bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic posterior ventricular cordectomy with contact diode laser: how I do it
Authors: Meneghesso Stefano , Saetti Roberto , Silvestrini Marina 
Published: September 2023

Abstract
Background
The treatment of bilateral vocal fold paralysis is mainly surgical and several procedures can be used to guarantee adequate breathing. Furthermore, other causes of the narrowing of the natural airways could coexist and the treatment should consider all of them.

Methods
A supraglottic extension of posterior cordectomy to the false homolateral chord is described, which provides a further widening of the airway while maintaining acceptable voice quality.

Conclusion
Endoscopic posterior ventricular cordectomy performed by contact diode laser may be a viable and safe option, especially in those patients who present bilateral vocal fold paralysis associated with various degrees of laryngospasm.
Prediction of instantaneous perceived effort during outdoor running using accelerometry and machine learning
Authors: Pirscoveanu Cristina-Ioana , Oliveira Anderson Souza 
Published: September 2023

AbstractThe rate of perceived effort (RPE) is a subjective scale widely used for defining training loads. However, the subjective nature of the metric might lead to an inaccurate representation of the imposed metabolic/mechanical exercise demands. Therefore, this study aimed to predict the rate of perceived exertions during running using biomechanical parameters extracted from a commercially available running smartwatch. Forty-three recreational runners performed a simulated 5-km race on a track, providing their RPE from a Borg scale (6–20) every 400 m. Running distance, heart rate, foot contact time, cadence, stride length, and vertical oscillation were extracted from a running smartwatch (Garmin 735XT). Machine learning regression models were trained to predict the RPE at every 5 s of the 5-km race using subject-independent (leave-one-out), as well as a subject-dependent regression method. The subject-dependent method was tested using 5%, 10%, or 20% of the runner’s data in the training set while using the remaining data for testing. The average root-mean-square error (RMSE) in predicting the RPE using the subject-independent method was 1.8 ± 0.8 RPE points (range 0.6–4.1; relative RMSE ~ 12 ± 6%) across the entire 5-km race. However, the error from subject-dependent models was reduced to 1.00 ± 0.31, 0.66 ± 0.20 and 0.45 ± 0.13 RPE points when using 5%, 10%, and 20% of data for training, respectively (average relative RMSE < 7%). All types of predictions underestimated the maximal RPE in ~ 1 RPE point. These results suggest that the data accessible from commercial smartwatches can be used to predict perceived exertion, opening new venues to improve training workload monitoring.
Fluviispira vulneris sp. nov., isolated from human wound secretions
Authors: Tang Peijuan , Peng Na , Ouyang Pengwen , Long Sheng , Wei Zhenhua , Chen Xingchun , Qu Pinghua , Xie Liangyi 
Published: September 2023

AbstractHuman infections by environmental bacteria is becoming an increasing problem and has become a matter of great concern due to the adverse effects worldwide. In this study, we reported a new environmental pathogen. Isolate GX5518T was a novel Gram-negative, aerobic, non-motile, pleomorphic and red-pigmented bacterium, was isolated from human wound secretions (GuangXi, People’s Republic of China). Growth occurred at pH 6.0–8.0 (optimum, pH 7.0) and 10–37 °C (optimum, 28–32 °C) with 0–1.5% (w/v) NaCl in R2A agar. Comparative analysis of the 16S rRNA gene sequences revealed that isolate GX5518T was closely related to Fluviispira sanaruensis JCM 31447T (99.73%) and Fluviispira multicolorata 33A1-SZDPT (98.49%). However, the estimated ANI values of the isolate GX5518T compared to the F. sanaruensis JCM 31447T and F. multicolorata 33A1-SZDPT were 88.67% and 77.35%, respectively. The estimated dDDH, ANI and AAI values between isolate GX5518T and its closely related strains were below the threshold values generally considered for recognizing a new species. The genome size was 3.6 Mbp and the DNA G + C content was 33.1%. The predominant fatty acids (> 5%) in GX5518T cells were iso-C15:0, C16:0, C17:0, C17:1ω8c and C16:1ω7c/C16:1ω6c. The major menaquinone was MK-8 (86.9%). The polar lipids were phosphatidylethanolamine (PE), phosphatidylglycerol (PG) and three unknown lipids (L1-3). The chemical composition was different from that of the F. sanaruensis JCM 31447T. Comparative genomics analysis between isolate GX5518T and its related strains revealed that there were a number of genes involved in resistance to antibiotics and toxic compounds in isolate GX5518T, which were responsible for the copper homeostasis, cobalt-zinc-cadmium resistance, resistance to fluoroquinolones, and zinc resistance. Based on the phenotypic, chemotaxonomic, and genomic analyses, isolate GX5518T (= CGMCC 1.18685T = KCTC 82149T) represents a novel species of the genus Fluviispira, for which the name Fluviispira vulneris sp. nov. is proposed.
The influence of phosphorus availability on rice root traits driving iron plaque formation and dissolution, and implications for phosphorus uptake
Authors: Martinengo Sara , Santoro Veronica , Schiavon Michela , Celi Luisella , Martin Maria , Said-Pullicino Daniel 
Published: September 2023

Abstract
Background and aims
Iron (Fe) plaque which normally coats rice roots has a strong affinity for phosphorus (P), with a debated effect on plant P uptake. Furthermore, plant responses to P availability shape the rhizospheric environment, possibly affecting the rates of Fe plaque formation and dissolution. The role of Fe plaque to serve as a sink or source of available P may depend on root traits, themselves influenced by P availability. However, the underlying mechanism regulating these interactions remains unclear. In this study, we investigated the effects of P availability on root traits, Fe plaque dynamics and their implications for P uptake and rice plant growth.

Methods
Plants were hydroponically grown for 60 days under P-sufficiency or P-deficiency, with or without Fe plaque. Root traits, rhizosphere acidification, and the rates of Fe plaque formation and dissolution were investigated and linked to differences in rice P content and growth.

Results
P-deficient conditions stimulated root development and promoted Fe plaque formation on the root surface compared to P-sufficient conditions. However, P limited plants exhibited a faster Fe plaque dissolution, along with increased net proton exudation. After 60 d, P-deficient plants showed higher P uptake in the presence of Fe plaque, whereas the opposite was observed in P-sufficient plants, where Fe plaque limited plant P uptake.

Conclusions
The role of Fe plaque in regulating P uptake highly depends on the dynamic nature of this Fe pool that is strictly linked to P availability and regulated by plant responses to P deficiency.
The influence of philosophical training on the evaluation of philosophical cases: a controlled longitudinal study
Authors: Maćkiewicz Bartosz , Kuś Katarzyna , Hensel Witold M. 
Published: September 2023

AbstractAccording to the expertise defense, practitioners of the method of cases need not worry about findings that ordinary people’s philosophical intuitions depend on epistemically irrelevant factors. This is because, honed by years of training, the intuitions of professional philosophers likely surpass those of the folk. To investigate this, we conducted a controlled longitudinal study of a broad range of intuitions in undergraduate students of philosophy (n = 226), whose case judgments we sampled after each semester throughout their studies. Under the assumption, made by proponents of the expertise defense, that formal training in philosophy gives rise to the kind of expertise that accounts for changes in the students’ responses to philosophically puzzling cases, our data suggest that the acquired cognitive skills only affect single case judgments at a time. There does not seem to exist either a general expertise that informs case judgments in all areas of philosophy, or an expertise specific to particular subfields. In fact, we argue that available evidence, including the results of cross-sectional research, is best explained in terms of differences in adopted beliefs about specific cases, rather than acquired cognitive skills. We also investigated whether individuals who choose to study philosophy have atypical intuitions compared to the general population and whether students whose intuitions are at odds with textbook consensus are more likely than others to drop out of the philosophy program.
Monetary incentives and eye movements: an eye-tracking investigation in a risky choice experiment with real and hypothetical incentives
Authors: Uto Nobuyuki 
Published: September 2023

Abstract
Although eye-tracking is useful for investigating economic decision-making processes, it remains unclear whether monetary incentives affect eye movements. The current study used a binary risky choice experiment with two incentive conditions: real incentive and hypothetical incentive. Eye movements, choices, and decision times were recorded and compared. For eye movements, participants’ total fixation durations, and visual transitions between probabilities and outcomes were analyzed. The choice distributions were almost identical between the two conditions. The decision times and total fixation durations were longer for the real incentive conditions. Visual transitions that are consistent with expected-utility-like models were less frequent in the real incentive conditions when the calculation of expected values of lotteries was easy. These findings indicate that decision-making processes, such as information processing patterns and the amount of cognitive effort, are affected by monetary incentives. To ensure that eye-tracking is used to examine economic decision-making processes appropriately, providing monetary incentives is important.
Utilizing vancomycin as secondary prophylaxis for the prevention of recurrent Clostridioides difficile infection
Authors: Kristen Zeitler , Nguyen Andrew , Mateja Candice , Jariwala Ripal , Bertran-Rodriguez Carlos , Mayer Cynthia , Nguyen Diep , Sampson Mindy 
Published: September 2023

Background: Recurrent Clostridioides difficile infection (CDI) is associated with significant morbidity, mortality, and healthcare-related costs. Although data are minimal, agents including oral vancomycin have been used as secondary prophylaxis to prevent recurrent CDI. Methods: We conducted a randomized, double-blind, placebo-controlled trial to determine the effectiveness of vancomycin at preventing CDI from October 2019 to September 2022. Eligible patients had a history of at least 1 episode of CDI and were receiving systemic antibiotics for another condition. Participants were randomized 1:1 to oral vancomycin 125 mg by mouth twice daily and were interviewed at 1, 2, and 3 months thereafter to assess recurrence. We enrolled 26 patients: 15 completed the 1-month interview, 12 completed the 2-month interview, and 11 completed the full study. Those 15 participants who did not complete the 3-month interview were considered dropouts. The final sample for this study included those 11 participants who completed all interviews. Demographics and outcomes are shown in Table 1. Results: One case of recurrent CDI was reported at the 1-month interview and a second was reported at 3 months; both cases had received the placebo. The study was terminated early due to low enrollment. Conclusions: Although our results did not reach statistical significance and this study was limited in small sample size, our findings suggest that secondary prophylaxis with oral vancomycin may be beneficial in patients who are actively receiving antibiotics, which is consistent with prior retrospective studies. Future studies with larger sample sizes are still needed to examine this important question of whether secondary prophylaxis is useful for preventing recurrent CDI.Disclosure: None
Relative risk of primary bloodstream infection in patients with mechanical circulatory support devices
Authors: Wolansky Rachel , Burke Patrick , Miller Ryan , Fraser Thomas 
Published: September 2023

Background: Patients requiring mechanical circulatory support (MCS) during episodes of cardiogenic shock are at risk for hospital-acquired bloodstream infection (HABSI). Clinically MCS devices include extracorporeal membrane oxygenation (ECMO) devices, durable and temporary left ventricular-assist devices (VADs), and intra-aortic balloon pumps (IABPs). However, the MCS exclusion to the NHSN central-line–associated bloodstream infection (CLABSI) surveillance rules in 2018 did not include IABP as a qualifying device. We have described utilization and incidence of primary HABSI (pHABSI) in our patients requiring MCS. Methods: The setting for this study was 9 cardiothoracic and heart failure intensive care units with 131 total beds at the Cleveland Clinic Main Campus. Surveillance for HABSI to include determination of CLABSI was performed prospectively. MCS-associated pHABSI were patients who had ECMO, LVAD, or IABP present for >2 calendar days with device in place on the date of infection or removed the day before. A patient with 2 device types at time of infection was counted as a pHABSI for both groups. Patient, device, and MCS days were extracted from an electronic database. Non-MCS patient days were calculated as the difference between total patient days and total MCS days. The incidence of ECMO-, VAD-, and IABP-associated pHABSI were compared to each other and to non–MCS-associated pHABSI using OpenEpi version 3.01 software. Results: Surveillance results are shown in Table 1. During the observation period, there were 221 pHABSIs and 139,013 patient days. Moreover, 67 pHABSIs were associated with an MCS device over 17,044 total MCS days: 43 ECMO days, 18 VAD days, and 13 IABP days. Also, 9 patients had >1 type of eligible device and 7 (39%) of the IABP-associated pHABSIs were CLABSIs.The cumulative incidences of pHABSI associated with ECMO, VAD, and IABP were 5.68, 4.59, and 2.34 per 1,000 MCS days, respectively. The incidence of IABP pHABSI was not significantly different from VAD pHABSI (P = .06), but it was different from ECMO pHABSI (P < .01). The pHABSI rate for non-MCS days was 1.26 per 1,000 patient days. Conclusions: In our patients requiring MCS, the risk of pHABSI associated with IABP was significantly greater than in patients without MCS and was similar to patients with VAD. MCS of all types should be considered a risk for HABSI in patients with cardiogenic shock beyond the presence of a central line. Protocols to further prevent HABSI morbidity in IABP patients are needed.Disclosure: None
Modifying water use practices to eliminate Pseudomonas aeruginosa bloodstream infections in the neonatal intensive care unit
Authors: Camelo Ingrid , Neshangi Srilatha , Thompson Amy 
Published: September 2023

Objective: To describe the strategies implemented at a tertiary-care healthcare center neopnatal intensive care unit (NICU) to control and assure prevention of subsequent central-line bloodstream infections (CLABSIs) with Pseudomonas aeruginosa after 4 cases of CLABSI with this organism were detected. Methods: During the months of September 2020 to February 2021, 4 cases of CLABSI with Pseudomonas aeruginosa were reported in our NICU in patients meeting criteria for extremely low birthweight (ELBW) infants. All patients were treated according to IDSA guidelines for management of bloodstream infections. To avoid the appearance of new events and to improve existing policies, we implemented a stepwise approach by reviewing routine disinfection and/or cleaning procedures of isolettes: (1) liners for bath basins were applied, (2) sterile water was provided for bathing newborns, (3) we ensured timely biomed preventive maintenance of water reservoirs for patient care equipment (nebulizers, isolettes and fluid warmers), and (4) we implemented the installment of point-of-care filters for tap water. Results: Measures were implemented from February 2021 to July 2021. During the following year from July 2021 to June 2022, no CLBSIs related to Pseudomonas aeruginosa were reported in our NICU in patients meeting criteria for ELBW infants. Conclusions: Recognition of CLABSI from organisms from water resources is important to implementing focused prevention strategies targeting water resources and water utilization practices. In our institution, these interventions yielded complete resolution, with no new infection events.Disclosure: None
Screening infection prevention policies for equity impacts
Authors: McGrath Caitlin , Fatemi Yasaman , Mirisola Therese , Ferreira Tanya , D’Alo Adrienne , Konold Victoria , Tieder Alicia , Durkin Ashley , Kronman Matthew , Zerr Danielle 
Published: September 2023

Background: Infection prevention teams utilize policies to guide practice; however, some policies may inadvertently uphold institutional racism and discrimination. Our institution utilizes an equity impact assessment tool during new policy creation or existing policy updates to identify, reduce, eliminate, and prevent inequities in care. Methods: We reviewed all 119 current institution-wide policy documents related to or managed by the infection prevention division at Seattle Children’s Hospital using an institutional equity impact assessment tool. The tool asks 6 open-ended questions to help policy owners identify potential inequities and to evaluate how marginalized groups may be affected. Each policy was assessed for its potential to create or sustain inequities for patients, families, or staff. Policies determined to have potential inequities were examined for any language to suggest that equity considerations had been incorporated into the existing policy. Initial policy review was performed by 2 infection prevention physicians, and disagreements were resolved by consensus. We defined the presence of equity considerations as any explicit mention of disparate impact of the policy on marginalized groups or mitigation of such effect. Results: Of the 119 policies reviewed, 43 (36%) were identified as having substantial potential to impact marginalized groups and create or sustain inequities. Among them, 42 (98%) of these policies lacked existing equity considerations. The policies with potential equity implications covered the following categories: COVID-19 (including masking, workforce restriction, testing), visitor restrictions, tuberculosis, central-line–associated bloodstream infections (CLABSIs), multidrug-resistant organisms (MDROs), public health reporting, medical behavioral unit policies, off-site affiliate housing policies, special pathogens program (including Ebola, MERS, SARS), surgical-site infections, home care including dialysis, and occupational health-related policies. Examples of policies that did not highlight inequities included those pertaining to construction, water intrusion, and transmission-based precautions. One example of change driven by use of the equity impact assessment tool concerned communication with patients and families about tuberculosis isolation and resulted in creation of a standardized multidisciplinary care conference to better communicate tuberculosis isolation processes (including testing required, visitor restrictions, and anticipated duration of isolation) to families in their language of care. Conclusions: Hospital-wide infection prevention policies have the potential to create or sustain existing inequities. Systematic consideration of equity implications using an equity impact assessment framework could be the first step in mitigating these effects and can result in concrete actions to reduce systemic racism.Disclosure: None
Modeling the impacts of influenza antiviral prophylaxis strategies in nursing homes
Authors: Zipfel Casey , Morris Sinead , Paul Prabasaj , Biggerstaff Matthew , Slayton Rachel 
Published: September 2023

Background: Antiviral chemoprophylaxis for influenza is recommended in nursing homes to prevent transmission and severe disease among residents with higher risk of severe influenza complications. Interim CDC guidance recommends that long-term care facilities initiate antiviral chemoprophylaxis with oral oseltamivir for all non-ill residents living in the same unit following the start of an outbreak in a facility (ie, ≥2 patients ill within 72 hours and of whom at least 1 resident has laboratory-confirmed influenza). Prophylaxis continues for a minimum of 2 weeks and for at least 7 days after the last laboratory-confirmed case. However, facilities may not strictly adhere to this guidance, with 1 study showing up to 68% of facilities were nonadherent to national guidance (Silva et al 2020). Here, we model the potential impacts of different antiviral prophylaxis strategies. Methods: We developed a susceptible–exposed–asymptomatic–infected–recovered (SEAIR) compartmental model of an average-sized nursing home comprising short-stay residents, long-stay residents, and healthcare personnel (HCP). Persons treated with antiviral chemoprophylaxis were less susceptible to infection, had a lower probability of symptoms if infected, a reduced viral load, and a shortened duration of infectiousness. We included influenza vaccination for residents and HCP through reduced probability of symptomatic infection. Coverage rates were estimated from CDC FluVaxView and CMS COVID-19 nursing home data. As a base case, we modeled a scenario with prophylaxis implemented according to guidance. We varied uptake by residents and HCP (from 10% to 90%), case thresholds for prophylaxis initiation (1–5 cases identified), and timing of prophylaxis cessation: either time dependent (ie, 10–14 days of prophylaxis) or case-dependent (ie, continuing prophylaxis for 1–7 days with no cases). Results: In the scenario based on current guidance, prophylaxis reduced resident cases by 16% and resident hospitalizations by 45%, compared to no prophylaxis (Fig. 1A). Scenarios that differed from the guidance altered case burden and timing: Time-dependent prophylaxis cessation increased resident cases and hospitalizations (Fig. 1A). Timing of prophylaxis initiation had slight effects on the timing of the epidemic and minimal effects on resident cases and hospitalizations (Fig. 1B). High resident uptake was important for reducing resident cases and hospitalizations (Fig. 1C), but increasing HCP uptake had minimal effect (Fig. 1D). Conclusions: Our findings support the current prophylaxis guidance. Promptly implementing prophylaxis reduces resident cases and hospitalizations. Continuing prophylaxis until cases are no longer identified reduces cases and hospitalizations.Disclosure: None