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Large calderas are among the Earth's major volcanic features. They are associated with large magma reservoirs and elevated geothermal gradients. Caldera-forming eruptions result from the withdrawal and collapse of the magma chambers and produce large-volume pyroclastic deposits and later-stage deformation related to post-caldera resurgence and volcanism. Unrest episodes are not always followed by an eruption; however, every eruption is preceded by unrest. The Campi Flegrei caldera (CFc), located along the eastern Tyrrhenian coastline in southern Italy, is close to the densely populated area of Naples. It is one of the most dangerous volcanoes on Earth and represents a key example of an active, resurgent caldera. It has been traditionally interpreted as a nested caldera formed by collapses during the 100–200 km3 Campanian Ignimbrite (CI) eruption at ∼39 ka and the 40 km3 eruption of the Neapolitan Yellow Tuff (NYT) at ∼15 ka. Recent studies have suggested that the CI may instead have been fed by a fissure eruption from the Campanian Plain, north of Campi Flegrei. A MagellanPlus workshop was held in Naples, Italy, on 25–28 February 2017 to explore the potential of the CFc as target for an amphibious drilling project within the International Ocean Discovery Program (IODP) and the International Continental Drilling Program (ICDP). It was agreed that Campi Flegrei is an ideal site to investigate the mechanisms of caldera formation and associated post-caldera dynamics and to analyze the still poorly understood interplay between hydrothermal and magmatic processes. A coordinated onshore–offshore drilling strategy has been developed to reconstruct the structure and evolution of Campi Flegrei and to investigate volcanic precursors by examining (a) the succession of volcanic and hydrothermal products and related processes, (b) the inner structure of the caldera resurgence, (c) the physical, chemical, and biological characteristics of the hydrothermal system and offshore sediments, and (d) the geological expression of the phreatic and hydromagmatic eruptions, hydrothermal degassing, sedimentary structures, and other records of these phenomena. The deployment of a multiparametric in situ monitoring system at depth will enable near-real-time tracking of changes in the magma reservoir and hydrothermal system.

Obstructive sleep apnea (OSA) in children is a prevalent, albeit largely undiagnosed disease associated with a large spectrum of morbidities. Overnight in-lab polysomnography remains the gold standard diagnostic approach, but is time-consuming, inconvenient, and expensive, and not readily available in many places. Simplified Home Respiratory Polygraphy (HRP) approaches have been proposed to reduce costs and facilitate the diagnostic process. However, evidence supporting the validity of HRP is still scarce, hampering its implementation in routine clinical use. The objectives were: Primary; to establish the diagnostic and therapeutic decision validity of a simplified HRP approach compared to PSG among children at risk of OSA. Secondary: (a) Analyze the cost-effectiveness of the HRP versus in-lab PSG in evaluation and treatment of pediatric OSA; (b) Evaluate the impact of therapeutic interventions based on HRP versus PSG findings six months after treatment using sleep and health parameters and quality of life instruments; (c) Discovery and validity of the urine biomarkers to establish the diagnosis of OSA and changes after treatment.

Using underground space to store natural gas resources is an important means by which to solve emergency peak shaving of natural gas. Rock salt gas storage is widely recognized due to its high-efficiency peak shaving and environmental protection. Damage and stress concentrations inside the cavern injection during withdrawal operations and throughout the storage facility life have always been among the most important safety issues. Therefore, accurate evaluation of the stability of rock salt gas storage during operation is of paramount significance to field management and safety control. In this study, we used the finite element numerical analysis software Flac3D to numerically simulate large displacement deformations of the cavern wall during gas storage—in addition to the distribution of the plastic zone of the rock around the cavern and the surface settlement—under different working conditions. We found that the maximum surface settlement value occurred near the upper part of the cavern. The surface settlement value increased as a function of creep time, but this increase leveled off, that is, a convergence trend was observed. The value was relatively small and, therefore, had little impact on the surface. The application of gas pressure inhibited the growth of the plastic zone, but on the whole, the plastic zone’s range increased proportionally to creep time. For the 20-year creep condition, the deformation value of the cavern’s surrounding rock was large. Combined with the distribution of the plastic zone, we believe that the cavern’s surrounding rock is unstable; thus, corresponding reinforcement measures must be taken.

Utilizing energy storage in depleted oil and gas reservoirs can improve productivity while reducing power costs and is one of the best ways to achieve synergistic development of \"Carbon Peak–Carbon Neutral\" and \"Underground Resource Utilization\". Starting from the development of Compressed Air Energy Storage (CAES) technology, the site selection of CAES in depleted gas and oil reservoirs, the evolution mechanism of reservoir dynamic sealing, and the high-flow CAES and injection technology are summarized. It focuses on analyzing the characteristics, key equipment, reservoir construction, application scenarios and cost analysis of CAES projects, and sorting out the technical key points and existing difficulties. The development trend of CAES technology is proposed, and the future development path is scrutinized to provide reference for the research of CAES projects in depleted oil and gas reservoirs. Graphical abstract

Background The value of serum triglycerides (TGs) related to complications and the severity of acute pancreatitis (AP) has not been clearly defined. Our study aimed to analyze the association of elevated levels of TG with complications and the severity of AP. Methods The demographic and clinical data of patients with AP were prospectively analyzed. TG levels were measured in the first 24 h of admission. Patients were divided into two groups: one with TG values of<200 mg/dL and another with TG≥200 mg/dL. Data on the outcomes of AP were collected. Results From January 2016 to December 2019, 247 cases were included: 200 with TG<200 mg/dL and 47 with TG≥200 mg/dL. Triglyceride levels≥200 mg/dL were associated with respiratory failure (21.3 vs. 10%, p =0.033), renal failure (23.4 vs. 12%, p =0.044), cardiovascular failure (19.1 vs. 7.5%, p =0.025), organ failure (34 vs. 18.5%, p =0.02), persistent organ failure (27.7 vs. 9.5%, p =0.001), multiple organ failure (19.1 vs. 8%, p =0.031), moderately severe and severe AP (68.1 vs. 40.5%, p =0.001), pancreatic necrosis (63.8 vs. 34%, p <0.001), and admission to the intensive care unit (27.7 vs. 9.5%, p =0.003). In the multivariable analysis, a TG level of≥200 mg/dL was independently associated with respiratory, renal, and cardiovascular failure, organ failure, persistent organ failure, multiple organ failure, pancreatic necrosis, severe pancreatitis, and admission to the intensive care unit ( p <0.05). Conclusions In our cohort, TG≥200 mg/dL was related to local and systemic complications. Early determinations of TG levels in AP could help identify patients at risk of complications.

Multi-fractured horizontal wells (MFHW) is one of the most effective technologies to develop tight gas reservoirs. The gas seepage from tight formations in MFHW can be divided into three stages: early stage with high productivity, transitional stage with declined productivity, and final stage with stable productivity. Considering the characteristics and mechanisms of porous flows in different regions and at different stages, we derive three coupled equations, namely the equations of porous flow from matrix to fracture, from fracture to near wellbore region, and from new wellbore region to wellbore then an unstable productivity prediction model for a MFHW in a tight gas reservoir is well established. Then, the reliability of this new model, which considers the multi-fracture interference, is verified using a commercial simulator (CMG). Finally, using this transient productivity prediction model, the sensitivity of horizontal well’s productivity to several relevant factors is analyzed. The results illustrate that threshold pressure gradient has the most significant influence on well productivity, followed by stress sensitivity, turbulence flow, and slippage flow. To summarize, the proposed model has demonstrated a potential practical usage to predict the productivity of multi-stage fractured horizontal wells and to analyze the effects of certain factors on gas production in tight gas reservoirs.

Unconventional geothermal resource development can contribute to increase power generation from renewable energy sources in countries without conventional hydrothermal reservoirs, which are usually associated with magmatic activity and extensional faulting, as well as to expand the generation in those regions where conventional resources are already used. Three recent drilling experiences focused on the characterization of unconventional resources are described and compared: the Campi Flegrei Deep Drilling Project (CFDDP) in Italy, the United Downs Deep Geothermal Power (UDDGP) project in the United Kingdom, and the DEEP Earth Energy Production in Canada. The main aspects of each project are described (geology, drilling, data collection, communication strategies) and compared to discuss challenges encountered at the tree sites considered, including a scientific drilling project (CFDDP) and two industrial ones (UDDGP and DEEP). The first project, at the first stage of pilot hole, although not reaching deep supercritical targets, showed extremely high, very rare thermal gradients even at shallow depths. Although each project has its own history, as well as social and economic context, the lessons learned at each drilling site can be used to further facilitate geothermal energy development.

Background Acute pancreatitis (AP) is a potentially severe or even fatal inflammation of the pancreas. Early identification of patients at high risk for developing a severe course of the disease is crucial for preventing organ failure and death. Most of the former predictive scores require many parameters or at least 24 h to predict the severity; therefore, the early therapeutic window is often missed. Methods The early achievable severity index (EASY) is a multicentre, multinational, prospective and observational study (ISRCTN10525246). The predictions were made using machine learning models. We used the scikit‐learn, xgboost and catboost Python packages for modelling. We evaluated our models using fourfold cross‐validation, and the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC), and accuracy metrics were calculated on the union of the test sets of the cross‐validation. The most critical factors and their contribution to the prediction were identified using a modern tool of explainable artificial intelligence called SHapley Additive exPlanations (SHAP). Results The prediction model was based on an international cohort of 1184 patients and a validation cohort of 3543 patients. The best performing model was an XGBoost classifier with an average AUC score of 0.81 ± 0.033 and an accuracy of 89.1%, and the model improved with experience. The six most influential features were the respiratory rate, body temperature, abdominal muscular reflex, gender, age and glucose level. Using the XGBoost machine learning algorithm for prediction, the SHAP values for the explanation and the bootstrapping method to estimate confidence, we developed a free and easy‐to‐use web application in the Streamlit Python‐based framework (http://easy‐app.org/). Conclusions The EASY prediction score is a practical tool for identifying patients at high risk for severe AP within hours of hospital admission. The web application is available for clinicians and contributes to the improvement of the model. The EASY prediction score is a practical tool for identifying patients at a greater risk for severe acute pancreatitis shortly after hospital admission. The explanation of the impact of features on the prediction helps physicians understand the decision of the machine learning model. The easy‐to‐use web application is available for clinicians and contributes to the improvement of the model.

Introduction. Obesity and obstructive sleep apnea syndrome (OSA) are common coexisting conditions associated with a chronic low-grade inflammatory state underlying some of the cognitive, metabolic, and cardiovascular morbidities. Aim. To examine the levels of inflammatory markers in obese community-dwelling children with OSA, as compared to no-OSA, and their association with clinical and polysomnographic (PSG) variables. Methods. In this cross-sectional, prospective multicenter study, healthy obese Spanish children (ages 4–15 years) were randomly selected and underwent nocturnal PSG followed by a morning fasting blood draw. Plasma samples were assayed for multiple inflammatory markers. Results. 204 children were enrolled in the study; 75 had OSA, defined by an obstructive respiratory disturbance index (RDI) of 3 events/hour total sleep time (TST). BMI, gender, and age were similar in OSA and no-OSA children. Monocyte chemoattractant protein-1 (MCP-1) and plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in OSA children, with interleukin-6 concentrations being higher in moderate-severe OSA (i.e., AHI > 5/hrTST; P < 0.01 ) , while MCP-1 levels were associated with more prolonged nocturnal hypercapnia ( P < 0.001 ) . Conclusion. IL-6, MCP-1, and PAI-1 are altered in the context of OSA among community-based obese children further reinforcing the proinflammatory effects of sleep disorders such as OSA. This trial is registered with ClinicalTrials.gov NCT01322763.

Purpose To assess the relevance of peritoneal reflection involvement in long-term oncological outcomes in patients with rectal cancer. Methods Prospective observational study from a specialized colorectal unit that included a consecutive series of patients undergoing mesorectal excision for rectal cancer. Peritoneal reflection (PR) involvement was evaluated on pathological examination using Shepherd’s classification. Overall survival (OS), disease-free survival (DFS), and local recurrence (LR) were assessed. Results One hundred sixty patients were included in the present analysis. Peritoneal involvement was present in 28.2% of the 85 tumors above or at the level of PR. There were no differences in OS, DFS, or LR according to tumor’s height location. The 5-year OS, DFS, and LR for tumors involving PR were 58.3%, 61.7%, and 30.3%, respectively. Patients with peritoneal involvement had a higher LR rate ( p  = 0.02) and shorter OS ( p  = 0.04). Shepherd’s grade 4 peritoneal involvement was an independent risk factor for OS (HR 2.9; 95% CI 1.1–9.5, p  = 0.04) and LR (HR 4.2; 95% CI 1.2–16.9, p  = 0.04). Conclusion After rectal cancer resection, peritoneal involvement is an independent risk factor for local recurrence and poor survival.