3D analysis of H-M coupled problem with zero-thickness interface elements applied to geomechanics

In spite of the significant developments seen in recent years,numerical modelin of Hydraulic Fracturing still poses major challenges due to the strong coupling between fluid flow and crack development,which is itself a strongly non-linear problem.The objective of this paper is to show advances in a line of work started by Segura and Carol,on the modelin of coupled H-M discontinuities via zero-thickness interface elements.In particular,this paper is focused on the 3D Applications of the approach,and the results obtained are compared to the existint GDK and PKN analytical solutions.For the comparison, two 3D models are described: a plate model for the GDK, and a block model for the PKN.In order to improve de modelling,both models are run withi nterfaces equipped with realistic non-linear materia llaws based on fracture energy. Results obtained show a good agreement with both analytical and numerical results

Numerical stress initialization in geomechanics via the FEM and a two-step procedure

The knowledge of the in-situ stress field in rock masses is crucial in different areas of geo-engineering, such as mining or civil underground excavations, hydrocarbon extraction, CO2 storage, hydraulic fracture operations, etc. A method for the numerical generation of the in-situ stress state is described in this paper, which involves two steps: 1) an estimate of the stress state at each Gauss point is generated, and 2) global equilibrium is verified and re-balancing nodal forces are applied as needed. While the re-equilibration step is a closed procedure based only on statics, the first estimate of the stress state can be done in a variety of ways to incorporate all the information available. In this paper, the various options available are discussed and compared, and a new alternative procedure is presented which is based on the Airy stress function. The performance of the various procedures is illustrated with a real application example

Nigral and striatal connectivity alterations in asymptomatic LRRK2 mutation carriers: A magnetic resonance imaging study

Background. The study of the functional connectivity by means of magnetic resonance imaging (MRI) in asymptomatic LRRK2 mutation carriers could contribute to the characterization of the prediagnostic phase of LRRK2 associated Parkinson's disease (PD). Objective. To characterize MRI functional patterns during resting state in asymptomatic LRRK2 mutation carriers. Methods. We acquired structural and functional MRI data of 18 asymptomatic LRRK2 mutation carriers and 18 asymptomatic LRRK2 mutation noncarriers, all first-degree relatives of LRRK2-PD patients. Starting from resting state data, we analyzed the functional connectivity of the striatocortical and the nigrocortical circuitry. Structural brain data was analyzed by voxel based morphometry, cortical thickness and volumetric measures. Results: Asymptomatic LRRK2 mutation carriers had functional connectivity reductions between the caudal motor part of the left striatum and ipsilateral precuneus and superior parietal lobe. Connectivity in these regions correlated with subcortical gray matter volumes in mutation carriers. Asymptomatic carriers also showed increased connectivity between the right substantia nigra and bilateral occipital cortical regions (occipital pole and cuneus bilaterally, and right lateral occipital cortex). No intergroup differences in structural MRI measures were found. In LRRK2 mutation carriers, age and functional connectivity correlated negatively with striatal volumes. Additional analyses including only subjects with the G2019S mutation revealed similar findings. Conclusion: Asymptomatic LRRK2 mutation carriers showed functional connectivity changes in striatocortical and nigrocortical circuits compared with noncarriers. These findings support the concept that altered brain connectivity precedes the onset of classical motor features in a genetic form of PD

Frequency of nut consumption and mortality risk in the PREDIMED nutrition intervention trial

BackgroundProspective studies in non-Mediterranean populations have consistently related increasing nut consumption to lower coronary heart disease mortality. A small protective effect on all-cause and cancer mortality has also been suggested. To examine the association between frequency of nut consumption and mortality in individuals at high cardiovascular risk from Spain, a Mediterranean country with a relatively high average nut intake per person.MethodsWe evaluated 7,216 men and women aged 55 to 80 years randomized to 1 of 3 interventions (Mediterranean diets supplemented with nuts or olive oil and control diet) in the PREDIMED (‘PREvención con DIeta MEDiterránea’) study. Nut consumption was assessed at baseline and mortality was ascertained by medical records and linkage to the National Death Index. Multivariable-adjusted Cox regression and multivariable analyses with generalized estimating equation models were used to assess the association between yearly repeated measurements of nut consumption and mortality.ResultsDuring a median follow-up of 4.8 years, 323 total deaths, 81 cardiovascular deaths and 130 cancer deaths occurred. Nut consumption was associated with a significantly reduced risk of all-cause mortality (P for trend 3 servings/week (32% of the cohort) had a 39% lower mortality risk (hazard ratio (HR) 0.61; 95% CI 0.45 to 0.83). A similar protective effect against cardiovascular and cancer mortality was observed. Participants allocated to the Mediterranean diet with nuts group who consumed nuts >3 servings/week at baseline had the lowest total mortality risk (HR 0.37; 95% CI 0.22 to 0.66).ConclusionsIncreased frequency of nut consumption was associated with a significantly reduced risk of mortality in a Mediterranean population at high cardiovascular risk.Please see related commentary: http://www.biomedcentral.com/1741-7015/11/165.Trial registrationClinicaltrials.gov. International Standard Randomized Controlled Trial Number (ISRCTN): 35739639. Registration date: 5 October 2005

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Coupled H-M fracture interaction using FEM with zero-thickness interface elements

Massive treatments of hydraulic fracturing is a procedure employed for low permeability reservoirs stimulation. This technique consists in generating a series of parallel spaced fractures parallel (multi-stage fracturing). The generation of a fracture involves the modification of the local stress state, so in the case of a multi-stage treatment, the fracture propagation can be modified by the injection sequence, as it is observed with microseismicity monitoring [1]. This work proposes the study of this technique by means of the finite element method with zerothickness interface elements for the geo-mechanical modelling of discontinuities [2]. The technique consists in inserting interface elements in between standard elements to allow jumps in the displacement solution fields. For the mechanical problem, their kinematic constitutive variables are relative displacements, and the corresponding static variables are stress tractions. The relationship between variables is controlled via a fracture-based constitutive law with elasto-plastic structure [3]. Concerning the hydraulic problem, the interface formulation includes both the longitudinal flow (with a longitudinal conductivity parameter strongly dependent on the fracture aperture), as well as and the transversal flow across the element (seepage)[4]. Previous works by the authors focused on the validation of the method, the analysis a single fracture plane problem [5,6]. In this case the method is extended to allow free propagation of fractures in any direction, by means of inserting interface elements between all continuum elements. The results presented in this paper analyse the effect of material properties, in particular fracture characterization, in the propagation and the effect of fracture job sequenc

Coupled H-M fracture interaction using FEM with zero-thickness interface elements

Massive treatments of hydraulic fracturing is a procedure employed for low permeability reservoirs stimulation. This technique consists in generating a series of parallel spaced fractures parallel (multi-stage fracturing). The generation of a fracture involves the modification of the local stress state, so in the case of a multi-stage treatment, the fracture propagation can be modified by the injection sequence, as it is observed with microseismicity monitoring [1]. This work proposes the study of this technique by means of the finite element method with zerothickness interface elements for the geo-mechanical modelling of discontinuities [2]. The technique consists in inserting interface elements in between standard elements to allow jumps in the displacement solution fields. For the mechanical problem, their kinematic constitutive variables are relative displacements, and the corresponding static variables are stress tractions. The relationship between variables is controlled via a fracture-based constitutive law with elasto-plastic structure [3]. Concerning the hydraulic problem, the interface formulation includes both the longitudinal flow (with a longitudinal conductivity parameter strongly dependent on the fracture aperture), as well as and the transversal flow across the element (seepage)[4]. Previous works by the authors focused on the validation of the method, the analysis a single fracture plane problem [5,6]. In this case the method is extended to allow free propagation of fractures in any direction, by means of inserting interface elements between all continuum elements. The results presented in this paper analyse the effect of material properties, in particular fracture characterization, in the propagation and the effect of fracture job sequenc