bluuebunny/crossref_metadata_2025 huggingface dataset:
Pilomatrix Carcinoma: A Benign-Mimic with Malignant Consequences – A Case Report and Review of the Current Literature
Authors: Slovacek Cedar A. , Li Yang , Hurley Maria , Behshad Ramona , Bernstein Michael L.
Published: August 2024

Introduction: Pilomatrix carcinomas (PMXCs) are uncommon, locally aggressive tumors with high recurrence rates, metastatic potential, and fewer than 130 cases reported in the literature. Typically, they present as an unassuming, firm, dermal swelling and therefore are frequently mistaken for more common, benign masses, leading to undertreatment which can cause local invasion and metastatic spread. Diagnosis relies on excision with pathologic analysis; however once diagnosed, there are no current recommendations to guide treatment or surveillance for recurrence or metastases. Case Presentation: Here, we present a case of one of these rare tumors. Our case describes a 1.5 × 2.5 cm firm, mobile mass at the supraorbital rim in an otherwise healthy, young patient. Prior to removal, we suspected a benign pathology; however, excision proved difficult and pathologic diagnosis was consistent with PMXC. Following discussion with tumor board, decision was made to perform Mohs micrographic surgery and staging via CT scans with regular follow-up and surveillance scans. Conclusion: PMXCs are exceedingly rare diagnoses and present like many benign lesions. Therefore, we elected to document this case to encourage providers to keep these biologically aggressive tumors on their list of differential diagnoses in an unsuspecting mass, as well as to provide our own recommendations for treatment and screening for recurrence and metastatic spread.
Pattern-Recognition Receptors and Immunometabolic Reprogramming: What We Know and What to Explore
Authors: Kumar Vijay , Stewart IV John H.
Published: August 2024

Background: Evolutionarily, immune response is a complex mechanism that protects the host from internal and external threats. Pattern-recognition receptors (PRRs) recognize MAMPs, PAMPs, and DAMPs to initiate a protective pro-inflammatory immune response. PRRs are expressed on the cell membranes by TLR1, 2, 4, and 6 and in the cytosolic organelles by TLR3, 7, 8, and 9, NLRs, ALRs, and cGLRs. We know their downstream signaling pathways controlling immunoregulatory and pro-inflammatory immune response. However, the impact of PRRs on metabolic control of immune cells to control their pro- and anti-inflammatory activity has not been discussed extensively. Summary: Immune cell metabolism or immunometabolism critically determines immune cells’ pro-inflammatory phenotype and function. The current article discusses immunometabolic reprogramming (IR) upon activation of different PRRs, such as TLRs, NLRs, cGLRs, and RLRs. The duration and type of PRR activated, species studied, and location of immune cells to specific organ are critical factors to determine the IR-induced immune response. Key Message: The work herein describes IR upon TLR, NLR, cGLR, and RLR activation. Understanding IR upon activating different PRRs is critical for designing better immune cell-specific immunotherapeutics and immunomodulators targeting inflammation and inflammatory diseases.
Gastrointestinal Symptom-Free Multiple Lymphomatous Polyposis: An Atypical Case Presentation of Mantle Cell Lymphoma
Authors: Desai Rahil , Khazey Katherine , Sandhu Hasnoor , Makar Peter , Randhawa Navkiran , Khalyfa Ahamed , Khan Mahnoor , Yarbrough Alex , Spyratos Tilemahos
Published: August 2024

Introduction: Mantle cell lymphoma (MCL), a rare non-Hodgkin’s lymphoma, exhibits a genetic translocation causing CCND1 gene overexpression, affecting 5% of NHL cases, predominantly in males aged 60–70. Typically diagnosed with advanced symptoms, MCL involves widespread disease and organ spread, being aggressive and incurable with a 1.8–9.4-year average survival. Optimal treatment depends on disease aggressiveness and age. Multiple lymphomatous polyposis (MLP), a rare MCL subtype in the GI tract, is usually present with GI symptoms. Case Presentation: A 71-year-old woman was diagnosed with asymptomatic MLP during MCL staging who underwent thoracentesis due to large right pleural effusion and significant axillary lymphadenopathy and was treated with a chemotherapy regimen of rituximab/cytarabine and later transitioned to bendamustine/rituximab. This patient eventually underwent a bone marrow biopsy and later a bone marrow transplant. Conclusion: We present a unique case of asymptomatic MLP, emphasizing the importance of early detection for the poor prognosis of MLP with a mean survival of less than 3 years.
Emphysematous Pyelonephritis in a Patient on SGLT2 Inhibitor Therapy: A Rare Clinical Case Report
Authors: Artinyan Elizabet , Dimov Nikolay , Vaysilova Marina
Published: August 2024

Introduction: Emphysematous pyelonephritis is a rare but potentially life-threatening urinary tract infection characterized by the formation of gas in the renal parenchyma, collecting system, and perinephric tissue. The condition typically develops in patients with specific predisposing factors such as diabetes mellitus, congenital or acquired obstructive uropathies, or individuals taking immunosuppressive agents. Rarely can the disease occur in patients with other predisposing factors, such as the use of SGLT2 inhibitors, but this is quite uncommon. The incidence of urinary tract infections associated with their use is still debatable, but cases of emphysematous pyelonephritis associated with SGLT2 inhibitors have been described in medical literature. Case Presentation: We present a rare case of a patient with emphysematous pyelonephritis without classical risk factors for the disease, who was taking an SGLT2 inhibitor. Conclusion: Although the frequency of urinary tract infections following the use of SGLT2 inhibitors is relatively low, their widespread application for treatment of numerous socially significant diseases underscores the necessity for specialists to be aware with all potential risks associated with their use, including the development of severe urinary tract infections.
Severe Refractory Diarrhea Associated with COVID-19: A Case Report
Authors: Tsuboi Akiyoshi , Shigenobu Shuya , Matsubara Yuka , Hirata Issei , Tanaka Hidenori , Yamashita Ken , Yuge Ryo , Urabe Yuji , Arihiro Koji , Oka Shiro
Published: August 2024

Introduction: Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is frequently associated with various gastrointestinal symptoms, including abdominal pain, vomiting, and diarrhea. Moreover, several cases of refractory diarrhea have been reported after COVID-19 recovery. Herein, we present a case of severe refractory diarrhea associated with COVID-19. Case Presentation: A 50-year-old man with no comorbidities was admitted to our hospital with SARS-CoV-2 pneumonia. His respiratory status deteriorated, and ventilatory management, including extracorporeal membrane oxygenation, was needed. The patient’s respiratory condition improved, resulting in a transfer to another hospital for rehabilitation. However, the patient developed diarrhea that worsened to 6,000–7,000 mL/day, and he was transferred to our hospital. We diagnosed the patient with enterocolitis caused by cytomegalovirus infection and treated him with ganciclovir on day 5 after transfer to our hospital. The diarrhea did not improve. We suspected enterocolitis associated with COVID-19 and administered a methylprednisolone pulse (intravenous injection, 1,000 mg/day for 3 days) on day 10 after transfer, resulting in a marked improvement in his symptoms. The prednisolone dose was tapered, and no recurrence of diarrhea was observed thereafter. Conclusion: The prevalence of COVID-19-associated enterocolitis is low, and the pathogenesis of the disease remains unclear. Prednisolone administration should be considered in cases of post-COVID-19 symptoms of severe diarrhea due to a possible abnormal immune response related to COVID-19.
Mesenteric Panniculitis
Authors: Azar Cecilio , Ibrahim Mohamad Ali , El Kouzi Zakaria , El Mokahal Ali , Omran Nadine , Muallem Nadim , Sharara Ala I.
Published: August 2024

Background: Mesenteric panniculitis (MP) is an uncommon non-neoplastic idiopathic inflammation of adipose tissue, mainly affecting the mesentery of the small intestine, with its etiology remaining largely speculative. The difference in prevalence of MP among females and males varies across multiple studies. In most cases, MP is asymptomatic; however, patients can present with nonspecific abdominal symptoms or can mimic underlying gastrointestinal and abdominal diseases. The diagnosis is suggested by computed tomography and is usually confirmed by surgical biopsies if necessary. Treatment is generally supportive and based on a few selected drugs, namely, nonsteroidal anti-inflammatory drugs or corticosteroids. Surgery is reserved when the diagnosis is unclear, when malignancy is suspected or in the case of severe presentation such as mass effect, bowel obstruction, or ischemic changes. Summary: MP is a rare inflammatory condition of the mesentery often asymptomatic but can cause nonspecific abdominal symptoms. Diagnosis relies on computed tomography imaging, with treatment mainly supportive, utilizing medications like nonsteroidal anti-inflammatory drugs or corticosteroids, while surgery is reserved for severe cases or diagnostic uncertainty. Key Messages: MP causes abdominal pain, and it is mainly diagnosed with CT scan.
Pressure-Induced Stromal Keratopathy after Surface Ablation Surgery
Authors: Guedes Jaime , Vilares-Morgado Rodrigo , Brazuna Rodrigo , Costa Neto Alexandre , Mora-Paez Denisse Josefina , Salomão Marcella Q. , Faria-Correia Fernando , Ambrósio Jr. Renato
Published: August 2024

Introduction: The purpose of this clinical report was to describe an unprecedented case of bilateral pressure-induced stromal keratopathy (PISK) following corneal photorefractive keratectomy, associated with presumed herpetic keratitis, and to present tomographic and biomechanical findings before and after appropriate treatment. Case Presentation: A 33-year-old male patient was referred to our clinic with suspected delayed corneal epithelial healing 3 weeks after an uncomplicated PRK. A central layer of corneal opacity with a presumed fluid-filled interface area was observed upon slit lamp biomicroscopy. Scheimpflug images from the Pentacam® revealed a hyperreflective area beneath the central cornea. Scheimpflug-based corneal tomography, biomechanical assessment using the Pentacam® AXL Wave, and the Corvis ST® were conducted. Goldmann applanation tonometry measured 23/13 mm Hg, while noncontact tonometry intraocular pressure measured with the Corvis ST® (Corvis ST IOPnct) was 40.5/43.5 mm Hg. Treatment with oral valacyclovir, combined with ocular hypotensive therapy, led to a significant reduction in IOP and improved corneal deformation parameters after 1 month. Conclusion: Surgeons should be aware of the inaccuracy of Goldmann applanation tonometry in PISK, which can occur after LASIK or surface ablation.
Patients’ Preference on Advanced Therapy and Follow-Up Procedure for Inflammatory Bowel Disease in Japan: A Web-Based 3A Survey
Authors: Morishita Toshifumi , Yanai Shunichi , Toya Yosuke , Matsumoto Takayuki
Published: August 2024

Introduction: With the recent increase in number of drugs for treating inflammatory bowel disease (IBD), it has become important to select treatments acceptable to patients. Endoscopy and biomarkers from blood and stool samples are used to evaluate IBD disease activity. This study aimed to clarify the acceptability of usage of advanced therapy and examination methods in patients through an internet-based survey. Methods: Patients with inflammatory bowel disease were asked via the internet to participate in a survey on the acceptability of nine therapies and three examination methods. The respondents rated acceptability on a scale of 1–10 and specified the most preferred option. Results: Responses were obtained from 388 patients with ulcerative colitis and 82 with Crohn’s disease; 14.5% and 11.5% of the patients underwent intravenous infusions and subcutaneous injections, respectively. Once-daily oral administration had the highest acceptability score, which was significantly different from other administration usages (p < 0.0001), regardless of prior treatment history. Oral administration was preferred by 88.9% of patients. The ranking of examination methods from most to least acceptable was blood tests > endoscopy > stool tests, with significant differences among all groups (p < 0.0001). Blood testing (76%) and stool testing (4.5%) were the most and least preferred methods, respectively. Conclusions: The most acceptable usage of advanced therapy in patients with inflammatory bowel disease was once-daily oral administration. Treatments that are effective, safe, and acceptable to patients should be selected, and examination methods acceptable to patients should be used.
Metastatic Pancreatic Adenocarcinoma Downstaged to T0N0 with Chemotherapy and Targeted Therapy, Confirmed by Surgical Pathology: A Case Report
Authors: Ardalan Bach , Livingstone Alan , Franceschi Dido , Sleeman Danny , Azqueta Jose , Gonzalez Rosali , England Jonathan
Published: August 2024

Introduction: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive human tumor that is typically diagnosed at a later stage when surgery is not possible. Case Presentation: We report the case of a 62-year-old woman who presented to the emergency department with abdominal pain. Computed tomography (CT) revealed a solitary hepatic lesion and a pancreatic body lesion. The pancreatic body lesion was biopsied endoscopically, and a tissue diagnosis was obtained to confirm the diagnosis of PDAC. She was then treated with 12 cycles of FOLFIRINOX with stable disease on CT. Due to the history of a hepatic lesion, she received 11 cycles of gemcitabine/Abraxane and a combination of a MEK inhibitor, Mekinist, and a BRAF inhibitor, BRAFTOVI. Subsequently, the patient underwent a liver biopsy. The biopsy result was negative, and the tumor was deemed resectable. The patient underwent a distal pancreatectomy. Surgical pathology demonstrated a 1.1-cm low-grade papillary mucinous neoplasm with negative margins and lymph nodes, staged T0N0. Adjuvant chemotherapy was not administered. Conclusion: To our knowledge, this is the first report of a patient with metastatic pancreatic adenocarcinoma who received prolonged IV and oral chemotherapy. At the time of the operation, the pathological stage was T0N0. The patient has recently been seen 9 months after surgery with no evidence cancer recurrence. Additionally, ctDNA remains negative.
Polypoid Large Intestinal Involvement of Metastatic Castrate-Resistant Prostate Cancer: A Case Report
Authors: Narayanan Sathya , Dvuchbabny Sapir , Arzivian Arteen , Kim Sang , Cheng Robert , Gurney Howard
Published: August 2024

Introduction: Prostate cancer most commonly metastasizes to the bone and lymph nodes. Gastrointestinal metastasis has been noted in the literature but appears to be an exceedingly uncommon phenomenon. Large intestinal involvement in particular has been reported on only a few occasions, and never concomitantly with small intestinal metastatic involvement. Case Report: We report the case of a 69-year-old gentleman with metastatic castrate-resistant prostate cancer with development of gastrointestinal symptomatology with extensive investigation eventually revealing small and large intestinal polyps subsequently confirmed to be representative of metastatic prostate cancer. Conclusion: This case demonstrates the importance of maintaining a wide differential diagnosis in the context of gastrointestinal symptomatology in malignancy. Thorough endoscopic evaluation may be necessary in such cases in order to identify potential metastatic malignancy in otherwise relatively unremarkable appearing polyps.
SMARCA4/SMARCA2-Deficient Undifferentiated Metastatic Malignant Tumor with Carcinoma of Unknown Primary: Case Report
Authors: Craven Amanda , Goodman Alexandra , Hariri Dana , de la Roza Gustavo , Sampat Parth , Poiesz Bernard
Published: August 2024

Introduction: SMARCA4/SMARCA2 deficiencies have been linked to a variety of neoplasms and have been mainly described in cases of thoracic non-small cell lung cancers. Case Presentation: Here we present a case of SMARCA4/SMARCA2-deficient undifferentiated metastatic malignant tumor with carcinoma of unknown primary. The staining on pathology as well as the unremarkable size of the lung masses raises the possibility of dedifferentiated tumor of unknown primary. Conclusion: This case highlights the need for more routine testing of SMARCA4/SMARCA2 deficiencies as well as the development of more targeted therapies as these mutations are often associated with an aggressive course and poor outcomes.
Low-Salicylate Diet in Patients with Non-Steroidal Anti-Inflammatory Drug-Exacerbated Respiratory Disease: Personalization of Indications to Dietary Treatment
Authors: Jura-Szoltys Edyta , Rymarczyk Barbara , Gawlik Radoslaw , Glück Joanna
Published: August 2024

Introduction: A particularly aggressive course of chronic sinusitis with nasal polyps is seen in patients with bronchial asthma and hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs). These patients often report exacerbation associated with consumption of foods reach in salicylates. Therefore, the authors analyzed the effect of a low-salicylate diet (LSD) on the course of chronic sinusitis with polyps in patients with NSAID-exacerbated respiratory disease (N-ERD) to answer the question: which patients would obtain the best therapeutic benefit? Methods: Adult patients with N-ERD were selected for dietary intervention with LSD. Patients were seen on two occasions: at an initial visit and a follow-up after 12 weeks of diet. At both visits, an evaluation was performed with total nasal symptom score (TNSS) and modified Lund-Kennedy (L-K) endoscopy score. Results: Forty patients (21 female, 52.5%, median and IQR of age 52; 43.5–61) used LSD for 12 weeks. Initial analysis of dietary intervention in the whole group revealed a significant decrease in TNSS and each symptom assessed separately, and the L-K score. The group was further divided into two subgroups based on the distance between NSAID intake and the beginning of symptoms: patients with immediate (n = 9; 22.5%) or non-immediate (n = 31; 77.5%) symptoms. The absolute change in nasal obstruction, itching, TNSS, and L-K scores were significantly higher in patients with immediate than with non-immediate symptoms. Conclusion: Results of the study indicate that patients with N-ERD and immediate symptoms may clinically benefit more from an LSD as an additional therapeutic option than patients with non-immediate symptoms.
A Simple Orbital Lymphatic Malformation Clinically Mimics Primary Conjunctival Cyst
Authors: Leelawongs Sasikant , Krungkraipetch Luksanaporn
Published: August 2024

Introduction: A simple orbital lymphatic malformation usually presents with acute proptosis with ophthalmoplegia after an upper respiratory tract infection. Various treatments have been described but the lesions often recur after treatment due to their infiltrative nature. Case Presentations: A 6-year-old girl presented with a 5 × 10 mm translucent mass in the left inferior fornix for 3 years but she denied diplopia and visual disturbance. Orbital computed tomography with contrast emphasized the clinical findings, a nonseptated cystic lesion without enhancement in the anterior orbit. The lesion was surgically totally excised. Histopathological findings revealed an endothelial lining cyst without intraluminal cells consistent with a lymphatic malformation. In a 1-year follow-up, the lesion does not recur. Conclusion: The simple orbital lymphatic malformation can present as a single nonseptate cystic lesion. Pathological study should be done for the definitive diagnosis. Surgical excision can achieve a favorable outcome.
Molecular Characterization of Enteric Viruses Causing Acute Gastroenteritis among Children under 5 Years Old in Distrito Central, Honduras
Authors: Ortiz-Quintero Jafet , Cabrera Yessy , Bourdett-Stanziola Lurys , Ferrera Annabelle
Published: August 2024

Introduction: Diarrheal diseases constitute a significant public health problem in terms of mortality and morbidity. In Honduras and around the world, RVs have consistently emerged as the single most important etiologic agent in acute childhood diarrhea. However, other viruses, such as NoVs and HAstVs, have also been shown to be responsible for viral gastroenteritis. Unfortunately, the country has limited information concerning the etiologic role of these viral agents in acute gastroenteritis. This study investigated the frequency, genotypes, and epidemiological characteristics of RV-A, NoVs, and HAstVs among children under 5 years old in Distrito Central, Honduras. Methods: Stool samples and their corresponding epidemiological data were collected from children with acute gastroenteritis in three healthcare centers in Distrito Central. All samples were screened by immunoassays for RV-A and HAstVs. RV-A-positive samples were molecularly characterized by RT-PCR and genotyping assays. RT-PCR was also applied to confirm HAstVs positivity and to detect NoVs, followed by nucleotide sequencing to assign their genotypes. Results: Our results show that at least one viral agent was detected in 31% of the children. The frequency of RV-A, NoVs, and HAstVs was 14%, 13%, and 5%, respectively. The most frequent RV-A genotype was G2P[4], occurring in 93% of cases. 92.3% of NoVs-positive samples belonged to genogroup II, with GII.4 and GII.16 being the most common. HAstVs were clustered into three genotypes: HAstV-1, HAstV-2, and HAstV-8. Only one sample showed coinfection with NoVs and HAstVs. Conclusion: This comprehensive molecular and epidemiological characterization of enteric viruses demonstrates the vast diversity of these agents and describes for the first time NoVs and HAstVs as causative agents of acute childhood gastroenteritis in Distrito Central, Honduras. This suggests that further in-depth studies of the pediatric population are necessary to develop and implement effective preventive and control measures in the country.
De-Escalated Adjuvant Treatment for Advanced MMR Deficient Mixed Endometrioid/Clear Cell Endometrial Carcinoma with PD-1 Inhibition Alone: A Case Report
Authors: Blemur Danielle M. , Reddy Ravali A. , Lang Susan M. , Renz Malte
Published: August 2024

Introduction: Advanced mixed epithelial endometrial carcinomas are rare high-grade cancers with a poor prognosis. A clear cell component infers relative chemotherapy insensitivity, likely further increased by p53 wild type status and MMR deficiency. PD-1 inhibition for MMR deficient endometrial cancers has been recently added to first-line adjuvant treatment in combination with platinum-based chemotherapy. Information on de-escalation of adjuvant treatment to PD-1 inhibition alone without chemotherapy is sparse. Case Presentation: Here, we present a patient with advanced stage mixed epithelial endometrial carcinoma, a clear cell component and MMR deficiency who underwent de-escalated adjuvant treatment with PD-1 inhibition alone without simultaneous chemotherapy. Conclusion: Histotype-agnostic adjuvant monotherapy with checkpoint immune inhibitors alone appears to be a highly effective even in the rare mixed endometrial carcinomas if MMR protein deficient as described in this case report.
Automate, Illuminate, Predict: A Universal Framework for Integrating Wearable Sensors in Healthcare
Authors: O'Brien Megan K. , Hohl Kristen , Lieber Richard L. , Jayaraman Arun
Published: August 2024

Background: Wearable sensors have been heralded as revolutionary tools for healthcare. However, while data are easily acquired from sensors, users still grapple with questions about how sensors can meaningfully inform everyday clinical practice and research. Summary: We propose a simple, comprehensive framework for utilizing sensor data in healthcare. The framework includes three key processes that are applied together or separately to (1) automate traditional clinical measures, (2) illuminate novel correlates of disease and impairment, and (3) predict current and future outcomes. We demonstrate applications of the Automate-Illuminate-Predict framework using examples from rehabilitation medicine. Key Messages: Automate-Illuminate-Predict provides a universal approach to extract clinically meaningful data from wearable sensors. This framework can be applied across the care continuum to enhance patient care and inform personalized medicine through accessible, noninvasive technology.
Iatrogenic Corneal Puncture at the Beginning of Cataract Surgery Which Was Managed Uneventfully
Authors: Kim Seonghwan , Lee Jeong Hyun
Published: August 2024

Introduction: Cataract surgery is one of the most commonly performed surgical procedures worldwide. Intraoperative and postoperative complications of cataract surgery include posterior capsule rupture, retinal detachment, suprachoroidal hemorrhage, cystoid macular edema, endophthalmitis, and intraocular lens dislocation. As corneal perforation is rarely related to cataract surgery, we report a case of intraoperative iatrogenic corneal puncture that led to a full-thickness laceration that was managed without severe complications. Case Presentation: An 81-year-old woman underwent immediate sequential bilateral cataract surgery. Cataract grading of both eyes was nuclear color grade II and cortical cataract grade III, according to the lens opacity classification system III. While performing cataract surgery on her right eye, a corneal puncture with a keratome incidentally occurred just before making the main temporal incision, resulting in a 3-mm full-thickness laceration at the peripheral cornea. One-bite of 10-0 nylon suture was placed, and the remaining procedure was performed through a superior main incision. Three-bites of 10-0 nylon suture were placed at the laceration site at the end of the procedure. The uncorrected visual acuity was 20/40 in both eyes the following day. Corneal astigmatism increased in the right eye, and the refractive error was more myopic than targeted. No leakage was observed. Conclusion: Slight corneal contact with a keratome can lead to full-thickness laceration when the anterior chamber is filled with an ophthalmic viscosurgical device during cataract surgery. Caution should be exercised while manipulating sharp surgical instruments to avoid such complications.
Exploring the Impact of Age and Pre-Stroke Modified Rankin Scale in Elderly Thrombectomy: A 15-Year Single-Center Experience
Authors: Enriquez Brian Anthony B. , Halling Heidi Kristine , Lund Christian Georg , Tennøe Bjørn , Brunborg Cathrine , Skjelland Mona Elisabeth , Aamodt Anne Hege , Skagen Karolina
Published: August 2024

Introduction: The selection of endovascular thrombectomy (EVT) for acute ischemic stroke in the elderly remains challenging due to the underrepresentation of these patients in landmark randomized trials. The aim of this study was to assess the association between age and the pre-stroke modified Rankin scale score with functional outcomes after EVT in elderly patients aged ≥80 years. Methods: We prospectively collected data from consecutive elderly patients who underwent EVT of the anterior or posterior circulation at our institution between 2007 and 2022. Clinical and radiological parameters were analyzed using a fair outcome (mRS ≤3 or retained pre-stroke mRS score of 4) as the primary outcome. Results: In total, 307 elderly patients were included in the analysis. Fair functional outcomes were achieved in 162 (53%) patients. Eighty-four (27.4%) patients were deceased at 3-month follow-up and the mortality rate increased to 37.1% (114 deceased) at 1-year follow-up. The likelihood of achieving a fair functional outcome decreased by 8% for every 1-year age increase (OR 0.81, 95% CI 0.73–0.90). Lower National Institutes of Health Stroke Scale (OR 0.89, 95% CI 0.85–0.93, p < 0.001) and pre-stroke mRS (OR 0.67, 95% CI 0.53–0.84, p < 0.001) were associated with fair outcomes. Conclusions: EVT in elderly patients with stroke is beneficial in selected cases. Increasing age was associated with an increased risk of an mRS change to 4 or worse and death within 1 year. The pre-stroke mRS may aid clinicians in the selection of elderly patients for EVT.
Association of Arterial Stiffness with Chronic Kidney Disease: A Systematic Review
Authors: Beros Angela L. , Sluyter John D. , Scragg Robert
Published: August 2024

Introduction: Significant kidney function may be lost before CKD is diagnosed. Arterial stiffness may be a risk factor for CKD and the relationship may be bi-directional. A systematic review of cohort studies was undertaken to ascertain the temporal relationship of arterial stiffness and CKD. Methods: MEDLINE and Embase were searched to 4 October 2023 to identify studies that investigated whether arterial stiffness, as estimated by pulse wave velocity, was predictive of the development or progression of CKD, rapid decline in kidney function, and vice versa. The characteristics and outcomes of the included studies were set out in a qualitative summary. The review protocol is registered with PROSPERO (CRD42019129563). Results: Forty-two studies were included, all of which were high quality with respect to bias. Thirteen of seventeen studies that investigated arterial stiffness as a predictor of incident CKD found a positive association (p < 0.05). Of the 10 studies that controlled for CKD risk factors, 6 found a positive association. Eight of seventeen studies that investigated arterial stiffness as a predictor of progression of CKD, and five out of eight studies, which investigated rapid kidney decline, found a positive association. One study of six found kidney function was able to predict future elevated arterial stiffness. Conclusion: Arterial stiffness may predict incident CKD and a rapid decline in CKD. It is uncertain if arterial stiffness is associated with CKD progression or whether reduced kidney function is predictive of increased arterial stiffness. Further longitudinal research is required.
Evaluation of Macular Thickness in Glaucoma Patients Using Prostaglandin Analog Eye Drops Undergoing Trabeculectomy with Mitomycin C: Prospective, Comparative, Randomized, Masked Examiner Study
Authors: Assis de Britto Santiago Sula Cristina , Pereira de Ávila Marcos , Magacho Leopoldo
Published: August 2024

Introduction: The aim of the study was to evaluate the macular thickness of glaucomatous patients undergoing trabeculectomy (TREC) with mitomycin C (MMC) with or without the use of prostaglandin analog (PA) eye drops. Methods: In this prospective, comparative clinical trial, patients with glaucoma and indications for TREC with MMC using PA and without previous macular changes were randomized into 2 groups: the study group (SG) and the control group (CG). In the CG, PA was suspended between 30 and 60 days after the preoperative exams. The subjects were evaluated, including optical coherence tomography (OCT) with the Cirrus 4000 macular protocol preoperatively and in the postoperative period on 3 occasions: 1–3 days (“PO1”), 6–9 days (“PO7”), and 27–30 days (“PO30”) after surgery. The results were compared between groups. Results: Thirty-five eyes of 35 patients were included (17 in the CG and 18 in the SG). There was no statistically significant difference in age (p = 0.2), the preoperative visual field mean deviation (p = 0.08), or the preoperative intraocular pressure (SG: 24.8 ± 7.8 mm Hg vs. CG: 22.8 ± 6.0 mm Hg, p = 0.4). The preoperative macular OCT parameters were equivalent between the groups (p > 0.05). When comparing the variation of parameters between the groups between preop and PO30 there was equivalence in all of the comparisons evaluated. The presence (or absence) of the lens did not affect the results. Conclusion: PA eye drops did not affect macular thickness after TREC with MMC in glaucomatous patients.
“Art Is the Armchair in Which the State Sits for Its Own Pleasure”
Authors: Susik Abigail
Published: August 2024

In mid-January 1925, André Breton published an editorial, “La dernière grève” (The Last Strike) in the opening pages of the second issue of the new Parisian journal he helped produce, La Révolution surréaliste (Surrealist revolution). Breton’s essay discusses the tentative economic value of cultural and intellectual production in the capitalist economy and calls for artists, philosophers, and scholars to undertake a general strike for a period lasting between several nights to one year. Breton’s “Last Strike” essay influenced another and much more well-known call for an art strike by a French writer who was closely aligned with surrealism, Alain Jouffroy. The purpose of this essay is to analyze Breton’s 1925 “Last Strike” essay in relation to Jouffroy’s late 1960s statements on the art strike and the revolutionary abolition of art, in order to determine the differences and similarities between their approaches, and to demonstrate how surrealism is essential to Jouffroy’s theories about the abolition of art as a key aspect of anticapitalist culture.
The Court’s Correcting Mechanism: ‘General Measures’ as a Judicial Remedy to Address Legislative Inaction?
Authors: Bombay Anne
Published: August 2024

Citizens confronted with a domestic legislator remaining inactive in contravention of its human rights obligations may turn to the European Court of Human Rights (ECtHR or Court). Having already passed legal challenges at the ‘heads’ end of the European system of human rights, the question arises whether they can find redress at the ‘tail’. When the ECtHR establishes a violation due to a lack of regulatory framework, it may decide to indicate general measures in Article 46 and pilot judgments. Based on an analysis of case law, this paper elaborates on how the Court goes about its remedial practice in legislative inactivity cases. The observations relate to addressing the domestic legislator directly, and the frequency, legal status, content, and deadline of the measures. They can, at least in part, be explained by the Court’s adherence to the principle of subsidiarity. Still, many uncertainties concerning the Court’s practice remain.
Revision of Janeirona Distant, 1911 (Hemiptera: Pentatomidae: Ochlerini) with the description of four new species from Brazil
Authors: SAMPAIO VINÍCIUS GOMES , OLIVEIRA GIULIA VALADÃO DE , CAMPOS LUIZ ALEXANDRE
Published: August 2024

Janeirona Distant, 1911 is a Neotropical pentatomid genus restricted to South America that was recently transferred from Pentatominae to Ochlerini (Discocephalinae). Janeirona was described for one species, and during the 20th century other five species were allocated in the genus. In this study we redescribe Janeirona and its known species, and propose two new synonyms: Serdia stali Kormilev, 1956 as junior synonym of Janeirona insignis Distant, 1911, and Janeirona asaroana Brailovsky, 1988 as junior synonym of Janeirona costalimai (Pirán, 1962). We describe four new species: Janeirona aurea Sampaio & Campos sp. nov., Janeirona flavipes Sampaio & Campos sp. nov., Janeirona roellae Sampaio & Campos sp. nov., and Janeirona stenosa Sampaio & Campos sp. nov.. An identification key to the species and distribution maps are given.
Relationship between Newly Fallen Snow Density and Polarimetric Parameters Obtained from X-Band Radar Observations along the Sea of Japan Coast in January 2021
Authors: Takami Kazuya , Kamamoto Rimpei , Suzuki Kenji , Yamaguchi Kosei , Nakakita Eiichi
Published: August 2024

The density of newly fallen snow ρN is an important parameter for assessing accumulated snowfall depth. We examined the relationships between polarimetric parameters of X-band radar and the ρN in dry snow cases with ground temperatures less than 0°C. Our study was based on observations at Niigata Prefecture, Japan, along the coastal region of the Sea of Japan. This region is subjected primarily to sea-effect snow during the winter monsoon season, and convective clouds and rimed snow are common. We assumed that snow particles that accumulated on the ground originated from altitudes above an altitude with a temperature of −15°C, and we focused on the ratio of the differential phase KDP to radar reflectivity Zh, which is influenced by both aspect ratio and inverse particle size. We found that KDP/Zh at an altitude with a temperature of −15°C exhibited a greater magnitude for lower ρN values. Its correlation coefficient was the best among the polarimetric parameters that we examined. The difference in ice crystal flatness is highlighted rather than the difference in size because aggregation growth has not progressed at this altitude. On the basis of this result, we propose an empirical relationship between KDP/Zh at an altitude with a temperature of −15°C and ρN on the ground, thereby facilitating the estimation of snowfall depth by combining the estimated ρN with the liquid equivalent snowfall rate from, for example, Zh or KDP.

Significance Statement

This study aims to estimate the density of newly fallen (just-accumulated) snow from polarimetric radar observations. Understanding the newly fallen snow density will help to determine the exact snowfall depth. Focusing on polarimetric parameters at an altitude with a temperature of −15°C, we conducted radar and ground-based observations of snow particles and found that the newly fallen snow density of dry snow can be estimated. We were able to highlight the difference in ice crystal flatness before aggregation growth progressed by focusing on higher altitudes.
Classic Lesions of the Biliary Tree
Authors: Cullen John M. , Malarkey David , Foster John R.
Published: August 2024

Abnormal findings in the biliary tree are frequently encountered in response to acute and chronic exposures to various compounds. The more common findings are described here in an overview of previous publications such as the INHAND Proliferative and Nonproliferative Lesions of the Rodent Liver and the Liver-Nonneoplastic Lesion Atlas NTP with comments regarding current considerations. This was presented at the 2023 Annual Meeting of the Society of Toxicologic Pathology. Histologic descriptions and some discussions regarding the pathogenesis of the various categories of non-neoplastic lesions in the biliary tree are presented. Discussions regarding the use of the term oval cell versus ductular reaction and the potentially neoplastic nature of cholangiofibrosis are presented in some detail.
A plasma lipid signature in acute human traumatic brain injury: Link with neuronal injury and inflammation markers
Authors: Nessel Isabell , Whiley Luke , Dyall Simon C , Michael-Titus Adina T
Published: August 2024

Traumatic brain injury (TBI) leads to major membrane lipid breakdown. We investigated plasma lipids over 3 days post-TBI, to identify a signature of acute human TBI and assess its correlation with neuronal injury and inflammation. Plasma from patients with TBI (Abbreviated Injury Scale (AIS)3 - serious injury, n = 5; AIS4 - severe injury, n = 8), and controls (n = 13) was analysed for lipidomic profile, neurofilament light (NFL) and cytokines, and the omega-3 index was measured in red blood cells. A lipid signature separated TBI from controls, at 24 and 72 h. Major species driving the separation were: lysophosphatidylcholine (LPC), phosphatidylcholine (PC) and hexosylceramide (HexCer). Docosahexaenoic acid (DHA, 22:6) and LPC (0:0/22:6) decreased post-injury. NFL levels were increased at 24 and 72 h post-injury in AIS4 TBI vs. controls. Interleukin (IL-)6, IL-2 and IL-13 were elevated at 24 h in AIS4 patients vs. controls. NFL and IL-6 were negatively correlated with several lipids. The omega-3 index at admission was low in all patients (controls: 4.3 ± 1.1% and TBI: 4.0 ± 1.1%) and did not change significantly over 3 days post-injury. We have identified specific lipid changes, correlated with markers of injury and inflammation in acute TBI. These observations could inform future lipid-based therapeutic approaches.
Use of a Memokath™ 045 temperature-controlled memory alloy stent for treating upper renal calyx calyceal neck atresia: a case report
Authors: Chen Shuangxing , Cai Zhiduan , Luo Wenjun , Zhu Rui , Zhou Zewen , Wu Weipei , Li Xun , Xu Guibin
Published: August 2024

Renal calyceal neck atresia is a rare disorder. There is no clear guidance for standard treatment of this condition. The Memokath™ 045 temperature-controlled memory alloy stent is commonly used in the treatment of urethral strictures, but it has not been used for treating calyceal neck atresia. We present a case of a 44-year-old female patient with left lumbar pain who underwent two stages of treatment to resolve calyceal neck atresia located at the upper calyx of her left kidney. The first procedure was transurethral ureteroscopy combined with percutaneous recanalization of the left upper calyx calyceal neck atresia. One 6 F internal stent and one 8 F internal stent were placed, and she was discharged with a left nephrostomy tube. After her urinary tract infection was fully resolved, the patient returned for the second procedure of percutaneous upper renal calyx calyceal neck metal stent implantation. The temporary stents and nephrostomy tube were successfully removed. Our findings suggest that the Memokath™ 045 temperature-controlled memory alloy stent is an effective choice for treating calyceal neck atresia.
Software Defined Radio-Based Long-Term Evolution for Infrastructure-Based Vulnerable Road Users Safety: A Field Demonstration
Authors: Khaleghian Seyedmehdi , Harris Austin , Fadul Mohamed , Reising Donald , Sartipi Mina
Published: August 2024

The limited connectivity of vehicles presents a notable challenge, as their inability to establish communication with other vehicles and pedestrians can lead to safety concerns, particularly for vulnerable road users (VRUs). The Infrastructure-to-Pedestrian (I2P) communication pathway can play a vital role in mitigating these safety concerns, as implementing I2P is expected to significantly enhance safety for pedestrians, cyclists, and motorcyclists. The Third Generation Partnership Program (3GPP) introduced cellular vehicle-to-everything (V2X) communication with the release for 3GPP Release 14 in 2017. In this paper, we conduct an extensive review of V2I and I2P communication, and then present a Long-Term Evolution (LTE)-I2P communication architecture. We later describe key ideas of software-defined networks and their concepts for I2P services. Additionally, we conduct a field test of I2P LTE-based communication and assess its feasibility. The urban connected testbed in downtown Chattanooga, “MLK Smart Corridor,” services is the experimental platform for this assessment. Performance indicators like average end-to-end (E2E) latency and packet delivery ratio (PDR) are used for comparison.
Geographic Patterns of Human Immunodeficiency Virus (HIV) Risk Behaviors Among Older Adults: A Strategy for Identifying Space as a Risk Exposure
Authors: Conner Laneshia R. , Adatorwovor Reuben , Robbins Sarah Jane K. , Machinga-Asaolu Rujeko O. , Showalter Kathryn , Oser Carrie
Published: August 2024

Objectives: This study examined geographical patterns of HIV risk among adults aged 60 and older. Methods: The 2019 Behavioral Risk Factor Surveillance System (BRFSS) weighted data was used to analyze self-reported participation in HIV risk behaviors among older adults ( n = 62,852). Logistic regression models were used on a dichotomous HIV risk variable to map the distribution of HIV risk behaviors across both census regions and divisions. Results: The weighted model revealed significance across regions. Across all regions, identifying as female, identifying as Hispanic, and reporting not having depression were protective from participating in HIV risk behaviors. Discussion: The geographic heterogeneity in patterns of high-risk behaviors among older adults are discussed, along with the implications of partner access (marital status) and emotional health (depression) that need further examination. Recommendations for additional geographic analysis are made.
Considerations for occupational risk management during pregnancy: A summary of a continuing education course
Authors: Roberts LG , Hoberman AM , Verpaele S , Inayat-Hussain SH , DeSesso JM , Fukumura M
Published: August 2024

Women comprise approximately 40% of the global workforce, and many women continue to work during pregnancy. Although occupational exposure limit values (OELVs) are intended to protect all workers, many OELVs may have been established without consideration of the unique changes in pregnant workers, and many chemicals lack OELVs altogether. A short educational course was developed to address the informational needs of health professionals who have responsibility to ensure a safe workplace for pregnant employees. The course was designed to raise awareness of the key elements in risk management and their application to the pregnant worker, such as physiological changes of pregnancy that influence susceptibility to exposures; guidance for nonclinical data interpretation; exposure assessment and control strategies; and risk management in practice in a diverse regulatory environment. This paper summarizes the course content and is intended to support informed risk management decision making to protect the health of pregnant workers and their offspring.
Do Cyberbullying Victims Feel more Entitled to Bully Others Online? The Moderating Role of Gender
Authors: Ding Huimin , Zhao Chengjia , Huang Feng , Wei Hua , Lei Li
Published: August 2024

Previous studies have found that adolescent cyberbullying victimization is associated with cyberbullying perpetration and have explored the potential mediating mechanisms between the two. Although some valuable research has been accumulated, further exploration is needed on the underlying mechanisms of why cyber victims are transformed into cyberbullying perpetrators. Based on the General Aggression Model of Cyberbullying and the Social Role Theory, this study examined the mediating role of psychological entitlement and the moderating role of gender on the relationship between cyberbullying victimization and cyberbullying perpetration. A questionnaire survey was conducted on 836 adolescents, utilizing the cyberbullying victimization scale, cyberbullying perpetration scale, and psychological entitlement questionnaire. The results found that (a) cyberbullying victimization, psychological entitlement, and cyberbullying perpetration were significantly and positively correlated with each other; (b) after controlling for gender and age, cyberbullying victimization significantly and positively predicted cyberbullying perpetration and psychological entitlement mediated the relationship between cyberbullying victimization and cyberbullying perpetration; (c) Gender moderates the relationship between cyberbullying victimization and cyberbullying perpetration. Specifically, compared with the girls, cyberbullying victimization had a greater effect on cyberbullying perpetration among boys. The results of this study suggest that cyberbullying victims consider that they have more entitlement to bully others online. These findings support the General Aggression Model of Cyberbullying and provide new insights for the prevention and intervention of cyberbullying perpetration.