bluuebunny/crossref_metadata_2025_split huggingface dataset:
Results of the 2018 Japan Society for Blood Purification in Critical Care survey: current status and outcomes
Authors: Abe Masanori , Shiga Hidetoshi , Tatsumi Hiroomi , Endo Yoshihiro , Kikuchi Yoshihiko , Suzuki Yasushi , Doi Kent , Nakada Taka-Aki , Nagafuchi Hiroyuki , Hattori Noriyuki , Hirohashi Nobuyuki , Moriguchi Takeshi , Yamaga Osamu , Nishida Osamu 
Published: November 2022

Abstract
Background
The Japan Society for Blood Purification in Critical Care (JSBPCC) has reported survey results on blood purification therapy (BPT) for critically ill patients in 2005, 2009, and 2013. To clarify the current clinical status, including details of the modes used, treated diseases, and survival rate, we conducted this cohort study using data from the nationwide JSBPCC registry in 2018.

Methods
We analyzed data of 2371 patients who underwent BPT in the intensive care units of 43 facilities to investigate patient characteristics, disease severity, modes of BPTs, including the dose of continuous renal replacement therapy (CRRT) and hemofilters, treated diseases, and the survival rate for each disease. Disease severity was assessed using Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores.

Results
BPT was performed 2867 times in the 2371 patients. Mean APACHE II and SOFA scores were 23.5 ± 9.4 and 10.0 ± 4.4, respectively. The most frequently used mode of BPT was CRRT (67.4%), followed by intermittent renal replacement therapy (19.1%) and direct hemoperfusion with the polymyxin B-immobilized fiber column (7.3%). The most commonly used anticoagulant was nafamostat mesilate (78.6%). Among all patients, the 28-day survival rate was 61.7%. CRRT was the most commonly used mode for many diseases, including acute kidney injury (AKI), multiple organ failure (MOF), and sepsis. The survival rate decreased according to the severity of AKI (P = 0.001). The survival rate was significantly lower in patients with multiple organ failure (MOF) (34.6%) compared with acute lung injury (ALI) (48.0%) and sepsis (58.0%). Multivariate logistic regression analysis revealed that sepsis, ALI, acute liver failure, cardiovascular hypotension, central nervous system disorders, and higher APACHE II scores were significant predictors of higher 28-day mortality.

Conclusion
This large-scale cohort study revealed the current status of BPT in Japan. It was found that CRRT was the most frequently used mode for critically ill patients in Japan and that 28-day survival was lower in those with MOF or sepsis. Further investigations are required to clarify the efficacy of BPT for critically ill patients.
Trial Registration: UMIN000027678.
Multiple sclerosis patients’ response to COVID-19 pandemic and vaccination in Egypt
Authors: Gad Adel Hassanein Elsayed , Ahmed Sandra Mohamed , Garadah Mostafa Yahya Abdelmohsen , Dahshan Ahmed 
Published: November 2022

Abstract
Background
On 11 March 2020, WHO declared COVID-19 has become a pandemic. This had an impact on everyday activity for every person. For special groups such as multiple sclerosis patients, the situation is a little bit confusing. In this study, COVID-19 infection impact on MS patients, willingness for vaccination, percentage of vaccinated patients and adverse effects of different vaccines were investigated. This cross-sectional descriptive study included 160 Egyptian MS patients. Demographic and clinical characteristics of all patients were extracted from their files MS unit archives. All these patients were contacted either by telephone and an oral informed consent was taken or in-person on their scheduled follow-up and informed written consent was taken to join this study. Patients were asked about: COVID-19 infection, severity of infection, and vaccination using a special questionnaire developed by the authors.

Results
Only 39 (24.3%) patients have had COVID-19 infection with confirmed diagnosis. Most of infected patients (84.6%) were treated at home with no need for hospital admission. Five patients (12.8%) reported symptom suggestive of relapses after COVID-19 infection. Sixty-five patients (40.6%) were vaccinated against COVID-19. Out of these vaccinated patients, 22 patients (33%) developed adverse events from vaccine. These adverse events were self-limiting and related to local injection site and general manifestations. MS relapse after vaccination was reported in 7.7% of the vaccinated group.

Conclusion
Prevalence of COVID-19 infection and severity of infection were equal to general population. Risk of relapse is low either with infection or vaccination. No severe adverse events were reported after vaccination.
Fasciola hepatica extract suppresses fibroblast-like synoviocytes in vitro and alleviates experimental arthritis
Authors: Dalmolin Suelen Pizzolatto , Pedó Renata Ternus , da Rosa Thales Hein , de Souza Silva Jordana Miranda , Farinon Mirian , Gasparini Maria Luísa , Chiela Eduardo Cremonese Filippi , Paz Ana Helena , Sehabiague Martín Pablo Cancela , Ferreira Henrique Bunselmeyer , do Espírito Santo Rafaela Cavalheiro , da Costa Gonçalves Fabiany , Xavier Ricardo Machado 
Published: November 2022

Abstract
Background
Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial inflammation, fibroblast-like synoviocytes (FLS) activation and joint destruction. Fasciola hepatica is a platyhelminth that releases excretory-secretory immunomodulatory products capable of suppressing the Th1 immune response. Despite the effectiveness of available treatments for inducing disease remission, current options are not successful in all patients and may cause side effects. Thus, we evaluated the therapeutic potential of F. hepatica extract on FLS from RA patients and arthritis models.

Methods
FLS were isolated from synovial fluid of RA patients, cultured, and exposed to F. hepatica extract (60, 80, and 100 µg/ml) for different time points to assess cell viability, adherence, migration and invasion. For in vivo experiments, mice with antigen (AIA) and collagen (CIA) induced arthritis received a 200 µg/dose of F. hepatica extract daily. Statistical analysis was performed by ANOVA and Student's t-test using GraphPad Prism 6.0.

Results
In vitro assays showed that extract decreased FLS cell viability at concentration of 100 µg/ml (83.8% ± 5.0 extract vs. 100.0% ± 0.0 control; p < 0.05), adherence in 20% (92.0 cells ± 5.8 extract vs. 116.3 cells ± 7.9 control; p < 0.05), migratory potential (69.5% ± 17.6 extract vs. 100.0% control; p < 0.05), and cell invasiveness potential through the matrigel (76.0% ± 8.4 extract vs. 100.0% control; p < 0.01). The extract reduced leukocyte migration by 56% (40 × 104 leukocytes/knee ± 19.00) compared to control (90.90 × 104 leukocytes/knee ± 12.90) (p < 0.01) and nociception (6.37 g ± 0.99 extract vs. 3.81 g ± 1.44 control; p < 0.001) in AIA and delayed clinical onset of CIA (11.75 ± 2.96 extract vs. 14.00 ± 2.56 control; p = 0.126).

Conclusion
Our results point out a potential immunomodulatory effect of F. hepatica extract in RA models. Therefore, the characterization of promising new immunomodulatory molecules should be pursued, as they can promote the development of new therapies.
Trial registration Collection of synovial liquid and in vitro procedures were approved by the Ethics Committee with Certificate of Presentation of Ethical Appreciation in Plataforma Brasil (CAAE: 89044918.8.0000.5327; date of registration: 26/07/2018).
Reliability of cross-regional applications of global fire danger models: a Peruvian case study
Authors: Podschwit Harry , Jolly William , Alvarado Ernesto , Verma Satyam , Ponce Blanca , Markos Andrea , Aliaga-Nestares Vannia , Rodriguez-Zimmermann Diego 
Published: November 2022

AbstractBackgroundFire danger indexes (FDIs) are used as proxies for fire potential and are often developed for specific locations. For practical purposes, the extrapolation of the underlying calculations into novel locations is common, but it is generally uncertain if the relationships between FDIs and fire potential observed in the environment in which the index was developed are equally relevant in others. For example, although a topographically, ecologically, and climatologically complex country, f ire danger forecasts in Peru use a standard set of nationwide thresholds applied to the Fire Weather Index. In this study, we validate the underlying assumption that weather-fire relationships are spatially uniform within Peru by (1) making cross-regional comparisons of the statistical distributions of four FDIs—Burning Index, Energy Release Component, Fire Weather Index, and Keetch-Byram Drought Index, and (2) making cross-regional comparisons of the expected daily MODIS hotspot count percentiles conditioned on FDI values.ResultsSignificant regional differences in the distributions of daily FDI values were observed in every pair of regions within Peru, and with the exception of a pair of regions within the Amazon, little data ($$<90$$<90days) were necessary to detect these differences. After controlling for FDI values and seasonal and annual effects with regressions, differences in predicted hotspot percentiles were common, differing by as much as 47 percentage points. Across the pairs of regions, the magnitude of these differences tended to decrease as climatic similarity increased, but some counterexamples were also apparent.ConclusionsThe noticeable differences in the distributions of daily FDI values suggest that a standard set of breakpoints may produce unreliable inferences regarding fire potential. We also find that even if the climatic conditions were similar across Peru, the same FDI values in two locations can produce substantially differing predictions of wildfire activity. This suggests that other factors besides FDI values can strongly mediate wildfire activity and that better fire potential predictions could be produced if these factors are accounted for.
Formulation development, optimization and characterization of Pemigatinib-loaded supersaturable self-nanoemulsifying drug delivery systems
Authors: Reddy Muthadi Radhika , Gubbiyappa Kumar Shiva 
Published: November 2022

Abstract
Background
Pemigatinib is a small molecule tyrosine kinase inhibitor of fibroblast growth factor receptor inhibitors. The oral bioavailability of Pemigatinib is constricted due to its limited solubility at physiological pH. It is essential to develop a novel formulation of Pemigatinib to improve the intrinsic solubility and to reduce the pharmacokinetic variability. Self-nanoemulsifying drug delivery system is an effective, smart and more adequate formulation approach for poorly soluble drugs. Different from conventional self-nanoemulsifying drug delivery system, a supersaturable self-nanoemulsifying drug delivery system of Pemigatinib was prepared by using a supersaturation promoter.

Results
Among all the oils, Captex® 300 have shown maximum solubility of Pemigatinib. Considering the solubilization potential and emulsification ability Kolliphor®RH 40 was selected as surfactant. Transcutol®HP was selected as co-surfactant. The composition of oil, surfactant and co-surfactant was identified using phase diagrams and further adjusted by simplex-lattice design. HPMC K4M as precipitation inhibitor at 5% concentration resulted in effective supersaturating with increased self-emulsification time. The droplet of sSNEDDS ranges from 166.78 ± 3.14 to 178.86 ± 1.24 nm with PDI 0.212 – 0.256, which is significantly smaller than that observed with plain SNEDDS. TEM images revealed the spherical shape of the nanodroplets. The final optimized formulation formed spontaneous nanoemulsion within 15 secs when added to physiological fluids. The percent transmittance of the diluted formulation was found to be 99.12 ± 0.46. The viscosity was found to be 574 ± 26 centipoises indicating the good flow ability. FTIR and DSC studies indicated the amorphization of the drug. The dissolution profile of sSNEDDS indicated the faster release of drug compared to both pure drug suspension and SNEDDS formulation. The drug release rate is directly proportional to the concentration of the drug. The drug release from the insoluble matrix is a square root of time-dependent Fickian diffusion process. The formulation was found to be stable and transparent at all pH values and the percent transmittance was more than 95%. Any kind of separation or precipitation was not observed at different temperatures cycles. No significant difference was observed with all the samples exposed at different storage conditions.

Conclusions
This study demonstrated the feasibility of stabilizing and improving the in-vitro performance of self-nanoemulsifying drug delivery systems of Pemigatinib by incorporating HPMC K4M as precipitation inhibitor.
Squamous cell carcinoma associated with an active cutaneous leishmaniasis in immunocompetent patient: case presentation of an unlikely association and literature—review
Authors: Ouattassi Naouar , Titou Anouar , Hammas Nawal , Kamal Dounia , El Alami Mohamed Nouredine El Amine 
Published: November 2022

Abstract
Background
Association between leishmaniasis and malignancy can be classified into four categories: leishmaniasis mimicking malignancy, leishmaniasis co-existing with malignancy, malignancy developing in patients with leishmaniasis scar, and leishmaniasis developing in patients with malignancy. In immunocompetent patients, the main form of association is cutaneous squamous cell carcinoma (cSCC) developing within cutaneous leishmaniasis scar years after cutaneous leishmaniasis is cured. Association of active cutaneous leishmaniasis and cSCC is exceptional, we are aware of two more cases.

Case presentation
A 30-year-old man presented with 2 years history of an unhealed wound on the dorsum nasi. As there still exist few sites of leishmaniasis in Morocco, systematic screening for leishmania was performed. Leishmania bodies were identified on slit skin smear by Giemsa staining. The patient received local antibiotic and on-site injections of 4 cc of meglumine antimonate for 2 months without any improvement. The lesion volume has increased significantly, a biopsy revealed an invasive squamous cell carcinoma. After staging assessment, the patient underwent a complete removal of the nasal tumor with a 1-cm margin, associated with right modified radical neck dissection. Histopathological examination confirmed the diagnosis of SCC with no lymph nodes metastasis. Nasal reconstruction was performed 2 weeks later using a frontal flap. Oncology meeting board advised adjuvant radiation on the tumor. The patient is followed up regularly and remains free of disease for a year now.

Conclusion
Although many cancers are related to infection (viral or parasitic), there is no proven link between leishmaniasis and malignancy. However, there are many etiopathogenic theories based on pathology finding that involve chronic inflammation inducing dysplasia, mitotic abnormalities, and expression of p53.
Addressing Osteonecrosis: A preventable catastrophe - A multi-center study
Authors: Alam Mafaza , Khan Zahid Mehmood , Alam Laima , Faraid Varqa , Khan Adnan 
Published: November 2022

Objectives: To assess the knowledge of medical doctors about osteonecrosis who prescribe radiotherapy and bisphosphonates and dentists who receive these patients with such risk factors.
Methods: This cross sectional multicenter study was carried out from 15th October 2021 to 20th November 2021 in different set-ups of Pakistan. A validated and piloted questionnaire was sent to dental and non-dental doctors working in different set-ups of Pakistan through email. All data was analyzed in SPSS version 22 with p value <0.05 being significant.
Results: A total of 400 completed responses were received. Only 58% and 67% of the participants were actively educating their patients regarding the hazards of bisphosphonate and radiotherapy, respectively whereas only 45% of the medical doctors referred their patients to dentists before prescribing bisphosphonates and/or radiotherapy. Although the medical doctors had a statistically better knowledge of the definition of osteonecrosis, overall both the dental and non-dental doctors performed poorly regarding answering the questions pertaining to definition, clinical features and risk factors. The dental doctors also showed a poor performance for more technical and in depth questions that was statistically related to lesser work experience, working in a tertiary care facility and previous exposure to such patients.
Conclusion: The inadequate awareness of dentists and physicians about the prevention and management of osteonecrosis of jaw is alarming. Efforts should be undertaken to raise the knowledge of dentists and physicians in this regard.
doi: https://doi.org/10.12669/pjms.39.1.5985
How to cite this: Alam M, Khan ZM, Alam L, Faraid V, Khan A. Addressing Osteonecrosis: A preventable catastrophe - A multi-center study. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.5985
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cardio protective effect of nicorandil in reperfusion injury among patients undergoing primary percutaneous coronary intervention
Authors: Ilyas Maria , Dr. Mudassar Noor  , Dr. Hamid Sharif Khan  , Dr. Sauleha Haroon  , Dr. Kulsoom Farhat  , Dr. Shabana Ali  
Published: November 2022

Objectives: To evaluate the effect of nicorandil in prevention of reperfusion injury during primary percutaneous coronary intervention by thrombolysis in myocardial infarction flow grade scoring.
Methods: A total of 140 patients from Rawalpindi Institute of Cardiology were enrolled in this study conducted from 7th September to 10th of October 2021. These participants were allocated into two major groups. Control group received conventional acute coronary syndrome protocol regimen only whereas experimental group was given nicorandil along with conventional acute coronary syndrome protocol. During primary percutaneous coronary intervention, thrombolysis in myocardial infarction flow grade scoring was analyzed and compared.
Results: Majority of participants in nicorandil group achieved thrombolysis in myocardial infarction Grade-3 scoring which indicated reduced rate of no reflow phenomenon as compared to control group. A statistically significant difference was noted in score of both groups (p value = 0.001) signifying prophylactic use of nicorandil before primary percutaneous coronary intervention along with conventional acute coronary syndrome protocol is superior to only conventional acute coronary syndrome protocol regimen to cases in the control group.
Conclusion: Use of nicorandil in ST elevated myocardial infarction patients before primary percutaneous coronary intervention prevents reperfusion injury thus decreasing the risk of post percutaneous coronary intervention complications and reducing mortality rate in cardiac patients suggesting its significant cardio protective role.
doi: https://doi.org/10.12669/pjms.39.1.6034
How to cite this: Ilyas M, Noor M, Khan HS, Haroon S, Farhat K, Ali S. Cardio protective effect of nicorandil in reperfusion injury among patients undergoing primary percutaneous coronary intervention. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6034
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Posterior fossa epidural hematoma: A 6-year management experience
Authors: Sharafat Seema , Azam Farooq , Khan Zahid 
Published: November 2022

Objective: Through this study, we sought to evaluate the management of posterior fossa extradural hematoma (PFEDH).
Methods: An observational study was conducted at the Neurosurgery Department of Lady Reading Hospital in Peshawar from January 2015 to December 2020. All patients who had a traumatic acute extradural hematoma (EDH) of the posterior fossa were included, irrespective of age and gender. The clinical predictors and outcomes were assessed, including the CT-scan findings and Glasgow Coma Scale (GCS) score.
Results: A total of 104 cases with posterior fossa extradural hematoma were identified from 1252 extradural hematoma patients admitted during the study period. The mean age of the enrolled patients was 18.17 ± 14.31 years. Most of the patients were male (65.39%) and belonged to the pediatric age group, i.e., < 15 years (60.6%). CT scan brain was done in all the cases for diagnosis. In 68.3% of cases, an associated occipital bone fracture was observed. Surgery was done in almost 71.2% of cases, and most of the patients experienced good recovery after surgery, as indicated by the GOS score. Linear regression model revealed that treatment (β=-0.20, p=0.038), time duration between surgery and trauma (β=0.43, p=0.000) and GCS category (β=-0.47, p=0.000) were significantly associated with PFEDH outcomes.
Conclusion: In conclusion, PFEDH was frequent among males and the pediatric age group. Serial CT brain is highly recommended in all suspected cases for early diagnosis.
doi: https://doi.org/10.12669/pjms.39.1.6408
How to cite this: Sharafat S, Azam F, Khan Z. Posterior fossa epidural hematoma: A 6-year management experience. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6408
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.