bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Recognition of Whispered Speech in Real-Time
Authors: Hendrickson Kristi , Ernest Danielle 
Published: September 2021

Objectives:
Whispered speech offers a unique set of challenges to speech perception and word recognition. The goals of the present study were twofold: First, to determine how listeners recognize whispered speech. Second, to inform major theories of spoken word recognition by considering how recognition changes when major cues to phoneme identity are reduced or largely absent compared with normal voiced speech.

Design:
Using eye tracking in the Visual World Paradigm, we examined how listeners recognize whispered speech. After hearing a target word (normal or whispered), participants selected the corresponding image from a display of four—a target (e.g., money), a word that shares sounds with the target at the beginning (cohort competitor, e.g., mother), a word that shares sounds with the target at the end (rhyme competitor, e.g., honey), and a phonologically unrelated word (e.g., whistle). Eye movements to each object were monitored to measure (1) how fast listeners process whispered speech, and (2) how strongly they consider lexical competitors (cohorts and rhymes) as the speech signal unfolds.

Results:
Listeners were slower to recognize whispered words. Compared with normal speech, listeners displayed slower reaction times to click the target image, were slower to fixate the target, and fixated the target less overall. Further, we found clear evidence that the dynamics of lexical competition are altered during whispered speech recognition. Relative to normal speech, words that overlapped with the target at the beginning (cohorts) displayed slower, reduced, and delayed activation, whereas words that overlapped with the target at the end (rhymes) exhibited faster, more robust, and longer lasting activation.

Conclusion:
When listeners are confronted with whispered speech, they engage in a “wait-and-see” approach. Listeners delay lexical access, and by the time they begin to consider what word they are hearing, the beginning of the word has largely come and gone, and activation for cohorts is reduced. However, delays in lexical access actually increase consideration of rhyme competitors; the delay pushes lexical activation to a point later in processing, and the recognition system puts more weight on the word-final overlap between the target and the rhyme.
The comparison of different medical treatment modalities in pes anserinus tendino-bursitis: a prospective clinical study
Authors: Yalcinozan Mehmet , Aydin Deniz , Sari Enes 
Published: September 2021

Background:
Periarticular knee pain is a frequent and age-independent condition that affects patients during daily life. Lower-extremity pain caused by disability is one of the major interests of both orthopaedic and physical therapy departments. The aim of this study was to compare different medical treatment options and describe an effective treatment modality in pes anserinus tendino-bursitis, which has been an underestimated problem. This study was a prospective randomized clinical study of 45 patients who were clinically diagnosed with pes anserinus tendino-bursitis.

Methods:
Three study groups (n=15) were created, and each group underwent different treatment modalities by different physicians. The first group of patients was prescribed one intralesional corticosteroid injection. The second group of patients was prescribed a topical medical treatment regimen for 20 days in total. The third group of patients was prescribed nonsteroidal antiinflammatory drugs (NSAIDs) in addition to cold application for 3 wk. The patients were observed according to Knee injury and Osteoarthritis Outcome Scores (KOOS) and Visual Analog Scale (VAS) scores.

Results:
This study revealed significantly better results with a triple topical treatment combination when compared with other common medical treatment modalities in terms of pain relief and functional improvement of patients.

Conclusions:
Combined topical treatment was an effective treatment regimen for pes anserinus bursitis. With the support of daily functional modification, this treatment decreased the healing time and increased patient function during the treatment with better pain control.

Level of Evidence:
Level II.
What Are the Risk Factors for Infection After Operative Treatment of Peritalar Fracture Dislocations?
Authors: Levitt Eli B. , Patch David A. , Johnson Michael D. , McLynn Ryan , Debell Henry , Harris James B. , Spitler Clay A. 
Published: September 2021

Objective:
To assess the risk factors associated with deep infection after operative treatment of peritalar fracture dislocations.

Design:
A retrospective study was performed to identify patients who had operative treatment of a peritalar fracture dislocation over an 11-year period (2008–2019).

Setting:
Level 1 trauma center.

Participants:
Patients were identified by review of all surgical billing that included open reduction of peritalar dislocation. Minimum follow-up for inclusion was 3 months or the outcome of interest. A total of 178 patients were identified, and 154 patients met inclusion criteria.

Main Outcome:
The primary outcome was deep infection, defined as return to the operating room for debridement with positive cultures.

Results:
A total of 19 (12.3%) patients developed a postoperative deep infection. The most common associated fractures were talus (47%), calcaneus (33%), and fibula (9%) fractures. The infected group was significantly older (47.2 vs. 39.5 years, P = 0.03). Patients undergoing operative management for peritalar fracture dislocations with current smoking were found to have significantly higher odds of postoperative deep infection (74 vs. 34%, adjusted odds ratio = 7.4, 95% confidence interval, 2.3–24.1, P = 0.001). There was a significantly higher risk of infection in patients with a Gustilo–Anderson type 3 open fracture (32 vs. 12%, adjusted odds ratio = 5.7, 95% confidence interval, 1.6–20.3, P = 0.007). The infected group had high rates of below knee amputation when compared with the group without infection (47 vs. 1%, P < 0.001).

Conclusion:
In our retrospective study, risk factors for infection after peritalar fracture dislocation included older age, smoking, and Gustilo–Anderson type 3 open fracture.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
The Coronavirus Disease 2019 Pandemic Impacts Burnout Syndrome Differently Among Multiprofessional Critical Care Clinicians—A Longitudinal Survey Study
Authors: Moll Vanessa , Meissen Heather , Pappas Sharon , Xu Kejun , Rimawi Ramzy , Buchman Timothy G. , Fisher Lisa , Bakshi Vishal , Zellinger Mary , Coopersmith Craig M. 
Published: September 2021

OBJECTIVES:
To determine the impact of coronavirus disease 2019 on burnout syndrome in the multiprofessional ICU team and to identify factors associated with burnout syndrome.

DESIGN:
Longitudinal, cross-sectional survey.

SETTING:
All adult ICUs within an academic health system.

SUBJECTS:
Critical care nurses, advanced practice providers, physicians, respiratory therapists, pharmacists, social workers, and spiritual health workers were surveyed on burnout in 2017 and during the coronavirus disease 2019 pandemic in 2020.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Burnout syndrome and contributing factors were measured using the Maslach Burnout Inventory of Health and Human Service and Areas of Worklife Survey. Response rates were 46.5% (572 respondents) in 2017 and 49.9% (710 respondents) in 2020. The prevalence of burnout increased from 59% to 69% (p < 0.001). Nurses were disproportionately impacted, with the highest increase during the pandemic (58–72%; p < 0.0001) with increases in emotional exhaustion and depersonalization, and personal achievement decreases. In contrast, although burnout was high before and during coronavirus disease 2019 in all specialties, most professions had similar or lower burnout in 2020 as they had in 2017. Physicians had the lowest rates of burnout, measured at 51% and 58%, respectively. There was no difference in burnout between clinicians working in ICUs who treated coronavirus disease 2019 than those who did not (71% vs 67%; p = 0.26). Burnout significantly increased in females (71% vs 60%; p = 0.001) and was higher than in males during the pandemic (71% vs 60%; p = 0.01).

CONCLUSIONS:
Burnout syndrome was common in all multiprofessional ICU team members prior to and increased substantially during the pandemic, independent of whether one treated coronavirus disease 2019 patients. Nurses had the highest prevalence of burnout during coronavirus disease 2019 and had the highest increase in burnout from the prepandemic baseline. Female clinicians were significantly more impacted by burnout than males. Different susceptibility to burnout syndrome may require profession-specific interventions as well as work system improvements.
Rapid Development and Deployment of an Intensivist-Led Venovenous Extracorporeal Membrane Oxygenation Cannulation Program
Authors: Kouch Michael , Green Adam , Damuth Emily , Noel Christopher , Bartock Jason , Rosenbloom Michael , Schorr Christa , Rios Robert , Loperfido Nancy , Puri Nitin 
Published: September 2021

OBJECTIVES:
To determine the safety and efficacy of a rapidly deployed intensivist-led venovenous extracorporeal membrane oxygenation cannulation program in a preexisting extracorporeal membrane oxygenation program.

DESIGN:
A retrospective observational before-and-after study of 40 patients undergoing percutaneous cannulation for venovenous extracorporeal membrane oxygenation in an established cannulation program by cardiothoracic surgeons versus a rapidly deployed medical intensivist cannulation program.

SETTING:
An adult ICU in a tertiary academic medical center in Camden, NJ.

PATIENTS:
Critically ill adult subjects with severe respiratory failure undergoing percutaneous cannulation for venovenous extracorporeal membrane oxygenation.

INTERVENTIONS:
Percutaneous cannulation for venovenous extracorporeal membrane oxygenation performed by cardiothoracic surgeons compared with cannulations performed by medical intensivists.

MEASUREMENTS AND MAIN RESULTS:
Venovenous extracorporeal membrane oxygenation cannulation site attempts were retrospectively reviewed. Subject demographics, specialty of physician performing cannulation, type of support, cannulation configuration, cannula size, imaging guidance, success rate, and complications were recorded and summarized. Twenty-two cannulations were performed by three cardiothoracic surgeons in 11 subjects between September 2019 and February 2020. The cannulation program rapidly transitioned to an intensivist-led and performed program in March 2020. Fifty-seven cannulations were performed by eight intensivists in 29 subjects between March 2020 and December 2020. Mean body mass index for subjects did not differ between groups (33.86 vs 35.89; p = 0.775). There was no difference in days on mechanical ventilation prior to cannulation, configuration, cannula size, or discharge condition. There was no difference in success rate of cannulation on first attempt per cannulation site (95.5 vs 96.7; p = 0.483) or major complication rate per cannulation site (4.5 vs 3.5; p = 1).

CONCLUSIONS:
There is no difference between success and complication rates of percutaneous venovenous extracorporeal membrane oxygenation canulation when performed by cardiothoracic surgeons versus medical intensivist in an already established extracorporeal membrane oxygenation program. A rapidly deployed cannulation program by intensivists for venovenous extracorporeal membrane oxygenation can be performed with high success and low complication rates.
Barotrauma in Coronavirus Disease 2019 Patients Undergoing Invasive Mechanical Ventilation: A Systematic Literature Review*
Authors: Belletti Alessandro , Todaro Gabriele , Valsecchi Gabriele , Losiggio Rosario , Palumbo Diego , Landoni Giovanni , Zangrillo Alberto 
Published: September 2021

OBJECTIVE:
There are concerns of a high barotrauma rate in coronavirus disease 2019 patients with acute respiratory distress syndrome receiving invasive mechanical ventilation. However, a few studies were published, and reported rates were highly variable. We performed a systematic literature review to identify rates of barotrauma, pneumothorax, and pneumomediastinum in coronavirus disease 2019 acute respiratory distress syndrome patients receiving invasive mechanical ventilation.

DATA SOURCE:
PubMed and Scopus were searched for studies reporting barotrauma event rate in adult coronavirus disease 2019 patients receiving invasive mechanical ventilation.

STUDY SELECTION:
We included all studies investigating adult patients with coronavirus disease 2019 acute respiratory distress syndrome requiring mechanical ventilation. Case reports, studies performed outside ICU setting, and pediatric studies were excluded. Two investigators independently screened and selected studies for inclusion.

DATA EXTRACTION:
Two investigators abstracted data on study characteristics, rate of pneumothorax, pneumomediastinum and overall barotrauma events, and mortality. When available, data from noncoronavirus disease 2019 acute respiratory distress syndrome patients were also collected. Pooled estimates for barotrauma, pneumothorax, and pneumomediastinum were calculated.

DATA SYNTHESIS:
A total of 13 studies with 1,814 invasively ventilated coronavirus disease 2019 patients and 493 noncoronavirus disease 2019 patients were included. A total of 266/1,814 patients (14.7%) had at least one barotrauma event (pooled estimates, 16.1% [95% CI, 11.8–20.4%]). Pneumothorax occurred in 132/1,435 patients (pooled estimates, 10.7%; 95% CI, 6.7–14.7%), whereas pneumomediastinum occurred in 162/1,432 patients (pooled estimates, 11.2%; 95% CI, 8.0–14.3%). Mortality in coronavirus disease 2019 patients who developed barotrauma was 111/198 patients (pooled estimates, 61.6%; 95% CI, 50.2–73.0%). In noncoronavirus disease 2019 acute respiratory distress syndrome patients, barotrauma occurred in 31/493 patients (6.3%; pooled estimates, 5.7%; 95% CI, −2.1% to 13.5%).

CONCLUSIONS:
Barotrauma occurs in one out of six coronavirus disease 2019 acute respiratory distress syndrome patients receiving invasive mechanical ventilation and is associated with a mortality rate of about 60%. Barotrauma rate may be higher than noncoronavirus disease 2019 controls.
Extended Lung Ultrasound to Differentiate Between Pneumonia and Atelectasis in Critically Ill Patients: A Diagnostic Accuracy Study
Authors: Haaksma Mark E. , Smit Jasper M. , Heldeweg Micah L. A. , Nooitgedacht Jip S. , de Grooth Harm J. , Jonkman Annemijn H. , Girbes Armand R. J. , Heunks Leo , Tuinman Pieter R. 
Published: September 2021

OBJECTIVES:
To determine the diagnostic accuracy of extended lung ultrasonographic assessment, including evaluation of dynamic air bronchograms and color Doppler imaging to differentiate pneumonia and atelectasis in patients with consolidation on chest radiograph. Compare this approach to the Simplified Clinical Pulmonary Infection Score, Lung Ultrasound Clinical Pulmonary Infection Score, and the Bedside Lung Ultrasound in Emergency protocol.

DESIGN:
Prospective diagnostic accuracy study.

SETTING:
Adult ICU applying selective digestive decontamination.

PATIENTS:
Adult patients that underwent a chest radiograph for any indication at any time during admission. Patients with acute respiratory distress syndrome, coronavirus disease 2019, severe thoracic trauma, and infectious isolation measures were excluded.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Lung ultrasound was performed within 24 hours of chest radiograph. Consolidated tissue was assessed for presence of dynamic air bronchograms and with color Doppler imaging for presence of flow. Clinical data were recorded after ultrasonographic assessment. The primary outcome was diagnostic accuracy of dynamic air bronchogram and color Doppler imaging alone and within a decision tree to differentiate pneumonia from atelectasis. Of 120 patients included, 51 (42.5%) were diagnosed with pneumonia. The dynamic air bronchogram had a 45% (95% CI, 31–60%) sensitivity and 99% (95% CI, 92–100%) specificity. Color Doppler imaging had a 90% (95% CI, 79–97%) sensitivity and 68% (95% CI, 56–79%) specificity. The combined decision tree had an 86% (95% CI, 74–94%) sensitivity and an 86% (95% CI, 75–93%) specificity. The Bedside Lung Ultrasound in Emergency protocol had a 100% (95% CI, 93–100%) sensitivity and 0% (95% CI, 0–5%) specificity, while the Simplified Clinical Pulmonary Infection Score and Lung Ultrasound Clinical Pulmonary Infection Score had a 41% (95% CI, 28–56%) sensitivity, 84% (95% CI, 73–92%) specificity and 68% (95% CI, 54–81%) sensitivity, 81% (95% CI, 70–90%) specificity, respectively.

CONCLUSIONS:
In critically ill patients with pulmonary consolidation on chest radiograph, an extended lung ultrasound protocol is an accurate and directly bedside available tool to differentiate pneumonia from atelectasis. It outperforms standard lung ultrasound and clinical scores.
Identifying Prokineticin2 as a Novel Immunomodulatory Factor in Diagnosis and Treatment of Sepsis*
Authors: Yu Xiaoyan , Chen Jingyi , Tang Hong , Tu Qianqian , Li Yue , Yuan Xi , Zhang Xuemei , Cao Ju , Molloy David Paul , Yin Yibing , Chen Dapeng , Song Zhixin , Xu Pingyong 
Published: September 2021

OBJECTIVES:
Sepsis remains a highly lethal disease, whereas the precise reasons for death remain poorly understood. Prokineticin2 is a secreted protein that regulates diverse biological processes. Whether prokineticin2 is beneficial or deleterious to sepsis and the underlying mechanisms remain unknown.

DESIGN:
Prospective randomized animal investigation and in vitro studies.

SETTING:
Research laboratory at a medical university hospital.

SUBJECTS:
Prokineticin2 deficiency and wild-type C57BL/6 mice were used for in vivo studies; sepsis patients by Sepsis-3 definitions, patient controls, and healthy controls were used to obtain blood for in vitro studies.

INTERVENTIONS:
Prokineticin2 concentrations were measured and analyzed in human septic patients, patient controls, and healthy individuals. The effects of prokineticin2 on sepsis-related survival, bacterial burden, organ injury, and inflammation were assessed in an animal model of cecal ligation and puncture–induced polymicrobial sepsis. In vitro cell models were also used to study the role of prokineticin2 on antibacterial response of macrophages.

MEASUREMENTS AND MAIN RESULTS:
Prokineticin2 concentration is dramatically decreased in the patients with sepsis and septic shock compared with those of patient controls and healthy controls. Furthermore, the prokineticin2 concentration in these patients died of sepsis or septic shock is significantly lower than those survival patients with sepsis or septic shock, indicating the potential value of prokineticin2 in the diagnosis of sepsis and septic shock, as well as the potential value in predicting mortality in adult patients with sepsis and septic shock. In animal model, recombinant prokineticin2 administration protected against sepsis-related deaths in both heterozygous prokineticin2 deficient mice and wild-type mice and alleviated sepsis-induced multiple organ damage. In in vitro cell models, prokineticin2 enhanced the phagocytic and bactericidal functions of macrophage through signal transducers and activators of transcription 3 pathway which could be abolished by signal transducers and activators of transcription 3 inhibitors S3I-201. Depletion of macrophages reversed prokineticin2-mediated protection against polymicrobial sepsis.

CONCLUSIONS:
This study elucidated a previously unrecognized role of prokineticin2 in clinical diagnosis and treatment of sepsis. The proof-of-concept study determined a central role of prokineticin2 in alleviating sepsis-induced death by regulation of macrophage function, which presents a new strategy for sepsis immunotherapy.
Obesity and metabolic syndrome induce hyperfiltration, glomerulomegaly, and albuminuria in obese ovariectomized female mice and obese male mice
Authors: Rodríguez-Rodríguez Ana Elena , Donate-Correa Javier , Luis-Lima Sergio , Díaz-Martín Laura , Rodríguez-González Covadonga , Pérez-Pérez José Antonio , Acosta-González Nieves Guadalupe , Fumero Cecilia , Navarro-Díaz Maruja , López-Álvarez Dolores , Villacampa-Jiménez Jacobo , Navarro-González José Antonio , Ortiz Alberto , Porrini Esteban 
Published: September 2021

Abstract

Objective:
Obese patients with metabolic syndrome have a high risk of chronic kidney disease. The prevalence of obesity, metabolic syndrome, and insulin resistance increase in women after menopause, as does the risk of chronic kidney disease. This may indicate an interaction between obesity, metabolic syndrome, and menopause in the induction of renal damage. However, the pathogenesis of kidney disease in postmenopausal obese women is poorly understood.

Methods:
We investigated the interaction of an obesogenic diet and menopause on renal dysfunction in ovariectomized and non-ovariectomized lean (n = 8 and 17) and obese (n = 12 and 20) female mice. Obese (n = 12) and lean (n = 10) male mice were also studied. Glucose metabolism, insulin resistance, and kidney function were evaluated with gold standards procedures. Changes in kidney histology and lipid deposition were analyzed. Females had a lower number of glomeruli than males at baseline.

Results:
Only female ovariectomized obese animals developed insulin resistance, hyperglycemia, and kidney damage, evidenced as glomerulomegaly, glomerular hyperfiltration, and increased urinary albumin excretion, despite a similar increase in weight than obese non-ovariectomized female mice. Male obese mice developed hyperglycemia, insulin resistance, and hyperfiltration without major renal histological changes. Males on high fat diet showed higher renal lipid content and females on high fat diet (ovariectomized or non-ovariectomized) showed higher total cholesterol content than males.

Conclusions:
In mice, there is a clear interplay between obesity, metabolic syndrome, and menopause in the induction of kidney damage.

Video Summary:
http://links.lww.com/MENO/A803.
Effect of Descemet Membrane Endothelial Keratoplasty Graft Storage Time on Graft Elasticity
Authors: Shilova Natalya F. , Anisimova Natalia S. , Livny Eitan , Malyugin Boris E. 
Published: September 2021

Purpose:
The purpose of this study was to evaluate the effect of Descemet membrane endothelial keratoplasty (DMEK) graft storage time on its elastic properties, measured using atomic force microscopy (AFM).

Methods:
Twenty human corneas (from 10 donors), unsuitable for transplantation, were obtained from the eye bank (S. Fyodorov Eye Microsurgery State Institution, Moscow). Ten DMEK grafts were prepared and stored in the corneal storage medium, Optisol-GS at 4°C after preparation, and AFM analysis was performed within 12 hours after preparation (group A). Ten paired corneas from the respective donors were stored in Optisol-GS at 4°C for 1 week after preparation before AFM analysis (group B). Data were analyzed using the Hertz model for the evaluation of the Young modulus of elasticity.

Results:
Force–distance curve analysis showed an increase in the Young modulus of elasticity in group B in comparison with that in group A, and the mean values were 10.4 ± 1.8 kPa and 6.77 ± 2.25 kPa, respectively (P < 0.001). There was no correlation between the Young modulus of elasticity and donor age (r = 0.110, P = 0.644), endothelial cell count (r = −0.145, P = 0.541), and procurement interval (r = 0.14, P = 0.755).

Conclusions:
A longer graft storage time in cold storage medium was found to significantly reduce the elasticity of the DMEK graft. Clinically, this could potentially influence the unfolding of the DMEK graft within the anterior chamber during surgery and the postoperative detachment rate.