bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract
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

AbstractThis 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

Abstract
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

AbstractPhotosynthetic 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

Abstract
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

AbstractWe 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

Abstract
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

Abstract
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

ABSTRACT
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

AbstractDeveloping 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

Abstract

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

Abstract
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

Abstract
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.