bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Clitic climbing” in Hittite
Authors: Sideltsev Andrei V. 
Published: October 2023

Abstract
Cross-linguistically, clitic climbing occurs when clitics that belong syntactically and semantically to the subordinate clause (most commonly non-finite, rarely finite) appear in the main clause, i.e., they climb out of the subordinate clause into the main clause. In Hittite, prototypical clitic climbing is attested in two constructions: with non-finite predicates and finite restructuring verbs (Lyutikova & Sideltsev 2021b); and in serial constructions with the finite motion verbs pai- ‘go’ and uwa- ‘come’ co-occurring with another finite verb in the same clause (Koller 2013). In both of these cases, clitics climb out of complements of finite verbs. This paper explores yet another potentially relevant context for clitic climbing, a particular type of complex sentence that may be called ‘mismatch sentences’ (Sideltsev 2023). These involve three structurally distinct types of complex sentences which share one common property: they all have the same surface structure (1a) one word of the main clause (2) subordinate clause (1b) rest of the main clause. The enclitics of the subordinate clause are in (1a), so that they appear to climb out of the subordinate into the main clause. The enclitics of the main clause are consistently in the rest of the main clause (1b), never attached to the first word of the main clause (1a). Structurally, all these subordinate clauses adjoin to the main clause. This distribution of clitics is attested only if there is a one-word constituent in the main clause to the left of the subordinate clause. As movement out of adjoined clauses is held to be illicit in current linguistic theory, it is argued that, differently from prototypical clitic climbing, this is a purely post-syntactic reordering and does not involve any kind of syntactic movement of clitics out of the subordinate into the main clause: the structure one-word constituent of main clause—subordinate clause—main clause is always prosodically realized at the post-syntactic stage as subordinate clause—main clause.
Chronic Rhinosinusitis After Maxillary Advancement Orthognathic Surgery
Authors: Ibrahim Nour , Hwang Peter H. , Jitaroon Kawinyarat , Tyler Matthew A. 
Published: October 2023

Introduction: Maxillomandibular advancement (MMA) remains an effective procedure for the management of obstructive sleep apnea (OSA). Maxillary advancement may lead to anatomical changes that impair paranasal sinus drainage, leading to chronic sinus inflammation. The aim of this study was to describe the clinical features and outcomes of patients suffering from chronic rhinosinusitis (CRS) following MMA. Methods: This is a retrospective case series study. Our study included subjects diagnosed with CRS following MMA from January 1992 to October 2018 at Stanford Hospital. We screened 730 patients undergoing MMA and identified a total of 57 with CRS after MMA. A descriptive analysis was performed using clinical data including patient demographics, comorbidities, prior surgical history, physical exam manifestations, CT findings, and quality of life outcomes (SNOT-22). Results: Out of 730 patients undergoing MMA, 57(7.8%) were found to have CRS after orthognathic surgery. Presenting symptoms included facial pain (92.5%), nasal drainage (75%), nasal obstruction (67.5%), and hyposmia (20%). Endoscopic examination revealed recirculation (30.5%), purulent discharge (27.7%), polypoid changes (22.2%), and scarring (13.8%). Preoperative CT prior to undergoing endoscopic sinus surgery (ESS) demonstrated mucosal thickening in maxillary (64.2%), anterior ethmoid (39.2%), frontal (14.2%), posterior ethmoid (10.7%), sphenoid sinus (14.2%), and ostiomeatal complex (55.3%). Average Lund-Mackay score was 5.5(±3.8). Additional CT findings included secondary ostium in the inferior meatus (42.8%). Forty patients (70.1%) underwent ESS at a mean of 4.6 years after MMA. Patients undergoing ESS experienced significant improvement in SNOT-22 scores at 12-months post-surgery ( P = .018). Conclusion: Patients undergoing maxillary advancement surgery are at risk of developing CRS postoperatively and should be advised of the risk of CRS associated with this procedure. Surgical treatment can be an option for medically refractory CRS related to MMA surgery.
Early transthoracic echocardiography and long-term mortality in moderate- to-severe acute respiratory distress syndrome: An analysis of the Medical Information Mart for Intensive Care database
Authors: Liu Qiuyu , Tang Yingkui , Tao Wu , Tang Ze , Wang Hongjin , Nie Shiyu , Wang Nian 
Published: October 2023

Background The clinical use of transthoracic echocardiography (TTE) in patients with acute respiratory distress syndrome (ARDS) in the intensive care unit (ICU) has dramatically increased, its impact on long-term prognosis in these patients has not been studied. This study aimed to explore the effect of early-TTE on long-term mortality in patients with moderate-to-severe ARDS in ICU. Methods A total of 2833 patients with moderate-to-severe ARDS who had or had not received early-TTE were obtained from the Medical Information Mart for Intensive Care (MIMIC-III) database after imputing missing values by a random forest model, patients were divided into early-TTE group and non-early-TTE group according to whether they received TTE examination in ICU. A variety of statistical methods were used to balance 41 covariates and increase the reliability of this study, including propensity score matching, inverse probability of treatment weight, covariate balancing propensity score, multivariable regression, and doubly robust estimation. Chi-Square test and t-tests were used to examine the differences between groups for categorical and continuous data, respectively. Results There was a significant improvement in 90-day mortality in the early-TTE group compared to non-early-TTE group (odds ratio  =  0.79, 95% CI: 0.64–0.98, p-value  =  0.036), revealing a beneficial effect of early-TTE. Net-input was significantly decreased in the early-TTE group on the third day of ICU admission and throughout the ICU stay, compared with non-early-TTE group (838.57 vs. 1181.89 mL, p-value  =  0.014; 4542.54 vs. 8025.25 mL, p-value  =  0.05). There was a significant difference in the reduction of serum lactate between the two groups, revealing the beneficial effect of early-TTE (0.59 vs. 0.83, p-value  =  0.009). Furthermore, the reduction in the proportion of acute kidney injury demonstrated a correlation between early-TTE and kidney protection (33% vs. 40%, p-value < 0.001). Conclusions Early application of TTE is beneficial to improve the long-term mortality of patients with moderate-to-severe ARDS.
Gentiopicroside ameliorates CCl4-induced liver injury in mice by regulating the PPAR-γ/Nrf2 and NF-κB/IκB signaling pathways
Authors: Zhang Yun , Pan Shiguang , Yi Shiming , Sun Jin , Wang Haitao 
Published: October 2023

Objective This study explored the mechanisms by which gentiopicroside protects against carbon tetrachloride (CCl4)-induced liver injury. Methods Male mice were randomly assigned to the control; CCl4; bifendate 100 mg/kg; or gentiopicroside 25, 50, or 100 mg/kg groups. Both vehicle and drugs were administered intragastrically for 7 days. Mice were administered CCl4 intraperitoneally 1 hour after the last drug dose. After 24 hours, we collected blood and liver samples for testing. Results Gentiopicroside significantly reduced serum alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase activities with corresponding reductions in hepatocyte denaturation and necrosis. Gentiopicroside enhanced superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities and glutathione levels and reduced heme oxygenase 1 (HO-1) activity and malondialdehyde levels in the liver, and these effects were attributed to peroxisome proliferator-activated receptor (PPAR)-γ/nuclear factor erythroid 2-related factor 2 (Nrf2) activation. Meanwhile, gentiopicroside significantly downregulated HO-1 and upregulated SOD and GSH-Px at the mRNA level in the liver. Furthermore, gentiopicroside significantly suppressed serum tumor necrosis factor-α and interleukin-1β secretion, which was associated with the inhibition of nuclear factor-kappa B (NF-κB)/inhibitor of NF-κB (IκB). Conclusions Gentiopicroside ameliorated CCl4-induced liver injury in mice via the PPAR-γ/Nrf2 and NF-κB/IκB pathways.
RRPE’s Memorial Symposium on Professor Jim Crotty* Some Reflections on Jim Crotty: His Life and Contributions to Economics
Authors: Epstein Gerald , Pollin Robert 
Published: October 2023

Jim Crotty was a beloved teacher and mentor and a treasured colleague at the University of Massachusetts-Amherst. In this short essay, we try to convey Jim’s enormous contributions to his students, colleagues, and friends, and to the development and reproduction of heterodox macroeconomic theory and practice. JEL Classification: B4, B5, E
Effectiveness of acupuncture for postoperative gastrointestinal recovery in patients undergoing thoracoscopic surgery: a prospective randomized controlled study
Authors: Zhang Yingjun , Ou Chaopeng , Luo Xiaolin , Kang Yinqian , Jiang Li , Wu Shaoyong , Ouyang Handong 
Published: October 2023

Background: Postoperative gastrointestinal dysfunction (PGD) is one of the most common complications among patients who have undergone thoracic surgery. Acupuncture has long been used in traditional Chinese medicine to treat gastrointestinal diseases and has shown benefit as an alternative therapy for the management of digestive ailments. This study aimed to explore the therapeutic effectiveness of acupuncture as a means to aid postoperative recovery of gastrointestinal function in patients undergoing thoracoscopic surgery. Methods: In total, 112 patients aged 18–70 years undergoing thoracoscopic surgery between 15 June 2022 and 30 August 2022 were randomized into two groups. Patients in the acupuncture group (AG) first received acupuncture treatment 4 h after surgery, and treatment was repeated at 24 and 48 h. Patients in the control group (CG) did not receive any acupuncture treatment. Both groups received the same anesthetic protocol. Ultrasound-guided thoracic paravertebral block (TPVB) was performed in the paravertebral spaces between T4 and T5 with administration of 20 mL of 0.33% ropivacaine. All patients received patient-controlled intravenous analgesia (PCIA) after surgery. Results: Median time to first flatus [interquartile range] in the AG was significantly less than in the CG (23.25 [18.13, 29.75] vs 30.75 [24.13, 45.38] h, p < 0.001). Time to first fluid intake after surgery was significantly less in the AG, as compared with the CG (4 [3, 7] vs 6.5 [4.13, 10.75] h, p = 0.003). Static pain, measured by visual analog scale (VAS) score, was significantly different on the third day after surgery (p = 0.018). Dynamic pain VAS scores were lower in the AG versus CG on the first three postoperative days (p = 0.014, 0.003 and 0.041, respectively). Conclusion: Addition of acupuncture appeared to improve recovery of postoperative gastrointestinal function and alleviate posteoperative pain in patients undergoing thoracoscopic surgery. Acupuncture may represent a feasible strategy for the prevention of PGD occurrence. Trial registration number: ChiCTR2200060888 (Chinese Clinical Trial Registry)
Accuracy and Retention of Molding Plates Used for Infants with Cleft Lip and Palate Fabricated from Different Materials: A Cross-Sectional Clinical Study
Authors: Oday Raghad , Abid Mushriq 
Published: October 2023

Objectives The study aimed to comparatively assess the accuracy and retention of molding plates made of polyethylene terephthalate modified with glycol (PET-G) and polymethyl methacrylate (PMMA) materials, while also investigating the effect of adhesive addition on retention. Design A cross-sectional clinical study. Patients/setting The study included 30 infants diagnosed with non-syndromic cleft lip and palate (16 unilateral, 14 bilateral). Two molding plates were fabricated for each infant, and their accuracy and retention were evaluated. The data were analyzed using independent t-tests, Mann-Whitney U tests, and Wilcoxon rank tests. Main outcome measures Accuracy: The accuracy of the molding plates was assessed by measuring the virtual gap between the inner surface of the plates and their working cast using Exocad software. The accuracy was evaluated in different regions (anterior, middle, and posterior) and compared between PET-G and PMMA materials. Retention: The retention of the molding plates was measured using a digital force gauge, which recorded the force required to dislodge the plates from the infant's mouth. The retention was compared between PET-G and PMMA materials, as well as the effect of adhesive addition on retention. Overall adaptation; PET-G plates showed a significantly smaller gap (mean= 0.264 ±0.106) compared to PMMA (mean= 0.362 ±0.130). Region-specific adaptation: PET-G plates demonstrated better accuracy in all regions (means of anterior =0.246, middle =0.262, posterior =0.282 µm). Significant differences in accuracy were observed in the middle and posterior regions compared to PMMA. Retention assessment revealed that the PET-G groups (with or without adhesive) exhibited significantly higher retention compared to the PMMA groups ( P<0.01). Conclusion PET-G plates demonstrated superior accuracy and retention compared to PMMA, with a significant difference observed in both accuracy and retention. Furthermore, the addition of denture adhesive had a positive effect on retention for both materials.
A multifaceted quality improvement intervention on venous thromboembolism prophylaxis compliance in hospitalized medical patients at a comprehensive cancer center
Authors: Wang Christopher , Toale Katy M 
Published: October 2023

Introduction Previous studies suggest that quality improvement initiatives focused on hospital-acquired venous thromboembolism have a positive impact on prescribing rates of venous thromboembolism prophylaxis, especially those that incorporate computerized changes. Methods We conducted a quality improvement project to determine whether education and computerized prescriber order entry system changes affect venous thromboembolism prophylaxis compliance rates in hospitalized medical patients at a Comprehensive Cancer Center. Between 1 January 2021 and 31 January 2023, 37,739 non-surgical, adult patient encounters with a length of stay > 48 h were analyzed in our study. From 18 December 2021 to 8 March 2022, provider education was delivered to the three largest admitting services, and computerized prescriber order entry changes were implemented incorporating a mandatory requirement to either order venous thromboembolism prophylaxis or document a contraindication for all patients at moderate venous thromboembolism risk. Results Monthly venous thromboembolism prophylaxis compliance rates, as defined by the Centers for Medicare and Medicaid Services VTE-1 metric, increased from a mean of 74% to 93% after the interventions. This change was driven primarily by an increased utilization of mechanical venous thromboembolism prophylaxis from 37% to 53%. Conclusion Our study demonstrated that a multi-faceted intervention incorporating provider education and computerized prescriber order entry system changes can significantly increase venous thromboembolism prophylaxis compliance rates in cancer patients.
The Utility of Researcher-Driven Projective and Enabling Techniques to Support Engagement in Research About Dementia Diagnosis and Post-Diagnostic Support
Authors: Phillipson L. , Hevink M. , McAiney C. , Gresham M. , Conway E. , Mackowiak M. , Szczesniak D. , Smith L. , Brodaty H. , Low L. F. 
Published: October 2023

Research involving people with dementia has highlighted the need to improve engagement in the conduct of interviews and focus groups. Projective and enabling techniques may be useful and avoid some of the drawbacks associated with direct questioning. However, researcher-driven projective techniques have not been extensively tested in research with people with dementia. In 2019, researchers in Australia, Canada, the Netherlands and Poland received training and trialled projective and enabling techniques to collect data about dementia diagnostic and early post-diagnostic experiences. The techniques were used with a total of thirty people with dementia (aged 67–97 years) in online and face-to-face individual and dyadic interviews and a focus group. Word association activities supported brainstorming about the concepts of ‘dementia’ and ‘support’. A researcher-driven photo elicitation technique was utilised to seek responses concerning a hypothetical couple at four time points: during a diagnostic conversation, and at 1, 6 and 12-month post-diagnosis. Discussions were audio recorded and transcribed and interviewers created ‘meta’ mind maps of word associations and made reflective notes regarding participant engagement. Deductive content analysis was used to assess the value of the techniques to support a manageable, comprehensible and meaningful research experience. Word associations supported free-flowing conversations around the key research concepts. Photo elicitation techniques promoted empathy and supported personal reflections on the probable experiences and needs of the hypothetical couple. The techniques were also useful in eliciting reflections on personal experiences, societal responses to dementia, and recommendations for improving the diagnostic conversation and supports for the post-diagnostic period. Overall, the techniques appeared to lessen some of the demands of direct questioning but were not manageable or meaningful for all participants. Further research should explore the vast array of projective techniques and engage in greater co-design and tailoring of research approaches to enhance the toolkit of dementia researchers.
Targeting inflammation to reduce recurrent stroke
Authors: Zietz Annaelle , Gorey Sarah , Kelly Peter J , Katan Mira , McCabe John J 
Published: October 2023

Background: Approximately one in four stroke patients suffer from recurrent vascular events, underlying the necessity to improve secondary stroke prevention strategies. Immune mechanisms are causally associated with coronary atherosclerosis. However, stroke is a heterogeneous disease and the relative contribution of inflammation across stroke mechanisms is not well understood. The optimal design of future randomized control trials (RCTs) of anti-inflammatory therapies to prevent recurrence after stroke must be informed by a clear understanding of the prognostic role of inflammation according to stroke subtype and individual patient factors. Aim: In this narrative review, we discuss (1) inflammatory pathways in the etiology of ischemic stroke subtypes; (2) the evidence on inflammatory markers and vascular recurrence after stroke; and (3) review RCT evidence of anti-inflammatory agents for vascular prevention. Summary of review: Experimental work, genetic epidemiological data, and plaque-imaging studies all implicate inflammation in atherosclerotic stroke. However, emerging evidence also suggests that inflammatory mechanisms are also important in other stroke mechanisms. Advanced neuroimaging techniques support the role of neuroinflammation in blood–brain barrier dysfunction in cerebral small vessel disease (cSVD). Systemic inflammatory processes also promote atrial cardiopathy, incident and recurrent atrial fibrillation (AF). Although several inflammatory markers have been associated with recurrence after stroke, interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) are presently the most promising markers to identify patients at increased vascular risk. Several RCTs have shown that anti-inflammatory therapies reduce vascular risk, including stroke, in coronary artery disease (CAD). Some, but not all of these trials, selected patients on the basis of elevated hsCRP. Although unproven after stroke, targeting inflammation to reduce recurrence is a compelling strategy and several RCTs are ongoing. Conclusion: Evidence points toward the importance of inflammation across multiple stroke etiologies and potential benefit of anti-inflammatory targets in secondary stroke prevention. Taking the heterogeneous stroke etiologies into account, the use of serum biomarkers could be useful to identify patients with residual inflammatory risk and perform biomarker-led patient selection for future RCTs.
Alemtuzumab following natalizumab is more effective in adult-onset than paediatric-onset multiple sclerosis
Authors: Puthenparampil Marco , Gaggiola Marta , Miscioscia Alessandro , Mauceri Valentina Annamaria , De Napoli Federica , Zanotelli Giovanni , Anglani Mariagiulia , Nosadini Margherita , Sartori Stefano , Perini Paola , Rinaldi Francesca , Gallo Paolo 
Published: October 2023

Background: Paediatric-onset multiple sclerosis (POMS) therapeutic approach derives from of adult-onset multiple sclerosis (AOMS) tailored algorithms. Objectives: To evaluate in a common clinical scenario the efficacy and safety of alemtuzumab (ALZ) in POMS and AOMS. Methods: All patients switching from natalizumab (NTZ) to ALZ for safety concerns (high anti-John Cunningham Virus Antibody Index value, anti-JCV Index) were enrolled in this single-centre, retrospective, case-control open-label study. Results: Ten POMS and 27 AOMS were followed up for 51.3 months. After month 12, we found a lower risk of clinical or radiological relapses among AOMS patients and among patients with older age at ALZ (both p < 0.05). Survival analysis revealed an increased risk of relapse in POMS compared with AOMS (logrank p = 0.00498) and patients starting ALZ before age 22.75 years than the elder ones (logrank p = 0.0018). Survival analysis did not disclose any difference between AOMS and POMS (logrank p = 0.27) in terms of progression independent of any relapse activity (PIRA). In addition, no evidence of relapse-associated worsening was observed. Autoimmune events were reported by 5 AOMS and no POMS (29.4% versus 0.0%, p = 0.057), and survival analysis was not significant (logrank p = 0.0786). Conclusion: ALZ seems more effective in AOMS than in POMS following NTZ. These findings underrate ALZ effectiveness when shifting from NTZ in POMS.