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Purpose: Top surgery, or masculinization of the chest, is often the first and sometimes only procedure in gender-affirming surgery for transgender- and gender-diverse persons assigned female at bir...

A milk fistula is a rare condition, and only 27 cases have been reported in the latest systematic review from 2020. A fistula can be iatrogenic or spontaneous. The content of tissue factors in breast milk promotes granulation in wounds, which can lead to hypergranulation and lack of epithelialization. In this case report, a 29-year-old breastfeeding woman developed a milk fistula after surgical removal of a naevus on suspicion of being a melanoma. Hypergranulation of the wound was successfully treated with corticosteroid, which inhibits growth factor in breastmilk, and breastfeeding was continued during treatment.

Thermal burns are by far the most frequent and account for approx. 90% of all burns, while frostbites, chemical and electrical burns (CB) cover the remaining approx. 10%. This review gives an overview of the treatment of corrosions and frostbites. CB and frostbites are relatively rare and prompt initiation of proper treatment is essential for both. CB should be diluted as soon as possible, preferably with a neutralizing solution. Treatment of systemic hypothermia comes before management of peripheral frostbite. Frostbites involve thawing in warm water, followed by vasodilation, thrombolysis and amputation if indicated.

Purpose: In recent years, there has been a significant increase in referrals for gender-affirming surgery to departments of plastic surgery in Denmark. There is currently no literature on postsurgical pain in trans men after mastectomy. We aimed at investigating the prevalence and severity of postsurgical persistent pain, sensory disturbances, and complications in trans men after mastectomy. Methods: The 90 trans men who underwent bilateral mastectomy between September 1, 2013 and August 31, 2018 were included. Patients' files were evaluated for complications, and 84 (response rate 93.3%) patients answered a questionnaire (validated for women undergoing oncologic mastectomy) regarding persistent pain and sensory disturbances. Results: Twenty-three patients (27.4%) reported either unilateral or bilateral persistent pain after mastectomy. Of these, 14 (60.9%) patients categorized the pain as mild. However, 77 (95.2%) of the patients did not use analgesics and nonopioid pain medication was sufficient for the remainder. Sensory disturbances were found in 44 (47.5%) of the patients, and 4 (4.8%) patients reported clear signs of neuropathic pain. Seven (7.8%) patients developed hematomas, and areola necrosis was seen in four (4.4%) patients. Due to infection, seven (7.8%) patients received antibiotics. Conclusion: Mastectomy as a part of gender-affirming surgery is a safe procedure with a few, nonsevere, complications. Although a quarter of the patients experienced persistent pain, the majority of that pain is mild, intermittent and can be treated with nonopioid pain medication.

Silicone implants have been used for breast augmentations, both cosmetically and in reconstructive surgery since the 1960s. Rupture of breast implants and silicone migration is a well-known complication. In this case report and literature review, we present a case of a 53-year-old woman with bilateral cosmetic silicone gel breast implant in 1986, and a replacement with saline gel in 2005. The patient had no breast complaints and observed no change in breast volume during this period. In 2020, silicone was randomly identified in a right-sided cervical lymph node in an attempt to remove suspicious lymphadenopathy. The source of the silicone is still doubted; that is, it is not known if the silicone originated from the saline implant or the silicone gel implant. In our literature review, we find that distant migration of silicone and lymphadenopathy have occurred for silicone breast implants although very rare for saline gel breast implants., Highlights • A case of cervical lymphadenopathy caused by silicone breast migration is described. • The patient had primarily long-standing silicone gel breast implant and has saline breast implant afterwards. • The origin of the silicone conglomerate in the cervical lymph node remains unknown.

TDP-43 aggregates are a salient feature of amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), and a variety of other neurodegenerative diseases, including Alzheimer's disease (AD). With an anticipated growth in the most susceptible demographic, projections predict neurodegenerative diseases will potentially affect 15 million people in the United States by 2050. Currently, there are no cures for ALS, FTD, or AD. Previous studies of the amyloidogenic core of TDP-43 have demonstrated that oligomers greater than a trimer are associated with toxicity. Utilizing a joint pharmacophore space (JPS) method, potential drugs have been designed specifically for amyloid-related diseases. These molecules were generated on the basis of key chemical features necessary for blood-brain barrier permeability, low adverse side effects, and target selectivity. Combining ion-mobility mass spectrometry and atomic force microscopy with the JPS computational method allows us to more efficiently evaluate a potential drug's efficacy in disrupting the development of putative toxic species. Our results demonstrate the dissociation of higher-order oligomers in the presence of these novel JPS-generated inhibitors into smaller oligomer species. Additionally, drugs approved by the Food and Drug Administration for the treatment of ALS were also evaluated and demonstrated to maintain higher-order oligomeric assemblies. Possible mechanisms for the observed action of the JPS molecules are discussed.

Accelerating the design and development of new advanced materials is one of the priorities in modern materials science. These efforts are critically dependent on the development of comprehensive materials cyberinfrastructures which enable efficient data storage, management, sharing, and collaboration as well as integration of computational tools that help establish processing–structure–property relationships. In this contribution, we present implementation of such computational tools into a cloud-based platform called BisQue (Kvilekval et al., Bioinformatics 26(4):554, 2010). We first describe the current state of BisQue as an open-source platform for multidisciplinary research in the cloud and its potential for 3D materials science. We then demonstrate how new computational tools, primarily aimed at processing–structure–property relationships, can be implemented into the system. Specifically, in this work, we develop a module for BisQue that enables microstructure-sensitive predictions of effective yield strength of two-phase materials. Towards this end, we present an implementation of a computationally efficient data-driven model into the BisQue platform. The new module is made available online (web address: https://bisque.ece.ucsb.edu/module_service/Composite_Strength/) and can be used from a web browser without any special software and with minimal computational requirements on the user end. The capabilities of the module for rapid property screening are demonstrated in case studies with two different methodologies based on datasets containing 3D microstructure information from (i) synthetic generation and (ii) sampling large 3D volumes obtained in experiments.

A microstructure analytics and 3D reconstruction software package, DREAM.3D, was integrated as a module into a cloud-based platform, BisQue. Parallelization of DREAM.3D module executions and the ability to parameterize pipeline variables over a range of values have led to insights about the grain segmentation misorientation tolerance in TriBeam-collected 3D EBSD datasets of additively manufactured materials with complex anisotropic microstructures. Furthermore, a comparison in grain size measurements was made between standard 2D metallographic slices and 3D measures using BisQue’s parallelized DREAM.3D module executions. The direction of cloud-based data infrastructure and the prospects for impact in material science are also discussed.

We study spatial isovector J = 1 meson correlators in nf = 2 QCD with dynamical domain-wall fermions on 323 × 8 lattices at temperatures T = 220–380 MeV. We observe an approximate degeneracy of all considered correlators with increasing temperature. This approximate degeneracy suggests emergent SU(2)CS and SU(2nf) symmetries at high temperatures, that mix left- and right-handed quarks. Since these symmetries are symmetries of the chromo-electric interaction in QCD we conclude that at 2Tc temperature the elementary objects are quarks with a definite chirality connected by the chromo-electric field.

Lentigo maligna melanoma (LMM) is the most common subtype of melanoma in the face. In this case report, a 95-year-old woman had a patch of dark hair growing out of her white hair on her scalp. A punch biopsi confirmed the diagnosis of LMM. The unusual in this case is the finding of melanocytic hair growth with no obliteration of follicles in the affected area. As described, obliteration of follicles is usually seen in histology when lentigo maligna progresses. To our knowledge, no similar cases have been described in literature.

Above the pseudocritical temperature T_c of chiral symmetry restoration a chiral spin symmetry (a symmetry of the color charge and of electric confinement) emerges in QCD. This implies that QCD is in a confining mode and there are no free quarks. At the same time correlators of operators constrained by a conserved current behave as if quarks were free. This explains observed fluctuations of conserved charges and the absence of the rho-like structures seen via dileptons. An independent evidence that one is in a confining mode is very welcome. Here we suggest a new tool how to distinguish free quarks from a confining mode. If we put the system into a finite box, then if the quarks are free one necessarily obtains a remarkable diffractive pattern in the propagator of a conserved current. This pattern is clearly seen in a lattice calculation in a finite box and it vanishes in the infinite volume limit as well as in the continuum. In contrast, the full QCD calculations in a finite box show the absence of the diffractive pattern implying that the quarks are confined., Comment: 6 pages, 5 figures. A new figure has been added and discussion that clarifies the main point of the paper has been expanded. Accepted by EPJA

TDP-43 aggregates are a salient feature of amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), and a variety of other neurodegenerative diseases, including Alzheimer's disease (AD). With an anticipated growth in the most susceptible demographic, projections predict neurodegenerative diseases will potentially affect 15 million people in the United States by 2050. Currently, there are no cures for ALS, FTD, or AD. Previous studies of the amyloidogenic core of TDP-43 have demonstrated that oligomers greater than a trimer are associated with toxicity. Utilizing a joint pharmacophore space (JPS) method, potential drugs have been designed specifically for amyloid-related diseases. These molecules were generated on the basis of key chemical features necessary for blood-brain barrier permeability, low adverse side effects, and target selectivity. Combining ion-mobility mass spectrometry and atomic force microscopy with the JPS computational method allows us to more efficiently evaluate a potential drug's efficacy in disrupting the development of putative toxic species. Our results demonstrate the dissociation of higher-order oligomers in the presence of these novel JPS-generated inhibitors into smaller oligomer species. Additionally, drugs approved by the Food and Drug Administration for the treatment of ALS were also evaluated and demonstrated to maintain higher-order oligomeric assemblies. Possible mechanisms for the observed action of the JPS molecules are discussed.

Based on a complete set of $J = 0$ and $J=1$ spatial isovector correlation functions calculated with $N_F = 2$ domain wall fermions we identify an intermediate temperature regime of $T \sim 220 - 500$ MeV ($1.2T_c$--$2.8T_c$), where chiral symmetry is restored but the correlators are not yet compatible with a simple free quark behavior. More specifically, in the temperature range $T \sim 220 - 500$ MeV we identify a multiplet structure of spatial correlators that suggests emergent $SU(2)_{CS}$ and $SU(4)$ symmetries, which are not symmetries of the free Dirac action. The symmetry breaking effects in this temperature range are less than 5%. Our results indicate that at these temperatures the chromo-magnetic interaction is suppressed and the elementary degrees of freedom are chirally symmetric quarks bound into color-singlet objects by the chromo-electric component of the gluon field. At temperatures between 500 and 660 MeV the emergent $SU(2)_{CS}$ and $SU(4)$ symmetries disappear and one observes a smooth transition to the regime above $T \sim 1$ GeV where only chiral symmetries survive, which are finally compatible with quasi-free quarks., A new figure and discussion added. Accepted for publication in PRD

This case report is about a 75-year-old man, who developed a subungual squamous cell carcinoma (SCC) after having a wooden splint sitting under his fingernail for 20 years. There were no signs of infection, inflammation or tumour. The splint was removed, and histology indicated SCC. The patient underwent amputation, and histological analysis confirmed SCC without bone involvement. Subungual SCC is often misdiagnosed with delayed treatment as a consequence, and it gives a wide variety of symptoms. Treatment includes Mohs surgery and marginal excision. If SCC is diagnosed early, extensive surgery can be avoided.

We report on the EMMI Rapid Reaction Task Force meeting 'Resonances in QCD', which took place at GSI October 12-14, 2015. A group of 26 people met to discuss the physics of resonances in QCD. The aim of the meeting was defined by the following three key questions: What is needed to understand the physics of resonances in QCD? Where does QCD lead us to expect resonances with exotic quantum numbers? What experimental efforts are required to arrive at a coherent picture? For light mesons and baryons only those with ${\it up}$, ${\it down}$ and ${\it strange}$ quark content were considered. For heavy-light and heavy-heavy meson systems, those with ${\it charm}$ quarks were the focus. This document summarizes the discussions by the participants, which in turn led to the coherent conclusions we present here., Comment: 20 pages, 1 figure, report on the EMMI Rapid Reaction Task Force meeting '{\it Resonances in QCD}', which took place at GSI October 12-14, 2015

Truncating the low-lying modes of the lattice Dirac operator results in an emergence of the chiral-spin symmetry $SU(2)_{CS}$ and its flavor extension $SU(2N_F)$ in hadrons. These are symmetries of the quark - chromo-electric interaction and include chiral symmetries as subgroups. Hence the quark - chromo-magnetic interaction, which breaks both symmetries, is located at least predominantly in the near - zero modes. Using as a tool the expansion of propagators into eigenmodes of the Dirac operator we here analytically study effects of a gap in the eigenmode spectrum on baryon correlators. We find that both $U(1)_A$ and $SU(2)_L \times SU(2)_R$ emerge automatically if there is a gap around zero. Emergence of larger $SU(2)_{CS}$ and $SU(4)$ symmetries requires in addition a microscopical dynamical input about the higher-lying modes and their symmetry structure., Comment: Accepted by PRD

Properties of QCD matter change significantly around the chiral crossover temperature, and the effects on $U(1)_A$ and topological susceptibilities, as well as the meson spectrum have been studied with much care. Baryons and the effect of parity doubling in this temperature range have been analyzed previously by various other groups employing different setups. Here we construct suitable operators to investigate chiral and axial $U(1)_A$ symmetries in the baryon spectrum. Measurements for different volumes and quark-masses are done with two flavors of chirally symmetric domain-wall fermions at temperatures above the critical one. The possibility of emergent $SU(4)$ and $SU(2)_{CS}$ symmetries is discussed., Comment: 7 pages, 4 figures, talk presented at the 37th International Symposium on Lattice Field Theory (Lattice 2019), 16-22 June 2019, Wuhan, China. Updated numerical data in Fig. 1 and Fig. 2

Alzheimer's disease (AD) is rapidly reaching epidemic status among a burgeoning aging population. Much evidence suggests the toxicity of this amyloid disease is most influenced by the formation of soluble oligomeric forms of amyloid β-protein, particularly the 42-residue alloform (Aβ42). Developing potential therapeutics in a directed, streamlined approach to treating this disease is necessary. Here we utilize the joint pharmacophore space (JPS) model to design a new molecule [AC0107] incorporating structural characteristics of known Aβ inhibitors, blood-brain barrier permeability, and limited toxicity. To test the molecule's efficacy experimentally, we employed ion mobility mass spectrometry (IM-MS) to discover [AC0107] inhibits the formation of the toxic Aβ42 dodecamer at both high (1:10) and equimolar concentrations of inhibitor. Atomic force microscopy (AFM) experiments reveal that [AC0107] prevents further aggregation of Aβ42, destabilizes preformed fibrils, and reverses Aβ42 aggregation. This trend continues for long-term interaction times of 2days until only small aggregates remain with virtually no fibrils or higher order oligomers surviving. Pairing JPS with IM-MS and AFM presents a powerful and effective first step for AD drug development. Graphical Abstract.

In situations where the low lying eigenmodes of the Dirac operator are suppressed one observed degeneracies of some meson masses. Based on these results a hidden symmetry was conjectured, which is not a symmetry of the Lagrangian but emerges in the quantization process. We show here how the difference between classes of meson propagators is governed by the low modes and shrinks when they disappear., 9 pages, 3 figures; final version, accepted at Phys.Rev.D

We present a lattice QCD study of the puzzling positive-parity nucleon channel, where the Roper resonance $N^*(1440)$ resides in experiment. The study is based on an ensemble of gauge configurations with $N_f=2+1$ Wilson-clover fermions with a pion mass of $156$ MeV and lattice size $L=2.9$ fm. We use several $qqq$ interpolating fields combined with $N\pi$ and $N\sigma$ two-hadron operators in calculating the energy spectrum in the rest frame. Combining experimental $N\pi$ phase shifts with elastic approximation and the L\"uscher formalism suggests in the spectrum an additional energy level near the Roper mass $m_R=1.43$ GeV for our lattice. We do not observe any such additional energy level, which implies that $N\pi$ elastic scattering alone does not render a low-lying Roper resonance. The current status indicates that the $N^*(1440)$ might arise as dynamically generated resonance from coupling to other channels, most notably the $N\pi\pi$., Comment: updated references