Initial 4D seismic results after CO 2 injection start-up at the Aquistore storage site

The first post-CO2-injection 3D time-lapse seismic survey was conducted at the Aquistore CO2 storage site in February 2016 using the same permanent array of buried geophones used for acquisition of three previous pre-CO2-injection surveys from March 2012 to November 2013. By February 2016, 36 kilotons of CO2 have been injected within the reservoir between 3170 and 3370 m depth. We have developed time-lapse results from analysis of the first post-CO2-injection data and three pre-CO2-injection data sets. The objective of our analysis was to evaluate the ability of the permanent array to detect the injected CO2. A “4D-friendly simultaneous” processing flow was applied to the data in an effort to maximize the repeatability between the pre- and post-CO2-injection volumes while optimizing the final subsurface image including the reservoir. Excellent repeatability was achieved among all surveys with global normalized root-mean-square (Gnrms) values of 1.13–1.19 for the raw prestack data relative to the baseline data, which decreased during processing to Gnrms values of approximately 0.10 for the final crossequalized migrated data volumes. A zone of high normalized root-mean-square (nrms) values (0.11–0.25 as compared with background values of 0.05–0.10) is identified within the upper Deadwood unit of the storage reservoir, which likely corresponds to approximately 18 kilotons of CO2. No significant nrms anomalies are observed within the other reservoir units due to a combination of reduced seismic sensitivity, higher background nrms values, and/or small quantities of CO2 residing within these zones

Power, fairness and trust: understanding and engaging with vaccine trial participants and communities in the setting up the EBOVAC-Salone vaccine trial in Sierra Leone.

BACKGROUND: This paper discusses the establishment of a clinical trial of an Ebola vaccine candidate in Kambia District, Northern Sierra Leone during the epidemic, and analyses the role of social science research in ensuring that lessons from the socio-political context, the recent experience of the Ebola outbreak, and learning from previous clinical trials were incorporated in the development of community engagement strategies. The paper aims to provide a case study of an integrated social science and communications system in the start-up phase of the clinical trial. METHODS: The paper is based on qualitative research methods including ethnographic observation, interviews with trial participants and key stakeholder interviews. RESULTS: Through the case study of EBOVAC Salone, the paper suggests ways in which research can be used to inform communication strategies before and during the setting up of the trial. It explores notions of power, fairness and trust emerging from analysis of the Sierra Leonean context and through ethnographic research, to reflect on three situations in which social scientists and community liaison officers worked together to ensure successful community engagement. Firstly, a section on "power" considers the pitfalls of considering communities as homogeneous and shows the importance of understanding intra-community power dynamics when engaging communities. Secondly, a section on "fairness" shows how local understandings of what is fair can help inform the design of volunteer recruitment strategies. Finally, a section on "trust" highlights how historically rooted rumours can be effectively addressed through active dialogue rather than through an approach focused on correcting misinformation. CONCLUSION: The paper firstly emphasises the value of social science in the setting up of clinical trials, in terms of providing an in depth understanding of context and social dynamics. Secondly, the paper suggests the importance of a close collaboration between research and community engagement to effectively confront political and social dynamics, especially in the context of an epidemic

The effect of unsupportive and supportive footwear on children’s multi-segment foot dynamics during gait

Footwear is necessary for children’s foot comfort and protection. Despite the popularity of flip-flop (thongs) footwear among children, strong clinical opinion endures of the potential deleterious effect this footwear may have on developing feet. On the contrary, thongs may be beneficial for children’s developing feet due to the footwear’s flexible and unrestrictive nature, as children who mature within habitually barefoot communities are observed to develop stronger and healthier feet. This thesis considers the developing nature of human ambulation and the physiological basis for children’s foot maturation. It then explores the effect of thong footwear on childrens barefoot dynamics with comparisons to traditionally advocated supportive footwear. Foot compensations were observed when thongs were worn while walking and to a lesser extent while jogging. Greater ankle dorsiflexion and reduced hallux dorsiflexion suggests a mechanism to retain the thong. Greater midfoot plantarflexion indicates a gripping action to sustain the thong. Barefoot motions were unaffected by thongs during the sidestep. The midfoot splinting effect of supportive shoes was reinforced while walking, jogging and sidestepping. Thongs had a minimal effect on barefoot dynamics, while supportive shoes limited midfoot power generation with a corresponding increase in ankle power generation. Overall findings suggest that foot motion when wearing thongs may be more replicable of barefoot motion than originally believed. In terms of foot arch development, thongs may be more beneficial than supportive shoes, due to the minimal alterations to barefoot motions when they are worn. The reported midfoot plantarflexion required to grip the thong may be beneficial to children’s foot arch strengthening and overall foot development. While supportive shoes have the necessary protective features, they have been shown to inhibit midfoot and hallux motions with a compensatory increase in ankle motions

"We are the heroes because we are ready to die for this country": Participants' decision-making and grounded ethics in an Ebola vaccine clinical trial.

The 2014-2016 Ebola epidemic presented a challenging setting in which to carry out clinical trials. This paper reports findings from social science research carried out in Kambia, Northern Sierra Leone during first year of an Ebola vaccine trial (August 2015-July 2016). The social science team collected data through ethnographic observation, 42 in depth interviews; 4 life narratives; 200 exit interviews; 31 key informant interviews; and 8 focus group discussions with trial participants and community members not enrolled in the trial. Whilst research often focuses on why people refuse vaccination, we instead explore participant motivations for volunteering for the study, in spite of prevailing anxieties, rumours and mistrust during and after the Ebola outbreak. In so doing the paper contributes to on-going debates about research ethics and community engagement in resource poor contexts, offering reflections from an emergency and post-epidemic setting. We analyse participants' perceptions of the risks and benefits of participations, highlighting the importance of a contextual approach. We focus on four types of motivation: altruism; curiosity and hope; health-seeking; and notions of exchange, and argue for the role of social science in developing grounded research ethics and community engagement strategies that can take into account context and local realities

The metaverse—Not a new frontier for crime.

Law enforcement co-ordination agencies have recently issued position/guidance documents relating to the potential for VR environments (the “Metaverse”) to become new environment for criminal activity, and calling for additional work to enhance investigative capability. By reviewing the historic development of VR and comparing it with the appearance of the WWW, the authors propose that the situation is not as dire as the issued documents may suggest, but represents an evolutionary rather than revolutionary step in online experiences. They conclude, therefore, that while ability to examine VR presentation/interaction devices may be useful, continued development of ability to examine online systems remains essential

Application of a challenge model to assess the protective efficacy of oral typhoid vaccines in humans

Human infection by Salmonella Typhi has been occurring for the last 50,000 years and still accounts for ∼ 22million new cases each year worldwide. Through faeco-oral transmission, this human-restricted infection disproportionately affects the most impoverished sections of endemic communities where adequate sanitation infrastructure and effective vaccination approaches are lacking. Development of new control measures to accurately measure the burden of disease and to prevent infection with new vaccine candidates are hindered by an incomplete understanding of host-pathogen interactions and of what constitutes a protective human response after exposure. In this thesis I describe the practical application of a recently developed human challenge model of typhoid infection in assessing new control measures, including the evaluation of the oral single-dose vaccine candidate, M01ZH09. In performing a large, double-blind, placebo-controlled study, I was able to measure the direct protective efficacy (PE) of vaccination with either M01ZH09 or 3-dose Ty21a by performing human challenge with 104CFU Salmonella Typhi, Quailes strain, 28-days later. Using clinical and microbiological definitions to confirm typhoid diagnosis during a 14-day period after ingestion, I found insignificant levels of protection afforded by a single dose of M01ZH09 (12.9%), and a low PE after Ty21a vaccination (35%), demonstrating the stringency of the model and the endpoints used. Many additional insights into pathogen dynamics and host responses were found highlighting several important characteristics of oral vaccination. M01ZH09 was highly immunogenic, and both active vaccines significantly reduced bacterial burden (bacteraemia and stool shedding) while having no effect on symptomatic severity of infection in those diagnosed. M01ZH09 receipt resulted in a significantly longer incubation period, suggesting underlying protective responses were being generated. Further findings included the first objective demonstration of primary bacteraemia occurring after typhoid exposure, and frequent asymptomatic infection or stool shedding in those exposed but remaining well. Overall, these data also demonstrated significant protective effects against challenge by anti-Vi antibody status and age at baseline. Taking these factors into account, M01ZH09 and Ty21a vaccination did convey an overall protective advantage against developing typhoid infection, each reducing the risk of diagnosis by ~two-fold during the challenge period

Pathophysiological aspects of severe Falciparum malaria in Thailand and Ghana

The mechanisms of parasite clearance in falciparum malaria are still unclear but the spleen is considered to be the major site of parasite removal. The process of removing intraerythrocytic parasites leaving the host erythrocyte intact is termed "pitting". We have investigated several possible mechanisms for parasite clearance. Using monoclonal antibodies to Ring Erythrocyte Surface antigen, (RESA or Pf 155) an early antigen expressed on the erythrocyte surface and staining for intraerythrocytic plasmodial DNA we have demonstrated that removal of intracellular parasites by host phagocytes leaving the erythrocyte intact, occurs in vivo. During acute falciparum malaria infection, red blood cells (RBC) containing abundant RESA, but no intracellular parasites, are present in the circulation. These RESA-positive parasite-negative RBC are not seen in parasite cultures in vitro. This indicates that in acute falciparum malaria there is active removal of intra-erythrocytic parasites by a host mechanism in vivo (probably the spleen) without destruction of the parasitized RBC. The ability of parasites to form rosettes has been considered a marker of pathogenicity in malaria and those parasites with a greater potential for this phenomenon were considered inherently more pathogenic. We have reported rosetting in a Thai patient with Plasmodium ovale infection suggesting that rosetting is in fact a common property of all plasmodia. Using a laser diffraction technique, we measured red blood cell (RBC) deformability over a range of shear stresses and related this to the severity of anemia in 36 adults with severe falciparum malaria. The RBC deformability at a high shear stress of 30 Pa, similar to that encountered in the splenic sinusoids, showed a significant positive correlation with the nadir hemoglobin concentration during hospitalization (r = 0.49, P < 0.002). Reduction in RBC deformability resulted mainly from changes in non-parasitised erythrocytes. Since reduced red blood cell deformability (RBC-D) can also contribute to impaired microcirculatory flow, RBC-D was measured and compared in 23 patients with severe falciparum malaria (seven of whom subsequently died), 30 patients with uncomplicated malaria, and 17 healthy controls. The RBC-D was significantly reduced in severe malaria and was particularly low in all fatal cases. At a low shear stress of 1.7 Pascal (Pa), a red blood cell elongation index less than 0.21 on admission to the hospital predicted fatal outcome with a sensitivity of 100% (confidence interval [Cl] 59 - 100%) and a specificity of 88% (Cl = 61 - 98%). The reduction in the RBC- D appeared to result mainly from changes in unparasitized erythrocytes. This finding may provide a rationale for the use of exchange transfusion in severe malaria since this process will replace rigid cells with more deformable cells. (Abstract shortened by ProQuest.)

Getting shot of elves: healing, witchcraft and fairies in the Scottish witchcraft trials

This paper re-examines the evidence of the Scottish witchcraft trials for beliefs associated by scholars with "elf-shot." Some supposed evidence for elf-shot is dismissed, but other material illuminates the interplay between illness, healing and fairy-lore in early modern Scotland, and the relationship of these beliefs to witchcraft itself

A pragmatic, multicentre, randomised controlled trial comparing stapled haemorrhoidopexy to traditional excisional surgery for haemorrhoidal disease (eTHoS): study protocol for a randomised controlled trial

Background: Current interventions for haemorrhoidal disease include traditional haemorrhoidectomy (TH) and stapled haemorrhoidopexy (SH) surgery. However, uncertainty remains as to how they compare from a clinical, quality of life (QoL) and economic perspective. The study is therefore designed to determine whether SH is more effective and more cost-effective, compared with TH. Methods/Design: eTHoS (either Traditional Haemorrhoidectomy or Stapled Haemorrhoidopexy for Haemorrhoidal Disease) is a pragmatic, multicentre, randomised controlled trial. Currently, 29 secondary care centres are open to recruitment. Patients, aged 18 year or older, with circumferential haemorrhoids grade II to IV, are eligible to take part. The primary clinical and economic outcomes are QoL profile (area under the curve derived from the EuroQol Group’s 5 Dimension Health Status Questionnaire (EQ-5D) at all assessment points) and incremental cost per quality adjusted life year (QALY) based on the responses to the EQ-5D at 24 months. The secondary outcomes include a comparison of the SF-36 scores, pain and symptoms sub-domains, disease recurrence, complication rates and direct and indirect costs to the National Health Service (NHS). A sample size of n =338 per group has been calculated to provide 90% power to detect a difference in the mean area under the curve (AUC) of 0.25 standard deviations derived from EQ-5D score measurements, with a two-sided significance level of 5%. Allowing for non-response, 400 participants will be randomised per group. Randomisation will utilise a minimisation algorithm that incorporates centre, grade of haemorrhoidal disease, baseline EQ-5D score and gender. Blinding of participants and outcome assessors is not attempted. Discussion: This is one of the largest trials of its kind. In the United Kingdom alone, 29,000 operations for haemorrhoidal disease are done annually. The trial is therefore designed to give robust evidence on which clinicians and health service managers can base management decisions and, more importantly, patients can make informed choices. Trial registration: Current Controlled Trials ISRCTN80061723 (assigned 8 March 2010