bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Efficacy of Continuous Water-Cooling 115-Watt 6.78-MHz Monopolar RF Therapy for Fine Wrinkle Reduction
Authors: Kim JongSeo 
Published: February 2024

Background:
Cosmetic procedures using radiofrequency (RF) technology have garnered significant attention as noninvasive approaches to skin rejuvenation and wrinkle reduction. This study investigates the efficacy of RF therapy in enhancing skin texture, firmness, and appearance. By harnessing the 6.78-MHz “VolNewMer” RF device, skin aging concerns, particularly in terms of skin roughness, laxity, and wrinkles, can be treated.

Methods:
This study engaged a cohort of 50 participants seeking wrinkle reduction and skin-lifting treatments. Employing noninvasive methods, the efficacy of RF therapy was evaluated immediately posttreatment and 1-month posttreatment. Skin roughness was quantified using a computer-based analysis of standardized 3D scanner images, capturing uniform lighting and angles to ensure accurate measurements.

Results:
Among the 45 participants who completed the study, significant improvements in skin roughness were observed. The average roughness (Ra) value decreased from 16.71 to 11.88 arbitrary units immediately posttreatment, signifying a 28.42% enhancement. At the 1-month follow-up, the Ra value further decreased to 12.33 arbitrary units, reflecting a sustained 26.23% improvement. However, 16 participants exhibited even greater improvements at 1 month than immediate.

Conclusions:
RF therapy’s profound impact on skin tightening and rejuvenation is rooted in its ability to trigger immediate collagen contraction, bolstering skin elasticity. The dual-phase process of immediate and delayed skin improvement underscores the intricate interplay between thermal stimulation and collagen remodeling. Optimal energy levels and controlled endpoint monitoring ensure safe and effective RF treatments. The use of the VolNewMer device tips and sliding technique contributes to patient comfort and treatment precision.
A novel model to study mechanisms of cholestasis in human cholangiocytes reveals a role for the SIPR2 pathway
Authors: Islam Diana , Israr Izza , Taleb Mohamed A. B. , Rao Aditya , Yosief Robel , Sultana Rukhsar , Sampaziotis Fotios , Tysoe Olivia C. , Trauner Michael , Karpen Saul J. , Ghanekar Anand , Kamath Binita M. 
Published: February 2024

Background:
Ductular reactivity is central to the pathophysiology of cholangiopathies. Mechanisms underlying the reactive phenotype activation by exogenous inflammatory mediators and bile acids are poorly understood.

Methods:
Using human extrahepatic cholangiocyte organoids (ECOs) we developed an injury model emulating the cholestatic microenvironment with exposure to inflammatory mediators and various pathogenic bile acids. Moreover, we explored roles for the bile acid activated Sphingosine-1-phosphate receptor 2 (S1PR2) and potential beneficial effects of therapeutic bile acids UDCA and norUDCA.

Results:
Synergistic exposure to bile acids (taurocholic acid, glycocholic acid, glycochenodeoxycholic acid) and TNF-α for 24 hours induced a reactive state as measured by ECO diameter, proliferation, lactate dehydrogenase activity and reactive phenotype markers. While NorUDCA and UDCA treatments given 8 hours after injury induction both suppressed reactive phenotype activation and most injury parameters, proliferation was improved by NorUDCA only. Extrahepatic cholangiocyte organoid stimulation with S1PR2 agonist sphingosine-1-phosphate reproduced the cholangiocyte reactive state and upregulated S1PR2 downstream mediators; these effects were suppressed by S1PR2 antagonist JET-013 (JET), downstream mediator extracellular signal-regulated kinase 1/2 inhibitor, and by norUDCA or UDCA treatments. JET also partially suppressed reactive phenotype after bile acid injury.

Conclusions:
We developed a novel model to study the reactive cholangiocyte state in response to pathological stimuli in cholestasis and demonstrated a contributory role of S1PR2 signaling in both injury and NorUDCA/UDCA treatments. This model is a valuable tool to further explore the pathophysiology of human cholangiopathies.
Factors Associated With Diabetes Self-Care Performance in Indonesians With Type 2 Diabetes: A Cross-Sectional Study
Authors: SUKARNO Anita , HU Sophia Huey-Lan , CHIU Hsiao-Yean , LIN Yen-Kuang , FITRIANI Kep S. , WANG Chao-Ping 
Published: February 2024

ABSTRACT

Background
In Indonesia, the number of Type 2 diabetes cases is increasing rapidly, making it the third leading cause of death and among the leading noncommunicable disease healthcare expenditures in the country. Thus, there is a critical need for Indonesians with Type 2 diabetes to perform better self-care to optimize their health and prevent the onset of comorbidities.

Purpose
This study was designed to investigate the influence of knowledge, depression, and perceived barriers on Type 2 diabetes self-care performance in Indonesia.

Methods
A cross-sectional study was conducted on 185 patients with Type 2 diabetes, with demographic, diabetes history, obesity status, diabetes knowledge, depression, perceived barriers, and self-care performance data collected. The Indonesian version of the Revised Diabetes Knowledge Test, Depression Anxiety Stress Scale, Perceived Barrier Questionnaire and Self-Care Inventory-Revised were used. Descriptive, bivariate, and multiple linear regression analyses were performed.

Results
Study participants were found to have moderate diabetes self-care performance scores. Annual eye checks, blood glucose self-monitoring, healthy diet selection, and regular exercise were the least common self-management techniques performed and were consistent with the perceived difficulties of the participants. Being illiterate or having an elementary school education (β = 4.59, p = .002), having a junior or senior high school education (β = 3.01, p = .006), having moderate depression (β = −0.92, p = .04), diabetes knowledge (β = 0.09, p = .006), and perceived barriers (β = 0.31, p < .001) were found to explain 40% of the variance in self-care performance. Educational level, depression, and perceived barriers were the strongest factors that impacted Type 2 diabetes self-care performance in this study.

Conclusions/Implications for Practice
Nurses should not only provide diabetes education but also identify barriers to diabetes self-care early, screen for the signs and symptoms of depression, and target patients with lower levels of education.
Metabolic dysfunction-associated steatotic liver disease and the risk of mortality in individuals with type 2 diabetes: a systematic review and meta-analysis
Authors: Wongtrakul Wasit , Charatcharoenwitthaya Natthinee , Charatcharoenwitthaya Phunchai 
Published: February 2024

The systematic review aimed to assess the risks of metabolic dysfunction-associated steatotic liver disease (MASLD) on all-cause and cause-specific mortality in patients with type 2 diabetes (T2DM). EMBASE and MEDLINE were searched from inception to June 2022 for observational studies examining the relationship between MASLD and the risk of mortality among T2DM patients. Meta-analysis was conducted using random-effects models with hazard ratios (HRs) to quantify the risk of mortality. A total of 5877 articles were screened, and ultimately, 12 eligible studies encompassing 368 528 T2DM patients, with a median follow-up of 8.9 years (interquartile range, 4.7–14.5), were included. Our analysis revealed a significant association between MASLD and an increased risk of all-cause mortality in T2DM patients [HR 1.28; 95% confidence interval (CI), 1.05–1.58; I2
= 90%]. Meta-regression analyses did not show significant effects of mean age, mean BMI, and percentage of smokers, hypertension, and hyperlipidemia on the association between MASLD and the risk of all-cause mortality. However, we found that MASLD was not significantly associated with mortality related to cardiovascular diseases (HR 1.05; 95% CI, 0.82–1.35; I
2 = 0%) or cancer (HR 1.21; 95% CI, 0.41–3.51; I2
= 79%) among patients with T2DM. No publication bias was observed. This comprehensive meta-analysis provides substantial evidence supporting a significant association between MASLD and an increased risk of all-cause mortality among the T2DM population. These findings underscore the potential benefits of screening for MASLD in T2DM patients, aiding in the early identification of high-risk individuals and enabling risk modification strategies to improve survival.
Renal dysfunction during treatment of chronic hepatitis B with tenofovir disoproxyl fumarate and associated risk factors
Authors: Maciel Alessandra M. de A. , Ferraz Maria Lucia C. G. , Perez Renata de M. , Brandão-Mello Carlos Eduardo 
Published: February 2024

Objectives
To analyze the evolution of glomerular filtration rate (GFR) and the presence of renal tubular dysfunction during the treatment of chronic hepatitis B virus (HBV) infection with tenofovir disoproxil fumarate (TDF) and to determine the risk factors involved.

Methods
Retrospective cohort observational study of adults with chronic hepatitis B. Exclusion: hepatitis C virus-HBV coinfection, diabetes, baseline GFR less than 60 ml/min. Measurements of serum and urinary creatinine and phosphate; urinary albumin, retinol-binding protein (RBP) and neutrophil gelatinase-associated lipocalin (NGAL) were performed. Univariate and multivariate analyses tracked factors associated with worsening GFR.

Results
A total of 120 individuals were included: 35% NAÏVE (G1); 49.2% HBV using TDF (G2); 15.8% HBV-HIV using TDF (G3); 63.3% men; 60.8% white; 30% hypertensive. Average age was 50.5 years (SD ± 12.9 years). Reactive HBeAg predominated in G3 (P < 0.001) and cirrhosis in G2 (P < 0.036). NGAL was elevated in 5.3% of cases (G1 = 3.2%; G2 = 8.7%; G3 = 0%; P = 0.582), RBP in 6.7% (G1, G3 = 0%; G2 = 13.6%; P = 0.012), urinary phosphate/creatinine ratio in 16.2% (G1 = 15.2%; G2 = 14.5%; G3 = 23.5%; P = 0.842) and urinary albumin/creatinine ratio in 12.9% (G1 = 12.2%; G2 = 10.7%; G3 = 21.1%; P = 0.494). Worsening of renal function occurred in 22.5% of the population (G1 = 11.9%; G2 = 28.8%; G3 = 26.3%; P = 0.122), independently associated only with systemic arterial hypertension [adjusted odds ratio (AOR) = 4.14; P = 0.008], but not to TDF (AOR = 2.66; P = 0.110) or male sex (AOR = 2.39; P = 0.135). However, the concomitance of these variables generated a high estimated risk for this outcome (51%).

Conclusions
Renal tubular dysfunction was uncommon according to NGAL, RBP or urinary phosphate/creatinine ratio. TDF was not an independent factor for worsening renal function, significantly associated only with systemic arterial hypertension. However, in hypertensive men, the use of TDF should be monitored.
Lipid metabolism during pregnancy: consequences for mother and child
Authors: Mulder Janneke W.C.M. , Kusters D. Meeike , Roeters van Lennep Jeanine E. , Hutten Barbara A. 
Published: February 2024

Purpose of review
Accommodating fetal growth and development, women undergo multiple physiological changes during pregnancy. In recent years, several studies contributed to the accumulating evidence about the impact of gestational hyperlipidemia on cardiovascular risk for mother and child. This review aims to provide a comprehensive overview of the current research on lipid profile alterations during pregnancy and its associated (cardiovascular) outcomes for mother and child from a clinical perspective.

Recent findings
In a normal pregnancy, total and LDL-cholesterol levels increase by approximately 30–50%, HDL-cholesterol by 20–40%, and triglycerides by 50–100%. In some women, for example, with familial hypercholesterolemia (FH), a more atherogenic lipid profile is observed. Dyslipidemia during pregnancy is found to be associated with adverse (cardiovascular) outcomes for the mother (e.g. preeclampsia, gestational diabetes, metabolic syndrome, unfavorable lipid profile) and for the child (e.g. preterm birth, large for gestational age, preatherosclerotic lesions, unfavorable lipid profile).

Summary
The lipid profile of women during pregnancy provides a unique window of opportunity into the potential future cardiovascular risk for mother and child. Better knowledge about adverse outcomes and specific risk groups could lead to better risk assessment and earlier cardiovascular prevention. Future research should investigate implementation of gestational screening possibilities.
Newborn screening for lipid disorders
Authors: Shao Xiangqiang , Steiner Robert , Peterson Amy L. 
Published: February 2024

Purpose of review
Newborn screening is one of the most successful public health programs of the last century and offers unparalleled access to universal screening for a variety of metabolic and other disorders. Interest in development of newborn screening for lipid disorders has intensified in recent years. Screening newborns for lipid disorders has important implications for the health of the newborn as well as their relatives, and in the case of more common lipid disorders like familial hypercholesterolemia, could have important public health implications.

Recent findings
Recent studies have demonstrated feasibility of measuring biomarkers for heterozygous familial hypercholesterolemia from newborn screening dried blood spot specimens. Another lipid disorder, cerebrotendinous xanthomatosis, is currently amenable to newborn screening utilizing currently available assays. New research in next-generation sequencing as a primary screen in newborns will also identify both common and rare lipid disorders in newborns.

Summary
Historically, newborn screening for lipid disorders was not done for many reasons, but new research has developed testing methods that may successfully identify common and rare lipid disorders. This will impact the health of the newborn but could also impact family members and public health.
Comparison of proximal and minus lens autorefraction techniques to measure monocular accommodative amplitude
Authors: Parks Sidney M. , Kulp Marjean T. , Anderson Heather A. 
Published: February 2024

SIGNIFICANCE
This study provides a faster method for objectively measuring accommodative amplitude with an open-field autorefractor in a research setting.

PURPOSE
Objective measures of accommodative amplitude with an autorefractor take time because of the numerous stimulus demands tested. This study compares protocols using different amounts and types of demands to shorten the process.

METHODS
One hundred participants were recruited for four age bins (5 to 9, 10 to 14, 15 to 19, and 20 to 24 years) and monocular amplitude measured with an autorefractor using three protocols: proximal, proximal-lens (letter), and proximal-lens (picture). For proximal, measurements were taken as participants viewed a 0.9 mm “E” placed at 13 demands (40 to 3.3 cm = 2.5 to 30 D). The other protocols used a target (either the “E” or a detailed picture) placed at 33 and 12.5 cm followed by 12.5 cm with a series of lenses (−2, −4, and −5.5 D). Adjustments were made for lens effectivity for the three lens conditions, which were thus 9.6, 11.1, and 12.0 D for individuals without additional spectacle lenses. Accommodative amplitude was defined as the greatest response measured with each technique. One-way analysis of variance was used to compare group mean amplitudes across protocols and differences between letter protocols by age bin.

RESULTS
Amplitudes were significantly different between protocols (p < 0.001), with proximal having higher amplitudes (mean ± standard deviation, 8.04 ± 1.70 D) compared with both proximal-lens protocols (letter, 7.48 ± 1.42 D; picture, 7.43 ± 1.42 D) by post hoc Tukey analysis. Differences in amplitude between the proximal and proximal-lens (letter) protocol were different by age group (p = 0 .003), with the youngest group having larger differences (1.14 ± 1.58 D) than the oldest groups (0.17 ± 0.58 and 0.29 ± 0.48 D, respectively) by post hoc Tukey analysis.

CONCLUSIONS
The proximal-lens protocols took less time and identified the maximum accommodative amplitude in participants aged 15 to 24 years; however, they may underestimate true amplitude in younger children.
Patient barriers and facilitators for making environmental and behavioral modifications for dry eye in the United States
Authors: Saldanha Ian J. , Petris Rebecca , Ifantides Cristos , Hauswirth Scott G. , Gregory Darren G. , Qureshi Riaz , McCann Paul , Liu Su-Hsun , Abraham Alison G. , Li Tianjing 
Published: February 2024

BACKGROUND
Managing dry eye disease (DED) is expensive. Often, prescribed treatments improve clinical signs but not patient-reported symptoms. In large surveys, clinicians and patients ranked environmental and behavioral modifications among the most important DED-related research priorities. Our purpose was to investigate the barriers to and facilitators of use of these modifications by patients with DED in the United States and how their use may be impacted by socioeconomic status (SES).

METHODS
Using Qualtrics, we conducted an anonymous online survey of adults with DED living in the United States in August to September 2022. Patients were identified through the Dry Eye Foundation, Sjögren's Foundation, and a DED clinic in Colorado. We used an established index for classifying respondent SES based on education, household income, and employment. Outcomes included use of environmental and behavioral modifications and barriers to and facilitators of their use.

RESULTS
We included 754 respondents (SES: 382 low, 275 high, and 97 unclear). Most were aged 18 to 49 years (67%), female (68%), and White (76%) and reported dealing with DED for ≤5 years (67%). The most frequent modifications were taking breaks to rest eyes (68%), increasing water intake (68%), and using hot/cold compresses (52%). For these three, the biggest facilitators were as follows: belief that the modification works (27 to 37%), being recommended it (24 to 26%), and ease of use/performance (21 to 32%). Across modifications, the biggest barriers were difficulty of use (55%), lack of family/employer/social/community support (33%), and lack of awareness (32%). The data do not suggest discernible patterns of differences in barriers or facilitators by SES.

CONCLUSIONS
Greater emphasis should be placed on explaining to patients how environmental and behavioral modifications might mitigate DED. Employers and members of patients' support systems should be guided regarding how best to support patients in managing DED symptoms.
Relationship Between Tenofovir Diphosphate Concentrations in Dried Blood Spots and Virological Outcomes After Initiating Tenofovir–Lamivudine–Dolutegravir as First-Line or Second-Line Antiretroviral Therapy
Authors: van Heerden Jennifer Kate , Meintjes Graeme , Barr David , Zhao Ying , Griesel Rulan , Keene Claire Marriott , Wiesner Lubbe , Galileya Lufina Tsirizani , Denti Paolo , Maartens Gary 
Published: February 2024

Background:
Tenofovir diphosphate (TFV-DP) concentration in dried blood spots is a marker of long-term adherence. We investigated the relationship between TFV-DP concentrations and virological outcomes in participants initiating tenofovir–lamivudine–dolutegravir (TLD) as first-line or second-line antiretroviral therapy.

Setting:
Three primary care clinics in Khayelitsha, Cape Town, South Africa.

Methods:
We conducted a post hoc analysis of 2 randomized controlled trials of participants initiating TLD. TFV-DP concentrations and viral loads were measured at 12, 24, and 48 weeks. Multivariable logistic regression was performed to assess the association with virological suppression (<50 copies/mL) per natural logarithm increase in TFV-DP concentration. Generalized estimating equations with logit link were used to assess associations with virological rebound. The Akaike Information Criterion and Quasi-likelihood Information Criteria were used to compare models built on continuous TFV-DP data to 4 previously defined concentration categories.

Results:
We included 294 participants in the analysis, 188 (64%) of whom initiated TLD as second-line therapy. Adjusted odds ratios (95% CIs) of virological suppression were 2.12 (1.23, 3.75), 3.11 (1.84, 5.65), and 4.69 (2.81, 8.68) per natural logarithm increase in TFV-DP concentration at weeks 12, 24, and 48, respectively. In participants with virological suppression at week 12, the adjusted odds ratio for remaining virologically suppressed was 3.63 (95% CI: 2.21 to 5.69) per natural logarithm increase in TFV-DP concentration. Models using continuous TFV-DP data had lower Akaike Information Criterion and Quasi-likelihood Information Criteria values than those using categorical data for predicting virological outcomes.

Conclusion:
TFV-DP concentrations in dried blood spots exhibit a dose–response relationship with viral load. Analyzing TFV-DP concentrations as continuous variables rather than conventional categorization may be appropriate.
Analysis of Diagnosis and Treatment Strategies for Primary Juvenile Psammomatoid Ossifying Fibroma Complicated With Primary Aneurysmal Bone Cyst
Authors: Li Fengzhen , Cheng Xiangyu , Xu Zengyi , Wang Tianyu , Cao Zhiwen , Cai Boyu , Peng Hu , Liu Huanhai 
Published: February 2024

Background:
Juvenile Psammomatoid Ossifying Fibroma (JPOF) is a type of noncancerous bone tumor that usually affects adolescents in the craniomaxillofacial area. Clinical manifestations are usually symptoms caused by the tumor’s invasive compression of surrounding tissues. Aneurysmal Bone Cyst (ABC) is also a benign bone tumor, and it typically occurs in long bones and the spine. Only 2% to 3% of cases occur in the head and neck. Due to the rarity of this combination of clinical cases, clinicians face difficulties in comprehensively understanding this complex lesion. Therefore, a comprehensive review of the clinical manifestations and characteristic imaging findings is necessary for surgeons.

Case presentations:
On April 6, 2019, a 13-year-old boy presented with left maxillofacial bulge and pain for 1 month. Magnetic resonance imaging of the paranasal sinuses showed an irregular hive-like mass signal in the left maxillary sinus, and cystic changes with fluid levels were seen in the lesion. After the initial diagnosis of JPOF with primary ABC, we decided to perform a facial mid-facial resection of maxillary sinus tumor to remove the tumor tissue. Finally, after 3 recurrences and 4 operations, there was no tumor recurrence for 20 months after the last operation, and the patient was still under continuous follow-up.

Conclusions:
This case provided a reference for the diagnosis and treatment of JPOF combined with ABC. In particular, a new understanding of the association between the two diseases and the management of recurrence were proposed, which had the potential to improve clinical understanding of this complicated condition.