A Multicenter, Single-Blind Randomized, Controlled Study of a Volumizing Hyaluronic Acid Filler for Midface Volume Deficit: Patient-Reported Outcomes at 2 Years

BackgroundJuvéderm Voluma XC is a volumizing hyaluronic acid filler used for correction of age-related midface volume deficit (MVD).ObjectivesThe effectiveness of Juvéderm Voluma XC was examined from the patient perspective.MethodsPatients with moderate to severe age-related MVD (N = 235) received Juvéderm Voluma XC. At quarterly follow-up visits for 2 years, patients rated treatment outcomes on the Global Aesthetic Improvement Scale (GAIS), overall satisfaction with facial appearance, satisfaction with midfacial regions, achievement of treatment goal, Look and Feel of the Midface (LAFM), and Self-Perception of Age (SPA). Patients recorded treatment-site responses in 30-day diaries.ResultsAt 6 months and 2 years after treatment, 92.8% and 79.0% of patients, respectively, rated their cheek volume as improved/much improved on the GAIS. Improvement in satisfaction with facial appearance was noted by 89.8% of patients at 6 months and 75.8% at 2 years. Increased satisfaction with outer and lower cheek areas and cheek-bone projection and clinically significant improvements in LAFM were noted through month 24. Treatment goals were achieved by 67.8% of patients at 6 months and 49.0% at 2 years. Patients reported looking, on average, 5 years younger at 6 months and 3 years younger at 2 years. The most common treatment site responses were tenderness, swelling, firmness, and lumps/bumps; most were mild to moderate in severity and lasted ≤2 weeks.ConclusionsJuvéderm Voluma XC for age-related MVD is effective and well-tolerated from the patient perspective, with results lasting up to 2 years.Level of Evidence4 Therapeuti

Duration of wrinkle correction following repeat treatment with Juvéderm hyaluronic acid fillers

Many patients elect to have repeat treatments with hyaluronic acid dermal fillers to maintain wrinkle correction, but the clinical performance of these products after repeat treatments has not been formally assessed. The primary objective of this study was to evaluate the effectiveness of Juvéderm injectable gel (Juvéderm Ultra, Juvéderm Ultra Plus, and Juvéderm 30) through 1 year after repeat treatment of nasolabial folds (NLFs) that were previously treated with Juvéderm or Zyplast 6–9 months prior to the repeat treatment. Upon completion of the pivotal IDE clinical trial for Juvéderm, five of the original 11 study sites were selected to participate in an extended follow-up evaluation, and a total of 80 subjects were enrolled. For the Juvéderm-treated NLFs in each treatment group, the median injection volume was 1.5–1.6 mL for initial treatment but only 0.5–0.6 mL for the repeat treatment (p < 0.0001). Mean Investigator-assigned NLF severity scores on a scale of 0–4 for the Juvéderm-treated NLFs improved from 2.5–2.7 (moderate to severe) at baseline to 1.2–1.5 (mild) just prior to repeat treatment (>24 weeks) and 0.7–0.9 (mild) at 4 weeks after repeat treatment. At 48 weeks post-repeat treatment, the mean NLF scores were 1.1–1.3 (mild), and 78–90% of subjects were considered responders (≥1 point improvement). Thus, subjects sustained a total of 18–21 months of wrinkle correction with a repeat treatment at 6–9 months and needed substantially less filler (60% less) for repeat treatment than for initial treatment, indicating that retreatment at this timepoint may be beneficial to patients

DNA methylation of imprinted genes at birth is associated with child weight status at birth, 1 year, and 3 years

Abstract Background This study assessed the associations between nine differentially methylated regions (DMRs) of imprinted genes in DNA derived from umbilical cord blood leukocytes in males and females and (1) birth weight for gestational age z score, (2) weight-for-length (WFL) z score at 1 year, and (3) body mass index (BMI) z score at 3 years. Methods We conducted multiple linear regression in n = 567 infants at birth, n = 288 children at 1 year, and n = 294 children at 3 years from the Newborn Epigenetics Study (NEST). We stratified by sex and adjusted for race/ethnicity, maternal education, maternal pre-pregnancy BMI, prenatal smoking, maternal age, gestational age, and paternal race. We also conducted analysis restricting to infants not born small for gestational age. Results We found an association between higher methylation of the sequences regulating paternally expressed gene 10 (PEG10) and anthropometric z scores at 1 year (β = 0.84; 95% CI = 0.34, 1.33; p = 0.001) and 3 years (β = 1.03; 95% CI = 0.37, 1.69; p value = 0.003) in males only. Higher methylation of the DMR regulating mesoderm-specific transcript (MEST) was associated with lower anthropometric z scores in females at 1 year (β = − 1.03; 95% CI − 1.60, − 0.45; p value = 0.001) and 3 years (β = − 1.11; 95% CI − 1.98, − 0.24; p value = 0.01). These associations persisted when we restricted to infants not born small for gestational age. Conclusion Our data support a sex-specific association between altered methylation and weight status in early life. These methylation marks can contribute to the compendium of epigenetically regulated regions detectable at birth, influencing obesity in childhood. Larger studies are required to confirm these findings

Dense Gas, Dynamical Equilibrium Pressure, and Star Formation in Nearby Star-Forming Galaxies

We use new ALMA observations to investigate the connection between dense gas fraction, star formation rate, and local environment across the inner region of four local galaxies showing a wide range of molecular gas depletion times. We map HCN (1-0), HCO$^+$ (1-0), CS (2-1), $^{13}$CO (1-0), and C$^{18}$O (1-0) across the inner few kpc of each target. We combine these data with short spacing information from the IRAM large program EMPIRE, archival CO maps, tracers of stellar structure and recent star formation, and recent HCN surveys by Bigiel et al. and Usero et al. We test the degree to which changes in the dense gas fraction drive changes in the SFR. $I_{HCN}/I_{CO}$ (tracing the dense gas fraction) correlates strongly with $I_{CO}$ (tracing molecular gas surface density), stellar surface density, and dynamical equilibrium pressure, $P_{DE}$. Therefore, $I_{HCN}/I_{CO}$ becomes very low and HCN becomes very faint at large galactocentric radii, where ratios as low as $I_{HCN}/I_{CO} \sim 0.01$ become common. The apparent ability of dense gas to form stars, $\Sigma_{SFR}/\Sigma_{dense}$ (where $\Sigma_{dense}$ is traced by the HCN intensity and the star formation rate is traced by a combination of H$\alpha$ and 24$\mu$m emission), also depends on environment. $\Sigma_{SFR}/\Sigma_{dense}$ decreases in regions of high gas surface density, high stellar surface density, and high $P_{DE}$. Statistically, these correlations between environment and both $\Sigma_{SFR}/\Sigma_{dense}$ and $I_{HCN}/I_{CO}$ are stronger than that between apparent dense gas fraction ($I_{HCN}/I_{CO}$) and the apparent molecular gas star formation efficiency $\Sigma_{SFR}/\Sigma_{mol}$. We show that these results are not specific to HCN.Comment: 31 pages, 13 figures, accepted for publication in The Astrophysical Journal, email for access to data table before publicatio

Long-Term Safety and Effectiveness of Style 410 Highly Cohesive Silicone Breast Implants

In 2006, a single-center Swedish study demonstrated a low rupture rate and high patient satisfaction with the Style 410 shaped, form-stable gel implant. The current study aimed to validate the accuracy of the previously published results across multiple European sites.Journal ArticleMulticenter StudyResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe

HIV Disease Impact on Mothers: What They Miss During Their Children’s Developmental Years

Adjusting to chronic illness is very complicated for families with children, as they are already faced with the challenge of development and childrearing. In this study, qualitative interviews were conducted with HIV positive mothers on a number of issues related to being an HIV positive mother raising young children. One topic of the interview was whether or not they felt that HIV had caused them to miss activities with their children while the children were growing up, what types of activities they had missed, the age of the child for each example, and how HIV had led to missing these activities. Interviews were conducted in 2008 with a random sample of 57 mothers being followed in a longitudinal assessment study. All study participants were English or Spanish speaking. Mean age was 44.1 (SD = 5.6) years; 47% were Latina; 35% African American; 11% White; and 7% other race. About 60% of the mothers disclosed that their HIV status had caused them to miss out on activities with their children while their children were growing up, ranging from daily care activities to major school and extra-curricular activities. Some mothers missed significant amounts of time with their children due to hospitalizations. In some cases mothers felt forced into a choice between mothering ability and their own health, including adherence to medications. Implications for the mothers and the children are discussed

Costs of Chronic Diseases at the State Level: The Chronic Disease Cost Calculator

IntroductionMany studies have estimated national chronic disease costs, but state-level estimates are limited. The Centers for Disease Control and Prevention developed the Chronic Disease Cost Calculator (CDCC), which estimates state-level costs for arthritis, asthma, cancer, congestive heart failure, coronary heart disease, hypertension, stroke, other heart diseases, depression, and diabetes.MethodsUsing publicly available and restricted secondary data from multiple national data sets from 2004 through 2008, disease-attributable annual per-person medical and absenteeism costs were estimated. Total state medical and absenteeism costs were derived by multiplying per person costs from regressions by the number of people in the state treated for each disease. Medical costs were estimated for all payers and separately for Medicaid, Medicare, and private insurers. Projected medical costs for all payers (2010 through 2020) were calculated using medical costs and projected state population counts.ResultsMedian state-specific medical costs ranged from $410 million (asthma) to$1.8 billion (diabetes); median absenteeism costs ranged from $5 million (congestive heart failure) to$217 million (arthritis).ConclusionCDCC provides methodologically rigorous chronic disease cost estimates. These estimates highlight possible areas of cost savings achievable through targeted prevention efforts or research into new interventions and treatments

Do Spectroscopic Dense Gas Fractions Track Molecular Cloud Surface Densities?

We use ALMA and IRAM 30-m telescope data to investigate the relationship between the spectroscopically-traced dense gas fraction and the cloud-scale (120 pc) molecular gas surface density in five nearby, star-forming galaxies. We estimate the dense gas mass fraction at 650 pc and 2800 pc scales using the ratio of HCN (1-0) to CO (1-0) emission. We then use high resolution (120 pc) CO (2-1) maps to calculate the mass-weighted average molecular gas surface density within 650 pc or 2770 pc beam where the dense gas fraction is estimated. On average, the dense gas fraction correlates with the mass-weighted average molecular gas surface density. Thus, parts of a galaxy with higher mean cloud-scale gas surface density also appear to have a larger fraction of dense gas. The normalization and slope of the correlation do vary from galaxy to galaxy and with the size of the regions studied. This correlation is consistent with a scenario where the large-scale environment sets the gas volume density distribution, and this distribution manifests in both the cloud-scale surface density and the dense gas mass fraction.Comment: 11 pages, 4 figures, accepted for publication in The Astrophysical Journal Letter

Impact of Plasmodium falciparum infection on the frequency of moderate to severe anaemia in children below 10 years of age in Gabon

BACKGROUND: Improving the understanding of childhood malarial anaemia may help in the design of appropriate management strategies. METHODS: A prospective observational study over a two-year period to assess the burden of anaemia and its relationship to Plasmodium falciparum infection and age was conducted in 8,195 febrile Gabonese children. RESULTS: The proportion of children with anaemia was 83.6% (n = 6830), higher in children between the ages of six and 23 months. Those under three years old were more likely to develop moderate to severe anaemia (68%). The prevalence of malaria was 42.7% and P. falciparum infection was more frequent in children aged 36-47 months (54.5%). The proportion of anaemic children increased with parasite density (p 60%), but was unrelated to P. falciparum parasitaemia. CONCLUSION: Malaria is one of the main risk factors for childhood anaemia which represents a public health problem in Gabon. The risk of severe malarial anaemia increases up the age of three years. Efforts to improve strategies for controlling anaemia and malaria are needed

Intrinsic excitation-inhibition imbalance affects medial prefrontal cortex differently in autistic men versus women

Excitation-inhibition (E:I) imbalance is theorized as an important pathophysiological mechanism in autism. Autism affects males more frequently than females and sex-related mechanisms (e.g., X-linked genes, androgen hormones) can influence E:I balance. This suggests that E:I imbalance may affect autism differently in males versus females. With a combination of in-silico modeling and in-vivo chemogenetic manipulations in mice, we first show that a time-series metric estimated from fMRI BOLD signal, the Hurst exponent (H), can be an index for underlying change in the synaptic E:I ratio. In autism we find that H is reduced, indicating increased excitation, in the medial prefrontal cortex (MPFC) of autistic males but not females. Increasingly intact MPFC H is also associated with heightened ability to behaviorally camouflage social-communicative difficulties, but only in autistic females. This work suggests that H in BOLD can index synaptic E:I ratio and that E:I imbalance affects autistic males and females differently