bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weight Status and Risk of Inpatient Admission for Children With Lower Respiratory Tract Disease
Authors: Halvorson Elizabeth E. , Saha Amit , Forrest Christopher B. , Razzaghi Hanieh , Rao Suchitra , Phan Thao-Ly Tam , Magnusen Brianna , Mejias Asuncion , McCrory Michael C. , Wells Brian J. , Skelton Joseph A. , Poehling Katherine A. , Tieder Joel S. 
Published: November 2021

OBJECTIVES
To identify associations between weight category and hospital admission for lower respiratory tract disease (LRTD), defined as asthma, community-acquired pneumonia, viral pneumonia, or bronchiolitis, among children evaluated in pediatric emergency departments (PEDs).

METHODS
We performed a retrospective cohort study of children 2 to &lt;18 years of age evaluated in the PED at 6 children’s hospitals within the PEDSnet clinical research network from 2009 to 2019. BMI percentile of children was classified as underweight, healthy weight, overweight, and class 1, 2, or 3 obesity. Children with complex chronic conditions were excluded. Mixed-effects multivariable logistic regression was used to assess associations between BMI categories and hospitalization or 7- and 30-day PED revisits, adjusted for covariates (age, sex, race and ethnicity, and payer).

RESULTS
Among 107 446 children with 218 180 PED evaluations for LRTD, 4.5% had underweight, 56.4% had healthy normal weight, 16.1% had overweight, 14.6% had class 1 obesity, 5.5% had class 2 obesity, and 3.0% had class 3 obesity. Underweight was associated with increased risk of hospital admission compared with normal weight (odds ratio [OR] 1.76; 95% confidence interval [CI] 1.69–1.84). Overweight (OR 0.87; 95% CI 0.85–0.90), class 1 obesity (OR 0.88; 95% CI 0.85–0.91), and class 2 obesity (OR 0.91; 95% CI 0.87–0.96) had negative associations with hospital admission. Class 1 and class 2, but not class 3, obesity had small positive associations with 7- and 30-day PED revisits.

CONCLUSIONS
We found an inverse relationship between patient weight category and risk for hospital admission in children evaluated in the PED for LRTD.
Physician Perspectives on the Impact of the COVID-19 Pandemic on Family-Centered Rounds
Authors: Craddock Kirsten E.S. , Grilo Stephanie , McCann Teresa A. , Catallozzi Marina , Banker Sumeet L. 
Published: November 2021

BACKGROUND
The coronavirus disease 2019 pandemic has required modifications to family-centered rounds (FCR), although the specific changes and the effects on patients, families, and providers are not well known. In this study, we explore physician perspectives on changes made to FCR during the initial wave of the coronavirus disease 2019 pandemic and recommendations for the future.

METHODS
Semistructured individual interviews were conducted with 20 pediatric attending and resident physicians who cared for hospitalized patients between March and May 2020 on pediatric hospital medicine and subspecialty services that typically perform FCR. Transcripts were reviewed by using principles of framework analysis to iteratively develop a codebook. Review of coded segments, with attention to code co-occurrences, was used to clarify themes in the data relating to the research objective and the conceptual framework.

RESULTS
The rounding format changed for all providers and varied on the basis of clinical service and phase of the pandemic. Themes highlighted specific areas of change: (1) the process of FCR, (2) reaching consensus with families, (3) collaboration with members of the medical team, and (4) resident education, modeling, and supervision. Participants offered recommendations, including standardization of rounds, intentional involvement of nursing staff, and inclusion of families through virtual or small-group bedside rounds.

CONCLUSIONS
The pandemic led to a variety of modifications to FCR, and these changes had varied effects on communication and education. These findings provide insight into the state of FCR during the pandemic and may frame future recommendations for the development of shared guidelines for circumstances requiring limited bedside rounding.
A Qualitative Analysis of Observed Behavior of Pediatric Rapid Response Team Performance
Authors: Levin Amanda B. , Cartron Alexander M. , Siems Ashley , Kelly Katherine Patterson 
Published: November 2021

BACKGROUND AND OBJECTIVES
Pediatric rapid response teams (RRTs) enhance patient safety, reduce cardiorespiratory arrests outside the PICU, and detect deteriorating patients before decompensation. RRT performance may be affected by failures in communication, poor team dynamics, and poor shared decision-making. We aimed to describe factors associated with team performance using direct observation of pediatric RRTs.

METHODS
Our team directly observed 73 in situ RRT activations, collected field notes of qualitative data, and analyzed the data using conventional content analysis. To assess accuracy of coding, 20% of the coded observations were reassessed for interrater reliability. The codes influencing team performance were categorized as enhancers or threats to RRT teamwork and organized under themes. We constructed a framework of the codes and themes, organized along a spectrum of orderly versus chaotic RRTs.

RESULTS
Three themes influencing RRT performance were teamwork, leadership, and patient and family factors, with underlying codes that enhanced or threatened RRT performance. Novel factors that were found to threaten team performance included indecision, disruptive behavior, changing leadership, and family or patient distress. Our framework delineating features of orderly and chaotic RRTs may be used to inform training and design of RRTs to optimize performance.

CONCLUSIONS
Observations of in situ RRT activations in a pediatric hospital both verified previously described characteristics of RRTs and identified new characteristics of team function. Our proposed framework for understanding these enhancers and threats may be used to inform future interventions to improve RRT performance.
COVID-19 Impact on Intern Exposure to Common Inpatient Diagnoses
Authors: Yarahuan Julia Whitlow , Bass Lanessa , Hess Lauren M. , Singhal Geeta , Lo Huay-ying 
Published: November 2021

OBJECTIVE
We sought to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on the clinical exposure of pediatric interns to common pediatric inpatient diagnoses.

METHODS
We analyzed electronic medical record data to compare intern clinical exposure during the COVID-19 pandemic from June 2020 through February 2021 with the same academic blocks from 2017 to 2020. We attributed patients to each pediatric intern on the basis of notes written during their pediatric hospital medicine rotation to compare intern exposures with common inpatient diagnoses before and during the pandemic. We compared the median number of notes written per intern per block overall, as well as for each common inpatient diagnosis.

RESULTS
Median counts of notes written per intern per block were significantly reduced in the COVID-19 group compared with the pre–COVID-19 group (96 [interquartile range (IQR): 81–119)] vs 129 [IQR: 110–160]; P &lt; .001). Median intern notes per block was lower in the COVID-19 group for all months except February 2021. Although the median number of notes for many common inpatient diagnoses was significantly reduced, they were higher for mental health (4 [IQR: 2–9] vs 2 [IQR: 1–6]; P &lt; .001) and suicidality (4.5 [IQR: 2–8] vs 0 [IQR: 0–2]; P &lt; .001). Median shifts worked per intern per block was also reduced in the COVID-19 group (22 [IQR: 21–23] vs 23 [IQR: 22–24]; P &lt; .001).

CONCLUSIONS
Our findings reveal a significant reduction in resident exposure to many common inpatient pediatric diagnoses during the COVID-19 pandemic. Residency programs and pediatric hospitalist educators should consider curricular interventions to ensure adequate clinical exposure for residents affected by the pandemic.
Prototipe Elektrokardiograf Tiga Lead Berbasis Komputer Jinjing
Authors: Putra Aulia Eka , Prawiroredjo Kiki , Candra Henry , Julian Engelin Shintadewi , Tjahjadi Gunawan 
Published: November 2021

Penyakit jantung masih menjadi ancaman di Indonesia, menurut Kementerian Kesehatan, pada tahun 2014 penyakit jantung koroner (PJK) merupakan penyebab kematian tertinggi setelah stroke. Persentase terbesar penyakit kardiovaskuler adalah pada gangguan irama jantung. Instrumentasi medik elektrokardiograf (EKG) digunakan untuk mendeteksi sinyal biopotensial yang dihasilkan jantung sehingga dapat didiagnosis oleh dokter spesialis jantung. Penelitian ini mengusulkan sebuah prototipe sistem rekam jantung EKG yang ekonomis, dengan memanfaatkan suatu program aplikasi menggunakan bahasa pemrograman C Sharp. Sistem menggunakan 3 buah surface electrodes, modul AD8232, dan modul Arduino Uno sebagai komponen pembentuk instrument elektrokardiograf. Surface electrodes berfungsi menangkap sinyal aktivitas listrik pada jantung yang dikondisikan oleh modul AD8232 dan diubah menjadi sinyal digital pada Arduino. Tampilan pada layar komputer memperlihatkan jumlah denyut jantung per menit (BPM) dan grafik gelombang EKG yang dapat dibaca nilai amplitudo dan lebar waktu gelombangnya. Berdasarkan hasil perbandingan pengujian antara prototype EKG terhadap Portable Easy ECG Monitor PC-08B didapati kesalahan rata-rata parameter gelombang jantung yaitu pada denyut jantung per menit 1,19%, pada interval R-R 2.44%, pada interval P-R 2,05 %, pada interval Q-T 1,16 %, pada interval waktu gelombang P 2,58 %, pada interval waktu gelombang QRS 2,07 %, pada interval waktu gelombang T 3,26 %, pada nilai amplitudo QRS 3,40 %, pada nilai amplitudo gelombang P 4 %, dan pada nilai amplitudo gelombang T 4,10 %. Heart disease was a threat in Indonesia, according to the Ministry of Health in 2014 coronary heart disease (CHD) was the highest cause of death after stroke. The largest percentage of cardiovascular disease was in heart rhythm disorders. Electrocardiograph (ECG) was used to detect biopotential signals generated by the heart. This research proposed a low cost electrocardiograph (ECG) prototype by utilizing an application using C Sharp. The system consisted of three surface electrodes, an AD8232 module, and an Arduino Uno module. Surface electrodes detected the electrical activity signal from the heart that was conditioned using AD8232 module and converted to digital signal in Arduino Uno. The bit per minute (BPM) of the heart and the ECG graph are displayed on the laptop screen with graticule to measure the amplitude and the width of the wave. Based on the test results of the ECG prototype compare to the Portable Easy ECG Monitor PC-08B, it is found that the average error of heartbeat per minute is 1.19 %, the R-R time interval is 2.44 %, the P-R time interval is 2.05 %, the Q-T time interval is 1.16 %, the P wave time interval is 2.58 %, the QRS time interval is 2.07 %, T wave time interval is 3.26 %, the QRS amplitude is 3.40 %, the P amplitude is 4 %, and the T amplitude is 4.10 %.
Comparison of confirmed and probable COVID-19 patients in the intensive care unit during the normalization period
Authors: Yeşiler Fatma İrem , Çapras Mesher , Kandemir Emre , Şahintürk Helin , Gedik Ender , Zeyneloğlu Pınar 
Published: November 2021

The decrease in social distance together with the normalization period as of June 1, 2020 in our country caused an increase in the number of COVID 19 patients. Our aim was to compare the demographic features, clinical courses and outcomes of confirmed and probable coronavirus disease 2019 (COVID-19) patients admitted to our intensive care unit (ICU) during the normalization period. Critically ill 128 COVID-19 patients between June 1 - December 2, 2020 were analyzed retrospectively. The mean age was 69.7±15.5y (61.7% male). Sixty-one patients (47.7%) were confirmed. Dyspnea (75.0%) was the most common symptom and hypertension (71.1%) was the most common comorbidity. The mean Acute Physiology and Chronic Health Evaluation System (APACHE II) score; Glasgow Coma Score (GCS); Sequential Organ Failure Assessment (SOFA) scores on ICU admission were 17.4 ± 8.2, 12.3 ± 3.9 and 5.9 ± 3.4, respectively. 101 patients (78.1%) received low flow oxygen, 48 had high flow oxygen therapy (37.5%) and 59 (46.1%) had invasive mechanical ventilation. 53 patients (41.4%) had vasopressor therapy and 30 (23.4%) patients had renal replacement therapy (RRT) due to acute kidney injury (AKI). Confirmed patients were more tachypneic (p=0.005) and more hypoxemic than probable patients (p<0.001). Acute respiratory distress syndrome (ARDS) and AKI were more common in confirmed patients than probable (both p<0.001). Confirmed patients had higher values of hemoglobin, C- reactive protein, fibrinogen, D-dimer than probables (respectively, p=0.028, 0.006, 0.000, 0.019). The overall mortality was higher in confirmed patients (p=0.209, 52.6% vs 47.4%). Complications are more common among confirmed COVID-19 patients admitted to ICU. The mortality rate of confirmed COVID-19 patients admitted to the ICU was found to be higher than probable patients. Mortality of confirmed cases were higher than prediction of APACHE-II scoring system.
Physalis macrosperma (Solanaceae: Physalinae), a new psammophyte endemic to the west Gulf Coastal Plain of the southeastern U.S.A., a global biodiversity hotspot
Authors: Pyne Milo , Orzell Steve L. , Bridges Edwin L. , Poindexter Derick 
Published: November 2021

A new species of Physalinae (Solanaceae) is described and illustrated that is endemic to the West Gulf Coastal Plain of the southeastern United States, a global biodiversity hotspot. Physalis macrosperma sp. nov. is distinguished by its large obpyramidal fruiting calyx (35–70 mm in length), its large seeds [3.2–4.2(4.8) mm in length and 2.5–3.5(3.9) mm in width], and its coarsely pitted seed testa. The ecological and geographical setting of P. macrosperma and its morphological relationships with similar taxa are presented. Physalis macrosperma is an herbaceous perennial psammophyte inhabiting open sand barrens within pyrogenic savanna-woodlands of xeric sandhills. It occurs on droughty undulating Eocene-age quartzipsamments within south-central and east-central Texas and on younger xeric sands embedded within the fire-maintained pinelands of southwestern Arkansas, western Louisiana, and southeastern Texas.
Ipomoea edwardsensis (Convolvulaceae) at specific rank
Authors: O'Kennon Robert J. 
Published: November 2021

Ipomoea costellata var. edwardsensis is distinct in morphology, phenology, and geography from typical I. costellata and is treated here at specific rank, as Ipomoea edwardsensis (O’Kennon & Nesom) O’Kennon, comb. et stat. nov.
New records of Phaseolus microcarpus (Leguminosae: Phaseoleae) for Costa Rica
Authors: Debouck D.G. , Chaves-Barrantes Néstor , Araya-Villalobos R. 
Published: November 2021

Evidence is presented about the presence of Phaseolus microcarpus in Costa Rica, while it was previously reported northwards in other Central American countries and Mexico. Fourteen populations are currently known, four from the Peninsula of Nicoya, and ten are in the tropical dry forest of the mainland of this country.
Exploraciones botánicas a poblaciones de Consolea (Cactaceae) en Cuba: estado de conservación y principales amenazas
Authors: Barrios Duniel , Díaz Edgardo , Majure Lucas C. 
Published: November 2021

Four species of Consolea have been reported from the Cuban archipelago, each of which has been considered under threat of extinction. During the last three years various expeditions were carried out to try to update existing information about the conservation status of populations of the different species and their primary threats. Likewise, we revised and identified herbarium specimens from HAC, HAJB, HMC, MNHN, and NY to put together distribution maps for each species on Cuba. All native species of Consolea on Cuba are under threat of extinction/ extirpation. Consolea moniliformis is the species with the largest populations on Cuba, while C. macracantha displays the widest range of any other species on the island. Two new localities of C. macracantha were found during this study, but likewise, showed the only signs to date of attack by the invasive moth, Cactoblastic cactorum. Among the principle threats detected for species of Consolea on Cuba are exotic, invasive plant species, livestock grazing and development. We provide a key to the species on Cuba.
La familia Schlegeliaceae en el occidente de México
Authors: Cuevas Guzmán Ramón , Sánchez Rodríguez Enrique V. , Del Castillo Batista Ana P. , Gpe. Morales Arias José , Núñez López Nora M. , Moreno Gómez Saúl 
Published: November 2021

Known distribution of Schlegeliaceae family is extended by the presence of Gibsoniothamnus cornutus in western Mexico. The description of the species is lengthened, including the pollen grain description, which is scarcely described in the family. Information on the ecology of the species is provided, and several of its characters are illustrated with photographs and microphotographs. A distribution map of Gibsoniothamnus cornutus in México is presented.
Claytonia perfoliata (Montiaceae) newly reported in Arkansas, U.S.A.
Authors: Schneider Adam C. 
Published: November 2021

This is the first record of the western American species Claytonia perfoliata Don ex Willd. (Montiaceae) in Arkansas, and the first record of this species in a natural, undeveloped area east of the Great Plains. A key to species of Claytonia in Arkansas is included.
The role of scoring systems in evaluation of the geriatric patients in emergency department
Authors: BAŞPINAR İsa , GÜLER Sertaç , DEMİRCİ Burak , YURDAKUL Mehmet , COŞKUN Abuzer , KATIRCI Yavuz 
Published: November 2021

Purpose: The aim of this study was to compare the reliability of scoring methods in determining critical geriatric patients in the emergency department.
Materials and Methods: This prospective study included patients aged over 65 who presented to the emergency department between 15 October 2014 and 15 November 2014. APACHE II (Acute Physiology and Chronic Health Evaluation II), REMS (Rapid Emergency Medicine Score), HOTEL (Hypotension, Oxygen saturation, low Temperature, ECG changes, and Loss of independence), VIEWS (Vital PAC Early Warning Score) and VIEWS-L (Vital PAC Early Warning Score with Lactate Level) were evaluated.
Results: Of the 244 patients included in the study, the mean age of survivors was 75.69 ± 6.96 years, and the mean age of the mortal cases was 80.47 ± 6.63 years, 139 (57%) women. It was found that 30 (12.3%) of the patients included in the study died. The risk scores of the patients hospitalized in the intensive care unit were higher than those who were discharged or hospitalized. All risk scores in the mortality group were found to be significantly higher than the other patient groups.
Conclusion: The study showed that risk scoring systems can be used safely in the evaluation of geriatric patients in the emergency department, to predict mortality and to select critically ill patients.
Comparison of the effects of hyperbaric and normobaric oxygen treatments on the repolarisation parameters of electrocardiography in children with carbon monoxide poisoning
Authors: BAĞCI Zafer , ARSLAN Abdullah , ARSLAN Derya , KOLSUZ Ayşenur 
Published: November 2021

Purpose: The aim of this study was to compare the effects of hyperbaric oxygen therapy (HBOT) induced hyper-oxygenation and normobaric oxygen therapy (NBOT) on myocardial repolarisation parameters in children with carbon monoxide (CO) poisoning.
Materials and Methods: This prospective study included 77 girls and boys aged 0–18 years who were diagnosed and treated for CO poisoning. There were no changes in the routine clinical evaluation and treatment practices of patients. Patients who received NBOT (n=40) and HBOT (n=37) were divided into two groups. These groups were compared in terms of their demographic characteristics, carboxyhaemoglobin, lactate, troponin levels and myocardial repolarisation parameters of electrocardiography (ECG) (Tp-e interval, Tp-e dispersion, QTc and Tp-e/QTc ratio).
Results: There were no significant intergroup differences in terms of carboxyhaemoglobin, lactate and troponin levels at the time of admission; admission and post-treatment Tp-e, Tp-e dispersion, corrected QTc and TPe/QTc ratio and post-treatment change rates of each ECG parameter.
Conclusion: There was no intergroup difference in terms of repolarisation parameters of ECG in children with CO poisoning. The possible reason for this may be myocardial reperfusion damage due to hyper-oxygenation associated with HBOT therapy.
Effects of earthquake on senior citizens of Shankharapur municipality, Kathmandu district of Nepal
Authors: Koirala Nigam , Sunuwar Sushmita Mukhiya 
Published: November 2021

<p class="abstract"><strong>Background:</strong> Senior citizens can face difficult situation in the immediate consequences of unpleasant disaster because of their physical vulnerabilities. Mortality rate of elderly is comparatively higher than younger individuals and are at risk of social isolation following natural disasters, as their reactions are not fast and they might be unable or unwilling to evacuate from their homes. To assess the effects of earthquake on senior citizens of Shankharapur municipality, Kathmandu district of Nepal.</p><p class="abstract"><strong>Methods:</strong> A descriptive cross sectional study was conducted. A semi structured questionnaire was used to collect the data from 115 senior citizens, Data were analyzed in SPSS version 20 and the descriptive statistics were reported. </p><p class="abstract"><strong>Results:</strong> The study found that majority (94%) of the senior citizens stayed outside in temporary shelter after earthquake for more than a month (35%) with less than 5 minutes distance (70%) from an original house after earthquake. 35% of the respondents faced problem due to leakage of rain water and suffered cold while staying in temporary shelter after earthquake. Among the total respondents majority (92%) of the respondent’s house was cracked or collapsed after earthquake where only 30% of the respondents went for reconstruction or maintenance and majority 91% spend their own money from pocket for maintenance.</p><p class="abstract"><strong>Conclusions:</strong> This study found that shifting to temporary shelter after earthquake and loss of economy due to cracked or collapse of house after earthquake as a major effect on senior citizens of Shankharapur municipality, Kathmandu district after earthquake.</p>
Spontaneous Regression of Multiple Pulmonary Metastasis of Sacral Chordoma
Authors: Takagi Kaito , Nagano Akihito , Tsugita Masanori , Nishimoto Yutaka , Miyazaki Tatsuhiko , Akiyama Haruhiko 
Published: November 2021

Case:
A 53-year-old man was referred to our institution for the treatment of sacral chordoma and underwent a wide resection. Multiple lung metastases were observed in both the lungs, a year after the surgery, and the diagnosis was confirmed by biopsy. The patient refused treatment, and the lesions continued to increase in size gradually. However, 3 years and 6 months after the surgery, computed tomography of both the lungs showed spontaneous regression of the lesions without any obvious causes. The metastatic lung lesions had disappeared at the final follow-up, 7 years and 5 months after the multiple pulmonary metastases were diagnosed.

Conclusion:
We report the first case of spontaneous regression of pathologically proven pulmonary metastases of a sacral chordoma.