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Aneurysmal subarachnoid hemorrhage (aSAH) continues to be associated with significant morbidity and mortality despite advances in care and aneurysm treatment strategies. Cerebral vasospasm continues to be a major source of clinical worsening in patients. We intended to review the clinical and experimental aspects of aSAH and identify strategies that are being evaluated for the treatment of vasospasm. A literature review on aSAH and cerebral vasospasm was performed. Available treatments for aSAH continue to expand as research continues to identify new therapeutic targets. Oral nimodipine is the primary medication used in practice given its neuroprotective properties. Transluminal balloon angioplasty is widely utilized in patients with symptomatic vasospasm and ischemia. Prophylactic “triple‐H” therapy, clazosentan, and intraarterial papaverine have fallen out of practice. Trials have not shown strong evidence supporting magnesium or statins. Other calcium channel blockers, milrinone, tirilazad, fasudil, cilostazol, albumin, eicosapentaenoic acid, erythropoietin, corticosteroids, minocycline, deferoxamine, intrathecal thrombolytics, need to be further investigated. Many of the current experimental drugs may have significant roles in the treatment algorithm, and further clinical trials are needed. There is growing evidence supporting that early brain injury in aSAH may lead to significant morbidity and mortality, and this needs to be explored further.

A cross-correlative precession electron diffraction – atom probe tomography investigation of Cr segregation in a Fe(Cr) nanocrystalline alloy was undertaken. Solute segregation was found to be dependent on grain boundary type. The results of which were compared to a hybrid Molecular Dynamics and Monte Carlo simulation that predicted the segregation for special character, low angle, and high angle grain boundaries, as well as the angle of inclination of the grain boundary. It was found that the highest segregation concentration was for the high angle grain boundaries and is explained in terms of clustering driven by the onset of phase separation. For special character boundaries, the highest Gibbsain interfacial excess was predicted at the incoherent ∑3 followed by ∑9 and ∑11 boundaries with negligible segregation to the twin and ∑5 boundaries. In addition, the low angle grain boundaries predicted negligible segregation. All of these trends matched well with the experiment. This solute-boundary segregation dependency for the special character grain boundaries is explained in terms of excess volume and the energetic distribution of the solute in the boundary.

The tantalum carbides, TaC x , have been repeatedly shown to harden dramatically with some loss of carbon content, then soften with further decarburization. First observed in 1963, this anomalous hardness behavior has been reproduced for decades without satisfactory explanation. Prior attempts to characterize this phenomenon using elastic stiffnesses have failed to reproduce the anomalous hardness behavior. In this work, we demonstrate a change in slip system preference from {111} B1 to {110} B1 in TaC x as x decreases, while no such transition is observed in TiC x . We find this to be the primary mechanism of the anomalous hardness, arising from reduced energetic favorability of dissociation of dislocations on {111} B1 into Shockley partials at lower carbon contents. We also present experimental hardness measurements for bulk and thin-film TaC x at different carbon contents. An anomalous hardness peak is observed in the bulk samples, but not in the thin films, due to loss of dislocation plasticity in the nanocrystalline films. Using a combined computational-experimental approach, the authors determine that the long-observed anomalous hardness of the tantalum carbides can be attributed to a loss of dislocation plasticity on {111} planes at lower carbon contents.

Microstructure and phase evolution in magnetron sputtered nanocrystalline tungsten and tungsten alloy thin films are explored through in situ TEM annealing experiments at temperatures up to 1000 °C. Grain growth in unalloyed nanocrystalline tungsten transpires through a discontinuous process at temperatures up to 550 °C, which is coupled to an allotropic phase transformation of metastable β-tungsten with the A-15 cubic structure to stable body centered cubic (BCC) α-tungsten. Complete transformation to the BCC α-phase is accompanied by the convergence to a unimodal nanocrystalline structure at 650 °C, signaling a transition to continuous grain growth. Alloy films synthesized with compositions of W–20 at.% Ti and W–15 at.% Cr exhibit only the BCC α-phase in the as-deposited state, which indicate the addition of solute stabilizes the films against the formation of metastable β-tungsten. Thermal stability of the alloy films is significantly improved over their unalloyed counterpart up to 1000 °C, and grain coarsening occurs solely through a continuous growth process. The contrasting thermal stability between W–Ti and W–Cr is attributed to different grain boundary segregation states, thus demonstrating the critical role of grain boundary chemistry in the design of solute-stabilized nanocrystalline alloys.

Abstract BACKGROUND: Frontotemporal craniotomies are commonly performed for a variety of neurosurgical pathologies. Infections related to craniotomies cause significant morbidity. We hypothesized that the risk of cranial surgical site infections (SSIs) may be increased in patients whose frontal sinuses are breached during craniotomy. OBJECTIVE: To compare the rate of cranial SSIs in patients undergoing frontotemporal craniotomies with and without frontal sinus breach (FSB). METHODS: We performed a retrospective analysis of all patients undergoing frontotemporal craniotomies for the management of cerebral aneurysms from 2005 to 2014. This study included 862 patients undergoing 910 craniotomies. Primary outcome of interest was occurrence of a cranial SSI. Standard statistical methods were utilized to explore associations between a variety of variables including FSB, cranial SSI, and infections requiring reoperation. RESULTS: Of the 910 craniotomies, 141 (15.5%) involved FSB. Of those involving FSB, 22 (15.6%) developed a cranial SSI, compared to only 56 of the 769 without FSB (7.3%; P = .001). Cranial SSI requiring reoperation was much more likely in patients with FSB compared to those without a breach (7.8% vs 1.6%; P < .001). In those presenting with cranial SSIs, epidural abscess formation was more common with FSB compared to no FSB (27.3% vs 5.4%; P = .006). In multivariate analysis, breach of the frontal sinus was significantly associated with cranial SSI (OR 2.16; 95% CI 1.24-3.78; P = .01) and reoperation (OR 4.20; 95% CI 1.66-10.65; P = .003). CONCLUSION: Patients undergoing frontotemporal craniotomies are at significantly greater risk of serious cranial SSIs if the frontal sinus has been breached.

Composition analysis of carbide and carbo-nitride precipitates was performed for two Nb-Ti microalloyed steels with yield strengths of 750 and 580 MPa using an atom probe study. In the high-Ti 750 MPa steel, Ti-rich (Ti,Nb)(C,N) and Ti-rich (Ti,Nb)(C) precipitates were observed. In the high-Nb 580 MPa steel, a Ti-rich (Ti,Nb)(C,N) precipitate and (Ti,Nb)(C) clusters were noted. These (Ti,Nb)(C) clusters in the high-Nb 580 MPa steel were smaller than the (Ti,Nb)(C) precipitates in high-Ti 750 MPa steel. In general, a larger number of precipitates were found in the high-Ti 750 MPa steel. This difference in the number density of the precipitates between the two steels is attributed to the difference in Ti content. Combining the atom probe tomography results and thermodynamic calculations, the precipitation sequence in these alloys was inferred to be the following: as the temperature decreases, TiN precipitates out of the solution with successive (Ti,Nb)(C,N) layers of varying composition forming on these Ti-rich precipitates. Once N is depleted from the solution, a second set of (Ti,Nb)(C) precipitates in a similar manner in the matrix and also onto the carbo-nitride phase. This observation is consistent with previous observations in high-strength low-alloy steels containing comparable amounts of only Nb. It was noted that the amount of Nb, Nb/(Nb + Ti), in the precipitates decreased from 0.20 to 0.04 with the size of the precipitate. We believe that this is due to the Nb supersaturation in the matrix when these precipitates nucleate.

Observations of microstructural coarsening at cryogenic temperatures, as well as numerous simulations of grain boundary motion that show faster migration at low temperature than at high temperature, have been troubling because they do not follow the expected Arrhenius behavior. This work demonstrates that classical equations, that are not simplified, account for all these oddities and demonstrate that non-Arrhenius behavior can emerge from thermally activated processes. According to this classical model, this occurs when the intrinsic barrier energies of the processes become small, allowing activation at cryogenic temperatures. Additional thermal energy then allows the low energy process to proceed in reverse, so increasing temperature only serves to frustrate the forward motion. This classical form is shown to reconcile and describe a variety of diverse grain boundary migration observations.

In this study, the hyperbaric (2 bar) laser chemical vapor deposition of TiC fibers grown under various percent pressures of hydrogen and ratios of ethylene and titanium tetrachloride (2:1 or 1:1) are reported. In the hydrogen-rich (85%) condition, sequential fiber depositions became stunted as a result of a loss of hydrogen, which served as a reducing agent for the metal halide as hydrogen evolved with the hydrocarbon gas in the reaction zone because of the Le Chatelier principle. For the hydrogen-lean (25%) condition, the intrinsic fiber growth rate was invariant, but gas phase nucleation resulted in the hydrocarbon forming carbon soot in the chamber which subsequently deposited and coated on the fibers. In the hydrogen-balanced composition (50%), the 2:1 precursor ratio resulted in inconsistent intrinsic growth rates which ranged from approximately 30 μm/s to 44 μm/s. However, for the hydrogen-balanced (50%) 1:1 condition, the intrinsic growth rate variation was reduced to approximately 12 μm/s. The differences in fiber uniformity, composition, and structure under these process conditions are discussed in terms of hydrogen’s ability to serve as a reducing agent, a fluid to transport heat from the deposition zone, and alter the structure of the fiber through thermophoresis.

Abstract BACKGROUND Autosomal dominant polycystic kidney disease (ADPKD) is a risk factor for formation of intracranial aneurysms (IAs), though the ideal screening and treatment strategies in this population are unclear. OBJECTIVE To report outcomes of observation, open surgical, or endovascular management of ruptured and unruptured aneurysms in patients with ADPKD. METHODS We performed a retrospective analysis of all patients with ADPKD and IAs at a single center from 2000 to 2016. RESULTS Forty-five patients with ADPKD harboring 71 aneurysms were identified, including 11 patients with subarachnoid hemorrhage (SAH). Of 22 aneurysms managed with observation, none ruptured in 136 yr of clinical follow-up. Thirty-five aneurysms were treated with open surgery and 14 with an endovascular approach. Among treated aneurysms, poor neurologic outcome (modified Rankin scale >2) was seen only in patients presenting with SAH (17% SAH vs 0% elective, P = .06). Acute kidney injury (AKI) was also significantly associated with SAH presentation (22% SAH vs 0% elective, P = .05). Neither procedural complications nor AKI were associated with treatment modality. Among 175 yr of radiographic follow-up in patients with known IAs, 8 de novo aneurysms were found, including 3 that were treated. Of 11 patients with SAH, 7 ruptured in the setting of previously known ADPKD, including 2 with prior angiographic screening and 5 without screening. CONCLUSION Poor outcomes occurred only with ruptured presentation but were equivalent between treatment modalities. Screening is performed only selectively, and 64% (7 of 11) of patients presenting with SAH had previously known ADPKD.