bluuebunny/crossref_metadata_2025 huggingface dataset:
Electronic Nicotine Delivery Devices Function as a Complement for Cigarillos in Sexual and Gender Minority Young Adult Women
Authors: Quisenberry Amanda J , Osborn Catherine C , Moore Stephanie Pike , Schneller Liane , John Lovina , Klein Elizabeth G , Trapl Erika
Published: August 2024

Introduction

Cigarillos are the second most used tobacco product among younger populations. The highest prevalence of the use of cigars is among sexual and gender minority (SGM) women. Policy interventions like flavor bans and the availability of alternative tobacco products may have a disparate effect.

Aims and Methods

The current study utilized an online store analog, The experimental tobacco marketplace, to investigate the effects of cigarillo and electronic nicotine delivery devices (ENDS) flavor bans on tobacco product purchasing. SGM (n = 72) and cisgender heterosexual (CisHet; n = 46) women viewed conditions in which cigarillo flavors were available or unavailable and ENDS flavors available or unavailable and the interaction between the two. Mixed models were conducted on each dependent variable with condition, price, and SGM identity as predictors and nicotine dependence, annual income, and race/ethnicity as covariates. Simple linear regressions were performed to determine the substitution profile for each tobacco product. Condition showed no effect.

Results

We found a main effect of price on cigarillo purchasing and a main effect of SGM identity in which SGM women purchased more ENDS than CisHet women. A complementary association between cigarillos and ENDS in which ENDS purchasing decreased as cigarillo purchasing decreased was found. This association was irrespective of flavor ban conditions and among SGM women only.

Conclusions

These results suggest that flavor availability of cigarillos and ENDS may not influence women who use cigarillos to move to another tobacco product and that women SGM cigarillo users are not likely to substitute their cigarillo smoking behavior with ENDS.

Implications

The results of this study suggest that SGM women are not likely to quit using cigarillos if flavors are removed from the market and instead will use unflavored products. Substituting their cigarillo use with ENDS does not appear likely given the complementary relation found between cigarillos and ENDS. The substitution patterns found for cigarettes and ENDS are not found for cigarillos and ENDS among young adult women who use cigarillos, further demonstrating the need for research on the conditions in which people who use cigarillos will decrease consumption or switch to a potentially less harmful product.
How do banks respond to limits on maturity transformation?
Authors: Bologna Pierluigi , Galardo Maddalena
Published: August 2024

We study the response of banks to the removal of a limit on maturity transformation, similar to the Net Stable Funding Ratio. We formalize the testable hypotheses using a simple banking model where the profitability function depends on the level of maturity transformation and the risk profile. We show that after the regulatory change, banks rebalanced the composition of their assets and liabilities. They increased their exposure to interest rate risk, while we find no effect on credit risk. Our evidence supports the common theoretical view that banks have an incentive to engage in maturity transformation and that this implies higher interest rate risk exposure. We also show that bank profitability is not affected. However, banks take advantage of the greater flexibility provided by deregulation to engage in some cross-selling associated with the increased supply of mortgages, which is consistent with the theory emphasizing the importance of increasing market power.
Australian adaptation and external validation of Commissioning for Quality in Rheumatoid Arthritis-RA-Patient Reported Experience Measure (CQRA-RA-PREM)
Authors: Bryant Madeleine J , Black Rachel J , Lester Susan , Chand Vibhasha , Barrett Claire , Buchbinder Rachelle , Lassere Marissa , March Lyn , Hill Catherine L
Published: August 2024

Objectives

To evaluate the reliability and validity of an adapted Commissioning for Quality in Rheumatoid Arthritis-RA-Patient-Reported Experience Measure (CQRA-RA-PREM) for assessing care experience in an Australian rheumatology outpatient cohort.

Methods

Individual patient interviews were performed to check the language and completion time of the CQRA-RA-PREM before modification. Australian Rheumatology Association Database (ARAD) participants completed the CQRA-PREM-Australian version (CQRA-PREM-AU) (22 items, 5 domains), disease activity measure (RAPID-3, BASDAI) and Assessment of Quality of Life (AQOL-6D) index. Exploratory factor analysis (EFA) assessed item correlation. Cronbach’s α assessed internal consistency.

Results

Individual patient interviews (n = 8, 62% male, mean age 50 years, mean disease duration 4.5 years) informed CQRA-RA-PREM modification. The ARAD survey response rate was 707/1124 (63%); 459 (65%) RA, 134 (19%) PsA, 114 (16%) AS; 67% female, mean age 62 years, mean disease duration 22 years. The median instrument completion time was 299 s (interquartile range 284–414). Scoring of responses allowed an averaged overall score. EFA extracted five factors: all items loading similarly onto factor 1, indicating validity of the overall score. The CQRA-PREM-AU score correlated with the AQOL-6D score (ρ = 0.23, P < 0.01); partial correlation with disease activity was not significant (ρ = 0.03, P = 0.45), indicating divergent validity. Reliability was comparable across disease subgroups (Cronbach’s α >0.94). The mean overall score did not differ by disease subgroup [4.1 (s.d. 0.6, P = 0.73) and there was no floor/ceiling effect.

Conclusion

CQRA-PREM-AU is a valid and reliable instrument to measure self-reported care experience in Australian rheumatology patients and may be interpreted as an average overall numerical score.
Clinical Validation of Human Papilloma Virus Circulating Tumor DNA for Early Detection of Residual Disease After Chemoradiation in Cervical Cancer
Authors: Han Kathy , Zou Jinfeng , Zhao Zhen , Baskurt Zeynep , Zheng Yangqiao , Barnes Elizabeth , Croke Jennifer , Ferguson Sarah E. , Fyles Anthony , Gien Lilian , Gladwish Adam , Lecavalier-Barsoum Magali , Lheureux Stephanie , Lukovic Jelena , Mackay Helen , Marchand Eve-Lyne , Metser Ur , Milosevic Michael , Taggar Amandeep S. , Bratman Scott V. , Leung Eric
Published: August 2024

(Abstracted from J Clin Oncol 2023;42:431–440

The majority of cervical cancers are caused by human papillomavirus (HPV), and despite treatment with chemoradiation (CRT), up to 40% of patients with locally advanced cervical cancer will relapse. Current prognostic factors are poor predictors of relapse; however, detection of HPV circulating tumor DNA (ctDNA) after CRT may identify those at higher risk of relapse.
Opioid alternatives in spine surgeries
Authors: Rajan Shobana , Rishi Gaiha , Ibrahim Marco
Published: August 2024

Purpose of review

The escalating opioid crisis has intensified the need to explore alternative pain management strategies for patients undergoing spine surgery. This review is timely and relevant as it synthesizes recent research on opioid alternatives for perioperative management, assessing their efficacy, side effects, and postoperative outcomes.

Recent findings

A systematic search was conducted to capture articles from the past 18 months that examined opioid-sparing strategies. Findings indicate that multimodal analgesia, incorporating nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, lidocaine, gabapentinoids, N-methyl-D-aspartate (NMDA) antagonists, dexmedetomidine, and emerging regional block techniques like the erector spinae block and TLIF (thoraco lumbar interfascial block), can significantly reduce opioid consumption without compromising pain relief. Additionally, these approaches reduce opioid-related side effects such as postoperative nausea, vomiting, and prolonged hospital stays.

The use of multimodal analgesia aligns with current pain management guidelines and addresses public health concerns related to opioid misuse. While effective, these alternatives are not without side effects, and the ultimate outcome depends on balancing benefits and risks. Future research should focus on the long-term outcomes of opioid alternatives, their effectiveness across diverse populations, and further validation and optimization of these strategies.
Disulfiram Should Remain Second-line Treatment for Most Patients With Alcohol Use Disorder
Authors: Axelrath Sarah
Published: August 2024

Alcohol use disorder (AUD) is responsible for a significant burden of medical, economic, and social harm globally and across the United States. Currently, only three FDA-approved medications for AUD are available, and most patients with AUD never receive pharmacotherapy. Disulfiram, the first medication that FDA approved for treatment of AUD, is recommended as a second-line treatment option by several national treatment guidelines citing safety concerns and lack of high-quality comparative studies. In this issue, Holt argues that disulfiram should be reclassified as a first-line treatment for AUD based on promising open-label randomized controlled trials (RCTs) for disulfiram as a behavioral intervention. Review of the literature suggests that disulfiram can be a useful treatment for a highly selected group of patients with no medical or psychiatric contraindications, high motivation for abstinence, and adequate family support. Unfortunately, many patients with AUD, a disorder characterized by high rates of medical and psychiatric multimorbidity and social vulnerability, fall outside of this narrow selection criteria. Prescribers should consider other FDA-approved medications as first-line treatment options for most patients with AUD, reserving disulfiram for the rare patients in whom the potential for benefit clearly outweighs risk of harm.
Rising Stillbirth Rates Related to Congenital Syphilis in the United States From 2016 to 2022
Authors: Machefsky Aliza , Hufstetler Kaitlin , Bachmann Laura , Barbee Lindley , Miele Kathryn , O'Callaghan Kevin
Published: August 2024

OBJECTIVE:

To identify trends in stillbirth rates attributed to congenital syphilis in the United States by describing congenital syphilis–related stillbirths and comparing characteristics of pregnant people who had congenital syphilis–related stillbirths with those of people who had preterm and full-term liveborn neonates with congenital syphilis.

METHODS:

Cases of congenital syphilis reported to the Centers for Disease Control and Prevention during 2016–2022 were analyzed and categorized as stillbirth, preterm live birth (before 37 weeks of gestation), or term live birth (37 weeks or later). Cases with unknown vital status or gestational age were excluded. Frequencies were calculated by pregnancy outcome, including pregnant person demographics; receipt of prenatal care; syphilis stage and titer; and timing of prenatal care, testing, and treatment.

RESULTS:

Overall, 13,393 congenital syphilis cases with vital status and gestational age were reported; of these, 853 (6.4%) were stillbirths. The number of congenital syphilis–related stillbirths increased each year (from 44 to 231); the proportion of congenital syphilis cases resulting in stillbirth ranged from 5.2% to 7.5%. Median gestational age at delivery for stillborn fetuses was 30 weeks (interquartile range 26–33 weeks). People with congenital syphilis–related stillbirths were more likely to have titers at or above 1:32 (78.9% vs 45.5%; P<.001) and to have received no prenatal care (58.4% vs 33.1%; P<.001) than people with liveborn neonates with congenital syphilis. The risk of stillbirth was twice as high in persons with secondary syphilis compared with those with primary syphilis (11.5% vs 5.7%, risk ratio 2.00; 95% CI, 1.27–3.13). Across all congenital syphilis cases, 34.2% of people did not have a syphilis test at their first prenatal visit.

CONCLUSION:

Stillbirths occurred in more than 1 in 20 pregnancies complicated by congenital syphilis. Risk factors for stillbirth included high titers, secondary stage, and lack of prenatal care. If the prevalence of congenital syphilis continues to rise, there will be a corresponding increase in the overall stillbirth rate nationally.
Management of Red Cell Alloimmunization in Pregnancy
Authors: Moise Kenneth J. , Abels Elizabeth A.
Published: August 2024

Rhesus immune globulin has resulted in a marked decrease in the prevalence of RhD alloimmunization in pregnancy; however, antibody formation to other red cell antigens continues to occur. Evaluation for the presence of anti–red cell antibodies should be routinely undertaken at the first prenatal visit. If anti–red cell antibodies are detected, consideration of a consultation or referral to a maternal–fetal medicine specialist with experience in the monitoring and treatment of these patients is warranted. Cell-free DNA can be used to determine fetal red cell antigen status to determine whether the pregnancy is at risk of complications from the red cell antibodies. First-time sensitized pregnancies are followed up with serial maternal titers, and, when indicated, serial Doppler assessment of the peak systolic velocity in the middle cerebral artery should be initiated by 16 weeks of gestation. When there is a history of an affected fetus or neonate, maternal titers are less predictive of fetal risk; if the fetus is antigen positive, serial peak systolic velocity in the middle cerebral artery measurements should be initiated by 15 weeks of gestation because intraperitoneal intrauterine blood transfusions can be used at this gestation if needed. The mainstay of fetal therapy involves intrauterine transfusion through ultrasound-directed puncture of the umbilical cord with the direct intravascular injection of red cells. A perinatal survival rate exceeding 95% can be expected at experienced centers. Neonatal phototherapy and “top-up” transfusions attributable to suppressed reticulocytosis often are still required for therapy after delivery.
Omega Fatty Acid-Based Therapy for Healing of Recalcitrant Wounds in Patients with Complex Comorbidities
Authors: Reinkraut Jacob , Khokhar Adeen , Abdou Sarah , Wali Sonya , Bell Desmond
Published: August 2024

The human body possesses the unique ability to repair itself after injury through complex, sequential phases. Current development of advanced wound care therapies generally focuses on addressing a single aspect of this biological process that can result in delayed or ineffective wound healing. When patients present with further systemic and local confounding pathologies, it can result in painful, chronic wounds that are especially challenging to treat.

In this case report, the authors demonstrate how treatment with a novel multimodal wound matrix expedited healing and decreased pain in two patients who had each been unresponsive to treatment with advanced modalities for more than 7 months. The first patient had factor V Leiden, and the second patient had sickle cell disease. Use of a once-weekly treatment protocol with the multimodal wound matrix, combined with sharp debridement when deemed clinically necessary, resulted in elimination of pain and expedited wound healing to closure. The wound matrix’s omega fatty acid-based formulation is designed to target multiple factors common among hard-to-heal wounds that when not addressed can adversely inhibit the wound-healing cascade.
Role of sphingolipid metabolism signaling in a novel mouse model of renal osteodystrophy based on transcriptomic approach
Authors: Wang Yujia , Di Yan , Li Yongqi , Lu Jing , Ji Bofan , Zhang Yuxia , Chen Zhiqing , Chen Sijie , Liu Bicheng , Tang Rining
Published: August 2024

Background:

Renal osteodystrophy (ROD) is a skeletal pathology associated with chronic kidney disease-mineral and bone disorder (CKD-MBD) that is characterized by aberrant bone mineralization and remodeling. ROD increases the risk of fracture and mortality in CKD patients. The underlying mechanisms of ROD remain elusive, partially due to the absence of an appropriate animal model. To address this gap, we established a stable mouse model of ROD using an optimized adenine-enriched diet and conducted exploratory analyses through ribonucleic acid sequencing (RNA-seq).

Methods:

Eight-week-old male C57BL/6J mice were randomly allocated into three groups: control group (n = 5), adenine and high-phosphate (HP) diet group (n = 20), and the optimized adenine-containing diet group (n = 20) for 12 weeks. We assessed the skeletal characteristics of model mice through blood biochemistry, microcomputed tomography (micro-CT), and bone histomorphometry. RNA-seq was utilized to profile gene expression changes of ROD. We elucidated the functions of differentially expressed genes (DEGs) using gene ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and gene set enrichment analysis (GSEA). DEGs were validated via quantitative real-time polymerase chain reaction (qRT-PCR).

Results:

By the fifth week, adenine followed by an HP diet induced rapid weight loss and high mortality rates in the mouse group, precluding further model development. Mice with optimized adenine diet-induced ROD displayed significant abnormalities in serum creatinine and blood urea nitrogen levels, accompanied by pronounced hyperparathyroidism and hyperphosphatemia. The femur bone mineral density (BMD) of the model mice was lower than that of control mice, with substantial bone loss and cortical porosity. ROD mice exhibited substantial bone turnover with an increase in osteoblast and osteoclast markers. Transcriptomic profiling revealed 1907 genes with upregulated expression and 723 genes with downregulated expression in the femurs of ROD mice relative to those of control mice. Pathway analyses indicated significant enrichment of upregulated genes in the sphingolipid metabolism pathway. The significant upregulation of alkaline ceramidase 1 (Acer1), alkaline ceramidase 2 (Acer2), prosaposin-like 1 (Psapl1), adenosine A1 receptor (Adora1), and sphingosine-1-phosphate receptor 5 (S1pr5) were successfully validated in mouse femurs by qRT-PCR.

Conclusions:

Optimized adenine diet mouse model may be a valuable proxy for studying ROD. RNA-seq analysis revealed that the sphingolipid metabolism pathway is likely a key player in ROD pathogenesis, thereby providing new avenues for therapeutic intervention.
Acute Limb Ischemia Management and Complications: From Catheter-Directed Thrombolysis to Long-Term Follow-up
Authors: Maheta Darshilkumar , Desai Dev , Agrawal Siddharth Pravin , Dani Avichal , Frishman William H. , Aronow Wilbert S.
Published: August 2024

Acute limb ischemia (ALI) is a vascular emergency that needs to be diagnosed and treated quickly to prevent permanent tissue damage and amputation. Catheter-directed thrombolysis is a possible treatment option for mild to moderate ALI, with improved results from endovascular procedures and thrombolytic drugs. However, patients receiving thrombolysis may experience higher rates of distal embolization, serious bleeding events, and stroke than those undergoing surgery. The review article emphasizes the need for postoperative and extended management of ALI patients, including monitoring for compartment syndrome, managing reperfusion damage, and reducing changeable cardiovascular risk factors such as lipid-lowering therapy, diabetes management, and smoking cessation. Complications that can arise from thrombolytic therapy are also discussed, including hemorrhagic complications, minor bleeding, and reperfusion damage, with recommendations to monitor patients closely during treatment and discontinue therapy immediately if any abnormalities are detected. Follow-up evaluations for patients, including Doppler ultrasound, ankle brachial index, pulse volume recordings, and laboratory tests, are recommended to ensure the best possible outcome for patients with ALI.
Contemporary Management of the Upper Limb in Apert Syndrome: A Review
Authors: Khabyeh-Hasbani Nathan , Lu Yi-Hseuh , Baumgartner William , Mendenhall Shaun D. , Koehler Steven M.
Published: August 2024

Background:

Apert syndrome is a relatively rare genetic disorder with a constellation of distinct craniofacial deformities and bilateral syndactyly of the hands and feet. Although the literature contains ample evidence for the need to treat cranial, midfacial, and hand abnormalities, there are severe shortcomings in the literature when attempting to describe the pathology and management of the entire upper limb in patients with Apert syndrome.

Methods:

A thorough literature search was performed using PubMed, Scopus, Web of Science, and Google Scholar, on the management of the upper extremity in Apert syndrome, including the shoulder, elbow, and hand.

Results:

Our findings of the literature discuss the clinical presentation and management trends of the upper extremity in patients with Apert syndrome. Through multicenter collaboration, discussion among experts in the field, and evidence gathered from the literature, we propose treatment algorithms to treat deformities of the hand, shoulder, and elbow in patients with Apert syndrome.

Conclusions:

This review identifies that even if hand pathologies have been correctly treated, shoulder and elbow abnormalities in patients with Apert syndrome are largely ignored. To optimize outcomes, added cognizance of additional upper limb congenital differences and their management should be highly advocated in this patient population.
Artificial intelligence applications in ophthalmic surgery
Authors: Leiderman Yannek I. , Gerber Matthew J. , Hubschman Jean-Pierre , Yi Darvin
Published: August 2024

Purpose of review

Technologies in healthcare incorporating artificial intelligence tools are experiencing rapid growth in static-image-based applications such as diagnostic imaging. Given the proliferation of artificial intelligence (AI)-technologies created for video-based imaging, ophthalmic microsurgery is likely to experience significant benefits from the application of emerging technologies to multiple facets of the care of the surgical patient.

Recent findings

Proof-of-concept research and early phase clinical trials are in progress for AI-based surgical technologies that aim to provide preoperative planning and decision support, intraoperative image enhancement, surgical guidance, surgical decision-making support, tactical assistive technologies, enhanced surgical training and assessment of trainee progress, and semi-autonomous tool control or autonomous elements of surgical procedures.

The proliferation of AI-based technologies in static imaging in clinical ophthalmology, continued refinement of AI tools designed for video-based applications, and development of AI-based digital tools in allied surgical fields suggest that ophthalmic surgery is poised for the integration of AI into our microsurgical paradigm.
Implementing Advance Care Planning and Care Coordination in the Care for People With Parkinson Disease: A Feasibility Study
Authors: Lennaerts-Kats Herma , Daeter Laura , Forkink Anoek , Hukema Renate K. , Bloem Bastiaan R. , Vissers Kris C.P. , Meinders Marjan J. , Groot Marieke M.
Published: August 2024

BACKGROUND: For people with a moderate stage of Parkinson disease (PD), dedicated care coordination combined with advance care planning (ACP) is highly needed. However, evidence is lacking. The objective of this study was to assess the feasibility and acceptability of the study processes to inform a larger randomized controlled trial, aiming the effectiveness of a combined intervention on ACP and care coordination for people with PD. METHODS: Two nurse practitioners with expertise in PD followed training on a combined intervention on ACP and care coordination. Patients were invited to participate in several sessions for a period of 12 months. Feasibility of the study was surveyed covering sample recruitment, attrition rate, eligibility, intervention delivery, number of ACP sessions, type of intervention administration, and satisfaction with the intervention. RESULTS: In total, 27 patients were invited to participate, and 20 (74%) enrolled into the study, together with 11 family caregivers; 7 patients (35%) dropped out. Most patients were men (n = 20), with a mean age of 73.4 (SD 8.2) years. In total, 71 ACP sessions were held (3.6 sessions per patient on average), of which 41% of the sessions were conducted face-to-face at home, 44% at the hospital, 11% over telephone, and 4% via a videoconference call. Patients perceived the intervention not only as supportive but also as confronting. CONCLUSION: The ACP aspect of the intervention was useful and feasible to stimulate patients to think about their current care situation as well as about future care. Care coordination was less profoundly provided and discussed.
Inclusive Excellence: A Roadmap to Cultivating Belonging for Faculty of Color in Physical Therapy Education
Authors: Brown Dawn S. , Magee Julian , Woods LaDarius , Portee Charlene
Published: August 2024

Cultivating a sense of belonging among faculty of color decreases feelings of isolation and marginalization, translating to increased job satisfaction and retention. This roadmap for cultivating a sense of belonging for faculty of color highlights the following critical strategies: (1) adopting inclusive leadership practices, (2) understanding professional and personal identities, (3) mitigating cultural taxation, (4) minimizing microaggressions and racism, (5) providing mentorship, and (6) prioritizing acculturation over assimilation. By following this roadmap, physical therapy programs can work toward cultivating a greater sense of belonging for faculty of color, enabling them to thrive in their roles and feel valued and respected as integral members of the academic community.
Efficacy and Safety of Cold Versus Hot Snare Endoscopic Mucosal Resection in Colorectal Polyp Removal
Authors: Niu Chengu , Zhang Jing , Joshi Utsav , Elkhapery Ahmed , Boppana Hemanth Krishna , Okolo Patrick I.
Published: August 2024

Background:

Cold snare endoscopic mucosal resection (C-EMR) is hypothesized to offer a safety advantage over hot snare endoscopic mucosal resection (H-EMR). The primary objective of this meta-analysis is to evaluate the effectiveness and safety of C-EMR versus H-EMR for the management of colorectal lesions.

Methods:

A meta-analysis was performed to determine pooled odds ratios (ORs) for comparing outcomes between the C-EMR and H-EMR groups.

Results:

The pooled OR for complete resection rates were estimated at 0.70 (95% CI: 0.36-1.36, P =0.29) and en bloc rates were 0.24 (95% CI: 0.05-1.08, P=0.06) between C-EMR group and H-EMR group. The overall complete resection rate for C-EMR was 84%, and the en bloc resection rate was 57. Notably, C-EMR was associated with a significantly lower incidence of delayed bleeding. The recurrence rate of polyps was very low (2%) when treating sessile serrated polyp (SSP) lesions, but higher (23%) for non-SSP lesions. Subgroup analysis revealed minimal recurrence of polyps after using C-EMR for lesions between 10 to 20 mm and ≥20 mm.

Conclusions:

This meta-analysis suggests that C-EMR could be a safer and equally effective alternative to H-EMR for resecting colorectal lesions. We recommend C-EMR as the preferred method for excising large colorectal lesions.
Energy balance and obesity: the emerging role of glucagon like peptide-1 receptor agonists
Authors: Beauregard Noémie , McInnis Kurt , Goldfield Gary S. , Doucet Éric
Published: August 2024

Purpose of review

With obesity affecting over one billion people globally, understanding and managing this complex condition is more crucial than ever. This review explores the emerging role of GLP-1 receptor agonists (GLP-1RA) in weight management, focusing on their impact on energy balance. It highlights the necessity of this investigation due to the limited knowledge on both the short-term and long-term implications of GLP-1RA on energy expenditure (EE) and energy intake (EI).

Recent findings

GLP-1RA, such as liraglutide and semaglutide, have shown significant efficacy in promoting weight loss by reducing appetite, cravings and consequently, EI. Newer medications such as tirzepatide have demonstrated even greater weight loss success. Emerging evidence also suggests potential effects on EE, which could explain the greater weight loss success achieved with GLP-1 RA rather than typical lifestyle changes. However, comprehensive data on the total impact of these drugs on energy balance remain limited.

The findings underscore the promising role of GLP-1RA in obesity management, particularly through mechanisms influencing both EI and EE. Future research should focus on systematically measuring all components of energy balance to fully elucidate the mechanisms of GLP-1RA and optimize their therapeutic use for personalized medicine.
The case for balloon eustachian tuboplasty in children
Authors: Toivonen Joonas , Poe Dennis
Published: August 2024

Purpose of review

Balloon dilation of the cartilaginous portion of the Eustachian tube has increasingly gained acceptance among otolaryngologists in the treatment of obstructive Eustachian tube dysfunction. There is however little data on the procedure performed in children. The purpose of this study is to review the recent developments regarding balloon dilation in pediatric patients.

Recent findings

Balloon dilation of the Eustachian tube is safe in pediatric patients. The effects of the procedure are durable during long term follow-up. Diagnosing obstructive dysfunction remains challenging. There is no single test or questionnaire for diagnosing the condition; instead a series of appropriate tests should be used. The pediatric Eustachian tube is very responsive to the effects of balloon dilation. While the treatment is effective, overtreatment can have unwanted results such as patulous symptoms. Reducing the time of dilation should therefore be considered.

Otolaryngologists performing the procedure should be familiar with the effects of balloon dilation on the pediatric Eustachian tube and consider altering the duration of dilation accordingly. Further studies are needed especially regarding patient selection, optimal age for dilation and balloon parameters for pediatrics (e.g. dimensions, inflation duration, inflation pressure).
Invasive fungal rhinosinusitis: current evidence and research opportunities
Authors: Ji Jenny , Roland Lauren T.
Published: August 2024

Purpose of review

To summarize the evidence surrounding diagnosis, treatment, prognosis, and surveillance of patients with acute invasive fungal sinusitis (AIFS) and discuss future research needs.

Recent findings

New risk factors for AIFS such as COVID have been identified, and a new prognostic staging system has been developed.

Most patients who develop AIFS are immunocompromised, with the majority having a history of diabetes or a hematologic malignancy. Unfortunately, there are not any highly sensitive and specific diagnostic tools. Therefore, a combination of signs and symptoms, imaging, endoscopy, biopsy, and labs should be used to diagnosis AIFS. Although surgery and systemic antifungals are known to improve outcomes, there is limited data on time to intervention, duration of antifungals, and surveillance patterns. There is also limited information on factors that can predict outcomes in AIFS patients. However, sensory/perceptual changes, prolonged neutropenia duration, and comorbidity burden may be associated with a poor prognosis.
Evaluation and diagnosis of pediatric patients with dizziness
Authors: Doerfer Karl W. , Harvey Erin , LaPrade Samantha
Published: August 2024

Purpose of review

Children experiencing dizziness frequently go unevaluated or experience delays in correct diagnosis due to systemic and inherent barriers. While most causes of pediatric dizziness do not involve the peripheral vestibular system, otolaryngologists are frequently consulted for expert opinion. This study offers a broad overview of the leading causes of pediatric dizziness and imbalance to assist otolaryngologists with evaluating and managing this challenging population.

Recent findings

Evaluation of children with dizziness should exclude serious central nervous system conditions. Approximately 70% of nonhazardous cases of pediatric dizziness are caused by migraine-related conditions, concussion, or functional disorders. Etiologies for peripheral vestibular dysfunction include inner ear malformations and vestibular disorders more commonly seen in adults. Audiometric and vestibular testing can provide helpful information, although correct diagnosis depends on a detailed history.

Otolaryngologists should be familiar with the conditions that cause dizziness in children. While most underlying causes are outside their scope of practice, understanding possible etiologies can facilitate correct diagnosis and appropriate management.
New developments in the application of artificial intelligence to laryngology
Authors: Torborg Stefan R. , Kim Ashley Yeo Eun , Rameau Anaïs
Published: August 2024

Purpose of review

The purpose of this review is to summarize the existing literature on artificial intelligence technology utilization in laryngology, highlighting recent advances and current barriers to implementation.

Recent findings

The volume of publications studying applications of artificial intelligence in laryngology has rapidly increased, demonstrating a strong interest in utilizing this technology. Vocal biomarkers for disease screening, deep learning analysis of videolaryngoscopy for lesion identification, and auto-segmentation of videofluoroscopy for detection of aspiration are a few of the new ways in which artificial intelligence is poised to transform clinical care in laryngology. Increasing collaboration is ongoing to est

ablish guidelines and standards for the field to ensure generalizability.

Artificial intelligence tools have the potential to greatly advance laryngology care by creating novel screening methods, improving how data-heavy diagnostics of laryngology are analyzed, and standardizing outcome measures. However, physician and patient trust in artificial intelligence must improve for the technology to be successfully implemented. Additionally, most existing studies lack large and diverse datasets, external validation, and consistent ground-truth references necessary to produce generalizable results. Collaborative, large-scale studies will fuel technological innovation and bring artificial intelligence to the forefront of patient care in laryngology.
Evaluation and Significance of Nonvisualization of the Cavum Septum Pellucidum on Prenatal Ultrasonography
Authors: Olsen Jaxon , Rhee Eleanor , Kuller Jeffrey , Kennedy Anne
Published: August 2024

Importance

The identification of the cavum septum pellucidum (CSP) is an integral part of the routine second trimester fetal anatomy scan. The absence or nonvisualization of the CSP has significant clinical implications and requires further evaluation and counseling for the pregnant patient.

Objective

The aim of this review is to review the importance of accurate sonographic identification of the CSP and the underlying pathologies that can be associated with nonvisualization of this structure.

Evidence Acquisition

A literature review was performed with PubMed using key words including CSP, fetal anatomy ultrasound, and fetal anomalies.

Results

The absence of the CSP is associated with several central nervous system pathologies, all with a wide range of phenotypic outcomes, ranging from normal to very severe or lethal.

Relevance

Most obstetrician-gynecologists will have a patient in whom a CSP is not identified on fetal ultrasound. Thus, it is imperative to have a general understanding of this relatively common entity.

Target Audience

Obstetricians and gynecologists, family physicians

Learning Objectives

After completing this activity, the learner will be able to describe the CSP, the importance of accurate identification on ultrasonography, and the pitfalls to avoid/be aware of; explain the additional workup required in the setting of absent CSP including utility of antenatal ultrasound, fetal magnetic resonance imaging, and genetic counseling; and discuss the various pathologies that have an association with the absence of the CSP and patient counseling regarding the absence of the CSP.
Pregnancy After Breast Cancer in Young BRCA Carriers: An International Hospital-Based Cohort Study
Authors: Lambertini Matteo , Blondeaux Eva , Agostinetto Elisa , Hamy Anne-Sophie , Kim Hee Jeong , Di Meglio Antonio , Molho Rinat Bernstein , Hilbers Florentine , Pogoda Katarzyna , Carrasco Estela , Punie Kevin , Bajpai Jyoti , Ignatiadis Michail , Moore Halle C. F. , Phillips Kelly-Anne , Toss Angela , Rousset-Jablonski Christine , Peccatori Fedro A. , Renaud Tiphaine , Ferrari Alberta , Paluch-Shimon Shani , Fruscio Robert , Cui Wanda , Wong Stephanie M. , Vernieri Claudio , Ruddy Kathryn J. , Dieci Maria Vittoria , Matikas Alexios , Rozenblit Mariya , Villarreal-Garza Cynthia , de Marchis Laura , del Mastro Lucia , Puglisi Fabio , Estevez-Diz Maria del Pilar , Rodriguez-Wallberg Kenny A. , Mrinakova Bela , Meister Sarah , Livraghi Luca , Clatot Florian , Yerushalmi Rinat , de Angelis Carmine , Sánchez-Bayona Rodrigo , Meattini Icro , Cichowska-Cwalińska Natalia , Berlière Martine , Salama Mahmoud , de Giorgi Ugo , Sonnenblick Amir , Chiodi Camila , Lee Young-Jin , Maria Camille , Azim Hatem A. , Boni Luca , Partridge Ann H.
Published: August 2024

(Abstracted from JAMA 2024;331(1):49–59

Individuals who are diagnosed with breast cancer at a young age are often carriers of a pathogenic variant in the BRCA1 or BRCA2 genes, and many young women in this situation are interested in preserving future fertility, if possible. Reproductive counseling in this situation can be complex due to the risk of passing on the variant, as well as the implications on their own fertility, as the mutation can impact ovarian reserve, fertility potential, and other factors.
Targeted Sacral Biopsy With Portable Gamma Camera and Intraoperative Gamma Probe
Authors: Rama Alonso Sandra , Campaña Díaz Eva , Blanco Blanco Juan Francisco , García-Talavera San Miguel Paloma , Gómez-Caminero López Felipe
Published: August 2024

A 58-year-old man with dysphagia and trismus symptoms presented a lobulated tumor in the right tonsil and ipsilateral laterocervical stony adenopathies in the physical examination. He had prostate carcinoma as clinical precedent. The tonsilar lesion showed focal FDG uptake (SUVmax, 10.89) on PET/CT and increased glycemic metabolism in the left sacral wing (SUVmax, 10.90) without clear morphological lesion in CT. There was also uptake of the tracer in sacrum in the bone scan. Metastatic involvement was suspected, requiring radioguided biopsy to determine the etiology. Due to radioguided biopsy, histological analysis of the metastasis was performed, with epidermoid carcinoma metastasis diagnosis.
Systematic review of the epidemiology of eating disorders in the Arab world
Authors: Melisse Bernou , van Furth Eric , Hoek Hans W.
Published: August 2024

Purpose of review

The Arab world is dealing with modernization and sociocultural changes both associated with eating disorders. The present review provides an update of ‘Eating disorders in the Arab world: a literature review’, which was published in 2020.

Recent findings

There are 22 recent epidemiological studies on eating disorders in five different countries in the Arab world. A large-scale national mental health survey reported a 12-month eating disorder prevalence of 3.2% and an eating disorder lifetime prevalence of 6.1%. Binge-eating disorder was the most common eating disorder (12-month prevalence = 2.1%, lifetime prevalence = 2.6%), 1.6% was at high risk for binge-eating disorder. Overall, between 23.8 and 34.8% was at high risk for any eating disorder. Body-shape dissatisfaction, a high BMI and separated/widowed/single marital status were associated with eating disorder pathology.

Although there is still a lack of studies compared to the western world, the number of epidemiological studies on eating disorders in the Arab world is growing and there is an increase in studies using appropriate assessment-tools and norms. It is recommended to offer specialized treatment and to implement preventive programs.
Infected grapevines are poor hosts but can serve as source of pathogen transmission for SLF
Authors: Islam Md Tariqul , Kudla-Williams Crosley , Harner Andrew D , Centinari Michela , Rosa Cristina
Published: August 2024

The potential of the invasive spotted lanternfly (Lycorma delicatulaWhite; SLF) to serve as vector of plant pathogens is especially a concern for grapevine growers, as SLF are known to invade and can heavily infest vineyards, where the insects may encounter grapevines with multiple diseases. In this study, we have found that, when given the choice, SLF preferentially fed on healthy vines and that, when forced, feeding on Pierce’s disease (PD)-infected vines had negative effects on nymph development. Upon transmission trials, most of the recipient vines showed scorching symptoms typical of PD and one of the recipient vines resulted positive by qPCR. Our study suggests that SLF could be a vector of PD, however further experiments are needed to determine if transmission would occur under field conditions.
Looking for unique signals of human expansion from Africa: Beyond diversity
Authors: Cenac Zarus
Published: August 2024

There are known to be different views on which portion of Africa modern humans globally spread from. Biological diversities have been employed to estimate the origin of our global expansion. These diversities vary with geographical distance from Africa, thereby expressing the signal of the expansion. In preprints, the signal supposedly appeared beyond diversity – in cranial sexual size dimorphism and a cranial shape distance-based measure. Compared to when diversity is used alone, the addition to analysis of variables which are beyond diversity could improve recovery of the signal, therefore improving origin identification. I explored this through cranial and genetic measures which had been calculated in prior studies. Various analyses were used, e.g., ridge regression and Mantel tests. Amongst cranial variables (shape diversity, sexual size dimorphism, and a shape distance-based measure), only dimorphism had a unique portion of the expansion signal. In comparison to when diversity was utilised alone, the additional use of dimorphism and the distance-based measure did not substantially impact signal recovery. However, their addition possibly improved origin identification, reducing by 46% the size of the geographical area which may have the origin. This smaller area approximately matched southern Africa, however, it was not only in the south. It was questionable if the signal was present in a genetic distance-based measure, which called into question whether the expansion signal is truly present in the cranial shape distance-based measure. Analysis suggested that the apparent presence of the signal in distance-based measures is affected by the representation of Oceanian populations. This study supports cranial sexual size dimorphism being a helpful indicator of the expansion whilst calling into question whether biological distance-based measures are indicators. Clarity remains missing on which African region was the origin.
Generating Advancements in Longitudinal Analysis in X and Y Variations: Rationale, Design, and Methods for the GALAXY Registry
Authors: Carl Alexandra , Bothwell Samantha , Swenson Karli , Bregante Ryan , Cohen Lilian , Cover Virginia , Dawczyk Anna , Decker Gail , Gerken Stephen B. , Hong David , Howell Susan , Raznahan Armin , Rogol Alan D. , Tartaglia Nicole , Davis Shanlee
Published: August 2024

Sex chromosome aneuploidies (SCAs) are a family of genetic disorders that result from an atypical number of X and/or Y chromosomes. SCAs are the most common chromosomal abnormality, affecting ∼1/400 live births, yet are often underdiagnosed, leading to over-representation of more severely impacted individuals in many clinical studies. In addition to this ascertainment bias, existing work in SCAs has also been limited by low geographic and demographic diversity. To address these limitations, we have created the Generating Advancements with Longitudinal Analysis in X and Y variations (GALAXY) Registry. To date, GALAXY has accrued 295 verified SCA participants. Next steps include targeted recruitment of minoritized individuals regarding race, ethnicity, and socioeconomic status, and continuing engagement with the SCA community.
Peripubertal antagonism of corticotropin-releasing factor receptor 1 results in sustained changes in behavioral plasticity and the transcriptomic profile of the amygdala
Authors: Martz Julia , Shelton Micah A , Langen Tristen J , Srinivasan Sakhi , Seney Marianne L. , Kentner Amanda C
Published: August 2024

Peripuberty is a significant period of neurodevelopment with long-lasting effects on the brain and behavior. Blocking type 1 corticotropin-releasing factor receptors (CRFR1) in neonatal and peripubertal rats attenuates detrimental effects of early-life stress on neural plasticity, behavior, and stress hormone action, long after exposure to the drug has ended. CRFR1 antagonism can also impact neural and behavioral development in the absence of stressful stimuli, suggesting sustained alterations under baseline conditions. To investigate this further, we administered the CRFR1 antagonist (CRFR1a) R121919 to young adolescent male and female rats across 4 days. Following each treatment, rats were tested for locomotion, social behavior, mechanical allodynia, or prepulse inhibition (PPI). Acute CRFR1 blockade immediately reduced PPI in peripubertal males, but not females. In adulthood, each assay was repeated without CRFR1a exposure to test for long-term effects of the adolescent treatment. Males continued to experience deficits in PPI while females displayed altered locomotion, PPI, and social behavior. In the adult amygdala, peripubertal CRFR1a induced alterations in pathways related to neural plasticity and stress in males. In females, pathways related to central nervous system myelination, cell junction organization, and glutamatergic regulation of synaptic transmission were affected. Understanding how acute exposure to neuropharmacological agents can have sustained impacts on brain and behavior, in the absence of further exposures, has important clinical implications for developing adolescents.