bluuebunny/crossref_metadata_2025_split huggingface dataset:
Setmelanotide: a promising advancement for pediatric patients with rare forms of genetic obesity
Authors: Trapp Christine M. , Censani Marisa 
Published: February 2023

Purpose of review
Examine Setmelanotide use in patients with rare genetic variants that disrupt the melanocortin pathway.

Recent findings
Between February 2017 and September 2018, 10 participants with pro-opiomelanocortin (POMC)/ proprotein convertase subtilisin/kexin type 1 (PCSK1) deficiency and 11 participants with leptin receptor (LEPR) deficiency were enrolled in open-label, phase 3 trials at 10 centers in the United States and internationally to assess the efficacy and safety of the melanocortin-4 receptor (MC4R) agonist Setmelanotide. 80% of POMC participants and 45% of LEPR participants achieved at least 10% weight loss at 1 year. Significant changes in hunger scores were seen for both cohorts as well. Setmelanotide was well tolerated with injection site reactions and hyperpigmentation being the most common adverse events reported. As a result, Setmelanotide was approved by the U.S. FDA in 2020 for chronic weight management in adult and pediatric patients ≥6 years of age with POMC, LEPR, or PCSK1 deficiency. In 2022, its approval was extended to include patients with Bardet–Biedel syndrome (BBS) after phase 3 trial data showed that, on average, Setmelanotide treatment resulted in a BMI loss of 7.9% for the 44 BBS participants.

Summary
Rare genetic variants such as POMC, LEPR, and PCSK1 deficiency disrupt MC4R pathway signaling, resulting in severe early-onset obesity, hyperphagia, and increased risk for metabolic co-morbidities. Patients with BBS also demonstrate severe early-onset obesity and hyperphagia, due in part to defective MC4R signaling. Setmelanotide has shown promising benefits in improving satiety scores and weight-related outcomes in patients with these early-life genetic obesity conditions, although longer-term studies are needed.
Ligaments’ preservation in Open Rhinoplasty: Prospective analysis
Authors: Ali Yasser Helmy , Elbadawy Yasser A. , El-dsoky Ibrahim , Autifi Mohamed A. , Elbanooby Tarek , Taha Ahmed , Eleowa Samy , Farahat Ayman , Mohamed Sayed A. , Hamza Fawzy A 
Published: February 2023

Background:
In open rhinoplasty technique, the soft tissue and ligaments are vulnerable to injury. Routine reconstruction of the ligaments usually has little attention by the surgeons.

Purpose:
to assess the effect of preservation of nasal ligaments; Scroll ligament, Septo-columellar ligament and Pitanguy's ligament in open approach rhinoplasty.

Methods:
Prospective Cohort study on 32 patients underwent open rhinoplasty with ligaments' preservation after precise meticulous training on 5 Cadavers.

Results:
All patients have better aesthetic and functional outcome with long lasting preservation of tip projection as well as the same results in early postoperative period. No patient needed secondary revision surgery due to tip dropping or malrotation. The objective findings and subjective assessments were satisfying for the patients and surgeons.

Conclusion:
Refinements of nasal surgery have no limits. Study Suggests that nasal ligaments reconstruction; Scroll ligament, Septo-columellar ligament and Pitanguy's ligament could maintain nasal tip projection and rotation for long time.
Current Surgical Outcomes of Nasal Tip Grafts in Rhinoplasty: A Systematic Review
Authors: Skochdopole Anna , Bay Caroline , Grome Luke , Vorstenbosch Joshua , Yu Jessie , Winocour Sebastian , Reece Edward M. 
Published: February 2023

Background:
Refinement of the nasal tip plays an important role in rhinoplasty surgery outcomes and may be considered the most technically challenging aspect of the procedure. Numerous techniques have been described for nasal tip augmentation utilizing grafts. The aim of this study was to systematically review the existing literature on nasal tip grafts and critically appraise it.

Methods:
A PubMed search was performed to identify journal articles related to nasal tip grafts from the last decade. A total of 44 studies met inclusion criteria. The Newcastle-Ottawa Quality Assessment Scale (NOQAS) and Jadad Scale were used to appraise 38 observational studies and six randomized trials, respectively, to determine the quality of the studies.

Results:
Critical assessment revealed that the studies were highly variable in focus and encompassed autologous, homologous, and alloplastic grafts. The quality of the data included an average NOQAS score of 6.5 (out of 9) and Jadad score of 2.5 (out of 5). A majority (86.4%) of studies included objective outcomes via anthropometric measurements and a portion (27.3%) of studies also included patient-reported outcomes.

Conclusions:
The results of this systematic review suggest that more than one type of nasal tip graft may result in satisfactory outcomes. This review provides an expansive collection of studies on nasal tip grafts which serves as an invaluable tool to the plastic surgeon engaging in rhinoplasty.
Brain volumetrics differ by Fiebig stage in acute HIV infection
Authors: Bolzenius Jacob , Sacdalan Carlo , Ndhlovu Lishomwa C. , Sailasuta Napapon , Trautmann Lydie , Tipsuk Somporn , Crowell Trevor A. , Suttichom Duanghathai , Colby Donn J. , Phanuphak Nittaya , Chan Phillip , Premeaux Thomas , Kroon Eugène , Vasan Sandhya , Hsu Denise C. , Valcour Victor , Ananworanich Jintanat , Robb Merlin L. , Ake Julie A. , Pohl Kilian M. , Sriplienchan Somchai , Spudich Serena , Paul Robert 
Published: February 2023

Objective:
People with chronic HIV exhibit lower regional brain volumes compared to people without HIV (PWOH). Whether imaging alterations observed in chronic infection occur in acute HIV infection (AHI) remains unknown.

Design:
Cross-sectional study of Thai participants with AHI.

Methods:
One hundred and twelve Thai males with AHI (age 20–46) and 18 male Thai PWOH (age 18–40) were included. Individuals with AHI were stratified into early (Fiebig I–II; n = 32) and late (Fiebig III–V; n = 80) stages of acute infection using validated assays. T1-weighted scans were acquired using a 3 T MRI performed within five days of antiretroviral therapy (ART) initiation. Volumes for the amygdala, caudate nucleus, hippocampus, nucleus accumbens, pallidum, putamen, and thalamus were compared across groups.

Results:
Participants in late Fiebig stages exhibited larger volumes in the nucleus accumbens (8% larger; P = 0.049) and putamen (19%; P < 0.001) when compared to participants in the early Fiebig. Compared to PWOH, participants in late Fiebig exhibited larger volumes of the amygdala (9% larger; P = 0.002), caudate nucleus (11%; P = 0.005), nucleus accumbens (15%; P = 0.004), pallidum (19%; P = 0.001), and putamen (31%; P < 0.001). Brain volumes in the nucleus accumbens, pallidum, and putamen correlated modestly with stimulant use over the past four months among late Fiebig individuals (Ps < 0.05).

Conclusions:
Findings indicate that brain volume alterations occur in acute infection, with the most prominent differences evident in the later stages of AHI. Additional studies are needed to evaluate mechanisms for possible brain disruption following ART, including viral factors and markers of neuroinflammation.
Predictors of intact HIV DNA levels among children in Kenya
Authors: Neary Jillian , Fish Carolyn S. , Cassidy Noah A.J. , Wamalwa Dalton , Langat Agnes , Ngugi Evelyn , Benki-Nugent Sarah , Moraa Hellen , Richardson Barbra A. , Njuguna Irene , Slyker Jennifer A. , Lehman Dara A. , John-Stewart Grace 
Published: February 2023

Objective:
We determined predictors of both intact (estimate of replication-competent) and total (intact and defective) HIV DNA in the reservoir among children with HIV.

Design:
HIV DNA in the reservoir was quantified longitudinally in children who initiated antiretroviral therapy (ART) at less than 1 year of age using a novel cross-subtype intact proviral DNA assay that measures both intact and total proviruses. Quantitative PCR was used to measure pre-ART cytomegalovirus (CMV) viral load. Linear mixed effects models were used to determine predictors of intact and total HIV DNA levels (log10copies/million).

Results:
Among 65 children, median age at ART initiation was 5 months and median follow-up was 5.2 years; 86% of children had CMV viremia pre-ART. Lower pre-ART CD4+ percentage [adjusted relative risk (aRR): 0.87, 95% confidence intervals (95% CI): 0.79–0.97; P = 0.009] and higher HIV RNA (aRR: 1.21, 95% CI: 1.06–1.39; P = 0.004) predicted higher levels of total HIV DNA during ART. Pre-ART CD4+ percentage (aRR: 0.76, 95% CI: 0.65–0.89; P < 0.001), CMV viral load (aRR: 1.16, 95% CI: 1.01–1.34; P = 0.041), and first-line protease inhibitor-based regimens compared with nonnucleoside reverse transcriptase-based regimens (aRR: 1.36, 95% CI: 1.04–1.77; P = 0.025) predicted higher levels of intact HIV DNA.

Conclusion:
Pre-ART immunosuppression, first-line ART regimen, and CMV viral load may influence establishment and sustainment of intact HIV DNA in the reservoir.
Longitudinal patterns of initiation, persistence, and cycling on preexposure prophylaxis among female sex workers and adolescent girls and young women in South Africa
Authors: Rao Amrita , Lesko Catherine , Mhlophe Hlengiwe , Rucinski Katherine , Mcingana Mfezi , Pretorius Anje , Mcloughlin Jennifer , Baral Stefan , Beyrer Chris , Hausler Harry , Schwartz Sheree 
Published: February 2023

Objective:
Female sex workers (FSW) and adolescent girls and young women (AGYW) face a disproportionately high risk of HIV in South Africa. Oral preexposure prophylaxis (PrEP) can avert new infections, but its effectiveness is linked to consistent use. Early discontinuation of PrEP in this population is high, but less is known about longitudinal patterns of PrEP use, including patterns of re-initiation and cycling.

Design:
Longitudinal descriptive analysis of routine program data.

Methods:
Between 2016 and 2021, 40 681 FSW and AGYW initiated PrEP at TB HIV Care, the largest PrEP provider to this population in South Africa and were included. Using survival analyses and group-based trajectory modeling, we described patterns of initiation, discontinuation, re-initiation, and cycling.

Results:
Total initiations increased over the life of the program for both FSW and AGYW. About 40% of FSW [0.41, 95% confidence interval (CI) [0.40–0.42]] and AGYW (0.38, 95% CI [0.37–0.38]) remained on PrEP at one month. FSW were more likely to restart PrEP, however <10% restarted PrEP within a year of initiation. Three latent trajectory groups of PrEP use were identified for FSW (low use, early cycling, and ongoing cycling) and two for AGYW (low use and ongoing cycling). Persistence was negatively associated with initiation among AGYW, but there was no clear relationship among FSW. Those initiating later in the program and older women had a reduced risk of discontinuation.

Conclusions:
Persistence on PrEP was low, but cycling on and off PrEP was common, with early missed visits and inconsistent, but ongoing use. A push to increase PrEP initiations needs to factor in readiness and persistence support, to achieve public health impact.
Investigation of the Value of T2 Mapping in the Prediction of Eosinophilic Chronic Rhinosinusitis With Nasal Polyps
Authors: Wang Yuchen , Lou Hongfei , Xian Mu , Cui Jing , Piao Yingshi , Wang Chengshuo , Zhang Luo , Xian Junfang 
Published: February 2023

Objectives
Patients with eosinophilic chronic rhinosinusitis with nasal polyps (eosCRSwNP) usually have more extensive sinus disease, severe symptoms, and poorer disease control compared with patients with non-eosCRSwNP. Separating these entities will be crucial for patient management. The purpose of this study is to investigate T1, T2, and apparent diffusion coefficient (ADC) values of the nasal polyps in patients with CRSwNP and evaluate the usefulness of these parameters for differentiating these diseases.

Methods
Sinonasal magnetic resonance imaging was performed in 36 patients with eosCRSwNP and 20 patients with non-eosCRSwNP (including T1 mapping, T2 mapping, and diffusion-weighted imaging) before surgery. The T1, T2, and ADC values were calculated and correlated with pathologically assessed inflammatory cells of nasal polyps.

Results
Significant higher T2 value, higher eosinophil count, and lower lymphocyte count of the nasal polyps were observed in eosCRSwNP than those in non-eosCRSwNP. There was no significant difference in T1 or ADC values between the 2 groups. T2 value was correlated with eosinophil count and lymphocyte count in CRSwNP. The area under the curve of T2 value for predicting eosCRSwNP was 0.78 with 89.9% sensitivity and 60.0% specificity.

Conclusion
T2 value is a promising imaging biomarker for predicting eosCRSwNP. It can help to distinguish eosCRSwNP from non-eosCRSwNP.
68Ga-PSMA and 68Ga-FAPI-04 PET/CT Findings With 18F-FDG PET/CT in a Patient With Recurrent Prostate Cancer
Authors: Tatar Gamze , Ergül Nurhan , Baloğlu Mehmet Can , Arslan Esra , Çermik Tevfik Fikret 
Published: February 2023

Abstract
A 79-year-old man with prostate cancer was evaluated with 68Ga–prostate-specific membrane antigen (PSMA), 68Ga-FAPI-04, and 18F-FDG PET/CT scans since a rise in prostate-specific antigen was seen at last control while receiving chemotherapy. Abnormal FDG uptakes were observed in the tumoral areas of the left half of the prostate and walls of the bladder, although PSMA and FAPI activity were absent or lower in the relevant tumoral areas. Restaging 68Ga-PSMA and 18F-FDG PET/CT scans were obtained on the patient whose progression continued after transurethral tumor resection. Herein, we present a case proving intraindividual tumor heterogeneity in prostate cancer underwent PET/CT imaging with 3 different radiopharmaceuticals.
A Drop-in Gamma Probe for Minimally Invasive Sentinel Lymph Node Dissection in Prostate Cancer
Authors: Abascal Junquera Jose M. , Harke Nina N. , Walz Jochen C. , Hadaschik Boris , Adshead Jim , Everaerts Wouter , Goffin Karolien , Grootendorst Maarten R. , Oldfield Francesca , Vyas Kunal , Fusco Antoni Mestre , Juanpere Nuria , Vidal-Sicart Sergi , Fumado Lluis 
Published: February 2023

Purpose
This study evaluated the performance of a drop-in gamma probe for prostate cancer (PCa) sentinel lymph node dissection (SLND) in a pelvic phantom, porcine model, and in PCa patients as part of an ongoing prospective multicenter clinical trial.

Methods
Two design variants of the drop-in gamma probe (SENSEI; Lightpoint Medical Ltd) were assessed in the pelvic phantom, and the preferred design was evaluated in a porcine model with clinically representative volumes and 99mTc activities. In the clinical trial, radical prostatectomy, SLND, and extended pelvic lymph node dissection were performed the day after 99mTc-nanocolloid injection and imaging. Sentinel lymph nodes (SLNs) were detected with the drop-in probe and a rigid laparoscopic gamma probe (RLGP). An interim analysis was performed after 10 patients were recruited.

Results
The narrow field of view probe design outperformed the wide field of view design in the pelvic phantom (detection rate, 100% vs 50%). In the porcine model, all activity concentrations could be successfully detected. The drop-in gamma probe successfully detected SLNs in all 10 patients (detection rate, 100%). Two of the SLNs identified by the drop-in gamma probe could not be found with the RLGP. No false-negative cases and no adverse events related to the SLND procedure or the drop-in gamma probe occurred.

Conclusion
The drop-in gamma probe meets the usability and performance requirements for SLND in PCa and provides performance advantages over the RLGP. The final clinical study results will confirm the performance of the technique across multiple sites.
Knowledge of Sunscreen Usage and Skin Cancer Among Malaysian Medical Students – A cross sectional study
Authors: Haris Fadzilah Hazwani Nuruljannah binti , Yea Lee How , Hewage Minduli Thirasaree Jayasree Dumingu , Azme Fathima Salima Mohamed , Soe Htoo Htoo Kyaw , Moe Soe , Htay Mila Nu Nu 
Published: February 2023

ABSTRACTBackgroundExcessive ultraviolet light (UV) can cause premature skin aging and potentially skin cancer. This study evaluated the knowledge, attitude of sunscreen, and skin cancer among Malaysian medical students.MethodsThis cross-sectional study was conducted from October 2022 to November 2022 among the clinical year medical students in a private medical university in Malaysia. The respondents were recruited by purposive sampling method. The content validated questionnaire was used to collect the data, and the data collection was done via online platform.ResultsThere are a total of 117 responses that we collected through an online questionnaire via Google Forms. Among the respondents, 59.8% of the respondents reported of having a poor knowledge about sunscreen. However, 64.96% reported to have good knowledge about skin cancer. Approximately half of the respondents (48.7%) had a good attitude towards sunscreen. Females are more likely to use them compared to men (OR: 9.12, 95% CI: 3.52, 23.64) and there is a difference between ethnicity and the usage of sunscreen.ConclusionThis study demonstrated limited knowledge of sunscreen among medical students. However, they are having better knowledge of skin cancer. Our results spotted the need for education about sunscreen among Malaysian medical students.
Positions of the International Society for Clinical Densitometry and their Etiology: A Scoping Review
Authors: Shepherd John 
Published: February 2023

ABSTRACTThe International Society for Clinical Densitometry convenes a Position Development Conference (PDC) every 2 to 3 years to make recommendations for guidelines and standards in the field of musculoskeletal measurement and assessment. The recommendations pertain to clinically relevant issues regarding the acquisition, quality control, interpretation, and reporting of measures of various aspects of musculoskeletal health. These PDCs have been meeting since 2002 and have generated 214 Adult, 26 FRAX, 41 pediatric, and 9 general nomenclature consideration positions, for a total of 290 positions. All positions are justified by detailed documents that present the background and rationale for each position. However, the linkage to these publications is not maintained by the ISCD or any other publication such that physicians cannot easily understand the etiology of the positions. Further, the wording of many positions has changed over the years after being reviewed by subsequent PDCs. This Scoping review captures the references, changes, and timeline associated with each position through the 2019 PDC. It is meant to serve as a guide to clinicians and researchers for intelligent use and application of the positions.
Data Imputation for Clinical Trial Emulation: A Case Study on Impact of Intracranial Pressure Monitoring for Traumatic Brain Injury
Authors: Zhao Zhizhen , Liu Ruoqi , Groner Jonathan I. , Xiang Henry , Zhang Ping 
Published: February 2023

AbstractRandomized clinical trial emulation using real-world data is significant for treatment effect evaluation. Missing values are common in the observational data. Handling missing data improperly would cause biased estimations and invalid conclusions. However, discussions on how to address this issue in causal analysis using observational data are still limited. Multiple imputation by chained equations (MICE) is a popular approach to fill in missing data. In this study, we combined multiple imputation with propensity score weighted model to estimate the average treatment effect (ATE). We compared various multiple imputation (MI) strategies and a complete data analysis on two benchmark datasets. The experiments showed that data imputations had better performances than completely ignoring the missing data, and using different imputation models for different covariates gave a high precision of estimation. Furthermore, we applied the optimal strategy on a medical records data to evaluate the impact of ICP monitoring on inpatient mortality of traumatic brain injury (TBI). The experiment details and code are available athttps://github.com/Zhizhen-Zhao/IPTW-TBI.
Range-wide differential adaptation and genomic vulnerability in critically endangered Asian rosewoods
Authors: Hung Tin Hang , So Thea , Thammavong Bansa , Chamchumroon Voradol , Theilade Ida , Phourin Chhang , Bouamanivong Somsanith , Hartvig Ida , Gaisberger Hannes , Jalonen Riina , Boshier David H. , MacKay John J. 
Published: February 2023

AbstractIn the billion-dollar global illegal wildlife trade, rosewoods have been the world’s most trafficked wild product since 20051.Dalbergia cochinchinensisandD. oliveriare the most sought-after rosewoods in the Greater Mekong Subregion2. They are exposed to significant genetic risks and the lack of knowledge on their adaptability limits the effectiveness of conservation efforts. Here we present genome assemblies and range-wide genomic scans of adaptive variation, together with predictions of genomic vulnerability to climate change. Adaptive genomic variation was differentially associated with temperature and precipitation-related variables between the species, although their natural ranges overlap. The findings are consistent with differences in pioneering ability and in drought tolerance3. We predict their genomic offsets will increase over time and with increasing carbon emission pathway but at a faster pace inD. cochinchinensisthan inD. oliveri. These results and the distinct gene-environment association in the eastern coastal edge suggest species-specific conservation actions: germplasm representation across the range inD. cochinchinensisand focused on vulnerability hotspots inD. oliveri. We translated our genomic models into a seed source matching application,seedeR, to rapidly inform restoration efforts. Our ecological genomic research uncovering contrasting selection forces acting in sympatric rosewoods is of relevance to conserving tropical trees globally and combating risks from climate change.Significant statementIn the billion-dollar global illegal wildlife trade, rosewoods have been the world’s most trafficked wild product since 2005, withDalbergia cochinchinensisandD. oliveribeing the most sought-after and endangered species in Southeast Asia. Emerging efforts for their restoration have lacked a suitable evidence base on adaptability and adaptive potential. We integrated range-wide genomic data and climate models to detect the differential adaptation betweenD. cochinchinensisandD. oliveriin relevance to temperature- and precipitation-related variables and projected their vulnerability until 2100. We highlighted the stronger local adaptation in the coastal edge of the species ranges suggesting conservation priority. We developed genomic resources including chromosome-level genome assemblies and a web-based application seedeR for genomic model-enabled assisted migration and restoration.
Genomic evidence for West Antarctic Ice Sheet collapse during the Last Interglacial
Authors: Lau Sally C. Y. , Wilson Nerida G. , Golledge Nicholas R. , Naish Tim R. , Watts Phillip C. , Silva Catarina N. S. , Cooke Ira R. , Allcock A. Louise , Mark Felix C. , Linse Katrin , Strugnell Jan M. 
Published: February 2023

AbstractThe marine-based West Antarctic Ice Sheet (WAIS) is considered vulnerable to irreversible collapse under future climate trajectories and its tipping point may even lie within the mitigated warming scenarios of 1.5–2 °C of the United Nations Paris Agreement. Knowledge of ice loss during similarly warm past climates, including the Last Interglacial, when global sea levels were 5–10 m higher than today, and global average temperatures of 0.5–1.5 °C warmer than preindustrial levels, could resolve this uncertainty. Here we show, using a panel of genome-wide, single nucleotide polymorphisms of a circum-Antarctic octopus, persistent, historic signals of gene flow only possible with complete WAIS collapse. Our results provide the first empirical evidence that the tipping point of WAIS loss could be reached even under stringent climate mitigation scenarios.One-Sentence SummaryHistorical gene flow in marine animals indicate the West Antarctic Ice Sheet collapsed during the Last Interglacial.