bluuebunny/crossref_metadata_2025 huggingface dataset:
Growth behavior and kinetics of austenite grain in low-carbon high-strength steel with copper
Authors: Meng Fanyun , Wang Jiaji , Guo Jing , Fu Kuijun , Zhao Ming , Wang Zhongjun , Xu Zhen
Published: August 2021

A low-carbon high-strength steel with copper has better antibiological corrosion property, more widely used in large marine projects and ships. In this study, an austenite grain growth model of a low-carbon ship plate steel with 1.6Cu was established by using Sellars equation at 900 °C–1200 °C and different holding times (30–120 min) to reveal its kinetics. The pinning effect of grain boundary precipitates was studied by scanning electron microscopy (SEM) and transmission electron microscopy (TEM), and a quantitative relationship between the solid solution and precipitation behavior of copper bearing precipitates in experimental steel and austenite grain growth was analyzed. The experimental results show that the austenite grains grow slowly, and the grains are fine grains when the heating temperature is below 1000 °C and the transition temperature of rapid grain coarsening is 1000 °C. The relative error of dynamic model can be controlled within 8.5%. During heat treatment, Cu atoms are segregated at the grain boundary to form a copper-rich region, providing a coating effect on the carbide and grain boundary and hindering the growth of grains. With the increase in temperature, the diffusion rate of copper atoms increases, and the precipitates containing copper are rapidly dissolved into austenite. Therefore, the pinning effect is weakened, and the austenite grains grow rapidly.
Experimental and numerical approach to titanium-aluminum explosive welding
Authors: Wu Xiaoming , Shi Changgen , Feng Ke , Gao Li , Li Wenxuan , Qian Kun
Published: August 2021

The welding parameters of TA2/1060/5083 were calculated accurately through a combination of explosive welding weldability window and numerical simulation, based on which explosion welding experiments were conducted using these parameters obtained. Then, a test was carried out on the mechanical properties of the composite plates obtained from the experiments and microstructure characterization was performed. As suggested by the results, TA2/1060 was a excellent straight bond, and the interface of 1060/5083 was a sine-wave featuring both vortex structure and splashing molten block structure, with an average wavelength of 700μm and a wave height of 100μm. The tensile strength and shear strength of the composite materials reached 354 MPa and 110 MPa, respectively, while the material showed the signs of ductile fracture. Moreover, work hardening and fine grain strengthening occurred at the interface, as did the element diffusion of Ti-Al, with a maximum diffusion depth of 32μm.
Anaplastic Thyroid Carcinoma: Cytomorphologic Features on Fine-Needle Aspiration and Associated Diagnostic Challenges
Authors: Podany Peter , Abi-Raad Rita , Barbieri Andrea , Garritano James , Prasad Manju L , Cai Guoping , Adeniran Adebowale J , Gilani Syed M
Published: August 2021

Objectives

Anaplastic thyroid carcinoma (ATC) is an aggressive malignancy, and early diagnosis, often aided by fine-needle aspiration (FNA), is key to improving patient prognosis. While the current literature describes some of the cytologic features (CFs) of this entity, a comprehensive examination of the CFs has not yet been performed.

Methods

We retrospectively searched our electronic database for ATC cases with available slides between January 2008 and December 2019. Cases were examined for 22 CFs and compared with a control group of differentiated thyroid carcinoma.

Results

A total of 18 ATC cases meeting our inclusion criteria were identified. Most cases showed moderate to high cellularity (83%) and epithelioid cytomorphology (83%). Architecture included either predominantly groups/clusters of tumor cells (56%) or single tumor cells (44%). The other CFs were as follows: nuclear enlargement (100%), nuclear crowding (89%), nuclear membrane irregularities (100%), multinucleated tumor cells (33%), and background acute inflammatory cells (50%). Of the CFs examined, statistically significant differences between ATC and the control groups were found in the following: nuclear pleomorphism, coarse/clumped chromatin, macronucleoli, apoptosis, and necrosis.

Conclusions

Identification of key CFs in FNA coupled with the clinical history aids in the diagnosis of ATC and helps distinguish it from other mimickers.
The little fishes that could: smaller fishes demonstrate slow body size evolution but faster speciation in the family Percidae
Authors: Arbour Jessica H , Stanchak Kathryn E
Published: August 2021

Body size affects numerous aspects of organismal biology and many factors have been invoked to explain body size distributions in a macroecological and macroevolutionary context. Body size in the freshwater fish family Percidae is strongly right-skewed (i.e. dominated by small sizes), with small body size potentially being associated with fast water habitats. We constructed a new species-level, multi-locus, time-calibrated phylogeny of Percidae, and used it to test for changes in the rate and pattern of maximum body size evolution. We also tested whether speciation rates varied as a function of body size. We found that Etheostomatinae evolved towards a smaller adaptive optimum in body size compared to the other subfamilies of Percidae, and that this shift was associated with a reduction in the rate of body size evolution. Speciation rates were associated with body size across percids, showing a peak around small to medium body size. Small body size appears to partially, but not fully, explain the diversity of small percids, as many darters fall well below the “optimum” body size. Reinforcement of selection for small body size via selection for novel morphologies or via sexual selection may help to fully explain the remarkable diversity of darter radiation.
Ecological and sexual roles of scale mechanoreceptors in two species of Neotropical freshwater snake (Dipsadinae: Helicops)
Authors: García-Cobos Daniela , Gómez-Sánchez Diego A , Crowe-Riddell Jenna M , Sanders Kate L , Molina Jorge
Published: August 2021

Understanding the roles of ecological and sexual selection in the variation of sensory systems may elucidate aspects of the natural history of organisms. Little is known about the evolution of mechanoreception in snakes and how the function and structure of mechanoreceptors vary between species or sexes. Here, we describe the internal and external morphology of cephalic mechanoreceptor sensilla and quantify inter- and intraspecific variation in four sensilla traits of two freshwater snake species that differ in their habitat and diet preferences, Helicops pastazae and Helicops angulatus, by combining scanning electron microscopy (SEM), histological techniques and image analyses. SEM showed sensilla as prominent evaginations of the epidermis surrounded by concentric rings, with H. pastazae having larger and more heterogeneous sensilla. In both species, histology showed a reduction in the outer epidermal layer above the sensilla with a grouping of dermally derived central cells below it. Higher values of sensilla traits were found in H. pastazae, except for the chin-shields. We also found that males of both species had significantly higher values of sensilla traits on all of the scales examined. We hypothesize that the variation in both qualitative and quantitative traits in scale sensilla might be a consequence of differences in foraging and/or reproductive strategies between species and sexes.
Moments Of (Re)vision: Thomas Hardy Making Amends
Authors: Dema Eva
Published: August 2021

Considered far less critically rewarding resources than those of the author’s prose, the manuscripts of Thomas Hardy’s verse have long been neglected. This essay seeks, in part, to challenge the ways in which we attribute significance to such documents, attempting a close textual study of the ‘fair’ copy of Moments of Vision (1917) – a late draft of the volume only minimally revised. The collection is one which invites us to attend to the hitherto overlooked, and in remaining attentive to the seemingly minor alterations of the manuscript itself, I work to uncover Hardy’s attempt to address an oversight of his own. Focusing upon the poems penned for Emma following her death, I read them against the narrative which has traditionally surrounded them: one of a re-visioning of a period of discontent. The manuscript’s revisions are rather those which work against the initial impulse to smooth over animosity, striving consistently to paint a harsher version of events, and to acknowledge differences now past alteration. The way in which an endlessly mutable form allows for reflection upon an ‘immutable’ division holds central focus, as I trace the ways in which this tension complicates the long-established view of the Emma verses as an ‘expiation’. I suggest, rather, that in keeping with a much wider sensibility found running through Hardy’s verse, these revisions work to undermine his attempt to offer the famously neglected Emma a long overdue attention; they are amendments, in short, which problematize the very possibility of amends.
Genome-wide association study for morphological, phenological, quality, and yield traits in einkorn (Triticum monococcumL. subsp.monococcum)
Authors: Volante Andrea , Barabaschi Delfina , Marino Rosanna , Brandolini Andrea
Published: August 2021

Einkorn (Triticum monococcum L. subsp. monococcum, 2n = 2× = 14, AmAm) is a diploid wheat whose cultivation was widespread in the Mediterranean and European area till the Bronze Age, before it was replaced by the more productive durum and bread wheats. Although scarcely cultivated nowadays, it has gained renewed interest due to its relevant nutritional properties and as source of genetic diversity for crop breeding. However, the molecular basis of many traits of interest in einkorn remain still unknown. A panel of 160 einkorn landraces, from different parts of the distribution area, was characterized for several phenotypic traits related to morphology, phenology, quality, and yield for 4 years in two locations. An approach based on co-linearity with the A genome of bread wheat, supported also by that with Triticum urartu genome, was exploited to perform association mapping, even without an einkorn anchored genome. The association mapping approach uncovered numerous marker-trait associations; for 37 of these, a physical position was inferred by homology with the bread wheat genome. Moreover, numerous associated regions were also assigned to the available T. monococcum contigs. Among the intervals detected in this work, three overlapped with regions previously described as involved in the same trait, while four other regions were localized in proximity of loci previously described and presumably refer to the same gene/QTL. The remaining associated regions identified in this work could represent a novel and useful starting point for breeding approaches to improve the investigated traits in this neglected species.
Vitamin A deficiency affects gene expression in the Drosophila melanogaster head
Authors: Dewett Deepshe , Labaf Maryam , Lam-Kamath Khanh , Zarringhalam Kourosh , Rister Jens
Published: August 2021

Insufficient dietary intake of vitamin A causes various human diseases. For instance, chronic vitamin A deprivation causes blindness, slow growth, impaired immunity, and an increased risk of mortality in children. In contrast to these diverse effects of vitamin A deficiency (VAD) in mammals, chronic VAD in flies neither causes obvious developmental defects nor lethality. As in mammals, VAD in flies severely affects the visual system: it impairs the synthesis of the retinal chromophore, disrupts the formation of the visual pigments (Rhodopsins), and damages the photoreceptors. However, the molecular mechanisms that respond to VAD remain poorly understood. To identify genes and signaling pathways that are affected by VAD, we performed RNA-sequencing and differential gene expression analysis in Drosophila melanogaster. We found an upregulation of genes that are essential for the synthesis of the retinal chromophore, specific aminoacyl-tRNA synthetases, and major nutrient reservoir proteins. We also discovered that VAD affects several genes that are required for the termination of the light response: for instance, we found a downregulation of both arrestin genes that are essential for the inactivation of Rhodopsin. A comparison of the VAD-responsive genes with previously identified blue light stress-responsive genes revealed that the two types of environmental stress trigger largely nonoverlapping transcriptome responses. Yet, both stresses increase the expression of seven genes with poorly understood functions. Taken together, our transcriptome analysis offers insights into the molecular mechanisms that respond to environmental stresses.
Analysing the impact of private health insurance on inequities in health care utilization: a longitudinal study from China
Authors: Wu Runguo , Ercia Angelo
Published: August 2021

Since the early 2000s, Chinese government has sought to encourage the growth of private health insurance (PHI) while simultaneously expanding the breadth of coverage in its social health insurance (SHI) system. This paper examines how the prevalence of PHI has changed during this period and the extent to which PHI contributed to the growth of horizontal and geographical inequities with a focus on healthcare utilization. National data from China Health and Nutrition Survey between 2000 and 2015 were analysed using a multilevel modelling approach. The analysis investigated the impact of SHI membership as related to PHI uptake, PHI enrolees’ utilization of health services and out-of-pocket (OOP) expenses. This study found being covered by an SHI scheme reduced the uptake of PHI between 2004 and 2015. Having PHI caused an increase in utilizing outpatient care but did not affect OOP expenses. Coverage prevalence of PHI in a residential community was positively associated with the average level of healthcare utilization. Coverage prevalence of PHI and its effects on healthcare utilization varied geographically. The findings suggest that expanding the role of PHI was not effective without clear support from government policy. Furthermore, the expansion of PHI may cause an increase in horizontal and geographical inequities in healthcare utilization.
Selective Effects of Methylphenidate on Attention and Inhibition in 22q11.2 Deletion Syndrome: Results From a Clinical Trial
Authors: Maeder Johanna , Mancini Valentina , Sandini Corrado , Journal Fiona , Schneider Maude , Kliegel Matthias , Eliez Stephan
Published: August 2021

Background

Attention deficit and/or hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children with 22q11.2 deletion syndrome (22q11DS) and frequently persists into adulthood. Although medication with stimulant has been demonstrated to be highly effective in idiopathic ADHD, evidence in 22q11DS is still scarce. Previous studies have shown safety and effectiveness of methylphenidate (MPH) on core symptoms of ADHD as well as improvement of associated cognitive deficits. However, only a limited number of cognitive domains have been explored.

Methods

Twenty-three participants with 22q11DS and attention difficulties, aged 8–24 years, entered a clinical trial aiming to specify the effects of MPH on clinical symptoms, cognition, and daily-life behavior. The effects of treatment were compared with/without medication in a within-subject design. The trial included both participants naïve to the molecule and chronic users.

Results

Benefit from the treatment was demonstrated through a decrease in core ADHD symptoms, specifically inattention symptoms, and improvement of cognitive measures of attention and inhibition. Conversely, no significant change was found for other executive functions (such as cognitive flexibility, working memory, initiation), learning, or memory. Moreover, no significant improvement on ecological measures of daily-life executive functioning was found, possibly because of the short treatment period. We replicated safety, and although very frequent, side effects were of mild intensity and comparable with previous findings.

Conclusions

This study extends the current knowledge on the effects of MPH in patients with 22q11DS. Treatment was found to be effective for core ADHD symptoms and cognitive measures of attention and inhibition.
Impact of event notification services on timely follow-up and rehospitalization among primary care patients at two Veterans Affairs Medical Centers
Authors: Dixon Brian E , Judon Kimberly M , Schwartzkopf Ashley L , Guerrero Vivian M , Koufacos Nicholas S , May Justine , Schubert Cathy C , Boockvar Kenneth S
Published: August 2021

Objective

To examine the effectiveness of event notification service (ENS) alerts on health care delivery processes and outcomes for older adults.

Materials and methods

We deployed ENS alerts in 2 Veterans Affairs (VA) medical centers using regional health information exchange (HIE) networks from March 2016 to December 2019. Alerts targeted VA-based primary care teams when older patients (aged 65+ years) were hospitalized or attended emergency departments (ED) outside the VA system. We employed a concurrent cohort study to compare postdischarge outcomes between patients whose providers received ENS alerts and those that did not (usual care). Outcome measures included: timely follow-up postdischarge (actual phone call within 7 days or an in-person primary care visit within 30 days) and all-cause inpatient or ED readmission within 30 days. Generalized linear mixed models, accounting for clustering by primary care team, were used to compare outcomes between groups.

Results

Compared to usual care, veterans whose primary care team received notification of non-VA acute care encounters were 4 times more likely to have phone contact within 7 days (AOR = 4.10, P < .001) and 2 times more likely to have an in-person visit within 30 days (AOR = 1.98, P = .007). There were no significant differences between groups in hospital or ED utilization within 30 days of index discharge (P = .057).

Discussion

ENS was associated with increased timely follow-up following non-VA acute care events, but there was no associated change in 30-day readmission rates. Optimization of ENS processes may be required to scale use and impact across health systems.

Conclusion

Given the importance of ENS to the VA and other health systems, this study provides guidance for future research on ENS for improving care coordination and population outcomes.

Trial Registration

ClinicalTrials.gov NCT02689076. “Regional Data Exchange to Improve Care for Veterans After Non-VA Hospitalization.” Registered February 23, 2016.
In AI We Trust? Effects of Agency Locus and Transparency on Uncertainty Reduction in Human–AI Interaction
Authors: Liu Bingjie
Published: August 2021

Artificial intelligence (AI) is increasingly used to make decisions for humans. Unlike traditional AI that is programmed to follow human-made rules, machine-learning AI generates rules from data. These machine-generated rules are often unintelligible to humans. Will users feel more uncertainty about decisions governed by such rules? To what extent does rule transparency reduce uncertainty and increase users’ trust? In a 2 × 3 × 2 between-subjects online experiment, 491 participants interacted with a website that was purported to be a decision-making AI system. Three factors of the AI system were manipulated: agency locus (human-made rules vs. machine-learned rules), transparency (no vs. placebic vs. real explanations), and task (detecting fake news vs. assessing personality). Results show that machine-learning AI triggered less social presence, which increased uncertainty and lowered trust. Transparency reduced uncertainty and enhanced trust, but the mechanisms for this effect differed between the two types of AI.
Near-infrared spectroscopic indices for unresolved stellar populations – II. Index measurements
Authors: Gasparri D , Morelli L , Ivanov V D , François P , Pizzella A , Coccato L , Corsini E M , Dalla Bontà E , Costantin L , Cesetti M
Published: August 2021

We measured the equivalent width of a large set of near-infrared (NIR, 0.8–2.4$\ \mu$m) line-strength indices in XShooter medium-resolution spectra of the central regions of 14 galaxies. We found that two aluminum indices, Al at 1.31 μm and Al1 at 1.67 μm, and two CO indices, CO1 at 1.56 μm and CO4 at 1.64 μm, are tightly correlated with the velocity dispersion. Moreover, the NIR Al and CO1 indices show strong correlations with the optical Mg2 and Mgb indices, which are usually adopted as α/Fe-enhancement diagnostics. The molecular FeH1 index at 1.58 μm correlates tightly with the optical 〈Fe〉 and [MgFe]′ indices, which are used as total metallicity diagnostics. The NIR Paβ index at 1.28 μm has a behaviour similar to the optical Hβ index, which is a diagnostic of mean age. We defined two new composite indices, 〈Al〉 and [AlFeH], as possible candidates to be used as NIR diagnostics of total metallicity and α/Fe enhancement. The NIR 〈Al〉 index has a strong correlation with the optical Mg2 and Mgb indices, while the [AlFeH] index is tightly correlated with the optical 〈Fe〉 and [MgFe]′ indices. The distribution of the data points in the NIR Paβ–〈Al〉 and Paβ–[AlFeH] diagrams mimics that in the optical [MgFe]′–Hβ and Mgb–〈Fe〉 diagrams, which are widely used to constrain the properties of the unresolved stellar populations. We concluded that some NIR line-strength indices could be useful in studying stellar populations as well as in fine-tuning stellar population models.
The rapidly oscillating Ap star γ Equ: linear polarization as an enhanced pulsation diagnostic?
Authors: Hubrig S , Järvinen S P , Ilyin I , Strassmeier K G , Schöller M
Published: August 2021

We present the first short time-scale observations of the rapidly oscillating Ap (roAp) star γ Equ in linear polarized light obtained with the Potsdam Echelle Polarimetric and Spectroscopic Instrument installed at the Large Binocular Telescope. These observations are used to search for pulsation variability in Stokes Q and U line profiles belonging to different elements. The atmospheres of roAp stars are significantly stratified with spectral lines of different elements probing different atmospheric depths. roAp stars with strong magnetic fields, such as γ Equ with a magnetic field modulus of 4 kG and a pulsation period of 12.21 min, are of special interest because the effect of the magnetic field on the structure of their atmospheres can be studied with greatest detail and accuracy. Our results show that we may detect changes in the transversal field component in Fe i and rare earth element lines possessing large second-order Landé factors. Such variability can be due to the impact of pulsation on the transverse magnetic field, causing changes in the obliquity angles of the magnetic force lines. Further studies of roAp stars in linear polarized light and subsequent detailed modelling are necessary to improve our understanding of the involved physics.
Real-World Preliminary Experience With Responsive Neurostimulation in Pediatric Epilepsy: A Multicenter Retrospective Observational Study
Authors: Nagahama Yasunori , Zervos Thomas M , Murata Kristina K , Holman Lynette , Karsonovich Torin , Parker Jonathon J , Chen Jia-Shu , Phillips H Westley , Fajardo Marytery , Nariai Hiroki , Hussain Shaun A , Porter Brenda E , Grant Gerald A , Ragheb John , Wang Shelly , O’Neill Brent R , Alexander Allyson L , Bollo Robert J , Fallah Aria
Published: August 2021

BACKGROUND

Despite the well-documented utility of responsive neurostimulation (RNS, NeuroPace) in adult epilepsy patients, literature on the use of RNS in children is limited.

OBJECTIVE

To determine the real-world efficacy and safety of RNS in pediatric epilepsy patients.

METHODS

Patients with childhood-onset drug-resistant epilepsy treated with RNS were retrospectively identified at 5 pediatric centers. Reduction of disabling seizures and complications were evaluated for children (<18 yr) and young adults (>18 yr) and compared with prior literature pertaining to adult patients.

RESULTS

Of 35 patients identified, 17 were <18 yr at the time of RNS implantation, including a 3-yr-old patient. Four patients (11%) had concurrent resection. Three complications, requiring additional surgical interventions, were noted in young adults (2 infections [6%] and 1 lead fracture [3%]). No complications were noted in children. Among the 32 patients with continued therapy, 2 (6%) achieved seizure freedom, 4 (13%) achieved ≥90% seizure reduction, 13 (41%) had ≥50% reduction, 8 (25%) had <50% reduction, and 5 (16%) experienced no improvement. The average follow-up duration was 1.7 yr (median 1.8 yr, range 0.3-4.8 yr). There was no statistically significant difference for seizure reduction and complications between children and young adults in our cohort or between our cohort and the adult literature.

CONCLUSION

These preliminary data suggest that RNS is well tolerated and an effective off-label surgical treatment of drug-resistant epilepsy in carefully selected pediatric patients as young as 3 yr of age. Data regarding long-term efficacy and safety in children will be critical to optimize patient selection.
Needle Parking Interrupted Suturing Technique for Microvascular Anastomosis: A Technical Note
Authors: Mehta Shyle H , Belykh Evgenii , Farhadi Dara S , Preul Mark C , Kikuta Ken-ichiro
Published: August 2021

BACKGROUND

Interrupted and continuous suturing are 2 common techniques for microvascular anastomosis in cerebrovascular surgery. One of the technical complexities of interrupted suturing includes the risk of losing the needle in between interrupted sutures during knot tying, which may result in unnecessary movements and wasted time.

OBJECTIVE

To report a new needle parking technique for microvascular anastomosis that addresses a needle control problem during interrupted suturing.

METHODS

The needle parking technique involves puncturing both vessel walls at the site of the next provisional suture and leaving the needle parked in place while the knots at the first suture are being made. The thread is then cut, the needle is pulled through, and the process is repeated. Illustrative cases in which the needle parking technique was used are presented. We also compared time of anastomosis completion between the conventional interrupted, needle parking interrupted, and continuous suturing techniques during an in vitro study on standardized artificial vessels.

RESULTS

This technique is being used successfully by the senior author for various cerebrovascular bypass surgeries. The in vitro study demonstrated that the needle parking technique can be significantly faster than the conventional interrupted suturing technique and may be as fast as continuous suturing.

CONCLUSION

Needle parking technique is a modification of conventional interrupted suturing and solves the problem of losing the needle during knot tying. This technique is simple, prevents unnecessary movements, and may result in a faster anastomosis time.
Microsurgical Treatment of a Petrotentorial Dural Arteriovenous Fistula: The Vein, the Whole Vein, and Nothing but the Vein: 2-Dimensional Operative Video
Authors: Khan Nickalus R , Elarjani Turki , Burks S Shelby , Wu Eva , Morcos Jacques J
Published: August 2021

Dural arteriovenous fistulas (dAVFs) consist of abnormal anastomoses between 1 or multiple meningeal arteries to meningeal veins, venous sinuses, or subarachnoid veins.
1
dAVFs account for 10% to 15% of all intracranial arteriovenous lesions.
2
dAVFs can be challenging to treat with various approaches that include microsurgical ligation, endovascular embolization (transarterial or transvenous), and stereotactic radiosurgery. All these treatments share the common goal of disconnecting the draining vein from the fistulous point. We present a case of a 43-yr-old male who presented with progressive headaches and was found to have an incidental Zipfel type 3A
3
right petrotentorial dAVF on catheter angiography. The patient underwent a right retrosigmoid craniotomy and clipping of 2 separate venous outflows. The case illustrates the principle that multiple venous outflows can exist in dAVF and a thorough analysis of the venous phase of the angiogram as well as corresponding inspection of the fistula at the time of surgical exploration is a necessity to avoid partial obliteration. The patient remained neurologically intact postoperatively and had complete resolution of his fistula on postoperative angiography. We review the neuroimaging, operative video, and technical nuances and provide a short literature review on the topic.
4
The patient gave informed consent for the procedure and verbal consent for this publication. The patient consented to the publication of their image.
Cervical Subarachnoid Drain for the Treatment of Cerebrospinal Fluid Leak: 2-Dimensional Operative Video
Authors: Perez-Roman Roberto J , Urakov Timur
Published: August 2021

Cerebrospinal fluid (CSF) leak is a common phenomenon encountered by the neurosurgeon. It is most commonly come across after a neurosurgical procedure, but it can be seen idiopathically. Treatment usually ranges from conservative management through cerebrospinal fluid diversion to direct surgical repair. Continuous CSF drainage provides a path for diversion and allowing the site of the dural injury to heal effectively.
1
Cervical subarachnoid drain is a safe and effective alternative when lumbar access is contraindicated or not achievable.
2
Here we present a case of a 22-yr-old female with progressive symptomatic positional headaches due to a CSF leak from a prior deformity surgery treated with a cervical subarachnoid drain after a failed attempt at a direct repair. This 2-dimensional video illustrates the technique used for the placement of a cervical subarachnoid drain for the treatment of symptomatic CSF leak.

 Patient consented to the procedure and for the publication of their image.
Hard Words
Authors: Trollope Anthony
Published: August 2021

IT is to be feared that men in general do not regret as they should do any temporary ill-feeling, or irritating jealousy between husbands and wives, of which they themselves have been the cause. The author is not speaking now of actual love-makings, of intrigues...
Miss Stanbury’s Generosity
Authors: Trollope Anthony
Published: August 2021

ON one Wednesday morning early in June, great preparations were being made at the brick house in the Close at Exeter for an event which can hardly be said to have required any preparation at all. Mrs. Stanbury and her elder daughter were coming into...
Priscilla’s Wisdom
Authors: Trollope Anthony
Published: August 2021

ON the night after the dinner party in the Close, Dorothy was not the only person in the house who laid awake thinking of what had taken place. Miss Stanbury also was full of anxiety, and for hour after hour could not sleep as she...
Brooke Burgess Takes Leave of Exeter
Authors: Trollope Anthony
Published: August 2021

THE time had arrived at which Brooke Burgess was to leave Exeter. He had made his tour through the county, and returned to spend his two last nights at Miss Stanbury’s house. When he came back Dorothy was still at Nuncombe, but she arrived in...
Mr. Gibson is Punished
Authors: Trollope Anthony
Published: August 2021

MISS STANBURY was divine in her wrath, and became more and more so daily as new testimony reached her of dishonesty on the part of the Frenches and of treachery on the part of Mr. Gibson. And these people, so empty, so vain, so weak,...
Hugh Stanbury is Shewn to be No Conjuror
Authors: Trollope Anthony
Published: August 2021

MANY weeks had now passed since Hugh Stanbury had paid his visit to St. Diddulph’s, and Nora Rowley was beginning to believe that her rejection of her lover had been so firm and decided that she would never see him or hear from him more;—and...
Mr. Gibson’s Threat
Authors: Trollope Anthony
Published: August 2021

MISS STANBURY for a long time persisted in being neither better nor worse. Sir Peter would not declare her state to be precarious, nor would he say that she was out of danger; and Mr. Martin had been so utterly prostrated by the nearly-fatal effects...
The Republican Browning
Authors: Trollope Anthony
Published: August 2021

MR. GLASCOCK had returned to Naples after his sufferings in the dining-room of the American Minister, and by the middle of February was back again in Florence. His father was still alive, and it was said that the old lord would now probably live through...
Sir Marmaduke at Home
Authors: Trollope Anthony
Published: August 2021

NORA ROWLEY had told her lover that there was to be no further communication between them till her father and mother should be in England; but in telling him so, had so frankly confessed her own affection for him and had so sturdily promised to...
Mysterious Agencies
Authors: Trollope Anthony
Published: August 2021

WHEN the thirty-first of March arrived, Exeter had not as yet been made gay with the marriage festivities of Mr. Gibson and Camilla French. And this delay had not been the fault of Camilla. Camilla had been ready, and when, about the middle of the...
Of A Quarter Of Lamb
Authors: Trollope Anthony
Published: August 2021

MISS STANBURY, looking out of her parlour window, saw Mr. Gibson hurrying towards the cathedral, down the passage which leads from Southern-hay into the Close. ‘He’s just come from Heavitree, I’ll be bound,’ said Miss Stanbury to Martha, who was behind her.

‘Like enough, ma’am.’...
Dorothy Returns to Exeter
Authors: Trollope Anthony
Published: August 2021

MISS STANBURY perfectly understood that Martha was to come back by the train reaching Exeter at 7 p.m., and that she might be expected in the Close about a quarter-of-an-hour after that time. She had been nervous and anxious all day,—so much so that Mr....
The Lioness Aroused
Authors: Trollope Anthony
Published: August 2021

BROOKE BURGESS had been to Exeter and had gone,—for he only remained there one night,—and everything was apparently settled. It was not exactly told through Exeter that Miss Stanbury’s heir was to be allowed to marry Miss Stanbury’s niece; but Martha knew it, and Giles...
The Rowleys Go Over The Alps
Authors: Trollope Anthony
Published: August 2021

BY the thirteenth of May the Rowley family had established itself in Florence, purposing to remain either there or at the baths of Lucca till the end of June, at which time it was thought that Sir Marmaduke should begin to make preparations for his...
The Future Lady Peterborough
Authors: Trollope Anthony
Published: August 2021

‘IF you have not sold yourself for British gold, and for British acres, and for British rank, I have nothing to say against it,’ said Miss Wallachia Petrie that same evening to her friend Caroline Spalding.

‘You know that I have not sold myself, as...
The Baths of Lucca
Authors: Trollope Anthony
Published: August 2021

JUNE was now far advanced, and the Rowleys and the Spaldings had removed from Florence to the Baths of Lucca. Mr. Glascock had followed in their wake, and the whole party were living at the Baths in one of those hotels in which so many...
Conclusion
Authors: Trollope Anthony
Published: August 2021

AT last the maniac was dead, and in his last moments he had made such reparation as was in his power for the evil that he had done. With that slight touch of his dry fevered lips he had made the assertion on which was...
Tailored physical activity behavior change interventions: challenges and opportunities
Authors: Ma Jasmin K , Floegel Theresa A , Li Linda C , Leese Jenny , De Vera Mary A , Beauchamp Mark R , Taunton Jack , Liu-Ambrose Teresa , Allen Kelli D
Published: August 2021

Lay Summary

Being physically active has many social, emotional, and health benefits, but very few individuals are active enough to see those benefits. Using interventions that are tailored, in other words, individualized to a person’s characteristics, needs, preferences, and/or situation, may help improve physical activity participation rates. However, a better understanding of how to do tailoring is needed. Our collaboration reviewed the literature and convened to suggest two key opportunities to better understand how tailored approaches to physical activity can be done: (a) improve engagement of those who the research is intended for and (b) understand the ethical impacts and patient/provider experience of using technology to support tailoring.
Supplemental Fumigant Placement Improves Root Knot and Fusarium Wilt Management for Tomatoes Produced on a Raised-Bed Plasticulture System in Florida’s Myakka Fine Sand
Authors: Land Caroline J. , Vallad Gary E. , Desaeger Johan , Van Santen Edzard , Noling Joe , Lawrence Kathy
Published: August 2021

Fresh-market tomatoes are produced on a raised-bed plasticulture system that relies heavily on soil-applied preplant fumigants for the management of soilborne pathogens, nematodes, and weeds. Since the transition from methyl bromide to alternative fumigants, growers have experienced a resurgence of several soilborne pests and pathogens, including root-knot nematode caused by Meloidogyne spp. and Fusarium wilt caused by Fusarium oxysporum f. sp. lycopersici race 3. This resurgence is attributed to the inability of the alternative fumigants to effectively disperse through the soil in the same manner as methyl bromide. Two supplemental fumigation strategies, the application of chloropicrin (PIC) below bed edges (herein “supplemental PIC”) and broadcast deep-shank applications of 1,3-dichloropropene (1,3-D), were evaluated in conjunction with standard raised-bed applications of Pic-Clor 60, Pic-Clor 80, and Pic 100 covered with a virtually impermeable film or a totally impermeable film. Large-plot replicated studies were conducted in two separate commercial tomato fields with a history of production losses caused by root-knot nematode and Fusarium wilt. Deep-shank 1,3-D applications significantly reduced the recovery of root-knot and total parasitic nematodes across field sites before the preparation of raised beds. Both supplemental PIC and deep-shank 1,3-D reduced root-knot galling and Fusarium wilt incidence, but the latter supplemental treatment statistically had the greatest impact. Fumigant applied within raised beds or plastic film had no significant effect on root-knot galling or Fusarium wilt. Although both supplemental fumigation strategies had a significant effect on pest and disease pressure, neither statistically improved tomato yields based on small subplot harvests. Controlled laboratory experiments confirmed the fungicidal activity of 1,3-D against F. oxysporum f. sp. lycopersici, with 75, 90, 95, and 99% lethal doses corresponding to estimated field application rates of 56.1, 93.5, 121.6, and 184.7 liters/ha, respectively. The results demonstrate how fumigant placement can improve pest and disease control activity with current fumigant alternatives to methyl bromide and further support the broader pesticidal activity of some chemical fumigants.
Notalgia paresthetica
Authors: Haney Beth
Published: August 2021

Notalgia paresthetica is a perplexing diagnosis in the primary care setting. Chronic itching, paresthesia, or pain causes discomfort in patients who suffer with notalgia paresthetica and it is thought to be a common but underdiagnosed condition. Recognition of this dermatologic condition can lead to reassurance and relief for affected patients.
Extended Flexor Carpi Radialis Approach
Authors: Imada Allicia O. , Oloyede Solomon F. , Mercer Deana
Published: August 2021

The extended flexor carpi radialis (FCR) approach is a useful, extensile surgical exposure that can be used in the treatment of distal radius fractures. It allows for reduction of partially healed, complex articular fractures and those fractures involving the volar rim of the ulnar fossa. It expands the traditional Henry approach by providing more distal exposure and access to the dorsal aspect of the radius. The extended FCR approach is performed in four steps: (1) The FCR tendon sheath is released distally to the tuberosity of the trapezium, (2) the radial septum including the brachioradialis insertion and the first dorsal extensor compartment is released, (3) the volar surface of the radius is exposed by elevating the transitional fibrous zone and the pronator quadratus, (4) and finally, the proximal fragment is pronated through the fracture site exposing the dorsal aspect of the distal radius. This intrafocal exposure allows debridement of the fracture by removing organized hematoma or callus to allow anatomical reduction of the fracture.

Level of Evidence:

Level V—Expert Opinion.
Risk Factors for Critical Coronavirus Disease 2019 and Mortality in Hospitalized Young Adults: An Analysis of the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) Coronavirus Disease 2019 Registry
Authors: Tripathi Sandeep , Sayed Imran A. , Dapul Heda , McGarvey Jeremy S. , Bandy Jennifer A. , Boman Karen , Kumar Vishakha K. , Bansal Vikas , Retford Lynn , Cheruku Sreekanth , Kaufman Margit , Heavner Smith F. , Danesh Valerie C. , St. Hill Catherine A. , Khanna Ashish K. , Bhalala Utpal , Kashyap Rahul , Gajic Ognjen , Walkey Allan J. , Gist Katja M.
Published: August 2021

IMPORTANCE:

Even with its proclivity for older age, coronavirus disease 2019 has been shown to affect all age groups. However, there remains a lack of research focused primarily on the young adult population.

OBJECTIVES:

To describe the epidemiology and outcomes of coronavirus disease 2019 and identify the risk factors associated with critical illness and mortality in hospitalized young adults.

DESIGN, SETTINGS, AND PARTICIPANTS:

A retrospective cohort study of the Society of Critical Care Medicine’s Viral Infection and Respiratory Illness Universal Study registry. Patients 18–40 years old, hospitalized from coronavirus disease 2019 from March 2020 to April 2021, were included in the analysis.

MAIN OUTCOMES AND MEASURES:

Critical illness was defined as a composite of mortality and 21 predefined interventions and complications. Multivariable logistic regression was used to assess associations with critical illness and mortality.

RESULTS:

Data from 4,005 patients (152 centers, 19 countries, 18.6% non-U.S. patients) were analyzed. The median age was 32 years (interquartile range, 27–37 yr); 51% were female, 29.4% Hispanic, and 42.9% had obesity. Most patients (63.2%) had comorbidities, the most common being hypertension (14.5%) and diabetes (13.7%). Hospital and ICU mortality were 3.2% (129/4,005) and 8.3% (109/1,313), respectively. Critical illness occurred in 25% (n = 996), and 34.3% (n = 1,376) were admitted to the ICU. Older age (p = 0.03), male sex (adjusted odds ratio, 1.83 [95% CI, 1.2–2.6]), and obesity (adjusted odds ratio, 1.6 [95% CI, 1.1–2.4]) were associated with hospital mortality. In addition to the above factors, the presence of any comorbidity was associated with critical illness from coronavirus disease 2019. Multiple sensitivity analyses, including analysis with U.S. patients only and patients admitted to high-volume sites, showed similar risk factors.

CONCLUSIONS:

Among hospitalized young adults, obese males with comorbidities are at higher risk of developing critical illness or dying from coronavirus disease 2019.
Bibliometrics and Co-Citation Network Analysis of Systematic Reviews of Evidence-Based Nursing Guidelines for Preventing Inpatient Falls
Authors: Cho Insook , Kim Dongwan , Park Hyunchul
Published: August 2021

Advances in bibliometrics and co-citation analysis provide the opportunity to analyze quantitatively the large amount of nursing research used in evidence-based nursing. Numerous nursing researchers have attempted to obtain evidence that using evidence-based nursing improves the quality of nursing practices. However, little is known about how these efforts comply with the rigorous methods required for a systematic review in a subject area. This study explored the comprehensiveness of systematic reviews in four guidelines for preventing inpatient falls using bibliometrics and a co-citation network technique. Citations (n = 659) and 9417 unique bibliographic records written by 6537 authors were collected from the guidelines in January 2020. The results showed none of the references spanned all four authoring bodies, whereas only 0.1% and 4.7% of the references spanned three and two of the authoring bodies, respectively. The co-citation analysis revealed differences in the scope and primary concerns among the development groups, even in the same setting, with differences in the highly influential articles and authors. These findings imply that although the systematic reviews of guidelines on fall prevention were of good quality, there remain areas for improvement in terms of harmonizing the selection of bibliographic citations comprehensively.
Maternal outcome of selective feticide due to fetal anomaly in late trimester: A retrospective 10 years’ experience in Taiwan
Authors: Sung Chen-Ai , Lin Tzu-Yi , Lee Han-Ni , Chan Kok-Seong , Hung Tai-Ho , Shaw Steven W.
Published: August 2021

Background:

Feticide was suggested to avoid delivering children with abnormalities. Recently, twin pregnancies have increased. Selective feticide was proposed to achieve a good outcome of pregnancy. This study aimed to evaluate the performance of feticide in twin pregnancy with fetal anomaly.

Methods:

This was a retrospective study enrolled from 2009 to 2018. A total of 68 pregnancies with fetal anomalies received feticide. Potassium chloride was injected into the left ventricle to induce fetal asystole. Maternal and fetal characteristics of 16 dichorionic twins were documented to compare before and after 24th gestational week.

Results:

All pregnant women received feticide without any maternal or fetal complication. The reasons for choosing feticide were divided into four groups, including morphologic defect (61.8%), genetic-chromosomal abnormality (30.9%), obstetrical complication (5.9%), and maternal request (1.5%). Mean gestational age at delivery was significantly higher in dichorionic twins who underwent selective feticide before than after 24th gestational week (36.7 vs 33.4, p = 0.04).

Conclusion:

Intracardiac injection of potassium chloride was effective for feticide and safe for mothers and fetuses. Selective feticide served as an alternative approach for twin pregnancy with fetal anomaly after sufficient discussion.
The Hidden Cost of Caregiving
Authors: Robbins Rebecca , Weaver Matthew D. , Quan Stuart F. , Barger Laura K. , Zhivotovsky Stephany , Czeisler Charles A.
Published: August 2021

Objective:

To evaluate whether caregiving for older adults is associated with insomnia symptoms and diminished workplace productivity.

Methods:

We analyzed data collected from caregivers to older adults in the US. Participants self-reported awakenings from sleep (caregiving-related or spontaneous) and workplace measures (presenteeism, absenteeism, and productivity impairment). We conduct generalized linear modeling to examine the relationship between awakenings and workplace outcomes, controlling for confounders.

Results:

Two hundred fifty-eight caregivers to older adults reported current employment and met our inclusion criteria. Adjusted analyses found that reporting caregiving-related awakenings was associated with presenteeism (OR = 1.27, 95%CI: 1.16 to 1.40), absenteeism (OR = 1.10, 95%CI: 1.06 to 1.15), and productivity impairment (OR = 1.41, 95%CI: 1.25 to 1.58). Adjusted analyses found that spontaneous nighttime awakenings were associated with absenteeism (OR = 1.05, 95%CI: 1.01 to 1.08) and productivity impairment (OR = 1.12, 95%CI: 1.02 to 1.124) but not presenteeism.

Conclusions:

Caregiving-related awakenings are a risk factor for workplace productivity impairment. Future studies should examine means for improving caregiver sleep.