bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric evaluation of a quality of recovery score for the postanesthesia care unit—A preliminary validation study
Authors: Kahl Ursula , Brodersen Katrin , Kaiser Sarah , Krause Linda , Klinger Regine , Plümer Lili , Zöllner Christian , Fischer Marlene 
Published: August 2023

Introduction
Patients’ perception of postoperative recovery is a key aspect of perioperative care. Self-reported quality of recovery (QoR) has evolved as a relevant endpoint in perioperative research. Several psychometric instruments have been introduced to assess self-reported recovery 24 hours after surgery. However, there is no questionnaire suitable for use in the postanesthesia care unit (PACU). We aimed to develop and psychometrically evaluate a QoR questionnaire for the PACU (QoR-PACU).

Methods
The QoR-PACU was developed in German language based on the 40-item QoR-40 questionnaire. Between March and November 2020, adult patients scheduled for elective urologic surgery completed the QoR-PACU preoperatively and during the PACU stay. We evaluated feasibility, validity, reliability, and responsiveness.

Results
We included 375 patients. After two piloting phases including 72 and 48 patients, respectively, we administered the final version of the QoR-PACU to 255 patients, with a completion rate of 96.5%. Patients completed the QoR-PACU at a median of 125.0 (83.0; 156.8) min after arrival in the PACU. Construct validity was good with postoperative QoR-PACU sum scores correlating with age (r = 0.23, 95% CI: 0.11 to 0.35, p < 0.001), length of PACU stay (r = -0.15, 95%CI: -0.27 to -0.03, p = 0.02), pain in the PACU (r = -0.48, 95% CI: -0.57 to -0.37, p < 0.001) and piritramide dose administered (r = -0.29, 95% CI: -0.40 to -0.17, p < 0.001). Cronbach’s alpha was 0.67 (95% CI: 0.61–0.73) with moderate test-retest reliability (ICC of 0.67, 95% CI: 0.38 to 0.83). Cohen’s effect size was 3.08 and the standardized response mean was 1.65 indicating adequate responsiveness.

Conclusion
The assessment of QoR in the early postoperative period is feasible. We found high acceptability, good validity, adequate responsiveness, and moderate reliability. Future studies should evaluate the psychometric properties of the QoR-PACU in more heterogeneous patient populations including female and gender-diverse patients with varying degress of perioperative risk.
The Effect of Using Premedication of Simethicone/Pronase With or Without Postural Change on Visualization of the Mucosa Before Endoscopy: A Prospective, Double Blinded, Randomized Controlled Trial
Authors: Cao Li , Zheng Fangqin , Wang Deqiong , Chen Li , Feng Xinxia , Zhou Zhenzhen , Liu Jingmei , Wang Mi , Guo Qiaozhen , Liu Mei 
Published: August 2023

INTRODUCTION:
To investigate the efficacy and safety of preprocedural simethicone (S) and pronase (P) for optimal mucosal visualization during esophagogastroduodenoscopy with sedation. The effect of postural change combined with premedication on mucosal visibility was also examined.

METHODS:
The study randomized 496 patients into 8 groups based on the type of premedication provided and whether a postural change occurred. The premedication in the control group was 100 mL of normal saline solution (NS). The remaining 3 intervention groups were administered 100 mL of simethicone alone (S), pronase solution alone (P), and simethicone plus pronase solution (S + P). Each group was classified into subgroups according to whether there was a postural change (PC). The mucosal visibility score (MVS), total mucosal visibility score (TVS), procedure time, water consumption for mucosal cleansing, and proportion of patients with diminutive lesions <5 mm were recorded.

RESULTS:
The P and S groups had a significantly better TVS than the NS group (11.86 ± 3.36 in group P vs 14.52 ± 2.57 in group NS, P < 0.001; 12.36 ± 2.93 in group S vs 14.52 ± 2.57 in group NS, P = 0.006). The TVS was better in the P group than in the S group (11.86 ± 3.36 vs 12.36 ± 2.93, P = 0.037). The MVS was significantly better in the esophagus and duodenum and worse in the upper and lower gastric body in the S group than in the P group. The P + S group had a significantly better TVS than the P and S groups (9.81 ± 2.90 in group P + S vs 11.86 ± 3.36 in group P and 12.36 ± 2.93 in group S, respectively, P < 0.001),\ and had a reduced amount of flushing water during the procedure (0 [interquartile range [IQR]: 0–33] mL in group P + S vs 40 [IQR: 0–70] mL in group P, P < 0.01; 0 [IQR: 0–33] mL in group P + S vs 50 [IQR: 20–98] mL in group S, P < 0.001). The TVS was significantly better in the P + S + PC group than in the P + S group (8.44 ± 2.10 vs 9.81 ± 2.90, P = 0.003). The MVS was significantly better in the gastric antrum, fundus, and upper and lower gastric body in the P + S + PC group than in the P + S group. There was no significant difference in the detection rate of diminutive lesions among the different groups during an endoscopic examination (P > 0.05).

DISCUSSION:
The combination of preprocedural administration with simethicone and pronase achieved superior mucosal visualization compared with saline, simethicone, or pronase alone in patients receiving upper endoscopy. Postural change maneuvers performed before endoscopy further improved the mucosal visibility in most parts of the stomach when used with preprocedural simethicone and pronase.
Pharmacokinetic parameters, safety and drug-drug interactions of mirtazapine and tizanidine, combined in the new original drug Dorsumio®
Authors: Goncharov A. S. , Grigoriev A. V. , Globenko A. A. , Goncharov I. S. , Muratov K. A. , Yaroshenko D. V. , Sidorova A. A. , Kapashin A. V. , Kovchan O.  V. , Bashkatova A. I. , Pasko M. A. 
Published: August 2023

Objective: to study the pharmacokinetic parameters and safety of Dorsumio® (mirtazapine + tizanidine, extended-release tablets, 15 mg + 6 mg, JSC Valenta Pharm, Russia) taken once by healthy volunteers in comparison with Calixta®, a monocomponent drug (INN: Mirtazapine, filmcoated tablets, 30 mg, Belupo, Drugs and Cosmetics d.d., Republic of Croatia) and Sirdalud® MR (INN: Tizanidine, modified-release capsules, 6 mg, Novartis Pharma AG, Switzerland) with an evaluation of their drug interactions when taken concomitantly or separately.Material and methods. A two-stage, randomized, comparative cross-over study of the pharmacokinetics and safety of the complex drug Dorsumio® was conducted. In the first stage, volunteers alternated between taking one or two tablets of the study drug in two administration periods; in the second stage, subjects alternated between taking the reference monodrugs Calixta® and Sirdalud® MR alone and in a joint combination in three administration periods. A total of 38 volunteers were randomized into the study, of which 14 subjects participated in the first and 24 in the second stage of the study. Quantitative levels of mirtazapine and tizanidine were determined by high-performance liquid chromatography with tandem mass spectrometry. Based on the data obtained, the main pharmacokinetic parameters reflecting the bioavailability of each drug were calculated, and the mutual influence of their combination on pharmacokinetics was also studied. During the study, vital signs and laboratory parameters of the subjects were monitored, and the occurrence of adverse events (AEs) and serious AEs was recorded.Results. A two-fold increase in the dose of the combination drug Dorsumio® resulted in a comparable increase in the pharmacokinetics of the individual drugs. There was no significant reciprocal effect of mirtazapine and tizanidine on their pharmacokinetic parameters. In one of the subjects participating in the second stage of the study, two mild side effects were registered after the joint use of Calixta® and Sirdalud® MR that did not require medical intervention and resolved on their own without health consequences.Conclusion. There were no differences in the safety profile of the combined use of mirtazapine and tizanidine in the form of a free or fixed combination. It was shown that the investigated drug combination had no mutual influence on the pharmacokinetics of the individual components.
A novel computational technique to analyse the corona generated ionized field environment of EHV/UHV DC transmission lines
Authors: Raja Nayak M. , Chandra Sekhar K. 
Published: August 2023

Abstact
The corona-generated electromagnetic field environment under and nearer to the extra high dc potential conductors generates an ill health environment which causes serious electrical threats to living organisms present in the conductor corridor. The ionized electromagnetic field environment is characterizing with ionized ionic current flow and enhanced electric field perturbation at ground levels. The primary factors which affect the safe and economical design dimensions of high potential dc conductors are conductor diameter, altitude, applied potential and atmospheric parameters such as temperature, humidity, pressure, and aerosol pollution, etc. This remains a challenging task to design the HVDC transmission system at extended potential levels, as HVDC system employed for a large amount of power transfer barrier in the electrical system to meet inevitable power thrust. To obtain a safe and economical design configuration, multiple experimental design measurements are essential at various climatic seasons which incorporates the tedious process and significant economical expenditure. To obtain the safe and cost-effective design dimension configuration, computational-based numerical analysis with final experimental validation offers substantial support. Using various computational methodologies, many researchers have attempted to guide the critical line design proportions to establish a safe and economical electrical environment beneath the lines at ground levels. All these computational techniques are emphasizing the algorithm iterative-based complex solutions claim the lack of computational accuracy. Hence, this work aims to provide a unique computational technique to analyse the ionised electromagnetic field environment of a unipolar UHV dc transmission system using modelling of the physics of the corona discharge procedure in the active high electrostatic field zone. Modelling of the corona discharge includes the estimation of the amount of new ionized ions generated in the ionization region dynamically claims complex less equations offer a unique solution. To validate the accuracy of the proposed computational technique, multiple outdoor experimental measurements are carried out at HV/EHV/UHV potential applications and discussed. Also, the computed results are compared with the experimental findings, from the comparison outstanding computational accuracy was marked.
Resonance and recombinant creativity: Why they are important for research in Cognitive Linguistics and Pragmatics
Authors: Tantucci Vittorio 
Published: August 2023

AbstractThe present paper discusses the key role of creativity as a form of engagement and categorisation in interaction. One important way to display engagement ‘at talk’ is via resonance, that is when speakers re-use linguistic features that they heard from one another. Speakers constantly imitate and creatively recombine the utterances and the behaviors of their interlocutors. Recombinant creativity is a key cognitive mechanism subserving this, as it involves speakers’ re-elaboration of utterances and illocutionary forces of others, but also, more generally, the creative intervention on observed patterns of behaviour in context. Recombinant creativity is crucial for primarily two pragmatic and conceptual mechanisms: relevance acknowledgement and schematic categorization. A persistent tendency towards the proactive reformulation of an interlocutor’s speech is a textual indicator of relevance acknowledgement. This is because what is said by the other speaker is overtly treated as useful information for the continuation of the interaction. The opposite trend – to be measured on a large scale – is an indicator of lack of engagement. Recombinant creativity varies intra- and inter-culturally and is decisive for speakers’ enactment of socio-pragmatic schemas and the generalisation of form and meaning as a process of shared categorization.
Relevance theory and the study of linguistic interfaces in second language acquisition
Authors: Ahern Aoife , Amenós-Pons José , Guijarro-Fuentes Pedro 
Published: August 2023

AbstractIn this paper we address Relevance-theoretical (RT) postulates with clear potential for contributing to the substantiation of the notion of interface in second language acquisition (SLA) processes. Whether the interface is considered the locus of contact between the structural linguistic properties and syntactic operations, on one hand, and the interpretive mechanisms of the conceptual-intentional system, on the other; or understood as points of interaction among cognitive modules, interfaces are fundamental to interpreting grammatical structures that require integrating discourse-contextual information. Assuming the RT conceptual-procedural meaning distinction is approximately correlated with that which exists between lexical and functional categories, it will be shown that recent research into SLA revolves around the problem of how procedural units are acquired. Certain functional categories, expressing interpretable features, have been analysed as encoding identical procedural indications across different languages. Thus, one challenge that L2 learners face is identifying diverse interface effects, derivable from a single procedure, across languages. To illustrate this point we discuss a recent analysis of phenomena involving tense and aspect acquisition applying RT principles to empirical findings. Finally, some new directions will be suggested for further theorizing in SLA research on inherent characteristics of utterance interpretation in an L2.
The Expression of Values, Humanity and Aesthetics: The Appearance of Chinese Films in the New Stage
Authors: Zhou Xing , Ouyang Yuhong 
Published: August 2023

Abstract
Since the turn of the 21st century, the creative focus of Chinese films has developed from “main theme films” to “new mainstream films”; this change has led to the transformation of Chinese films as the world’s second largest market, enabling the diversification of artistic creative types and the expression of spiritual connotations. Since 2012, new mainstream films in China have increasingly occupied the leading position in film creation, with many outstanding works being produced. The adherence to China’s mainstream values, as well as the multi-tiered and diverse types of creation, make Chinese films in this new stage an important representative of Chinese culture. The progress of new mainstream films may be seen in relation to the following aspects: cultural values, the expression of humanity, family ethics, and aesthetic expression, all of which are constantly advancing the development of Chinese films.
Voicing the Terrestrial: Theory of the Lyric and the Pressures of the Anthropocene
Authors: Pietrzak Wit 
Published: August 2023

Abstract
In the present essay, I argue that lyric ecopoetry is particularly suited to alter our worldview in favor of a more ecologically-aware stance. In itself this position has been announced by numerous ecocritics, with some doubts as to its adequacy expressed by Timothy Clark in his Ecocriticism on the Edge. Partly in response to his critique, it is here argued that poems do offer a viable way of altering human modes of thinking not by what or how they evoke but by the way in which they register in the reader’s consciousness. To this effect, I depart from the theories of the lyric advanced in the last two decades by the likes of Jonathan Culler, Derek Attridge and the poet Don Patterson, all of whom argue that lyric poetry differs from any other form of linguistic expression in being itself the event it evokes rather than a representation of an event. This is because by dint of being performed by readers, lyric poems compel one to embrace the voices that comprise them as one’s own, as a result helping one interiorize an experience of ultimate otherness. It is this modus of poetry’s existence that makes it a particularly apt literary form for impelling one to appreciate the complexity of and one’s imbrication in the networks of planetary ecosystems. In this way, as I claim further on, poetry may be conceived of as a vehicle for instilling a form of thinking that Bruno Latour has recently theorized as Terrestrial. For him, the Terrestrial is characterized by what he calls the system of engendering, a way of dwelling in the interrelated systems of the Earth that is reciprocally beneficial for human and non-humans. After an overview of Latour’s idea, which is put forward as a potential political platform, and its relation to the extant theories of environmental humanities that emphasize poetry’s role in conjuring the awareness of the intricacy of natural processes, I suggest that lyric poetry offers not only a means of linguistic expression of the interdependence of all elements in any given ecosystem but also constitutes a language capable of swaying human modes of thinking in favor of the Terrestrial.
Delayed discovery: the COVID-19 pandemic’s influence on osteoarthritis clinical trials
Authors: Sajjadi Nicholas B. , Anderson Jon Michael , Hughes Griffin K. , Abraham Christena E. , Malik Jamal , Hartwell Micah , Vassar Matt 
Published: August 2023

Abstract

Context
The COVID-19 pandemic disrupted clinical research in many medical and surgical fields, resulting in research waste and loss of treatment for patients. Although other areas have been explored, the extent of the pandemic’s influence on osteoarthritis (OA) trials is currently unknown.

Objectives
This study aims to explore the reasons for termination of clinical trials investigating OA during the COVID-19 pandemic.

Methods
We searched ClinicalTrials.gov for OA trials and characterized their reason for discontinuation, noting where trialists directly cited the COVID-19 pandemic as the reason for trial discontinuation. We also coded other common reasons for trial discontinuation. Descriptive and inferential statistics were performed to determine the difference in enrollment, funding source, trial phase, allocation, and intervention type between the trials terminated early due to pandemic and nonpandemic reasons.

Results
Out of 135 clinical trials, 119 were included and 27 (22.7 %) of them reported the COVID-19 pandemic as a primary reason for discontinuation, which was the overall most common reason for OA trial discontinuation during the study period. We found statistically significant differences for trials discontinued due to pandemic vs. non–pandemic-related reasons, with trials having sites outside the United States, randomized allocation, and drug or device intervention type being most affected. However, there was no statistically significant difference between groups regarding trial phase, funding source, or enrollment.

Conclusions
This study highlights the impact of the COVID-19 pandemic on the clinical trials related to OA. We found that many trials reported discontinuation directly due to the pandemic, which may lead to the loss or delay of novel treatments for OA. To avoid such discontinuation in the future, alternative methods for conducting OA-related clinical trials should be explored and implemented.
Classic genetic and hormonal switches during fetal sex development and beyond
Authors: Holterhus Paul-Martin , Kulle Alexandra , Busch Hauke , Spielmann Malte 
Published: August 2023

Abstract
Critical genetic and hormonal switches characterize fetal sex development in humans. They are decisive for gonadal sex determination and subsequent differentiation of the genital and somatic sex phenotype. Only at the first glace these switches seem to behave like the dual 0 and 1 system in computer sciences and lead invariably to either typically male or female phenotypes. More recent data indicate that this model is insufficient. In addition, in case of distinct mutations, many of these switches may act variably, causing a functional continuum of alterations of gene functions and -dosages, enzymatic activities, sex hormone levels, and sex hormone sensitivity, giving rise to a broad clinical spectrum of biological differences of sex development (DSD) and potentially diversity of genital and somatic sex phenotypes. The gonadal anlage is initially a bipotential organ that can develop either into a testis or an ovary. Sex-determining region Y (SRY) is the most important upstream switch of gonadal sex determination inducing SOX9 further downstream, leading to testicular Sertoli cell differentiation and the repression of ovarian pathways. If SRY is absent (virtually “switched off”), e. g., in 46,XX females, RSPO1, WNT4, FOXL2, and other factors repress the male pathway and promote ovarian development. Testosterone and its more potent derivative, dihydrotestosterone (DHT) as well as AMH, are the most important upstream hormonal switches in phenotypic sex differentiation. Masculinization of the genitalia, i. e., external genital midline fusion forming the scrotum, growth of the genital tubercle, and Wolffian duct development, occurs in response to testosterone synthesized by steroidogenic cells in the testis. Müllerian ducts will not develop into a uterus and fallopian tubes in males due to Anti-Müllerian-Hormone (AMH) produced by the Sertoli cells. The functionality of these two hormone-dependent switches is ensured by their corresponding receptors, the intracellular androgen receptor (AR) and the transmembrane AMH type II receptor. The absence of high testosterone and high AMH is crucial for anatomically female genital development during fetal life. Recent technological advances, including single-cell and spatial transcriptomics, will likely shed more light on the nature of these molecular switches.