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Caecal herniation through the foramen of Winslow is an uncommon presentation of internal hernia with an estimated overall incidence of 0.02%. Even rarer still is a caecal volvulus strangulated in the lesser sac, a surgical emergency seldom described in the literature. A woman in her 70s presented with a 1-day history of acute-onset right upper quadrant and epigastric pain associated with nausea and vomiting. Prompt CT imaging revealed caecal volvulus within a foramen of Winslow hernia. The diagnosis was confirmed by laparotomy. A right hemicolectomy was performed and the foraminal defect was closed. We identified eight case reports of this rare entity published within the last 30 years. Our patient was managed in a similar manner and recovered without complication, providing further guidance for the operative management of caecal volvulus in the foramen of Winslow.

The individual in our case was troubled with difficult to control arrhythmia in the context of RYR2-mutation positive catecholaminergic polymorphic ventricular tachycardia (CPVT) despite medication. Recurrent implantable cardioverter defibrillator (ICD) shocks occurred for ventricular tachycardia (VT) and ventricular fibrillation (VF) as well as inappropriate shocks as a result of rapidly conducted atrial fibrillation (AF). Catheter ablation was effective in controlling these episodes of AF. Despite left cardiac sympathetic denervation, episodes of ventricular arrhythmia and subsequent ICD shocks persisted. Contralateral sympathetic cardiac denervation was subsequently undertaken, with histology suggesting T-cell mediated ganglionitis. 18 months on, there have been no further episodes of ventricular arrhythmia.

Debris strikes on operational spacecraft are becoming more common due to increasing numbers of space objects. Sample return missions indicate hundreds of minor strikes, but rigorous analysis is often only performed when a strike causes an anomaly in spacecraft performance. Developing techniques to identify and assess minor strikes that do not immediately cause anomalous behavior can help to validate models for debris populations and aid in the attribution of future anomalies. This study develops methods to detect subtle abrupt orbit perturbations indicative of minor debris strikes. An extended Kalman filter with dynamic model compensation is used to estimate a spacecraft’s orbit state based on simulated full-state (i.e., GPS) measurements. The filter is applied to the data forward and backward in time, and then a modified Fraser–Potter smoother is used to produce a fused state estimate. Various test statistics are developed and compared to identify abrupt unexpected changes in spacecraft velocity; techniques include McReynold’s filter-smoother consistency test and the Mahalanobis distance between forward and backward filter states. A trade study is performed to investigate the performance of test statistics as a function of filter parameters, and a Monte Carlo analysis illustrates the filter’s ability to detect and estimate strikes.

Pancreatic ductal adenocarcinoma (PDA) is a lethal disease notoriously resistant to therapy1,2. This is mediated in part by a complex tumour microenvironment3, low vascularity4, and metabolic aberrations5,6. Although altered metabolism drives tumour progression, the spectrum of metabolites used as nutrients by PDA remains largely unknown. Here we identified uridine as a fuel for PDA in glucose-deprived conditions by assessing how more than 175 metabolites impacted metabolic activity in 21 pancreatic cell lines under nutrient restriction. Uridine utilization strongly correlated with the expression of uridine phosphorylase 1 (UPP1), which we demonstrate liberates uridine-derived ribose to fuel central carbon metabolism and thereby support redox balance, survival and proliferation in glucose-restricted PDA cells. In PDA, UPP1 is regulated by KRAS–MAPK signalling and is augmented by nutrient restriction. Consistently, tumours expressed high UPP1 compared with non-tumoural tissues, and UPP1 expression correlated with poor survival in cohorts of patients with PDA. Uridine is available in the tumour microenvironment, and we demonstrated that uridine-derived ribose is actively catabolized in tumours. Finally, UPP1 deletion restricted the ability of PDA cells to use uridine and blunted tumour growth in immunocompetent mouse models. Our data identify uridine utilization as an important compensatory metabolic process in nutrient-deprived PDA cells, suggesting a novel metabolic axis for PDA therapy.

The adult healthy human pancreas has been poorly studied given the lack of indication to obtain tissue from the pancreas in the absence of disease and rapid postmortem degradation. We obtained pancreata from brain dead donors, thus avoiding any warm ischemia time. The 30 donors were diverse in age and race and had no known pancreas disease. Histopathologic analysis of the samples revealed pancreatic intraepithelial neoplasia (PanIN) lesions in most individuals irrespective of age. Using a combination of multiplex IHC, single-cell RNA sequencing, and spatial transcriptomics, we provide the first-ever characterization of the unique microenvironment of the adult human pancreas and of sporadic PanIN lesions. We compared healthy pancreata to pancreatic cancer and peritumoral tissue and observed distinct transcriptomic signatures in fibroblasts and, to a lesser extent, macrophages. PanIN epithelial cells from healthy pancreata were remarkably transcriptionally similar to cancer cells, suggesting that neoplastic pathways are initiated early in tumorigenesis. Significance: Precursor lesions to pancreatic cancer are poorly characterized. We analyzed donor pancreata and discovered that precursor lesions are detected at a much higher rate than the incidence of pancreatic cancer, setting the stage for efforts to elucidate the microenvironmental and cell-intrinsic factors that restrain or, conversely, promote malignant progression.

Animal models are vital for the development of radiation medical countermeasures for the prophylaxis or treatment of acute radiation syndrome and for the delayed effects of acute radiation exposure. Nonhuman primates (NHPs) play an important role in the regulatory approval of such agents by the United States Food and Drug Administration following the Animal Rule. Reliance on such animal models requires that such models are well characterized. Data gathered from both male and female animals under the same conditions and gathered concurrently are limited; therefore, the authors compared and contrasted here the radiosensitivity of both male and female NHPs provided different levels of clinical support over a range of acute, total-body gamma irradiation, as well as the influence of age and body weight. Under matched experimental conditions, the authors observed only marginal, but clearly evident differences between acutely irradiated male and female NHPs relative to the measured response endpoints (rates of survival, blood cell changes, and cytokine fluctuations). These differences appeared to be accentuated by the level of exposure as well as by the nature of clinical support. Additional studies with both sexes under various experimental conditions and different radiation qualities run concurrently are needed.

Background. Well-written and transparent case reports (1) reveal early signals of potential benefits, harms, and information on the use of resources; (2) provide information for clinical research and clinical practice guidelines, and (3) inform medical education. High-quality case reports are more likely when authors follow reporting guidelines. During 2011–2012, a group of clinicians, researchers, and journal editors developed recommendations for the accurate reporting of information in case reports that resulted in the CARE (CAse REport) Statement and Checklist. They were presented at the 2013 International Congress on Peer Review and Biomedical Publication, have been endorsed by multiple medical journals, and translated into nine languages.Objectives. This explanation and elaboration document has the objective to increase the use and dissemination of the CARE Checklist in writing and publishing case reports.Article design and setting. Each item from the CARE Checklist is explained and accompanied by published examples. The explanations and examples in this document are designed to support the writing of high-quality case reports by authors and their critical appraisal by editors, peer reviewers, and readers.Results and conclusion. This article and the 2013 CARE Statement and Checklist, available from the CARE website [www.care-statement.org] and the EQUATOR Network [www.equator-network.org], are resources for improving the completeness and transparency of case reports.Source. This article is a translation of the original paper «CARE guidelines for case reports: explanation and elaboration document» in the Journal of Clinical Epidemiology (doi: 10.1016/j.jclinepi.2017.04.026), prepared under the permission of the copyright holder (Elsevier Inc.), with supervision from the Scientific Editor by Professor E.G. Starostina, MD, PhD (translator) (Moscow, Russia). Present translation was first published in Digital Diagnostics. doi: 10.17816/DD105291. It is published with minor changes related to the literary editing of the translation itself. Keywords: case report; case study; EQUATOR network; health research reporting guidelines; CARE guideline; timelines; N-of-1 For citation: Riley David S., Barber Melissa S., Kienle Gunver S., Aronson Jeffrey K., von Schoen-Angerer Tido, Tugwell Peter, Kiene Helmut, Helfand Mark, Altman Douglas G., Sox Harold, Werthmann Paul G., Moher David, Rison Richard A., Shamseer Larissa, Koch Christian A., Sun Gordon H., Hanaway Patrick, Sudak Nancy L., Kaszkin-Bettag Marietta, Carpenter James E., Gagnier Joel J. CARE Guidelines for Case Reports: Explanation and Elaboration Document. Translation into Russian. Voprosy sovremennoi pediatrii — Current Pediatrics. 2023;22(2):88–108. (In Russ). doi: https://doi.org/10.15690/vsp.v22i2.2540

Few studies have explored student perceptions of participating in STEM multidisciplinary students-as-partners (SaP) projects integrated into the curriculum. We conducted content analysis on focus groups to determine partner perceptions of a STEM and liberal arts SaP project and used a mixed methods concurrent triangulation design to explore the degree to which partners thought the underpinning SaP values had been enacted. Four staff and seven students participated in the study. Perceptions of the project were aligned to four themes: outstanding student experience, development of student employability skills, a transformative change in the student-to-staff relationship, and barriers to success and enabling strategies. Qualitative and quantitative data indicated strong inclusion of the partnership values. This paper provides new insights into STEM and liberal arts SaP projects, indicating they may be well-suited to the embodiment of the underpinning SaP values, and help students prepare for the world of work.

Using a US nationally representative online sample, we measure the level of knowledge on employment nondiscrimination laws. Although Americans are well informed about sex, race, and disability being protected characteristics, only about 71 percent think that sexual orientation is a protected characteristic. Sexual minorities are as uninformed as heterosexual individuals that sexual orientation is legally protected from employment discrimination. Furthermore, sexual minorities living in states that did not previously have statewide employment nondiscrimination protections prior to the 2020 Supreme Court ruling in Bostock v. Clayton County are less likely to think that sexual orientation is a protected characteristic.

Cigarette smoke (CS) exposure is a risk factor for many chronic diseases including chronic obstructive pulmonary disease (COPD), however the mechanism by which smoke exposure can alter homeostasis and bring about chronic inflammation is poorly understood. Here, we showcase a novel role for smoke in regulating long noncoding RNAs (lncRNAs), showing that it activates lincRNA-Cox2, which we previously characterized as functional in inflammatory regulation. Exposing lincRNA-Cox2 murine models to smoke in vivo confirmed lincRNA-Cox2 as a regulator of inflammatory gene expression in response to smoke both systemically and within the lung. We also report that lincRNA-Cox2 negatively regulates genes in smoked bone marrow derived macrophages exposed to LPS stimulation. In addition to the effects on lncRNAs, we also report dysregulated transcription and splicing of inflammatory protein-coding genes in the bone marrow niche following CS exposure in vivo. Collectively, this work provides insights into how innate immune signaling from gene expression to splicing is altered following in vivo exposure to CS and highlights an important new role for lincRNA-Cox2 in regulating immune genes following smoke exposure.

While self-monitoring can help mitigate alcohol misuse in young adults, engagement with digital self-monitoring is suboptimal. The present study investigates the utility of two types of digital prompts (reminders) to encourage young adults to self-monitor their alcohol use. These prompts leverage information that is self-relevant (i.e., represents and is valuable) to the person.Five hundred ninety-one college students (The self-interest (vs. prosocial) prompt was significantly more effective in promoting proximal self-monitoring at the beginning of the study, Est = exp(.14) = 1.15; 95% confidence interval (CI) [1.01, 1.29], whereas the prosocial (vs. self-interest) prompt was significantly more effective at the end, Est = exp(-.17) = 0.84; 95% CI [0.70, 0.98]. Further, the prosocial (vs. self-interest) prompt was significantly more effective among participants who previously allocated all their reward points to drawings for their preferred item, Est = exp(-.15) = 0.86; 95% CI [.75, .97].These results suggest that the advantage of prompts that appeal to a person's self-interest (vs. prosocial) motives varies over time and based on what reward options participants prioritized in previous decisions. Theoretical and practical implications for intervention design are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: Impulsivity is implicated in the development and maintenance of Cocaine Use Disorder (CUD). Less work has examined impulsivity’s role on interest in initiating treatment, treatment adherence, or treatment response. No pharmacotherapies are approved for CUD, so efforts to understand and bolster the effects of psychotherapy are important in guiding and refining treatment. The present study examined the impact of impulsivity on interest in treatment, treatment initiation, treatment adherence, and treatment outcomes in individuals with CUD. Methods: Following the completion of a larger study on impulsivity and CUD participants were offered 14 sessions of (12 weeks) Cognitive Behavioral Relapse Prevention (CBT-RP). Before starting treatment, participants completed seven self-report and four behavioral measures of impulsivity. Sixty-eight healthy adults (36% female) with CUD (aged 49.4 ± 7.9) expressed an interest in treatment. Results: Greater scores on several self-report measures of impulsivity, and fewer difficulties with delayed gratification were associated with increased interest in treatment in both males and females. 55 participants attended at least 1 treatment session, while 13 participants did attend a single session. Individuals who attended at least one treatment session scored lower on measures of lack of perseverance and procrastination. Still, measures of impulsivity did not reliably predict session attendance nor the frequency of cocaine-positive urine samples throughout treatment. Males attended nearly twice as many treatment sessions as females despite nonsignificant associations between impulsivity in males and the number of sessions attended. Conclusions: Greater impulsivity in individuals with CUD was associated with expressing an interest in treatment, but not treatment adherence or response.

Field-based forest inventory plots are fundamental for many forest studies. These on-the-ground measurements of small samples of forested areas provide foresters with key information such as the size, abundance, health, and value of their forests. Recently, forest inventory plots have begun to be used as ground validation for tree features automatically extracted from remotely sensed data sets. Additionally, machine learning methods for feature extraction rely heavily on large quantities of training data and require these field forest inventory measurement datasets for algorithm training. Undermining the usefulness of forest inventory plot data as validation or training data is the positional uncertainty of plot location measurements. Because global navigation satellite systems (GNSS) cannot reliably measure plot center coordinates under thick tree canopy, plot center coordinates usually contain multiple meters of horizontal error. We present a method for reliably measuring plot center coordinates in which plot centers are individually marked with low-cost targets, allowing plot centers to be manually measured from orthoimagery captured during the leaf-off season. Our plot center measurements are shown to have less than 10 cm of horizontal error, an improvement of an order of magnitude over traditional GNSS methods.

Genetics contribute to smoking cessation, which is important for cancer prevention. Prior genetic studies, limited by short-term follow-up, have not examined multiple quit attempts and relapse events experienced by most smokers. This research investigated genetic associations with smoking relapse throughout adulthood. Participants were from two, all-female longitudinal cohort studies and included 12,060 European ancestry ever-smokers with existing genotype data who quit smoking at ≥1 timepoint. Median follow-up was 32 years. Associations between selected SNPs and odds of relapse and, conditional on relapse, SNP associations with proportion of follow-up relapsed were modeled using zero-inflated beta regression. Genotype by menopausal status interactions were evaluated. Women with AA genotypes for CHRNA5 SNP rs16969968 G>A or CHRNA3 SNP rs1051730 G>A (P-value = 0.04 for both) had lower odds of relapse. Among women who relapsed, those with CC genotypes of CHRNA5 SNPs rs588765 T>C (P-value = 0.04) and rs680244 T>C (P-value = 0.048) and AA genotype of DRD2 SNP rs6277 G>A (P-value = 0.01) had higher proportion follow-up in relapse. Associations were stronger among postmenopausal women (genotype by menopause interactions: rs588765 P-value = 0.003, rs680244 P-value = 0.001, rs6277 P-value = 0.04). Women with AA or AG genotypes for COMT SNP rs4680 G>A (P-value = 0.03) had lower proportion follow-up relapsed. This study identified SNP associations with likelihood of relapse or proportion of follow-up in relapse. Several associations were stronger among postmenopausal women. The findings demonstrate the importance of long-term follow-up and factors unique to women when characterizing smoking phenotypes. Prevention Relevance: This study is the first to quantify genetic associations with smoking relapse among female smokers throughout adulthood. These findings could inform precision medicine approaches to improve long-term smoking relapse prevention to reduce smoking attributable cancer morbidity and mortality.

Purpose: Interprofessional practice within early intervention is underscored by policy, research, and recommended practices. The purpose of this study was to explore the impact of a brief interprofessional training on preservice speech-language pathology, early intervention/early childhood special education, physical therapy, and occupational therapy students' knowledge, beliefs, and attitudes about teaming and collaboration. Students' satisfaction with and perspectives of the training were also examined. Method: A one-group, pretest–posttest design was used to examine differences in 36 students' knowledge, attitudes, and beliefs around interprofessional practice after the training. Descriptive approaches were used to analyze student satisfaction data and focus group data in order to evaluate student perceptions of the interprofessional training. Results: A paired–samples t test showed preservice students demonstrated increased scores in self-perceived ability, value, and comfort in working with others after the training institute. Descriptive analyses illustrated students gained a richer knowledge and appreciation for other disciplines and perceived the practice of interprofessional collaboration as a valuable learning experience. Conclusion: The interprofessional training procedures, evaluation of impacts, and future directions are discussed.

AimsEarly detection of developmental dysplasia of the hip (DDH) is associated with improved outcomes of conservative treatment. Therefore, we aimed to evaluate a novel screening programme that included both the primary risk factors of breech presentation and family history, and the secondary risk factors of oligohydramnios and foot deformities.MethodsA five-year prospective registry study investigating every live birth in the study’s catchment area (n = 27,731), all of whom underwent screening for risk factors and examination at the newborn and six- to eight-week neonatal examination and review. DDH was diagnosed using ultrasonography and the Graf classification system, defined as grade IIb or above or rapidly regressing IIa disease (≥4o at four weeks follow-up). Multivariate odds ratios were calculated to establish significant association, and risk differences were calculated to provide quantifiable risk increase with DDH, positive predictive value was used as a measure of predictive efficacy. The cost-effectiveness of using these risk factors to predict DDH was evaluated using NHS tariffs (January 2021).ResultsThe prevalence of DDH that required treatment within our population was 5/1,000 live births. The rate of missed presentation of DDH was 0.43/1000 live births. Breech position, family history, oligohydramnios, and foot deformities demonstrated significant association with DDH (p < 0.0001). The presence of breech presentation increased the risk of DDH by 1.69% (95% confidence interval (CI) 0.93% to 2.45%), family history by 3.57% (95% CI 2.06% to 5.09%), foot deformities by 8.95% (95% CI 4.81% to 13.1%), and oligohydramnios nby 11.6% (95 % CI 3.0% to 19.0%). Primary risk factors family history and breech presentation demonstrated an estimated cost-per-case detection of £6,276 and £11,409, respectively. Oligohydramnios and foot deformities demonstrated a cost-per-case detected less than the cost of primary risk factors of £2,260 and £2,670, respectively.ConclusionThe inclusion of secondary risk factors within a national screening programme was clinically successful as they were more cost and resource-efficient predictors of DDH than primary risk factors, suggesting they should be considered in the national guidance.Cite this article: Bone Jt Open 2023;4(4):234–240.

OBJECTIVES To characterize the pharmacokinetics of a single oral dose (6 mg/kg) of mavacoxib in New Zealand White rabbits (Oryctolagus cuniculus) and to characterize any clinicopathologic effects with this medication and dose. ANIMALS Six healthy, 4-month-old New Zealand White rabbits (3 male, 3 female). PROCEDURES Before drug administration, clinicopathologic samples were collected for baseline data (CBC, serum biochemical analyses, and urinalysis including urine protein-to-creatinine ratio). All 6 rabbits received a single oral dose (6 mg/kg) of mavacoxib. Clinicopathologic samples were collected at set time intervals to compare with the baseline. Plasma mavacoxib concentrations were determined using liquid chromatography with mass spectrometry, and pharmacokinetic analysis was performed using non-compartmental methods. RESULTS After a single oral dose, the maximum plasma concentration (Cmax; mean, range) was 854 (713–1040) ng/mL, the time to Cmax (tmax) was 0.36 (0.17–0.50) days, the area under the curve from 0 to the last measured time point (AUC0-last) was 2000 (1765–2307) days*ng/mL, the terminal half-life (t1/2) was 1.63 (1.30–2.26) days, and the terminal rate constant (λz) was 0.42 (0.31–0.53) days. All results for CBCs, serum biochemical analyses, urinalyses, and urine protein-to-creatinine ratios remained within published normal reference intervals. CLINICAL RELEVANCE This study determined that plasma concentrations reached target levels of 400 ng/mL for 48 hours in 3/6 rabbits at 6 mg/kg PO. In the remaining 3/6 rabbits, the plasma concentrations were 343–389 ng/mL at 48 hours, which is below the target concentration. Further research is needed to make a dosing recommendation, including a pharmacodynamic study and investigating pharmacokinetics at different doses and multiple doses.

Fernando Contreras Castro’s novel Única mirando al mar (1993 and 2010) is a bitter, scathing social critique of Costa Rica’s government, a government which only occasionally remembers its duty to its taxpayers and its environment. Rewritten in 2010 after the closure of Río Azul, a landfill near San José, the novel explores the way this action affected the population of the landfill, locally known as the buzos. Analyses of the novel address primarily the buzos’ resilience and the complexity of the relationship between the buzos’ society and the rest of the country. This study will consider the buzos’ society as a social order based on habit, and trace its adaptability and persistence in the face of multiple changes to the buzos’ life. To this end, I will use the theory of posthegemony with a particular focus on Pierre Bourdieu’s concepts of habit and habitus to explore the adaptability and persistence of the buzos’ habitus as reflected in habitual practices, rituals and ritual language. I will analyse the 2010 version of the novel, published after the closure of the landfill.

PURPOSE: Median duration of daratumumab (DARA) administration for treatment of multiple myeloma is 3-7 hours for the intravenous formulation (DARA IV) and 3-5 minutes for the subcutaneous formulation (DARA SC). Here, we describe clinical administration characteristics of DARA using a novel method for data extraction from electronic health records. METHODS: Time-based measurements were extracted using a scheduling/pharmacy software program that tracked patient movement through appointments for patients initiating DARA in Mayo Clinic infusion centers from April 5, 2017, to October 14, 2021. Cohorts included patients who received DARA IV or DARA SC, or converted from DARA IV to DARA SC. The DARA SC cohort was further analyzed before (DARA SC initial) and after (DARA SC shortened) a reduction in the postadministration observation time mandated by the treatment plan. Events associated with administration-related reactions (ARRs) were also identified. RESULTS: Median total clinic times were 2.7-3.0 hours shorter for DARA SC versus DARA IV. Median clinic times were highest at dose 1 and decreased with subsequent doses. Median total chair times were 2.7-2.8 hours shorter for DARA SC versus DARA IV. Incidences of ARR-related events with DARA SC were low across doses. CONCLUSION: Reduced clinic times were observed with DARA SC, indicating that use of DARA SC as a treatment option results in time savings that may free clinic resources. Furthermore, novel methods of electronic health record data extraction can provide insights that may help inform clinic resource optimization.

_ This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper SPE 207941, “Underground Gas-Storage Process Optimization Using Integrated Subsurface Characterization, Dynamic Modeling, and Monitoring: A Case Study,” by Longxin Li, Yuan Zhou, and Limin Li, PetroChina Southwest Oil and Gasfield Company, et al. The paper has not been peer reviewed. _ The operator’s Xiangguosi (XGS) gasfield facility began underground gas storage (UGS) operations in a depleted gas field in southwest China in 2013. Following this initial period, the site was reassessed to increase deliverability safely during the winter months to meet future peak gas demand. The results of that analysis informed the resulting system design, in combination with fit-for-purpose reservoir-surveillance systems; caprock-seal recording pressure, rock deformation, and seismicity data in real time; and regular wellbore inspection. Introduction The XGS UGS facility currently operates in a previously depleted gas reservoir in Sichuan province. Its construction took place during the second half of 2011; cushion gas injection started in June 2013. Located in a high-tectonic-stress region, the geological setting of the XGS field is structurally complex and highly faulted and the targeted carbonate formation is heterogeneous and naturally fractured. When the studies described in the complete paper commenced in November 2019, the field hosted 22.80×108 m3 of working gas along with 19.80×108 m3 of cushion gas. As of May 2020, the reservoir had completed eight injection and six withdrawal cycles and delivered a maximum withdrawal rate of 21.96×106 m3/d. The UGS conversion plans required a revisit to analyze the possibility of increasing the withdrawal rate to 28.55×106 m3/d, thereby positioning better for future peak gas demand. The drilling of five new wells commenced in 2019. Planned Technical Approach The purpose of the study was to optimize the XGS UGS facility’s working gas capacity and improve operational performance throughout asset life. It was proposed to achieve this by 4D geomechanical and 3D dynamic flow-simulation models. The geomechanical model would hinge on an integrated subsurface characterization work flow combined with an advanced monitoring network tightly connected with the surface facility operation to ensure maximum containment and optimal injection and withdrawal rates and volumes. This holistic approach would aid in ascertaining optimal drawdown pressures to minimize rock fatigue and ensure operation of the UGS facility within safe pressure limits. Fully integrated Subsurface Characterization A detailed review of the existing petrophysical interpretation from wells calibrated with core analysis data was undertaken. Petrophysical interpretations from 29 wells were used to construct a reservoir classification and petrophysical property models. This led to the understanding that depositional facies were not the overriding control on reservoir quality in this case because the reservoir is highly affected by karstification, diagenesis, and fracturing. Prestack migrated seismic data was improved with acquisition footprint, noise, and multiple removal and then interpreted to map subsurface structure. The edited well logs were used to build synthetic seismograms. A complex structural model was created that included 22 stratigraphic zones and a detailed fault model within the main field structure, integrating stratigraphic data and log curves from all recently drilled wells.

_ This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper SPE 209965, “System Engineering Recommendations To Improve Intelligent Completions,” by Ron Nelson, SPE, Consultant; Eric Handley, MacDermid Offshore Solutions; and Jonathon Joubran, SPE, Halliburton, et al. The paper has not been peer reviewed. _ The complete paper compiles recommendations from a broad range of sources into a single document to aid future intelligent-completion installations and operations. While emphasis is placed on subsea completions, these recommendations can be applied readily to differing well types. Important differences between production wells and injection wells also are addressed. Introduction Intelligent-completion interfaces span drilling, completions, facilities, production operations, and subsea-systems-engineering disciplines. Affected system components include the tree and tubing hanger, control system, control fluid, control lines, well fluids, well casing, downhole sensors, feed-through packers, and interval control valves (ICVs). Example diagrams are provided in Appendix B of the complete paper. While a successful intelligent completion can enhance a well’s value significantly, a failed intelligent completion can severely diminish that value, possibly rendering the well inoperable. Proposed Intelligent-Well-Design Process Control-Fluid Selection. The design process should start with the control fluid, which provides hydraulic force to open and close the ICV. It traverses the entirety of the system and will affect most system components. A successful control fluid will accomplish the following goals, which are further detailed in the complete paper: - Provide adequate lubricity - Maintain required properties across all design temperatures - Be compatible with all materials - Be compatible with completion brines - Provide adequate hydrate inhibition - Minimize environmental impact If the intelligent completion is to be installed in an existing development already using a fluid that cannot be used for the ICV, it may be possible to fill or “stack” the ICV lines with another control fluid that meets the downhole requirements and also is fully compatible with the in-service control fluid. The fluid’s original equipment manufacturer (OEM) should be consulted when a mixed-fluid system is considered. Assessing Thermally Induced Pressure Gains. Once a preferred control fluid has been identified, the next recommended step is to assess worst-case thermally induced pressure changes in the control lines. Thermal effects directly affect numerous intelligent-completion components. API SPEC 17D recommends keeping the tree-mounted ICV control-line isolation valves [tree-isolation valves (TIVs)] closed when not shifting the ICVs. At the other end of the control line, the ICV’s seals isolate the control fluids from the well fluids. Each downhole control line is a closed system when the TIVs are closed. A closed control line will behave like a casing annulus in that internal pressure will rise when warmed and fall when cooled. The pressure changes in the lines, however, can be far greater than those seen in the casing annuli and can affect the intelligent completion system’s pressure requirements profoundly.

Research suggests situational pain may motivate alcohol consumption, suggesting that pain may be an antecedent for problematic drinking behavior. In this pilot project, we assessed the effect of a painful thermal stimulus on drinking topography in a virtual reality bar environment using real alcohol-containing beverages. We also examined psychosocial factors that may account for individual differences in pain as an antecedent for alcohol use. Participants (N=20, M(age)=25.65 years, 55% female, 15% Hispanic/Latino/a/x) completed a psychosocial screening battery before completing two counterbalanced alcohol self-administration sessions. In each, participants experienced either painful heat (44°C) or non-noxious warmth (38°C). Sip interval (seconds) and sip volume (grams) were measured. Effects of pain on drinking topography were assessed using multilevel models. Multilevel models assessed associations of pain-related changes in topography with hypothesized vulnerability factors. Analyses indicated a significant interaction of pain condition and sex on sip interval (b=−.16.96, p=.015, 95% Cl: −30.75, −2.97), such that painful heat significantly decreased sip interval in men (b=16.38) but not women (b=−.45). No effect of pain on sip volume was detected (p>.49). Exploratory analyses indicated significant interactions such that the effect of the painful heat condition was stronger in individuals with higher levels of greater negative urgency, but the opposite effect for pain catastrophizing. Results suggest acute pain has sex-contingent effects on drinking topography, such that men drank more rapidly while experiencing painful heat. Furthermore, analyses indicated that individuals with greater negative urgency, regardless of sex, may be at elevated risk for hazardous alcohol use when experiencing pain.