bluuebunny/crossref_metadata_2025_split huggingface dataset:
Which Factors Promote Shared Understanding Between Physicians and Nurses in Inpatient Oncology Care Settings?
Authors: Crist Kaycee , Lafferty Megan , Umberfield Elizabeth , Manojlovich Milisa 
Published: May 2021

Background
Effective communication between physicians and nurses is crucial to the safety of patients, especially for those with cancer, which is a complex disease requiring multidisciplinary treatment. However, little is known about the factors that contribute to effective communication, which is defined as the development of shared understanding between two or more people.

Objective
This qualitative secondary analysis was conducted to identify factors that contribute to shared understanding between physicians and nurses from video-recorded conversations that occurred between them during inpatient rounds on oncology units.

Methods
We used inductive grounded theory to identify videos depicting moments of shared understanding. We then searched for preceding events to develop a preliminary conceptual model that described the factors contributing to shared understanding.

Results
Four factors emerged as contributors to shared understanding: engagement, clarification, confirmation, and resolution. These factors occurred in sequence with engagement occurring first and resolution occurring last, as the closure of a communication exchange.

Conclusions
Existing interventions to improve communication include some of the factors identified as contributing to shared understanding (eg, closed-loop communications require clarification and confirmation). However, nurses may need to pay attention to all four factors to develop shared understanding that will promote effective communication with physicians and thereby enhance cancer care.

Implications for Practice
Nurses achieve effective communication when they are assertive and avoid indirect communication. A greater awareness of body language and positioning in relation to a physician at the start of a communication exchange may increase the effectiveness of nurse-physician communication.
Applying Artificial Intelligence to Gynecologic Oncology: A Review
Authors: Mysona David Pierce , Kapp Daniel S. , Rohatgi Atharva , Lee Danny , Mann Amandeep K. , Tran Paul , Tran Lynn , She Jin-Xiong , Chan John K. 
Published: May 2021

Importance
Artificial intelligence (AI) will play an increasing role in health care. In gynecologic oncology, it can advance tailored screening, precision surgery, and personalized targeted therapies.

Objective
The aim of this study was to review the role of AI in gynecologic oncology.

Evidence Acquisition
Artificial intelligence publications in gynecologic oncology were identified by searching “gynecologic oncology AND artificial intelligence” in the PubMed database. A review of the literature was performed on the history of AI, its fundamentals, and current applications as related to diagnosis and treatment of cervical, uterine, and ovarian cancers.

Results
A PubMed literature search since the year 2000 showed a significant increase in oncology publications related to AI and oncology. Early studies focused on using AI to interrogate electronic health records in order to improve clinical outcome and facilitate clinical research. In cervical cancer, AI algorithms can enhance image analysis of cytology and visual inspection with acetic acid or colposcopy. In uterine cancers, AI can improve the diagnostic accuracies of radiologic imaging and predictive/prognostic capabilities of clinicopathologic characteristics. Artificial intelligence has also been used to better detect early-stage ovarian cancer and predict surgical outcomes and treatment response.

Conclusions and Relevance
Artificial intelligence has been shown to enhance diagnosis, refine clinical decision making, and advance personalized therapies in gynecologic cancers. The rapid adoption of AI in gynecologic oncology will depend on overcoming the challenges related to data transparency, quality, and interpretation.
Artificial intelligence is rapidly transforming health care. However, many physicians are unaware that this technology is being used in their practices and could benefit from a better understanding of the statistics and computer science behind these algorithms. This review provides a summary of AI, its applicability, and its limitations in gynecologic oncology.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After completing this CME activity, physicians should be better able to describe the basic functions of AI algorithms; explain the potential applications of machine learning in diagnosis, treatment, and prognostication of cervical, endometrial, and ovarian cancers; and identify the ethical concerns and limitations of the use of AI in the management of gynecologic cancer patients.
The Use of Host Cell DNA Methylation Analysis in the Detection and Management of Women With Advanced Cervical Intraepithelial Neoplasia: A Review
Authors: Kremer W. W. , Steenbergen R. D. M. , Heideman D. A. M. , Kenter G. G. , Meijer C. J. L. M. 
Published: May 2021

(Abstracted from BJOG 2021;128:504–514)
Premalignant lesions such as cervical intraepithelial neoplasia (CIN) can develop into cervical cancer through a slow process taking up to 30 years from initial high-risk human papillomavirus (hrHPV) infection. Primary hrHPV DNA testing has superior sensitivity compared with cytology and has a high negative predictive value for high-grade CIN or worse (CIN2+).
Antenatal Dexamethasone for Early Preterm Birth in Low-Resource Countries
Authors:   The WHO ACTION Trial Collaborators
Published: May 2021

(Abstracted from N Engl J Med 2020;383:2514–2525)
The use of antenatal glucocorticoids to reduce infant morbidity and mortality associated with preterm birth has been supported by a number of studies conducted in high-resource countries. However, a 2015 population-based trial conducted in low-resource countries called their use into question.
Induction Therapy Strategies in the Transplant-Ineligible Population
Authors: Attar Narsis , O'Donnell Elizabeth K. 
Published: May 2021

Abstract
Multiple myeloma (MM), a plasma cell malignancy, accounts for ~10% of hematologic malignancies and predominantly affects the older population. It exhibits a heterogeneous biology and a complex genetic phenotype that affect patient prognosis. The treatment of MM has evolved significantly over the last decade with the use of autologous stem cell transplantation and several novel agents. Consequently, outcomes have improved in this time period, with the most impact in younger patients. Management of MM in elderly frail patients requires a thoughtful approach as majority of these patients carry multiple comorbidities and are precluded from high-dose chemotherapy and autologous stem cell transplantation—accounting for the more modest improvement in outcomes. Assessing transplant eligibility and performance status is a critical first step. Subsequently, the choice of frontline therapy in transplant-ineligible frail patients must balance efficacy with adverse effects to optimize quality of life. Here, we review the current state of induction regimens in this patient population.
Monoclonal Antibodies in Myeloma
Authors: Hartley-Brown Monique , Chitty David , Thakur Richa 
Published: May 2021

Abstract
In the past several years, there have been significant advances in the therapeutic arsenal of agents used to treat multiple myeloma (MM). Despite these advances, MM remains incurable. One of the most recent therapeutic advances is the development of targeted monoclonal antibodies (MoAbs). The MoAbs have significantly improved disease response rates, and extended survival in MM patients. In this review, we highlight the current US Food and Drug Administration approved MoAbs, namely, belantamab mafodotin, daratumumab, elotuzumab, and isatuximab. The mechanisms of action and pivotal clinical trials that led to US Food and Drug Administration approval of these agents and their current therapeutic use in the management of patients with MM are discussed in detail. Lastly, we describe several novel MoAbs under clinical investigation with potential for approval in the future.
From VAD to VRD
Authors: Parmar Harsh , Vesole David H. , Biran Noa 
Published: May 2021

Abstract
High-dose therapy followed by autologous stem cell transplantation (ASCT) is considered the standard of care for transplant-eligible patients with newly diagnosed multiple myeloma (MM). With new treatment combinations offering the advantage of improved clinical outcomes of MM patients, the utilization of ASCT is again being addressed in the evolving treatment landscape. In this article, we review the role of frontline ASCT in the management of patients with MM.
Strategies to Overcome High-Risk Multiple Myeloma
Authors: Sanchez Larysa 
Published: May 2021

Abstract
Multiple myeloma (MM) patients with high-risk cytogenetics continue to have inferior outcomes despite recent advances in the treatment of MM. As defined by the International Myeloma Working Group, the presence of t(4;14), t(14;16), del(17p), t(14;20) and amplification of 1q are considered to be high-risk chromosomal abnormalities associated with poor survival. Despite the use of immunomodulatory agents, proteasome inhibitors, autologous stem cell transplantation, and anti-CD38 monoclonal antibodies, clinical trials of current therapies have not shown strong statistical evidence of being able to overcome the poor prognosis of high-risk disease. Novel treatment approaches are urgently needed to improve survival in this subset of MM patients.
Managing uncertainty in antifungal dosing: antibiograms, therapeutic drug monitoring and drug-drug interactions
Authors: Lewis Russell E. , Andes David R. 
Published: May 2021

Purpose of review
A number of pharmacokinetic and pharmacodynamic factors in critically ill or severely immunosuppressed patients influence the effectiveness of antifungal therapy making dosing less certain. Recent position papers from infectious diseases societies and working groups have proposed methods for dosage individualization of antibiotics in critically ill patients using a combination of population pharmacokinetic models, Monte-Carlo simulation and therapeutic drug monitoring (TDM) to guide dosing. In this review, we examine the current limitations and practical issues of adapting a pharmacometrics-guided dosing approaches to dosing of antifungals in critically ill or severely immunosuppressed populations.

Recent findings
We review the current status of antifungal susceptibility testing and challenges in incorporating TDM into Bayesian dose prediction models. We also discuss issues facing pharmacometrics dosage adjustment of newer targeted chemotherapies that exhibit severe pharmacokinetic drug-drug interactions with triazole antifungals.

Summary
Although knowledge of antifungal pharmacokinetic/pharmacodynamic is maturing, the practical application of these concepts towards point-of-care dosage individualization is still limited. User-friendly pharmacometric models are needed to improve the utility of TDM and management of a growing number of severe pharmacokinetic antifungal drug-drug interactions with targeted chemotherapies.
Update on neuroimaging for categorization of Parkinson's disease and atypical parkinsonism
Authors: Chougar Lydia , Pyatigorskaya Nadya , Lehéricy Stéphane 
Published: May 2021

Purpose of review
Differential diagnosis of Parkinsonism may be difficult. The objective of this review is to present the work of the last three years in the field of imaging for diagnostic categorization of parkinsonian syndromes focusing on progressive supranuclear palsy (PSP) and multiple system atrophy (MSA).

Recent findings
Two main complementary approaches are being pursued. The first seeks to develop and validate manual qualitative or semi-quantitative imaging markers that can be easily used in clinical practice. The second is based on quantitative measurements of magnetic resonance imaging abnormalities integrated in a multimodal approach and in automatic categorization machine learning tools.

Summary
These two complementary approaches obtained high diagnostic around 90% and above in the classical Richardson form of PSP and probable MSA. Future work will determine if these techniques can improve diagnosis in other PSP variants and early forms of the diseases when all clinical criteria are not fully met.
Ataxin-2 gene: a powerful modulator of neurological disorders
Authors: Laffita-Mesa Jose Miguel , Paucar Martin , Svenningsson Per 
Published: May 2021

Purpose of review
To provide an update on the role of Ataxin-2 gene (ATXN2) in health and neurological diseases.

Recent findings
There is a growing complexity emerging on the role of ATXN2 and its variants in association with SCA2 and several other neurological diseases. Polymorphisms and intermediate alleles in ATXN2 establish this gene as a powerful modulator of neurological diseases including lethal neurodegenerative conditions such as motor neuron disease, spinocerebellar ataxia 3 (SCA3), and peripheral nerve disease such as familial amyloidosis polyneuropathy. This role is in fact far wider than the previously described for polymorphism in the prion protein (PRNP) gene. Positive data from antisense oligo therapy in a murine model of SCA2 suggest that similar approaches may be feasible in humans SCA2 patients.

Summary

ATXN2 is one of the few genes where a single gene causes several diseases and/or modifies several and disparate neurological disorders. Hence, understanding mutagenesis, genetic variants, and biological functions will help managing SCA2, and several human diseases connected with dysfunctional pathways in the brain, innate immunity, autophagy, cellular, lipid, and RNA metabolism.
Cerebellar ataxia, neuropathy, vestibular areflexia syndrome: genetic and clinical insights
Authors: Sullivan Roisin , Kaiyrzhanov Rauan , Houlden Henry 
Published: May 2021

Purpose of review
This review aims to summarise the present cerebellar ataxia, neuropathy, vestibular ataxia syndrome (CANVAS) literature, providing both clinical and genetic insights that might facilitate the timely clinical and genetic diagnosis of this disease.

Recent findings
Recent advancements in the range of the clinical features of CANVAS have aided the development of a broader, more well-defined clinical diagnostic criteria. Additionally, the identification of a biallelic repeat expansion in RFC1 as the cause of CANVAS and a common cause of late-onset ataxia has opened the door to the potential discovery of a pathogenic mechanism, which in turn, may lead to therapeutic advancements and improved patient care.

Summary
The developments in the clinical and genetic understanding of CANVAS will aid the correct and timely diagnosis of CANVAS, which continues to prove challenging within the clinic. The insights detailed within this review will raise the awareness of the phenotypic spectrum and currently known genetics. We also speculate on the future directions of research into CANVAS.
Neuromuscular hyperexcitability syndromes
Authors: De Wel Bram , Claeys Kristl G. 
Published: May 2021

Purpose of review
To provide an update on recent developments regarding acquired, antibody-mediated, neuromuscular hyperexcitability syndromes, including Isaac's and Morvan's syndromes, cramp-fasciculation syndrome and rippling muscle disease, and their genetic differential diagnoses.

Recent findings
Antibodies in auto-immune peripheral nerve hyperexcitability syndromes (PNHS) are directed against CASPR2 and LGI1, proteins of the voltage-gated potassium channel (VGKC) complex. We discuss the significance of ‘double-negative’ VGKC antibodies in PNHS and the rationale for ceasing VGKC antibody testing (but testing CASPR2 and LGI1 antibodies instead) in clinical practice. Recent case reports also expand the possible clinical phenotypes related to CASPR2/LGI1 antibodies, but the interpretation of these findings is complicated by the frequent association of antibody-mediated neuromuscular hyperexcitability syndromes with other auto-immune disorders (e.g. myasthenia gravis).
Finally, a hereditary origin of neuromuscular hyperexcitability should always be considered, even in non-VGKC-related genes, as evidenced by the recently discovered high frequency of HINT1 mutations in people of Slavic origin.

Summary
This review provides an update on recent clinical, immunological and genetic developments in neuromuscular hyperexcitability syndromes. We also provide a guide for the clinician for diagnosing and managing these disorders in clinical practice, with a special focus on the main differential diagnoses.
Covid-19: predictive mathematical formulae for the number of deaths during lockdown and possible scenarios for the post-lockdown period
Authors: Fokas Athanassios S. , Dikaios Nikolaos , Kastis George A. 
Published: May 2021

In a recent article, we introduced two novel mathematical expressions and a deep learning algorithm for characterizing the dynamics of the number of reported infected cases with SARS-CoV-2. Here, we show that such formulae can also be used for determining the time evolution of the associated number of deaths: for the epidemics in Spain, Germany, Italy and the UK, the parameters defining these formulae were computed using data up to 1 May 2020, a period of lockdown for these countries; then, the predictions of the formulae were compared with the data for the following 122 days, namely until 1 September. These comparisons, in addition to demonstrating the remarkable predictive capacity of our simple formulae, also show that for a rather long time the easing of the lockdown measures did not affect the number of deaths. The importance of these results regarding predictions of the number of Covid-19 deaths during the post-lockdown period is discussed.
A new perspective on the BO06 trial in osteosarcoma: short- and long-term prognostic value of histologic response and intensified chemotherapy
Authors: Musta Eni , van Geloven Nan , Anninga Jakob , Gelderblom Hans , Fiocco Marta 
Published: May 2021

AbstractPurposeCure rate models accounting for cured and uncured patients, provide additional insights into long and short term survival. We aim to better understand the prognostic value of histologic response and chemotherapy intensification on cure fraction and progression-free survival (PFS) for the uncured patients.MethodsA logistic model is assumed for the effect of histologic response and intensified chemotherapy on the cure status, while a Cox regression model is estimated only for the uncured patients on PFS. The mixture cure model is used to simultaneously study these two effects.ResultsHistologic response is a strong prognostic factor for the cure status (OR: 3.00 [1.75-5.17]), but it has no clear effect on PFS for the uncured patients (HR: 0.78 [0.53-1.16]). The cure fractions are 55% [46%-63%] and 29% [22%-35%] among patients with good histologic response (GR) and poor responders (PR) respectively. The intensified regimen was associated with higher cure fraction among PR (OR: 1.90 [0.93 – 3.89]), with no evidence of effect for GR (OR: 0.78 [0.38 – 1.59]).ConclusionsAccounting for cured patients is valuable in distinguishing the covariate effects on cure and PFS. Estimating cure chances based on these prognostic factors is relevant for counseling patients and can affect treatment decisions.
Evaluation of High Flow Local Extraction on control of the aerosol plume in an operating theatre
Authors: Marriott Logan , Harper Matthew , Zhou Tongming , Sun Chenlin 
Published: May 2021

BackgroundEngineering controls are a necessity for minimising aerosol transmission of SARS-CoV-2, yet so far, little attention has been given to such interventions. High flow local extraction (HFLE) is a standard in other industries that deal with airborne contaminants.ObjectiveThis study aims to provide a quantitative evaluation of an HFLE concept feasible to implement in most real clinical settings.DesignA unique combined experimental model of Laser sheet illumination videography paired with continuous nanoparticle counts was used to quantitatively assess the impact of HFLE in an operating theatre. Propylene Glycol was aerosolised via a customised physiological lung simulator and dispersion was measured in 3 dimensions. Cumulative probability heat maps were generated to describe aerosol behaviour. Continuous particle counts were made at 15 locations throughout the room to validate laser assessments.ResultsHigh flow local extraction reduced dispersion of simulated exhaled aerosols to undetectable levels. With the HFLE in operation and optimally positioned, the aerosol plume was tightly controlled. Particle counts remained at baseline when HFLE was active. HFLE becomes less effective when positioned at increasing distance from the mouth.Aerosol plume behaviour in the absence of HFLE was highly variable and unpredictable.ConclusionsThis analysis demonstrates great potential for HFLE to have a significant impact in reducing aerosol transmission. Simple HFLE devices can be easily engineered and could be widely deployed without impacting on the safe delivery of care.
A Cross-Sectional Analysis of Oral Health Spending Over the Lifespan in Commercial and Medicaid Insured Populations
Authors: Tranby Eric P , Frantsve-Hawley Julie , Minter-Jordan Myechia , Thommes James , Jacob Matt , Monopoli Michael , Okunev Ilya , Boynes Sean G. 
Published: May 2021

AbstractBackgroundLife course theory creates a better framework to understand how oral health needs and challenges align with specific phases of the lifespan, care models, social programs, and changes in policy.MethodsData are from the 2018 IBM Watson Multi-State Medicaid Marketscan Database (31 million claims) and the 2018 IBM Watson Dental Commercial and Medicare Supplemental Claims Database (45 million claims). Analysis compares per enrollee spending fee-for-service dental claims and medical spending on dental care from ages 0 to 89.ResultsDental utilization and spending are lower during the first 4 years of life and in young adulthood than in other periods of life. Stark differences in the timing, impact, and severity of caries, periodontal disease, and oral cancer are seen between those enrolled in Medicaid and commercial dental plans. Early childhood caries and oral cancer occur more frequently and at younger ages in Medicaid populations.ConclusionsThis unique lifespan analysis of the U.S. multi-payer dental care system demonstrates the complexities of the current dental service environment and a lack of equitable access to oral healthcare.Practical ImplicationsHealth policies should be focused on optimizing care delivery to provide effective preventive care at specific stages of the lifespan.