion may play only a minor role in the effect. These observations indicate that internal monovalent cations can exert trans-channel influences on external toxin binding sites on sodium channels.

Objectives: Using bilateral internal thoracic arteries (BITA) for coronary artery bypass grafting (CABG) has been suggested to improve survival compared to CABG using single internal thoracic arteries (SITA) for patients with advanced coronary artery disease. We used data from the Arterial Revascularisation Trial (ART) to assess long-term cost-effectiveness of BITA grafting compared to SITA grafting from an English health system perspective. Methods: Resource use, healthcare costs and quality-adjusted life-years (QALYs) were assessed across 10-years of follow-up. An intention-to-treat analysis of differences between trial arms was conducted. Missing data were addressed using multiple imputation. Incremental cost-effectiveness ratios were calculated with uncertainty characterised using non-parametric bootstrapping. Results were extrapolated beyond 10 years using Gompertz functions for survival and linear models for total cost and utility. Results: Total mean costs at 10 years of follow-up were estimated at £17,594736 in the BITA arm and £16,462594 in the SITA arm (mean difference £1,133118 95% CI £239195 to £2,026041, p= 0.01520). Total mean QALYs at 10 years were 6.54 in the BITA are and 6.57 in the SITA arm (adjusted mean difference -0.01 95% CI -0.2 to 0.1, p= 0.883). The estimated probability of BITA grafting being cost-effective compared to SITA grafting was 33% over 10 years of follow-up assuming a cost-effectiveness threshold of £20,000. Mean costs extrapolated to life-time increased to £20,760 in the SITA arm and £21,925 in the BITA arm. Mean QALYs extrapolated to life-time were 12.52 in the SITA arm and 12.61 in the BITA arm., The probability of BITA being cost-effective at a £20,000 threshold increased to 5160% when extrapolated to lifetime. Conclusions: BITA grafting has significantly higher costs but similar quality-adjusted survival at 10 years compared to SITA grafting.

Introduction:New-onset atrial fibrillation (NOAF) is a common arrhythmia in patients on an intensive care unit (ICU). NOAF in this setting is associated with adverse short and long-term outcomes. Little is known about modifiable risk factors for NOAF. Developing a model to identify patients at high risk of developing NOAF is vital for future studies investigating prevention strategies to allow stratification, sample enrichment and efficient study design. Methods:We will use data from 7 general ICUs in the UK and USA to develop a predictive model for NOAF. We will assess whether including longitudinal, dynamic predictors, along with the use of machine learning approaches improves model predictive ability. Generalisability and Implications:This work will be the largest assessment of predictors of NOAF in patients treated on a general ICU. It will be the first to analyse international data to ensure worldwide applicability. A detailed understanding of modifiable risk factors underpins future work to prevent NOAF in these patients.

Objective:Malignant Pleural Mesothelioma (MPM) has a poor prognosis and high symptom burden. RESPECT-Meso was a multicentre randomised study examining the role of early specialist palliative care (SPC) on quality of life (QoL) with MPM. This is a post-hoc exploratory analysis of the symptom burden and unmet needs identified from RESPECT-Meso participants. Methods: Exploratory analysis from 174 participants using the General Health Status (GHS) measure (from the EORTCQLQ-C30 QoL questionnaire) and 87 participants using validated assessment questionnaires in those randomised to SPC. Eligibility for the study included confirmed MPM with diagnosis Results: Participants were predominantly male (79.9%), mean age 72.8 years, PS was 0 in 38%, 78% of MPM was epithelioid. At least three symptoms were reported in 69.8% of participants, including fatigue (81%), dyspnoea (73.3%), pain (61.2%), weight loss (59.3%). Anxiety was reported by 54.7% of participants, 52.3% low mood and 48.8% anhedonia symptoms. After multivariable adjustment, only pain remained statistically significant with a hazard ratio (HR) 2.9 (95% CI 1.3-6.7; p=0.01). For each 1 unit increase in GHS score, the HR for death was 0.987 (0.978-0.996; p=0.006), indicating a worse reported QoL is related to shorter survival. Unmet needs were common: 25.9% wanted more information about their condition, 24.7% about their care and 21.2% about their treatment. 79.1% were concerned about the effect of their illness on family. Conclusion: There is a high symptom burden in mesothelioma despite good baseline performance status. A worse QoL is associated with a worse survival. Unmet needs are common, perhaps highlighting a need for improved communication and information sharing.