Summary Increased expression of SIRT1 extends the lifespan of lower organisms and delays the onset of age-related diseases in mammals. Here, we show that SRT2104, a synthetic small molecule activator of SIRT1, extends both mean and maximal lifespan of mice fed a standard diet. This is accompanied by improvements in health, including enhanced motor coordination, performance, bone mineral density and insulin sensitivity associated with higher mitochondrial content and decreased inflammation. Short-term SRT2104 treatment preserves bone and muscle mass in an experimental model of atrophy. These results demonstrate it is possible to design a small molecule that can slow aging and delay multiple age-related diseases in mammals, supporting the therapeutic potential of SIRT1 activators in humans.

Objective Sinonasal inverted papillomas (IP) are benign neoplasms with a propensity for local recurrence. Many risk factors are reported, with little consistency between studies. This study aimed to comprehensively assess for demographic, imaging, histopathologic, and intraoperative risk factors for recurrence. Methods We performed a single‐center retrospective cohort study of patients with pathologically diagnosed IP without malignancy who underwent surgical resection between 1997 and 2018. Eligible patients were identified through a database maintained by the Department of Pathology. Logistic regression identified variables associated with recurrence, and conjunctive consolidation was performed to create a predictive model. Results Of 76 subjects, 37% (n = 28) had recurrence. Median follow‐up and time to recurrence were 2.9 (range 0.5–21.1) and 1.7 (range 0.2–13.0) years, respectively. Confirmed negative margins on histology were protective (odds ratio [OR] 0.25, 95% confidence interval [CI] 0.08–0.85). Frontal sinus involvement (adjusted odds ratio [aOR] 5.83, 95% CI 1.20–28.37), incomplete resection (aOR 9.67, 95% CI 2.24–41.72), and presence of dysplasia (aOR 4.38, 95% CI 1.01–19.10) were significantly associated with recurrence on multivariable analysis. A three‐level composite recurrence risk staging system was created by consolidating the above three variables. The recurrence risks of composite stage I, II, and III disease were 20%, 38%, and 100%, respectively. No demographic, imaging, staging, or surgical approach variables were associated with recurrence. Conclusion Frontal sinus involvement, incomplete resection, and dysplasia were significant risk factors for IP recurrence, whereas confirmed negative margins were protective. Creation of a composite staging system using the above variables may allow for risk stratification and a patient‐specific approach to postoperative IP management. Level of Evidence 3 Laryngoscope, 130:590–596, 2020

Purpose: To determine the presence and characterize location of retinal vascular lesions in patients with hereditary hemorrhagic telangiectasia. Design: Prospective cross-sectional pilot descriptive study. Participants: Eighteen patients (age 22 to 65) with a clinical diagnosis of hereditary hemorrhagic telangiectasia. Methods: Patients completed the Visual Function Questionnaire-25 and underwent a single study visit with dilated ophthalmic examination, optical coherence tomography angiography (OCTA) and fluorescein angiography (FA) with widefield imaging. Main Outcome Measures: Presence of retinal vascular abnormalities in 1 or more quadrants identified on widefield FA, VFQ-25 scores, retinal vessel architecture on FA and OCTA, and dilated ophthalmic exam findings. Results: Of the 18 patients recruited, fine telangiectatic vessels with capillary dilation and tortuosity were identified in 78% by FA imaging. Conclusions: In the first FA and OCTA analysis of the retina of unrelated HHT subjects, we found a high rate of temporal and nasal telangiectasias. These telangiectasias were more apparent

Introduction: Assault appears to be the most frequent cause of facial fractures in certain urban trauma centers, possibly due to the ease of acquiring weapons and increasingly aggressive behavior. The objectives of this study were to identify specific demographic, socioeconomic, maxillofacial fracture, and assault patterns in urban versus suburban communities. Methods: A retrospective chart review of patients who sustained maxillofacial fractures from August 2014 through August 2016 at one urban campus, Einstein Medical Center, Philadelphia, and two suburban campuses, Einstein Medical Center Montgomery and Elkins Park. The χ2 testing was used to compare the categorical variables between the 2 groups. Results: A total of 259 maxillofacial trauma patients were identified, with 204 (79%) in the urban and 55 (21%) in the suburban environment. Patients in the urban population were more likely to be African American (70% vs 33%) and Hispanic (15% vs 6%) but less likely to be Caucasian (12% vs 55%, P < .0001). Urban patients were more likely to be single (70% vs 47%, P < .01), unemployed (64% vs 44%, P < .001), and receive Medicaid coverage (58% vs 26%, P < .001). Urban patients were more likely to be victims of assault (63% vs 44%), whereas suburban patients were more likely to sustain accidental injuries (16% vs 2%, P < .0001). Urban victims were more likely to be assaulted with an object (30% vs 12%) or gun (7% vs 0%, P = .05). Conclusion: Maxillofacial trauma patterns were shown to be significantly different in the urban versus suburban environment.