bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Characteristics and Intrauterine Vertical Transmissions Potential of COVID-19 Infection in 9 Pregnant Women: A Retrospective Review of Medical Records
Authors: Chen H. , Guo J. , Wang C. , Luo F. , Yu X. , Zhang W. , Li J. , Zhao D. , Xu D. , Gong Q. , Liao J. , Yang H. , Hou W. , Zhang Y. 
Published: February 2021

(Lancet. 2020;395:809–815)
While the clinical characteristics, treatments, and outcomes of the 2019 novel coronavirus (COVID-19) pneumonia have been previously described, the clinical characteristics for pregnant COVID-19 patients are still emerging. Particularly of interest are whether pregnant patients will present differently than the general population, whether pregnant women will be more likely to die from COVID-19 or experience preterm labor while infected, whether vertical transmission is possible, and the risks for fetuses and neonates when mothers have COVID-19.This retrospective study examined clinical data from pregnant women with confirmed COVID-19 infection in Wuhan, China.
CE: A Nurse's Guide to COVID-19
Authors: Perkins Russell , Ingebretson Emily , Holifield Linda , Bergeron Amanda 
Published: February 2021

ABSTRACT:
To assist nurses caring for hospitalized adults with coronavirus disease 2019 (COVID-19), the authors synthesize evidence-based information on the disease, providing background on the epidemiology and history of severe acute respiratory syndrome coronavirus 2, the causative virus. They also discuss the risks for severe effects of the illness, the multiple signs and symptoms hospitalized adults with COVID-19 may manifest, and the precautions hospitals should take to keep health care providers and patients safe during the course of this pandemic.
QSEN in an Amazon World
Authors: Disch Joanne , Barnsteiner Jane 
Published: February 2021

ABSTRACT:
Quality and Safety Education for Nurses (QSEN) was launched in 2005 as a national nursing initiative aimed at preparing nurses with the competencies needed to continuously improve the quality and safety of the health care they provide. The six QSEN competencies—and the knowledge, skills, and attitudes that each entails—have served as a basis for significant curricular revision, more enlightened professional practice, relevant research, and health care system improvements. Since the launch of QSEN, new technologies have emerged, the range of care sites has broadened, new practice roles have emerged, and patients and families have become more active health care consumers. This article highlights these changes, considers Amazon as a powerful contemporary social force, examines the company's core values, and considers their relevancy to the six QSEN competencies. Essential new literacies and cognitive capacities are also identified. Lastly, the authors outline steps nurses can take to incorporate the QSEN competencies, along with the literacies and capacities, into their practice and organizations. Doing so is vital to delivering safe, high-quality care in this rapidly changing health care climate, and will enable nurses to claim their leadership and thrive professionally in an Amazon world.
Missing the Care in Health Care
Authors: Koch Amie M. 
Published: February 2021

ABSTRACT:
This article describes the case of a chronically ill patient whose care was grossly mismanaged as a result of the policies and practices of a dysfunctional health system. This case illustrates the importance of truly listening to patients and communicating effectively with colleagues within the health care system. It also discusses appropriate steps for the practice of patient-centered care, including a reevaluation of late arrival policies at hospitals and clinics.
Scholarly Requirements and Support for Nursing Faculty Development and Career Advancement: A Nationwide Delphi Study
Authors: McPherson Sara , Reese Cynthia , Van Schyndel Jennie , Wendler M. Cecilia 
Published: February 2021

Abstract

AIM
The aim of the study was to better understand the scholarship requirements and support for nursing faculty as they work to advance their scholarship and careers.

BACKGROUND
Nursing faculty are often required to participate in teaching, service, and scholarship. New faculty often struggle with the scholarship component.

METHOD
A nationwide Delphi study was conducted, surveying deans and/or associate deans for research at master's and doctoral degree-granting institutions.

RESULTS
Scholarly requirements provided for faculty to enable development of scholarship were well defined: having a dedicated leader; funding support; a culture of scholarship; publications, presentations, and grant writing expectations; formal programs; mentors; and support.

CONCLUSION
This study provided a beginning understanding of important aspects of faculty support for scholarship and career development. More information is needed to determine if the support structures and activities described reach faculty and enhance career development.
Family Nurse Practitioner Students and Diagnostic Readiness Tests: Performances and Perceptions
Authors: Tankimovich Mariya 
Published: February 2021

Abstract
Nursing schools use diagnostic readiness tests (DRTs) to prepare family nurse practitioner (FNP) graduates to pass certification exams, but overall effectiveness estimates of DRTs are scant in the nursing literature. This pilot investigation used statistical analysis and Likert attitude scales with a convenience sample of FNP students to 1) discover any correlations between score results of two DRTs and 2) elicit test-takers’ perceptions of their effectiveness. Perceptions of effectiveness were sometimes less positive than statistical indicators of test effectiveness. Disconnects between effectiveness and student perceptions need further study to guarantee optimal employment of DRTs in FNP program curricula.
Helping persons with multiple chronic conditions overcome barriers to self-management
Authors: Jin Yuanyuan , Bratzke Lisa , Baumann Linda C. 
Published: February 2021

Abstract:
The prevalence of multiple chronic conditions is growing dramatically, which complicates day-to-day self-management for patients. This article describes the features of multiple chronic conditions, an updated chronic care model, barriers to self-management, and strategies NPs can use to reduce or eliminate barriers to self-management in adults with multiple chronic conditions.
Understanding the most commonly billed diagnoses in primary care
Authors: Rogers Julia , Allen Jodi 
Published: February 2021

Abstract:
Musculoskeletal pain is a common chief complaint in primary care and contributes to disability and a loss of independence. Musculoskeletal pain can be a diagnostic challenge for NPs. A thorough understanding of the pathophysiologic processes involved can help clinicians link the clinical manifestations and treatment for musculoskeletal injury causing pain.
COVID-19 and telehealth
Authors: Fant Catherine , Adelman Deborah S. , Summer Georgianne A. 
Published: February 2021

Abstract:
Providing safe nonemergent care during the coronavirus disease 2019 (COVID-19) pandemic has been challenging for NPs. This article, the first of a three-part series, will overview telehealth and telemedicine and provide a brief history of the two. The benefits, challenges, and temporary changes due to COVID-19 will also be addressed.
Breast cancer and gynecologic risks in lesbian and bisexual women
Authors: Panganiban Jannelyn M. , O'Neil Jean 
Published: February 2021

Abstract:
Lesbian and bisexual women may be at an increased risk for gynecologic infections and breast cancer due to a higher prevalence of factors such as obesity, smoking, and lower pregnancy rates. This article discusses the role of healthcare professionals in preventive screening for breast and gynecologic cancers and promoting healthy living in these patients by avoiding smoking, maintaining an ideal body weight, and limiting alcohol consumption.
Omalizumab as an adjuvant in food allergen immunotherapy
Authors: Dantzer Jennifer A. , Wood Robert A. 
Published: February 2021

Purpose of review
To review the most relevant studies in the rapidly advancing field of omalizumab as an adjunct to food allergen oral immunotherapy (OIT).

Recent findings
Clinical trials have primarily focused on milk, peanut, and multiallergen OIT combined with omalizumab. These studies suggest that omalizumab in addition to OIT can decrease the time required to reach maintenance OIT dosing and adverse events; however, serious adverse events did still occur. There is limited long-term data but available information suggests that individuals are at risk for increased reactivity after stopping omalizumab, and many discontinued treatment. There has been diversity in study designs, dosing, and populations.

Summary
The use of anti-IgE antibody as an adjunct to food allergen OIT has been an expanding area of research with several additional trials underway. Significant progress has been made in the past decades but further studies are needed to optimize protocols, improve safety and efficacy, and identify patients who will have the greatest benefit.
Biologicals for the prevention of anaphylaxis
Authors: Tanno Luciana Kase , Demoly Pascal 
Published: February 2021

Purpose of review
To review the use of biological agents (BA) in the treatment of anaphylaxis in the view of the new knowledge in the field to support the quality of care and prevention.

Recent findings
Some BA, as a single medication or as combined therapy to food or venom immunotherapy, are effectively able to reduce most of the severe anaphylactic reactions.

Summary
Anaphylaxis is a recognized clinical emergency, which requires prompt identification and treatment. Several biologic therapies and new devices are emerging as a potential preventive treatment for anaphylaxis. However, adrenaline (epinephrine) is still the first-line treatment for any type of anaphylaxis. Biological drugs, such as omalizumab, whereas not US Food and Drug Administration (FDA) nor European Medicines Agency (EMA) approved for anaphylaxis, have been used as therapeutic adjuvants in the preventive treatment of anaphylaxis, but cost-effectiveness should be considered individually.
Machine Scoring of Medical Students’ Written Clinical Reasoning: Initial Validity Evidence
Authors: Cianciolo Anna T. , LaVoie Noelle , Parker James 
Published: February 2021

Purpose
Developing medical students’ clinical reasoning requires a structured longitudinal curriculum with frequent targeted assessment and feedback. Performance-based assessments, which have the strongest validity evidence, are currently not feasible for this purpose because they are time-intensive to score. This study explored the potential of using machine learning technologies to score one such assessment—the diagnostic justification essay.

Method
From May to September 2018, machine scoring algorithms were trained to score a sample of 700 diagnostic justification essays written by 414 third-year medical students from the Southern Illinois University School of Medicine classes of 2012–2017. The algorithms applied semantically based natural language processing metrics (e.g., coherence, readability) to assess essay quality on 4 criteria (differential diagnosis, recognition and use of findings, workup, and thought process); the scores for these criteria were summed to create overall scores. Three sources of validity evidence (response process, internal structure, and association with other variables) were examined.

Results
Machine scores correlated more strongly with faculty ratings than faculty ratings did with each other (machine: .28–.53, faculty: .13–.33) and were less case-specific. Machine scores and faculty ratings were similarly correlated with medical knowledge, clinical cognition, and prior diagnostic justification. Machine scores were more strongly associated with clinical communication than were faculty ratings (.43 vs .31).

Conclusions
Machine learning technologies may be useful for assessing medical students’ long-form written clinical reasoning. Semantically based machine scoring may capture the communicative aspects of clinical reasoning better than faculty ratings, offering the potential for automated assessment that generalizes to the workplace. These results underscore the potential of machine scoring to capture an aspect of clinical reasoning performance that is difficult to assess with traditional analytic scoring methods. Additional research should investigate machine scoring generalizability and examine its acceptability to trainees and educators.
Reimagining Well-Being Initiatives in Medical Education: Shifting From Promoting Wellness to Increasing Satisfaction
Authors: Slavin Stuart 
Published: February 2021

The well-being movement in medical education has been underway for over a decade. It seems appropriate to examine and evaluate these efforts to support the mental health needs of learners, faculty, and staff as medicine and medical education evolve in response to the COVID-19 pandemic and beyond.
To date, most interventions intended to promote well-being have focused on individual strategies rather than environmental drivers of distress, and the primary offerings have comprised strategies such as mindfulness, meditation, yoga, nutrition, exercise, and sleep. Responses to this programming from medical learners have primarily ranged from ambivalence to resentment, with many feeling that the programming failed to adequately address their particular needs and the challenges they were experiencing.
In this commentary, the author challenges the assumption that well-being per se should be the ideal target or goal. Learners and faculty may be better served by considering other goals—those that do not focus directly on well-being but that are instead foundational for well-being in that they directly address the challenges that students, residents, and faculty are facing. In other words, goals and associated interventions would focus on the experience of school and work rather than focusing primarily on encouraging healthy practices outside of school and work. The author proposes using the lens of satisfaction through which to view and assess progress toward well-being, increasing satisfaction within 3 interconnected domains: (1) school and/or work, (2) self, and (3) life in general. Attention to these domains may be more likely to produce improvements in well-being that have been sought for years but that remain elusive.
Adequacy of workforce – are there enough critical care doctors in the US-post COVID?
Authors: Hussain Rashid S. , Kataria Tripti C. 
Published: February 2021

Purpose of review
The ICU is a complex ecosystem in which intensive care physicians, advanced practice providers (APPs), pharmacists, and respiratory therapists work in concert to take care of critically ill patients. The SARS COV2 pandemic highlighted weaknesses in the American healthcare system. This article explores the ability of American healthcare to adapt to this challenge.

Recent findings
With the COVID-19 pandemic, intensivists, and ventilators have been identified as the most critical components leading to shortages in ICU capacity. Anesthesiologists play a unique role in being able to provide ‘flex capacity’ with critical care staffing, space, and equipment (post-anesthesia care units, operating rooms, and ventilators). With the advent of APPs, intensive care physician staffing ratios may potentially be increased to cover patients safely in a physician-led team model. Tele-medicine expands this further and can allow hospital coordination for optimizing ICU bed use.

Summary
Although intensivists have been able to take care of the increased ICU caseload during the COVID-19 pandemic through recruiting other specialties, the question of what is the appropriate staffing model for the future is yet to be elucidated. Creating stronger multidisciplinary care teams that have the capacity to flex up critical care capacity may be the most prudent longer-term solution.
Enhanced Recovery After Surgery, Lean, and claims-based quality databases: how does it all make sense?
Authors: Shah Pranav R. , Leichtle Stefan , Spencer Paula 
Published: February 2021

Purpose of review
Healthcare is rapidly evolving toward value-focused objectives, integrating outcomes and cost instead of simply volume. Concepts pertaining to Enhanced Recovery After Surgery (ERAS), Lean, and claims-based risk-adjusted databases can be used to optimize value, but the application of Lean principles and risk-adjusted outcomes is poorly described in perioperative medicine in perioperative medicine.

Recent findings
Lean management and process optimization tools allow the consistent application of a perioperative medical framework of ERAS to improve outcomes. Vizient risk-stratified outcomes are often used by hospitals to measure and compare quality.

Summary
Understanding administrative databases and Lean concepts for change management will allow the perioperative physician to better align medical concepts with health system tools for improving quality and reducing cost.
Gender pay disparity in anesthesiology
Authors: Hu Yaqi , Couser Deanna 
Published: February 2021

Purpose of review
The purpose of this review is to look at the historical and current gender pay gap in healthcare, specifically in the field of anesthesiology, as well as discuss some of the reasons for the difference in compensation and its consequences. Future aims and directions to bridge the gap will also be explored.

Recent findings
Even though women have achieved equality in terms of admission to medical school and residency programs, disparities still exist in terms of compensation for equal or comparable work. However, institutional initiatives to close the pay gap have achieved success.

Summary
In order to improve the gender pay inequality, there needs to be continuous efforts on the institutional level for recognition of the disparity, initiation of programs for mentorship and sponsorship for female faculties, and continuous monitoring of the effect of the programs.
Procedural episode-based cost measures: anesthesia matters
Authors: Tolbert Coombs Alice A. 
Published: February 2021

Purpose of review
Episode-based cost measures (EBCM) is a method of combining all services related to a defined episode of care, identified as either a procedure, acute illness or chronic disease, and providing expected cost for that episode or bundle of care. Procedural EBCM has become a major scheme for payment methodology and patient quality of care evaluation. Anesthesiologists need to know how EBCM can impact their clinical practice.

Recent finding
Centers for Medicare and Medicaid Services (CMS) pays physicians with fee-for-service payment for Clinical Episodes and, in 2020, the EBCM are increasing and currently, represents 4.5% of the total Medicare Part A and B spending [1]. With the recent changes in CMS, it is important, for anesthesia providers to know how cost attribution identifies the cost for all services and complications under anesthetic management.

Summary
EBCM can impact the anesthesiologist's quality performance, efficiencies measures, and payment. To preserve practice viability, anesthesiologists must understand how their compensation is impacted by services ordered. Anesthesiologists will increasingly be expected to improve quality and efficiencies in EBCM.
Risk Factors Associated with 90-day Readmissions Following Odontoid Fractures
Authors: von Glinski Alexander , Frieler Sven , Elia Christopher , Patchana Tye , Takayanagi Ariel , Arvind Varun , Pierre Clifford , Ishak Basem , Chapman Jens R. , Oskouian Rod J. 
Published: February 2021

Study Design.
Nationwide Readmissions Database Study.

Objective.
The aim of this study was to investigate readmission rates and factors related to readmission after surgical and nonsurgical management of odontoid fractures.

Summary of Background Data.
Management of odontoid fractures, which are the most common isolated spine fracture in the elderly, continues to be debated. The choice between surgical or nonsurgical treatment has been reported to impact mortality and might influence readmission rates. Hospital readmissions represent a large financial burden upon our healthcare system. Factors surrounding hospital readmissions would benefit from a better understanding of their associated causes to lower health care costs

Methods.
A retrospective study was performed using the 2016 Healthcare Utilization Project (HCUP) Nationwide Readmission Database (NRD). Demographic information and factors associated with readmission were collected. Readmission rates, complications, length of hospital stay were collected. Patients treated operatively, nonoperatively, and patients who were readmitted or not readmitted were compared. Statistical analysis was performed using open source software SciPy (Python v1.3.0) for all analyses.

Results.
We identified 2921 patients who presented with Type II dens fractures from January 1, 2016 to September 30, 2016, 555 of which underwent surgical intervention. The readmission rate in patients who underwent surgery was 16.4% (91/555) and 29.4% (696/2366) in the nonoperative group. Hospital costs for readmitted and nonreadmitted patients were $353,704 and $174,922, and $197,099 and $80,715 for nonoperatively managed patients, respectively. Medicaid and Medicare patients had the highest readmission rate in both groups. Charlson and Elixhauser comorbidity indices were significantly higher in patients who were readmitted (P < 0.0001).

Conclusion.
We report an overall 90-day readmission rate of 16.4% and 29.4%, in operative and nonoperative management of type II odontoid fractures, respectively. In the face of a rising incidence of this fracture in the elderly population, an understanding of the comorbidities and age-related demographics associated with 90-day readmissions following both surgical and nonsurgical treatment are critical.

Level of Evidence: 3