bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thoracic migration of silicone gel after breast implant rupture: a case report and literature review
Authors: Fanelli Benedetta , Marcasciano Marco , Lovero Stefano , Codolini Luca , Casella Donato , Onesti Maria Giuseppina , Ribuffo Diego , Scuderi Nicolo 
Published: February 2021

AbstractNowadays silicone is a widespread material for medical devices. In particular, it is commonly used for implants manufacturing, for that patients undergoing breast augmentation or breast reconstruction after mastectomy. However, the use of silicone implants is not free from risks. Ruptures of silicone breast implants are uncommon, in general post-traumatic or iatrogenic, and usually related to implant’s wall weakness of unknown origin but probably due to biochemical reactions that cause wall rupture. As a consequence of a rupture, silicone gel from damaged implants may have a continuity migration to the chest wall, axillae, and upper extremities, resulting in granulomatous inflammation or siliconoma, or a lymphatic migration to axillary lymph nodes. In this regard, silicone thoracic migration is extremely rare, and nowadays a leakage is unlikely to happen with more modern cohesive silicone gel implants. Nevertheless, procedures such as thoracic surgery and thoracotomies may be responsible for accidental breast implant rupture, capsular discontinuity, and eventually intrathoracic silicone migration, especially when dealing with older generations of breast implants. We report a rare case of a 75-year-old woman presenting with pleural silicone effusion, 18 years after a right breast reconstruction for breast cancer, followed by right upper lobe resection for a lung carcinoma. A combination of muscular flap and DTI pre-pectoral breast reconstruction with biological membrane (ADM) has been used for treatment. Literature was reviewed for cases of breast implants free silicone localization in the chest cavity, focusing on previous surgeries, anamnestic relevances, and surgical management.Level of Evidence: Level V, risk/prognostic study.
Constructive Neutral Evolution 20 Years Later
Authors: Muñoz-Gómez Sergio A. , Bilolikar Gaurav , Wideman Jeremy G. , Geiler-Samerotte Kerry 
Published: February 2021

AbstractEvolution has led to a great diversity that ranges from elegant simplicity to ornate complexity. Many complex features are often assumed to be more functional or adaptive than their simpler alternatives. However, in 1999, Arlin Stolzfus published a paper in the Journal of Molecular Evolution that outlined a framework in which complexity can arise through a series of non-adaptive steps. He called this framework Constructive Neutral Evolution (CNE). Despite its two-decade-old roots, many evolutionary biologists still appear to be unaware of this explanatory framework for the origins of complexity. In this perspective piece, we explain the theory of CNE and how it changes the order of events in narratives that describe the evolution of complexity. We also provide an extensive list of cellular features that may have become more complex through CNE. We end by discussing strategies to determine whether complexity arose through neutral or adaptive processes.
Membrane fusion studied by colloidal probes
Authors: Witt Hannes , Savić Filip , Verbeek Sarah , Dietz Jörn , Tarantola Gesa , Oelkers Marieelen , Geil Burkhard , Janshoff Andreas 
Published: February 2021

AbstractMembrane-coated colloidal probes combine the benefits of solid-supported membranes with a more complex three-dimensional geometry. This combination makes them a powerful model system that enables the visualization of dynamic biological processes with high throughput and minimal reliance on fluorescent labels. Here, we want to review recent applications of colloidal probes for the study of membrane fusion. After discussing the advantages and disadvantages of some classical vesicle-based fusion assays, we introduce an assay using optical detection of fusion between membrane-coated glass microspheres in a quasi two-dimensional assembly. Then, we discuss free energy considerations of membrane fusion between supported bilayers, and show how colloidal probes can be combined with atomic force microscopy or optical tweezers to access the fusion process with even greater detail.
Intravital microscopy of tumor vessel morphology and function using a standard fluorescence microscope
Authors: Gaustad Jon-Vidar , Simonsen Trude G. , Hansem Lise Mari K. , Rofstad Einar K. 
Published: February 2021

Abstract
Purpose
The purpose of the study was to demonstrate the performance and possible applications of an intravital microscopy assay using a standard fluorescence microscope.

Methods
Melanoma and pancreatic ductal adenocarcinoma xenografts were initiated in dorsal window chambers and subjected to repeated intravital microscopy. The entire tumor vasculature as well as the normal tissue surrounding the tumor was imaged simultaneously with high spatial and temporal resolution. Vascular morphology images were recorded by using transillumination, and vascular masks were produced to quantify vessel density, vessel diameter, vessel segment length, and vessel tortuosity. First-pass imaging movies were recorded after an intervenous injection of a fluorescent marker and were used to investigate vascular function. Lymphatics were visualized by intradermal injections of a fluorescent marker.

Results
The intravital microscopy assay was used to study tumor growth and vascularization, tumor vessel morphology and function, tumor-associated lymphatics, and vascular effects of acute cyclic hypoxia and antiangiogenic treatment. The assay was sensitive to tumor-line differences in vascular morphology and function and detected tumor-induced lymphatic dilation. Acute cyclic hypoxia induced angiogenesis and increased the density of small diameter vessels and blood supply times, whereas antiangiogenic treatment selectively removed small-diameter vessels, reduced blood supply times, and induced hypoxia. Moreover, the window chamber was compatible with magnetic resonance imaging (MRI), and parametric images derived by dynamic contrast-enhanced MRI were shown to reflect vascular morphology and function.

Conclusions
The presented assay represents a useful and affordable alternative to intravital microscopy assays using confocal and multi-photon microscopes.
Changes in Serum Lactate Level Predict Postoperative Intra‐Abdominal Infection After Pancreatic Resection
Authors: Li Yatong , Chen Lixin , Xing Cheng , Ding Cheng , Zhang Hanyu , Wang Shunda , Long Yun , Guo Junchao , Liao Quan , Zhang Taiping , Zhao Yupei , Dai Menghua 
Published: February 2021

AbstractObjectivePostoperative intra‐abdominal infection is one of the most serious complications after pancreatic resection. In this article, we investigated the relationship between serum lactate level and postoperative infection, to suggest a new predictor of potential infection risk after pancreatectomy.MethodsA retrospective analysis of 156 patients who underwent pancreatic surgery and admitted in the intensive care unit for recovery after surgery between August 2017 and August 2019 was performed.ResultsThe basic characteristics, preoperative information, pathological diagnoses, surgical methods, and intraoperative situations of patients in the postoperative intra‐abdominal infection group (n = 52) and non‐infection group (n = 104) showed no significant differences. With the same postoperative treatments and results of fluid balance, blood pressure maintenance, and laboratory tests, postoperative serum lactate level increased much higher in the infection group than non‐infection group (P < 0.001), while the base excess level declined much lower (P = 0.002). Patients in the infection group needed more time to elute lactate (P < 0.001), and stayed longer in the intensive care unit after surgery (P = 0.007). The overall postoperative complications were certainly more in the infection group (P < 0.001), resulting in a longer hospitalization time (P < 0.001).ConclusionsWhen patients recovered smoothly from anesthesia with a stable hemodynamics situation and normal results of laboratory tests, abnormally high serum lactate level could be a predictor of postoperative intra‐abdominal infection after pancreatic resection.
Choosing the best algorithm among five thyroid nodule ultrasound scores: from performance to cytology sparing—a single-center retrospective study in a large cohort
Authors: Sparano Clotilde , Verdiani Valentina , Pupilli Cinzia , Perigli Giuliano , Badii Benedetta , Vezzosi Vania , Mannucci Edoardo , Maggi Mario , Petrone Luisa 
Published: February 2021

Abstract
Objective
Incidental diagnosis of thyroid nodules, and therefore of thyroid cancer, has definitely increased in recent years, but the mortality rate for thyroid malignancies remains very low. Within this landscape of overdiagnosis, several nodule ultrasound scores (NUS) have been proposed to reduce unnecessary diagnostic procedures. Our aim was to verify the suitability of five main NUS.

Methods
This single-center, retrospective, observational study analyzed a total number of 6474 valid cytologies. A full clinical and US description of the thyroid gland and nodules was performed. We retrospectively applied five available NUS: KTIRADS, ATA, AACE/ACE-AME, EUTIRADS, and ACRTIRADS. Thereafter, we calculated the sensitivity, specificity, PPV, and NPV, along with the number of possible fine-needle aspiration (FNA) sparing, according to each NUS algorithm and to clustering risk classes within three macro-groups (low, intermediate, and high risk).

Results
In a real-life setting of thyroid nodule management, available NUS scoring systems show good accuracy at ROC analysis (AUC up to 0.647) and higher NPV (up to 96%). The ability in FNA sparing ranges from 10 to 38% and reaches 44.2% of potential FNA economization in the low-risk macro-group. Considering our cohort, ACRTIRADS and AACE/ACE-AME scores provide the best compromise in terms of accuracy and spared cytology.

Conclusions
Despite several limitations, available NUS do appear to assist physicians in clinical practice. In the context of a common disease, such as thyroid nodules, higher accuracy and NPV are desirable NUS features. Further improvements in NUS sensitivity and specificity are attainable future goals to optimize nodule management.

Key Points
• Thyroid nodule ultrasound scores do assist clinicians in real practice.
• Ultrasound scores reduce unnecessary diagnostic procedures, containing indolent thyroid microcarcinoma overdiagnosis.
• The variable malignancy risk of the “indeterminate” category negatively influences score’s performance in real-life management of thyroid lesions.
The importance of including uric acid in the definition of metabolic syndrome when assessing the mortality risk
Authors: Pugliese Nicola Riccardo , Mengozzi Alessandro , Virdis Agostino , Casiglia Edoardo , Tikhonoff Valerie , Cicero Arrigo F. G. , Ungar Andrea , Rivasi Giulia , Salvetti Massimo , Barbagallo Carlo M. , Bombelli Michele , Dell’Oro Raffaella , Bruno Berardino , Lippa Luciano , D’Elia Lanfranco , Verdecchia Paolo , Mallamaci Francesca , Cirillo Massimo , Rattazzi Marcello , Cirillo Pietro , Gesualdo Loreto , Mazza Alberto , Giannattasio Cristina , Maloberti Alessandro , Volpe Massimo , Tocci Giuliano , Georgiopoulos Georgios , Iaccarino Guido , Nazzaro Pietro , Parati Gianfranco , Palatini Paolo , Galletti Ferruccio , Ferri Claudio , Desideri Giovambattista , Viazzi Francesca , Pontremoli Roberto , Muiesan Maria Lorenza , Grassi Guido , Masi Stefano , Borghi Claudio ,   The Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension
Published: February 2021

Abstract
Introduction
Serum uric acid (SUA) has been depicted as a contributory causal factor in metabolic syndrome (MS), which in turn, portends unfavourable prognosis.

Aim
We assessed the prognostic role of SUA in patients with and without MS.

Methods
We used data from the multicentre Uric Acid Right for Heart Health study and considered cardiovascular mortality (CVM) as death due to fatal myocardial infarction, stroke, sudden cardiac death, or heart failure.

Results
A total of 9589 subjects (median age 58.5 years, 45% males) were included in the analysis, and 5100 (53%) patients had a final diagnosis of MS. After a median follow-up of 142 months, we observed 558 events. Using a previously validated cardiovascular SUA cut-off to predict CVM (> 5.1 mg/dL in women and 5.6 mg/dL in men), elevated SUA levels were significantly associated to a worse outcome in patients with and without MS (all p < 0.0001) and provided a significant net reclassification improvement of 7.1% over the diagnosis of MS for CVM (p = 0.004). Cox regression analyses identified an independent association between SUA and CVM (Hazard Ratio: 1.79 [95% CI, 1.15–2.79]; p < 0.0001) after the adjustment for MS, its single components and renal function. Three specific combinations of the MS components were associated with higher CVM when increasing SUA levels were reported, and systemic hypertension was the only individual component ever-present (all p < 0.0001).

Conclusion
Increasing SUA levels are associated with a higher CVM risk irrespective of the presence of MS: a cardiovascular SUA threshold may improve risk stratification.

Graphic abstract
LUCL reconstruction of the elbow: clinical midterm results based on the underlying pathogenesis
Authors: Geyer Stephanie , Heine Caroline , Winkler Philipp W. , Lutz Patricia M. , Lenich Andreas , Scheiderer Bastian , Imhoff Andreas B. , Siebenlist Sebastian 
Published: February 2021

Abstract
Purpose
Traumatic and atraumatic insufficiency of the lateral ulnar collateral ligament (LUCL) can cause posterolateral rotatory instability (PLRI) of the elbow. The influence of the underlying pathogenesis on functional outcomes remains unknown so far. The objective of this study was to determine the impact of the initial pathogenesis of PLRI on clinical outcomes after LUCL reconstruction using an ipsilateral triceps tendon autograft.

Methods
Thirty-six patients were reviewed in this retrospective study. Depending on the pathogenesis patients were assigned to either group EPI (atraumatic, secondary LUCL insufficiency due to chronic epicondylopathia) or group TRAUMA (traumatic LUCL lesion). Range-of-motion (ROM) and posterolateral joint stability were evaluated preoperatively and at follow-up survey. For clinical assessment, the Mayo elbow performance (MEPS) score was used. Patient-reported outcomes (PROs) consisting of visual analogue scale (VAS) for pain, disability of arm, shoulder and hand (DASH) score, patient-rated elbow evaluation (PREE) score and subjective elbow evaluation (SEV) as well as complications were analyzed.

Results
Thirty-one patients (group EPI, n = 17; group TRAUMA, n = 14), 13 men and 18 women with a mean age of 42.9 ± 11.0 were available for follow-up evaluation (57.7 ± 17.5 months). In 93.5%, posterolateral elbow stability was restored (n = 2 with re-instability, both group TRAUMA). No differences were seen between groups in relation to ROM. Even though group EPI (98.9 ± 3.7 points) showed better results than group TRAUMA (91.1 ± 12.6 points) (p = 0.034) according to MEPS, no differences were found for evaluated PROs (group A: VAS 1 ± 1.8, PREE 9.3 ± 15.7, DASH 7.7 ± 11.9, SEV 92.9 ± 8.3 vs. group B: VAS 1.9 ± 3.2, PREE 22.4 ± 26.1, DASH 16.0 ± 19.4, SEV 87.9 ± 15.4. 12.9% of patients required revision surgery.

Conclusion
LUCL reconstruction using a triceps tendon autograft for the treatment of PLRI provides good to excellent clinical outcomes regardless of the underlying pathogenesis (traumatic vs. atraumatic). However, in the present case series, posterolateral re-instability tends to be higher for traumatic PLRI and patient-reported outcomes showed inferior results.

Level of evidence
Therapeutic study, LEVEL III.
Three-dimensional exoscope-assisted laser stapedotomy: a preliminary experience
Authors: Milanesi Umberto , Pasquariello Benedetta , Saibene Alberto Maria , Felisati Giovanni , Atac Murat , Corbetta Davide 
Published: February 2021

Abstract
Purpose
Stapes surgery, despite the introduction of lasers and endoscopes, still represents a challenging procedure. Recently introduced 3-dimensional exoscopes have known advantages in otological surgery. This study aims to evaluate exoscopes role in stapes surgery, both from a surgical perspective and on the educational profile.

Methods
Seven consecutive otosclerosis patients underwent single-sided endaural laser stapedotomy with a 4K 3-dimensional exoscope. The surgical setting allowed all operating room personnel 3-dimensional vision. Pre- and postoperative pure tone audiometry and air-bone gaps, and information on the postoperative course and complications were systematically collected. An informal ergonomic evaluation was carried out by the operating room personnel and an informal didactic evaluation was provided by the trainees. A comparable group of microscope-assisted stapedotomy patients undergoing the same procedures and evaluations was chosen as a control group.

Results
Outcomes were solid in all patients, median air-bone gap decreased from 26.5 to 10 dB at the 3-month evaluation (p = 0.01, Wilcoxon’s test). No vertigo, tinnitus, or facial palsy was reported. The median operating time was 40 min. The compact design and configuration of the exoscope allowed more practical management of the operating theater. All personnel had the chance for a better understanding of the procedure and trainees felt more confident when asked to identify surgical landmarks and procedure steps. Audiological outcomes, operative times, and complication rates were not different between study and control groups.

Conclusion
Though further validation and systematic comparison with microscope- and endoscope-assisted stapedotomy are required, the exoscope proved a safe, practical, and educational tool.
Deficient visuomotor hand coordination in normal pressure hydrocephalus
Authors: Köster Hannah , Müller-Schmitz Katharina , Kolman Aschwin G. J. , Seitz Rüdiger J. 
Published: February 2021

AbstractObjectiveTo investigate if visuomotor coordination of hand movements is impaired in patients with normal pressure hydrocephalus (NPH) identified by dedicated testing procedures.MethodsForty-seven patients admitted for diagnostic workup for suspected NPH were studied prospectively with MRI, testing of cognitive and motor functions, lumbar puncture, and visuomotor coordination of hand movements using the PABLOR-device before and after a spinal tap of 40–50 ml CSF. Statistical analyses were carried out with repeated measures ANOVA and non-parametric correlation analyses.ResultsFourteen patients were found to suffer from ideopathic NPH. They were severely impaired in visuomotor control of intermittent arm movements in comparison to patients who were found not to be affected by NPH (n = 18). In the patients with NPH the deficient arm control was improved after the spinal tap in proportion to the improvement of gait. There was no improvement of cognitive and motor functions in the patients not affected by NPH, while the patients with possible NPH (n = 15) showed intermediate deficit and improvement patterns.Interpretation: Our data underline the importance of a multiparametric assessment of NPH and provide evidence for a motor control deficit in idiopathic NPH involving leg and arm movements. It is suggested that this motor control deficit resulted from an affection of the output tracts from the supplementary motor area in the periventricular vicinity.
The pulmonary pathology of COVID-19
Authors: Bösmüller Hans , Matter Matthias , Fend Falko , Tzankov Alexandar 
Published: February 2021

AbstractThe lung is the main affected organ in severe coronavirus disease 2019 (COVID-19) caused by the novel coronavirus SARS-CoV-2, and lung damage is the leading cause of death in the vast majority of patients. Mainly based on results obtained by autopsies, the seminal features of fatal COVID-19 have been described by many groups worldwide. Early changes encompass edema, epithelial damage, and capillaritis/endothelialitis, frequently combined with microthrombosis. Subsequently, patients with manifest respiratory insufficiency exhibit exudative diffuse alveolar damage (DAD) with hyaline membrane formation and pneumocyte type 2 hyperplasia, variably complicated by superinfection, which may progress to organizing/fibrotic stage DAD. These features, however, are not specific for COVID-19 and can be found in other disorders including viral infections. Clinically, the early disease stage of severe COVID-19 is characterized by high viral load, lymphopenia, massive secretion of pro-inflammatory cytokines and hypercoagulability, documented by elevated D-dimers and an increased frequency of thrombotic and thromboembolic events, whereas virus loads and cytokine levels tend to decrease in late disease stages, when tissue repair including angiogenesis prevails. The present review describes the spectrum of lung pathology based on the current literature and the authors’ personal experience derived from clinical autopsies, and tries to summarize our current understanding and open questions of the pathophysiology of severe pulmonary COVID-19.
Mineralogical and geochemical investigation of megaspherulites from Argentina, Germany, and the USA
Authors: Breitkreuz Christoph , Götze Jens , Weißmantel Alexandra 
Published: February 2021

AbstractTextures and whole-rock chemistry, as well as mineral composition, were analyzed in megaspherulites (high-temperature crystallization domains [HTCDs]) that formed in different geographical and geotectonic contexts and during different geological periods (Silver Cliff, CO, USA—Paleogene; El Quevar, Argentina—Miocene; Meissen Volcanic Complex, Germany—Late Carboniferous). All of these megaspherulites have formed exclusively in rhyolitic lava, and their mineral composition is dominated by K-feldspar (sanidine) and SiO2phases (quartz, cristobalite, tridymite). All megaspherulites represent composite HTCDs, comprising three zones: inner domain (ID), outer domain (OD), and a marginal domain (MD). Early evolution of megaspherulites is characterized by either central cavities and sector- to full-sphere spherulites or dendritic quartz-sanidine domains. The latter consist of bundles of fibrils each radiating from a single point reflecting relatively high growth rates. A common feature of OD and MD of all three megaspherulite occurrences is autocyclic banding. It mainly comprises fibrous (≤ 100 μm length), radially oriented sanidine and quartz, which formed at a temperature close to glass transition temperature (Tg). The termination of megaspherulite growth is marked by centimeter-sized sector-sphere spherulites on the surface. Megaspherulite formation requires limited nucleation, which is probably related to the low phenocryst content of the hosting lava. Latent heat from overlying crystallizing lithoidal rhyolite maintained low undercooling conditions keeping nucleation density low and facilitating high diffusion and growth rates. Late megaspherulite growth and its termination under low diffusion conditions is controlled by cooling close toTg. Calculations based on literature data suggest that the megaspherulite growth presumably lasted less than 60 years, perhaps 30 to 40 years.