bluuebunny/crossref_metadata_2025 huggingface dataset:
A micropore array-based solid lift-off method for highly efficient and controllable cell alignment and spreading
Authors: Hun Tingting , Liu Yaoping , Guo Yechang , Sun Yan , Fan Yubo , Wang Wei
Published: September 2020

Interpretation of cell–cell and cell-microenvironment interactions is critical for both advancing knowledge of basic biology and promoting applications of regenerative medicine. Cell patterning has been widely investigated in previous studies. However, the reported methods cannot simultaneously realize precise control of cell alignment and adhesion/spreading with a high efficiency at a high throughput. Here, a novel solid lift-off method with a micropore array as a shadow mask was proposed. Efficient and precise control of cell alignment and adhesion/spreading are simultaneously achieved via an ingeniously designed shadow mask, which contains large micropores (capture pores) in central areas and small micropores (spreading pores) in surrounding areas contributing to capture/alignment and adhesion/spreading control, respectively. The solid lift-off functions as follows: (1) protein micropattern generates through both the capture and spreading pores, (2) cell capture/alignment control is realized through the capture pores, and (3) cell adhesion/spreading is controlled through previously generated protein micropatterns after lift-off of the shadow mask. High-throughput (2.4–3.2 × 104 cells/cm2) cell alignments were achieved with high efficiencies (86.2 ± 3.2%, 56.7 ± 9.4% and 51.1 ± 4.0% for single-cell, double-cell, and triple-cell alignments, respectively). Precise control of cell spreading and applications for regulating cell skeletons and cell–cell junctions were investigated and verified using murine skeletal muscle myoblasts. To the best of our knowledge, this is the first report to demonstrate highly efficient and controllable multicell alignment and adhesion/spreading simultaneously via a simple solid lift-off operation. This study successfully fills a gap in literatures and promotes the effective and reproducible application of cell patterning in the fields of both basic mechanism studies and applied medicine.
Oil-mediated high-throughput generation and sorting of water-in-water droplets
Authors: Nan Lang , Cao Yang , Yuan Shuai , Shum Ho Cheung
Published: September 2020

Aqueous two-phase system (ATPS) droplets have demonstrated superior compatibility over conventional water-in-oil droplets for various biological assays. However, the ultralow interfacial tension hampers efficient and stable droplet generation, limiting further development and more extensive use of such approaches. Here, we present a simple strategy to employ oil as a transient medium for ATPS droplet generation. Two methods based on passive flow focusing and active pico-injection are demonstrated to generate water-water-oil double emulsions, achieving a high generation frequency of ~2.4 kHz. Through evaporation of the oil to break the double emulsions, the aqueous core can be released to form uniform-sized water-in-water droplets. Moreover, this technique can be used to fabricate aqueous microgels, and the introduction of the oil medium enables integration of droplet sorting to produce single-cell-laden hydrogels with a harvest rate of over 90%. We believe that the demonstrated high-throughput generation and sorting of ATPS droplets represent an important tool to advance droplet-based tissue engineering and single-cell analyses.
Induction of STK11-dependent cytoprotective autophagy in breast cancer cells upon honokiol treatment
Authors: Muniraj Nethaji , Siddharth Sumit , Shriver Marey , Nagalingam Arumugam , Parida Sheetal , Woo Juhyung , Elsey Justin , Gabrielson Kathleen , Gabrielson Edward , Arbiser Jack L. , Saxena Neeraj K. , Sharma Dipali
Published: September 2020

Cancer cells hijack autophagy pathway to evade anti-cancer therapeutics. Many molecular signaling pathways associated with drug-resistance converge on autophagy induction. Honokiol (HNK), a natural phenolic compound purified from Magnolia grandiflora, has recently been shown to impede breast tumorigenesis and, in the present study, we investigated whether breast cancer cells evoke autophagy to modulate therapeutic efficacy and functional networks of HNK. Indeed, breast cancer cells exhibit increased autophagosomes-accumulation, MAP1LC3B-II/LC3B-II-conversion, expression of ATG proteins as well as elevated fusion of autophagosomes and lysosomes upon HNK treatment. Breast cancer cells treated with HNK demonstrate significant growth inhibition and apoptotic induction, and these biological processes are blunted by macroautophagy/autophagy. Consequently, inhibiting autophagosome formation, abrogating autophagosome-lysosome fusion or genetic-knockout of BECN1 and ATG7 effectively increase HNK-mediated apoptotic induction and growth inhibition. Next, we explored the functional impact of tumor suppressor STK11 in autophagy induction in HNK-treated cells. STK11-silencing abrogates LC3B-II-conversion, and blocks autophagosome/lysosome fusion and lysosomal activity as illustrated by LC3B-Rab7 co-staining and DQ-BSA assay. Our results exemplify the cytoprotective nature of autophagy invoked in HNK-treated breast cancer cells and put forth the notion that a combined strategy of autophagy inhibition with HNK would be more effective. Indeed, HNK and chloroquine (CQ) show synergistic inhibition of breast cancer cells and HNK-CQ combination treatment effectively inhibits breast tumorigenesis and metastatic progression. Tumor-dissociated cells from HNK-CQ treated tumors exhibit abrogated invasion and migration potential. Together, these results implicate that breast cancer cells undergo cytoprotective autophagy to circumvent HNK and a combined treatment with HNK and CQ can be a promising therapeutic strategy for breast cancer.
The quest for planets around subdwarfs and white dwarfs fromKeplerspace telescope fields
Authors: Krzesinski J. , Blokesz A. , Siwak M. , Stachowski G.
Published: September 2020

Context.In this study, we independently test the presence of an exoplanet around the binary KIC 9472174, which is composed of a red dwarf and a pulsating type B subdwarf. We also present the results of our search for Jupiter-mass objects orbiting near to the eclipsing binary KIC 7975824, which is composed of a white dwarf and type B subdwarf, and the pulsating white dwarf KIC 8626021.

Aims.The goal is to test analytical techniques and prepare the ground for a larger search for possible substellar survivors on tight orbits around post-common envelope binaries and stars at the end of their evolution, that is, extended horizontal branch stars and white dwarfs. We, therefore, mainly focus on substellar bodies orbiting these stars within the range of the host’s former red-giant or asymptotic-giant phase envelopes. Due to the methods we use, the quest is restricted to single-pulsating type B subdwarf and white dwarf stars and short-period eclipsing binaries containing a white dwarf or a subdwarf component.

Methods.Our methods rely on the detection of exoplanetary signals hidden in photometric time series data from theKeplerspace telescope, and they are based on natural clocks within the data itself, such as stellar pulsations and eclipse times. The light curves are analyzed using Fourier transforms, time-delays, and eclipse timing variations.

Results.Based on the three objects studied in this paper, we demonstrate that these methods can be used to detect giant exoplanets orbiting around pulsating white dwarf or type B subdwarf stars as well as short-period binary systems, at distances which fall within the range of the former red-giant envelope of a single star or the common envelope of a binary. Using our analysis techniques, we reject the existence of a Jupiter-mass exoplanet around the binary KIC 9472174 at the distance and orbital period previously suggested in the literature. We also found that the eclipse timing variations observed in the binary might depend on the reduction and processing of theKeplerdata. The other two objects analyzed in this work do not have Jupiter mass exoplanets orbiting within 0.7–1.4 AU from them, or larger-mass objects on closer orbits (the given mass limits are minimum masses).

Conclusions.Depending on the detection threshold of the time-delay method and the inclination of the exoplanet orbit toward the observer, data from the primaryKeplermission allows for the detection of bodies with a minimum of ~1 Jupiter-mass orbiting these stars at ~1 AU, while data from the K2 mission extends the detection of objects with a minimum mass of ~7 Jupiter-mass on ~0.1 AU orbits. The exoplanet mass and orbital distance limits depend on the length of the available photometric time series.
Navigating a Carotico-Clinoid Foramen and an Interclinoidal Bridge in the Endonasal Endoscopic Approach: An Anatomical and Technical Note
Authors: Zhao Xiaochun , Labib Mohamed A. , Avci Emel , Preul Mark C. , Baskaya Mustafa K. , Little Andrew S. , Nakaji Peter
Published: September 2020

Objective The carotico-clinoid foramen and interclinoid bridge are two anatomical variants of the sellar region. If these anatomical variants go unrecognized and are not managed safely by the surgeon during expanded endoscopic endonasal surgery for a posterior clinoidectomy, a carotid artery injury may occur. We summarize a method to safely navigate in the presence of the carotico-clinoid foramen and interclinoid bridge in an endoscopic endonasal approach.

Study Design The study involves cadaveric dissection and management of the anatomical variants.

Setting The study took place in a cadaveric dissection laboratory.

Participants The object of study is one cadaveric head.

Main Outcome Measures After discovering the two variants in both cavernous sinuses of a cadaveric head, we established a stepwise coping strategy to avoid carotid artery injury while performing an endoscopic endonasal bilateral interdural pituitary transposition, and we report the final view after endoscopic management.

Results Debulking of the middle clinoid process can decrease the obstacle effect, and the pituitary transposition can be performed medial to the ossified carotico-clinoid ligament. Disconnection of the interclinoid bridge is the prerequisite to an effective posterior clinoidectomy, and distinguishing the transition between the sellar diaphragm and the interclinoid bridge is essential.

Conclusion In the presence of both the carotico-clinoid foramen and the interclinoid bridge, a bilateral interdural pituitary transposition can still be performed, although preoperative strategic preparation, full inspection, and stepwise disconnections are of paramount importance in such a scenario to avoid cavernous carotid artery injury.
Tolosa-Hunt Syndrome in Childhood and Adolescence: A Literature Review in the Last 10 Years
Authors: Gama Bárbara Pinheiro , Silva-Néto Raimundo Pereira
Published: September 2020

Objectives The aim of the study is to review the articles published in the last 10 years on Tolosa-Hunt syndrome (THS) in childhood and adolescence to learn about its clinical and epidemiological characteristics and its therapeutic management.

Methods Based on the literature search in the major medical databases and using the descriptors “Tolosa-Hunt syndrome and children” and “Tolosa-Hunt syndrome and adolescent” we included articles published between 2009 and 2019. We found 51 articles, but only 11 met the inclusion criteria.

Results There were eight women and four men with THS, whose average age was 12.0 ± 4.3 years, ranging from 4 to 17 years. Magnetic resonance imaging showed inflammation in the cavernous sinus (100%), orbit (25%), and superior orbital fissure (8.3%), unilateral in all patients. The internal carotid artery (58.3%), third (66.7%), sixth (33.3%), and fourth (25%) cranial nerves were injured. Headache was located in the orbital region, ipsilaterally to nerve involvement and had mild to severe intensity. Corticosteroid was the treatment used in 91.7% of the patients. They were followed for an average of 13.4 ± 12.4 months. Only two patients had recurrence of the disease.

Conclusion THS is infrequent in childhood and adolescence and knowledge of its clinical and epidemiological characteristics and its therapeutic management is necessary for pediatricians.
Obstetrical Unit Response to the COVID-19 Pandemic: OUR Study
Authors: Pluym Ilina D. , Rao Rashmi , Ballas Jerasimos , Ramos Gladys A. , Cross Sarah N. , Zapata Mya , Srinivas Sindhu , Louis Judette M. , Werner Erika , Afshar Yalda , Han Christina S.
Published: September 2020

Objective This study aimed to describe the response of labor and delivery (L&D) units in the United States to the novel coronavirus disease 2019 (COVID-19) pandemic and determine how institutional characteristics and regional disease prevalence affect viral testing and personal protective equipment (PPE).

Study Design A cross-sectional survey was distributed electronically through the Society for Maternal-Fetal Medicine e-mail database (n = 584 distinct practices) and social media between April 14 and 23, 2020. Participants were recruited through “snowballing.” A single representative was asked to respond on behalf of each L&D unit. Data were analyzed using Chi-square and Fisher's exact tests. Multivariable regression was performed to explore characteristics associated with universal testing and PPE usage.

Results A total of 301 surveys (estimated 51.5% response rate) was analyzed representing 48 states and two territories. Obstetrical units included academic (31%), community teaching (45%) and nonteaching hospitals (24%). Sixteen percent of respondents were from states with high prevalence, defined as higher “deaths per million” rates compared with the national average. Universal laboratory testing for admissions was reported for 40% (119/297) of units. After adjusting for covariates, universal testing was more common in academic institutions (adjusted odds ratio [aOR] = 1.73, 95% confidence interval [CI]: 1.23–2.42) and high prevalence states (aOR = 2.68, 95% CI: 1.37–5.28). When delivering asymptomatic patients, full PPE (including N95 mask) was recommended for vaginal deliveries in 33% and for cesarean delivery in 38% of responding institutions. N95 mask use during asymptomatic vaginal deliveries remained more likely in high prevalence states (aOR = 2.56, 95% CI: 1.29–5.09) and less likely in hospitals with universal testing (aOR = 0.42, 95% CI: 0.24–0.73).

Conclusion Universal laboratory testing for COVID-19 is more common at academic institutions and in states with high disease prevalence. Centers with universal testing were less likely to recommend N95 masks for asymptomatic vaginal deliveries, suggesting that viral testing can play a role in guiding efficient PPE use.

Key Points
Single Artery Upper Extremity Salvage with Two Free Flap End-to-Side Brachial Artery Anastomoses
Authors: Stein Michael J. , Zhang Jing
Published: September 2020

Background A 36-year-old male was involved in a motor vehicle accident, presenting with a Guistillo's IIIB crush injury to the upper extremity. A severely comminuted ulnar fracture resulted in a 10-cm bone defect with significant overlying soft tissue injury.

Methods The injury resulted in a wide zone of injury with inadequate collateral vascularity at the level of the elbow and distal viability dependent on the brachial artery. An osteocutaneous free fibular flap and fasciocutaneous anterolateral thigh flap were used to reconstruct the defect with both flaps anastomosed in an end-to-side fashion to the brachial artery.

Results The upper extremity was successfully salvaged, and the patient discharged from hospital at postoperative day 10. Both free flaps survived with no donor or recipient site complications at a follow-up period of 2 years.

Conclusion The case illustrates the challenges inherent to significant Guistillo's IIIB injuries with insufficient recipient vessels over a large zone of injury. While performing anastomoses outside the zone of injury is preferred, this case demonstrates the success of performing multiple anastomoses to the brachial artery in an end-to-side fashion within the zone of injury.
Utilization of Therapeutic Hypothermia and Neurological Injury in Neonates with Mild Hypoxic-Ischemic Encephalopathy: A Report from Children's Hospital Neonatal Consortium
Authors: Rao Rakesh , Mietzsch Ulrike , DiGeronimo Robert , Hamrick Shannon E. , Dizon Maria L. V. , Lee Kyong-Soon , Natarajan Girija , Yanowitz Toby D. , Peeples Eric S. , Flibotte John , Wu Tai-Wei , Zaniletti Isabella , Mathur Amit M. , Massaro An
Published: September 2020

Objective This study was aimed to describe utilization of therapeutic hypothermia (TH) in neonates presenting with mild hypoxic-ischemic encephalopathy (HIE) and associated neurological injury on magnetic resonance imaging (MRI) scans in these infants.

Study Design Neonates ≥ 36 weeks' gestation with mild HIE and available MRI scans were identified. Mild HIE status was assigned to hyper alert infants with an exaggerated response to arousal and mild HIE as the highest grade of encephalopathy recorded. MRI scans were dichotomized as “injury” versus “no injury.”

Results A total of 94.5% (257/272) neonates with mild HIE, referred for evaluation, received TH. MRI injury occurred in 38.2% (104/272) neonates and affected predominantly the white matter (49.0%, n = 51). Injury to the deep nuclear gray matter was identified in (10.1%) 20 infants, and to the cortex in 13.4% (n = 14 infants). In regression analyses (odds ratio [OR]; 95% confidence interval [CI]), history of fetal distress (OR = 0.52; 95% CI: 0.28–0.99) and delivery by caesarian section (OR = 0.54; 95% CI: 0.31–0.92) were associated with lower odds, whereas medical comorbidities during and after cooling were associated with higher odds of brain injury (OR = 2.31; 95% CI: 1.37–3.89).

Conclusion Majority of neonates with mild HIE referred for evaluation are being treated with TH. Odds of neurological injury are over two-fold higher in those with comorbidities during and after cooling. Brain injury predominantly involved the white matter.

Key Points
In Pursuit of the “Perforator” in the Perforator Skin Flap
Authors: Taylor G. Ian , Hallock Geoffrey G.
Published: September 2020

Another congress of the World Society for Reconstructive Microsurgery (WSRM) this past year in Bologna was magnificent not just for the presentation of so many keynote lectures by the giants of our field nor the novel and innovative ideas shown by those who will someday follow in those footsteps, but by making all of us realize how many capable microsurgeons there are now practically everywhere in this world, doing incredibly important surgical management of challenges that previously were unmet and resulted in sheer devastation for so many of our patients. How much we are the same in our goals, aspirations, and abilities could not be overlooked, but it is amazing how much we also want to learn more together—each relying on the other. To do so, we must not forget our origins as we appropriately plan for the future. All this we philosophized in our WSRM panel on lower extremity reconstruction, while emphasizing on the surface the perforator flap that at the least today has caught everyone's attention. In this overview to follow, we once again tell two stories, starting with the beginnings of the concept of flaps in showing how the nomenclature has evolved over time according to our various surgical manipulations. Often overlooked, though, is a parallel timeline by the anatomists who have better elucidated the circulation to these flaps, where it will become obvious that often long ago the existence of perforators was recognized by them long before known by the surgeons. At least today, these two paths have at least temporarily intersected. Our pursuit of the “perforator” in the perforator skin flap has come full circle, following the course of the history of the flap itself—a pursuit of excellence.
Impact of Blood Transfusion in Free Flap Breast Reconstruction Using Propensity Score Matching
Authors: Karamanos Efstathios , Shah Amita R. , Kim Julie N. , Wang Howard T.
Published: September 2020

Background Microvascular thrombosis has been associated with cytokine release and inflammatory syndromes which can occur as a result of blood transfusions. This phenomenon could potentially lead to complications in breast free flap reconstruction. The aim of this study was to evaluate the impact of perioperative blood transfusion in free flap breast reconstruction using large population analysis.

Methods The American College of Surgeons National Quality Improvement Program database was queried for delayed free flap breast reconstructions performed in 2016. The study population was divided based on perioperative blood transfusion within 24 hours of the start of the operation. Propensity score matching analysis was used to ensure homogeneity between the two study groups. Primary outcome was unplanned return to the operating room (OR) within 30 days. Secondary outcomes were readmission and complications.

Results A total of 1,256 patients were identified. Out of those, 91 patients received a perioperative blood transfusion. All the patients received only one unit of PRBC within the first 24 hours. Those patients were matched with similar patients who did not receive a transfusion on a ratio of 1:3 (273 patients). Patients who received a transfusion had a significantly higher incidence of reoperation (42 vs. 10%, p < 0.001). Patients who received a transfusion were more likely to return to the OR after 48 hours from the initial operation (13 vs. 5%, p = 0.001). All returns to the OR were due to flap-related complications. Perioperative blood transfusion increased the incidence of wound dehiscence (9 vs. 2%, p = 0.041) but had no protective effect on the development of other postoperative complications.

Conclusion Perioperative blood transfusion in free flap breast reconstruction is associated with an increased probability of flap-related complications and subsequent return to the OR without decreasing the probability of developing other systemic postoperative complications.
Intraoperative Microvascular Complications in Autologous Breast Reconstruction: The Effects of Resident Training on Microsurgical Outcomes
Authors: Teotia Sumeet S. , Dickey Ryan M. , Liu Yulun , Jayaraman Avinash P. , Haddock Nicholas T.
Published: September 2020

Background Academic medical centers with large volumes of autologous breast reconstruction afford residents hand-on educational experience in microsurgical techniques. We present our experience with autologous reconstruction (deep inferior epigastric perforators, profunda artery perforator, lumbar artery perforator, bipedicled, and stacked) where a supervised trainee completed the microvascular anastomosis.

Methods Retrospective chart review was performed on 413 flaps (190 patients) with microvascular anastomoses performed by postgraduate year (PGY)-4, PGY-5, PGY-6, PGY-7 (microsurgery fellow), or attending physician (AP). Comorbidities, intra-operative complications, revisions, operative time, ischemia time, return to operating room (OR), and flap losses were compared between training levels.

Results Age and all comorbidities were equivalent between groups. Total operative time was highest for the AP group. Flap ischemia time, return to OR, and intraoperative complication were equivalent between groups. Percentage of flaps requiring at least one revision of the original anastomosis was significantly higher in PGY-4 and AP than in microsurgical fellows: PGY-4 (16%), PGY-5 (12%), PGY-6 (7%), PGY-7 (2.1%), and AP (16%), p = 0.041. Rates of flap loss were equivalent between groups, with overall flap loss between all groups 2/413 (<1%).

Conclusion With regard to flap loss and microsurgical vessel compromise, lower PGYs did not significantly worsen surgical outcomes for patients. AP had the longest total operative time, likely due to flap selection bias. PGY-4 and AP groups had higher rates of revision of original anastomosis compared with PGY-7, though ultimately these differences did not impact overall operative time, complication rate, or flap losses. Hands-on supervised microsurgical education appears to be both safe for patients, and also an effective way of building technical proficiency in plastic surgery residents.
Hospital Outcomes of Infants with Neonatal Opioid Withdrawal Syndrome at a Tertiary Care Hospital with High Rates of Concurrent Nonopioid (Polysubstance) Exposure
Authors: Morris Erin , Bardsley Tyler , Schulte Krista , Seidel Jeanette , Shakib Julie H. , Buchi Karen F. , Fung Camille M.
Published: September 2020

Objective Neonatal opioid withdrawal syndrome (NOWS) describes infants' withdrawal signs and symptoms after birth due to an interruption of prenatal opioid exposure. Many infants with NOWS are also exposed to nonopioids, however. This study was to determine hospital outcomes of infants exposed to opioids alone or coexposed with nonopioid substances (polysubstance).

Study Design We reviewed infants of ≥34 weeks of gestation with prenatal opioid exposure from April 2015 to May 2018. We compared the median lengths of stay (LOS) and treatment (LOT) and the percentages of infants requiring pharmacologic and adjunctive treatment in infants exposed to opioids alone or polysubstance. We used Wilcoxon's test for continuous outcomes or Chi-squared test for categorical outcomes to determine statistical significance. We used multivariable regression model to calculate each drug category's estimates of adjusted mean ratios for LOS and LOT plus estimates of adjusted odds ratios for pharmacologic/adjunctive treatments.

Results Of the 175 infants, 33 (19%) infants had opioid exposure alone. Opioid exposure included short- and/or long-acting opioids. A total of 142 (81%) had polysubstance exposure with 47% of mothers using nicotine products. We saw similar hospital outcomes between infants exposed to opioids alone or polysubstance; however, a higher percentage of infants with both short- and long-acting opioid exposure required pharmacologic treatment compared with either opioid alone. Focusing on individual drug categories, we detected differential hospital outcomes in which short-acting opioids decreased LOT, whereas long-acting opioids increased LOS, LOT, and need for pharmacologic and adjunctive treatment. Coexposure of opioids with stimulants decreased LOT and reduced need for adjunctive treatment. Coexposures with antidepressants increased LOT, while with antiepilepetics increased LOS.

Conclusion Because infants with NOWS often have coexposures to other nonopioid substances, appreciating the associated risks of individual or combination of drugs in modulating hospital outcomes may help counsel families on their infants' expected hospital course.

Key Points
Weaning Strategy of Diuretics in Outpatient Preterm Infants with Bronchopulmonary Dysplasia: A National Survey
Authors: Armoni Domany Keren , Amirav Israel , Sadot Efraim , Diamant Nir , Mandel Dror , Lavie Moran
Published: September 2020

Objective Long-term diuretic treatment in patients with bronchopulmonary dysplasia (BPD) is common despite lack of data that support its use. We aimed to characterize the commonly used diuretics weaning strategies for outpatient clinically stable preterm infants with BPD.

Study Design We conducted a cross-sectional web-based survey among all pediatric pulmonologists and neonatologists in Israel. Questionnaire included data regarding practitioners' different diuretics-weaning practice in this population.

Results The response rate for pulmonologists and neonatologists were 35/50 (70%) and 36/120 (30%), respectively. When both oxygen and diuretics are used, 59% wean oxygen first and 32% wean diuretics first. If patients are solely on diuretics, 27% discontinue instantly, 34% decrease the dosage gradually, and 34% outgrow the discharge dosage. Significantly more pulmonologists decrease the dosage gradually, while more neonatologists discontinue at once (p < 0.001). Most participants (94%) reported being unsatisfied with the existing data and guidelines regarding these issues.

Conclusion Our results showed a wide range of practice patterns in the weaning strategy of diuretics in outpatient preterm infants with BPD. Pulmonologists and neonatologists differ significantly in their weaning strategy. A prospective larger controlled study to explore the outcome of gradual tapering versus discontinuation without weaning is warranted.

Key Points
Not cricket, not classics? A case study in the limits of reception
Authors: Haimson Lushkov Ayelet
Published: September 2020

This article offers a reading of the coverage of the 2013–14 Ashes series by way of exploring the limits of classical reception. Focusing on the poetics of recusal (recusatio, praetritio) and their place in advertising memory sanctions as site of contested power, I suggest that although the coverage lacks explicit reference to classical material, it nevertheless can be read as classical by analogy, and as such ought to be treated as a case of classical reception.
Magic Masala Versus Magical Masala: Madras High Court’s spicy remark on the acquired distinctiveness of laudatory marks
Authors: Jadoun Harshit Singh , Vyas Lokesh
Published: September 2020

M/s. ITC Limited v Nestle India Limited C.S.No.231 of 2013 (Judge: Mr Justice C. Saravanan, 10 June 2020)
Seasonal variations in the relationship between sun-induced chlorophyll fluorescence and photosynthetic capacity from the leaf to canopy level in a rice crop
Authors: Li Ji , Zhang Yongguang , Gu Lianhong , Li Zhaohui , Li Jing , Zhang Qian , Zhang Zhaoying , Song Lian
Published: September 2020

Photosynthetic capacity (leaf maximum carboxylation rate, Vcmax) is a critical parameter for accurately assessing carbon assimilation by plant canopies. Recent studies of sun-induced chlorophyll fluorescence (SIF) have shown potential for estimating Vcmax at the ecosystem level. However, the relationship between SIF and Vcmax at the leaf and canopy levels is still poorly understood. In this study, we investigated the dynamic relationship between SIF and Vcmax and its controlling factors using SIF and CO2 response measurements in a rice paddy. We found that SIF and its yield (SIFy) were strongly correlated with Vcmax during the growing season, although the relationship varied with plant growth stages. After flowering, SIFy showed a stronger relationship with Vcmax than SIF flux at both the leaf and canopy levels. Further analysis suggested that the divergence of the link between SIF and Vcmax from leaf to canopy are the result of changes in canopy structure and leaf physiology, highlighting that these need to be considered when interpreting the SIF signal across spatial scales. Our results provide evidence that remotely sensed SIF observations can be used to track seasonal variations in Vcmax at the leaf and canopy levels.
Responses of isoprene emission and photochemical efficiency to severe drought combined with prolonged hot weather in hybrid Populus
Authors: Sun Zhihong , Shen Yan , Niinemets Ülo
Published: September 2020

Isoprene emissions have been considered as a protective response of plants to heat stress, but there is limited information of how prolonged heat spells affect isoprene emission capacity, particularly under the drought conditions that often accompany hot weather. Under combined long-term stresses, presence of isoprene emission could contribute to the maintenance of the precursor pool for rapid synthesis of essential isoprenoids to repair damaged components of leaf photosynthetic apparatus. We studied changes in leaf isoprene emission rate, photosynthetic characteristics, and antioxidant enzyme activities in two hybrid Populus clones, Nanlin 1388 (relatively high drought tolerance) and Nanlin 895 (relatively high thermotolerance) that were subjected to long-term (30 d) soil water stress (25% versus 90% soil field capacity) combined with a natural heat spell (day-time temperatures of 35–40 °C) that affected both control and water-stressed plants. Unexpectedly, isoprene emissions from both the clones were similar and the overall effects of drought on the emission characteristics were initially minor; however, treatment effects and clonal differences increased with time. In particular, the isoprene emission rate only increased slightly in the Nanlin 895 control plants after 15 d of treatment, whereas it decreased by more than 5-fold in all treatment × clone combinations after 30 d. The reduction in isoprene emission rate was associated with a decrease in the pool size of the isoprene precursor dimethylallyl diphosphate in all cases at 30 d after the start of treatment. Net assimilation rate, stomatal conductance, the openness of PSII centers, and the effective quantum yield all decreased, and non-photochemical quenching and catalase activity increased in both control and water-stressed plants. Contrary to the hypothesis of protection of leaf photosynthetic apparatus by isoprene, the data collectively indicated that prolonged stress affected isoprene emissions more strongly than leaf photosynthetic characteristics. This primarily reflected the depletion of isoprene precursor pools under long-term severe stress.
Notions of Cauchyness and metastability
Authors: Diener Hannes , Lubarsky Robert
Published: September 2020

We show that several weakenings of the Cauchy condition are all equivalent under the assumption of countable choice, and investigate to what extent choice is necessary. We also show that the syntactically reminiscent notion of metastability allows similar variations, but is empty in terms of its constructive content.1
Operator algebras with hyperarithmetic theory
Authors: Goldbring Isaac , Hart Bradd
Published: September 2020

We show that the following operator algebras have hyperarithmetic theory: the hyperfinite II$_1$ factor $\mathcal R$, $L(\varGamma )$ for $\varGamma $ a finitely generated group with solvable word problem, $C^*(\varGamma )$ for $\varGamma $ a finitely presented group, $C^*_\lambda (\varGamma )$ for $\varGamma $ a finitely generated group with solvable word problem, $C(2^\omega )$ and $C(\mathbb P)$ (where $\mathbb P$ is the pseudoarc). We also show that the Cuntz algebra $\mathcal O_2$ has a hyperarithmetic theory provided that the Kirchberg embedding problems have affirmative answers. Finally, we prove that if there is an existentially closed (e.c.) II$_1$ factor (resp. $\textrm{C}^*$-algebra) that does not have hyperarithmetic theory, then there are continuum many theories of e.c. II$_1$ factors (resp. e.c. $\textrm{C}^*$-algebras).
NIHAO XXVI: Nature versus nurture, the Star Formation Main Sequence and the origin of its scatter
Authors: Blank Marvin , Meier Liam E , Macciò Andrea V , Dutton Aaron A , Dixon Keri L , Soliman Nadine H , Kang Xi
Published: September 2020

We investigate how the NIHAO galaxies match the observed star formation main sequence (SFMS) and what the origin of its scatter is. The NIHAO galaxies reproduce the SFMS and generally agree with observations, but the slope is about unity and thus significantly larger than observed values. This is because observed galaxies at large stellar masses, although still being part of the SFMS, are already influenced by quenching. This partial suppression of star formation by AGN feedback leads to lower star formation rates and therefore to lower observed slopes. We confirm that including the effects of AGN in our galaxies leads to slopes in agreement with observations. We find the deviation of a galaxy from the SFMS is correlated with its z = 0 dark matter halo concentration and thus with its halo formation time. This means galaxies with a higher-than-average star formation rate (SFR) form later and vice versa. We explain this apparent correlation with the SFR by re-interpreting galaxies that lie above the SFMS (higher-than-average SFR) as lying to the left of the SFMS (lower-than-average stellar mass) and vice versa. Thus later forming haloes have a lower-than-average stellar mass, this is simply because they have had less-than-average time to form stars, and vice versa. It is thus the nature, i.e. how and when these galaxies form, that sets the path of a galaxy in the SFR versus stellar mass plane.
On the nature of massive helium star winds and Wolf–Rayet-type mass-loss
Authors: Sander Andreas A C , Vink Jorick S
Published: September 2020

The mass-loss rates of massive helium stars are one of the major uncertainties in modern astrophysics. Regardless of whether they were stripped by a binary companion or managed to peel off their outer layers by themselves, the influence and final fate of helium stars – in particular the resulting black hole mass – highly depends on their wind mass-loss as stripped-envelope objects. While empirical mass-loss constraints for massive helium stars have improved over the last decades, the resulting recipes are limited to metallicities with the observational ability to sufficiently resolve individual stars. Yet, theoretical efforts have been hampered by the complexity of Wolf–Rayet (WR) winds arising from the more massive helium stars. In an unprecedented effort, we calculate next-generation stellar atmosphere models resembling massive helium main-sequence stars with Fe-bump driven winds up to $500\, \mathrm{M}_\odot$ over a wide metallicity range between 2.0 and $0.02\, \mathrm{Z}_\odot$. We uncover a complex Γe-dependency of WR-type winds and their metallicity-dependent breakdown. The latter can be related to the onset of multiple scattering, requiring higher L/M-ratios at lower metallicity. Based on our findings, we derive the first ever theoretically motivated mass-loss recipe for massive helium stars. We also provide estimates for Lyman continuum and $\rm{He\,{\small II}}$ ionizing fluxes, finding stripped helium stars to contribute considerably at low metallicity. In sharp contrast to OB-star winds, the mass-loss for helium stars scales with the terminal velocity. While limited to the helium main sequence, our study marks a major step towards a better theoretical understanding of helium star evolution.
HydraPsiSeq: a method for systematic and quantitative mapping of pseudouridines in RNA
Authors: Marchand Virginie , Pichot Florian , Neybecker Paul , Ayadi Lilia , Bourguignon-Igel Valérie , Wacheul Ludivine , Lafontaine Denis L J , Pinzano Astrid , Helm Mark , Motorin Yuri
Published: September 2020

Developing methods for accurate detection of RNA modifications remains a major challenge in epitranscriptomics. Next-generation sequencing-based mapping approaches have recently emerged but, often, they are not quantitative and lack specificity. Pseudouridine (ψ), produced by uridine isomerization, is one of the most abundant RNA modification. ψ mapping classically involves derivatization with soluble carbodiimide (CMCT), which is prone to variation making this approach only semi-quantitative. Here, we developed ‘HydraPsiSeq’, a novel quantitative ψ mapping technique relying on specific protection from hydrazine/aniline cleavage. HydraPsiSeq is quantitative because the obtained signal directly reflects pseudouridine level. Furthermore, normalization to natural unmodified RNA and/or to synthetic in vitro transcripts allows absolute measurements of modification levels. HydraPsiSeq requires minute amounts of RNA (as low as 10–50 ng), making it compatible with high-throughput profiling of diverse biological and clinical samples. Exploring the potential of HydraPsiSeq, we profiled human rRNAs, revealing strong variations in pseudouridylation levels at ∼20–25 positions out of total 104 sites. We also observed the dynamics of rRNA pseudouridylation throughout chondrogenic differentiation of human bone marrow stem cells. In conclusion, HydraPsiSeq is a robust approach for the systematic mapping and accurate quantification of pseudouridines in RNAs with applications in disease, aging, development, differentiation and/or stress response.
A Retrospective Analysis in 1347 Patients Undergoing Cement Augmentation for Osteoporotic Vertebral Compression Fracture: Is the Sandwich Vertebra at a Higher Risk of Further Fracture?
Authors: Chiu Ping-Yeh , Kao Fu-Cheng , Hsieh Ming-Kai , Tsai Tsung-Ting , Chen Wen-Jer , Niu Chi-Chien , Lai Po-Liang
Published: September 2020

BACKGROUND

Multiple percutaneous vertebral cement augmentation may create sandwich vertebrae. Whether the sandwich vertebra is at higher risk of further fracture remains unknown.

OBJECTIVE

To compare the incidence of further fractures of sandwich vertebrae and adjacent vertebrae and to identify potential risk factors for sandwich vertebral fractures.

METHODS

Patients who underwent cement augmentation for osteoporotic vertebral compression fractures (OVCFs) in a single medical center between January 2012 and December 2015 were included. A sandwich vertebra was defined as an intact vertebra located between 2 previously cemented vertebrae. Demographic data and imaging findings were recorded. All patients were followed up for at least 24 mo postoperatively. During follow-up period, if the patient reported new-onset back pain with corresponding imaging findings, a diagnosis of sandwich vertebral fracture was made.

RESULTS

Among the 1347 patients who underwent vertebroplasty/kyphoplasty for OVCFs, 127 patients with 128 fracture levels met the criteria for sandwich vertebrae (females/males 100/27, mean age 77.8 ± 7.7 yr old). The fracture location was most common in the thoraco-lumbar junction (T10-L2), 68.5% (87/127). The incidence of sandwich vertebral fracture was 21.3%, whereas the incidence of adjacent level fracture of those with no sandwich vertebra was 16.4% (196/1194), P = .1879.

CONCLUSION

The incidence of sandwich vertebral fracture is not higher than that at the adjacent levels. The factor associated with further sandwich vertebral fracture was male gender. Once sandwich vertebral fracture occurred, patients may seek more surgical intervention than those with only adjacent fractures.
A Review of Cortical and Subcortical Stimulation Mapping for Language
Authors: Young Jacob S , Lee Anthony T , Chang Edward F
Published: September 2020

Since the early descriptions of language function based on observations of patients with language deficits by Broca and Wernicke, neurosurgeons have been focused on characterizing the anatomic regions necessary for language perception and production, and preserving these structures during surgery to minimize patient deficits post operatively. In this supplementary issue on awake intraoperative mapping, we review language processing across multiple domains, highlighting key advances in direct electrical stimulation of different cortical and subcortical regions involved in naming, repetition, reading, writing, and syntax. We then discuss different intraoperative tasks for assessing the function of a given area and avoiding injury to critical, eloquent regions.
Preparation of phospholipid-based polycarbonate urethanes for potential applications of blood-contacting implants
Authors: Li Peichuang , Cai Wanhao , Li Xin , Wang Kebing , Zhou Lei , You Tianxue , Wang Rui , Chen Hang , Zhao Yuancong , Wang Jin , Huang Nan
Published: September 2020

Polyurethanes are widely used in interventional devices due to the excellent physicochemical property. However, non-specific adhesion and severe inflammatory response of ordinary polyurethanes may lead to severe complications of intravenous devices. Herein, a novel phospholipid-based polycarbonate urethanes (PCUs) were developed via two-step solution polymerization by direct synthesis based on functional raw materials. Furthermore, PCUs were coated on biomedical metal sheets to construct biomimetic anti-fouling surface. The results of stress–strain curves exhibited excellent tensile properties of PCUs films. Differential scanning calorimetry results indicated that the microphase separation of such PCUs polymers could be well regulated by adjusting the formulation of chain extender, leading to different biological response. In vitro blood compatibility tests including bovine serum albumin adsorption, fibrinogen adsorption and denaturation, platelet adhesion and whole-blood experiment showed superior performance in inhibition non-specific adhesion of PCUs samples. Endothelial cells and smooth muscle cells culture tests further revealed a good anti-cell adhesion ability. Finally, animal experiments including ex vivo blood circulation and subcutaneous inflammation animal experiments indicated a strong ability in anti-thrombosis and histocompatibility. These results high light the strong anti-adhesion property of phospholipid-based PCUs films, which may be applied to the blood-contacting implants such as intravenous catheter or antithrombotic surface in the future.
Impact of Educational Format on Learner Commitment to Change and Satisfaction
Authors: Bird Gary C. , Kozakowski Stanley M. , Mullins Amy , Campbell Elizabeth
Published: September 2020

Introduction:

The value proposition of CME lies in its ability to elicit change in learners so new knowledge and skills are used to improve patient outcomes. In this study, we test the hypothesis that, in contrast to passive learning, education with an active engagement component has a greater impact on the motivation of learners to make changes in their practice.

Methods:

We analyzed nine educational formats produced by the American Academy of Family Physicians. CME program between 2015 and 2017. Postactivity learner evaluations were used to measure both satisfaction and “commitment to change”—the percentage of learners who committed in making a change in their practice as a result of their participation.

Results:

We found education that was interactive and leveraged elements of social learning theory produced the greatest commitment to change the score. Lower scores were obtained for more passive education formats. By contrast, satisfaction scores were not significantly different between formats.

Discussion:

Our data demonstrate differences between commitment to change and educational format that could inform how format types might be better used to promote a behavior change. We also demonstrate that learner satisfaction has little or no value as a measure of educational efficacy.
Footprints of Birth: An Innovative Educational Intervention Foregrounding Women's Voices to Improve Empathy and Reflective Practice in Maternity Care
Authors: Swordy Alice , Noble Lorraine M. , Bourne Theresa , Van Lessen Logan , Lokugamage Amali U.
Published: September 2020

Introduction:

A global movement on respectful maternity care has arisen because of widespread accounts of dehumanized maternity care. This article considers the use of a transformative learning approach to highlight patient agency and personhood in health care. An educational intervention using patient narratives was introduced in a maternity unit to foster a culture of listening and responsiveness to women's voices. This article reports the impact on staff and student learning, empathy, and reflective practice.

Methods:

A total of 245 interprofessional providers participated in 14 workshops over a 16-month period. Participants represented a range of health professions including medicine, midwifery, nursing, and allied professions. Senior management, administrators, and peer support volunteers also attended. Session sizes ranged from 5 to 60 attendees. The format included documentary-style videos of patient feedback followed by audience discussion. Discussion points were collected and qualitatively analyzed for participants' critical reflection, emotional engagement, cognitive dissonance, and perspective transformation.

Results:

Learners reflected on the client–caregiver relationship and care provision. Staff and students showed empathy for the women sharing their stories. Learners were disturbed by failings in care and wished to improve services. All provider groups highlighted the importance of communication, compassion, and patient autonomy as key elements of maternity care.

Discussion:

Multiprofessional learners engaged emotionally with women's narratives and reflected critically on their roles in maternity care. Learners' responses showed evidence of transformative learning. Staff and students recognized the value of providing respectful, empathic care. Educational interventions highlighting patients' voices may promote patient autonomy by reducing dehumanization in health care.