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Undocumented Orphaned Wells (UOWs) are wells without an operator that have limited or no documentation with regulatory authorities. An estimated 310,000 to 800,000 UOWs exist in the United States (US), whose locations are largely unknown. These wells can potentially leak methane and other volatile organic compounds to the atmosphere, and contaminate groundwater. In this study, we developed a novel framework utilizing a state-of-the-art computer vision neural network model to identify the precise locations of potential UOWs. The U-Net model is trained to detect oil and gas well symbols in georeferenced historical topographic maps, and potential UOWs are identified as symbols that are further than 100 m from any documented well. A custom tool was developed to rapidly validate the potential UOW locations. We applied this framework to four counties in California and Oklahoma, leading to the discovery of 1301 potential UOWs across >40,000 km2. We confirmed the presence of 29 UOWs from satellite images and 15 UOWs from magnetic surveys in the field with a spatial accuracy on the order of 10 m. This framework can be scaled to identify potential UOWs across the US since the historical maps are available for the entire nation.

In the United States, hundreds of thousands of undocumented orphan wells have been abandoned, leaving the burden of managing environmental hazards to governmental agencies or the public. These wells, a result of over a century of fossil fuel extraction without adequate regulation, lack basic information like location and depth, emit greenhouse gases, and leak toxic substances into groundwater. For most of these wells, basic information such as well location and depth is unknown or unverified. Addressing this issue necessitates innovative and interdisciplinary approaches for locating, characterizing, and mitigating their environmental impacts. Our survey of the United States revealed the need for tools to identify well locations and assess conditions, prompting the development of technologies including machine learning to automatically extract information from old records (95%+ accuracy), remote sensing technologies like aero-magnetometers to find buried wells, and cost-effective methods for estimating methane emissions. Notably, fixed-wing drones equipped with magnetometers have emerged as cost-effective and efficient for discovering unknown wells, offering advantages over helicopters and quadcopters. Efforts also involved leveraging local knowledge through outreach to state and tribal governments as well as citizen science initiatives. These initiatives aim to significantly contribute to environmental sustainability by reducing greenhouse gases and improving air and water quality.

BackgroundEmergency medicine (EM) consultants are expected to provide leadership to facilitate optimal clinical results, effective teamwork and learning. To foster leadership skills, the Emergency Medicine Leadership Programme (EMLeaders) was launched in 2018 by the Royal College of Emergency Medicine (RCEM), Health Education England and National Health Service England. A mixed-methods evaluation of EMLeaders was commissioned to assess the impact at the strategic, team and individual levels. This paper reports the qualitative evaluation component.MethodsQualitative data collected from 2021 to 2022 were drawn from an online survey of RCEM members in England, which included four open questions about leadership training. At the end of the survey, participants were asked to share contact details if willing to undertake an in-depth qualitative interview. Interviews explored perceptions of the programme and impact of curriculum design and delivery. Data were analysed thematically against the Kirkpatrick framework, providing in-depth understanding.ResultsThere were 417 survey respondents, of whom 177 had participated in EMLeaders. Semistructured interviews were completed with 13 EM consultants, 13 trainees and 1 specialty and associate specialist doctor. EMLeaders was highly valued by EM consultants and trainees, particularly group interaction, expert facilitation and face-to-face practical scenario work. Consultant data yielded the themes: we believe in it; EM relevance is key; on a leadership journey; shaping better leaders; and a broken system. Challenges were identified in building engagement within a pressured workplace system and embedding workplace role modelling. Trainees identified behavioural shift in themselves following the programme but wanted more face-to-face discussions with senior colleagues. Key trainee themes included value in being together, storytelling in leadership, headspace for the leadership lens and survival in a state of collapse.ConclusionThe development of leadership skills in EM is considered important. The EMLeaders programme can support leadership learning but further embedding is needed.

ABSTRACTFeeding problems are common in autistic children. They include eating a limited repertoire of foods and often impact on health and quality of life. To examine the experiences of parents of autistic children who have feeding problems, and their service needs. A pragmatic, qualitative research approach was adopted. Six participants were recruited using purposive and snowball sampling. Data was collected via semi-structured interviews. Participants also submitted photographs with captions. These illustrated their child’s feeding problems and the effect on them and their family. Interviews were transcribed. They were analyzed alongside the photos and captions using inductive thematic analysis. Rigor was ensured via member checking, peer review of themes, and reflexive journaling. Five themes emerged. Parents and children found ‘mealtimes difficult.’ Parents were ‘unsure when or whether to pursue help.’ They felt ‘let down by a lack of support.’ ‘Lowered expectations of parents and professionals’ prevailed about their child’s feeding problems. Parents desired ‘services that are easily accessible and supportive.’ This is the first qualitative study of parents’ experiences of feeding problems in autistic children in the UK. It has been the first study to incorporate participatory photography. These problems have a negative impact on the child’s learning and the child’s, and family’s wellbeing. Support needs are largely unmet. This study has provided rich insight into autistic children’s feeding problems. The findings will inform the design of better support for autistic children and their families.

Fluid flow through fractured media is typically governed by the distribution of fracture apertures, which are in turn governed by stress. Consequently, understanding subsurface stress is critical for understanding and predicting subsurface fluid flow. Although laboratory‐scale studies have established a sensitive relationship between effective stress and bulk electrical conductivity in crystalline rock, that relationship has not been extensively leveraged to monitor stress evolution at the field scale using electrical or electromagnetic geophysical monitoring approaches. In this paper we demonstrate the use time‐lapse 3‐dimensional (4D) electrical resistivity tomography to image perturbations in the stress field generated by pressurized borehole packers deployed during shear‐stimulation attempts in a 1.25 km deep metamorphic crystalline rock formation. Time‐lapse electrical geophysical sensing is used to image 3D changes in rock stress generated by an isolated and pressurized interval of a borehole in a deep, dense, fractured rock formation. Remotely monitoring stress is challenging but important for relating geomechanical behavior to flow pathways during energy productionBulk electrical conductivity is sensitive to stress in crystalline rockTime‐lapse electrical resistivity tomography can be used to remotely monitor 3D changes in effective stress Remotely monitoring stress is challenging but important for relating geomechanical behavior to flow pathways during energy production Bulk electrical conductivity is sensitive to stress in crystalline rock Time‐lapse electrical resistivity tomography can be used to remotely monitor 3D changes in effective stress

Background:traditional health workforce roles are changing, with existing roles being extended and advanced, while new roles are being created, often undertaking duties previously completed by doctors, sometimes referred to as non-medical practitioners (NMPs).Aim:to investigate which NMP roles exist within the UK, mapping distribution, and explore factors influencing their development and recruitment.Methods:two descriptive, exploratory, online self-completed semi-structured questionnaires were used. One was sent to all NHS acute healthcare providers (n=156) and private/independent healthcare providers in England (n=90). A separate questionnaire collected data, using convenience and snowballing approaches, from NMPs across the UK. Quantitative data were analysed using descriptive and frequency statistics. Qualitative data derived from open questions and comments were analysed using content and thematic analysis.Results:healthcare organisations in England returned 23/246 useable questionnaires; 115 NMPs returned responses, 19 did not meet the criteria, leaving 96 useable responses.Conclusion:seven NMP roles were identified, throughout the UK, with regional variation. Several factors influence the development and recruitment of NMP roles in England such as service delivery and national policies. Inconsistencies were noted in Agenda for Change pay banding. Many practitioners undertook NMP roles to progress their career clinically.

ABSTRACTThe home advantage in various sports has been well documented. So far, we lack knowledge whether playing in neutral venues indeed removes many, if not all, theoretically assumed advantages of playing at home. Analysing over 3,500 senior men’s Gaelic football and hurling matches – field games with the highest participation rates in Ireland – between 2009 and 2018, we test the potential moderating influence of neutral venues. In hurling and Gaelic football, a considerable share of matches is played at neutral venues. We test the influence of neutral venues based on descriptive statistics, and multilevel logistic and multinomial regressions controlling for team strength, the importance of the match, the year, and the sport. With predicted probabilities ranging between 0.8 and 0.9, the favourite team is very likely to win home matches. The predicted probability drops below 0.6 for away matches. At neutral venues, the favourite team has a predicted probability of winning of 0.7. A Coarsened Exact Matching (CEM) approach also reveals very substantive and significant effects for the “treatment” of neutral venues. Overall, neutral venues appear to be an under-utilised option for creating fairer and less predictable competition, especially in single-game knock-out matches.

Failure of eruption (FOE) of first and second permanent molars is rare, with an estimated prevalence of 0.01% in the case of the first permanent molar and 0.06% in the case of the second.1When there is failure of eruption of a permanent molar, the following differential diagnoses should be considered in addition to tooth impaction: primary failure of eruption (PFE) (Type I/Type II) and mechanical failure of eruption (MFE) owing to ankylosis. Limited studies have proposed protocols for the management of failure of eruption (FOE) of permanent molars with no clear consensus or guidelines.CPD/Clinical Relevance:Making an early distinction between MFE and PFE is important in the management of patients with failure of eruption of permanent molars since they dictate different treatment modalities. This paper reviews the clinical characteristics of FOE of permanent molars to aid the clinician in diagnosis and subsequent management of this rare and challenging condition.

We form methane hydrate by injecting methane gas into a brine‐saturated, coarse‐grained sample under hydrate‐stable thermodynamic conditions. Hydrate forms to a saturation of 11%, which is much lower than that predicted assuming three‐phase (gas‐hydrate‐brine) thermodynamic equilibrium (67%). During hydrate formation, there are temporary flow blockages. We interpret that a hydrate skin forms a physical barrier at the gas‐brine interface. The skin fails periodically when the pressure differential exceeds the skin strength. Once the skin is present, further hydrate formation is limited by the rate that methane can diffuse through the solid skin. This process produces distinct thermodynamic states on either side of the skin that allows gas to flow through the sample. This study illuminates how gas can be transported through the hydrate stability zone and thus provides a mechanism for the formation of concentrated hydrate deposits in sand reservoirs. It also illustrates that models that assume local equilibrium at the core‐scale and larger may not capture the fundamental behaviors of these gas flow and hydrate formation processes. Methane hydrate is a crystalline solid composed of water and methane that forms at low temperature and high pressure. It is a major component of the carbon cycle and an enormous potential energy resource. It can be found in deep ocean sediments within thick, sandy layers above accumulations of methane gas. These hydrate deposits may form by the upward flow of buoyant methane gas from warm regions, where gas is stable, to cold regions, where hydrate is stable. We simulate this process experimentally by injecting gas into a cold, pressurized sand core. A significant amount of hydrate forms, and methane gas advances through the sand despite being in a region where it should solidify into hydrate. Our analysis of the X‐ray images and the fluid volumes and pressures suggests that, during injection, a thin hydrate skin forms at the gas‐brine interface. The hydrate skin separates the gas from the liquid and limits hydrate formation, allowing gas to flow through the sand. This mechanism may form high concentrations of hydrates in sands in geologic systems. Hydrate forms rapidly during gas flow into the hydrate stability zone and results in temporary flow blockages and low hydrate saturationsHydrate formation at the gas‐brine interface limits hydrate formation and sustains gas transport through the hydrate stability zoneThis is a potential mechanism for gas flow through the hydrate stability zone resulting in high hydrate saturations over long time scales

For better understanding of frequency dependence (dispersion) of seismic wave velocities caused by stress‐induced fluid flow, broadband laboratory measurements were performed on a suite of synthetic glass media containing both equant pores and thermal cracks. Complementary forced oscillation, resonant bar, and ultrasonic techniques provided access to millihertz‐hertz frequencies, ~1 kHz frequency, and ~1 MHz frequency, respectively. The wave speeds or effective elastic moduli and associated dissipation were measured on samples under dry, argon‐ or nitrogen‐saturated, and water‐saturated conditions in sequence. The elastic moduli, in situ permeability, and crack porosity inferred from in situ X‐ray computed tomography all attest to strong pressure‐induced crack closure for differential (confining‐minus‐pore) pressures <30 MPa, consistent with zero‐pressure crack aspect ratios <4 × 10−4. The low permeabilities of these materials allow access to undrained conditions, even at subhertz frequencies. The ultrasonically measured elastic moduli reveal consistently higher shear and bulk moduli upon fluid saturation—diagnostic of the saturated‐isolated regime. For a glass rod specimen, containing cracks but no pores, saturated‐isolated conditions apparently persist to subhertz frequencies—requiring in situ aspect ratios (minimum/maximum dimension) <10−5. In marked contrast, the shear modulus measured at subhertz frequencies on a cracked glass bead specimen of 5% porosity, is insensitive to fluid saturation, consistent with the Biot‐Gassmann model for the saturated‐isobaric regime. The measured dispersion of the shear modulus approaches 10% over the millihertz‐megahertz frequency range for the cracked and fluid‐saturated media—implying that laboratory ultrasonic data should be used with care in the interpretation of field data. Glass media containing thermal cracks of low aspect ratio are of low enough permeability to remain undrained even at subhertz frequenciesUse of forced oscillation (subhertz), resonant bar (kilohertz), and ultrasonic (megahertz) methods exposes dispersive behavior of such fluid‐saturated mediaUltrasonic methods consistently probe the saturated isolated regime, whereas low‐frequency methods can also access saturated isobaric conditions

Depressurization of hydrate‐bearing sediments (HBS) can cause the movement of fine particles, and in turn, such fines migration affects fluid flow and mechanical behavior of sediments, ultimately affecting long‐term hydrocarbon production and wellbore stability. This study investigated how and to what extent depressurization of HBS causes fines migration using X‐ray computed tomography (CT) imaging. Methane hydrate was synthesized in sediments with 10% fines content (FC), composed of sands with silt and/or clay, and the hydrate‐bearing samples were stepwisely depressurized while acquiring CT images. The CT images were analyzed to quantify the spatial changes in FC in the host sediment and thus to capture the fines migration during depressurization. It was found that the FC changes began occurring from the hydrate dissociation regions. This confirms that the multiphase flow caused by depressurization accompanies fines migration. Depressurization of HBS with a hydrate saturation of ~20–40% caused FC reduction from ~10% to ~6–9%, and the extent of fines migration differed with the particle sizes of the host sands and the types of fines. It was found that fines migration was more pronounced with coarse sands and with silty fines. Such observed level of FC reduction is estimated to increase sediment permeability by several factors based on the Kozeny‐type permeability model. Our results support the notion that the extent of fines migration and its effect on fluid flow behavior need to be assessed in consideration of physical properties of host sediment and fine particles to identify optimum depressurization strategies. Fines migration caused by depressurization of hydrate‐bearing sediments was monitored by X‐ray CT imagingChanges in fine contents began occurring from hydrate dissociation regions due to the multiphase flows caused by hydrate dissociationThe extent of fines migration differed with host sand size and fines types but more pronounced in coarse sands with silty fines

Permafrost physicochemical parameters play a key role in controlling the response of permafrost carbon to climate change. We studied the physicochemical parameters of permafrost in an Arctic tundra region to evaluate (1) how soil parameters vary with depth and whether and how they are interrelated, (2) whether and how permafrost soil differs from its overlaying active layer, and (3) whether soil property‐depth relationships are different across geomorphic features (e.g., low, flat, and high centered polygons). We also explored the possible biogeochemical processes that led to these soil characteristics and how they may affect biogeochemical reactions upon permafrost thaw. We observed (1) consistent relationships between soil property and depth and between major parameters, (2) large contrasts of key soil parameters between active layer and permafrost, indicative of potentially different response of the permafrost carbon to warming when compared to the active layer, and (3) a correlation between soil hydraulic conductivity and topographic features that impacts soil hydrologic processes. Our analysis suggests that the permafrost has a marine‐derived chemical signature that differs from the active layer and shapes the physicochemical fingerprints of the different geomorphic features. Specifically, we revealed the unique signatures of the high center polygons, indicative of possible microbial activity at depth (>1 m). Our study suggested consistent key soil parameter‐depth correlations while demonstrating complex lateral and vertical variabilities. These results are valuable for identifying approaches to upscale point‐based measurements and for improving model parameterization to predict permafrost carbon behavior and feedback under future climate. Key soil parameters show consistent changes with depth across polygon types with strong interparameter correlationsSoil parameters show large contrasts between active layer and permafrost, suggesting differential biogeochemical behaviorsUnique biogeochemical signature of high center polygons was revealed, indicative of microbial activity in the permafrost at depth (>1 m)

The few prethaw observations of tundra carbon fluxes suggest that there may be large spring releases, but little is known about the scale and underlying mechanisms of this phenomenon. To address these questions, we combined ecosystem eddy flux measurements from two towers near Barrow, Alaska, with mechanistic soil‐core thawing experiment. During a 2 week period prior to snowmelt in 2014, large fluxes were measured, reducing net summer uptake of CO2by 46% and adding 6% to cumulative CH4emissions. Emission pulses were linked to unique rain‐on‐snow events enhancing soil cracking. Controlled laboratory experiment revealed that as surface ice thaws, an immediate, large pulse of trapped gases is emitted. These results suggest that the Arctic CO2and CH4spring pulse is a delayed release of biogenic gas production from the previous fall and that the pulse can be large enough to offset a significant fraction of the moderate Arctic tundra carbon sink. Prethaw carbon flux pulses during thaw offset 46% of CO2summer uptake and added 6% to CH4summer fluxesLaboratory experiment linked pulse emissions to a delayed microbial production mechanismThe spring pulse may be a large underrepresented source of carbon in Arctic regions

The purpose of this article is to discuss the evolving workforce required to deliver quality healthcare in NHS acute care settings within the UK. The development and implementation of non-medical practitioner (NMP) roles, such as advanced clinical practitioners, surgical care practitioners, surgical first assistants, physician associates and physician assistants in anaesthesia are discussed in relation to training, regulation, governance and evaluation in clinical practice.

Methane hydrate formation and dissociation are buffered by salinity in a closed system. During hydrate formation, salt excluded from hydrate increases salinity, drives the system to three‐phase (gas, water, and hydrate phases) equilibrium, and limits further hydrate formation and dissociation. We developed a zero‐dimensional local thermodynamic equilibrium‐based model to explain this concept. We demonstrated this concept by forming and melting methane hydrate from a partially brine‐saturated sand sample in a controlled laboratory experiment by holding pressure constant (6.94 MPa) and changing temperature stepwise. The modeled methane gas consumptions and hydrate saturations agreed well with the experimental measurements after hydrate nucleation. Hydrate dissociation occurred synchronously with temperature increase. The exception to this behavior is that substantial subcooling (6.4°C in this study) was observed for hydrate nucleation. X‐ray computed tomography scanning images showed that core‐scale hydrate distribution was heterogeneous. This implied core‐scale water and salt transport induced by hydrate formation. Bulk resistivity increased sharply with initial hydrate formation and then decreased as the hydrate ripened. This study reproduced the salinity‐buffered hydrate behavior interpreted for natural gas‐rich hydrate systems by allowing methane gas to freely enter/leave the sample in response to volume changes associated with hydrate formation and dissociation. It provides insights into observations made at the core scale and log scale of salinity elevation to three‐phase equilibrium in natural hydrate systems. Salinity buffers methane hydrate formation and dissociation in closed systemsA thermodynamic equilibrium‐based model is developed to explain this conceptA laboratory experiment is conducted and demonstrated in this concept

The increasing importance of rehabilitation in the health sector and the nurses' critical role therein make it essential that nurses have the right skills and knowledge to work effectively in rehabilitation settings. Drawing from a wider qualitative investigation of the role of the nurse within the multi-professional rehabilitation team, gaps in the skills and knowledge of qualified nurses working in rehabilitation settings are presented and ways to address them are proposed. Both pre- and post-registration education were found wanting. Only one third of nurses thought, in retrospect, that their pre-registration education had provided them with adequate skills and knowledge for their role in rehabilitation. A need for greater focus on rehabilitation per se and associated clinical skills was identified. Whilst post-registration education was highly valued, substantial difficulties accessing relevant courses were noted. In-service training and ad hoc learning ‘from experience’ and colleagues formed additional ways to develop hands-on skills. Benefits of better education included enhancing confidence, promoting inter-professional equality and improving client care. Potential ways to address some of these concerns included: adoption of a ‘thread and module’ approach and dedicated rehabilitation student placements, a nationally recognized multi-professional post-registration course, and an integration of work based learning with formal educational provision. Copyright 2002, Elsevier Science Ltd. All rights reserved.

Effective team working is essential to the delivery of consistent and goal-directed rehabilitation. Within the rehabilitation team, the nurse has a key role to play. This paper reports on a study which gained insight into the nursing contribution to rehabilitation.

AbstractThere is currently much interest in the potential for small producers in the speciality food and drinks industry to develop niche markets based on the regionally distinctive character of their products. One Possible tool for developing such markets lies in the use of marketing and promotional strategies which attempt to create associations between ‘regional images’ and ‘quality’. This article presents some initial findings from research into the use of regional images to promote speciality food and drink products within the English ‘West Country’. These findings suggest that, although producers are aware of regional images, their use within marketing strategies is limited. Furthermore, as both ‘regional images’ and ‘quality’ are subjective, contested and socially constructed, attempts to use one to Promote the other are fraught with complexity.

Although controversial, diagnosis of luteal phase defect (LPD) includes the morphological assessment of endometrial development. This study was conducted to determine if refresher training in the histological criteria could improve the accuracy and interobserver reproducibility of endometrial dating. Seventy-eight endometrial biopsies were dated by a reference panel of two pathologists and then reviewed twice by a study panel of four pathologists. In the first review, usual practice was applied. Prior to the second review, they studied a standard document of histological criteria. Samples were dated as proliferative, secretory (post-ovulatory day, POD), menstrual, and undatable. Accuracy levels based on the reference dating and agreement levels using values were calculated per review and compared. The κ for overall dating was 0.683 in the first review and 0.696 in the second. The respective first and second review κ values were 0.736 and 0.771 for proliferative, and 0.794 and 0.764 for secretory. Amongst those dated as secretory in the first and second reviews, respectively, 31 and 28% were assigned the same POD by any two panellists, 68 and 63% were dated to within 1 day, and 77 and 71% were dated to within 2 days. Accuracy levels per panellist for overall dating were very high in both reviews but were low for individual PODs. Accuracy and interobserver reproducibility were unaffected by refresher training, suggesting the limits of histological dating have been reached.

Summary Regional food products are of contemporary interest as people are increasingly concerned to know where food comes from and how it is produced. Geographers have been slow to examine the link between product and place and this paper provides initial insights into the uptake of a European regulation designed to protect and promote high quality regional food and drink products in the United Kingdom. The early adopters of EU quality marks are shown to use them to protect their names from cheaper imitations rather than as a marketing device. Bureaucracy and costs of implementation, together with a lack of consumer knowledge, are likely to prevent rapid future adoption in the UK.

Despite the increasingly globalized nature of food production and consumption patterns, the demand for regional speciality food and drink products is also increasing. Yet little research exists that examines the link between specific products and particular places. This paper reports on an EU regulation aimed at ‘protecting’ and ‘promoting’ food and drink products with a recognizable geographical origin. Results indicate quite marked national and regional variations in patterns of uptake, reflecting differences in both the cultural significance of regional foods in Europe and the importance of producer cooperatives. There is a real danger that the regulation will benefit larger producers and retailers, rather than genuine small-scale businesses.

We present hydro‐mechanical measurements that characterize shear on natural fractures in schist, amphibolite, and rhyolite specimens from the enhanced geothermal system (EGS) Collab Project's Experiment 1 and 2 sites (E1 and E2) at the Sanford Underground Research Facility. We employed a triaxial direct shear method augmented with X‐ray imaging to perform hydroshearing (injection‐induced shearing) and mechanical shearing on naturally fractured specimens at in situ stress conditions. Measurements included fracture permeability, strength, stress‐dependent aperture, shear dilation, and frictional strength. Results reveal that in situ natural fractures must be permeable, weak, and shear‐oriented to be hydrosheared, and only a subset of the observable in situ fractures were suitable. When sheared, the fracture permeability typically increased by a factor of 10 or more and this increase was retained over time. However, shear slip did not always result in permeability increase. High phyllosilicate content associated with exceptionally weak fractures exhibited poor or even decreased permeability after stimulation. These measurements in combination with site data were used to conduct a slip‐tendency analysis for different fracture sets, and we selected the top candidate natural fractures for hydroshearing at the EGS Collab sites. We also found that the lower in situ shear stress and stronger fractures at the E2 site make hydroshearing more challenging than at the E1 site. Overall, the methods and analysis used in our work can be applied to any geothermal project to identify in situ joint sets that are best suited for hydroshearing, which in turn can help to optimize well placement and energy production. Geothermal energy is attractive because it is green, clean, and “always on”. However, technical challenges and high‐capital costs historically hindered its development. Among the technical challenges, is a need to reliably increase the rock permeability to promote productive geothermal wells. One leading method is called “hydroshearing”, where fluid is injected to encourage shear slip along pre‐existing natural fractures and thus open the fractures to increase permeability. Our research focuses on the enhanced geothermal system (EGS) Collab Project's field sites where we characterize actual natural fractures so that we can predict shear slip via hydroshearing and then identify the best locations for drilling wells suitable for hydroshearing. This work included measuring a suite of coupled hydraulic and mechanical properties for crystalline geothermal rocks drilled from this field site. We demonstrate that pre‐existing natural fractures must be mechanically weak, favorably oriented, and sufficiently permeable to be hydrosheared. Combining measured in situ stresses with natural fractures properties, we were able to identify suitable natural fractures for hydroshearing and to better optimize well design at the EGS Collab sites. This positive outcome from our work could be similarly applied to full‐scale geothermal systems to improve well productivity, reduce the risk of failed wells, and to improve economics. Hydroshearing requires a natural fracture that is mechanically weak, hydraulically conductive, and favorably orientedFracture shear slip does not always result in permeability enhancement; when phyllosilicate rich, we observed decreasing permeabilitySlip‐tendency analysis improved by hydro‐mechanical measurement helps to select the best candidate fracture for hydroshearing in the field Hydroshearing requires a natural fracture that is mechanically weak, hydraulically conductive, and favorably oriented Fracture shear slip does not always result in permeability enhancement; when phyllosilicate rich, we observed decreasing permeability Slip‐tendency analysis improved by hydro‐mechanical measurement helps to select the best candidate fracture for hydroshearing in the field

Candida albicansis a commensal of the urogenital tract and the predominant cause of vulvovaginal candidiasis (VVC). Factors that increase circulatory estrogen levels such as pregnancy, the use of oral contraceptives, and hormone replacement therapy predispose women to VVC, but the reasons for this are largely unknown. Here, we investigate how adaptation of C. albicansto estrogen impacts the fungal host-pathogen interaction. Estrogen promotes fungal virulence by enabling C. albicansto avoid the actions of the innate immune system. Estrogen-induced innate immune evasion is mediated via inhibition of opsonophagocytosis through enhanced acquisition of the human complement regulatory protein, Factor H, on the fungal cell surface. Estrogen-induced accumulation of Factor H is dependent on the fungal cell surface protein Gpd2. The discovery of this hormone-sensing pathway might pave the way in explaining gender biases associated with fungal infections and may provide an alternative approach to improving women's health.

Fluid flow through fractured rock systems is governed in large part by the distribution, interconnectivity, and size of fracture apertures. In‐situ stress is one of the primary factors controlling fracture aperture, and one that is altered significantly during high‐pressure fluid injections or extractions. Interactions between stress, pore pressure, aperture, and fluid flow can result in complex and evolving poroelastic behavior with significant implications regarding the predictability and risk involved with developing and managing deep subsurface reservoirs (geothermal, fossil energy, and geologic carbon sequestration). In saturated rocks, bulk electrical conductivity is sensitive to both primary and secondary porosity (i.e., matrix porosity and fractures), and therefore to fracture aperture size and distribution. We demonstrate the use of time‐lapse 3D electrical resistivity tomography for remotely monitoring stress induced changes in aperture distribution during high pressure injections into a dense fractured rock system at a scale of tens of meters. Results reveal a complex and continuously evolving stress field involving aperture dilations in the natural fracture system and aperture contractions in adjacent zones of shadow stress. Results provide information about the spatiotemporal changes in the system behavior and point to the potential of electrical imaging for autonomously and remotely monitoring evolving stress conditions by proxy through changes in bulk electrical conductivity. The state and evolution of the stress exerted on rocks has a governing influence on how fluids migrate through deep, fractured rock systems. Dynamic changes in stress during subsurface fluid injections and extractions are difficult to observe, which limits the ability to optimize the management of subsurface reservoirs. We demonstrate how time‐lapse 3D (i.e., 4D) electrical geophysical imaging can be used to monitor how fractures expand and contract in response to stresses induced during high‐pressure injections into a deep fractured rock formation. Results point to the potential of autonomous electrical imaging for providing actionable feedback information during reservoir operations, enabling enhanced understanding and control. Time‐Lapse 3D ERT imaging is used to monitor stress‐induced fracture dilation and contraction during high pressure injectionsHigh temporal resolution reveals fine details of complex dynamic poroelastic system behavior during and after high pressure injectionsResults demonstrate the potential of ERT for remote, proxy monitoring of changes in stress and fracture aperture in fractured‐rock systems Time‐Lapse 3D ERT imaging is used to monitor stress‐induced fracture dilation and contraction during high pressure injections High temporal resolution reveals fine details of complex dynamic poroelastic system behavior during and after high pressure injections Results demonstrate the potential of ERT for remote, proxy monitoring of changes in stress and fracture aperture in fractured‐rock systems

Enhanced geothermal systems (EGS) offer the potential for a much larger energy source than conventional hydrothermal systems. Hot, low-permeability rocks are prevalent at depth around the world, but the challenge of extracting thermal energy depends on the ability to create and sustain open fracture networks. Laboratory experiments were conducted using a suite of selected rock cores (granite, metasediment, rhyolite ash-flow tuff, and silicified rhyolitic tuff) at relevant pressures (uniaxial loading up to 20.7 MPa and fluid pressures up to 10.3 MPa) and temperatures (150–250 °C) to evaluate the potential impacts of circulating fluids through fractured rock by monitoring changes in fracture aperture, mineralogy, permeability, and fluid chemistry. Because a fluid in disequilibrium with the rocks (deionized water) was used for these experiments, there was net dissolution of the rock sample: this increased with increasing temperature and experiment duration. Thermal-hydrological-mechanical-chemical (THMC) modeling simulations were performed for the rhyolite ash-flow tuff experiment to test the ability to predict the observed changes. These simulations were performed in two steps: a thermal-hydrological-mechanical (THM) simulation to evaluate the effects of compression of the fracture, and a thermal-hydrological-chemical (THC) simulation to evaluate the effects of hydrothermal reactions on the fracture mineralogy, porosity, and permeability. These experiments and simulations point out how differences in rock mineralogy, fluid chemistry, and geomechanical properties influence how long asperity-propped fracture apertures may be sustained. Such core-scale experiments and simulations can be used to predict EGS reservoir behavior on the field scale.

Atypical polypoid adenomyoma (APA) is an uncommon uterine tumor that rarely metastasizes, although it closely resembles a welldifferentiated endometrioid carcinoma. A 37-year-old woman with a history of pelvic endometriosis and oral contraceptive use developed an APA and later presented with bilateral ovarian endometrioid carcinomas. DNA ploidy analysis and human papilloma virus (HPV) typing of the APA and ovarian carcinomas were performed to characterize the primary or metastatic nature of the tumors. Both tumors were aneuploid. The APA had a DNA index of 1.53, compared with 1.19 for the ovarian carcinoma. The APA contained HPV 18, and the ovarian carcinoma a mixed infection of HPV 6, 11, 16, and 18, with types 6 and 11 predominating. These differences in DNA index and HPV type supported the autonomous nature of the APA and the ovarian carcinomas. The report affirms the benign outcome of APA, highlights its complication by a second malignancy, and suggests an etiological role for endometriosis, steroid hormones, and possibly the HPV in the formation of one or both tumors.

Paediatric liver transplantation for small infants is limited by donor availability. This study investigates whether anencephalic babies might be potential neonatal liver donors. We reviewed 174 cases of anencephalic babies born (1970–1987) in the National Maternity Hospital, Dublin. Out of a total number of 69 (40%) live births, 27 were term or older, and of these 22 weighed >-2.5 kg. This group of 22 probably represent the most suitable “potential donors” (13% of total): only 4 had associated serious anomalies (4 renal, 1 cardiac). There were no hepatic anomalies. The mean duration of life was 37 h (median 28 h) in the study group compared to 1.5 h (median 30 min) in the remainder of the anencephalic population. Liver weights fell within 20% of the predicted range. Liver histology was re-examined to assess maturity, extramedulary haematopoiesis, and any biliary pathology; when compared with a control group of neonates there was no statistical difference. From this study it appears that physically and structurally these livers may be suitable for transplantation.

Patients with developmental breast abnormalities often present to the plastic surgeon at a young age. We report our experience with 4 cases of unilateral breast abnormality (3 hypoplastic and 1 tuberous) treated with a Becker permanent expander/implant. Our approach is to insert the expander/implant, expand intermittently to keep pace with growth of the other breast and remove the filling valve under local anaesthesia on maturity. The techniques and advantages of this approach are illustrated and discussed.

Since the paramilitary cease-fire in Northern Ireland in August 1994 we have seen a change in the pattern of so called 'punishment attacks'. Shootings with low velocity handguns have been replaced by severe beatings to the extremities from multiple assailants using iron bars or similar weapons. In the 18 months prior to the cease-fire there were 177 punishment shootings, which were usually relatively minor and did not require any plastic surgical expertise. Between August 1994 and November 1996, however, there were 461 punishment beatings. These beatings result in much greater morbidity and require considerable orthopaedic and plastic surgical input. In the Northern Ireland Plastic and Maxillofacial Unit we have treated 18 patients with a mean age of 22.9 years (range 16-32 years) who have been the victims of punishment beatings. These patients sustained multiple injuries, all with severe soft tissue involvement; 70% had compound fractures. The majority of patients had multiple wounds. Four patients with compartment syndrome as a result of their injuries required fasciotomies. Soft tissue reconstruction included split skin grafting (4 patients), fasciocutaneous flaps (4 patients), adipofascial flaps (2 patients), local muscle flaps (2 patients) and free muscle transfers (2 patients). Six patients required more than one procedure for soft tissue reconstruction because of multiple injuries. Each patient had a cumulative mean time in theatre of 6.7 hours. The mean hospital stay was 22.2 days (range 2-52 days). This change in the pattern of injury has led to an increased use of plastic surgical resources. Patient morbidity is significantly greater than when guns are used, and permanent disability is often the result.

The capsule of the proximal interphalangeal joint consists of the central slip of the extensor tendon dorsally, the collateral ligaments at the sides and the palmar ligament ventrally. Fibrocartilaginous menisci have been reported extending into the joint cavity and the central slip has a sesamoid fibrocartilage articulating with the proximal phalanx. This study relates ECM composition in the joint capsule to function. Each part of the capsule from 24 fingers amputated because of trauma, carcinoma, isthaemia, fixed-flexion deformities or Dupuytren's contracture, was dissected out. Sections were prepared for routine histology or immunolabelled with a panel of monoclonal and polyclonal antibodies against collagens and glycosaminoglycans using the avidin/biotin/peroxidase procedure. All parts of the capsule consistently labelled for types I, III and VI collagens and for dermatan and keratan sulphate, though labelling was more pericellular in fibrocartilaginous regions. In contrast, only certain regions of the capsule in some fingers labelled for type II collagen, chondroitin 4 or 6 sulphate. The sesamoid fibrocartilage in the central slip showed the greatest degree of fibrocartilage differentiation, especially in fixed-flexion deformity fingers, and the palmar ligament the least. The immunolabelling patterns suggest that there is an ordered sequence of matrix changes accompanying fibrocartilage differentiation. Chondroitin sulphate-containing proteoglycans accumulate first, and type II collagen appears later. The presence or absence of type II collagen probably relates to different levels of compressive loading. No fibrocartilaginous menisci were found in normal joints and those described previously are regarded as synovial folds. Anat. Rec. 250:281–291, 1998. © 1998 Wiley-Liss, Inc.

Objective This study evaluated the craniofacial form of a sample of Northern Irish children with unilateral cleft lip and palate (UCLP). The quality of the outcomes achieved was compared with the outcomes reported for the six centers involved in the European multicenter study (Mars et al., 1992; Mølsted et al, 1992).Design Retrospective analysis.Patients All children born with complete skeletal UCLP in Northern Ireland during the years 1983 to 1987.Main outcome Measures Cephalometric analysis was used to determine the craniofacial form and soft tissue profile. The quality of the dental arch relationships was independently assessed using the Goslon ranking system.Results The sample comprised 25 children with complete skeletal UCLP who had cephalometric radiographs and study casts recorded at a mean age of 9.4 years (range, 8 to 11 years). Cephalometric analysis revealed no important skeletal differences between the Northern Irish UCLP children and the published results from the six Eurocleft centers. The soft tissue profile of the Northern Irish UCLP children was significantly more convex than the soft tissue profile recorded for center D in the Eurocleft study. The Goslon ranking system revealed that 18 (72%) of the Northern Irish UCLP children had good or satisfactory dental arch relationships.Conclusions No clinically important differences were detected between the mean cephalometric skeletal parameters of the Northern Irish UCLP children and those published for the six cleft centers involved in the Eurocleft study. On average, the Northern Irish UCLP children were found to differ significantly from Eurocleft's center D in their soft tissue facial contour and sagittal lip profile. The quality of the dental arch relationships of the Northern Irish sample was between the best and the less good Eurocleft centers.

Quality products and services (niche markets) could be an important instrument of rural development in the lagging regions of the European Union. However, there is little research which relates product to place in a rural context. After providing a brief insight into aspects of agricultural and rural restructuring, the article reviews existing literature and relevant concepts under the separate headings of 'Constructing quality' and 'Constructing regional images: linking product to place'. Many of these ideas are being applied in an interdisciplinary and international (EU) research project which attempts to link specific quality products and services to specific regions. The aims of RIPPLE are outlined in the hope of encouraging more research into the links between quality products and rural places.

The mixed‐wet nature of reservoir formations imposes a wide range of rock wettability from strong resident‐fluid wetting to strong invading‐fluid wetting. The characteristics of two‐phase flow in porous media composed of mixed‐wetting surfaces remain poorly understood. In this study, we investigated the displacement of resident ethylene glycol (EG) by hexane in two mixed‐wet micromodels of identical 2.5‐D geometry heterogeneity, with uniformly or heterogeneously distributed patches strongly wetting to hexane. These patches are mixed among pores with unaltered EG‐wetting surfaces. Along with control tests in the originally EG‐wet micromodel, we show the classic fingering and transitions in flow regimes at logCa(capillary number) from −7.2 to −3.9. Moreover, pore‐scale distributions of wettability and their spatial correlation influence displacement efficiency. In the two mixed‐wet micromodels, we found (a) an increase of steady‐state hexane saturation at the end of experiments by up to 0.12 in the capillary fingering regime and a decrease of at most by 0.06 in the viscous fingering regime, compared to the EG‐wet micromodel, and (b) dispersed and fragmented hexane distribution after displacement. Brine drainage during supercritical CO2(scCO2) injections in these micromodels occurs with lower wettability contrasts, and under similar viscosity ratios and interfacial tensions resulted in higher displacement efficiency relative to displacement of EG by hexane. While mixed‐wettability can enhance displacement efficiency compared to uniform wettability, the dynamics of immiscible fluids in strong mixed‐wet reservoirs are expected to be less pronounced in contributing to the efficiency of geological CO2sequestration, oil recovery, and remediation of hydrocarbon‐contaminated aquifers. Fingering flow of hexane–ethylene glycol was investigated in mixed‐wet micromodels with bimodal contact angle distributions at 47° and 145°Mixed‐wettability diminishes displacement efficiency when contact angles vary beyond 90°, and at low capillary numbersWe proposed a new set of capillary numbers to characterize the displacement and fingering flow in strong mixed‐wet systems Fingering flow of hexane–ethylene glycol was investigated in mixed‐wet micromodels with bimodal contact angle distributions at 47° and 145° Mixed‐wettability diminishes displacement efficiency when contact angles vary beyond 90°, and at low capillary numbers We proposed a new set of capillary numbers to characterize the displacement and fingering flow in strong mixed‐wet systems

The final version of the above article was posted prematurely on 16 July 2021, owing to a technical error. The final, corrected version of record will be made fully available at a later date.

We provide direct observations of the three‐dimensional displacements of a fluid‐driven fracture during water injections in a borehole at ∼1.5 km depth in the crystalline rock at the Sanford Underground Research Facility (USA). Micro‐shearing of the borehole initiates on a foliation plane at 61% of the minimum principal stress σ3. As the fluid pressure increases further up to 112% of σ3,borehole axial and radial displacements increase with injection time highlighting the opening and sliding of a new hydrofracture growing ∼10 m away from the borehole, in accordance with the ambient normal stress regime and in alignment with the microseismicity. Our study reveals how important it is to consider monitoring zonal deformation in conjunction with pressure and flow to better manage the complex hydromechanical evolution of the growing fracture. We provide an observation of the direct coupling between three‐dimensional displacement, injection pressure, and flow during growth of a hydraulic fracture in rock types (intact metamorphic rock) relevant for enhanced geothermal systems and the mining industry. The displacement data indicate a complex interplay of fracture opening and fracture dilation including interaction with natural, preexisting fractures, and induced seismicity. Hydrofracture (HF) nucleates on a plane of weakness controlled by the rock fabricHF macroscopic propagation is in good accordance with the stress tensor and the alignment of induced seismicityBorehole displacements highly complement pressure data to estimate fracture orientation and growth away from the borehole Hydrofracture (HF) nucleates on a plane of weakness controlled by the rock fabric HF macroscopic propagation is in good accordance with the stress tensor and the alignment of induced seismicity Borehole displacements highly complement pressure data to estimate fracture orientation and growth away from the borehole

Geothermal resources offer a stable low‐carbon energy source. However, geothermal sites can collocate with the hypocenters of large‐magnitude seismic events. Large seismic events pose a risk to public safety and are therefore a liability for efforts to develop geothermal resources. Here, we propose “fracture caging” to limit induced seismic event magnitudes and present evidence from numerical model predictions, laboratory experiments, and field observations. Fracture caging involves drilling tactical production wells around a geothermal injection zone to contain fluids in fracture‐dominated flow systems. Prior to our work, the effect of small wells on the growth of large fractures and on flow through fractures was subject to debate. Our work shows that production wells can impede fracture growth and contain high‐pressure fluids in fracture‐dominated rocks. This containment offers a mechanism to limit induced seismicity. Below the ground's surface, fluid can lubricate rocks which enables them to more easily slip and generate earthquakes. This is a problem for developing geothermal energy resources that require long‐term injection of water. If water could be injected without risk of earthquakes, geothermal energy production could be expanded to supply more than 60 GW of electricity in the United States alone. To confront the earthquake risk, we propose that tactical arrangements of production wells around geothermal injection wells can be used to prevent large seismic events. We refer to this arrangement as “fracture caging” because it contains injected fluid in a limited volume of fractured rock in order to prevent uncontrolled stimulation of the larger fractures that generate earthquakes. Prior to this work, we incorrectly assumed that small wells (e.g., 0.3 m diameter) could not inhibit the growth of large fractures (e.g., greater than 100 m diameter). We also incorrectly assumed that these wells could not contain fluids in the dynamic and uncertain fracture networks that are common in natural rocks. However, our models, experiments, and field data now show that fracture caging can work to contain injected fluids and thereby also limit induced seismicity, even in complex natural rock. A production well cage can enable high‐pressure fluid‐injection simultaneously with closed‐loop flow‐containment in fractured rockModel, laboratory, and field evidence indicate that fracture caging can reduce induced seismic magnitudes despite natural complexityA cage of production wells improves subsurface flow control and adaptability to transient and dynamic fracture networks A production well cage can enable high‐pressure fluid‐injection simultaneously with closed‐loop flow‐containment in fractured rock Model, laboratory, and field evidence indicate that fracture caging can reduce induced seismic magnitudes despite natural complexity A cage of production wells improves subsurface flow control and adaptability to transient and dynamic fracture networks

Enhanced Geothermal Systems could provide a substantial contribution to the global energy demand if their implementation could overcome inherent challenges. Examples are insufficient created permeability, early thermal breakthrough, and unacceptable induced seismicity. Here we report on the seismic response of a mesoscale hydraulic fracturing experiment performed at 1.5‐km depth at the Sanford Underground Research Facility. We have measured the seismic activity by utilizing a 100‐kHz, continuous seismic monitoring system deployed in six 60‐m length monitoring boreholes surrounding the experimental domain in 3‐D. The achieved location uncertainty was on the order of 1 m and limited by the signal‐to‐noise ratio of detected events. These uncertainties were corroborated by detections of fracture intersections at the monitoring boreholes. Three intervals of the dedicated injection borehole were hydraulically stimulated by water injection at pressures up to 33 MPa and flow rates up to 5 L/min. We located 1,933 seismic events during several injection periods. The recorded seismicity delineates a complex fracture network comprised of multistrand hydraulic fractures and shear‐reactivated, preexisting planes of weakness that grew unilaterally from the point of initiation. We find that heterogeneity of stress dictates the seismic outcome of hydraulic stimulations, even when relying on theoretically well‐behaved hydraulic fractures. Once hydraulic fractures intersected boreholes, the boreholes acted as a pressure relief and fracture propagation ceased. In order to create an efficient subsurface heat exchanger, production boreholes should not be drilled before the end of hydraulic stimulations. Mesoscale hydraulic fracturing in crystalline rock is observed with multigeophysical sensor array at close proximityCreated fracture network consists of multistrand hydraulic fractures and reactivated preexisting structuresHydraulic fracture growth is strongly influenced by rock fabric, preexisting fractures, and stress heterogeneities

Geological carbon storage (GCS) involves unstable drainage processes, the formation of patterns in a morphologically unstable interface between two fluids in a porous medium during drainage. The unstable drainage processes affect CO2storage efficiency and plume distribution and can be greatly complicated by the mixed‐wet nature of rock surfaces common in hydrocarbon reservoirs where supercritical CO2(scCO2) is used in enhanced oil recovery. We performed scCO2injection (brine drainage) experiments at 8.5 MPa and 45°C in heterogeneous micromodels, two mixed‐wet with varying water‐ and intermediate‐wet patches, and one water‐wet. The flow regime changes from capillary fingering through crossover to viscous fingering in the micromodels of the same pore geometry but different wetting surfaces at displacement rates with logCa(capillary number) increasing from −8.1 to −4.4. While the mixed‐wet micromodel with uniformly distributed intermediate‐wet patches yields ~0.15 scCO2saturation increase at both capillary fingering and crossover flow regimes (−8.1 ≤ logCa≤  − 6.1), the one heterogeneous wetting to scCO2results in ~0.09 saturation increase only at the crossover flow regime (−7.1 ≤ logCa≤  − 6.1). The interconnected flow paths in the former are quantified and compared to the channelized scCO2flow through intermediate‐wet patches in the latter by topological analysis. At logCa>  − 6.1(near well), the effects of wettability and pore geometry are suppressed by strong viscous force. Both scCO2saturation and distribution suggest the importance of wettability on CO2storage efficiency and plume shape in reservoirs and capillary leakage through caprock at GCS conditions. We created two mixed‐wet systems with varying water‐ and intermediate‐wet patches in a 2.5‐D heterogeneous micromodelThe uniformly distributed intermediate‐wet patches yield bridging flow topology and highest storage efficiency after drainageThe heterogeneously distributed intermediate‐wet patches enhance channelized CO2flow and hinder storage efficiency after drainage

High-pressure injection injuries to the hand are uncommon, but often result in poor outcome or even amputation. We report a review of the 28 cases treated surgically in our department over the last 10 years and have examined the factors leading to increased morbidity. The severity of these injuries was related to the nature of the injected material, involvement of the tendon sheath and proximal spread of the injected substance. All cases in which the digit was noted to be poorly perfused from the outset resulted in amputation. We conclude that early amputation should be considered in cases in which the affected digit is initially cool or poorly perfused.

High-pressure injection injuries to the hand are uncommon, but often result in poor outcome or even amputation. We report a review of the 28 cases treated surgically in our department over the last 10 years and have examined the factors leading to increased morbidity. The severity of these injuries was related to the nature of the injected material, involvement of the tendon sheath and proximal spread of the injected substance. All cases in which the digit was noted to be poorly perfused from the outset resulted in amputation. We conclude that early amputation should be considered in cases in which the affected digit is initially cool or poorly perfused.