bluuebunny/crossref_metadata_2025 huggingface dataset:
Modifiable Lifestyle Factors and Cognitive Function: A Population‐Based Study Amongst Nondemented Men
Authors: Corney Kayla B. , Stuart Amanda L. , Mohebbi Mohammadreza , Pasco Julie A. , Kavanagh Bianca E. , Sui Sophia X. , Williams Lana J.
Published: August 2024

Background: As cognitive decline and dementia‐related diseases are currently incurable, identifying modifiable and preventative factors is imperative. Thus, we aimed to investigate the associations between modifiable lifestyle factors and cognitive function in a population‐based sample of nondemented men.

Methods: Data for 537 men were drawn from the ongoing, population‐based, Geelong Osteoporosis Study (GOS). The CogState Brief Battery (CBB) was utilised to determine cognitive function (overall cognitive function [OCF], psychomotor function, attention, working memory, and visual learning). Demographic and lifestyle factors (diet, smoking, physical activity [sport, work/home, and leisure time], alcohol use, and body mass index [BMI]) were self‐reported and documented across three waves of data collection. Generalised estimating equation (GEE) models were used to determine associations between the time‐updating exposures of interest and each of the cognitive domains.

Results: Age was associated with OCF (η2 = 0.298), psychomotor function (η2 = 0.163), attention (η2 = 0.210), working memory (η2 = 0.215), and visual learning (η2 = 0.097). Playing sport was associated with all aspects of cognition: OCF (η2 = 0.014), psychomotor function (η2 = 0.007), attention (η2 = 0.004), working memory (η2 = 0.013), and visual learning (η2 = 0.004), and being physically active during leisure time was associated with visual learning (η2 = 0.008). Being physically active at work and home, smoking, diet quality, energy consumed per day, alcohol intake, and BMI were not associated with any of the cognitive domains.

Conclusion: In this study of nondemented men, elements of a healthy lifestyle such as playing sport and being physically active during leisure time were associated with better cognition. Further studies into whether these factors, amongst others, prevent the onset and progression of dementia are needed.
A Neglected Disease: Hidradenitis Suppurativa a Rare Cause of Amyloidosis Complicated With Sepsis and Renal Failure: A Case Report
Authors: Demir Orhun , Yondem Omer Zuhtu , Doganay Mehmet
Published: August 2024

Background: Hidradenitis suppurativa (HS) is a painful relapsing inflammatory disease characterized with subcutaneous nodules, abscesses, tunnels, and deforming scars. We present a case of HS complicated with amyloidosis who was admitted with sepsis and acute renal failure.

Case Report: A 53‐year‐old male patient with a history of HS and amyloidosis was accepted to the intensive care unit suffering from acute kidney failure and sepsis symptoms. He was receiving adalimumab during admission. He received hemodialysis and piperacillin–tazobactam antibiotherapy. After 15 days of hospitalization, his sepsis was treated, but he was taken to a routine hemodialysis programme.

Conclusion: In the presence of amyloidosis with intervenient infections, the risk of chronic renal failure in HS cases can be kept in mind even if the patient is receiving TNF inhibitors.
Metabolomic Analysis of Nonvolatile Substances in Yingde Black Tea (Camellia sinensis) from Different Regions at Various Processing Stages
Authors: Chen Yiqin , Song Jiayan , Li Na , He Jiaxing , Sun Hongyu , Xiang Yi , Xiao Lizheng
Published: August 2024

The influence of origin on tea quality has been understudied. Little research has compared metabolites during tea processing from different origins. This study aims to address this gap by using nontargeted metabolomics to examine the differential metabolites present in Yingde black tea from various origins at different processing stages. Nontargeted metabolomics was employed to compare the differential metabolites present in fresh tea leaves, withered leaves, rolled leaves, fermented leaves, and processed tea from various origins. The study revealed significant differences in the metabolites present at each processing stage. Despite using identical processing techniques, the quality of finished teas from different regions was found to vary through sensory evaluation. The study found that taste differences between regions were primarily influenced by flavonoids and amino acids. The relative taste activity value (RTAV) approach was used to identify key contributors to taste differences and regulation. The quality of fresh tea leaves was found to be the main determinant of the taste of black tea from various regions. To reduce these differences, the same processing techniques were employed. These findings enhance our understanding of quality variations in dried tea from different origins and contribute to the theoretical foundation of tea processing.
Dynamic Node Management for Energy Optimization in Cognitive Radio Systems
Authors: Huang Tangsen , Yin Haibing , Yin Xiangdong , Xiao Huijun
Published: August 2024

Energy efficiency and spectrum sensing performance are two crucial parameters in cognitive radio networks. Enhancing energy efficiency should not come at the cost of sacrificing spectrum sensing performance. This paper introduces a novel sensing node grouping algorithm to address the challenge of balancing energy efficiency and sensing performance. The proposed algorithm first prioritizes spectrum sensing training for each node and estimates their reliability. Nodes with reliability values exceeding a predefined threshold are selected for cooperative spectrum sensing. The selected nodes are divided into two groups using a staggered grouping approach, ensuring equivalent sensing performance between the groups. The groups alternate in performing spectrum sensing operations, with one group engaging in sensing while the other participates in data transmission or remains idle. The optimal number of cooperative nodes is determined through a greedy algorithm, formulated as a constrained optimization problem. The objective is to maximize energy efficiency subject to a constraint on the error probability, ensuring the highest possible energy efficiency while satisfying the required sensing performance criteria. Experimental results demonstrate that the proposed algorithm effectively maximizes energy efficiency while fulfilling the sensing performance requirements. Compared to traditional algorithms, the dynamic grouping algorithm significantly enhances spectrum sensing performance and improves energy efficiency. The algorithm is adaptable to various network configurations and environmental conditions, addressing the challenges faced by existing solutions. This research contributes to the advancement of cognitive radio networks and their applications in various domains, offering a comprehensive and adaptive solution to optimize energy efficiency and spectrum sensing performance.
Figure 3 from ANGPTL4 Suppresses Clear Cell Renal Cell Carcinoma via Inhibition of Lysosomal Acid Lipase
Authors: Jin Zeng , De Umasankar , Tithi Tanzia Islam , Kleberg Jeremy , Nataraj Akhila , Jolley Elena , Carelock Madison E. , Davies Brandon S. , Zhang Weizhou , Kolb Ryan
Published: August 2024

nANGPTL4 suppresses ccRCC colony formation. A, MTS assay of the indicated CAKi-1 cells. Graph depicts the average absorbance ± SD. Two-way ANOVA was done to determine significance (n = 6 all groups). B, The indicated 786O cells were incubated with CSFE and analyzed by flow cytometry. The graph depicts the average % proliferation of the cells ± SD. Welch’s t test was done to determine significance. C, Soft agar colony assay. The indicated CAKi-1 cells were cultured on soft agar for 30 days and the number of colonies per well was counted. Left: representative images of colonies from the indicated cells (10× magnification). Right: graph depicts the average number of colonies ± SD. Welch’s t test was used to determine significance. D, The indicated RCC4 cell line was incubated in nonadherent conditions for 72 hours. The graph depicts the average number of colonies/well ± SD. Welch’s t test was done to determine significance. E, Graph depicts the average number of colonies/well of the indicated CAKi-1 cells treated as indicated with rat IgG or anti-cANGPTL4 ± SD. One-way ANOVA with Dunnett’s test to correct for multiple comparisons was done to determine significance. F, Graph depicts the average number of colonies per well ± SD. of CAKi-1 A4 KO cells transfected with full length (FL), N-terminus or mock transfected as indicated. One-way ANOVA with Dunnett’s test to correct for multiple comparisons was done to determine significance. G, Graph depicts the average number of colonies/well of the indicated 786O cells ± SD. Welch’s t test was done to determine significance. H, Graph depicts the average number of colonies/well ± SD of 786O A4 KO cells transfected with N-terminus or mock transfected as indicated. One-way ANOVA with Dunnett’s test to correct for multiple comparisons was done to determine significance.
Figure 2 from ANGPTL4 Suppresses Clear Cell Renal Cell Carcinoma via Inhibition of Lysosomal Acid Lipase
Authors: Jin Zeng , De Umasankar , Tithi Tanzia Islam , Kleberg Jeremy , Nataraj Akhila , Jolley Elena , Carelock Madison E. , Davies Brandon S. , Zhang Weizhou , Kolb Ryan
Published: August 2024

ANGPTL4 suppresses tumor growth of RCC cells with wild-type VHL. A, Graph depicts expression of ANGPTL4 in CAKi-1 WT or A4KO cells relative to PPIA as a fold change compared to WT. B, 2 × 106 of the indicated CAKi-1 cells were implanted into the flank of NOD-SCID/IL2RG (NSG) mice. Graph depicts the average tumor volume ± SEM. Two-way ANOVA was done to determine significance (n = 8 for both groups). C, Renca mouse RCC cells were stably selected for expression of human ANGPTL4-V5. Immunoblot for V5 in the indicated Renca cells. D, Renca or Renca cells expressing human ANGPTL4-V5 (Renca-A4) from (C) were implanted into the mammary gland of Balb/C mice. Graph depicts the average tumor volume ± SEM. Two-way ANOVA was done to determine significance (n = 8 WT, n = 7 Renca-A4). E, 5 × 106 of CAKi-1 cells were implanted into the flank of NSG mice. CAKi-1 tumor–bearing mice were treated with 200 μg anti-cANGPTL4 antibody or rat IgG isotype control twice weekly starting at day 14. Graph depicts the average tumor volume ± SEM. F, Graph depicts the number of CD31+/CD34+ endothelial cells ± SD as a % of single cells from the indicated tumor from (B). Welch’s t test was done to determine significance. G, Tumor sections from the indicated tumors in B, were stained for CD31. Graph depicts the average CD31+ staining as a % of total area ± SD. At least three images from three samples were used for each group. Welch’s t test was done to determine significance.
Figure 1 from ANGPTL4 Suppresses Clear Cell Renal Cell Carcinoma via Inhibition of Lysosomal Acid Lipase
Authors: Jin Zeng , De Umasankar , Tithi Tanzia Islam , Kleberg Jeremy , Nataraj Akhila , Jolley Elena , Carelock Madison E. , Davies Brandon S. , Zhang Weizhou , Kolb Ryan
Published: August 2024

Subset of patients with ccRCC with low expression of ANGPTL4 is associated with shorter survival and lipid metabolism. A,ANGPTL4 expression in the indicated cancer types. Data generated from TCGA pan-cancer normalized RNAseq data generated using the Human Protein Atlas. B,ANGPTL4 mRNA expression in TCGA ccRCC samples compared to normal kidney tissue samples. C,ANGPTL4 expression in the indicated human ccRCC cell lines or immortalized human proximal tubule cells (HK-2) relative to GAPDH. D, Distribution of ANGPTL4 mRNA levels in TCGA ccRCC (KIRC) samples. Graph depicts the number of samples within the indicated robust Z-score range. A subset of patients with significantly lower ANGPTL4 expression (robust Z-score ≤ −3.5) is indicated as ANGPTL4-low distinguishable from the rest of the samples labeled as bulk samples. E, Kaplan–Meier curve depicting overall survival (OS) of ccRCC samples with low expression of ANGPTL4 compared to the rest of the sample. F, GSEA of TCGA samples comparing ANGPTL4-low (robust Z ≤ −3.5) and bulk samples (robust Z > −3.5). Graph depicts the nominal enrichment score (NES) of indicated gene sets enriched in the indicated group. The FDR is indicated. G and H, Enrichment plot for the indicated gene set from the GSEA in F.
Effects of voluntary exercise on heart function in streptozotocin (STZ) – induced diabetic rat
Authors: Howarth F.C. , Al-Ali S. , Al-Sheryani S. , Al-Dhaheri H. , Al-Junaibi S.S. , Almugaddum F.A. , Qureshi M.A. , Ljubisavijevic M.
Published: August 2024

Exercise training improves cardiac performance and has been utilized as an effective adjunct to pharmacotherapy in the
management of diabetes mellitus. The aims of this study were to characterize voluntary exercise habits in streptozotocin
(STZ)-induced diabetic rats and investigate whether attained levels of voluntary exercise induce effects on diabetic heart
function. Diabetes was induced by a single intraperitoneal injection of STZ (60 mg/kg). Animals were divided into 4 groups:
Control Sedentary (CS), Diabetic Sedentary (DS), Control Running (CR) and Diabetic Running (DR). DR and CR rats were
provided with running wheels. Body weight and blood glucose were measured in running rats at the start and end of the 60-
day exercise period. Ventricular action potentials were measured in spontaneously beating heart. Shortening and intracellular
Ca2+ were measured in electrically stimulated ventricular myocytes. DR rats exercised less than CR rats. At 60 days the mean
distance covered by DR rats was 1027 ± 289 m compared to 5975 ± 1117 m in CR rats. CR gained whilst DR rats lost weight
at the end of the exercise period. Mean blood glucose in CR and DR rats at the start of the exercise period was 71 ± 4 and 426
± 21 mg/dl, respectively. Glucose levels were not altered in CR rats but were reduced in DR rats at the end of the exercise
period. The time to peak shortening and peak Ca2+ transient and time to half relaxation of the Ca2+ transient were prolonged
in myocytes from DS compared to CS rats and were not additionally altered by voluntary exercise. In conclusion, diabetic
rats were less inclined to partake in voluntary exercise compared to controls and the levels and duration of exercise were
insufficient to significantly alter cardiac performance in either control or diabetic rats. (Int J Diabetes Metab 15: 32-37,
2007)
The beneficial effect of vitamin E supplementation on zinc status, carbohydrate metabolism, transaminases and alkaline phosphatase activities in alloxan-diabetic rats fed on zinc deficiency diet
Authors: Kechrid Zine , Derai EL-Hadjla , Layachi Naima
Published: August 2024

The aim of this study was to investigate the beneficial effect of vitamin E supplementation on zinc deficiency in experimental
diabetes. Male alloxan-diabetic Wistar, albino rats of 10 weeks of age were divided into three groups. The first group
received a diet containing 54 mg zinc/kg (adequate zinc group, AZ), the second group received a diet containing 1mg zinc/kg
(zinc deficient group, ZD), and the third group received a diet containing 1mg zinc/kg supplemented with vitamin E
(500mg/kg diet) (ZD+VE). Body weight gain and food intake of all rats were recorded regularly over a period of four weeks.
On day 28, after overnight fasting, animals were killed and blood glucose, serum cholesterol, serum triglycerides, serum
protein, serum urea, serum zinc, femur zinc, pancreatic zinc, testis zinc, liver glutathione concentrations and serum glutamic
oxalic transaminase (GOT), serum glutamic pyruvic transaminase (GPT) and serum alkaline phosphatase activities were
determined on blood and tissue samples. Body weight gain of zinc deficient diabetic animals at the end of four weeks of
dietary manipulation was significantly lower than that of zinc adequate diabetic animals. Dietary zinc intake significantly
increased blood glucose, serum cholesterol, serum triglycerides, and serum urea of zinc deficient diabetic rats. In contrast,
serum zinc, femur zinc, pancreatic zinc, serum protein and liver glutathione levels were lower. The consumption of zinc
deficient diet led also to an increase in serum GOT, GPT coupled with a decrease in serum alkaline phosphatase. Vitamin E
ameliorated all the previous parameters. In conclusion, the present study demonstrates that vitamin E supplementation
significantly reduced the severity of zinc deficiency in diabetes mellitus. (Int J Diabetes Metab 15: 46-50, 2007)
Obesity, overweight and under weight in suburban northern Nigeria
Authors: Bakari A.G. , Onyemelukwe G.C. , Sani B.G. , Aliyu I.S. , Hassan S.S. , Aliyu T.M.
Published: August 2024

Background: Weight has long been known to be a determinant of health and disease. Both overweight and underweight are
associated with health consequences. We report the results of a community survey of underweight, obesity and overweight in
two suburban communities in northern Nigeria. Methods: We studied an adult population sample in suburban northern
Nigeria. Obesity was defined as BMI >30KgM-2 while overweight was defined as BMI > 25.0 but <30.0; and underweight
was defined as BMI <18.5 KgM-2. Results: 317 subjects participated in the study, 267 (84.23%) were males and 50
(15.77%) females. Forty-one (13.1%) of the subjects had obesity, overweight occurred in 58 (18.5%) while underweight
occurred in 21(6.7%) subjects. Conclusion: Both over-nutrition and under-nutrition are common in these communities with
the former being more prevalent. Concerted efforts should be made to appropriately control the prevalence of overweight and
obesity. (Int J Diabetes Metab 15:68-69, 2007)
Beneficial effects of levo-carnitine on lipid metabolism and cardiac function in neonatal streptozotocin rat model of diabetes
Authors: Patel Jigneshkumar , Goyal Ramesh , Bhatt Parloop
Published: August 2024

Levo-carnitine (L-carnitine) facilitates the transport of long chain fatty acyl co-enzyme A (CoA) across the mitochondrial membrane for eventual oxidation and energy production. Carnitine deficiency results in free fatty acid accumulation and contributes to cardiovascular complications in experimental diabetes. In this condition, oral carnitine supplementation provides cardio-protection by its various metabolic effects. The beneficial effects of six weeks treatment with L-carnitine (600 mg/kg day orally) were studied in neonatal streptozotocin (STZ) diabetic rats. STZ (90 mg/kg) was administered to five day old rats and after fourteen weeks of STZ administration, the rats showed hyperglycemia, hyperinsulinemia, hypercholesterolemia, hypertriglyceridemia and associated cardiac defects like hypertension and bradycardia. L-carnitine treatment for six weeks after induction of diabetes and associated complications significantly lowered cholesterol and triglyceride levels and normalized blood pressure and heart rate; however the treatment was not found to produce beneficial effects against hyperglycemia and hyperinsulinemia in diabetic rats. The L-carnitine treatment may have fulfilled the carnitine deficiency and have improved the lipid metabolism and subsequently the cardiac function in diabetic rats. The study suggest that long term treatment with L-carnitine not only prevents but also partially reverses the diabetes-associated lipid metabolism and cardiac function abnormalities in neonatal STZ diabetic rats.
Anti-diabetic effect of Costus pictus leaves in normal and streptozotocin-induced diabetic rats
Authors: Jayasri M.A. , Gunasekaran S. , Radha A. , Mathew T.L.
Published: August 2024

Costus pictus D. Don, commonly known as ‘insulin plant’ is a member of Zingiberacea family and is used as a munching dietary supplement for the treatment of diabetes in Southern India. The present study was carried out to evaluate the antidiabetic effect of Costus pictus leaves in normal and streptozotocin-induced diabetic rats. The oral feeding of aqueous leaf solution of this plant in diabetic rats for 28 days at a dosage of 2gm/kg body weight exhibited a significant (P<0.001) reduction in fasting blood glucose level and a remarkable increase in serum insulin level. There was a significant reduction (P<0.001) in serum parameters like SGOT, SGPT, lipids, triglycerides, total cholesterol, urea, TBARS, and albumin in diabetic rats treated with leaf solution. The body weight of diabetic rats was restored to normal state when treated with the C. pictus. Morphometric analysis of C. pictus-treated rat pancreatic islets showed a significant (P<0.001) increase in the number and area of islets when compared with normal and diabetic control rats. Histopathology studies in liver and kidney of diabetic rats treated with aqueous solution did not show any marked difference from normal which revealed the non-toxic effect of this plant. Estimation of trace elements using particle induced X-ray emission analysis in the leaf was also determined to find the antidiabetic potential elements in this plant. Based on the above results it is evident that the leaves of C. pictus have antidiabetic effect and must be considered as a potential candidate for future studies on diabetes mellitus.
Effects of pioglitazone and metformin on carbohydrate metabolism in experimental models of glucose intolerance
Authors: Gad Mohamed Z. , Ehssan Noha A. , Ghiet Mansour H. , Wahman Lobna F.
Published: August 2024

The aim of the study was to compare the effects of pioglitazone and metformin on carbohydrate metabolism in diabetic and insulin resistant rats. Male albino rats were randomized into seven groups. The first, control group received high carbohydrate diet. The second, third and fourth groups were fed high fat diets for 6 weeks and either left untreated, or given pioglitazone (2.7 mg/kg/day) or metformin (180 mg/kg/day) in the last 3 weeks. The 5th, 6th, and 7th groups were made diabetic by single intraperitoneal injection of streptozotocin (STZ, 50 mg/kg) on day 15 of the 6-week high fat regimen. They were either left untreated, or given pioglitazone or metformin in the last 3 weeks. High fat diet induced insulin resistance evidenced by increased serum glucose, associated with increase in liver glucose-6-phosphatase and decrease in liver glucose-6-phosphate dehydrogenase and glucokinase activities. No significant difference was observed between rats treated with either pioglitazone or metformin. Both treatments showed significant increase in glucose-6-phosphate dehydrogenase activity by ~20 %, decrease in glucose-6-phosphatase activity by ~25 %, and decreases in liver and kidney glycogen. In diabetic rats, both pioglitazone and metformin decreased elevated serum glucose by ~30 %. Only metformin caused more than 2-fold increase in hepatic glycogen content, and normalized glucose-6-phosphatase activity. Only pioglitazone normalized elevated renal glycogen content and increased glucose-6-phosphate dehydrogenase activity. In conclusion pioglitazone and metformin had comparable effects on estimates of carbohydrate metabolism and insulin sensitivity in insulin resistant rats, but different effects in diabetic rats.
Unexpected Vision Loss following Six Intravitreal Injections for Neovascular Age-Related Macular Degeneration
Authors: Hui Maggie , Gunzenhauser Robert , Dillon Alexander , Tsui Irena
Published: August 2024

Introduction: We present a case of a patient with preceding vitreomacular traction (VMT) who developed a full-thickness macular hole (FTMH) following his sixth intravitreal aflibercept injection for the treatment of age-related macular degeneration and review the literature on risk factors and pathogenesis of this adverse event. Case Presentation: FTMH can occur after an extended number of repeat intravitreal injections in the setting of worsening vitreomacular adhesion or VMT. This patient’s FTMH was successfully treated surgically in a timely manner, and additional injections were resumed safely. Conclusions: Patients with an unexpected decrease in vision after intravitreal injections should be reevaluated with optical coherence tomography to rule out alternative pathology including vitreomacular interface abnormalities. FTMH, if present, should be treated promptly to allow for resumption of therapy as needed and visual optimization.
Laparoscopy-Assisted Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in Middle Colic Artery Ligation Immediately before Specimen Removal
Authors: Matsuda Keiji , Hashiguchi Yojiro , Hayama Tamuro , Hayashi Kurara , Miyata Toshiya , Asako Kentaro , Fukushima Yoshihisa , Shimada Ryu , Kaneko Kensuke , Nozawa Keijiro , Ochiai Hiroki , Yamamoto Takatsugu
Published: August 2024

Introduction: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical procedure for ulcerative colitis (UC). Intestinal ischemia may occur if the main blood vessels are ligated at an early stage of this surgery. Considering that the blood flow in the large intestine can be maintained by preserving the middle colic artery, we have used a new IPAA method: ligating the middle colic artery immediately before removal of the specimens (“M-method”). Here, we evaluated the M-method’s clinical outcomes. Methods: Between April 2009 and December 2021, 13 patients underwent a laparoscopy-assisted IPAA procedure at our institution. The conventional method was used for 6 patients, and the M-method was used for the other 7 patients. We retrospectively analyzed the cases’ clinical notes. Results: The M-method’s rate of postoperative complications (Clavien-Dindo classification grade II or more) was significantly lower than that of the conventional method (14.2% vs. 83.3%). The M-method group’s postoperative stay period was also significantly shorter (average 16.4 days vs. 55.5). There were significant differences in the albumin value and the ratio of the modified GPS score 1 or 2 on the 7th postoperative day between the M- and conventional methods (average 3.15 vs. 2.5, average 4/7 vs. 6/6). However, it is necessary to consider the small number of cases and the uncontrolled historical comparison. Conclusion: Late ligation of the middle colic artery may be beneficial for patients’ post-surgery recovery and can be recommended for IPAAs in UC patients.
Use of Potentially Inappropriate Medications among Older Adults with Dementia or Cognitive Impairment Attending Memory Clinics: A Protocol for a Systematic Review and Meta-Analysis
Authors: Sharma Rishabh , Gill Jasdeep Kaur , Carter Caitlin , Alkabbani Wajd , Chhabra Manik , Vidyasagar Kota , Chang Feng , Lee Linda , Patel Tejal
Published: August 2024

Introduction: Older adults with dementia who are on multiple medications are more vulnerable to the use of potentially inappropriate medications (PIMs), which can significantly increase the risk of adverse events and drug-related problems. PIMs use is prevalent and varies among older adults with dementia or cognitive impairment (CI) attending memory clinics. However, the prevalence of PIMs, polypharmacy, and hyper-polypharmacy among older adults with dementia or CI who are attending memory clinics is not well understood. We will conduct a systematic review and meta-analyses to examine the overall estimate of the prevalence of the PIMs, polypharmacy, and hyper-polypharmacy use among older adults attending memory clinics, with dementia or CI. The secondary objective of this study will be to compile a list of commonly implicated PIMs and to investigate factors that may be associated with using PIMs in this population. Methods: Ovid MEDLINE, Ovid Embase, Scopus, Cochrane library, EBSCOhost CINAHL, and Ovid International Pharmaceutical Abstracts (IPA) will be systematically searched by a researcher (R.S.) with the help of a librarian (C.C.). All databases will be searched from inception to May 05, 2023. Cross-sectional, cohort, randomized clinical trials, quasi-experimental, and case-control studies will be included if they assess PIM’s use among older adults with dementia and/or CI. A step-by-step guide by Pai et al. [Natl Med J India. 2004;17(2):86–95] will be followed when conducting this systematic review (S.R.). The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist will be followed for reporting this SR. Conclusion: The findings from this SR/MA will identify the pooled prevalence of PIMs, providing a more precise estimate of the true prevalence of the PIMs, polypharmacy, hyper-polypharmacy in older adults with dementia or CI who are attending memory clinics at primary, secondary, or tertiary healthcare settings by considering the results of multiple studies.
A Case of Incidental and Uncomplicated Subretinal Triamcinolone Acetonide
Authors: Zhou You , Guiseppi Rodney , Banaee Touka
Published: August 2024

Introduction: Posterior subtenon injection of triamcinolone acetonide (PSTA) is commonly done to treat refractory cases of macular edema. Complications may arise from the procedure as well as from the use of the periocular steroid medications. Side effects include subconjunctival hemorrhage, progression of cataract, scleral perforation (resulting in subretinal, subhyaloid, or intravitreal injection of the drug), retinal detachment, ptosis, orbital fat prolapse, orbital abscess, infectious scleritis, ocular hypertension, and scleral abscess. Here we describe a case of inadvertent subretinal triamcinolone acetonide (TA) deposition from a PSTA procedure without any adverse vision-threatening outcomes. Case Presentation: We report a patient who presented with a history of superior temporal left eye macula-off rhegmatogenous retinal detachment, which was successfully repaired with a scleral buckle (SB), pars plana vitrectomy, and gas placement. Due to persistent diplopia, the SB was removed after 1 year post-operatively. Due to the development of cystoid macular edema, a PSTA was performed after the patient failed topical steroids and NSAIDs. The procedure was halted early due to unexpected resistance during the injection. A dilated fundus exam showed the presence of subretinal triamcinolone acetonide. The patient was observed and found to have no complications with almost complete resolution of the triamcinolone acetonide after 3 months. Conclusion: In previous SB patients, it is important to highlight the risk of globe penetration, subretinal deposition of TA, formation of retinal breaks, or reopening of prior retinal breaks with posterior subtenon injection, which could have adverse effects on the local retina as well as the risk of retinal detachment.
Incidentally Discovered Endocarditis Leading to the Diagnosis of an Epidermal Growth Factor Receptor Mutant Metastatic Pulmonary Malignancy of Occult Primary Tumor
Authors: Guzik Gregory L. , Li Joy W. , Wiener Joshua B. , Bruno Debora S.
Published: August 2024

Introduction: Non-bacterial thrombotic endocarditis is well documented in the literature to occur in patients with known malignancies. It is, however, much less common for patients to be diagnosed with marantic endocarditis as the presenting sign of an unknown primary malignancy. Case Presentation: We discuss a case in which a patient was undergoing routine surveillance for his known heart failure with a transthoracic echocardiogram when an aortic valve vegetation was discovered. After further investigation, he was found to have metastatic adenocarcinoma of the lung. Next-generation sequencing was utilized to identify an EGFR mutation, which led to the patient being treated with osimertinib. Conclusion: Adequate treatment of his primary malignancy, along with anticoagulation, led to overall clinical improvement of the patient.
Sustained Clinical Response to Ivosidenib in Previously Treated Patients with Advanced Intrahepatic Cholangiocarcinoma Harboring an IDH1 R132 Mutation: Two Case Reports
Authors: Müller Christian , Franke Sabine , Reisländer Timo , Keitel Verena , Venerito Marino
Published: August 2024

Introduction: Patients with progressing intrahepatic cholangiocarcinoma (iCCA) harboring an isocitrate dehydrogenase 1 (IDH1) mutation who received ivosidenib showed a median progression-free survival (PFS) benefit of 1.3 months compared to placebo in the phase 3 ClarIDHy trial. Case Presentations: We describe 2 consecutive patients with previously treated unresectable and metastatic iCCA harboring an IDH1 R132 mutation who achieved durable clinical responses with ivosidenib 500 mg once daily for >12 months until disease progression. In one case with a mixed response, a single progressive liver metastasis was additionally treated locally with interstitial brachytherapy, while ivosidenib was continued until further progression. Ivosidenib therapy resulted in long-term disease control with PFS of 20 and 13 months and duration of treatment of 26 and 13 months, respectively, with no relevant side effects. Conclusion: Patients with unresectable or metastatic IDH1-mutated iCCA can achieve sustained clinical responses for >12 months with ivosidenib. No new safety signals were observed during long-term treatment with ivosidenib.
Infected Inclusion Cyst of a Conjunctival Nevus Treated with a Mini-Incision: A Case Report
Authors: Blavakis Emmanouil , Kecik Mateusz , Thumann Gabriele , Massa Horace
Published: August 2024

Introduction: Conjunctival cysts are usually asymptomatic but they can cause foreign body sensation and contribute to dry eye disease. The purpose of this case report is to describe the presentation and treatment of an infected inclusion cyst of a conjunctival nevus in a healthy 36-year-old patient. Case Presentation: A healthy 36-year-old man presented to the emergency department for redness and pain in his left eye for 1 day. Slit-lamp examination revealed a conjunctival hyperemia and a conjunctival nevus with 4 inclusion cysts, one of which was filled with purulent material. Fluorescein staining of the conjunctival epithelium was negative. Α mini-incision of the white cyst was performed using a 30 G needle, followed by bimanual drainage and topical treatment with tobramycin and moxifloxacin drops every 3 h for a week. A swab of the purulent drainage was positive for gram-positive flora. One week after the drainage of the cyst, the patient was asymptomatic and on slit-lamp examination, the 4 inclusion cysts were filled with a transparent liquid, there was not any vessel dilation and fluorescein staining was negative. Conclusion: Conjunctival inclusion cysts, although considered benign, can become infected and form a conjunctival abscess. A mini-incision on the slit lamp combined with bimanual drainage and followed by topical antibiotic drops seems to be a safe and effective treatment.
The First Case of Eruptive Pyogenic Granuloma following COVID-19 Vaccination
Authors: Al-Zahawi Saman , Ghanadan Alireza , Saberi Fatema , Balighi Kamran , Razavi Zahra
Published: August 2024

Introduction: Pyogenic granuloma presents clinically as a rapidly growing, friable, red papule of skin or mucosa, commonly measuring less than 10 mm with frequent bleeding due to ulceration. Angioproliferative diseases including pyogenic granuloma and cherry angioma have been reported during COVID-19 infection or following COVID-19 vaccination. Case Presentation: Here, we report a 52-year-old female patient who developed diffuse skin eruptions 3 weeks after the second dose of COVID-19 vaccination. Conclusion: As per our knowledge, this is the first case of eruptive PG following COVID-19 vaccination. Oral propranolol and PDL laser therapy were administered after obtaining inconvenient results from electro-cautery, and there was a good response within 6 weeks of starting therapy, defined by the cessation of new lesion formation and a decrease in the size of large lesions.
Rituximab in Steroid-Dependent Podocytopathies
Authors: Costa Cláudia , Antunes Amélia , Oliveira João , Pereira Marta , Godinho Iolanda , Fernandes Paulo , Jorge Sofia , Lopes José António , Gameiro Joana
Published: August 2024

Introduction: Rituximab (RTX) has been reported as an effective treatment alternative in primary forms of minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) associated with steroid dependence and frequent relapses. However, the optimal RTX regimen and the outcomes of further doses of RTX remain unclear. This study aimed to evaluate the use of induction and maintenance RTX therapy for adults with primary podocytopathies. Methods: We performed a retrospective case series on adult patients with steroid-dependent podocytopathies who received an induction RTX therapy. Maintenance therapy was performed at physician’s discretion. Remission and relapse rates, concomitant corticosteroids and immunosuppressants use, B-cell depletion and adverse events were analyzed. Results: Fourteen patients (mean age at start of RTX 29.1 ± 21.9 years) with MCD (n = 7) or FSGS (n = 7) were treated with 2 doses of 1,000 mg 2 weeks apart (n = 13) or four doses of 375 mg/m2 (n = 1) of RTX. At last follow-up (mean 47.3 ± 101.7 months), 10 patients were in complete remission and two remained in partial remission. A reduction in the number of relapses, number of patients under corticosteroids and immunosuppressants, and dose of prednisolone was observed when compared to baseline (14 [100%] vs. 5 [35.7%]; 8/14 [57.1%] vs. 4/12 [33.3%]; 13/14 [92.9%] vs. 7/12 [58.3%]; 20 mg/day vs. 5.25 mg/day, respectively). Maintenance RTX therapy was used in 6 patients, with sustained complete remission. Infusion reactions were observed in 4 patients (one required treatment withdrawal). Conclusions: Our findings support the use of RTX for a steroid-free remission in podocytopathies and suggest that maintenance RTX is well-tolerated and associated with prolonged remission. Further studies are needed to confirm its efficacy and safety and establish the optimal induction and maintenance RTX regimen in steroid-dependent podocytopathies.
Idiopathic Vitreopapillary Traction: Case Report and Literature Review
Authors: Abdullah Hind , Alsakran Wael A. , Hanbazazh Mehenaz Adly
Published: August 2024

Introduction: Vitreopapillary traction (VPT) syndrome occurs at the vitreopapillary interface. VPT can be idiopathic which indicates an abnormal or anomalous posterior vitreous detachment which present in elderly patients. Case Presentation: We describe the presentation and management of case of idiopathic VPT in a healthy 40-year-old male who presented with decreased vision and visual field changes corresponding to the area of retinal traction. This case was managed with surgery including removal of the tractional membrane. Conclusion: The vitreopapillary interface is an important structure because it is the last and the strongest attachment of the posterior hyaloid. Early detection of VPT may prevent progression to tractional membrane which can induce vision loss.
A Case of Malignant Transformation of Recurrent Respiratory Papillomatosis That Was Effectively Treated with Pembrolizumab
Authors: Mizuno Yusuke , Okada Ryuhei , Kirimura Susumu , Yoshimura Ryoichi , Asakage Takahiro
Published: August 2024

Introduction: Recurrent respiratory papillomatosis (RRP) is a benign tumor caused by the human papillomavirus that mainly occurs in the larynx; the tumor is known to show malignant transformation in a small percentage of cases. In this report, we describe a case of rapidly growing cervical metastasis due to malignant transformation of RRP that was successfully treated with pembrolizumab. Case Presentation: A 79-year-old man diagnosed as having laryngeal papilloma was referred to our department, and we resected the tumor by transoral laser microsurgery (TLM). Postoperative histopathology showed papillary lesions with mild cellular atypia, suggestive of papilloma. Six years later, the patient visited our hospital again with worsening hoarseness of the voice and an enlarged papillary lesion of the larynx. We performed a second TLM and postoperative histopathological examination revealed a papillary squamous cell carcinoma. In the early postoperative period, the patient developed a recurrence at the primary site and received radiotherapy (70 Gy). Three months after the completion of radiotherapy, a rapidly enlarging metastatic lymph node was observed in the right cervical region, and we performed neck dissection. Five months after the surgery, a rapidly enlarging mass appeared in the anterior cervical subcutaneous region, and the patient received palliative radiation. Since an immunohistochemical examination of a specimen obtained at the time of neck dissection showed high PD-L1 expression, with a combined positive score of 100, the patient was initiated on treatment with pembrolizumab 1 month later. Although the patient developed fever and a skin rash as adverse events, the tumor disappeared almost entirely within 3 weeks. Thereafter, we have observed no evidence of recurrence for over 1 year. Conclusion: The PD-1/PD-L1 pathway has been implicated in the tumorigenesis of RRP. This pathway may also play an important role in the malignant transformation of RRPs. Therefore, evaluation of tumor PD-L1 expression is recommended in these cases.
A Temporal Association between Regression of Pachydrusen and Use of Proprotein Convertase Subtilisin Kexin 9 Inhibitor: A Case Report
Authors: Chantarasorn Yodpong , Funilkul Kriengsak
Published: August 2024

Introduction: We aim to report the clinical course of a patient with pachychoroidopathy who experienced regression of subfoveal drusen during cholesterol treatment using PCSK9 inhibitors. Case Presentation: A 62-year-old woman who was visually asymptomatic complained of recent visual loss in the left eye (OS). She was diagnosed with foveal pachydrusen (OS) that had remained stable for 10 years. Three months after starting cholesterol treatment with a PCSK9 inhibitor, the latest class of lipid-lowering medication, her vision improved in parallel with gradual regression of material deposited beneath the retinal pigment epithelium (RPE). Recurrence of drusen was observed after discontinuing the drug. Conclusions: Use of PCSK9 inhibitors may improve the retina’s lipid homeostasis by increasing the number of RPE-LDL receptors and partly contribute to the improvement of ocular phenotypes associated with dysfunctional RPE in pachychoroidopathy.
Omics-Based Investigation on Mechanisms Controlling Cellular Internalization of Keratin Monomers during Biodegradation by Stenotrophomonas maltophilia DHHJ
Authors: Xue Kai , Song XiaoXiao , Zhang Wei , Zhang YunLong , Chen Ting , Cao ZhangJun , Hong Feng , Zhang XingQun
Published: August 2024

Introduction: The global poultry industry produces millions of tons of waste feathers every year, which can be bio-degraded to make feed, fertilizer, and daily chemicals. However, feather bio-degradation is a complex process that is not yet fully understood. This results in low degradation efficiency and difficulty in industrial applications. Omics-driven system biology research offers an effective solution to quickly and comprehensively understand the molecularmechanisms involved in a metabolic pathway. Methods: In the early stage of this process, feathers are hydrolyzed into water-soluble keratin monomers. In this study, we used high-throughput RNA-seq technology to analyze the genes involved in the internalization and degradation of keratin monomers in Stenotrophomonas maltophilia DHHJ strain cells. Moreover, we used Co-IP with LC-MS/MS technology to search for proteins that interact with recombinant keratin monomers. Results: We discovered TonB transports and molecular chaperones associating with the keratin monomer, which may play a crucial role in the transmembrane transport of keratin. Meanwhile, multiple proteases belonging to distinct families were identified as binding partners of keratin monomers, among which ATPases associated with diverse cellular activity (AAA+) family proteases are overrepresented. Four genes, including JJL50_15620, JJL50_17955 (TonB-dependent receptors), JJL50_03260 (ABC transporter ATP-binding protein), and JJL50_20035 (ABC transporter substrate-binding protein), were selected as representatives for determining their expressions under different culture conditions using qRT-PCR, and they were found to be upregulated in response to keratin degradation consistent with the data from RNA-seq and Co-IP. Conclusion: This study highlights the complexity of keratin biodegradation in S. maltophilia DHHJ, in which multiple pathways are involved such as protein folding, protein transport, and several protease systems. Our findings provide new insights into the mechanism of feather degradation.
Small Bowel Bleeding Caused by a Small Bowel Lipoma in a Patient with Hemodialysis
Authors: Yamagishi Shunsuke , Kang Woodae , Shindate Masataka , Matsuno Yoritaka , Yoshida Masahiro , Kochi Mitsugu
Published: August 2024

Introduction: Small bowel bleeding is being diagnosed with increasing frequency with the development of capsule endoscopy. Case Presentation: We report a case of lipoma that caused hematochezia in an 80-year-old woman with ischemic heart disease receiving antiplatelet therapy and on hemodialysis for renal failure. Contrast-enhanced computed tomography scans, esophagogastroduodenoscopy, and colonoscopy failed to identify the source of hematochezia. Capsule endoscopy revealed a small bowel tumor, which was removed through laparoscopic surgery without interruption of antiplatelet agents. The small bowel tumor was pathologically diagnosed as a lipoma. There was no recurrence of the hematochezia after surgery. Conclusion: Lipomas could cause hematochezia. With appropriate preoperative testing, comorbidity assessment, and surgical planning, we believe that surgical resection is a safe treatment option for the removal of small bowel lipomas even in patients who are on hemodialysis or are taking antiplatelet agents.
Esophageal Tuberculosis as a Rare Cause of Dysphagia: Case Report
Authors: Zhao Billy , Kim Hyun Jae , Farrell Jessica , Xiong Wei , Telford Jennifer , Moosavi Sarvee
Published: August 2024

Introduction: The esophagus and duodenum are rare sites of manifestation for extrapulmonary tuberculosis (TB). Its rarity makes the diagnosis challenging, especially when no other organ is involved, and the endoscopic findings may resemble malignancy. Case Presentation: We report a unique case of a 37-year-old woman who presented with dysphagia secondary to esophageal TB with an endoscopic appearance of a submucosal mass resembling malignancy. Conclusion: Esophageal TB is a rare cause of dysphagia, especially in a western setting. It should always be considered as a potential etiology in patients with dysphagia.