Purpose In recent years the tumor microenvironment and its interaction with the tumor has emerged into research focus with increased attention to the composition of Tumor-infiltrating lymphocytes. We wanted to quantify the composition of Regulatory T cells (Tregs) and T helper 17 cells (Th17 cells) and their prognostic impact in high-grade serous tubo-ovarian carcinoma. Methods Tregs and Th17 cells were determined by immunohistochemical analysis of CD25 FoxP3 and RORγt, respectively on tissue microarrays of a cohort of 222 patients with reviewed histology and available clinical data. Expression was analyzed with Qupath for quantification and integration with clinical data enabled calculation of prognostic impact. For validation FOXP3 and RORC mRNA expression levels from 502 patients with HGSC in publicly available datasets were evaluated. Results An average percentage of 0.93 Tregs and of 0.06 Th17 cells was detected per cells in overall tissue. Optimal cut-offs were determined and higher Tregs were associated with a better overall survival in stroma (p = 0.006), tumor area (p = 0.0012) and overall tissue (p = 0.02). After accounting for well-known prognostic factors age at diagnosis, residual tumor and FIGO stage, this association remained significant for stromal Tregs with overall survival (p = 0.02). Survival analysis for Th17 cells revealed no significant association with survival rates. Moreover, lower Th17/Treg ratios had a positive impact on patient overall survival (p = 0.025 tumor, p = 0.049 stroma and p = 0.016 overall tissue). Conclusion Our results outline a positive prognostic effect for higher Tregs but not for Th17 in high grade serous tubo-ovarian carcinoma.
Setting cement plugs for sidetrack operations is a critical, challenging, and time-consuming operation. In many cases, a successful sidetrack operation requires several cement plug attempts or lengthy drilling operations, resulting in increased operation cost. In the past, when required to sidetrack a well, cement kickoff plugs were regularly tagged without having achieved the desired compressive strength, with added risk of stuck pipe in soft cement and increased wait-on-cement (WOC) time. The poor cement plugs usually resulted in a time drilling operation after additional WOC time. Placing a successful kickoff-plug (KOP) consistently on the first attempt is required for a cost-effective sidetrack operation, which, by itself, is considered an additional cost to any drilling project. In the Awali field in Bahrain, drilling operations faced the challenge of increased loss time in KOP operations. Operator wanted to reduce WOC time by improving the performance of the cement KOPs. The target was to complete the sidetrack operation in well depths less than 3,000 ft and static temperatures of about 140°F within 8 to 12 hr, after the cement plug has been placed.A thorough analysis of previous design and execution cement practices was performed to identify the actions needed to optimize the previous performance of cement plugs. Advanced cement plug optimization software was used to support the evaluation of the risks associated with the placement of the slurry. Data from extensive laboratory testing of several cement slurry systems were used to evaluate the effect of the slurry properties on optimizing the system deemed most suitable for this application. The studies also included a detailed review of the industry best practices that are applicable to the conditions of the field. The results of the implemented best practices for the design and execution of KOPs in shallow wells in the field under study demonstrated an improvement of the success rate to 100% and better cement plug performance, contributing significantly to minimizing the time and cost of performing sidetrack operations.
The well services division of an oilfield services company in Kuwait initiated a safety campaign to support field personnel in a proactive approach to personnel injury prevention. The initiative targets the root causes of personnel injury incidents; i.e., human behavior, poor hazard identification, failure to intervene and stop at-work risk behaviors, and non-compliance with recommended procedures and standards. The foundation of the campaign is the personal commitment from all employees involved to follow safe work procedures at all times. Additionally, the initiative established the role of a safety coach who observes crews at work, identifies potentially unsafe situations and intervenes when necessary, coaches individuals, challenges performance, and leads safety meetings focused on individual tasks or subtasks. Management is actively involved in the campaign by making safety visits to wellsites, to better understand the issues facing the crews, demonstrate support of the crews, and participate in the observation and intervention program. Inventories of the tasks at each wellsite are incorporated into site-specific risk assessments. Compliance to standards is supported by ensuring that the standards are clear and are understood by all of the field personnel. Complementing the safety campaign were exercises to help the personnel understand how an individual’s personality impacts their response to different situations. After these activities, debriefing sessions were conducted to highlight positive behaviors, identify areas for improvement, compile lessons learned, and formulate action items. The most important result of the campaign to date is a reduction in the incident rate for the pumping services unit to zero incidents. In addition, the increase in the reporting rate of hazardous situations, interventions following observation, and field audits indicates that the campaign heightens safety awareness and understanding of safe practices. This campaign is currently being extended to other segments in Kuwait and is being pilot tested by a major drilling contractor with the support of the operator.
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