Cyclical hydraulic pressure pulses reduce breakdown pressure and initiate staged fracture growth in PMMA

Using unique experimental equipment on large bench-scale samples of Polymethylmethacrylate, used in the literature as an analogue for shale, we investigate the potential benefits of applying cyclical hydraulic pressure pulses to enhance the near-well connectivity through hydraulic fracturing treatment. Under unconfined and confined stresses, equivalent to a depth of up to 530 m, we use dynamic high-resolution strain measurements from fibre optic cables, complemented by optical recordings of fracture development, and investigate the impact of cyclical hydraulic pressure pulses on the number of cycles to failure in Polymethylmethacrylate at different temperatures. Our results indicate that a significant reduction in breakdown pressure can be achieved. This suggests that cyclic pressure pulses could require lower power consumption, as well as reduced fluid injection volumes and injection rates during stimulation, which could minimise the occurrence of the largest induced seismic events. Our results show that fractures develop in stages under repeated pressure cycles. This suggests that Cyclic Fluid Pressurization Systems could be effective in managing damage build-up and increasing permeability. This is achieved by forming numerous small fractures and reducing the size and occurrence of large fracturing events that produce large seismic events. Our results offer new insight into cyclical hydraulic fracturing treatments and provide a unique data set for benchmarking numerical models of fracture initiation and propagation

Rate-dependence of the compressive and tensile strength of granites

The strength and rupture of geomaterials are integral to subsurface engineering practices, such as those required to optimise geothermal energy extraction. Of particular importance is the time- and strain-rate-dependence of material strength, which dictates the energy released upon failure, and impacts the magnitude of induced seismicity, fracture architecture and thus hydraulic conductivity and system permeability. Here, we performed a series of uniaxial compression and Brazilian tensile strength measurements at a range of deformation rates in order to constrain the impact of strain rate on the strength of G603 granite. The dense, low permeability, medium-grained granites were mechanically tested at 4 strain rates (or diametric equivalent strain rates in the case of Brazilian tests) from 10−5 to 10−2 s−1, such that sample failure was achieved in anything from below 1s at the fastest rate in tension, to over 1000s at the slowest rate in compression. The applied rates encompassed those recommended by ISRM and ASTM material testing standards for compressive and Brazilian tensile testing. We found a significant rate strengthening effect, whereby compressive and tensile strength both increased by approximately 35 % across the 4 orders of magnitude of strain rate tested. We found that the static Young's modulus remained relatively constant across this range of deformation rates, however variability was reduced at faster rates, owing to the reduced time for equilibration of the system to imposed stresses. The lower strength at slower strain rates causes smaller stress drops, indicating that rocks driven to compressive and tensile failure at slower rates release less energy upon failure. Such constraints of the strain-rate-dependence of material strength, in contrast to the use of standardised material characteristics conventionally used in Engineering Geology applications, will prove useful as we develop increasingly sophisticated strategies such as cyclic soft stimulation to access resources using less energy, whilst reducing environmental risk and producing less waste

The accuracy of pulse oximetry in measuring oxygen saturation by levels of skin pigmentation: a systematic review and meta-analysis

Background During the COVID-19 pandemic, there have been concerns regarding potential bias in pulse oximetry measurements for people with high levels of skin pigmentation. We systematically reviewed the effects of skin pigmentation on the accuracy of oxygen saturation measurement by pulse oximetry (SpO2) compared with the gold standard SaO2 measured by CO-oximetry. Methods We searched Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform (up to December 2021) for studies with SpO2–SaO2 comparisons and measuring the impact of skin pigmentation or ethnicity on pulse oximetry accuracy. We performed meta-analyses for mean bias (the primary outcome in this review) and its standard deviations (SDs) across studies included for each subgroup of skin pigmentation and ethnicity and used these pooled mean biases and SDs to calculate accuracy root-mean-square (Arms) and 95% limits of agreement. The review was registered with the Open Science Framework (https://osf.io/gm7ty). Results We included 32 studies (6505 participants): 15 measured skin pigmentation and 22 referred to ethnicity. Compared with standard SaO2 measurement, pulse oximetry probably overestimates oxygen saturation in people with the high level of skin pigmentation (pooled mean bias 1.11%; 95% confidence interval 0.29 to 1.93%) and people described as Black/African American (1.52%; 0.95 to 2.09%) (moderate- and low-certainty evidence). The bias of pulse oximetry measurements for people with other levels of skin pigmentation or those from other ethnic groups is either more uncertain or suggests no overestimation. Whilst the extent of mean bias is small or negligible for all subgroups evaluated, the associated imprecision is unacceptably large (pooled SDs > 1%). When the extent of measurement bias and precision is considered jointly, pulse oximetry measurements for all the subgroups appear acceptably accurate (with Arms < 4%). Conclusions Pulse oximetry may overestimate oxygen saturation in people with high levels of skin pigmentation and people whose ethnicity is reported as Black/African American, compared with SaO2. The extent of overestimation may be small in hospital settings but unknown in community settings

Efficacy of a multifaceted podiatry intervention to improve balance and prevent falls in older people: study protocol for a randomised trial

<p>Abstract</p> <p>Background</p> <p>Falls in older people are a major public health problem, with at least one in three people aged over 65 years falling each year. There is increasing evidence that foot problems and inappropriate footwear increase the risk of falls, however no studies have been undertaken to determine whether modifying these risk factors decreases the risk of falling. This article describes the design of a randomised trial to evaluate the efficacy of a multifaceted podiatry intervention to reduce foot pain, improve balance, and reduce falls in older people.</p> <p>Methods</p> <p>Three hundred community-dwelling men and women aged 65 years and over with current foot pain and an increased risk of falling will be randomly allocated to a control or intervention group. The "usual cae" control group will receive routine podiatry (i.e. nail care and callus debridement). The intervention group will receive usual care plus a multifaceted podiatry intervention consisting of: (i) prefabricated insoles customised to accommodate plantar lesions; (ii) footwear advice and assistance with the purchase of new footwear if current footwear is inappropriate; (iii) a home-based exercise program to strengthen foot and ankle muscles; and (iv) a falls prevention education booklet. Primary outcome measures will be the number of fallers, number of multiple fallers and the falls rate recorded by a falls diary over a 12 month period. Secondary outcome measures assessed six months after baseline will include the Medical Outcomes Study Short Form 12 (SF-12), the Manchester Foot Pain and Disability Index, the Falls Efficacy Scale International, and a series of balance and functional tests. Data will be analysed using the intention to treat principle.</p> <p>Discussion</p> <p>This study is the first randomised trial to evaluate the efficacy of podiatry in improving balance and preventing falls. The trial has been pragmatically designed to ensure that the findings can be generalised to clinical practice. If found to be effective, the multifaceted podiatry intervention will be a unique addition to common falls prevention strategies already in use.</p> <p>Trial registration</p> <p>Australian New Zealand Clinical Trials Registry: ACTRN12608000065392</p