bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of Optimal Foot Tactile Sensation Threshold for Detecting Fall Risk Among Community-Dwelling Older Adults
Authors: Yang Feng 
Published: April 2021

Abstract

Objective
Foot tactile sensitivity loss, commonly assessed by monofilaments, is a fall risk factor among older adults. The broadly used threshold of the monofilament for fall risk assessment in older adults is 5.07. However, this threshold originates from assessing foot ulceration risk in people with peripheral neuropathy. The primary purpose of this study was to identify the optimal filament size and its cutoff number of sensitive sites that can be used to best identify a high risk of falls in terms of the foot tactile sensitivity for community-dwelling older adults.

Methods
In this cross-sectional study, the foot tactile sensitivity was assessed by a 6-piece Semmes-Weinstein monofilament kit at 9 sites per foot among 94 older adults, including 38 fallers and 56 nonfallers. The number of sensitive sites was determined for each monofilament size as the cutoff. Logistical regression analyses were used to determine the monofilament size and number of sensitive sites best able to differentiate fallers from nonfallers.

Results
Fallers showed overall worse foot tactile sensory measurements than nonfallers. Logistical regression analyses identified 4.31 as the best monofilament size and 7 as the number of sensitive sites to differentiate fallers from nonfallers with an accuracy of 71.3%.

Conclusion
The 4.31 monofilament could be the best filament to detect the risk of falls among older adults in terms of tactile sensory loss. Inability to feel the pressure from the 4.31 filament at more than 7 sites could indicate a high risk of falls.

Impact
These findings could help physical therapists and other rehabilitation professionals improve decision making in detecting older adults with a high risk of falls, thus facilitating the effort of fall prevention in older adults.
Philippine community pantries as a way of helping the marginalized during the COVID-19 pandemic
Authors: Gozum Ivan Efreaim A , Capulong Harvey Gain M , Gopez Jose Ma W , Galang Joseph Renus F 
Published: April 2021

Abstract
In a previous correspondence, the author tried to establish the crucial relationship of the country’s public health with the government officials’ economic decisions and actions. Understanding such, we look at the perspective of the handling of the pandemic, in terms of economic decisions and actions, in the Philippines. In the country, complaints from the citizens surfaced because the government failed in providing an appropriate response to the economic imbalance generated by the pandemic. Thus, in this paper, we surveyed the sudden engenderment of community pantries in the Philippines as a way of filling the gaps of the government.
The Effects of Foreign Multinationals on Workers and Firms in the United States
Authors: Setzler Bradley , Tintelnot Felix 
Published: April 2021

AbstractGovernments go to great lengths to attract foreign multinationals because they are thought to raise the wages paid to their employees (direct effects) and to improve outcomes at local domestic firms (indirect effects). We construct the first U.S. employer-employee data set with foreign ownership information from tax records to measure these direct and indirect effects. We find the average direct effect of a foreign multinational firm on its U.S. workers is a 7% increase in wages. This premium is larger for higher-skilled workers and for the employees of firms from high GDP per capita countries. We find evidence that it is membership in a multinational production network—instead of foreignness—that generates the foreign-firm premium. We leverage the past spatial clustering of foreign-owned firms by country of ownership to identify the indirect effects. An expansion in the foreign-multinational share of commuting-zone employment substantially increases the employment, value added, and—for higher-earning workers—wages at local domestic-owned firms. Per job created by a foreign multinational, our estimates suggest annual gains of US$13,400 to the aggregate wages of local incumbents, two-thirds of which are from indirect effects. Our estimates suggest that—via mega-deals for subsidies from local governments—foreign multinationals are able to extract a sizable fraction of the local surplus they generate.
Accuracy for Mortality Prediction With Additive Biomarkers Including Interleukin-6 in Critically Ill Patients: A Multicenter Prospective Observational Study
Authors: Yamamoto Ryo , Sasaki Junichi , Shibusawa Takayuki , Nakada Taka-aki , Mayumi Toshihiko , Takasu Osamu , Matsuda Kenichi , Shimazui Takashi , Otsubo Hiroki , Teshima Yuto , Nabeta Masakazu , Moriguchi Takeshi , Oda Shigeto 
Published: April 2021

Objectives:
Several inflammation markers have been reported to be associated with unfavorable clinical outcomes in critically ill patients. We aimed to elucidate whether serum interleukin-6 concentration considered with Sequential Organ Failure Assessment score can better predict mortality in critically ill patients.

Design:
A prospective observational study.

Setting:
Five university hospitals in 2016–2018.

Patients:
Critically ill adult patients who met greater than or equal to two systemic inflammatory response syndrome criteria at admission were included, and those who died or were discharged within 48 hours were excluded.

Interventions:
Inflammatory biomarkers including interleukin (interleukin)–6, -8, and -10; tumor necrosis factor–α; C-reactive protein; and procalcitonin were blindly measured daily for 3 days. Area under the receiver operating characteristic curve for Sequential Organ Failure Assessment score at day 2 according to 28-day mortality was calculated as baseline. Combination models of Sequential Organ Failure Assessment score and additional biomarkers were developed using logistic regression, and area under the receiver operating characteristic curve calculated in each model was compared with the baseline.

Measurements and Main Results:
Among 161 patients included in the study, 18 (11.2%) did not survive at day 28. Univariate analysis for each biomarker identified that the interleukin-6 (days 1–3), interleukin-8 (days 0–3), and interleukin-10 (days 1–3) were higher in nonsurvivors than in survivors. Analyses of 28-day mortality prediction by a single biomarker showed interleukin-6, -8, and -10 at days 1–3 had a significant discrimination power, and the interleukin-6 at day 3 had the highest area under the receiver operating characteristic curve (0.766 [0.656–0.876]). The baseline area under the receiver operating characteristic curve for Sequential Organ Failure Assessment score predicting 28-day mortality was 0.776 (0.672–0.880). The combination model using additional interleukin-6 at day 3 had higher area under the receiver operating characteristic curve than baseline (area under the receiver operating characteristic curve = 0.844, area under the receiver operating characteristic curve improvement = 0.068 [0.002–0.133]), whereas other biomarkers did not improve accuracy in predicting 28-day mortality.

Conclusions:
Accuracy for 28-day mortality prediction was improved by adding serum interleukin-6 concentration to Sequential Organ Failure Assessment score.
Vitamin C-Induced Oxalate Nephropathy in a Septic Patient
Authors: Wissanji Tasheen , Dupuis Marie-Eve , Royal Virginie , Pichette Vincent , Wang Han Ting 
Published: April 2021

OBJECTIVES:
Vitamin C is a novel treatment currently under investigation in the management of sepsis. Adverse renal effects of vitamin C through hyperoxaluria have been described in the past.

DATA SOURCES:
We report the case of a 63-year-old man admitted in a community-based hospital with a diagnosis of sepsis of pulmonary origin.

DATA EXTRACTION:
On day 19, despite a having developed oligoanuric acute kidney injury, a regimen of IV vitamin C, hydrocortisone, and thiamine was undertaken for 4 days. On day 23, the patient required renal replacement therapy with an estimated glomerular filtration rate of 7 mL/min. Renal biopsy revealed extensive acute tubular necrosis associated with the presence of intratubular crystal of calcium oxalate.

Conclusion:
Although vitamin C seems to be a possible therapeutic asset in the supportive care of sepsis patients, larger cohorts are required to ensure its safety and underlying or novel kidney injury should forewarn clinicians as to its use.
Existing Crisis Standards of Care Triage Protocols May Not Significantly Differentiate Between Patients With Coronavirus Disease 2019 Who Require Intensive Care
Authors: Rubin Emily B. , Knipe Rachel S. , Israel Rebecca A. , McCoy Thomas H. , Courtwright Andrew M. 
Published: April 2021

Objectives:
To determine how several existing crisis standards of care triage protocols would have distinguished between patients with coronavirus disease 2019 requiring intensive care.

Design:
Retrospective cohort study.

Setting:
Single urban academic medical center.

Patients:
One-hundred twenty patients with coronavirus disease 2019 who required intensive care and mechanical ventilation.

Interventions:
None.

Measurements and Main Results:
The characteristics of each patient at the time of ICU triage were used to determine how patients would have been prioritized using four crisis standards of care protocols. The vast majority of patients in the cohort would have been in the highest priority group using a triage protocol focusing on Sequential Organ Failure Assessment alone. Prioritization based on Sequential Organ Failure Assessment and 1-year life expectancy would have resulted in only slightly more differentiation between patients. Prioritization based on Sequential Organ Failure Assessment and 5-year life expectancy would have added significant additional differentiation depending on how priority groups were defined.

Conclusions:
There is considerable controversy regarding the use of criteria other than prognosis for short-term survival in initial allocation of critical care resources under crisis standards of care triage protocols. To the extent that initial triage protocols would not create sufficient differentiation between patients, effectively resulting in a first-come, first-served initial allocation of resources, it is important to focus on how resources would be reallocated in the event of ongoing scarcity.
CHOROIDAL MELANOMA IN PHAKOMATOSIS PIGMENTOVASCULARIS WITH OVERLAPPING STURGE–WEBER SYNDROME AND KLIPPEL–TRENAUNAY SYNDROME
Authors: Fry Matthew V. , Williams Basil K. , Kim Hyun Jun , Di Nicola Maura 
Published: April 2021

Purpose:
To present the rare occurrence of choroidal melanoma in an adult patient with phakomatosis pigmentovascularis and an overlap of Sturge–Weber syndrome and Klippel–Trenaunay syndrome.

Methods:
Observational case report.

Results:
A 75-year-old White woman with nevus flammeus involving the left forehead, periorbital area, cheek, chin, upper limb, and trunk, along with hemihypertrophy of the left side of the face and left upper limb, presented for evaluation of an intraocular mass in the left eye. Anterior examination of the left eye showed diffuse episcleral and iris melanocytosis. Fundus examination of the left eye showed diffuse choroidal melanocytosis and an elevated choroidal lesion. B-scan ultrasonography demonstrated a hollow lesion, and the patient was diagnosed with choroidal melanoma in the left eye in the setting of phakomatosis pigmentovascularis with overlap of Sturge–Weber syndrome and Klippel–Trenaunay syndrome. Fine-needle aspiration biopsy confirmed the diagnosis, and Iodine 125 plaque radiotherapy was performed.

Conclusion:
Individuals with clinical features suggestive of phakomatosis pigmentovascularis, Sturge–Weber syndrome, or Klippel–Trenaunay syndrome should undergo a complete ophthalmological evaluation for the presence of ocular melanocytosis and uveal melanoma.
The Role of Community Health Workers in HIV Care Engagement: A Qualitative Study of Stakeholder Perspectives in Tanzania
Authors: Knettel Brandon A. , Fernandez Kimberly M. , Wanda Lisa , Amiri Ismail , Cassiello-Robbins Clair , Watt Melissa H. , Mmbaga Blandina T. , Relf Michael V. 
Published: April 2021

Abstract
Suboptimal retention in HIV care is a major driver of the global epidemic, including in sub-Saharan Africa. In Tanzania, the national Community-Based HIV Services program integrates volunteer community health workers (CHWs) to support patient care engagement and reduce the burden placed on HIV clinic nurses; however, few studies have assessed the value of CHWs supporting HIV care. Qualitative interviews were conducted with 48 administrators, nurses, CHWs, and patients to explore strengths and limitations of the Community-Based HIV Services program. Stakeholders believed CHWs are uniquely positioned to establish trust and provide patient support. Patients who had frequent contact with CHWs described them as valued sources of education and encouragement, but fewer than half of the patients interviewed had ever met with a CHW. Clinic nurses described feeling disconnected from CHWs, and stakeholders highlighted the need for financial, logistical, and educational support to rejuvenate the program and effectively address care engagement challenges.
Low back pain with lumbar subcutaneous edema successfully treated using traditional Chinese medicine, including radix astragali
Authors: Nakajima Keiji , Fujita Tadashi , Nakano Ryota 
Published: April 2021

Abstract

Introduction:
Lumbar subcutaneous edema (LSE) is incidentally found in obese patients during the course of evaluating the cause of low back pain using magnetic resonance imaging (MRI). However, there is no established treatment for LSE, and the mechanism underlying its development is unknown.

Patient concerns:
A 77- year- old woman presented with chronic low back pain that had persisted for several years. Her BMI was 25.1 kg/m2, which indicates obesity in Japan.

Diagnosis:
MRI revealed LSE, which extended from the level of the L2 vertebral body to the sacrum.

Interventions:
We prescribed Maxing Yigan (MYG), a traditional Chinese medicine formula, to which we added powdered cinnamon bark and processed aconite root (hereafter referred to as modified MYG).

Outcomes:
This treatment was ineffective for six months. We then added Radix Astragali (RA) to the modified MYG. One month later, her low back pain was found to have markedly improved. MRI also confirmed that the LSE decreased remarkably.

Conclusions:
According to the clinical and MRI findings, modified MYG, including RA, was effective for the treatment of low back pain and LSE. The mechanism underlying the development of LSE could be lymphatic pooling due to perilymphatic inflammation associated with obesity. Modified MYG, including RA, might suppress perilymphatic inflammation and thereby improve lymphatic drainage. Further investigations are required to support this hypothesis.
Pediatric Emergency Department Management of C1 Inhibitor Deficiency
Authors: García Sánchez Paula , Plata Gallardo Marta , Pedrosa Delgado María , Caballero Molina María Teresa , de Ceano-Vivas la Calle María 
Published: April 2021

Introduction
C1 inhibitor deficiency is a rare, potentially life-threatening syndrome. Acute attacks of angioedema may occur at any time, so the emergency department (ED) constitutes an indispensable component of its care.

Aim
To describe the reasons for consultation by children with C1 inhibitor deficiency at the ED, as well as its management and complications.

Patients and Methods
This is a longitudinal retrospective study conducted in a pediatric ED of a tertiary care hospital in Madrid. The study includes children with C1 inhibitor deficiency, aged 0 to 16 years, who had consulted the ED for whatever reason, over a span of 9 years (2011–2020). Analyzed data include the following: age, sex, type of disease, reason for query, complementary examinations, established diagnosis, treatment, number of visits to the ED, length of ED stay, and admissions.

Results
Sixteen patients, amounting a total of 83 ED visits, were analyzed. Fifty-six percent were boys, and the median age was 6.9 years (5 months to 15.9 years). The median and mean of number of visits to the ED per patient was 2 (1–22) and 5.2 ± 6.11, respectively. There were 85.5% of the ED visits initially attributed to acute angioedema attacks. Additional tests were conducted in 30.1%, and 31.3% required C1 inhibitor concentrate. Three episodes required hospital admission (3.6%), and there were no complications. The stay in the ED was longer for patients who needed specific intravenous treatment.

Conclusions
C1 inhibitor deficiency is a rare disease that may require ED care. The main reasons for ED visits were respiratory problems, and the main location of the acute attacks of angioedema were abdominal and cutaneous. Almost one third of the ED visits needed specific treatment, resulting in longer stays. A proper management in the ED and the specific treatment with C1 inhibitor concentrate were effective in 96.2% of the acute attacks of angioedema. Knowledge of this disease in the ED is key to prevent complications.
Caregiver Perceptions of Mental Health and Barriers to and Facilitators of Their Child's Treatment
Authors: Hellerova Lenka , Gonzalez Ariana E. , Dayan Peter S. , George Maureen 
Published: April 2021

Objectives
Nearly 1 million children visit emergency departments (EDs) annually for mental health crises. Caregivers play a critical role in the outcome of mental illness in their children, yet there is limited research on effective means to engage caregivers in the ED and provide the support they need. Our aim was to determine caregivers' perceptions about mental illness in their children, specifically regarding suicidality and depression, the impact of the children's mental health on the caregiver, and barriers to and facilitators of treatment.

Methods
Guided by qualitative descriptive methodology, we conducted semistructured, open-ended interviews with a purposive sample of English-speaking primary caregivers of children 6 to 17 years old who presented with suicidal ideations or behaviors to 1 urban pediatric ED. Interviews were recorded and transcribed verbatim, and conventional content analysis was performed.

Results
The participants (n = 20) were largely single ethnic-racial minority mothers. Content analysis identified 6 categories: caregivers' definitions of mental health, depression, and suicidality; perceived causes of mental illness; difficulty in identification of mental illness; the influence of the mental illness on caregivers; a complex network of communication among involved parties that resulted in the child's ED visit, as well as barriers to and facilitators of treatment.

Conclusions
We identified several categories that encapsulate caregivers' perceptions of mental health and mental illness in their children and its effect on them. Future research should explore how inner-city EDs might partner with schools and trusted community-based organizations to enhance caregiver knowledge, reduce obstacles to care, increase screening for at-risk youth and implement strategies to optimize outcomes for children with depression and suicidal ideations.
Sorting pain out of salience: assessment of pain facial expressions in the human fetus
Authors: Bernardes Lisandra S. , Carvalho Mariana A. , Harnik Simone B. , Teixeira Manoel J. , Ottolia Juliana , Castro Daniella , Velloso Adriano , Francisco Rossana ,   Grupo de Estudo da Dor Fetal (Fetal Pain Study Group), Listik Clarice , Galhardoni Ricardo , Aparecida da Silva Valquiria , Moreira Larissa I. , Amorim Filho Antonio G. de , Fernandes Ana M. , Ciampi de Andrade Daniel 
Published: April 2021

Abstract

Introduction:
The question of whether the human fetus experiences pain has received substantial attention in recent times. With the advent of high-definition 4-dimensional ultrasound (4D-US), it is possible to record fetal body and facial expressions.

Objective:
To determine whether human fetuses demonstrate discriminative acute behavioral responses to nociceptive input.

Methods:
This cross-sectional study included 5 fetuses with diaphragmatic hernia with indication of intrauterine surgery (fetoscopic endoluminal tracheal occlusion) and 8 healthy fetuses, who were scanned with 4D-US in 1 of 3 conditions: (1) acute pain group: Fetuses undergoing intrauterine surgery were assessed in the preoperative period during the anesthetic injection into the thigh; (2) control group at rest: Facial expressions at rest were recorded during scheduled ultrasound examinations; and (3) control group acoustic startle: Fetal facial expressions were recorded during acoustic stimulus (500–4000 Hz; 60–115 dB).

Results:
Raters blinded to the fetuses’ groups scored 65 pictures of fetal facial expressions based on the presence of 12 items (facial movements). Analyses of redundancy and usefulness excluded 5 items for being of low discrimination capacity (P>0.2). The final version of the pain assessment tool consisted of a total of 7 items: brow lowering/eyes squeezed shut/deepening of the nasolabial furrow/open lips/horizontal mouth stretch/vertical mouth stretch/neck deflection. Odd ratios for a facial expression to be detected in acute pain compared with control conditions ranged from 11 (neck deflection) to 1,400 (horizontal mouth stretch). Using the seven-item final tool, we showed that 5 is the cutoff value discriminating pain from nonpainful startle and rest.

Conclusions:
This study inaugurates the possibility to study pain responses during the intrauterine life, which may have implications for the postoperative management of pain after intrauterine surgical interventions
Undibacterium crateris sp. nov., isolated from water of crater lake
Authors: Phurbu Dorji , Liu Zi-Xuan , Liu Hong-Can , Pema Yangzom , Yungchen Lhamo , Zhou Yu-Guang , Li Ai-Hua 
Published: April 2021

A Gram-stain-negative, aerobic, flagellated, non-spore-forming, rod-shaped bacterium, named B2R-29T, was isolated from water collected from a crater lake on Da Hinggan mountain, PR China. Strain B2R-29T was oxidase- and catalase-positive. On the basis of the results of 16S rRNA gene sequence analyses, strain B2R-29T clearly belonged to the family

Oxalobacteraceae

, class

Betaproteobacteria

and showed the highest similarity to

Undibacterium oligocarboniphilum

EM1T (97.4 %) and to the other species of

Undibacterium

(less than 96.8 %). In the phylogenetic tree, strain B2R-29T formed a clade with

U. oligocarboniphilum

EM1T and

Undibacterium squillarum

CMJ-9T, indicating that is a member of the genus

Undibacterium

. Digital DNA–DNA hybridization and average nucleotide identity analyses were performed and the values between strain B2R-29T and its closely related

Undibacterium

species were less than 75.1 % and 16.9 %, respectively. The chemotaxonomic data of B2R-29T were as follows: major uniquinone, Q-8; predominant polar lipids, phosphatidylethanolamine, diphosphatidylglycerol and phosphatidylglycerol; major fatty acids, C16 : 0 and summed feature 3 (C16 : 1
ω7c / C16 : 1
ω6c); predominant polyamines, putrescine, 2-hydroxyputrescine and spermidine. The DNA G+C content was 51.7 mol% from the genomic sequencing data. In accordance with the phenotypic, physiological and chemotaxonomic properties mentioned above, strain B2R-29T represents a novel species of the genus

Undibacterium

for which the name Undibacterium crateris sp. nov. is proposed. The type strain is B2R-29T (=CGMCC 1.13792T=KCTC 72018T).