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Many biomedical analysis applications require trapping and manipulating single cells and cell clusters within microfluidic devices. Dielectrophoresis (DEP) is a label-free technique that can achieve flexible cell trapping, without physical barriers, using electric field gradients created in the device by an electrode microarray. Little is known about how fluid flow forces created by the electrodes, such as thermally driven convection and electroosmosis, affect DEP-based cell capture under high conductance media conditions that simulate physiologically relevant fluids such as blood or plasma. Here, we compare theoretical trajectories of particles under the influence of negative DEP (nDEP) with observed trajectories of real particles in a high conductance buffer. We used 10-µm diameter polystyrene beads as model cells and tracked their trajectories in the DEP microfluidic chip. The theoretical nDEP trajectories were in close agreement with the observed particle behavior. This agreement indicates that the movement of the particles was highly dominated by the DEP force and that contributions from thermal- and electroosmotic-driven flows were negligible under these experimental conditions. The analysis protocol developed here offers a strategy that can be applied to future studies with different applied voltages, frequencies, conductivities, and polarization properties of the targeted particles and surrounding medium. These findings motivate further DEP device development to manipulate particle trajectories for trapping applications.

Increasingly, highly multiplexed tissue imaging methods are used to profile protein expression at the single-cell level. However, a critical limitation is the lack of robust cell segmentation tools for tissue sections. We present Multiplexed Image Resegmentation of Internal Aberrant Membranes (MIRIAM) that combines (a) a pipeline for cell segmentation and quantification that incorporates machine learning-based pixel classification to define cellular compartments, (b) a novel method for extending incomplete cell membranes, and (c) a deep learning-based cell shape descriptor. Using human colonic adenomas as an example, we show that MIRIAM is superior to widely utilized segmentation methods and provides a pipeline that is broadly applicable to different imaging platforms and tissue types.

The presence of complete concentric collapse of the soft palate (CCCp) during drug-induced sleep endoscopy (DISE) has important therapeutic consequences. However, CCCp may present in various, sometimes doubtful, ways due to the complex anatomy of the upper airway. Herein, we aimed to characterize these doubtful variants by reviewing the DISE recordings of patients with obstructive sleep apnea (n = 332). We observed in some individuals that the soft palate collapsed in an anteroposterior-laterolateral (AP-LL) way, producing a polygonal shape that was distinct from CCCp. Patients with this collapse pattern (n = 29) had a smaller neck circumference and less severe obstructive sleep apnea than patients with CCCp (n = 68). The majority of patients with AP-LL collapse (n = 19) were originally diagnosed with CCCp. Based on these findings, AP-LL collapse of the soft palate might represent a distinct DISE phenotype that is easily confounded with CCCp.

International audience; Two new dumbbell-shaped molecules based on two solubilizing and structuring triazatruxene (TAT) units linked by a central chromophore were synthesized and studied. The central chromophore was an electro-deficient fluorene-malononitrile (FM) unit, that can be functionalized symmetrically on two different positions, giving rise to two positional isomers, called TAT-pFM and TAT-mFM, when the TATs are connected to the 2,7-and 3,6positions, respectively. The two isomers exhibited different electronic conjugation pathways that drastically affect their absorption properties and energy levels. Moreover, while TAT-pFM was organized in a stable 3D mesomorphic structure from room-temperature to the melting, TAT-mFM remained crystalline and decomposed before melting. Finally, despite a lower hole mobility, the TAT-mFM exhibited the highest Power Conversion Efficiency (PCE) of about 2% in organic solar cells. This higher PCE was attributed essentially to the pronounced internal charge transfer band contribution to the charge photogeneration observed in TAT-mFM solar cells.

BACKGROUND Protoporphyrinogen IX oxidase 2 (PPO2) inhibitors are important for the management of glyphosate- and acetolactate synthase-resistant Palmer amaranth [Amaranthus palmeri (S.) Wats.]. The evolving resistance to PPO inhibitors is of great concern. We surveyed the evolution of resistance to fomesafen in the US Mid-south and determined its correlation with the known functional PPO2 target-site mutations (TSM). RESULTS The 167 accessions analyzed were grouped into five categories, four resistant (147) and one susceptible (20). Arkansas accessions constituted 100% of the susceptible group while the Missouri accessions comprised 60% of the most resistant category. The majority of Mississippi accessions (88%) clustered in the high-survival-high-injury category, manifesting an early-stage resistance evolution. One hundred and fifteen accessions were genotyped for four known TSMs; 74% of accessions carried at least one TSM. The most common single TSM was ΔG210 (18% of accessions) and the predominant double mutation was ΔG210 + G399A (17%). Other mutations are likely less favorable, hence are rare. All TSMs were detected in three accessions. Further examination revealed that 9 and two individuals carried G399A + G210 and G399A + R128G TSM in the same allele, respectively. The existence of these combinations is supported by molecular modeling. CONCLUSIONS Resistance to PPO inhibitors is widespread across the Mid-southern USA. Highly resistant field populations have plants with multiple mutations. G399A is the most prone to co-occur with other ppo2 mutations in the same allele. Mutation at R128 in the configuration of the PPO2 catalytic domain restrains the co-occurrence of R128G with ΔG210, making ΔG210 + G399A the most plausible, tolerable functional mutation combination to co-occur in the same ppo2 allele.

To (1) summarize strategies proposed in the recent otolaryngology-head and neck surgery (OTO-HNS) literature for improving the residency application and selection process, (2) evaluate the effects of recently implemented changes to the OTO-HNS match, and (3) discuss recommendations for future changes to the OTO-HNS residency application and selection process.PubMed, Medline Ovid database, and article reference lists.A structured literature search was performed to identify current English language articles relating to the objectives of this study using the aforementioned data sources, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. The search was limited to submissions published between January 1, 2015, and January 1, 2020.Numerous proposals have been made for improving the otolaryngology residency application and selection process and addressing the competitive nature of the Match. These proposals include but are not limited to mandating a secondary essay, implementing consortia and early match processes, using a signaling system, conducting regional and web-based interviews, offering early engagement with interest groups, instituting a hard cap on applications, increasing costs of applying, counseling self-restraint to prospective applicants, and creating application filters.As the volume of literature surrounding the OTO-HNS Match continues to increase, this review aims to provide a summary of past proposals and serve as a guide for possible future innovations. We propose 3 initiatives that may improve the residency application and selection process for both program and resident, with minimal impact to the current National Resident Matching Program (NRMP) Match structure.

Diffusion tensor imaging (DTI) can be used to index white matter integrity of the corticospinal tract (CST) after stroke; however, the psychometric properties of DTI‐based measures of white matter integrity are unknown. The purpose of this study was to examine test–retest reliability as determined by intraclass correlation coefficients (ICC) and calculate minimal detectable change (MDC) of DTI‐based measures of CST integrity using three different approaches: a Cerebral Peduncle approach, a Probabilistic Tract approach, and a Tract Template approach. Eighteen participants with chronic stroke underwent DTI on the same magnetic resonance imaging scanner 4 days apart. For the Cerebral Peduncle approach, a researcher hand drew masks at the cerebral peduncle. For the Probabilistic Tract approach, tractography was seeded in motor areas of the cortex to the cerebral peduncle. For the Tract Template approach, a standard CST template was transformed into native space. For all approaches, the researcher performing analyses was blind to participant number and day of data collection. All three approaches had good to excellent test–retest reliability for fractional anisotropy (FA; ICCs >0.786). Mean diffusivity, axial diffusivity, and radial diffusivity were less reliable than FA. The ICC values were highest and MDC values were the smallest for the most automated approach (Tract Template), followed by the combined manual/automated approach (Probabilistic Tract) then the manual approach (Cerebral Peduncle). The results of this study may have implications for how DTI‐based measures of CST integrity are used to define impairment, predict outcomes, and interpret change after stroke.

Background Upper Airway Stimulation (UAS) is a well-established therapy option for obstructive sleep apnea (OSA). Aims There are no data on whether respiratory sensing contributes to successful UAS therapy. Materials & methods After initial measurements of 3 implanted patients (M1), the sensing signal was inverted (M2) without changing other parameters. Two weeks later, the signal was converted back again, and the sensitivity of breathing cycle detection was turned to a very low state (M3). Results At M2 and M3, the apnea-hypopnea index and oxygen desaturation index increased. Discussion Correct respiratory sensing is important for controlling OSA using UAS. Conclusions Therefore, implant centers should should optimize respiratory sensing placement and adjustment.

Objectives Advanced nasal malignancies may require rhinectomy, which can have profound psychosocial impacts. Rhinectomy defects can be rehabilitated through surgery or prosthetics. We seek to understand the health utility of the rhinectomy defect, surgical, and prosthetic reconstruction, which have not been previously studied. Study Design Prospective clinical study Methods Adult naive observers (n = 273) ranked the utility of five randomized health states (monocular blindness, binocular blindness, post-rhinectomy nasal defect, postsurgical reconstruction, and post-prosthetic rehabilitation). Health utilities were measured using visual analogue scale (VAS), standard gamble (SG), and time trade-off (TTO). One-way analysis of variance (ANOVA) with post hoc Scheffe's test and the independent samples T-test for a priori comparisons were performed. Multiple linear regression was performed using participant demographics as independent predictors of utility scores. Results Health utilities (VAS, SG, TTO) were reported as follows (mean +/- SD): monocular blindness (0.71 +/- 0.21, 0.84 +/- 0.20, 0.85 +/- 0.19), binocular blindness (0.48 +/- 0.25, 0.68 +/- 0.28, 0.63 +/- 0.28), post-rhinectomy nasal defect (0.59 +/- 0.24, 0.74 +/- 0.24, 0.74 +/- 0.24), postsurgical reconstruction (0.88 +/- 0.16, 0.90 +/- 0.18, 0.89 +/- 0.13), and post-prosthetic rehabilitation (0.67 +/- 0.22, 0.80 +/- 0.23, 0.82 +/- 0.20). Both surgical reconstruction (P < .001) and prosthetic rehabilitation (P < .001) significantly improved health utility. SG and TTO utility scores were inversely associated with observer age (P < .001) and participants who identified themselves as non-Caucasians (P < .05) in post-rhinectomy nasal defect, post-nasal surgical reconstruction, and post-nasal prosthetic rehabilitation health states, while higher levels of education were directly associated with SG scores (P < .05), respectively. Conclusion This is the first study to demonstrate the significant negative impact of the rhinectomy nasal defect on health utility. Rehabilitation by surgical or prosthetic techniques significantly increases health utility as rated by naive observers. Laryngoscope, 2019

AIM: To test if physiological acclimation can buffer species against increasing extreme heat due to climate change. LOCATION: Global. TIME PERIOD: 1960 to 2015. MAJOR TAXA STUDIED: Amphibians, arthropods, brachiopods, cnidarians, echinoderms, fishes, molluscs, reptiles. METHODS: We draw together new and existing data quantifying the warm acclimation response in 319 species as the acclimation response ratio (ARR): the increase in upper thermal limit per degree increase in experimental temperature. We develop worst‐case scenario climate projections to calculate the number of years and generations gained by ARR until loss of thermal safety. We further compute a vulnerability score that integrates across variables estimating exposure to climate change and species‐specific tolerance through traits, including physiological plasticity, generation time and latitudinal range extent. RESULTS: ARR is highly variable, but with marked differences across taxa, habitats and latitude. Polar terrestrial arthropods show high ARRs [95% upper confidence limit (UCL95%) = 0.68], as do some polar aquatic invertebrates that were acclimated for extended durations (ARR > 0.4). While this physiological plasticity buys 100s of years until thermal safety is lost, combination with long generation times leads to decreased potential for evolutionary adaptation. Additionally, 27% of marine polar invertebrates have no capacity for acclimation and reptiles and amphibians have minimal ARR (UCL95% = 0.16). Low physiological plasticity, long generations times and restricted latitudinal ranges combine to distinguish reptiles, amphibians and polar invertebrates as being highly vulnerable amongst ectotherms. MAIN CONCLUSIONS: In some taxa the combined effects of acclimation capacity and generation time can provide 100s of years and generations before thermal safety is lost. The accuracy of assessments of vulnerability to climate change will be improved by considering multiple aspects of species’ biology that, in combination may increase persistence under extreme heat events, and increase the probability for evolutionary rescue.

OBJECTIVES/HYPOTHESIS To identify the epidemiology and impact of facial fractures on player performance and return to play (RTP) in the National Basketball Association (NBA). STUDY DESIGN Retrospective case-control series METHODS: Fifty-three NBA players who sustained facial fractures between 1984 and 2018 were identified. Players with pre- and postinjury statistics were included in the performance analysis. A control group was matched by age, body mass index (BMI), position, NBA experience, and player efficiency rating. Fisher exact tests and Student t tests were performed to analyze player demographics and performance variables. RESULTS At the time of injury, the average player's age was 26.17 years, BMI was 24.80 kg/m2 , and NBA experience was 4.97 years. Players missed an average of 3.77 games and 18.21 days prior to RTP. Forty-eight players (90.6%) did RTP the subsequent season, whereas 43 of those players (81.1%) met inclusion criteria for performance analysis. There was no significant change in performance between pre- and postinjury seasons. Players managed operatively missed significantly more games (8.15 vs. 1.85; P = .034) and days (51.08 vs. 5.53; P = .003) than players managed nonoperatively, whereas performance was not impacted. Average career length following facial fracture was significantly shorter compared to controls (5.14 vs. 6.42 years; P = .010) and a decrease in three-pointer percentage (P = .004) was observed. CONCLUSIONS The majority of players who suffer facial fractures RTP in the NBA and do not experience significant decline in performance following injury. These results should aid physicians caring for basketball players at any level, and may help inform future guidelines for treatment and injury prevention. LEVEL OF EVIDENCE 3b Laryngoscope, 2020.

International audience; Doping polymer semiconductors is a central topic in plastic electronics and especially in the design of novel thermoelectric (TE) materials. In this contribution, it has been demonstrated that doping of oriented semicrystalline P3HT thin films with the dopant tris(4-bromophenyl)ammoniumyl hexachloroantimonate), known as magic blue (MB), helps reach charge conductivities of 3000 S cm−1 and TE power factors of 170 ± 30 μW mK−2 along the polymer chain direction. A combination of transmission electron microscopy, polarized optical absorption spectroscopy, Rutherford backscattering, and TE property measurements helps clarify the conditions necessary to achieve such high charge conductivities. A comparative study with different dopants demonstrates that the doping mechanism is intimately related to the semicrystalline structure of the polymer and whether crystalline, amorphous or both phases are doped. The highest charge mobilities are observed when the dopant MB is preferentially located in the amorphous phase of P3HT, leaving the structure of P3HT nanocrystals almost unaltered. In this case, the P3HT nanocrystals are doped from their interface with the surrounding amorphous phase. These results indicate that doping preferentially the amorphous phase of semicrystalline polymer semiconductors is an effective strategy to reduce polaron localization, enhance charge mobilities, and improve TE power factors

Background The first edition of the European position paper (EPP) on drug-induced sleep endoscopy (DISE) was published in 2014 with the aim to standardise the procedure, to provide an in-depth insight into the main aspects of this technique and to have a basis for future research. Since 2014, new studies have been published concerning new sedative agents or new insights into the pattern/levels of the obstruction depending on the depth of sedation. Therefore, an enlarged group of European experts in the field of sleep breathing disorders (SBD), including the most of the first DISE EPP main authors, has decided to publish an update of the European position paper on DISE, in order to include new evidence and to find a common language useful for reporting the findings of this endoscopic evaluation in adult population affected by SBD. Methods The authors have evaluated all the available evidence reported in the literature and have compared experience among various departments in leading European centres in order to provide an update regarding the standardisation of the DISE procedure and an in-depth insight into the main aspects of this technique. Results After the first European Position Consensus Meeting on DISE and its update, consensus was confirmed for indications, required preliminary examinations, where to perform DISE, technical equipment required, staffing, local anaesthesia, nasal decongestion, other medications, patient positioning, basics and special diagnostic manoeuvres, drugs and observation windows. So far, no consensus could be reached on a scoring and classification system. However, regarding this aim, the idea of an essential classification, such as VOTE with the possibility of its graded implementation of information and descriptions, seems to be the best way to reach a universal consensus on DISE classification at this stage. A common DISE language is mandatory, and attempts to come to a generally accepted system should be pursued.

Objectives/hypothesis An elevated body mass index (BMI) influences the severity of disease and treatment options utilized for obstructive sleep apnea (OSA). With this study, we aim to evaluate a cohort of patients undergoing upper airway stimulation (UAS) for treatment of OSA and assess the impact of BMI on surgical and quality of life outcomes. Methods We designed a case-control, retrospective review, of all patients undergoing UAS at two academic institutions between 2014 and 2017. We compare those with an elevated BMI to those without. We included patients with moderate-severe OSA, who were unable to tolerate therapy with continuous positive airway pressure (CPAP), were treated with UAS, and had a postoperative sleep study performed. We evaluated postoperative sleep study data including apnea-hypopnea index (AHI), O2 desaturation nadir, rate of cure, and rate of success in those with an elevated BMI to those without an elevated BMI. Success was defined as a drop in the postoperative AHI by 50% compared to the preoperative value and to less than 20. We also assessed daytime sleepiness using the Epworth Sleepiness Scale. Results When defining an elevated BMI as greater than 32, we found no difference between elevated and nonelevated BMI cohorts in postoperative AHI, O2 desaturation nadir, daytime sleepiness, rate of surgical success, or rate of cure. Conclusions Patients with obstructive sleep apnea, unable to tolerate CPAP, and with an elevated BMI can be successfully treated with upper airway stimulation therapy. Level of evidence 3. Laryngoscope, 128:2425-2428, 2018.