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Buprenorphine-naloxone is a combination medication of an opioid partial agonist and opioid antagonist that is proven to be effective in outpatient management of opioid use disorder (OUD). Tramadol is a centrally acting analgesic. This commonly used pain medication inhibits serotonin and noradrenaline reuptake by acting as a selective agonist on opioid μ receptors. Transition and tapering high-dose tramadol to buprenorphine-naloxone is not well described in the literature. We report a case of a patient who was taking 1,000-1,250 mg of tramadol daily upon presentation to the clinic. She was originally prescribed 150 mg daily with escalation in dose and frequency over a 10-year period. The patient was converted to buprenorphine-naloxone and has been successful in treatment of OUD for 1 year.

To review the literature of venous sinus stenosis (VSS) treatment in children for idiopathic intracranial hypertension (IIH) and present our own institutional case.A literature review was conducted using the PubMed and MEDLINE databases up to June 2020. From 134 studies that were screened, 6 studies were chosen for analysis that included patients18 years old, a diagnosis of IIH that fit Dandy diagnostic criteria, and angiogram obtained to assess for VSS. IIH symptoms experienced in the pediatric population and efficacy of venous sinus stenting were analyzed.Eleven patients identified in the literature and 1 patient from our institution were included in the analysis. There was no statistically significant difference in pressure gradient response to stenting between male and female patients (P = 0.424) or patients with body mass index90th percentile (P = 0.626). Larger decreases in pressure gradient after stent placement correlated with headache resolution (P = 0.0005). Patients who underwent unilateral stenting showed greater reduction in pressure gradient compared with patients who underwent bilateral stenting (average change 24 mm Hg vs. 5.75 mm Hg, P = 0.003).Our analysis showed that VSS treatment has the potential to be a safe option for IIH in pediatric patients. VSS treatment has shown similar results to traditional cerebrospinal fluid diversion procedures, with a lower complication rate and need for revision. More studies should be conducted to analyze the long-term efficacy and safety of VSS treatment in pediatric patients with IIH.

Author(s): Wu, H; Fu, P; Frone, Z; White, MD; Ajo-Franklin, JB; Morris, JP; Knox, HA; Schwering, PC; Strickland, CE; Roberts, BQ; Vermeul, VR; Mattson, ED; Ingraham, MD; Kneafsey, TJ; Blankenship, DA | Abstract: Heat recovery from an enhanced geothermal system (EGS) is a complex process involving heat transport in both fracture networks and rock formations. A comprehensive understanding of and the ability to model the underlying heat transport mechanisms is important for the success of EGS commercialization but remains challenging in practice due to the generally insufficient characterization of EGS reservoirs. In the present study, we analyze an extensively monitored intermediate-scale EGS field experiment performed in a well-characterized testbed. The high-resolution, high-quality measurements from the field experiment enable the development of a high-fidelity model incorporating a well-constrained fracture network. Based on the field experiment, we investigate the complex heat transport processes in an EGS-relevant environment and validate the capability of a numerical approach in simulating these inherently coupled heat transport processes. A series of numerical simulations were performed to study the effects of different heat transport mechanisms, including thermal convection with fracture flow, thermal conduction in rock formations, and the Joule-Thomson effect. The agreement of thermal responses between field measurements and simulation results indicates that our numerical approach can appropriately model the heat transport processes pertaining to heat recovery from EGS reservoirs.

Author(s): Johnson, TC; Burghardt, J; Strickland, C; Knox, H; Vermeul, V; White, M; Schwering, P; Blankenship, D; Kneafsey, T

Surface barriers are designed to isolate subsurface contaminants for 1000 years or longer, functionally limiting water infiltration and removing the driving force for contaminant transport to groundwater. Cost-effective monitoring is challenging because of the long design life for surface barriers, spatial limitations and finite lifetime of in situ sensors, and performance metrics related to drainage. Hence, ground-penetrating radar (GPR) and electromagnetic induction (EMI) tools were evaluated for use in performance monitoring of surface barriers. GPR and EMI were used to non-invasively interrogate the Prototype Hanford Barrier (PHB), an evapotranspiration-capillary break barrier established in 1994 at the Hanford Site, in southeastern Washington State. Both geophysical methods were evaluated for providing indirect estimates of subsurface moisture content conditions that were compared to point scale measurements from borehole neutron logs. Surveys were performed during characteristically wet and dry periods to observe a range of hydrologic states of the barrier soil. Although EMI surveys were expected to show seasonal changes associated with changes in the bulk conductivity of the barrier soil layers, the effectiveness of the method was limited by the effects of metallic infrastructure embedded in the barrier. GPR estimates of volumetric water content were typically within 2–3% of the highest water contents from neutron probe measurements for both wet and dry periods, providing reasonable estimates of water content. Given that PHB monitoring data over the past 25 years has demonstrated its success in limiting deep drainage, GPR was found to be a cost-effective method for demonstrating continued barrier performance, with a greater capacity to quantify moisture content distributions over much larger areas relative to point measurements.

Compressional seismic (P‐wave) velocities were measured experimentally at different matric suctions and confining pressure states using a variety of sediments collected from the USDOE Hanford Site in southeastern Washington State. The P‐wave velocity was measured in variably saturated sediments using ultrasonic piezoelectric transducers, and matric suction was measured with a heat dissipation sensor. Desaturation of the samples occurred by means of evaporative drying. We propose a model to relate changes in P‐wave velocity to soil stress conditions using an effective stress formulation that includes capillary stress as well as adsorptive stress. We show that compressional wave velocities can be related to matric suction and confining stress using a model with five fitted parameters. A single set of parameters describing the relationship between effective stress and P‐wave velocity provide an excellent fit to data acquired on Hanford Formation samples. The results presented here suggest the utility of seismic methods for establishing low matric suction and flow conditions within variably saturated Hanford formation sediments, which could be applied at the field scale for evaluating the performance of environmental remediation efforts, such as soil desiccation and surface infiltration barriers.

Author(s): Fu, P; Schoenball, M; Ajo-Franklin, JB; Chai, C; Maceira, M; Morris, JP; Wu, H; Knox, H; Schwering, PC; White, MD; Burghardt, JA; Strickland, CE; Johnson, TC; Vermeul, VR; Sprinkle, P; Roberts, B; Ulrich, C; Guglielmi, Y; Cook, PJ; Dobson, PF; Wood, T; Frash, LP; Huang, L; Ingraham, MD; Pope, JS; Smith, MM; Neupane, G; Doe, TW; Roggenthen, WM; Horne, R; Singh, A; Zoback, MD; Wang, H; Condon, K; Ghassemi, A; Chen, H; McClure, MW; Vandine, G; Blankenship, D; Kneafsey, TJ | Abstract: The final version of the above article was posted prematurely on 16 July 2021, owing to a technical error. The final, corrected version of record will be made fully available at a later date.

Background and purpose Cerebral vasospasm in the setting of subarachnoid hemorrhage causes morbidity and mortality due to delayed cerebral ischemia and permanent neurological deficits. Vasospasm treatment includes intra-arterial injection of a spasmolytic during cerebral angiography. To evaluate effectiveness, neurointerventionalists subjectively examine a posttreatment cerebral angiogram to determine change in vessel diameter or increase in microvascular perfusion. Flat-detector computed tomography (FDCT) scanner has the ability to quantitatively measure cerebral blood volume (CBV) within the parenchyma and detect a quantitative change following treatment. Methods This is a prospective study at a single institution between October 5, 2017 and June 3, 2019 that examines CBV studies from the Artis Q biplane (Siemens). Regions of interest were made in various territories to measure the CBV within the parenchyma before and after treatment with the spasmolytic verapamil. All instances of vasospasm involved vasculature within the left middle cerebral artery or internal carotid artery. The Wilcoxon signed-rank test was used to determine significance before and after treatment. Results Our cohort consists of 6 patients who underwent Digital Subtraction Angiography (DSA) and FDCT scans for cerebral vasospasm within the left hemisphere. After intra-arterial injection of 20 mg of verapamil, average increases in blood volume were 59%, 22%, and 24% for the temporal, frontal, and parietal lobes, respectively. P-values associated were .03. We also observed decrease in the mean arterial blood pressure and transcranial Doppler values after treatment. Conclusion In conclusion, FDCT could measure the effectiveness of a change in CBV from infusion of verapamil in the setting of cerebral vasospasm. The authors believe quantifying the change allows for reassurance of improvement of cerebral vasospasm.

Aqueous iodine removal via adsorption onto Fe oxides could provide an efficient remedial pathway for the vadose zone and groundwater contamination. We conducted a series of macroscopic batch experi...

Background Dasatinib, a tyrosine kinase inhibitor commonly used in treatment of acute lymphoblastic leukemia and chronic myelogenous leukemia, is often associated with hemorrhagic complications. Safety of dasatinib after thrombolytic therapy in acute ischemic stroke is unknown. Case Description A 63-year-old man with multiple vascular risk factors and chronic myelogenous leukemia (in molecular remission) on dasatinib presented with signs and symptoms of right hemispheric stroke owing to acute intracranial internal carotid artery occlusion that was treated with intravenous thrombolysis and mechanical thrombectomy resulting in near-complete resolution of stroke symptoms. The patient developed clinical worsening (>24 hours of thrombolytic therapy) after receiving a second dose of dasatinib that was due to symptomatic intracerebral hemorrhage and necessitated decompressive hemicraniectomy. Routine coagulation profile was normal. The etiology of this hemorrhagic complication was likely secondary to primary platelet dysfunction due to dasatinib as reported in some recent in vitro and ex vivo studies. Conclusions It is advisable to withhold dasatinib during the poststroke period owing to its associated risk of symptomatic intracerebral hemorrhage.

Author(s): Schoenball, M; Ajo-Franklin, JB; Blankenship, D; Chai, C; Chakravarty, A; Dobson, P; Hopp, C; Kneafsey, T; Knox, HA; Maceira, M; Robertson, MC; Sprinkle, P; Strickland, C; Templeton, D; Schwering, PC; Ulrich, C; Wood, T; Ajo-Franklin, J; Baumgartner, T; Beckers, K; Blankenship, D; Bonneville, A; Boyd, L; Brown, S; Burghardt, JA; Chai, C; Chakravarty, A; Chen, T; Chen, Y; Chi, B; Condon, K; Cook, PJ; Crandall, D; Dobson, PF; Doe, T; Doughty, CA; Elsworth, D; Feldman, J; Feng, Z; Foris, A; Frash, LP; Frone, Z; Fu, P; Gao, K; Ghassemi, A; Guglielmi, Y; Haimson, B; Hawkins, A; Heise, J; Hopp, C; Horn, M; Horne, RN; Horner, J; Hu, M; Huang, H; Huang, L; Im, KJ; Ingraham, M; Jafarov, E; Jayne, RS; Johnson, TC; Johnson, SE; Johnston, B; Karra, S; Kim, K; King, DK; Kneafsey, T; Knox, H; Knox, J; Kumar, D; Kutun, K; Lee, M; Li, K; Li, Z; Mackey, P; Makedonska, N; Marone, CJ; Mattson, E; McClure, MW; McLennan, J; McLing, T; Medler, C; Mellors, RJ; Metcalfe, E; Miskimins, J | Abstract: Enhanced Geothermal Systems could provide a substantial contribution to the global energy demand if their implementation could overcome inherent challenges. Examples are insufficient created permeability, early thermal breakthrough, and unacceptable induced seismicity. Here we report on the seismic response of a mesoscale hydraulic fracturing experiment performed at 1.5-km depth at the Sanford Underground Research Facility. We have measured the seismic activity by utilizing a 100-kHz, continuous seismic monitoring system deployed in six 60-m length monitoring boreholes surrounding the experimental domain in 3-D. The achieved location uncertainty was on the order of 1nm and limited by the signal-to-noise ratio of detected events. These uncertainties were corroborated by detections of fracture intersections at the monitoring boreholes. Three intervals of the dedicated injection borehole were hydraulically stimulated by water injection at pressures up to 33nMPa and flow rates up to 5nL/min. We located 1,933 seismic events during several injection periods. The recorded seismicity delineates a complex fracture network comprised of multistrand hydraulic fractures and shear-reactivated, preexisting planes of weakness that grew unilaterally from the point of initiation. We find that heterogeneity of stress dictates the seismic outcome of hydraulic stimulations, even when relying on theoretically well-behaved hydraulic fractures. Once hydraulic fractures intersected boreholes, the boreholes acted as a pressure relief and fracture propagation ceased. In order to create an efficient subsurface heat exchanger, production boreholes should not be drilled before the end of hydraulic stimulations.

The cosmic origin of fluorine is still not well constrained. Several nucleosynthetic channels at different phases of stellar evolution have been suggested, but these must be constrained by observations. For this, the fluorine abundance trend with metallicity spanning a wide range is required. Our aim is to determine stellar abundances of fluorine for -1.1 < [Fe H] < +0.4. We determine the abundances from HF lines in infrared K-band spectra ( 2.3 mm) of cool giants, observed with the IGRINS and Phoenix high-resolution spectrographs. We derive accurate stellar parameters for all our observed K giants, which is important as the HF lines are very temperaturesensitive. We find that [F/Fe] is flat as a function of metallicity at [ F/Fe]0, but increases as the metallicity increases. the fluorine slope shows a clear secondary behavior in this metallicity range. We also find that the [F/ Ce] ratio is relatively flat for -0.6 < [Fe H] < 0, and that for two metal-poor ([Fe H] < - 0.8), s-process element-enhanced giants, we do not detect an elevated fluorine abundance. We interpret all of these observational constraints as indications that several major processes are at play for the cosmic budget of fluorine over time: from those in massive stars at low metallicities, through the asymptotic giant branch star contribution at -0.6 < [Fe H] < 0, to processes with increasing yields with metallicity at supersolar metallicities. the origins of the latter, and whether or not Wolf-Rayet stars and/or novae could contribute at supersolar metallicities, is currently not known. To quantify these observational results, theoretical modeling is required. More observations in the metal-poor region are required to clarify the processes there., Swedish Research Council, V.R.Swedish Research Council [621-2014-5640]; Royal Physiographic Society in Lund through the Stiftelse Walter Gyllenbergs fond; Crafoord Foundation; Stiftelsen Olle Engkvist ByggmastareSwedish Research Council; Ruth och Nils-Erik Stenbacks stiftelse; US National Science FoundationNational Science Foundation (NSF) [AST-1229522, AST-1702267]; McDonald Observatory of the University of Texas at Austin; Korean GMT Project of KASI, We would like to thank George Meynet for fruitful and enlightening discussions on massive-star yields and the theoretically predicted role of Wolf-Rayet stars for the production of fluorine. N.R. acknowledges support from the Swedish Research Council, V.R. (project numbers 621-2014-5640), and the Royal Physiographic Society in Lund through the Stiftelse Walter Gyllenbergs fond and Marta och Erik Holmbergs donation. H.J. acknowledges support from the Crafoord Foundation, Stiftelsen Olle Engkvist Byggmastare, and Ruth och Nils-Erik Stenbacks stiftelse. This work used the Immersion Grating Infrared spectrograph (IGRINS) that was developed under a collaboration between the University of Texas at Austin and the Korea Astronomy and Space Science Institute (KASI) with the financial support of the US National Science Foundation under grants AST-1229522 and AST-1702267, of the McDonald Observatory of the University of Texas at Austin, and of the Korean GMT Project of KASI. Facilities: McDonald Observatory (IGRINS), Lowell Observatory (IGRINS), KPNO (Phoenix).

Riverbeds can have an important impact on large-scale fluxes of biogeochemically active solutes in river corridor systems. The hyporheic zone is an important area of both hydrology and biogeochemistry, particularly in a hydropeaked river system where rapid variations in river stage height, hydraulic gradients, and residence times occur. We measured several biogeochemical and hydrological parameters at three different subsurface depths in the riverbed of the Columbia River in Washington state, a complex hydropeaked river system with significant subsurface heterogeneity. During the study, episodes of significant dissolved oxygen (DO) change were observed. The DO signal changes were the most apparent, compared to more modest changes in other biogeochemical markers. While DO is often associated with biological activity, we ultimately found that the notable DO excursions were associated with hydrologic gradients. Here we describe hydrologic perturbations and biogeochemical responses in terms of hydrobiogeochemical regimes. Two different forms of DO response to hydraulic gradient perturbation were observed, defining different hydrobiogeochemical regimes. The system tips abruptly from one regime to the other, exhibiting threshold behavior that is uncaptured in current estimations of cumulative influences of subsurface processes from reach to earth system scales.Plain language summaryThe water in a river is constantly flowing in and out of the river’s bed. While it is in the bed, microbes process environmentally and ecologically important nutrients and other compounds. The exchange of water between the river and the riverbed is largely controlled by the stage of the river. Many processes, both natural and human, can cause rapid changes in the river stage. These rapid stage changes can cause abrupt changes in the riverbed’s ability to process nutrients and other compounds. In this study, we use dissolved oxygen as a window into riverbed microbial and chemical processing. We see that relatively rapid changes in river stage can cause abrupt changes in the concentrations of chemicals in the riverbed, indicating fundamental changes in how the riverbed processes are occurring. Understanding these abrupt and fundamental changes is important to our overall understanding of the ecological function of river corridor systems.3 key pointsA hydrobiogeochemical regime is defined by the functional form of the relationship of a hydrologic perturbation and biogeochemical marker.Short-term hydrologic perturbations drive tipping points between distinct hydrobiogeochemical regimes.Linear and hysteretic dissolved oxygen dynamics define distinct regimes as observed throughout the hyporheic zone.

Injection of fluids into geologic formations for long term disposition (CO 2 ) or to improve energy extraction operations can benefit from subsurface monitoring programs capable of providing three dimensional spatial imaging of fluid distributions in the host reservoirs. More importantly, advancements in horizontal drilling and fluid fracking technologies are attracting a broader portfolio of non-traditional engineered subsurface reservoirs that possess complex fluid flow typically through engineered fracture networks. For example, producing fossil fuels from tight sands or shale formations, geothermal based heat extraction operations in low-permeability rock formations, and storing injected fluids (i.e. CO 2 , acid gases, waste waters, etc.) in the subsurface all require rigorous tracking techniques capable of identifying fluid migration. Current methodologies for four dimensional (3D spatial changes over time) subsurface monitoring of injected fluids are typically geophysical, using surface stations and borehole devices which employ seismic, electromagnetic, and gravitational techniques. However current methods often lack sufficient measurement sensitivity to adequately track fluid migration, and often incur a large economic cost. In this paper, we describe an entirely new class of acoustically responsive contrast agents to enable high-sensitivity, high-resolution tracking of injected fluids via conventional seismic imaging that have the potential of improving subsurface fracture network mapping and plume monitoring in CO 2 storage operations.

A new probe was designed to quantify groundwater-surface water exchange in the hyporheic zone under dynamic stage condition. Current methods focus on either vertical pore water velocity or Darcy flux measurements. Both parameters must be understood to evaluate residence time and mass flux of constituents. Furthermore, most instruments are not well suited for monitoring instantaneous velocity or flux under dynamic exchange conditions. For this reason, the flux detection probe (FDP) was designed that employs electrogeophysical measurements to estimate in situ sediment porosity, which can be used to convert pore water velocity to Darcy flux. Dynamic pore water velocity is obtained by monitoring fluid conductivity and temperature along the FDP probe. Pressure sensors deployed at the top and bottom of the probe provide the additional information necessary to estimate vertical permeability. This study focuses on the use of a geophysical method to estimate pore water velocity, porosity, and permeability within a controlled soil column where simulated river water displaces simulated groundwater. The difference between probe derived and theoretical pore water velocity using natural tracers such as electrical conductivity and temperature was -4.9 and 3.9% for downward flow and 1.1 and 12.8% for upward flow, respectively. The difference in porosity calculated from mass and volume packed in the soil column and probe measure porosity ranged between -3.2% and 1.5%. Also, the calculated hydraulic conductivity differed from probe derived values by -8.9%.

A 5-year-old girl was brought to the clinic because of chronic intermittent left-sided headaches. The patient underwent computed tomographic angiography, which demonstrated a giant aneurysm that involved the P2 segment of the left posterior cerebral artery. Before treatment proceeded, consent was obtained from the patient's legal guardian. A trapping-evacuation technique was used for proximal control and decompression so that a clip could be placed on the proximal inflow artery of the aneurysm. First, embolization was performed for aneurysm trapping and for sacrifice of the parent vessel. Two days later, the patient was taken to the operating room for open surgical decompression, clipping, and reconstruction. Heparin was administered during the embolization stage of the operation. The patient did well postoperatively and was discharged home. The 3-month follow-up evaluation demonstrated a right superior homonymous quadrantanopia and no other neurologic deficits. The patient's clinical course is summarized in Video 1.

Intrathalamic aneurysms are a cause of patient morbidity and mortality. Aneurysms in this location can be accessed microsurgically when they cannot be accessed endovascularly. Care must be taken to avoid critical white matter tracts when approaching the thalamus microsurgically. Use of a tubular retractor can offer safe brain retraction during the approach. A 53-year-old female with a history of hypertension and cerebrovascular accidents presented with slurred speech, altered mental status, and right-sided weakness. CT demonstrated an acute parenchymal hemorrhage within the left thalamus and the internal capsule. CT angiography demonstrated a left dorsal thalamic aneurysm. Following angiography with consideration for embolization, the patient was taken to the operating room for microsurgical clip ligation with the use of minimally invasive techniques. The aneurysm was accessed using a contralateral transventricular approach with a tubular retractor for microsurgical clip ligation. Postoperative imaging demonstrated successful interval clipping of the aneurysm within the thalamus. This is the first report using our described surgical approach for treatment of a dorsal intrathalamic aneurysm. We combined the use of diffusion tensor imaging with a tubular retractor to clip a dorsal thalamic aneurysm.

Background The PulseRider (Pulsar Vascular, Inc, Los Gatos, California, USA) device was developed to treat wide-neck aneurysms, and the Adjunctive Neurovascular Support of Wide-neck aneurysm Embolization and Reconstruction (ANSWER) Trial showed efficacy in the treatment of unruptured wide-neck aneurysms. Our case series demonstrates the use of the PulseRider device in the treatment of ruptured wide-neck aneurysms. Case Description The 2 patients in our series presented with subarachnoid hemorrhage secondary to ruptured basilar apex aneurysms. The patients were taken to the neurointervention suite for embolization of their aneurysms with the PulseRider and platinum microcoils. Conclusions In both cases, a Roy Raymond class III embolization was achieved. The patients recovered from their subarachnoid hemorrhage and were discharged with resolution of their symptoms. The presented cases document the safety and efficacy of treating ruptured aneurysms with the PulseRider device.

River corridors, the spatial domains around rivers in which river water interacts with surrounding sediment and rock, are important components of watersheds. They comprise extremely complex ecosyst...

Relative permeability is an important attribute influencing subsurface multiphase flow. Characterization of relative permeability is necessary to support activities such as carbon sequestration, geothermal energy production, and oil and gas exploration. Previous research efforts have largely neglected the relative permeability of wellbore cement used to seal well bores where risks of leak are significant. Therefore this study was performed to evaluate fracturing on permeability and relative permeability of wellbore cement. Studies of relative permeability of water and air were conducted using ordinary Portland cement paste cylinders having fracture networks that exhibited a range of permeability values. The measured relative permeability was compared with three models, 1) Corey-curve, often used for modeling relative permeability in porous media, 2) X-curve, commonly used to represent relative permeability of fractures, and 3) Burdine model based on fitting the Brooks-Corey function to fracture saturation-pressure data inferred from x-ray computed tomography (XCT) derived aperture distribution results. Experimentally-determined aqueous relative permeability was best described by the Burdine model. Though water phase tended to follow the Corey-curve for the simple fracture system while air relative permeability was best described by the X-curve.

WOS: 000474880400015, We present near-infrared spectroscopic analysis of 12 red giant members of the Galactic open cluster NGC 6940. High-resolution (R similar or equal to 45 000) and high-signal-to-noise ratio (S/N > 100) near-infrared H-and K-band spectra were gathered with the Immersion Grating Infrared Spectrograph (IGRINS) on the 2.7-m Smith Telescope at McDonald Observatory. We obtained abundances of H-burning (C, N, O), alpha (Mg, Si, S, Ca), light odd-Z (Na, Al, P, K), Fe-group (Sc, Ti, Cr, Fe, Co, Ni), and neutron-capture (Ce, Nd, Yb) elements. We report the abundances of S, P, K, Ce, and Yb in NGC 6940 for the first time. Many OH and CN features in the H band were used to obtain O and N abundances. C abundances were measured from four different features: CO molecular lines in the K band, high excitation CI lines present in both near-infrared and optical, CH and C-2 bands in the optical region. We have also determined C-12/C-13 ratios from the R-branch band heads of first overtone (2-0) and (3-1) (CO)-C-12 and (2-0) (CO)-C-13 lines near 23 440 angstrom and (3-1) (CO)-C-13 lines at about 23 730 angstrom. We have also investigated the HF feature at 23 358.3 angstrom, finding solar fluorine abundances without ruling out a slight enhancement. For some elements (such as the alpha group), IGRINS data yield more internally self-consistent abundances. We also revisited the CMD of NGC 6940 by determining the most probable cluster members using Gaia DR2. Finally, we applied Victoria isochrones and MESA models in order to refine our estimates of the evolutionary stages of our targets., Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [116F407]; US National Science Foundation (NSF)National Science Foundation (NSF) [AST 16-16040]; University of Texas Rex G. Baker, Jr. Centennial Research Endowment; US National Science FoundationNational Science Foundation (NSF) [AST-1229522]; Korean GMT Project of KASI; University of Texas at Austin, We thank the anonymous referee for her/his comments and suggestions that improved the quality of the paper. We thank Karin Lind and Henrique Reggiani for helpful discussions on this work. Our work has been supported by The Scientific and Technological Research Council of Turkey (TUBI. TAK, project No. 116F407), by the US National Science Foundation (NSF, grant AST 16-16040), and by the University of Texas Rex G. Baker, Jr. Centennial Research Endowment. This work used the Immersion Grating Infrared Spectrometer (IGRINS) that was developed under a collaboration between the University of Texas at Austin and the Korea Astronomy and Space Science Institute (KASI) with the financial support of the US National Science Foundation under grant AST-1229522, of the University of Texas at Austin, and of the Korean GMT Project of KASI. This work has made use of data from the European Space Agency (ESA) mission Gaia (https://www.cosmos.esa.int/gaia), processed by the Gaia Data Processing and Analysis Consortium (DPAC, https://www.cosmos.esa.int/web/gaia/dpac/consortium).Funding for the DPAC has been provided by national institutions, in particular the institutions participating in the Gaia Multilateral Agreement. This research has made use of NASA's Astrophysics Data System Bibliographic Services; the SIMBAD database and the VizieR service, both operated at CDS, Strasbourg, France. This research has made use of the WEBDA database, operated at the Department of Theoretical Physics and Astrophysics of the Masaryk University, and the VALD database, operated at Uppsala University, the Institute of Astronomy RAS in Moscow, and the University of Vienna. This paper includes data taken at The McDonald Observatory of The University of Texas at Austin.

Assemblages of fossil plant remains have been widely used to reconstruct past climatic conditions, usually through the application of methods that involve either finding vegetation analogues on the modern landscape (and using the modern associated climatic values as the basis for an estimate) or using the modern climatic ranges of individual taxa in an assemblage to determine the range of a given climate variable that would allow these plant taxa to live together. Although these approaches are relatively straightforward, it is difficult to assess the uncertainties associated with each approach, particularly in regard to their application to plant macrofossil assemblages. To explore the uncertainty that may arise from inaccuracy and imprecision in climate reconstructions and from ecological considerations we used variants of both approaches to estimate climate from two data sets of modern vegetation assemblages from the southwestern United States: (1) 1752 gridded “virtual plant assemblages” based on plant range maps that provide uniform spatial coverage of the presence or absence of major woody plant taxa across the study area; and (2) 43 modern packrat (Neotoma spp.) midden presence-absence assemblages that are similar to fossil midden assemblages. By comparing observed and estimated climate values, we evaluated the quality of the climate estimates, identified sources of uncertainty, and characterized the nature and magnitude of the effects of these uncertainties on the climate estimates. Uncertainties in estimating climate from vegetation assemblages arise because any given plant taxon (or assemblage) must have the resiliency to survive a range of climatic variability, and because of the strong intercorrelations among climatic variables in the modern climate data. Additional sources of uncertainty in climate estimates from plant assemblages include: (1) the modern climate and plant distribution data that are selected as the basis for estimation; (2) the particular quantitative approach that is used to estimate climate; (3) the sufficiency of the number of taxa in the analysis for providing an unbiased representation of the vegetation community as it existed for each time period in the analysis; and, (4) the location of the assemblage on the climatic and environmental gradients in the calibration data set for each climate variable under consideration. We conclude that vegetation assemblages can provide valid and reproducible estimates of climatic variables and that the primary trends and mapped patterns in the observed climate data can be reconstructed from such estimates. However, many factors may affect the quality of an estimate from a given plant assemblage, including aspects of data selection, data adequacy, methodologies, and the location of the assemblage site relative to gradients in the base climate data. It is particularly difficult to accurately estimate extreme values in the observed climate data, because estimated values from either end of an observed climate gradient necessarily “move toward the middle” of the gradient. In addition, the interval chosen to represent modern climate (here we used 1961 to 1990) may have a large impact on the size of the estimated difference between modern and past climate at a given site.

As part of the FutureGen 2.0 Project, a design was developed for a first-of-its-kind, commercial-scale, near-zero emissions coal-fueled power plant that includes carbon capture and storage (CCS) in a deep saline reservoir. To assess storage site performance and meet the regulatory requirements of the Class VI Underground Injection Control Program for CO2 Geologic Sequestration, the FutureGen 2.0 Project evaluated, selected, and designed a suite of monitoring technologies for use in (1) evaluating CO2 mass balance, (2) detecting significant loss of CO2 containment, (3) tracking the spatial extent of the CO2 plume and advancement of the pressure front within the storage reservoir, and (4) identifying the occurrence and location of injection-related induced seismicity. The monitoring program design includes direct monitoring of the injection process (above ground and in the injection wells), injection-zone monitoring, early-leak-detection monitoring directly above the primary confining zone, and compliance monitoring within the lowermost underground source of drinking water (USDW); it also includes measurements of formation pressure and other geochemical/isotopic signatures that provide an indication of changes in CO2 concentration and/or brine composition, both within the injection zone and immediately above the primary confining zone. In addition to these direct measurements, several indirect geophysical monitoring technologies were included in the monitoring program design such as passive seismic and integrated surface deformation monitoring. Although the FutureGen 2.0 Project was suspended by the U.S. Department of Energy prior to implementation of the monitoring program design, this overview is provided with the hope that other current or future CCS projects will derive benefit from consideration of the approach and monitoring network configuration adopted by the project.

Background Surgical resection of parasellar meningiomas is a challenging operation that traditionally has been performed with a large pterional or orbitozygomatic craniotomy. In this study, we report patient outcomes and detail our surgical approach when resecting these tumors with a smaller, less invasive “mini-pterional” craniotomy. Methods We performed a retrospective review on all patients undergoing a mini-pterional craniotomy for resection of parasellar meningiomas from 2012 to 2016. We describe the technical aspects of the mini-pterional craniotomy and provide the outcomes of patients who received an operation with this approach. Results Twenty-four patients were treated with a mini-pterional craniotomy for resection of parasellar meningiomas. Median tumor volume was 6.2 cm3. Twenty-two of 24 (92%) patients had a World Health Organization grade I meningioma, and 2 of 24 (8%) patients had a World Health Organization grade II meningioma. Tumors were located at the medial sphenoid wing (60%), anterior clinoid (24%) and spheno-cavernous junction (12%). Nineteen of 24 (79%) patients had a Simpson Grade I resection and 5 of 24 (21%) a Simpson Grade IV resection. Median length of the operations was 242 minutes. Neurosurgical complications occurred in 2 patients who had a surgical-site infection and cerebrospinal fluid leak; one of these patients also developed postoperative hydrocephalus. In this series, no deaths, parenchymal contusions, or repeat operations occurred. Conclusions The mini-pterional craniotomy can be used to resect parasellar meningiomas with good results and a low complication profile. This approach provides an efficacious method of resecting these tumors without sacrificing Simpson grade or patient safety.

The authors present a case of Chiari type 1.5 malformation with the uncommon presenting symptoms of esotropia and diplopia due to divergence insufficiency in a 12-year-old girl. Imaging at initial diagnosis revealed cerebellar herniation with extension of the tonsils to the C2 vertebral body, a retroflexed odontoid, and a small cervical syrinx. The patient was initially treated with an uncomplicated Chiari malformation decompression without dural opening. Repeat imaging revealed an adequate decompression. Three months postoperatively the patient’s diplopia recurred and she underwent repeat posterior fossa decompression with dural opening and duraplasty. Following repeat decompression with dural opening and duraplasty, the patient’s diplopia had not recurred by the 2-year follow-up.https://thejns.org/doi/abs/10.3171/2018.5.PEDS1886

This study presents a synthesis of century-scale hydroclimate variations in North America for the Common Era (last 2000 years) using new age models of previously published multiple proxy-based paleoclimate data. This North American Hydroclimate Synthesis (NAHS) examines regional hydroclimate patterns and related environmental indicators, including vegetation, lake water elevation, stream flow and runoff, cave drip rates, biological productivity, assemblages of living organisms, and salinity. Centennial-scale hydroclimate anomalies are obtained by iteratively sampling the proxy data on each of thousands of age model realizations and determining the fractions of possible time series indicating that the century-smoothed data was anomalously wet or dry relative to the 100 BCE to 1900 CE mean. Results suggest regionally asynchronous wet and dry periods over multidecadal to centennial timescales and frequent periods of extended regional drought. Most sites indicate drying during previously documented multicentennial periods of warmer Northern Hemisphere temperatures, particularly in the western U.S., central U.S., and Canada. Two widespread droughts were documented by the NAHS: from 50 BCE to 450 CE and from 800 to 1100 CE. Major hydroclimate reorganizations occurred out of sync with Northern Hemisphere temperature variations and widespread wet and dry anomalies occurred during both warm and cool periods. We present a broad assessment of paleoclimate relationships that highlights the potential influences of internal variability and external forcing and supports a prominent role for Pacific and Atlantic Ocean dynamics on century-scale continental hydroclimate., final draft, peerReviewed

To evaluate whether knowledge of a personalized Diabetes Risk Score (DRS) improved performance in a 12-week lifestyle change program for prediabetes.Randomized subjects at four clinics provided samples for a DRS at baseline, 12, and 24 weeks. The intervention group received scores at each point, whereas the control group only received this information at 12 and 24 weeks. Outcomes included attendance and changes in weight, abdominal circumference, blood pressure, fasting glucose, hemoglobin A1c, cholesterol, and risk score.Baseline characteristics were similar in the groups (n = 192) and within risk-stratified subgroups. At 12 weeks, there were no differences in outcomes, with mean weight loss of 4.61 kg in the intervention group and 4.43 kg in the control group (p = 0.79). Both groups were given 12-week risk scores, with previously unseen baseline scores for the control group. The control group continued to lose additional weight (1.21 kg) by 24 weeks, whereas the intervention group regained previously lost weight (0.33 kg) (p = 0.04).The knowledge of a single baseline personalized DRS did not affect performance in a lifestyle modification program. However, the knowledge of an improvement in risk score, and the timing of this information, may impact further adherence.

One important issue in the storage of large volumes of fluids, mainly water and CO2, in the deep subsurface is to determine the resulting field-scale-induced displacements and consequences of overpressures on the mechanical integrity of the storage reservoir and surroundings. A quantifiable estimation of displacement can be made by combining the robust, cost-effective, and repeatable geophysical techniques of micro-gravimetry, differential global positioning system (DGPS), and differential synthetic aperture radar interferometry (DInSAR). These techniques were field tested and evaluated for the first time on an active large-volume aquifer storage and recovery (ASR) project in Pendleton, Oregon, USA, where three ASR wells are injecting up to 1.9 million m 3 year −1 into basalt aquifers to a depth of about 150 m. Injection and recovery of water at the wells are accompanied by significant gravity anomalies and vertical deformation of the ground surface localized to the immediate surroundings of the injection wells as evidenced by DGPS and gravity measurements collected in 2011. At a larger scale, and between 2011 and 2013, DInSAR monitoring of the Pendleton area shows sub- centimetric deformation in the western part of the city and close to the injection locations associated with ASR cycle. Deformations are found to be temporally out phased with the injection and recovery events due to complex groundwater flow. A numerical simulation of the effect of the water injection gives results in good agreement with the observations and confirms the validity of the approach, which could be deployed in similar geological contexts to look at the mechanical effects of water and gas injections.