bluuebunny/crossref_metadata_2025_split huggingface dataset:
The pathogenesis of obesity in people living with HIV
Authors: Bailin Samuel S. , Koethe John R. , Rebeiro Peter F. 
Published: November 2023

Purpose of review
The public health challenge of overweight and obesity increasingly affects people living with HIV (PWH). These effects have also accelerated as the prevalence of antiretroviral therapy (ART) use has increased among PWH. It is therefore also critical that we examine and understand the pathogenesis of obesity among PWH.
This review will aim to summarize relevant and recent literature related to the risks of weight gain and obesity associated with HIV disease progression, cardiometabolic disease, and multimorbidity among PWH. Further, we will discuss adipose tissue changes associated with weight gain and obesity and how these changes relate to metabolic complications.

Recent findings
Several observational and experimental studies in recent years have evaluated the role of contemporary ART regimens, particularly integrase strand transfer inhibitors (INSTIs) and tenofovir alafenamide (TAF), as contributors to weight gain, obesity, and cardiometabolic disease, though the mechanisms remain unclear. Metabolic dysregulation has also been linked to ectopic fat deposition and alterations in innate and adaptive immune cell populations in adipose tissue that accompany HIV and obesity. These factors continue to contribute to an increasing burden of metabolic diseases in an aging HIV population.

Summary
Obesity accompanies an increasing burden of metabolic disease among PWH, and understanding the role of fat partitioning and HIV and ART-related adipose tissue dysfunction may guide prevention and treatment strategies.
Meconium Concentrations of Pesticides and Risk of Hypospadias: A Case–Control Study in Brittany, France
Authors: Rouget Florence , Bihannic Adèle , Le Bot Barbara , Mercier Fabien , Gilles Erwann , Garlantezec Ronan , Multigner Luc , Cordier Sylvaine , Arnaud Alexis , Pladys Patrick , Chevrier Cécile 
Published: November 2023

Background:
Hypospadias is a male genital tract defect for which an increase in prevalence has been documented over the last few decades. A role for environmental risk factors is suspected, including prenatal exposure to pesticides.

Objectives:
To study the risk of hypospadias in association with multiple pesticide measurements in meconium samples.

Methods:
The Brittany Registry of Congenital Anomalies (France) conducted a case–control study between 2012 and 2018. Cases were hypospadias, ascertained by a pediatrician and a pediatric surgeon, excluding genetic conditions, following European Surveillance of Congenital Anomalies guidelines (N = 69). Controls (N = 135) were two male infants without congenital anomaly born after each case in the same maternity unit. Mothers in the maternity units completed a self-administered questionnaire, we collected medical data from hospital records, and medical staff collected meconium samples. We performed chemical analysis of 38 pesticides (parent compound and/or metabolite) by UHPLC/MS/MS following strict quality assurance/quality control criteria and blind to case–control status. We carried out logistic regression accounting for frequency-matching variables and major risk factors.

Results:
Among the 38 pesticides measured, 16 (42%) were never detected in the meconium samples, 18 (47%) were in <5% of samples, and 4 (11%) in ≥5% of the samples. We observed an association between the detection of fenitrothion in meconium and the risk of hypospadias (OR = 2.6 [1.0–6.3] with ncases = 13, ncontrols = 21), but not the other pesticides.

Conclusions:
Our small study provides a robust assessment of fetal exposure. Fenitrothion’s established antiandrogenic activities provide biologic plausibility for our observations. Further studies are needed to confirm this hypothesis.
Carotid intima media thickness and cardiometabolic dysfunction: the Study of Women's Health Across the Nation
Authors: Leis Aleda M. , Jackson Elizabeth A. , Baylin Ana , Barinas-Mitchell Emma , El Khoudary Samar R. , Karvonen-Gutierrez Carrie A. 
Published: November 2023

Abstract

Objective
Carotid artery intima media thickness (cIMT) and adventitial diameter (AD) are subclinical atherosclerosis indicators. Metabolic syndrome (MetS) and obesity are risk factors for atherosclerosis, but their combined impact on atherosclerosis risk is unknown. This study sought to examine the effect of the co-occurrence of MetS with obesity on cIMT and AD.

Methods
The Study of Women's Health Across the Nation (SWAN) is a multi-center, multi-ethnic study. Carotid ultrasound assessments and concurrent physiologic measurements were undertaken between 2009 and 2013. This cross-sectional analysis included 1,433 women with body mass index ≥18.5 kg/m2 and free of prevalent clinical cardiovascular disease. Multivariable linear regression models were used to relate maximum cIMT and AD (dependent variables) with obesity, MetS and their interaction.

Results
The average age was 60.1 years (standard deviation [SD], 2.7 y). The prevalence of obesity and MetS was 44% and 35%, respectively. Women with obesity had a 0.051 mm larger mean cIMT and women with MetS had a 0.057 mm larger cIMT versus women without the respective conditions (both P < 0.001). There was a statistically significant interaction between obesity and MetS (P = 0.011); women with both had a model-adjusted predicted mean cIMT of 0.955 mm (95% confidence interval [CI], 0.897-1.013), higher than those with MetS alone (0.946 mm; 95% CI, 0.887-1.005), obesity alone (0.930 mm; 95% CI, 0.873-0.988), or neither condition (0.878 mm; 95% CI, 0.821-0.935). AD results were similar.

Conclusions
Early detection and treatment of atherosclerotic changes may prevent significant disease. This study suggests there is a minimal impact of obesity on carotid artery thickness beyond MetS alone. All individuals with metabolic dysfunction, regardless of obesity status, should be considered at increased risk for atherosclerotic changes.
Bilateral Free Deep Inferior Epigastric Artery Perforator Flaps for Reconstruction following Mastectomy in Poland Syndrome Patients
Authors: Malekpour Mahdi , Tozzi Federico , Walker John , Fries Charles Anton , Hosein Rayaad C. 
Published: November 2023

Background:
Poland syndrome is classically described as symbrachydactyly, with hypoplasia of the pectoralis major and other upper thoracic musculoskeletal structures. It is thought to be caused by intrauterine interruption in subclavian arterial flow and often includes breast hypoplasia. Affected vasculature can pose a challenge for reconstruction with free flaps because inflow may not be reliable in this patient population.

Methods:
We present the rare case of a 28-year-old woman with left-sided Poland syndrome, significant family history of breast cancer, and BRCA1+ mutation who underwent bilateral prophylactic nipple-sparing mastectomies with successful immediate bilateral deep inferior epigastric artery perforator free flap reconstruction. The surgical literature in this clinical scenario is also reviewed.

Results:
Preoperative computed tomography angiography of the chest successfully demonstrated the patency and quantified the caliber of the internal mammary vessels to support free flap breast reconstruction.

Conclusions:
Free tissue transfer is a viable option for breast reconstruction in patients with Poland syndrome undergoing mastectomy guided by preoperative computed tomography angiography to characterize the internal mammary vasculature.
Is Immediate Lymphatic Reconstruction on Breast Cancer Patients Oncologically Safe? A Preliminary Study
Authors: Lin Ying-Sheng , Kuan Chen-Hsiang , Lo Chiao , Tsai Li-Wei , Wu Chien-Hui , Huang Chieh-Huei , Yeong Eng-Kean , Tai Hao-Chih , Huang Chiun-Sheng 
Published: November 2023

Background:
In breast cancer patients receiving axillary lymph node dissection (ALND), immediate lymphatic reconstruction (ILR) with lymphovenous anastomosis is an emerging technique for reducing the risk of arm lymphedema. However, the oncologic safety of surgically diverting lymphatic ducts directly into venules in a node-positive axilla is still a concern of inadvertently inducing metastasis of remaining cancer cells. This study aimed to assess the oncologic safety of ILR.

Methods:
From January 2020 to January 2022, 95 breast cancer patients received ALND, and 45 of them also received ILR. Patients with recurrent cancer, with follow-up less than 12 months, and with missed data were excluded. Variables were compared between ILR and non-ILR groups, and the outcome of interest was the rate of distant recurrence after follow-up for at least 1 year.

Results:
Thirty-four patients in the ILR group and 32 patients in the non-ILR group fulfilled the inclusion criteria for analysis. No statistically significant difference was noted between groups in terms of age, body mass index, type of breast surgery, pathologic cancer staging, histologic type and grade of breast cancer, molecular subtypes, frequency of axillary lymph node metastasis, or adjuvant therapy. For the patients receiving follow-up for at least 1 year, no statistically significant difference was found in terms of distant recurrence rates between ILR and non-ILR groups (P = 0.44).

Conclusion:
For breast cancer patients receiving ALND, ILR with lymphovenous anastomosis is oncologically safe, within an average follow-up period of 21 months.
Liver disease in germline mutations of telomere-related genes: Prevalence, clinical, radiological, pathological features, outcome, and risk factors
Authors: Sidali Sabrina , Borie Raphaël , Sicre de Fontbrune Flore , El Husseini Kinan , Rautou Pierre-Emmanuel , Lainey Elodie , Goria Odile , Crestani Bruno , Cadranel Jacques , Cottin Vincent , Bunel Vincent , Dumortier Jérôme , Jacquemin Emmanuel , Reboux Noémi , Hirschi Sandrine , Bourdin Arnaud , Meszaros Magdalena , Dharancy Sebastien , Hilaire Sophie , Mallet Vincent , Reynaud-Gaubert Martine , Terriou Louis , Gottrand Frédéric , Abou Chahla Wadih , Khan Jean-Emmanuel , Carrier Paul , Saliba Faouzi , Rubbia-Brandt Laura , Aubert John-David , Elkrief Laure , de Lédinghen Victor , Abergel Armand , Olivier Tournilhac , Houssel Pauline , Jouneau Stephane , Wemeau Lidwine , Bergeron Anne , Leblanc Thierry , Ollivier-Hourmand Isabelle , Nguyen Khac Eric , Morisse-Pradier Hélène , Ba Ibrahima , Boileau Catherine , Roudot-Thoraval Françoise , Vilgrain Valérie , Bureau Christophe , Nunes Hilario , Naccache Jean-Marc , Durand François , Francoz Claire , Roulot Dominique , Valla Dominique , Paradis Valérie , Kannengiesser Caroline , Plessier Aurélie 
Published: November 2023

Background and Aim:
Germline mutations of telomere-related genes (TRG) induce multiorgan dysfunction, and liver-specific manifestations have not been clearly outlined. We aimed to describe TRG mutations-associated liver diseases.

Approach and Results:
Retrospective multicenter analysis of liver disease (transaminases > 30 IU/L and/or abnormal liver imaging) in patients with TRG mutations. Main measurements were characteristics, outcomes, and risk factors of liver disease in a TRG mutations cohort. The prevalence of liver disease was compared to a community-based control group (n = 1190) stratified for age and matched 1:3 for known risk factors of liver disease. Among 132 patients with TRG mutations, 95 (72%) had liver disease, with associated lung, blood, skin, rheumatological, and ophthalmological TRG diseases in 82%, 77%, 55%, 39%, and 30% of cases, respectively. Liver biopsy was performed in 52/95 patients, identifying porto-sinusoidal vascular disease in 48% and advanced fibrosis/cirrhosis in 15%. After a follow-up of 21 months (12–54), ascites, hepato-pulmonary syndrome, variceal bleeding, and HCC occurred in 14%, 13%, 13%, and 2% of cases, respectively. Five-year liver transplantation-free survival was 69%. A FIB-4 score ≥ 3·25 and ≥1 risk factor for cirrhosis were associated with poor liver transplantation-free survival. Liver disease was more frequent in patients with TRG mutations than in the paired control group [80/396, (20%)], OR 12.9 (CI 95%: 7.8–21.3, p < 0.001).

Conclusions:
TRG mutations significantly increase the risk of developing liver disease. Although symptoms may be mild, they may be associated with severe disease. Porto-sinusoidal vascular disease and cirrhosis were the most frequent lesions, suggesting that the mechanism of action is multifactorial.
Aesthetic Outcome and Psychosexual Distress After Treatment for Vulvar High-Grade Squamous Intraepithelial Lesions
Authors: Trutnovsky Gerda , Holter Magdalena , Gold Daniela , Kopera Daisy , Deban Julia , Misut Dina , Aust Stefanie , Tamussino Karl , Greimel Elfriede 
Published: November 2023

Objectives
This study compared aesthetic outcome, psychosexual distress, and treatment satisfaction between women receiving surgical treatment or medical treatment with imiquimod for vulvar high-grade squamous intraepithelial lesion.

Materials and Methods
This is an extended analysis of the multicenter, randomized noninferiority trial “topical imiquimod versus surgery for vulvar intraepithelial neoplasia.” Patients were randomized to primary topical treatment or surgery and stratified by unifocal or multifocal disease. Digital photos of vulvar appearance were subsequently assessed for aesthetic outcome by 3 investigators blinded to group allocation. Psychosexual distress and treatment satisfaction were assessed with the Cervical Dysplasia Distress Questionnaire, the Sexual Activity Questionnaire, and the Client Satisfaction Questionnaire at baseline and follow-up.

Results
One hundred ten patients aged between 19 and 82 years were enrolled. Per-protocol analysis showed complete clinical response in 80% (37/46) using imiquimod, compared with 79% (41/52) after one surgical intervention. Photodocumentation at baseline and 6-month follow-up was available for 84 of these patients (44 imiquimod, 40 surgery). Blinded reviewer assessments of lesion size and lesion severity showed improvement from baseline to follow-up, with no differences between treatment groups. Sexual pleasure, discomfort, and distress remained stable from baseline to follow-up in both groups.

Conclusions
Good aesthetic outcome of vulvar high-grade squamous intraepithelial lesion treatment can be achieved with imiquimod and surgery, consisting of ablation or local excision. Treatment satisfaction and stable psychosexual health may not be dependent on chosen treatment modality, but rather on counseling in accordance with patients’ preferences.
Should endoscopic laser excision be offered as the first-line management for patients with eroded mesh? Outcomes of a systematic review of literature
Authors: Ripa Francesco , Enikeev Dmitry , Talyshinskii Ali , Juliebø-Jones Patrick , Tzelves Lazaros , Kallidonis Panagiotis , Somani Bhaskar 
Published: November 2023

Purpose of review
Mesh erosions following previous synthetic sling/mesh surgery for stress urinary incontinence (SUI) have become increasingly common. This systematic review provides evidence for the role of laser excision as a first-line management in patients with eroded mesh.

Recent findings
Fourteen articles (173 patients) were included for the final review. Among these, 138 patients (79.8%) were submitted to trans-urethral laser excision of eroded urethral/bladder mesh over a median time to presentation of 36.6 months. Over a median follow-up of 23.6 months, 88 (63.7%) reported a complete resolution, 32 (23.2%) reported persistence or recurrence of SUI and 17 (12.3%) presented with recurrent mesh erosion. The success rate after a single endoscopic procedure was 66.5, vs. 93.5% after additional endoscopic procedures, with only 9 (6.6%) requiring open surgical excision. Overall, there were seven (5.1%) postoperative complications including two urethrovaginal fistulas, two UTIs and haematuria each, and one case of urethral diverticulum.

Summary
Laser excision of eroded mid-urethral slings into either the bladder or urethra is a challenging complication of minimally invasive incontinence surgery. Laser excision was able to achieve a good success rate with single or staged endoscopic procedure with a low risk of complication. It represents a valid first treatment option, although patients should be managed in mesh referral centres in collaboration with uro-gynaecology teams.
CEP55, serving as a diagnostic marker gene for osteosarcoma, triggers the JAK2-STAT3-MMPs axis
Authors: Yan Yiqun , He Junyan , Cheng Wendan 
Published: November 2023

Background:
Osteosarcoma (OS) stands as the prevailing form of primary bone cancer in clinical practice. Lack of effective treatment options and an overall poor prognosis are caused by the disease’s exceptionally rare occurrence and unclear rationale.

Objective:
This study’s goal is to determine diagnostic marker genes involved in the progression of OS and investigate related pathways and mechanisms with the purpose of offering effective methods for OS diagnostics and therapy.

Methods:
The Gene Expression Omnibus database provided the gene microarray data. Core genes were identified through differential expression analysis and WGCNA. Three techniques for machine learning, random forest, least absolute shrinkage and selection operator regression, and support vector machine recursive feature elimination, were used to further screen the core genes and obtain diagnostic marker genes for OS. The specificity and sensitivity of the diagnostic marker genes for OS diagnosis were evaluated using receiver operating characteristic curves. Western blotting analysis was used for preliminary validation of the diagnostic marker genes and their related pathways.

Results:
Two diagnostic marker genes were identified through screening, including CEP55 and VWF. Receiver operating characteristic curves have been utilized to assess the diagnostic and therapeutic effects of CEP55 and VWF on OS. Western blotting analysis preliminarily validated the overexpression of CEP55 in OS and its capacity to control MMP2 and MMP9 levels by activating the JAK2/STAT3 signaling pathway.

Conclusion:
At the first time, this research shows that CEP55 and VWF are more powerful diagnostic and predictive indicators for OS. CEP55 holds the capacity to activate the JAK2/STAT3 signaling pathway and modulate MMP2 and MMP9 levels, thereby positioning it as a promising target in OS treatment.
Preventive Practices and Knowledge of Human Papillomavirus in Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome Individuals
Authors: Shim Jessica , Boskey Elizabeth R. , Lossie Amy , Staffa Steven J. , Grimstad Frances W. 
Published: November 2023

Abstract
Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) is a congenital disorder typified by an underdeveloped female reproductive tract. An exploratory online survey of adults with MRKH found that many did not recall receiving the HPV vaccine, and answers to knowledge questions suggested inadequate HPV counseling. However, recalled vaccine counseling was associated with improved uptake.
Mapping Online Community Spaces through Online Focus Group Discussions among GBMSM in Guangdong, China: Implications for HIV/STD Prevention Services
Authors: Tan Rayner Kay Jin , Marley Gifty , Wang Tong , Li Chunyan , Byrne Margaret Elizabeth , Mu Rong , Tang Qiwen , Ramaswamy Rohit , Wang Cheng , Tang Weiming , Tucker Joseph D. 
Published: November 2023

AbstractBackgroundChinese gay, bisexual and other men who have sex with men (GBMSM) face discrimination in many facility-based health services, thus increasing the importance of online engagement. The purpose of this study was to examine online GBMSM community spaces and implications for HIV/STD prevention services.MethodsWe conducted a total of six online focus group discussions with Chinese GBMSM from Guangdong province on the chat-based platform WeChat in 2021. Focus group discussions were asynchronous, and participants were able to provide and map out online spaces that they had participated in and share their perspectives on online engagement. Data were analyzed through framework analysis.ResultsOverall, 48 participants participated. Most were mainly sexually attracted to men (n = 43, 90.0%), and never participated in in-person LGBTQ-related events (n = 29, 60.4%). Participants articulated a typology of online spaces along the axes of whether such spaces were Chinese platforms (vs. non-Chinese) or whether they were GBMSM-specific (vs. non-GBMSM-specific). Participants articulated several advantages of online spaces, including greater anonymity, opportunities for community building, sharing of sexual health information and being able to meet other GBMSM more efficiently. Drawbacks included the lack of personal connection, lack of safety measures for youth, encountering deception and the use of fake profile pictures, and needing a virtual proxy network to access some websites. Participants provided suggestions to further improve their experiences of online spaces.ConclusionsWhile broad-based, GBMSM-specific messaging can be implemented in Chinese, GBMSM-specific spaces, sexual health messaging may also reach niche GBMSM communities in a variety of non-GBMSM spaces.
Predictors of long-term pain and function in individuals who received a custom dynamic orthosis and device-centric care pathway
Authors: Williamson Jared N. , Grunst Megan M. , Lynn Jeffrey , Williamson Gary A. , Blanck Ryan V. , Wilken Jason M. 
Published: November 2023

Introduction:
Carbon fiber custom dynamic orthoses (CDOs) have been shown to effectively reduce pain and improve function in military service members with lower-limb impairment, but data are limited for civilians.

Objectives:
To evaluate the long-term outcomes of individuals who completed a CDO-centric care pathway in a civilian clinic by comparing baseline pain, mobility, and function with outcomes at long-term follow-up. To identify baseline characteristics and postintervention outcomes predictive of outcomes at long-term follow-up.

Methods:
Records of 131 adult patients who received a CDO and CDO-centric training were reviewed. Patient-reported measures of pain and physical function and timed assessment of walking and agility collected during routine clinical care were extracted. These patients were contacted on average 4 (±1) years postintervention to complete a survey including measures of pain and physical function.

Results:
The 63 participants who responded reported improved or greatly improved function, maximum pain, and typical pain on average, irrespective of age or sex (P < 0.001). Change in function from baseline to long-term follow-up was predicted by short-term change in function (35.1% of the variance; P < 0.001). Change in pain from baseline to long-term follow-up was predicted by baseline typical pain and change in four square step test time (63% of variance; P < 0.001).

Conclusions:
Most survey respondents reported positive outcomes. Long-term pain reduction and improved function were predicted by baseline status and by short-term changes associated with receiving a CDO and completing an intensive training program.
Large Bladder Stone Detected on Renal Scintigraphy
Authors: Deng Yan , Su Juan , Liu Zhaohui , Zhang Wei , Lei Xiaoping 
Published: November 2023

AbstractA 39-year-old woman with hydronephrosis underwent99mTc-DTPA renal dynamic scintigraphy to evaluate renal function. The images revealed a central photopenic region in the urinary bladder. SPECT/CT images suggested the abnormal tracer distribution corresponding to a large urinary bladder stone.