bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reverse triggering ? a novel or previously missed phenomenon?
Authors: Jackson Robert , Kim Audery , Moroz Nikolay , Damiani L. Felipe , Grieco Domenico Luca , Piraino Thomas , Friedrich Jan O. , Mercat Alain , Telias Irene , Brochard Laurent J. 
Published: May 2024

Abstract
Background
Reverse triggering (RT) was described in 2013 as a form of patient-ventilator asynchrony, where patient’s respiratory effort follows mechanical insufflation. Diagnosis requires esophageal pressure (Pes) or diaphragmatic electrical activity (EAdi), but RT can also be diagnosed using standard ventilator waveforms.

Hypothesis
We wondered (1) how frequently RT would be present but undetected in the figures from literature, especially before 2013; (2) whether it would be more prevalent in the era of small tidal volumes after 2000.

Methods
We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials, from 1950 to 2017, with key words related to asynchrony to identify papers with figures including ventilator waveforms expected to display RT if present. Experts labelled waveforms. ‘Definite’ RT was identified when Pes or EAdi were in the tracing, and ‘possible’ RT when only flow and pressure waveforms were present. Expert assessment was compared to the author’s descriptions of waveforms.

Results
We found 65 appropriate papers published from 1977 to now, containing 181 ventilator waveforms. 21 cases of ‘possible’ RT and 25 cases of ‘definite’ RT were identified by the experts. 18.8% of waveforms prior to 2013 had evidence of RT. Most cases were published after 2000 (1 before vs. 45 after, p = 0.03). 54% of RT cases were attributed to different phenomena. A few cases of identified RT were already described prior to 2013 using different terminology (earliest in 1997). While RT cases attributed to different phenomena decreased after 2013, 60% of ‘possible’ RT remained missed.

Conclusion
RT has been present in the literature as early as 1997, but most cases were found after the introduction of low tidal volume ventilation in 2000. Following 2013, the number of undetected cases decreased, but RT are still commonly missed.

Prior Abstract
Reverse Triggering, A Missed Phenomenon in the Literature. Critical Care Canada Forum 2019 Abstracts. Can J Anesth/J Can Anesth 67 (Suppl 1), 1–162 (2020). https://doi-org.myaccess.library.utoronto.ca/https://doi.org/10.1007/s12630-019-01552-z.
Environmental drivers of tree species richness in the southernmost portion of the Paranaense forests
Authors: Toranza Carolina , Martínez-Lanfranco Juan Andrés , Haretche Federico , Brazeiro Alejandro 
Published: May 2024

Abstract
Background
The Rio de la Plata grassland region is dominated by temperate grasslands, with the scarce natural forests, influenced floristically by adjacent biogeographical provinces. Uruguay represents the southern limit for many tree species of the Paranaense Province, several of which inhabit the hillside forests. With many species shifting poleward due to climate change, we do not yet know how current environmental factors, particularly climatic ones, are linked to the tree diversity of this flora nowadays. The aim of this study is to understand the geographic pattern of tree richness in the hillside forests of Uruguay, evaluating the water–energy and the environmental heterogeneity hypotheses. The distribution of the hillside forest trees was obtained by compiling and updating the herbaria database and distribution maps of woody plants of Uruguay. The presence/absence of each species, and then the species richness, were georeferenced over a grid that covers Uruguay with 302 cells (660 km2). Over the same grid were compiled environmental variables associated with climate and environmental heterogeneity. The relationship between richness and environmental variables was studied by applying general linear models (GLM). As a strong autocorrelation was detected, a residuals auto-covariate term was incorporated into the GLM, to take into account the species richness spatial structure.

Results
The tree flora of the hillside forest was composed mainly by Paranaense species that show a latitudinal gradient, with two high richness cores, in the east and northeast of Uruguay. The final model including the environmental variables and the spatial term explained 84% of the variability of tree richness. Species richness showed a positive relationship with precipitation, forest cover, potential evapotranspiration and productivity, while a negative effect of temperature variation was found. The spatial component was the primary predictor, accounting for a 30% of spatial pattern of tree richness.

Conclusions
This study accounts for a large proportion of the environmental and spatial variations of the tree richness pattern of the Paranense flora in its southernmost portion. It brings support to both water–energy and environmental heterogeneity hypotheses, emphasizing the role of climate and its variation and the habitat availability on the hillside forest diversity.
Exploring the medicinal potential of Senna siamea roots: an integrated study of antibacterial and antioxidant activities, phytochemical analysis, ADMET profiling, and molecular docking insights
Authors: Gebrehiwot Hadush , Ensermu Urgessa , Dekebo Aman , Endale Milkyas , Hunsen Mo 
Published: May 2024

AbstractNowadays, infectious diseases pose an alarming global threat to human health. The genus Senna is among the most well-known taxonomic categories commonly used in folk medicine to confront these challenges. Motivated by its traditional uses, a comprehensive study was conducted on the roots extract of Senna siamea, aiming to address the in vitro antibacterial and antioxidant efficacy of phytochemicals from the dichloromethane: methanol (1:1) roots extract of the plant, along with in silico computational studies. The separation of compounds was achieved using silica gel column chromatography. Whereas, the antibacterial and antioxidant activities were examined using paper disc diffusion and 2, 2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assays, respectively. Silica gel column chromatography of the dichloromethane: methanol (1:1) roots extract afforded lupeol (1), β-sitosterol (2a) and stigmasterol (2b), chrysophanol (3), betulinic acid (4), and glyceryl-1-hexacosanoate (5). Although these compounds have been previously reported from the plant, proof of their medicinal applications via in vitro and in silico studies is still lacking. Notably, our findings showed remarkable inhibition zones by the extract (18.00 ± 0.00 mm and 17.17 ± 0.24 mm) against E. coli and S. aureus, respectively, at 50 mg/mL compared to ciprofloxacin (23.33 ± 0.47 mm and 22.00 ± 0.00 mm, respectively), showcasing its potential antibacterial efficiency. Considerable inhibition zones were also recorded by chrysophanol (3) against E. coli (16.33 ± 0.24 mm) and S. pyogenes (16.00 ± 0.00 mm) at 2 mg/mL, compared to ciprofloxacin which showed 23.33 ± 0.47 mm and 21.67 ± 0.47 mm, respectively, signifying its potent antibacterial activities. In addition, the crude extract and chrysophanol (3) exhibited substantial IC50 values (1.24 and 1.71 µg/mL, respectively), suggesting their significant antioxidant potential compared to that of ascorbic acid (IC50: 0.53 µg/mL). Chrysophanol (3) fulfilled Lipinski’s rule with no violation and lupeol (1), β-sitosterol (2a), stigmasterol (2b), betulinic acid (4), and glyceryl-1-hexacosanoate (5) displayed one violation each which were in favor of the drug-likeness predictions. All the compounds exhibited no cytotoxicity and except betulinic acid (4), all the compounds also showed no carcinogenicity properties which were consistent with the prediction results of ciprofloxacin. The molecular docking computations revealed that all the compound isolates displayed strong and nearly strong binding affinities against all protein targets, ranging from − 6.6 kcal/mol to -9.2 kcal/mol (lupeol (1) against E. coli DNA gyrase B and topoisomerase II α, respectively). Thus, the present findings suggest the roots of Senna siamea for potential medicinal applications against multi-drug resistant pathogens hence validating its ethno-medicinal uses.
Transfemoral hepatic vein catheterization reduces procedure time in double vein embolization
Authors: Steffen Dominik A. , Najafi Arash , Binkert Christoph A. 
Published: May 2024

Abstract
Background
Double vein embolization with simultaneous embolization of the portal and hepatic vein aims to grow the future liver remnant in preparation for major hepatectomy. Transvenous hepatic vein embolization is usually done via a transjugular access. The purpose of this study is to describe the transfemoral approach as an alternative option and to discuss potential advantages.

Results
Twenty-three patients undergoing hepatic vein embolization via a transjugular (n = 10) or transfemoral access (n = 13) were evaluated retrospectively. In all cases the portal vein embolization was done first. All procedures were technically successful. There were no peri-interventional complications. Only two patients were not able to proceed to surgery. Standardized future liver remnant hypertrophy was non-inferior with the transfemoral approach compared to the transjugular route. Procedure time was significantly shorter in the transfemoral access group (40 ± 13 min) compared to the transjugular group (67 ± 13 min, p < 0.001).

Conclusion
Transfemoral hepatic vein embolization is feasible, safe, and faster due to easier catheterization, improved stability, and simpler patient preparation. These findings will need to be validated in larger studies.
Effects of environmental factors and storage periods on sesame seed quality and longevity
Authors: Gebregergis Zenawi , Baraki Fiseha , Fiseseha Dawit 
Published: May 2024

Abstract
Sesame is one of the world’s oldest oil seed crops grown mainly for its seeds. Lengthened storage time, inappropriate staking, back warded threshing method and poor storage facilities are major causes for postharvest and quality losses of sesame seed. Therefore, the objective was to review the effect of storage time and storage conditions on sesame seed quality and longevity. Seed quality and longevity are mostly governed by moisture content, temperature, humidity, storage period, pre-storage conditions, and pest infestations. Moisture content is a pre-requisite for long-term seed storage, and is the most important factor affecting seed longevity. Sesame seeds remain consistent and viable up to 12 months under appropriate storage facilities and conditions, otherwise it get lessened its viability. The crop should be harvested at the appropriate time and seeds should be stored at 6% or lower moisture content. In the tropics where temperature is as high as 33 °C and relative humidity of about 80%, seeds deteriorate rapidly. Varietal mixtures and harvest conditions affect longevity of seeds in storage. Pests such as, Mites, Indian mealy moth, Weevils, Flour beetles, are serious problems in stored sesame seeds. Under low seed moisture content and temperature, insects may not be a problem. Oil seeds require high-quality constructions to prevent leakages and to allow easy access to the bin for sampling and monitoring. Therefore, sesame seeds should be stored in well-constructed room/ware house to maintain seed viability and longevity.
CsWRKY11 cooperates with CsNPR1 to regulate SA-triggered leaf de-greening and reactive oxygen species burst in cucumber
Authors: Zhang Dingyu , Zhu Ziwei , Yang Bing , Li Xiaofeng , Zhang Hongmei , Zhu Hongfang 
Published: May 2024

AbstractSalicylic acid (SA) is a multi-functional phytohormone, regulating diverse processes of plant growth and development, especially triggering plant immune responses and initiating leaf senescence. However, the early SA signaling events remain elusive in most plant species apart from Arabidopsis, and even less is known about the multi-facet mechanism underlying SA-regulated processes. Here, we report the identification of a novel regulatory module in cucumber, CsNPR1-CsWRKY11, which mediates the regulation of SA-promoted leaf senescence and ROS burst. Our analyses demonstrate that under SA treatment, CsNPR1 recruits CsWRKY11 to bind to the promoter of CsWRKY11 to activate its expression, thus amplifying the primary SA signal. Then, CsWRKY11 cooperates with CsNPR1 to directly regulate the expression of both chlorophyll degradation and ROS biosynthesis related genes, thereby inducing leaf de-greening and ROS burst. Our study provides a solid line of evidence that CsNPR1 and CsWRKY11 constitute a key module in SA signaling pathway in cucumber, and gains an insight into the interconnected regulation of SA-triggered processes.
Association of Genetic Polymorphism rs 77630697(Gly64Asp) of Multidrug and Toxin Extrusion -1 with glycemic response to metformin in patients with Type 2 Diabetes Mellitus
Authors: Hakim Zunera , Najam ul Hasan  , Asma Khan  , Akbar Waheed  
Published: May 2024

Objective: To determine the relationship between Gly64Asp (rs77630697) polymorphism of multidrug and toxin extrusion-1 (MATE-1) and therapeutic response of metformin in Type-2 diabetic patients.
Methods: A longitudinal study was conducted at Riphah International Hospital, Islamabad from June 2020 to December 2021. Type-2 diabetic patients (n=200) on metformin monotherapy fulfilling the inclusion criteria were enrolled and followed up till three months. Based on change in HbA1c, they were divided into responders and non-responders. DNA was extracted and genotyping was done by TETRA ARMS PCR. Data was entered and association was analyzed by SPSS 22.
Results: Out of 200 participants, 104 were categorized as responders and 96 as non-responders. The genotype and allelic distribution of rs77630697 was significantly different between responders and non-responders. The variant genotype (GG) was most prevalent among the study population and among responders. After follow up of three months, difference in glycemic response was found to be statistically significant (p < 0.05) among three genotypes (GG, GA and AA). The decline in HbA1c was highest in GG genotype with almost two-fold reduction in comparison with GA and AA. Carriers of allele A were significantly associated with impaired response to metformin.
Conclusion: The variable therapeutic response to metformin in the responders and non-responders may be contributed to rs77630697 isoform variation of MATE-1.
doi: https://doi.org/10.12669/pjms.40.6.8170
How to cite this: Hakim Z, Najam ul Hasan, Khan A, Waheed A. Association of Genetic Polymorphism rs 77630697(Gly64Asp) of Multidrug and Toxin Extrusion -1 with glycemic response to metformin in patients with Type 2 Diabetes Mellitus. Pak J Med Sci. 2024;40(6):1256-1260. doi: https://doi.org/10.12669/pjms.40.6.8170
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.
Factors affecting asthma control in pregnancy: A cross-sectional study
Authors: Kaleem Ullah Toori  , Qureshi Muhammad Arsalan 
Published: May 2024

Background and Objective: Asthma control in pregnant women remains of utmost importance; suboptimal control can have adverse repercussions on both fetal and maternal health. The objective was to identify the factors that affect asthma control in pregnant Pakistani women presenting to a tertiary care hospital.
Methods: This descriptive, cross-sectional research was conducted at KRL General Hospital between 1st November 2022 to 30th April 2023. Non-probability technique was used to sample one hundred and forty-five pregnant women with confirmed bronchial asthma irrespective of their trimester presented. Data regarding demographics and factors affecting asthma control was collected.
Results: The mean age was 30.39 ± 4.33 years, with two-thirds (65%) being multiparous. Approximately 48% of participants were non-compliant with treatment, and less than 40% achieved adequate asthma control. A chi-squared test applied showed that multiparity (p = 0.003), treatment compliance (p < 0.001), BMI (p < 0.001), and proper inhaler technique (p < 0.001) were statistically significant factors affecting asthma control in pregnant women while, the level of education and household income did not exhibit a significant association. Multiple regression analysis qualified higher BMI, multiparity, treatment compliance, and inhaler technique as significant predictors of asthma control amongst pregnant women.
Conclusion: Ensuring asthma control during pregnancy is important. This study identified BMI, multiparity, inhaler technique, and treatment compliance as factors that affect asthma control in pregnant women. Addressing these factors through regular antenatal check-ups can significantly mitigate risks and promote the optimal health of both maternal and fetal lives.
doi: https://doi.org/10.12669/pjms.40.6.8659
How to cite this: Toori KU, Qureshi MA. Factors affecting asthma control in pregnancy: A cross-sectional study. Pak J Med Sci. 2024;40(6):1146-1150. doi: https://doi.org/10.12669/pjms.40.6.8659
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.
Multiplex attacks in sigmoid volvulus
Authors: Disci Esra , Peksoz Rifat , Agirman Enes , Atamananalp Sabri Selcuk 
Published: May 2024

Objectives: Sigmoid volvulus (SV) recurs in about one quarter of the patients, whereas multiplex (≥3) attacks are quite rare and attacks with five or more times are extremely rare. The aim of this study was to evaluate multiplex SV attacks in our series and worldwide data.
Methods: In Ataturk University Faculty of Medicine Department of General Surgery, among 1,071-case SV series, data were evaluated retrospectively in 612 patients, while prospectively in 459 with respect to age, gender, previous volvulus attacks, and prognosis. Worldwide data were obtained from Web of Science database and they were compared with our results.
Results: Mean SV attack count, multiple- (≥2) and multiplex- (≥3) attack rates were 1.4, 26.1%, and 4.2%, respectively, in our series, while they were 1.7, 26.7%, and 3.2%, respectively, in worldwide data (p>0.05, in all). In our series, recurrence rates were 26.1%, 19.3%, and 51.2%, respectively, (p<0.001, in all), while mortality rates were 7.3%, 13.7%, and 19.5%, respectively, (p<0.001, in all) in single-, double-, and multiplex- (≥3) attack patients.
Conclusion: Although multiplex (≥3) attacks are uncommon in SV, when it goes up, elective surgery must be considered in selected cases to avoid repetitive attacks and related high mortality.
doi: https://doi.org/10.12669/pjms.40.6.9172
How to cite this: Disci E, Peksoz R, Agirman E, Atamanalp SS. Multiplex attacks in sigmoid volvulus. Pak J Med Sci. 2024;40(6):1185-1189. doi: https://doi.org/10.12669/pjms.40.6.9172
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.
Effectiveness of nursing care intervention for alleviation of anxiety, pain and functional improvement amongst patients undergoing ambulatory surgery: A systematic review and meta-analysis
Authors: Xu Hongna , Shi Yan 
Published: May 2024

Background & Objective: Ambulatory surgeries are increasingly prevalent, yet they often result in postoperative pain and anxiety, impacting patient recovery and satisfaction. Effective management of these complications is crucial, and nursing care interventions have been proposed as a potential solution. This meta-analysis aims to evaluate the effectiveness of nursing care interventions in reducing pain and anxiety and improving functional status among patients undergoing ambulatory surgery.
Methods: A comprehensive literature search done on December 2023 of PubMed Central, MEDLINE, Scopus, Google Scholar, Cochrane library, CINAHL, and trial registries was done for studies from inception till November 2023, that met predefined eligibility criteria. Standardized mean differences (SMD) for continuous outcomes and odds ratios (OR) for binary outcomes were calculated using a random-effects inverse-variance model. Sensitivity analysis was performed to assess the robustness of the findings, and heterogeneity was evaluated using I² statistics.
Results: Nine studies were included. Pooled analysis revealed a significant reduction in pain (SMD = -1.224, 95% CI: -2.445 to -0.003, p=0.049) and anxiety (SMD = -1.53, 95% CI: -2.77 to -0.28, p=0.016) among patients receiving nursing care interventions, with substantial heterogeneity (I² = 98.2% for pain and 96.6% for anxiety). However, no significant improvement was observed in the functional status (SMD = -0.28, 95% CI: -0.35 to 0.91, p=0.385). Sensitivity analysis confirmed the stability of these results.
Conclusion: Nursing care interventions are effective in significantly reducing pain and anxiety in patients undergoing ambulatory surgery. However, their impact on improving functional status remains inconclusive. Our findings underscore the importance of integrating nursing care into postoperative management protocols in ambulatory surgeries and highlight areas for future research, particularly concerning functional recovery.
doi: https://doi.org/10.12669/pjms.40.6.9472
How to cite this: Hongna Xu1, Yan Shi2. Effectiveness of nursing care intervention for alleviation of anxiety, pain and functional improvement amongst patients undergoing ambulatory surgery: A systematic review and meta-analysis. Pak J Med Sci. 2024;40(6):1287-1293. doi: https://doi.org/10.12669/pjms.40.6.9472
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.
Leo Strauss and Carl Schmitt
Authors: Herrero Montserrat , Vatter Miguel 
Published: May 2024

I have devoted part of my work to the political thought of Carl Schmitt, in my opinion one of the most enlightened minds of the 20th century, not only because of his intellectual acuteness, but also because the historical point of view from which he spoke was exceptional: the collapse of the Second Reich, i.e. the absolute end of a world centred on the imperial idea, the rise of the Weimar Republic and its agony in the arms of the Third Reich, and the new international order that took shape after its fall with the total humiliation of Germany, which Schmitt saw as the triumph of liberal Americanist imperialism. Many were Carl Schmitt’s correspondents during his lifetime. Thousands of letters can be found in Schmitt’s archive. Three of these letters were from Leo Strauss. We cannot find the correlative letters of Schmitt. But from the content of the letters we have to deduce that Schmitt did not reply to Strauss, at least not to these three letters. Strange for someone who was in the habit of always replying to letters. These letters were sent between 1932 and 1933 and inform us of an opinion written by Schmitt to evaluate Strauss’s research on Hobbes before the Rockefeller Foundation in order to Strauss to apply for a grant. Strauss won the grant and thanks Schmitt. Many scholars speculate on the idea of Schmitt’s silence and put it down to the dangers of corresponding with a Jew like Strauss at that time. There is undoubtedly a good biographical argument there, but that does not interest me as much as the content of their relationship through their texts.