Cathedral Health Services

Conducting multicenter, longitudinal epidemiological studies on emerging pathogens in real time during health emergencies presents significant challenges, especially in low- and middle-income countries, where substantial logistical and resource constraints hinder the rapid design and implementation of research protocols. This is particularly difficult when the disease spreads rapidly and its nature changes due to the onset of vaccination. During the COVID-19 pandemic, a cohort study (AVISA) was conducted in eleven research sites to assess seroprevalence. The objective of this study is to identify the challenges to the successful execution of the AVISA study through a retrospective analysis of quantitative and qualitative indicators. The rapid spread of SARS-CoV-2 infections, particularly in large urban areas in Brazil, and the initiation of COVID-19 vaccination in January 2021 posed significant challenges for recruiting individuals who met the eligibility criteria. Participant enrollment was slower than initially planned, and fewer participants from the youngest and oldest cohorts were recruited. The implementation of the study protocol encountered significant logistical and operational challenges due to the evolving COVID-19 context, including the effects of vaccination, the loosening of social distancing measures, and difficulties conducting household visits and collecting samples in high-risk areas. To ensure participant retention and protocol adherence, the study employed flexible strategies, including rescheduling visits, enhancing communication, and mobilizing experienced staff, which were crucial for maintaining data collection and study continuity over time. Despite concurrent demands of the COVID-19 response, Instituto Butantan and its partners successfully mobilized resources, staff, and infrastructure to conduct the AVISA study across 11 sites, leveraging existing collaborations from prior clinical trials. The study conducted over 16,000 household visits, collected nearly 7,000 blood samples, and gathered detailed clinical and sociodemographic data from participants. Despite the complexities of conducting real-time research during a public health emergency, the AVISA study demonstrated that large-scale, multi-site longitudinal studies can be implemented in resource-constrained settings through adaptive strategies, institutional partnerships, and flexible field operations. The lessons learned offer essential insights for strengthening the design and execution of epidemiological studies in future health emergencies, particularly in low- and middle-income contexts.

The castle of Petropigi is a small, ruined castle near the village of Petropigi, 20 km east of the town of Kavala in the province of Eastern Macedonia in northern Greece. It is situated on the narrow coastal plain between the delta of the river Nestos and the foothills of the Rhodopi Mountains, close to the modern road, which was only recently replaced by the new EU-funded Via Egnatia, which is carved into the hills behind the village. The excavation (1993-1999) was conducted by a team of Norwegian archaeologists led by Professor Siri Sande. The project was initiated by The Norwegian Institute of Athens in cooperation with the Ephorate of Byzantine Antiquities of Eastern Macedonia in Kavala, led by Dr Charalambos Bakirtzis. The castle of Petropigi had a function that was very unusual in Western Europe, as it was built by the Byzantine state to protect a stretch of an important communication route between Constantinople and Thessaloniki, the two largest cities of the Byzantine Empire.

Les travaux de sculpture à la cathédrale de Strasbourg entre 1888 et 1934, ou la néogothisation du Dom — La cathédrale de Strasbourg, suite aux dommages de la Révolution française, reçoit pendant plus de 135 ans des restitutions de sa statuaire, par différents artistes. À cette fin, six sculpteurs se succèdent à la tête de l’atelier de sculpture de l’Œuvre Notre-Dame, pour tenter de rendre l’image primitive du monument. Après l’annexion de l’Alsace à l’Allemagne, une nouvelle approche en matière de restauration de la cathédrale est mise en place, avec un accent prononcé sur la préservation des parties anciennes, et la volonté de produire des figures aux formes d’inspiration gothique. Cela se fait toutefois sans abandonner l’ajout de parties nouvelles, avec des remplacements de la statuaire non médiévale. Nous percevons ainsi, après 1890, un changement qui s’opère progressivement au niveau du principe de restauration des statues, révélant un nouveau regard sur les monuments historiques de manière générale.

There he taught religion and geography. 2 When he left Norway on his journey, he had already published his textbook in biblical history (1858) for the primary school, 3 and a similar textbook for the secondary schools appeared with a separate chapter on the Holy Land. 4 The following year, he started his journey, which led to his great work Det hellige Land [The Holy Land] (1879), being published after he had worked on it for 15 years, as he wrote in the introduction. 5 He also published the diary he kept during the journey. 6 Vogt's book about the Holy Land, which is about 750 pages, is a comprehensive depiction of Palestine and the surrounding area. It is, in part, formed as a reference book where cities and other places are described in alphabetical order. With its detailed ethnographic, botanical, zoological, and geographical information, it is largely organised according to the same pattern as the topographical literature that appeared in abundance from the late 1700s onwards; partly because the authorities in Copenhagen encouraged it. 7 His books are richly illustrated with drawings of important destinations for travellers (Fig. The presentation stands out with its sober and impersonal style. He carefully explains the connection of the various places to the Bible, but also informs the reader about their later history. He also uses other sources, especially Josephus, but also Eusebius, Tacitus, and Herodotus. His description of Jerusalem is particularly extensive and covers almost 200 pages.

Même si, comparé aux autres conflits sanglants du xxe siècle en Europe, le taux de destruction de la guerre civile espagnole n’est pas élevé – environ 2 % du bâti –, il est très concentré sur les lignes de front. Ce chiffre ne rend donc pas compte de l’intensité des destructions dans certaines zones de combat, notamment celui du nord de la péninsule ibérique qui, à l’été 1937, vit l’effondrement du front de résistance républicain. La guerre d’Espagne est restée célèbre pour avoir été le théât...

Abstract Description of Proposed Paper As the drilling industry moves towards extended-reach wells in more challenging formations, the need to identify operational solutions (e.g., drilling fluids/lubricity additives) to reduce friction, torque, and drag has become more important. Additionally, as the industry looks to maximize the use of water-based drilling fluids (to benefit from lower drilling fluid costs and improved environmental profile), the need to find novel additives that can improve lubricity has become more pressing. However, current methodologies for reducing downhole friction in horizontal wells generally involve reactive addition of lubricant products that are broadly acting, that may adversely affect the rheology of the fluid system, or that may dissipate or degrade over time. To address the need for new additives, a novel biotechnology method for encapsulating oil in polysaccharide-based polymers has been developed that selectively delivers high pressure lubricants at areas of high shear, pressure, and friction (e.g., between the drill string and formation or casing and also between drill bit and formation). Application Due to the protection afforded by encapsulation, this targeted friction inhibitor can be proactively added to water-based drilling fluid systems, where it circulates through the system until conditions are met to break the capsule and release lubricant. Observations in laboratory and field testing suggest potential operational improvements in running casing, reduction of torque/drag, reduction of bit balling, and faster Rate of Penetration (ROP) from targeted lubrication. Results, Observations and Conclusions Our characterization of encapsulated oil has shown the ability to reduce the coefficient of friction by over 80% in water-based mud formulations in the laboratory. In field-scale testing at the Catoosa Testing Facility, we have observed reductions in drag of up to 50%, reductions in torque of up to 45%, and up to 20% improvement in Rate of Penetration (ROP) in horizontal drilling after addition of encapsulated oil to a water-based polymer mud system. These results were substantially improved relative to observed results in an exploratory field well, in which ROP increased by up to 216% after addition of encapsulated oil in a saturated sodium chloride drilling fluid system. Significance of Subject Matter Our field testing and characterization in the laboratory and field have demonstrated the utility of adding encapsulated oil to a water-based mud-system to drill horizontal wells to improve the operational efficiency of drilling.