Subsidence monitoring system for offshore applications: technology scouting and feasibility studies

Because of concern about possible impacts of hydrocarbon production activities on coastal-area environments and infrastructures, new hydrocarbon offshore development projects in Italy must submit a monitoring plan to Italian authorities to measure and analyse real-time subsidence evolution. The general geological context, where the main offshore Adriatic fields are located, is represented by young unconsolidated terrigenous sediments. In such geological environments, sea floor subsidence, caused by hydrocarbon extraction, is quite probable. Though many tools are available for subsidence monitoring onshore, few are available for offshore monitoring. To fill the gap ENI (Ente Nazionale Idrocarburi) started a research program, principally in collaboration with three companies, to generate a monitoring system tool to measure seafloor subsidence. The tool, according to ENI design technical-specification, would be a robust long pipeline or cable, with a variable or constant outside diameter (less than or equal to 100 mm) and interval spaced measuring points. The design specifications for the first prototype were: to detect 1 mm altitude variation, to work up to 100 m water depth and investigation length of 3 km. Advanced feasibility studies have been carried out with: Fugro Geoservices B.V. (Netherlands), D'Appolonia (Italy), Agisco (Italy). Five design (using three fundamental measurements concepts and five measurement tools) were explored: cable shape changes measured by cable strain using fiber optics (Fugro); cable inclination measured using tiltmeters (D'Appolonia) and measured using fiber optics (Fugro); and internal cable altitude-dependent pressure changes measured using fiber optics (Fugro) and measured using pressure transducers at discrete intervals along the hydraulic system (Agisco). Each design tool was analysed and a rank ordering of preferences was performed. The third method (measurement of pressure changes), with the solution proposed by Agisco, was deemed most feasible. Agisco is building the first prototype of the tool to be installed in an offshore field in the next few years. This paper describes design of instruments from the three companies to satisfy the design specification

Subsidence monitoring system for offshore applications: technology scouting and feasibility studies

Abstract. Because of concern about possible impacts of hydrocarbon production activities on coastal-area environments and infrastructures, new hydrocarbon offshore development projects in Italy must submit a monitoring plan to Italian authorities to measure and analyse real-time subsidence evolution. The general geological context, where the main offshore Adriatic fields are located, is represented by young unconsolidated terrigenous sediments. In such geological environments, sea floor subsidence, caused by hydrocarbon extraction, is quite probable. Though many tools are available for subsidence monitoring onshore, few are available for offshore monitoring. To fill the gap ENI (Ente Nazionale Idrocarburi) started a research program, principally in collaboration with three companies, to generate a monitoring system tool to measure seafloor subsidence. The tool, according to ENI design technical-specification, would be a robust long pipeline or cable, with a variable or constant outside diameter (less than or equal to 100 mm) and interval spaced measuring points. The design specifications for the first prototype were: to detect 1 mm altitude variation, to work up to 100 m water depth and investigation length of 3 km. Advanced feasibility studies have been carried out with: Fugro Geoservices B.V. (Netherlands), D'Appolonia (Italy), Agisco (Italy). Five design (using three fundamental measurements concepts and five measurement tools) were explored: cable shape changes measured by cable strain using fiber optics (Fugro); cable inclination measured using tiltmeters (D'Appolonia) and measured using fiber optics (Fugro); and internal cable altitude-dependent pressure changes measured using fiber optics (Fugro) and measured using pressure transducers at discrete intervals along the hydraulic system (Agisco). Each design tool was analysed and a rank ordering of preferences was performed. The third method (measurement of pressure changes), with the solution proposed by Agisco, was deemed most feasible. Agisco is building the first prototype of the tool to be installed in an offshore field in the next few years. This paper describes design of instruments from the three companies to satisfy the design specification.</p

Subsidence monitoring network: an Italian example aimed at a sustainable hydrocarbon E&P activity

Abstract. According to the Italian law in order to start-up any new hydrocarbon exploitation activity, an Environmental Impact Assessment study has to be presented, including a monitoring plan, addressed to foresee, measure and analyze in real time any possible impact of the project on the coastal areas and on those ones in the close inland located. The occurrence of subsidence, that could partly be related to hydrocarbon production, both on-shore and off-shore, can generate great concern in those areas where its occurrence may have impacts on the local environment. ENI, following the international scientific community recommendations on the matter, since the beginning of 90's years, implemented a cutting-edge monitoring network, with the aim to prevent, mitigate and control geodynamics phenomena generated in the activity areas, with a particular attention to conservation and protection of environmental and territorial equilibrium, taking care of what is known as "sustainable development". The current ENI implemented monitoring surveys can be divided as: – Shallow monitoring: spirit levelling surveys, continuous GPS surveys in permanent stations, SAR surveys, assestimeter subsurface compaction monitoring, ground water level monitoring, LiDAR surveys, bathymetrical surveys. – Deep monitoring: reservoir deep compaction trough radioactive markers, reservoir static (bottom hole) pressure monitoring. All the information, gathered through the monitoring network, allow: 1. to verify if the produced subsidence is evolving accordingly with the simulated forecast. 2. to provide data to revise and adjust the prediction compaction models 3. to put in place the remedial actions if the impact exceeds the threshold magnitude originally agreed among the involved parties. ENI monitoring plan to measure and monitor the subsidence process, during field production and also after the field closure, is therefore intended to support a sustainable field development and an acceptable exploitation programme in which the actual risk connected with the field production is evaluated in advance, shared and agreed among all the involved subjects: oil company, stakeholders and local community (with interests in the affected area)

Accuracy of botulinum toxin type A injection into the forearm muscles of chronic stroke patients with spastic flexed wrist and clenched fist: manual needle placement evaluated using ultrasonography.

Objective: To investigate the accuracy of manual needle placement for injection of botulinum toxin type A into the forearm muscles of adults with spastic flexed wrist and clenched fist as a consequence of stroke. Design: Prospective clinical study. Patients: A total of 41 adults with chronic stroke who were scheduled to receive botulinum toxin type A injection into the following forearm muscles: flexor carpi radialis, flexor carpi ulnaris, flexor digitorum superficialis and flexor digitorum profundus. Methods: According to Huber & Heck's atlas suggestions on treatment of spasticity with botulinum toxin, surface identification of muscles to inject was performed by means of palpation and anatomical landmarks. Accuracy of needle placement and muscle thickness at the site of needle insertion were assessed using ultrasonography. Results: Overall accuracy of manual needle placement evaluated using ultrasonography was 51.2%. Accuracy was significantly higher for the finger flexors than for the wrist flexors (63.4% vs 39.0%). The finger flexors were significantly thicker than the wrist flexors (mean 1.58 vs 0.49 cm). Conclusion: Instrumental guidance should be used in order to achieve an acceptable accuracy of needle placement when performing botulinum toxin type A injections into the forearm muscles of chronic stroke patients with spastic flexed wrist and clenched fist

Psychological treatments and psychotherapies in the neurorehabilitation of pain. Evidences and recommendations from the italian consensus conference on pain in neurorehabilitation

BACKGROUND: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. OBJECTIVES: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. METHODS: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. RESULTS: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive-Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post-Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. CONCLUSIONS: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the pape

Effectiveness and safety of adjunctive cenobamate in people with focal-onset epilepsy: Interim results after 24-week observational period from the BLESS study

Objective: Cenobamate is an antiseizure medication (ASM) with a dual mechanism of action that was recently approved for the treatment of focal seizures in adults. This analysis aimed to describe the outcomes at 12 and 24 weeks after starting cenobamate therapy in a real-world setting. Methods: BLESS [NCT05859854] is an ongoing, observational, retrospective and prospective cohort study to evaluate the real-world effectiveness and safety of adjunctive cenobamate in adults with uncontrolled focal epilepsy. Subgroup analysis was performed in subjects with 2 to 3 previous ASMs (early users) and those with &gt;3 previous ASMs (late users). Results: The second interim analysis of the BLESS study included 388 participants with a median (interquartile range) age of 43.0 (31.0-54.0) years. They had a median of 6.0 (4.0-9.0) prior ASMs and a median of 7.2 (3.0-20.6) monthly seizures at baseline. The median monthly seizure frequency was reduced by 59.9% (19.2%-87.3%) from baseline to 24 weeks; 229 (59.0%) subjects had a &gt;= 50% seizure frequency reduction, and 44 (11.3%) showed sustained seizure freedom. The proportion of participants taking &lt;= 2 concomitant ASMs increased from 217 (56.5%) at baseline to 239 (65.7%) at 24 weeks. Among the early users (n = 76, 19.6%), the median reduction in monthly seizure frequency at 24 weeks was 78.0% (50.0-97.1%), and 76.3% of subjects had a &gt;= 50% response rate. The frequency of adverse drug reactions (ADRs) was 5.3% and 23.4% in early and late users. The most frequent ADRs were somnolence, dizziness, and balance disorder; after the occurrence of ADRs, 63.5% of participants maintained the prescribed dose, and 5.2% permanently discontinued treatment. Significance: Cenobamate was effective in reducing seizure frequency in a real-world setting and showed a manageable safety profile. The treatment with cenobamate also reduced the burden of concomitant ASMs in both early and late users

Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia

Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia