bluuebunny/crossref_metadata_2025 huggingface dataset:
Cupid’s Bow Leveling and Preservation of Lip Height and Width: A Modified rotation-advancement Technique
Authors: Alkebsi Khaled , Li Chenghao , Aonan Xie , Zeyu Huang , Shi Bing , Li Yang , Sakran Karim A. , Al-Watary Mohammed Q. , Abotaleb Bassam M. , Almoraissi Essam
Published: February 2023

Background:

Several methods for cleft lip repair have been developed over time, indicating no single best one. In our department, the use of a modified rotation advancement technique rather than the rotation-advancement technique in unilateral complete cleft lip repair has increased over the last decade. This study aims to determine which technique gives better outcomes accordingly.

Material and method:

This retrospective study was conducted by analyzing the preoperative and postoperative aesthetic nasal and labial anthropometric measurements of the front and basal views of 213 consecutive patient’s photographs treated between October 2013- June 2019. 141 participants were treated by using the rotation-advancement technique, and 72 patients by the modified rotation-advancement technique. The inclusion criteria included; non-syndromic unilateral complete cleft lip patients with high-resolution quality photographs, no pre-surgical nasoalveolar molding, no revision in the lip and nose areas, and at least one year of follow-up.

Result:

Patients who received the modified rotation-advancement technique had significantly improved Cupid's bow position and orientation (P<0.02, P<0.01 respectively) and enhanced vertical lip height symmetry (P<0.01) while preserving the lip width. The columellar length (P<0.03) and angulation (P<0.045) were also significantly improved, with enhanced nostril inclination in this group (P<0.06).

Conclusion:

According to the findings of the current study, modified rotation-advancement technique assisted surgeons in improving the symmetrical leveling of the Cupid's bow and significantly aided in correcting lip height without compromising lip width. Moreover, the modified rotation-advancement technique resulted in better aesthetic nasal outcomes.
Crowdsourcing in Plastic & Reconstructive Surgery: A Systematic Review with Reporting Recommendations
Authors: Villavisanis Dillan F , Blum Jessica D , Cheung Liana , Cho Daniel Y , Bartlett Scott P , Swanson Jordan W , Taylor Jesse A
Published: February 2023

Background:

Crowdsourcing uses online platforms to collect large data from laypersons and has been increasingly utilized over the past five years to answer questions about aesthetic and functional outcomes following plastic and reconstructive surgery. This systematic review evaluates crowdsourcing manuscripts in plastic and reconstructive surgery based on study topic, participants, and effect size in the hopes of describing best-practices.

Methods:

A systematic search strategy was developed with a licensed librarian and attending plastic surgeon to query all manuscripts using crowdsourcing in plastic and reconstructive surgery. Covidence systematic review manager was used by two independent reviewers to import articles, screen abstracts, evaluate full texts, and extract data.

Results:

A search run on October 8, 2021 yielded 168 studies, of which 45 were ultimately included. Craniofacial surgery and aesthetic surgery collectively comprised over one half of studies. Participants in plastic surgery crowdsourcing studies are more commonly from the US, female, straight, 25 to 35 years old, have completed college, and earn 20,000 – 50,000 USD per year. Studies typically assessed aesthetic perceptions, cost about $350, run a median of nine days, include about 60 unique survey items, and include about 40 unique human images.

Conclusions:

Crowdsourcing is a relatively new, low-cost method of garnering high-volume data from laypersons that may further our understanding of public perception in plastic and reconstructive surgery. As with other nascent fields, there is significant variability in number of subjects utilized, subject compensation, and methodology, indicating an opportunity for quality improvement.
Conscientious Objection to Gender-Affirming Surgery: Institutional Experience and Recommendations
Authors: Morrison Shane D , Nolan Ian T , Santosa Katherine , Shuman Andrew G , Vercler Christian J , Kuzon William M
Published: February 2023

As more academic institutions with surgical residency training programs begin to offer gender-affirming surgery, issues of trainee conscientious objection related to participation in these patient encounters may arise. Herein, we discuss our institutional experience with resident conscientious objection to involvement in gender-affirming surgery. Although there are ethical arguments for and against conscientious objection, current U.S. Federal policy grants all health care workers conscientious objector status upon their request. Recommendations are offered for other institutions who may experience similar situations regarding conscientious objection to gender-affirming care or to other aspects of plastic and reconstructive surgery.
Microsurgical Peritoneovenous Bypass for the Treatment of Recalcitrant Chylous Ascites
Authors: Klifto Kevin M. , Card Elizabeth B. , Itkin Maxim , Kovach Stephen J.
Published: February 2023

Background:

New treatments for recalcitrant chylous ascites are needed to avoid sequelae associated with increased intra-abdominal pressures, chyle loss, and diminished quality of life. An autologous microsurgical technique was developed to treat recalcitrant chylous ascites and restore normal physiology.

Methods:

A retrospective case-series was performed for patients with recalcitrant chylous ascites surgically treated from 2018 to 2020. We included all patients with recalcitrant chylous ascites refractory to current standard of care interventions such as diet modifications, pharmacologic therapies, and peritoneovenous mechanical shunts. All were treated with microsurgical peritoneovenous bypass with a minimum follow-up of 12 months.

Results:

Six patients were included over a 2-year period. Surgery was aborted for two patients (33%) with intra-operative venous reflux of the deep inferior epigastric vein (DIEV), negative on pre-operative ultrasound. One patient had a successful reoperation using the contralateral greater saphenous vein (GSV), while the other elected for a chronic indwelling drain for chyle drainage. Among the five successful surgeries (83%), ascites drainage decreased from a median pre-operative volume of 1 L/day to post-operative volume of 0.06 L/day. Median hospital length-of-stay (LOS) was 7 days (range: 2-194). Three patients each had one complication, including vancomycin resistant enterococcus (VRE), spontaneous bacterial peritonitis (SBP), and pulmonary embolism (PE). All complications resolved with additional interventions. Median follow-up was 13.5 months (range: 12-27).

Conclusions:

Microsurgical peritoneovenous bypass was a reliable and reproducible autologous surgery for the treatment of recalcitrant chylous ascites at a minimum follow-up of 12 months.
A 20-Year Analysis of Medicare Reimbursement for Abdominal Wall Reconstruction (2000-2020)
Authors: Harrington Maya T. , Hammond Jacob B. , Janbieh Javier , Haglin Jack M. , Thornburg Danielle A. , Pearson David , Harold Kristi , Rebecca Alanna M. , Howard Michael A. , Teven Chad M.
Published: February 2023

Purpose:

The purpose of this study was to evaluate monetary trends in Medicare reimbursement rates for 30 abdominal wall reconstruction surgical procedures over a 20-year period (2000-2020).

Methods:

The Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services was utilized for each of the 30 included current Procedural Terminology (CPT) codes, and reimbursement data was extracted. Monetary data was adjusted for inflation to 2020 US dollars (USD) utilizing changes to the United States consumer price index (CPI). The R-squared, average annual percent change and average total percentage change in reimbursement were calculated based on these adjusted trends for all included procedures.

Results:

After adjusting for inflation, the average reimbursement for all procedures decreased by 17.1% from 2000 to 2020. The greatest mean decrease was observed for CPT code 49568 (the implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection, -34.4%). The only procedure with an increased adjusted reimbursement rate throughout the study period was CPT code 20680 (+3.9%). From 2000 to 2020, the adjusted reimbursement rate for all included procedures decreased by an average of 0.85% each year, with an average R-squared value of 0.78, indicating a stable decline throughout the study period.

Conclusions:

Reimbursement rates are declining when adjusted for inflation. Increased awareness of these trends is helpful to maintain access to optimal abdominal reconstruction care in the US.
The Careful Return of Sports Medicine Procedures in the United States During COVID-19: Comparison of Utilization, Patient Demographics, and Complications
Authors: Gordon Adam M. , Sheth Bhavya K. , Horn Andrew R. , Magruder Matthew L. , Conway Charles A. , Erez Orry
Published: February 2023

Objectives

Sports medicine procedures encompass some of the highest-volume elective surgeries performed annually. Elective surgery was suspended because of the severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic; therefore, the purpose was to compare temporal trends in procedural volume, patient demographics, and postoperative complications of elective sports medicine procedures in 2019 and 2020.

Methods

Using a multicenter, nationwide sample, a retrospective query of the 2019 to 2020 American College of Surgeon’s National Surgery Quality Improvement Program database was conducted for all patients undergoing common elective sports medicine procedures. Temporal trends in utilization, demographics, and 30-day complications were compared pre-COVID (2019 and 2020Q1) with post-COVID (2020Q2–Q4). Linear regression was used to evaluate changes in procedural volume over time. A significance threshold ofP< 0.05 was used.

Results

A total of 48,803 patients underwent elective surgery in 2019 (n = 27,883) and 2020 (n = 20,920), a 25.0% decline. Procedural utilization declined by 42.5% in 2020Q2 and never returned to prepandemic baseline in 2020Q3–Q4. The percentage decline in case volume from 2019 to 2020Q2 was greatest for meniscectomy (47.6%), rotator cuff repair (42.7%), labral repair (41.6%), biceps tenodesis (41.3%), and anterior cruciate ligament reconstruction (38.5%). Total complication rates were similar in 2019 (1.31%) versus 2020 (1.51%;P= 0.072). The 30-day readmission (0.74% versus 0.67%;P= 0.374), reoperation (0.35% versus 0.35%;P= 0.963), and mortality (0.01% versus 0.01%;P= 0.657) rates were similar between calendar years.

Conclusions

Sports medicine procedures declined during the second quarter of 2020. Despite pandemic restrictions, patients who did undergo surgery did not experience increased complications. The present study may be used by surgeons, hospitals, and subspecialty societies to support the careful utilization of elective surgery during COVID-19.

Level of Evidence

III, prognostic study.
HIV in the Russian Federation: mortality, prevalence, risk factors, and current understanding of sexual transmission
Authors: Nikoloski Zlatko , King Elizabeth J. , Mossialos Elias
Published: February 2023

Background:

Although HIV infection in the Russian Federation was historically concentrated among marginalized populations (people who inject drugs, sex workers, MSM, and the prison population), recent evidence suggests that it has become a more generalized epidemic. The objective of our research was to explore how these trends in HIV prevalence and HIV-related mortality compare across Russia.

Methods:

We calculated HIV-associated mortality for both male and female individuals in each region (oblast) of the Russian Federation using data from the Russian Fertility and Mortality Database (RusFMD). Using current data on HIV prevalence, we computed the correlation between HIV prevalence and HIV-associated mortality. We also used oblast-level data to examine the associations between HIV prevalence and the risk factors most commonly associated with HIV infection.

Results:

Over the past 20 years, the Russian Federation has experienced a rapid increase in HIV-associated mortality in both male and female individuals. Our findings revealed significant heterogeneity, with higher rates of HIV-associated mortality reported in oblasts in the Siberian and Ural Federal Districts. There is a strong correlation (0.8) between HIV-associated mortality and virus prevalence. These findings confirm that there are regional disparities in access and adherence to antiretroviral therapy (ART), as indicated by the low correlation (−0.4) between virus prevalence and access to ART coverage. The results from our modeling analysis revealed that, in addition to the factors most commonly associated with this disease (e.g. intravenous drug use), knowledge about sexual transmission of HIV in the general population has a broad impact on its prevalence at the oblast level.

Conclusion:

Interventions that reduce HIV prevalence, for example, opioid substitution therapy and needle-sharing programs for people who inject drugs, as well as the increased availability of educational and preventive programs may halt the spread of HIV across the Russian Federation. Similarly, increased access to treatment could help in reducing HIV-related mortality.
Sex modulates the association between inflammation and coronary atherosclerosis among older Ugandan adults with and without HIV
Authors: Shakil Saate S. , Temu Tecla M. , Kityo Cissy , Nazzinda Rashidah , Erem Geoffrey , Kentoffio Katherine , Bittencourt Marcio , Ntusi Ntobeko A.B. , Zanni Markella V. , Longenecker Chris T.
Published: February 2023

Objective:

Inflammation is key in the pathogenesis of atherosclerotic coronary artery disease (CAD). Distinct sex-specific inflammatory mechanisms may contribute to CAD in sub-Saharan Africa (SSA), where environmental and biological determinants of systemic inflammation may differ from those in high-income settings.

Approach and results:

We investigated sex differences in inflammatory markers and CAD in a 2-year prospective cohort of Ugandan adults enriched for cardiometabolic risk factors (RFs) and HIV. Seven plasma biomarkers were quantified at the baseline visit among 125 females and 75 males (50% with HIV) at least 45 years old at enrollment with one or more major cardiovascular RF. In year 2, coronary CT angiography (CCTA) was performed in 82 females and 50 males returning for follow-up (52% with HIV). In sex-specific models adjusted for cardiovascular RFs and HIV, tumor necrosis factor-alpha (TNF-α) RII and sCD163 predicted subsequent CAD in females, while only fibrinogen was predictive in males (P < 0.05). Interleukin-6 (IL-6) and sCD14 were inversely associated with CAD in males (P < 0.05). Sex modified the associations of TNF-α RII, sCD14, and sCD163 with CAD (P < 0.05 for interaction). In multivariable multiple imputation models applied to missing year 2 CCTA data to test associations between serum biomarkers in the baseline cohort (n = 200) and subsequent CAD, higher sCD163 was predictive in females only (P < 0.05).

Conclusions:

The positive link between inflammation and subclinical CAD was stronger among females than males in Uganda. Mechanisms by which sex modulates the relationship between inflammation and CAD should be further investigated in SSA.
Gestational weight gain in persons with HIV in the United States
Authors: Jao Jennifer , Kacanek Deborah , Broadwell Carly , Jacobson Denise L. , Chadwick Ellen G. , Williams Paige L. , Powis Kathleen M. , Haddad Lisa B. , Yee Lynn
Published: February 2023

Objective:

We evaluated gestational weight gain (GWG) in pregnant persons with HIV (PWH) enrolled in the Surveillance Monitoring for ART Toxicities study.

Design:

This was a cohort study.

Methods:

GWG was classified as excessive, adequate, or inadequate; weekly GWG in second and third trimesters was calculated using National Academy of Medicine standards. Adjusted modified Poisson and linear regression models were fit with generalized estimating equations to assess the association of antiretroviral treatment (ART) with GWG outcomes stratified by timing of ART initiation [at conception (ART-C) and initiating during pregnancy (ART-I)].

Results:

We included 1477 pregnancies (847 ART-C, 630 ART-I) from 1282 PWH. The proportion of excessive, adequate, and inadequate GWG was 44, 24, and 32%, respectively. No associations of ART class with excessive GWG were observed overall. However, among ART-I pregnancies with overweight prepregnancy BMI-based, protease inhibitor-based, nonnucleoside reverse transcriptase inhibitor-based, and nucleoside reverse transcriptase inhibitor-based ART were associated with significantly lower GWG per week than integrase inhibitor (INSTI)-based ART [mean differences: −0.14, −0.27, and −0.29 kg/week, respectively]. Among ART-I pregnancies with obese prepregnancy BMI, lower weekly GWG was also observed for protease inhibitor-based vs. INSTI-based ART (mean difference: −0.14 kg/week).

Conclusion:

ART class type was not associated with excessive GWG. However, PWH entering pregnancy already overweight/obese and initiating INSTI-based ART had higher weekly GWG in second and third trimesters vs. other ART classes. Further studies to understand how increases in weekly GWG for overweight/obese PWH impinges on long-term maternal/child health are warranted.
Factors associated with reduced function and quality of life among adult people with HIV with depression and substance use in the Asia-Pacific region
Authors: Rajasuriar Reena , Chong Meng Li , Ross Jeremy L. , Jiamsakul Awachana , Avihingsanon Anchalee , Lee Man Po , Ditangco Rossana , Choi Jun Yong , Gatechompol Sivaporn , Chan Iris , Melgar Maria Isabel Echanis , Kim Jung Ho , Sohn Annette H. , Law Matthew
Published: February 2023

Background:

Depression and substance use (SU) disorders are prevalent among people with HIV (PWH) and impact health outcomes despite successful antiretroviral therapy (ART). We explored quality of life, functional ability and associated factors among PWH screened positive for depression and/or SU.

Methods:

This cross-sectional study recruited adult PWH during routine follow-up at five HIV clinical sites in the Asia-Pacific region. Participants were screened for depression using Patient Health Questionnaire-9 and SU using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Quality of life (QoL) was assessed with WHOQOL-HIV BREF and functional ability with World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Factors associated with mean QoL and disability scores were analysed using linear regression.

Results:

Of 864 PWH enrolled, 753 screened positive for depression or SU. The median (interquartile range, IQR) age was 38 (31–47) years and 97% were on ART. Overall mean WHOQOL-HIV BREF and WHODAS scores indicated greater impairment with increasing depressive symptom severity and SU risk. In multivariate analysis, PWH reporting previous trauma/stress (difference = 2.7, 95% confidence interval [CI] 1.5–3.9, P < 0.001) and past mental health diagnosis (difference = 5.0, 95% CI 2.9–7.1, P < 0.001) were associated with greater disability and poorer QoL scores across multiple domains (P < 0.01 for all). Higher CD4 T-cell counts was also associated with better QoL scores and functional ability.

Conclusion:

PWH with depression/SU experienced poorer QoL and function despite routine engagement in HIV care. Efforts to integrate mental health services and interventions addressing disability into HIV management should be prioritized in the region.
A prospective 18F-fluorodeoxyglucose positron emission tomography/computed tomography study of the neurometabolic effects in cocaine use and HIV infection
Authors: Mamidi Ramya S. , Ayubcha Cyrus , Rigney Grant , Kirschner Jason , Gerke Oke , Werner Thomas J. , Tebas Pablo , Alavi Abass , Revheim Mona-Elisabeth
Published: February 2023

Objectives:

HIV affects 36 million people globally with prevalence decreasing due to antiretroviral therapy (ART) and social awareness; transmission occurs during substance use. Cocaine usage independently affects brain activity and may result in reduced ART adherence. This study evaluates brain glucose metabolism measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in cocaine users with HIV infection.

Design:

Sixty-three participants were categorized into groups: 36 HIV infected (HIV+) and 27 non-HIV infected (HIV−) individuals. Each group was further split into cocaine users (CO+) and non-cocaine users (CO−). Of the HIV+, half were cocaine users and half were not. Of the HIV−, 14 were cocaine users and 13 were not. 18F-FDG-PET and low dose CT scans were performed on all participants.

Methods:

Brain glucose metabolism was evaluated by 18F-FDG uptake in the whole brain, cortex, basal ganglia, and cerebellum 120 min after injection. ROVER software was used for image analysis and regions of interest masks were applied via an adaptive threshold system. ANOVA tests and t-tests were performed to assess the respective differences between the four groups.

Results:

Generally, the HIV+/CO+ group (group A) displayed the lowest levels of uptake whereas the HIV−/CO− group (group D) showed the highest; the HIV+/CO− and HIV−/CO+ groups (groups B and C) showed intermediate levels of activity across the whole brain, cortex, basal ganglia, and cerebellum.

Conclusion:

HIV infection and cocaine usage were independently associated with a decrease in brain glucose uptake as measured by 18F-FDG PET/CT. When combined, positive HIV status and cocaine patients showed the most decreased 18F-FDG uptake.
Telemedicine Use Among People With HIV in 2021: The Hybrid-Care Environment
Authors: El-Nahal Walid G. , Chander Geetanjali , Jones Joyce L. , Fojo Anthony T. , Keruly Jeanne C. , Manabe Yukari C. , Moore Richard D. , Gebo Kelly A. , Lesko Catherine R.
Published: February 2023

Background:

Telemedicine use for the care of people with HIV (PWH) significantly expanded during the COVID-19 pandemic. During 2021, vaccine uptake increased and patients were encouraged to resume in-person care, resulting in a mixture of in-person and telemedicine visits. We studied how different patient populations used telemedicine in this hybrid-care environment.

Methods:

Using observational data from patients enrolled in the Johns Hopkins HIV Clinical Cohort, we analyzed all in-person and telemedicine HIV primary care visits completed in an HIV clinic from January 1st, 2021, to December 31st, 2021. We used log-binomial regression to investigate the association between patient characteristics and the probability of completing a telemedicine versus in-person visit and the probability of completing a video versus telephone visit.

Results:

A total of 5518 visits were completed by 1884 patients; 4282 (77.6%) visits were in-person, 800 (14.5%) by phone, and 436 (7.9%) by video. The relative risk (RR) of completing telemedicine vs. in-person visits was 0.65 (95% Confidence Interval (CI): 0.47, 0.91) for patients age 65 years or older vs. age 20–39 years; 0.84 (95% CI: 0.72, 0.98) for male patients vs. female patients; 0.81 (95% CI: 0.66, 0.99) for Black vs. White patients; 0.62 (95% CI: 0.49, 0.79) for patients in the highest vs. lowest quartile of Area Deprivation Index; and 1.52 (95% CI: 1.26, 1.84) for patients >15 miles vs. <5 miles from clinic.

Conclusions:

In the second year of the pandemic, overall in-person care was used more than telemedicine and significant differences persist across subgroups in telemedicine uptake.
Brief Report: Long-Term Clinical, Immunologic, and Virologic Outcomes Among Early-Treated Children With HIV in Botswana: A Nonrandomized Controlled Clinical Trial
Authors: Ajibola Gbolahan , Maswabi Kenneth , Hughes Michael D. , Bennett Kara , Pretorius-Holme Molly , Capparelli Edmund V. , Jean-Philippe Patrick , Moyo Sikhulile , Mohammed Terence , Batlang Oganne , Sakoi Maureen , Ricci Lucia , Lockman Shahin , Makhema Joseph , Kuritzkes Daniel R. , Lichterfeld Mathias , Shapiro Roger L.
Published: February 2023

Background:

Early antiretroviral treatment (ART) improves outcomes in children, but few studies have comprehensively evaluated the impact of ART started from the first week of life.

Methods:

Children diagnosed with HIV within 96 hours of life were enrolled into the Early Infant Treatment Study in Botswana and followed on ART for 96 weeks. Nevirapine, zidovudine, and lamivudine were initiated; nevirapine was switched to lopinavir/ritonavir between weeks 2–5 in accordance with gestational age. Clinical and laboratory evaluations occurred at weeks 1, 2, 4, 8, 12, 24, 36, 48, 60, 72, 84, and 96.

Findings:

Forty children initiated ART at a median of 2 (IQR 2, 3) days of life; 38 (95%) completed follow-up through 96 weeks, and 2 (5%) died between 12 and 24 weeks. ART was well tolerated; 9 children (24%) experienced a grade 3 or 4 hematologic event, and 2 (5%) required treatment modification for anemia. The median 96-week CD4 count was 1625 (IQR 1179, 2493) cells/mm3 with only 5/38 (13%) having absolute counts <1000 cells/mm3. Although 23 (61%) had at least one visit with HIV-1 RNA ≥40 copies/mL at or after 24 weeks, 28 (74%) had HIV-1 RNA <40 copies/mL at the 96-week visit. Median cell-associated HIV-1 DNA at 84/96-week PBMCs was 1.9 (IQR 1.0, 2.6) log10 copies/106 cells. Pre-ART reservoir size at birth was predictive of the viral reservoir at 84/96 weeks.

Interpretation:

Initiation of ART in the first week of life led to favorable clinical outcomes, preserved CD4 cell counts, and low viral reservoir through 96 weeks of life.
Relationships Between Stress-Responsive Biomarkers, ART Adherence, and Viral Suppression Among Adolescent Girls and Young Women Living With HIV in South Africa: An HPTN 068 Analysis
Authors: Stoner Marie C.D. , Kelly Nicole K. , Gomez-Olive F. Xavier , Kahn Kathleen , Wagner Danielle , Bhushan Nivedita L. , Aiello Allison E. , Pettifor Audrey E.
Published: February 2023

Background:

Adolescent girls and young women (AGYW) living with HIV who have higher stress levels may be at risk of stress-related biological alterations, which could influence HIV progression and adherence to antiretroviral therapy (ART).

Setting:

We aimed to estimate associations among stress-responsive biomarkers, ART adherence, and viral suppression in AGYW living with HIV in South Africa. We also hypothesized that psychosocial stressors [eg, depression, food insecurity, low socioeconomic status (SES), and HSV-2] would be associated with higher biomarker levels.

Methods:

We used 2018/2019 data from the HIV Prevention Trials Network 068 cohort to assess associations between stress-responsive biomarkers and viral suppression (<1000 copies/mL) and ART adherence measured using dried blood spot cards. Stress-responsive biomarkers included C-reactive protein, herpes simplex virus type 1, and cytomegalovirus infection and reactivation. Associations were estimated using unadjusted log-binomial or ordinal logistic regression models.

Results:

In 166 AGYW living with HIV, there was no association between stress-responsive biomarkers and viral suppression or ART adherence. However, increased C-reactive protein levels were associated with higher HSV-2 infection [odds ratio (OR) 1.98; 95% confidence interval (CI) 1.11, 3.52], being a government grant recipient (OR 3.21; 95% CI: 1.30, 7.92), lower food insecurity (OR 0.34; 95% CI: 0.13, 0.90), and increased body mass index (OR 1.07; 95% CI: 1.01, 1.14).

Conclusions:

High prevalence of psychosocial stressors and persistent herpesviruses in AGYW living with HIV has the potential to lead to poorer health outcomes. More research is needed to untangle relationships between economic stability, chronic disease, and chronic stress.
Focal adhesion kinase signaling is necessary for the hydrogen sulfide-enhanced proliferation, migration and invasion of HTR8/SVneo human trophoblasts
Authors: Wang Xian-Li , Tang Jing
Published: February 2023

Objective:

Hydrogen sulfide (H2S) has been elucidated that it promotes migration and invasion in human placenta trophoblasts. However, the signaling pathway underlying H2S-based regulation of trophoblasts remains unknown. Hence, we investigated the potential effect of sodium hydrosulfide (NaHS), an exogenous H2S donor, on extravillous trophoblasts.

Methods:

The Cell Counting Kit-8 was used to detect the proliferative activity of trophoblasts and to screen the optimal concentration of NaHS. The migration and invasion of HTR8/SVneo cells were measured by Transwell assays. Gene expression was determined by quantitative real-time PCR analysis. Protein expression was determined by western blot.

Results:

We found that NaHS could promote the proliferation, migration, and invasion of HTR8/SVneo cells. The phosphorylation of focal adhesion kinase (FAK), Src, and extracellular signal-regulated kinase (ERK) were activated by NaHS. Moreover, NaHS also upregulated the expression of matrix metalloproteinase-2(MMP-2) and MMP-9, downregulated the expression of E-cadherin in HTR8/SVneo cells. The application of NaHS could increase the expression of cystathionine-β-synthase.

Conclusion:

Both FAK–Src signaling and the upstream signaling cascade of ERK activation play a significant important role in NaHS-induced proliferation, migration, and invasion via upregulating activity of MMP-2, MMP-9, and downregulating E-cadherin in HTR8/SVneo cells. These novel findings may provide a strong foundation for the clinical application of H2S donor drugs.
Functional Analysis of Missense Mutations in GLI2 and GLI3 Involved in Congenital Heart Disease
Authors: Peng Rui , Lu Lei , Lei Bing-Kun , Wang Hong-Yan , Yao Xiao-Ying
Published: February 2023

Objective:

In this study, we aimed to explore the biological functions of 10 rare case-specific missense mutations in GLI2 and 4 in GLI3, which were previously screened in a cohort of 412 patients with congenital heart disease and 213 normal controls from Shandong Province, China.

Methods:

A dual-luciferase reporter assay was used to assess the effects of these mutations in GLI2 and GLI3 on the activity of the sonic Hedgehog signaling pathway in HEK293T cells. Differences in protein levels between mutant and wild-type GLI2 and GLI3 were detected in HEK293T cells using Western blotting.

Results:

The dual-luciferase reporter assay showed that compared to the wild-type GLI2 protein, p.A1113V significantly increased activation of the sonic Hedgehog signaling pathway, whereas p.H78P and p.I1451S did not have a significant effect. The other mutations largely reduced the activation effect. Compared with the wild-type GLI3 protein, only p.A286V, among the four mutations, significantly reduced the activation effect on the SHH signaling pathway. Western blot data showed reduced expression of GLI2 p.G716V, GLI2 p.K736N, GLI2 p.I1451S, and GLI3 p.A286V, whereas the remaining mutations had no significant effects.

Conclusion:

The mutations GLI2 c.2147G>T (p.G716V), GLI2 c.2208G>C (p.K736N), and GLI3 c.857C>T (p.A286V) involved in congenital heart disease affect the regulation of the sonic Hedgehog signaling pathway; thus, these rare missense mutations in GLI2 and GLI3 might increase the risk of congenital heart disease.
Association of sleep characteristics and night shift work with self-reported diagnosis of polycystic ovary syndrome: A questionnaire based cross-sectional study
Authors: Shao Shu-Yi , Zhao Huan-Qiang , Lu Zhi-Ying , Lei Xiao-Hong , Zhang Ying
Published: February 2023

Objective:

To examine the association between sleep characteristics and night shift work and the risk of polycystic ovary syndrome (PCOS) in Chinese women and to investigate their relationship with infertility in PCOS.

Methods:

From March 21, 2021 to April 31, 2021, 3,927 Chinese women with or without PCOS were recruited online. All participants completed WeChat-based electronic questionnaires. Sleep characteristics were measured using the Pittsburgh sleep quality index.

Results:

A total of 2,871 women were included in the final analysis. Sleep duration (odds ratio [OR], 0.857; 95% confidence interval [CI], 0.763–0.963), sleep midpoint (OR, 1.142; 95% CI, 1.049–1.244), sleep disturbance (OR,1.320; 95% CI, 0.957–1.146), daytime dysfunction (OR, 1.136; 95% CI, 1.030–1.253), and night shift work (OR, 1.628; 95% CI, 1.264–2.097) were associated with a higher risk of PCOS. After adjusting for confounders, including age, body mass index, smoking status, and coffee and tea drinking status, sleep disturbance (OR, 1.314; 95% CI, 1.111–1.555), daytime dysfunction (OR, 1.143; 95% CI, 1.034–1.264), and night shift work (OR, 1.800; 95% CI, 1.388–2.333) remained associated. In addition, sleep disturbance (OR, 1.887; 95% CI, 1.400–2.542) and subjective sleep quality (OR, 1.299; 95% CI, 1.037–1.627) were associated with infertility in women with PCOS, and sleep disturbance (OR, 1.750; 95% CI, 1.281–2.390) remained significant after adjusting for confounders.

Conclusions:

Sleep disturbance, daytime dysfunction, and night shift work are significantly associated with PCOS. Screening for sleep disturbances and providing appropriate treatment could be potential strategies for managing PCOS and its long-term complications.
Contrast-Enhanced 3D Spin Echo T1-Weighted Sequence Outperforms 3D Gradient Echo T1-Weighted Sequence for the Detection of Multiple Sclerosis Lesions on 3.0 T Brain MRI
Authors: de Panafieu Ariane , Lecler Augustin , Goujon Adrien , Krystal Sidney , Gueguen Antoine , Sadik Jean-Claude , Savatovsky Julien , Duron Loïc
Published: February 2023

Background

Using reliable contrast-enhanced T1 sequences is crucial to detect enhancing brain lesions for multiple sclerosis (MS) at the time of diagnosis and over follow-up. Contrast-enhanced 3D gradient-recalled echo (GRE) T1-weighted imaging (WI) and 3D turbo spin echo (TSE) T1-WI are both available for clinical practice and have never been compared within the context of this diagnosis.

Purpose

The aim of this study was to compare contrast-enhanced 3D GRE T1-WI and 3D TSE T1-WI for the detection of enhancing lesions in the brains of MS patients.

Methods

This single-center prospective study enrolled patients with MS who underwent a 3.0 T brain MRI from August 2017 to April 2021 for follow-up. Contrast-enhanced 3D GRE T1-WI and 3D TSE T1-WI were acquired in randomized order. Two independent radiologists blinded to all data reported all contrast-enhanced lesions in each sequence. Their readings were compared with a reference standard established by a third expert neuroradiologist. Interobserver agreement, contrast ratio, and contrast-to-noise ratio were calculated for both sequences.

Results

A total of 158 MS patients were included (mean age, 40 ± 11 years; 95 women). Significantly more patients had at least 1 contrast-enhanced lesion on 3D TSE T1-WI than on 3D GRE T1-WI for both readers (61/158 [38.6%] vs 48/158 [30.4%] and 60/158 [38.6%] vs 47/158 [29.7%], P < 0.001). Significantly more contrast-enhanced lesions per patient were detected on 3D TSE T1-WI (mean 2.47 vs 1.56 and 2.56 vs 1.39, respectively, P < 0.001). Interobserver agreement was excellent for both sequences, κ = 0.96 (confidence interval [CI], 0.91–1.00) for 3D TSE T1-WI and 0.92 (CI, 0.86–0.99) for 3D GRE T1-WI. Contrast ratio and contrast-to-noise ratio were significantly higher on 3D TSE T1-WI (0.84 vs 0.53, P < 0.001, and 87.9 vs 57.8, P = 0.03, respectively).

Conclusions

At 3.0 T, contrast-enhanced 3D TSE-T1-WI supports the detection of significantly more enhancing lesions than 3D GRE T1-WI and should therefore be used for MS patients requiring contrast-enhanced examination.
Accurate Diagnosis of Cortical and Infratentorial Lesions in Multiple Sclerosis Using Accelerated Fluid and White Matter Suppression Imaging
Authors: Martin Anna , Emorine Thibaut , Megdiche Imen , Créange Alain , Kober Tobias , Massire Aurélien , Bapst Blanche
Published: February 2023

Objectives

The precise location of multiple sclerosis (MS) cortical lesions can be very challenging at 3 T, yet distinguishing them from subcortical lesions is essential for the diagnosis and prognosis of the disease. Compressed sensing–accelerated fluid and white matter suppression imaging (CS-FLAWS) is a new magnetic resonance imaging sequence derived from magnetization-prepared 2 rapid acquisition gradient echo with promising features for the detection and classification of MS lesions. The objective of this study was to compare the diagnostic performances of CS-FLAWS (evaluated imaging) and phase sensitive inversion recovery (PSIR; reference imaging) for classification of cortical lesions (primary objective) and infratentorial lesions (secondary objective) in MS, in combination with 3-dimensional (3D) double inversion recovery (DIR).

Materials and Methods

Prospective 3 T scans (MS first diagnosis or follow-up) acquired between March and August 2021 were retrospectively analyzed. All underwent 3D CS-FLAWS, axial 2D PSIR, and 3D DIR. Double-blinded reading sessions exclusively in axial plane and final consensual reading were performed to assess the number of cortical and infratentorial lesions. Wilcoxon test was used to compare the 2 imaging datasets (FLAWS + DIR and PSIR + DIR), and intraobserver and interobserver agreement was assessed using the intraclass correlation coefficient.

Results

Forty-two patients were analyzed (38 with relapsing-remitting MS, 29 women, 42.7 ± 12.6 years old). Compressed sensing–accelerated FLAWS allowed the identification of 263 cortical lesions versus 251 with PSIR (P= 0.74) and 123 infratentorial lesions versus 109 with PSIR (P= 0.63), corresponding to a nonsignificant difference between the 2 sequences. Compressed sensing–accelerated FLAWS exhibited fewer false-negative findings than PSIR either for cortical lesions (1 vs 13;P< 0.01) or infratentorial lesions (1 vs 15;P< 0.01). No false-positive findings were found with any of the 2 sequences. Diagnostic confidence was high for each contrast.

Conclusion

Three-dimensional CS-FLAWS is as accurate as 2D PSIR imaging for classification of cortical and infratentorial MS lesions, with fewer false-negative findings, opening the way to a reliable full brain MS exploration in a clinically acceptable duration (5 minutes 15 seconds).
A Randomized Trial of Intra-articular Injection Therapy for Knee Osteoarthritis
Authors: Tschopp Marcel , Pfirrmann Christian W.A. , Fucentese Sandro F. , Brunner Florian , Catanzaro Sabrina , Kühne Nathalie , Zwyssig Iwan , Sutter Reto , Götschi Tobias , Tanadini Matteo , Rosskopf Andrea B.
Published: February 2023

Background

Intra-articular injections are widely used for conservative treatment of knee osteoarthritis (OA). However, rigorous data are lacking regarding the comparative therapeutic effectiveness of these injections.

Purpose

The aim of this study was to compare clinical outcomes after intra-articular injections of glucocorticoid, hyaluronic acid, platelet-rich plasma (PRP), or placebo in patients with mild or moderate OA of the knee.

Materials and Methods

In a double-blinded, placebo-controlled, single-center trial, we randomly assigned knees with early- to middle-stage knee OA (Kellgren-Lawrence grade 1–3) to an intra-articular injection with one of these substances: glucocorticoid, hyaluronic acid, PRP, or placebo. Primary outcome was pain reduction within 6 months after the injection, assessed with the numeric rating scale (NRS; range, 0–100). Secondary outcome parameters included WOMAC scores, Tegner Activity Scale, knee mobility, and adverse events. Finally, a linear mixed-effects model was calculated and corrected for possible patient and covariate effects.

Results

One hundred twenty knees (30 knees per treatment group) in 95 patients (41 female) were included in the final analysis. The median age of patients was 60 years (interquartile range, 54.0–68.0). There was no evidence that the drug effects of primary and secondary outcome parameters differed over time. The median pain at baseline was 32.5 (interquartile range, 15.00–50.00) on NRS. The changes in pain level during the first 6 months compared with baseline were small (within ±5 points on NRS), whereas the intrapatient variability was large between −20 and +20 points. Secondary outcome parameters did not differ significantly among the groups. Kellgren-Lawrence grade did not have a statistically significant effect on pain reduction (P = 0.61).

Conclusions

There is no evidence that knee injections with glucocorticoid, PRP, or hyaluronic acid have superior short- or long-term effects in patients with low pain level at baseline and early- to middle-stage knee OA when compared with placebo.
Hypermetabolic Broad Ligament Leiomyoma in Postmenopausal Women Mimicking Ovarian Tumors on 18F-FDG PET/CT
Authors: Liu Meixi , Wang Peipei , Huo Li , Cheng Wuying
Published: February 2023

Extrauterine leiomyomas are rare and often occur in broad ligament or fallopian tube. Diagnosis of broad ligament leiomyoma is challenging for its solid nature and special location. Leiomyomas typically exhibit mild FDG uptake, especially in postmenopausal woman. We here reported a 57-year-old postmenopausal woman with intense FDG-avid broad ligament leiomyoma on 18F-FDG PET/CT, which might be misdiagnosed as ovarian tumor.
Nuclear Medicine—A Name for Now and the Future
Authors: Bashir Humayun , Gul Muhammad R. , Younis Muhammad N. , Tulchinsky Mark , Li Yaming , Fanti Stefano , Alavi Abass
Published: February 2023

Our article addresses the prevailing trend of new terminology introduced alongside the progress being made in nuclear medicine. Our article provides a historic, current, and future perspective.
PET/CT Manifestations of a Case of Penicilliosis Marneffei Misdiagnosed as Lung Cancer
Authors: Cheng You , Li Wen-min , Wang Shu-xia , Shao Dan
Published: February 2023

Penicilliosismarneffeiis an extremely rare fungal infectious disease and is especially rare in people with normal immunity. Penicilliosismarneffeirestricted to the lung and involving the formation of a pulmonary tumor is difficult to distinguish from peripheral lung cancer. This kind of case has rarely been reported. We report the case of a 53-year-old man with penicilliosismarneffeimisdiagnosed as lung cancer by18F-FDG PET/CT.
18F-THK5351 PET Can Evaluate Tumor Extension in Intravascular Large B-Cell Lymphoma
Authors: Hatano Keiko , Ishibashi Kenji , Kondo Soichiro , Ishii Kenji , Iwata Atsushi
Published: February 2023

A 79-year-old man presenting with gait disturbance and cognitive decline was diagnosed with intravascular large B-cell lymphoma (IVLBCL) by random skin biopsy. Some IVLBCL lesions were identified by PET examinations using 11C-methionine, 18F-FDG, and 18F-THK5351. 11C-methionine and 18F-FDG uptake, which likely reflects the presence of the lymphoma cells themselves, increased clearly in the left putamen but weakly in the left deep white matter. 18F-THK5351 uptake increased in all lesions, likely reflecting perivascular astrogliosis caused by IVLBCL. Hence, 18F-THK5351 PET can evaluate tumor extension in IVLBCL lesions where 11C-methionine and 18F-FDG PET may fail in its visualization.
Is 18F-FDG/18F-Choline Dual-Tracer PET Behavior a Surrogate of Tumor Differentiation in Hepatocellular Carcinoma
Authors: Sivapathasundaram Abarnaa , Golse Nicolas , Pascale Alina , Durand Emmanuel , Sebagh Mylène , Besson Florent L.
Published: February 2023

Background

In hepatocellular carcinoma (HCC) setting, 18F-FDG and 18F-choline PET/CT radiotracers are classically considered surrogates of the degree of differentiation, a strong predictor of disease recurrence after curative treatment. Because the corresponding level of evidence has never been assessed as primary end point, the aim of this retrospective study was to specifically assess the relevance of 18F-FDG combined to 18F-choline PET imaging as a surrogate of tumor differentiation in HCC.

Patients and Methods

A total of 49 histologically proven HCCs (46 patients treated by surgery or liver transplantation) with available baseline 18F-FDG and 18F-choline PET/CT, dedicated liver contrast-enhanced CT scan, and histological key features were retrospectively reviewed. Hepatocellular carcinoma tumors with well, moderately, and poorly differentiation (grades I, II, and III of the World Health Organization classification) were compared on their PET findings (double-blinded visual analysis and 8 usual semiquantitative metrics) by using nonparametric Kruskal-Wallis analyses of variance. In the case of statistical significance, pairwise post hoc tests with family-wise error rate adjustment were performed.

Results

No statistical difference between the grades was observed for any of the patients’ or lesions’ characteristics (P > 0.05), except for the macrovascular invasion between the grades I and II (adjusted P = 0.03). None of the PET findings showed statistical difference between the grades, except the tumor-to-background ratio of 18F-FDG, higher for the grade III compared with grades I (adjusted P = 0.02) and II (adjusted P = 0.01). For less than one third of cases (14 lesions; 28.5%), the regional uptake was judged visually heterogeneous, but none of the related semiquantitative PET metrics were statistically discriminant (P > 0.05).

Conclusions

Contrary to a common belief, 18F-FDG/18F-choline dual-tracer PET behavior is not a relevant surrogate of tumor differentiation in HCC. Future multitracer PET studies are mandatory to refine our knowledges of their deep biological meaning in this field.
Updates on Diagnosis and Treatment of PIK3CA-Related Overgrowth Spectrum
Authors: Chen Hongrui , Gao Wei , Liu Hongyuan , Sun Bin , Hua Chen , Lin Xiaoxi
Published: February 2023

Hyperactivation of the PI3K/AKT/mTOR signaling pathway caused by PIK3CA mutations is associated with a category of overgrowth syndromes that are defined as PIK3CA-related overgrowth spectrum (PROS). The clinical features of PROS are highly heterogeneous and usually present as vascular malformations, bone and soft tissue overgrowth, and neurological and visceral abnormalities. Detection of PIK3CA variants is necessary for diagnosis and provides the basis for targeted therapy for PROS. Drugs that inhibit the PI3K pathway offer alternatives to conventional therapies. This article reviews the current knowledge of PROS and summarizes the latest progress in precise treatment, providing new insights into future therapies and research goals.