Houston Methodist Sugar Land Hospital

Abstract The objective of this study was to demonstrate the technical and economic advantages of Single-Phase Retarded Acid (SPRA) in combination with a Particulate and Fiber-laden Degradable Diverter (PFDD) for stimulating long open hole carbonate intervals. These objectives were achieved through laboratory testing on field cores, which were used to calibrate the acidizing simulator. The calibrated simulator enabled the evaluation of multiple design sensitivities, including improvements in wormhole penetration, fluid distribution, total skin reduction, volume optimizations, and optimizations in deployment methods. The laboratory work involved Pore Volume to Break-Through (PVBT) testing to assess the efficiency of the proposed SPRA compared to 15% HCl in Field B. The PVBT test results were used to calibrate the acidizing simulator by determining an effective reaction coefficient (keff) and a flow fraction coefficient (f). PFDD dissolution was evaluated at bottom hole static temperature (BHST) in bottle tests with two brine types. Additional testing was performed on unstimulated and stimulated cores to evaluate PFDD dissolution on a core face, PFDD effectiveness at plugging a wormhole created by the SPRA, and PFDD dissolution effectiveness within a wormhole. PVBT testing demonstrated that SPRA achieved up to 76% reduction in the acid volume required to achieve breakthrough compared to 15% HCl. The calibration effort and post-calibration simulations revealed that acid penetration efficiency in Field B was lower than expected based on the baseline software correlations for both SPRA and 15% HCl; however, SPRA still outperformed 15% HCl in terms of wormhole efficiency and skin reduction. While the reduced efficiency resulted in less skin decrease than expected for both fluid systems, it was still possible to obtain total skin below 0. Bottle tests for the diverter showed complete dissolution with mass loss approaching 100% within 7 days at 90°C. Core face dissolution testing indicated a filter cake mass loss of approximately 95% after 10 days. Testing on the stimulated core demonstrated a 97% to 99% reduction in wormhole permeability immediately after PFDD placement, with complete recovery of the initial stimulated core permeability after 13 days dissolution time. To the best of our knowledge, this study represents the first instance of testing a fully degradable PFDD on a pre-stimulated core with the intent of evaluating the effectiveness at plugging the open wormhole channel as well as evaluating post-dissolution permeability in the wormhole itself.

Gastrostomy tube placement is a method used to provide nutritional support or decompress the stomach to manage gastrointestinal symptoms. Although a relatively safe procedure, there are indications and contraindications for its use. It is essential for healthcare providers to have a solid understanding of the risk, benefits, and tube management to ensure the best patient outcomes and shared decision-making. • Minimally invasive tubes improve safety and access to long-term nutrition. • Standardized protocols are important to ensure safety, efficiency, and consistency. • Early, clear education for patients and caregivers improves confidence and outcomes. • Interdisciplinary collaboration supports physical, emotional, and cultural needs. • Nurses play a key role in advocacy, education, and supporting informed decisions.

Atherosclerotic cardiovascular disease (ASCVD) is a global health concern. Reducing low-density lipoprotein cholesterol (LDL-C) is critical in ASCVD prevention and treatment. Inclisiran, a novel RNA therapeutic agent, offers a promising solution by lowering LDL-C with twice-yearly dosing after an initial and 3-month dose. The study objective was to evaluate adherence to inclisiran and its lipid-lowering effectiveness over a year of treatment. This retrospective cohort study involved patients over 18 years old with ASCVD or hyperlipidemia who initiated inclisiran between January 1, 2022, and May 17, 2023, in US outpatient clinics. LDL-C reduction was evaluated in patients with ≥ 1 pre- and post-index LDL-C measurement by comparing baseline levels to the lowest value within 12 months after initiating inclisiran. Overall, 225 patients initiated inclisiran. The mean age was 69.9 years and 50.7% were female. Most patients (81.8%) had ASCVD. Most patients (91.6%) received a second dose, and 84.5% of these received a third dose. Overall, 202 patients had ≥ 2 LDL-C measurements, with a mean baseline LDL-C of 134.8 mg/dl. Mean absolute LDL-C reduction was 66.1 (standard deviation: 45.6) mg/dl, corresponding to a 46.8% (95% confidence interval: 42.7-51.0) relative reduction, and 46.8% achieved ≥ 50% reduction. Patients on concurrent statins and those without prior anti-proprotein convertase subtilisin/kexin type 9 monoclonal antibodies experienced the largest relative LDL-C reductions: 55.4% and 51.1%, respectively. Inclisiran significantly reduced LDL-C. The dosing schedule promoted high adherence in a real-world setting, particularly among older adults with ASCVD. These findings indicate inclisiran may be a particularly valuable addition to lipid-lowering strategies.

Abstract Acid fracturing remains a critical stimulation method for enhancing well performance in carbonate reservoirs by creating etched fractures that provide conductive pathways for fluid flow. The etched fracture length plays a pivotal role in determining treatment success. However, conventional methods for evaluating acid fracture conductivity, which rely on 7-inch long and 2-inch wide core samples tested using an API conductivity apparatus after acid etching, often fail to capture the full extent of acid etching behavior due to the limited length of conventional test samples. This study introduces a new systematic protocol designed to assess alternative acid systems’ ability to transport live acid and achieve extended etched lengths under high-temperature conditions. The experimental work utilized 4-inch diameter Indiana limestone cores, each 20 inches in length and sawed in half longitudinally, with permeability below 2 mD. Different acid systems were injected at a temperature of 200 °F for prescribed durations, and fracture conductivity was measured across a range of closure stresses. Effluent samples were analyzed for calcium ion concentration using inductively coupled plasma (ICP) to quantify rock dissolution, while computed tomography (CT) scans captured fracture morphology before and after acid injection. A successful procedure was developed which ensured the core sample integrity under closure stress similar to reservoir conditions. This new procedure is not only a more effective method to evaluate acid etching length and conductivity characteristics; it is also an easier and faster procedure compared with the traditional method. The conductivity measured with the new procedure was compared with the results from the traditional procedure with similar conditions. The results of this work demonstrate that the novel protocol provides a robust framework for evaluating acid systems in fracture conductivity studies, addressing the limitations of traditional short-core experiments. These findings contribute to optimized acid fracturing designs tailored for challenging high-temperature reservoirs, enhancing treatment efficiency and reservoir productivity. The experimental observations and measurements can be used to calibrate predictive acid fracture models.

Maxwell–Lodge effect is the observed electric field (or electromotive force) outside a long solenoid, where the magnetic field is essentially zero. Proposed explanations for the Maxwell–Lodge effect include non-local induction (the magnetic field inside the solenoid generating an electric field outside), the magnetic vector potential acting as a physical quantity that produces the electric field outside the solenoid, or Weber’s force resulting from moving electrons. In this paper, we calculate the electric fields of a solenoid using the electric field theory of Weber’s electrodynamics. We show that the solenoid not only generates the conventional magnetic field inside the solenoid but also produces velocity- and acceleration-related electric fields both inside and outside the solenoid. This explanation, based on the electric field theory of Weber’s electrodynamics, is simpler and more straightforward.

Abstract In unconventional fracturing, current practices for friction reducer (FR) concentration management lack engineered techniques. The modification of FR typically is using pressure trends and established practices that could lead to high amounts of FR utilization and suboptimal project economics. Here we present a novel approach to address this by incorporating an advisory machine learning (ML) model that could be used in real time. The model is capable of recognizing trends to predict when a change in concentration is ideal. The historical stimulation data from more than 250 stages from 10 different wells is mined and appended with domain fundamentals to generate recommendations for adjusting FR concentrations. An essential step involved feature engineering, enabling the creation of new variables to extract meaningful insights from the data. As the data are unlabeled, two methodologies that included unsupervised learning and domain logic were compared to create the classes. In this study we present a novel workflow for developing an FR advisor that provides categorical recommendations to increase, decrease, or hold FR concentrations during hydraulic fracturing operations. The model is designed to selectively capture data points that exhibit a direct pressure-FR relation while disregarding points that have other variables influencing pressure. A classification model exhibited the highest accuracy of around 94%. Implementing the advisor recommendations can potentially yield significant FR savings ranging from 3.4% to 21.1% of the total FR consumed in each stage while maintaining an optimal stimulation. The potential cost savings ranges from USD 12,000 to USD 42,000 per well while manufacturing and transportation emissions reduction can be up to 182.3 t carbon dioxide equivalent (CO2e) per well. A detailed benefit analysis was conducted to address concerns regarding formation damage, additional wear on pumping equipment, and associated emissions. Additive management lacks real-time adaptability: most treatments focus only on achieving the designed rate and avoiding potential issues, leading to avoidable FR volume utilization that results in a waste of materials. This innovative FR advisor model is useful for fracturing engineers and project managers to enhance operational efficiency while promoting a more sustainable and cost-effective stimulation. The approach can be easily extended to other fracturing materials beyond FR. While operational oversight remains essential, the advisor provides actionable insights with suggestions, leading the way to an enhanced efficiency, reduced material waste, and environmental benefits.

Abstract A crucial part of scale squeeze management in the oilfield is the ability to accurately and precisely monitor scale inhibitor residual concentrations. Reliable residual measurements are essential to determining the lifetime of deployed scale squeeze treatments. When a squeeze campaign is deployed to multiple wells that will comingle into a single flowline, the ability to monitor residuals becomes increasingly challenging and the need to effectively distinguish between the different inhibitors deployed comes into play. A method to differentiate multiple phosphorous-containing scale inhibitors in a single comingled stream has been developed and successfully implemented in the Gulf of Mexico. This analytical method does not require the use of inhibitor tagging for detection or quantification of the scale squeeze residuals. Ion Chromatography-Mass Spectrometry (IC-MS) is currently being used to accurately monitor residuals of three different scale inhibitors from three wells producing/comingling into a single flowline. This field proven method of residual monitoring will significantly reduce the amount of deferred oil production that is often associated with monitoring multiple squeezed wells in the same flowline. Choosing the correct method of sample preservation is a key part of inhibitor residual monitoring. It is well understood that maintaining the stability of ions is critical to determine the scaling potential, effectiveness of a treatment program and as outlined in this paper, the inhibitor molecules of interest. This paper discusses lessons learned when implementing the above mentioned novel analytical method to monitor field samples by highlighting the key optimizations to the current sample preservation methods. The optimized sampling methods used include samples stabilized with an acid, a polymeric scale inhibitor and the addition of a biocide to a polymeric scale inhibitor. The intent of this study was to evaluate the most effective way to preserve water samples being monitored for inhibitor residuals via an IC-MS method.