bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acellular dermal matrix in direct-to-implant breast reconstruction: univariate and multivariate analysis on potential risk factors
Authors: Hansen Laura , Paulsen Jakob Felbo , Hemmingsen Mathilde Nejrup , Herly Mikkel , Bredgaard Rikke , Gramkow Christina S. , Vester-Glowinski Peter Viktor 
Published: March 2024

Abstract

Background
Acellular dermal matrices (ADM) are widely used in direct-to-implant breast reconstruction and were introduced as part of the implant-based breast reconstruction within the previous decade. This study presents clinical outcomes of ADM-assisted direct-to-implant breast reconstruction and evaluates the most frequent and severe postoperative complications.

Methods
We performed a retrospective analysis of patients who underwent ADM-assisted submuscular direct-to-implant breast reconstruction from March 2013 to February 2017 at the University Hospital Copenhagen, Rigshospitalet. All postoperative complications were classified using the Clavien Dindo classification of surgical complications. We used univariate and multivariate analyses with Fisher’s exact test and multiple logistic regression to determine potential risk factors.

Results
A total of 102 breast reconstructions were carried out in the inclusion period. The incidence rate of severe skin flap necrosis and surgical site infection was 6% and 4%, respectively. The total rate of skin flap necrosis was 14.7%, surgical site infection 11.8%, rotation of anatomical implants 4.90%, seroma 3.92%, dynamic breast deformity 1.96% and hematoma 1.96%. No patients suffered from red breast syndrome or capsular contracture. Total explantation rate was 4.90%. The median follow-up period was 32 months.

Conclusion
This study demonstrates an acceptable rate of explantation in ADM-assisted direct-to-implant breast reconstruction. We found that skin flap necrosis and surgical site infection were the most frequently occurring complications with low rates of severe cases. However, there is a need for larger, controlled studies to further explore the impact of patient and surgery related risk factors.

Level of evidence
Level III, Risk/Prognostic.
Adaptive responses of erythritol-producing Yarrowia lipolytica to thermal stress after evolution
Authors: Xia Kai , Chen Yuqing , Liu Fangmei , Zhao Xuequn , Sha Ruyi , Huang Jun 
Published: March 2024

Abstract
Elucidation of the thermotolerance mechanism of erythritol-producing Yarrowia lipolytica is of great significance to breed robust industrial strains and reduce cost. This study aimed to breed thermotolerant Y. lipolytica and investigate the mechanism underlying the thermotolerant phenotype. Yarrowia lipolytica HT34, Yarrowia lipolytica HT36, and Yarrowia lipolytica HT385 that were capable of growing at 34 °C, 36 °C, and 38.5 °C, respectively, were obtained within 150 days (352 generations) by adaptive laboratory evolution (ALE) integrated with 60Co-γ radiation and ultraviolet ray radiation. Comparative genomics analysis showed that genes involved in signal transduction, transcription, and translation regulation were mutated during adaptive evolution. Further, we demonstrated that thermal stress increased the expression of genes related to DNA replication and repair, ceramide and steroid synthesis, and the degradation of branched amino acid (BCAA) and free fatty acid (FFA), while inhibiting the expression of genes involved in glycolysis and the citrate cycle. Erythritol production in thermotolerant strains was remarkably inhibited, which might result from the differential expression of genes involved in erythritol metabolism. Exogenous addition of BCAA and soybean oil promoted the growth of HT385, highlighting the importance of BCAA and FFA in thermal stress response. Additionally, overexpression of 11 out of the 18 upregulated genes individually enabled Yarrowia lipolytica CA20 to grow at 34 °C, of which genes A000121, A003183, and A005690 had a better effect. Collectively, this study provides novel insights into the adaptation mechanism of Y. lipolytica to thermal stress, which will be conducive to the construction of thermotolerant erythritol-producing strains.

Key points
• ALE combined with mutagenesis is efficient for breeding thermotolerant Y. lipolytica
• Genes encoding global regulators are mutated during thermal adaptive evolution
• Ceramide and BCAA are critical molecules for cells to tolerate thermal stress
Feasibility and Safety of Superomedial Pedicle for Breast Reduction in Geriatric Patients
Authors: Ercan Alp 
Published: March 2024

Abstract
Introduction
Historically, inferior breast reduction is more commonly performed overall and this applies to the elder population. No study to this date has compared whether there is any difference in complications and overall safety between when using superomedial pedicle and inferior pedicle in geriatric patients and furthermore whether the safety profile of superomedial pedicle differs when compared to general population.

Methods
Patient files of women who had undergone breast reduction by a single surgeon over a 9 year period (2015–2023) was reviewed retrospectively. Patients over 65 years old at the time of surgery were selected as the main study group. Results were compared to a control group aged 65 years and younger consisting of 136 patients, who also had a breast reduction by the same surgeon.

Results
Fifty-four women met the inclusion criteria for the study group and they were further broken down into two subgroups; inferior and superomedial pedicle groups with 25 and 29 patients into each group, respectively. The mean age at the time of the operation was 67.8 years. Geriatric group had more significant comorbidities (37% vs. 9%, p<0.05). Looking solely on patients undergone superomedial pedicle breast reduction, OR times were similar between two age groups and hospital stay was slightly longer in the geriatric population albeit statistically insignificant. The average weight of specimens resected from each breast was 592.4 gr in geriatric population and slightly higher in the younger population with an average weight of 624 grams (p=0.27). Two women in the geriatric group and six women in the non-geriatric group developed major complications where superomedial pedicle was utilized, no meaningful difference was seen when major complications were compared (p=0.24). On the other hand, minor complications were significantly higher in the geriatric population compared to the younger cohort regarding superomedial pedicle reductions (p=0.02). ‘Satisfaction with breasts’ scores of BreastQ from the superomedial breast reduction subgroup was slightly higher than inferior pedicle breast reduction subgroup in geriatric population and it was statistically significant (0.032).

Conclusion
Safety margins and satisfaction scores of superomedial pedicled breast reduction in geriatric patients seem similar to their younger counterparts. Furthermore, with similar complication rates and with its slightly higher ‘Satisfaction with breasts’ scores when compared to inferior pedicle, superomedial pedicled breast reduction technique can be utilized without reservation in geriatric candidates for breast reduction.

Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Enhancing dielectric properties of ZnO nanopowders with 2D hBN doping: production, structural, morphological and dielectric characterization
Authors: Ozel Cihan , Macit Cevher Kursat , Gurgenc Turan , Biryan Fatih , Gurgenc Ezgi , Bellucci Stefano 
Published: March 2024

AbstractIn this study, it was aimed to improve the dielectric properties of ZnO nanoparticles with the addition of hBN, which was not previously available in the literature, and thus to expand their usage areas. Sol–gel synthesis method was used in this study to create pure and hexagonal boron nitride (hBN) doped zinc oxide (ZnO) nanoparticles. Zinc acetate dihydrate Zn(CH3COO)22H2O), sodium hydroxide NaOH, and hexagonal boron nitride (hBN), all from Sigma Aldrich, were used as starting reagents. The reagents were dissolved during the sol–gel synthesis by being heated to 90 °C for 4 h in a magnetic stirrer. FT-IR, XRD, FE-SEM, EDX characterization techniques, and impedance analyzer were used to find functional groups, structural, morphological, and chemical composition, and dielectric properties of the nanoparticles, respectively. The produced un-doped and hBN-doped ZnO particles consist of nano-sized structures. Changes occurred in the intensities and locations of the XRD diffraction peaks and FT-IR peaks with the addition of hBN. Characteristic peaks of both ZnO and hBN were observed in the diffraction peaks of the doped nanoparticles. All nanoparticles were of high purity and were successfully produced by the sol–gel method. It was shown that as the hBN doping level increased, there were more hBN nanoplates in the ZnO matrix, and the EDX results also showed an increase in hBN addition. The frequency stability of the dielectric properties improved after hBN doping. While the dielectric constant at 1 kHz frequency at room temperature is 12.07 in pure ZnO nanoparticles, the increase up to 55.21 is observed in 10% hBN doped nanocomposites. This situation is considered as a great potential for technological applications of this novel nanocomposite material.
The impact of the relationship between lesion diameter and total core length on the detection rate of clinically significant prostate cancer for PI-RADS 3 lesions
Authors: Yakut Emrah 
Published: March 2024

Abstract
Background
The aim of our study was to determine the effect of total core length (TCL) for prostate imaging reporting and data system (PI-RADS) 3 lesions to facilitate clinically significant prostate cancer (csPCa) detection based on the lesion diameter.

Materials and methods
A total of 149 patients with at least 1 lesion with a PI-RADS 3 were evaluated retrospectively. The lesions with diameters of < 1 cm were categorized as small lesions and lesions of ≥ 1 cm were categorized as large lesions. The lengths of biopsy cores from PI-RADS 3 lesions were summed for each lesion separately, and TCL was calculated. The relationship between TCL and csPCa was analyzed separately for the small and large groups with multiple logistic regression analyses.

Results
A total of 208 lesions were detected by multiparametric magnetic resonance imaging (MpMRI) in 149 males included in the study. The mean TCL was 44.68 mm (26–92) and the mean lesion diameter was 10.73 mm (4–27) in PIRADS 3 lesions. For small diameter lesions (< 1 cm), the odds of finding clinically insignificant prostate cancer (ciPCa) increase by 1.67 times if TCL increases by one unit. Hence, increasing TCL for small lesions only increases the odds of ciPCa detection. For large diameter lesions (≥ 1 cm), if TCL increases by one unit, the odds of finding ciPCa increase 1.13 times and the odds of finding csPCa increases1.16 times. Accordingly, large lesions are more likely to have both csPCa and ciPCa as TCL increases.

Conclusions
Our study showed that for PI-RADS 3 lesions, both more csPCa and more ciPCa were detected as TCL increased. However, in lesions with a size of < 1 cm, only ciPCa was detected more frequently as TCL increased. In conclusion, taking more and longer biopsy cores in PI-RADS 3 lesions below 1 cm does not contribute to the detection of csPCa.
Retrospective analysis of the perioperative outcome in living donor kidney transplantation with multiple renal arteries: does accessory vessel ligation affect the outcome?
Authors: Schmidt Jacob , Peters Robert , Mang Josef , Ralla Bernhard , Moldovan Diana Elena , Dagnæs-Hansen Julia , Liefeldt Lutz , Budde Klemens , Lerchbaumer Markus , Friedersdorff Frank 
Published: March 2024

Abstract
Purpose
Accurate surgical reconstruction of arterial vascular supply is a crucial part of living kidney transplantation (LDKT). The presence of multiple renal arteries (MRA) in grafts can be challenging. In the present study, we investigated the impact of ligation versus anastomosis of small accessory graft arteries on the perioperative outcome.

Methods
Clinical and radiological outcomes of 51 patients with MRA out of a total of 308 patients who underwent LDKT with MRA between 2011 and 2020 were stratified in two groups and analyzed. In group 1 (20 patients), ligation of accessory arteries (ARAs) and group 2 (31 patients) anastomosis of ARAs was performed.

Results
Significant differences were observed in the anastomosis-, surgery-, and warm ischemia time (WIT) in favor of group 1. Students t-test showed comparable serum creatinine levels of 2.33 (± 1.75) to 1.68 (± 0.83) mg/dL in group 1 and 2.63 (± 2.47) to 1.50 (± 0.41) mg/dL in group 2, were seen from 1 week to 1 year after transplant. No increased rates of Delayed graft function (DGF), primary transplant dysfunction and transplant rejection were seen, but graft loss and revision rates were slightly higher when the ARAs were ligated. Analysis of Doppler sonography revealed that segmental perfusion deficits tend to regenerate during the clinical course.

Conclusion
Ligation of smaller accessory renal arteries may not affect the outcome of living kidney transplantation, except for a minor increase in the reoperation rate. Segmental perfusion deficits of the graft seem to regenerate in most cases as seen in Doppler sonography.
The impact of perioperative risk factors on long-term survival after radical cystectomy: a prospective, high-volume cohort study
Authors: Pyrgidis Nikolaos , Schulz Gerald B. , Volz Yannic , Ebner Benedikt , Rodler Severin , Westhofen Thilo , Eismann Lennert , Marcon Julian , Stief Christian G. , Jokisch Friedrich 
Published: March 2024

Abstract
Introduction
Radical cystectomy (RC) is the gold standard for muscle-invasive bladder cancer. Nevertheless, RC is associated with substantial perioperative morbidity and mortality. We aimed to evaluate the role of important perioperative risk factors in predicting long-term survival after RC.

Methods
An analysis of the prospective cohort of patients undergoing open RC from 2004 to 2023 at our center was performed. Patients who died within one month after RC were excluded from the study. A univariate and multivariable Cox regression analysis was performed to assess the role of sex, age, urinary diversion, preoperative values of creatinine and hemoglobin, first-day postoperative values of CRP, leucocytes, and thrombocytes, perioperative Clavien-Dindo complications, perioperative chemotherapy, admission to the intensive or intermediate care unit, as well as type of histology, pathologic T-stage, positive lymph nodes, and positive surgical margins on predicting the long-term overall survival after RC. For all analyses hazard ratios (HRs) with the corresponding 95% confidence intervals (CIs) were estimated.

Results
A total of 1,750 patients with a median age of 70 years (IQR: 62–76) were included. Of them, 1,069 (61%) received ileal conduit and 650 (37%) neobladder. Overall, 1,016 (58%) perioperative complications occurred. At a median follow-up of 31 months (IQR: 12–71), 884 (51%) deaths were recorded. In the multivariable Cox regression analysis, increasing age (HR: 1.03, 95%CI: 1.02–1.04, p < 0.001), higher preoperative creatinine values (HR: 1.27, 95%CI: 1.12–1.44, p < 0.001), lower preoperative hemoglobin values (HR: 0.93, 95%CI: 0.89–0.97, p = 0.002), higher postoperative thrombocyte values (HR: 1.01, 95%CI: 1.01–1.02, p = 0.02), Clavien-Dindo 1–2 complications (HR: 1.26, 95%CI: 1.03–1.53, p = 0.02), Clavien-Dindo 3–4 complications (HR: 1.55, 95%CI: 1.22–1.96, p < 0.001), locally advanced bladder cancer (HR: 1.29, 95%CI: 1.06–1.55, p = 0.009), positive lymph nodes (HR: 1.74, 95%CI: 1.45–2.11, p < 0.001), and positive surgical margins (HR: 1.61, 95%CI: 1.29–2.01, p < 0.001) negatively affected long-term survival.

Conclusion
Beside increased age and worse oncological status, impaired renal function, lower preoperative hemoglobin values, higher postoperative thrombocyte values, and perioperative complications are independent risk factors for mortality in the long term in patients undergoing open RC.
Machine learning mesh-adaptation for laminar and turbulent flows: applications to high-order discontinuous Galerkin solvers
Authors: Tlales Kenza , Otmani Kheir-Eddine , Ntoukas Gerasimos , Rubio Gonzalo , Ferrer Esteban 
Published: March 2024

AbstractWe present a machine learning-based mesh refinement technique for steady and unsteady incompressible flows. The clustering technique proposed by Otmani et al. (Phys Fluids 35(2):027112, 2023) is used to mark the viscous and turbulent regions for the flow past a cylinder at $$Re=40$$

R
e
=
40

(steady laminar flow), at $$Re=100$$

R
e
=
100

(unsteady laminar flow), and at $$Re=3900$$

R
e
=
3900

(unsteady turbulent flow). Within this clustered region, we use high mesh resolution, while downgrading the resolution outside, to show that it is possible to obtain levels of accuracy similar to those obtained when using a uniformly refined mesh. The mesh adaptation is effective, as the clustering successfully identifies the two flow regions, a viscous/turbulent dominated region (including the boundary layer and wake) that requires high resolution and an inviscid/irrotational region, which only requires low resolution. The new clustering sensor is compared with traditional feature-based sensors (Q-criterion and vorticity based) commonly used for mesh adaptation. Unlike traditional sensors that rely on problem-dependent thresholds, our novel approach eliminates the need for such thresholds and locates the regions that require adaptation. After the initial validation using flows past cylinders, the clustering technique is applied in an engineering context to study the flow around a horizontal axis wind turbine configuration which has been tested experimentally at the Norwegian University of Science and Technology. The data used within this framework are generated using a high-order discontinuous Galerkin solver, allowing to locally refine the polynomial order (p-refinement) in each element of the clustered region. For the laminar test cases, we can reduce the computational cost by 32% (steady $$Re=40$$

R
e
=
40

case) and 20% (unsteady $$Re=100$$

R
e
=
100

case), while we get a reduction of 33% for the $$Re=3900$$

R
e
=
3900

turbulent case. In the context of the wind turbine, a reduction of 43% in computational cost is observed, while maintaining the accuracy.
High soil moisture rather than drying-rewetting cycles reduces the effectiveness of nitrification inhibitors in mitigating N2O emissions
Authors: Ribeiro Pablo Lacerda , Singh Abhijeet , Sagervanshi Amit , Naeem Asif , Mühling Karl Hermann 
Published: March 2024

AbstractClimate change has been intensifying soil drying and rewetting cycles, which can alter the soil microbiome structure and activity. Here we hypothesized that a soil drying-rewetting cycle enhances biodegradation and, hence, decreases the effectiveness of nitrification inhibitors (NIs). The effectiveness of DMPP (3,4-Dimethylpyrazole phosphate) and MP + TZ (3-Methylpyrazol and Triazol) was evaluated in 60-day incubation studies under a drying and rewetting cycle relative to constant low and high soil moisture conditions (40% and 80% water-holding capacity, WHC, respectively) in two different textured soils. The measurements included (i) daily and cumulative N2O-N emissions, (ii) soil NH4+-N and NO3−-N concentrations, and (iii) the composition of bacterial soil communities. Application of DMPP and MP + TZ reduced the overall N2O-N emissions under drying-rewetting (-45%), as well as under 40% WHC (-39%) and 80% WHC (-25%). DMPP retarded nitrification and decreased N2O-N release from the sandy and silt loam soils, while MP + TZ mitigated N2O-N production only from the silt loam soil. Unexpectedly, between days 30 and 60, N2O-N emissions from NI-treated soils increased by up to fivefold relative to the No-NI treatment in the silt loam soil at 80% WHC. Likewise, the relative abundance of the studied nitrifying bacteria indicated that the NIs had only short-term effectiveness in the silt loam soil. These results suggested that DMPP and MP + TZ might trigger high N2O-N release from fine-textured soil with constant high moisture after this short-term inhibitory effect. In conclusion, DMPP and MP + TZ effectively reduce N2O-N emissions under soil drying and rewetting.
Characterizing the immune response to myocardial infarction in pigs
Authors: Schnitter Florian , Stangl Franziska , Noeske Elisabeth , Bille Maya , Stadtmüller Anja , Vogt Niklas , Sicklinger Florian , Leuschner Florian , Frey Anna , Schreiber Laura , Frantz Stefan , Beyersdorf Niklas , Ramos Gustavo , Gladow Nadine , Hofmann Ulrich 
Published: March 2024

AbstractThough myocardial infarction (MI) in pigs is a well-established translational large animal model, it has not yet been widely used for immunotherapy studies, and a comprehensive description of the immune response to MI in this species is lacking. We induced MI in Landrace pigs by balloon occlusion of the left anterior descending artery over 90 min. Within 14 days, the necrotic myocardium was progressively replaced by scar tissue with involvement of myofibroblasts. We characterized the immune response in the heart ex vivo by (immuno)histology, flow cytometry, and RNA sequencing of myocardial tissue on days 3, 7, and 14 after MI. Besides a clear predominance of myeloid cells among heart-infiltrating leukocytes, we detected activated T cells and an increasing proportion of CD4+ Foxp3+ regulatory T cells (Treg), especially in the infarct core—findings that closely mirror what has been observed in mice and humans after MI. Transcriptome data indicated inflammatory activity that was persistent but markedly changing in character over time and linked to extracellular matrix biology. Analysis of lymphocytes in heart-draining lymph nodes revealed significantly higher proliferation rates of T helper cell subsets, including Treg on day 7 after MI, compared to sham controls. Elevated frequencies of myeloid progenitors in the spleen suggest that it might be a site of emergency myelopoiesis after MI in pigs, as previously shown in mice. We thus provide a first description of the immune response to MI in pigs, and our results can aid future research using the species for preclinical immunotherapy studies.