bluuebunny/crossref_metadata_2025_split huggingface dataset:
eLearning in Physical Therapy: Lessons Learned From Transitioning a Professional Education Program to Full eLearning During the COVID-19 Pandemic
Authors: Ng Leo , Seow Kuang Cheng , MacDonald Laetitia , Correia Christina , Reubenson Alan , Gardner Peter , Spence Angela L , Bunzli Samantha , De Oliveira Beatriz Ito Ramos 
Published: February 2021

Abstract

Objective
The objectives of this cross-sectional qualitative study were to explore the perspectives of students enrolled in one physical therapist undergraduate education program in Australia about their experience with transitioning to full eLearning and student recommendations to improve the learning experience during the COVID-19 pandemic.

Methods
Seven focus groups with 28 undergraduate physical therapist students were conducted following the transitioning to full eLearning as a result of strict physical distancing measures. Focus group questions explored the students’ experiences of the transition from face-to-face to full eLearning approach and the students’ recommendations for improving future eLearning experiences. Data were analyzed using inductive thematic analysis.

Results
The 3 themes identified were: (1) students presenting heightened negative feelings such as anxiety, stress, and reduced motivation to study; (2) students continuing to value the face-to-face learning, as it provided social support and facilitated feedback from peers and tutors; (3) student recommendations for eLearning included having online lectures and supplementary videos but face-to-face practical classes and developing healthy learning habits such as scheduled times for studying, exercise, and other activities that regulate stress.

Conclusions
The transition to a full eLearning approach in an undergraduate physical therapist education program during the COVID-19 pandemic revealed that students had heightened negative emotions due to the pandemic. Students valued face-to-face practical classes to learn and receive social support from peers and tutors. Student recommendations to future eLearning suggested changes to curriculum development geared toward a greater blended approach to learning. Blended learning may include using online lectures instead of face-to-face lectures and online resources to supplement student learning of practical skills.

Impact
As higher education moves toward a more blended approach, lessons learned from this study can help educators design future physical therapist education programs. The findings can also assist programs in delivering a full eLearning approach as the COVID-19 pandemic continues.
Learning From the Law. A Review of 21 Years of Litigation of Nerve Injury Following Central Neuraxial Blockage in Obstetrics
Authors: McCombe K. , Bogod D.G. 
Published: February 2021

(Anaesthesia. 2020;75:541–548)
Medicolegal claims from neurological injury following central neuraxial blockade (CNB) are the second most common claims against obstetric anesthesiologists. Data is presented on 55 cases from a personal claims database maintained by one of the authors of the cases in which he served as an expert witness between 1994 and 2015. The lessons learned from having served as an expert witness, fall into 3 broad themes: Consent, Nerve Injury, and Recognition and Management of Nerve Injury.
39-Week Nulliparous Inductions Are Not Elective
Authors: Ghartey J. , Macones G.A. 
Published: February 2021

(Am J Obstet Gynecol. 2020;222:519–520)
The ARRIVE trial, whose findings were published in 2018, randomly assigned over 6000 women to either “elective” labor induction at 39 weeks (n=3062), or to expectant management (n=3044). The primary outcome, a composite of adverse perinatal outcomes, showed no difference between the 2 groups. In fact, women undergoing induction of labor were significantly less likely to experience hypertensive disorders of pregnancy, or to require cesarean delivery. However, despite these and similar findings in other studies, labor induction for low-risk women has not been widely adopted.
Termination of Pregnancy as a Means to Reduce Maternal Mortality in Pregnant Women With Medical Comorbidities
Authors: Aziz M.M. , Calfee A. , Albright C. , Gladstein N. , Houser M.V. 
Published: February 2021

(Obstet Gynecol. 2019;134:1105–1108)
Recently, maternal-fetal medicine (MFM) specialists have been asked to advocate for safer abortion access. This is particularly true in the case of pregnant women with potentially life-threatening comorbidities. As the maternal mortality rate in the United States rises and maternal mortality review committees are increasingly developed, there has not been attention given to the option of pregnancy termination to reduce mortality.
Associations Between Maternal Antenatal Corticosteroid Treatment and Mental and Behavioral Disorders in Children
Authors: Räikkönen K. , Gissler M. , Kajantie E. 
Published: February 2021

(JAMA. 2020;323:1924–1933)
Before 34 weeks gestation, antenatal corticosteroids are often administered when there is a risk of delivery within 7 days, accelerating fetal lung maturation and reducing the risk of adverse outcomes including respiratory distress syndrome, intraventricular hemorrhage, and death. In 2016, updated guidelines recommended corticosteroids for pregnancies before 36 weeks and 6 days gestation at risk for delivery within 7 days. There are notable gaps in the knowledge of long-term outcome of this treatment in children. This study examined the association between antenatal corticosteroid exposure and risk of mental and behavioral disorders in children, including children born at term.
Work-related Post-traumatic Stress Symptoms in Obstetricians and Gynaecologists: Findings From INDIGO, a Mixed-methods Study With a Cross-sectional Survey and In-depth Interviews
Authors: Slade P. , Balling K. , Sheen K. , Goodfellow L. , Rymer J. , Spiby H. , Weeks A. 
Published: February 2021

(BJOG. 2020;127:600–608)
The impact of adverse mental health has been recognized as a major contributing factor in decreasing an individual’s productivity and career satisfaction across both working class and professional individuals. Physicians are not exempt from this phenomenon and, in fact, are often at high risk of experiencing work-related posttraumatic stress disorder (PTSD) due to the not uncommon situation of exposure to trauma as a consequence of death or serious injury in their patients. To date, there has only been one study specific to obstetricians looking at the prevalence of PTSD that came out of the Netherlands. This study aimed to evaluate the prevalence and predictors of PTSD in physicians as well as the impact such has on both professional and personal functions.
Maternal Mortality From Coronavirus Disease 2019 (COVID-19) in the United States
Authors: Metz T.D. , Collier C. , Hollier L.M. 
Published: February 2021

(Obstet Gynecol. 2020;136:313–316)
As maternal deaths from coronavirus disease 2019 (COVID-19) are reported, there should be careful thought to how these deaths should be reviewed and interpreted with the goal of preventing future deaths.
Anesthesiologists’ and Intensive Care Providers’ Exposure to Coronavirus Disease 2019 Infection in a New York City Academic Center: A Prospective Cohort Study Assessing Symptoms and Coronavirus Disease 2019 Antibody Testing
Authors: Morcuende M. , Guglielminotti J. , Landau R. 
Published: February 2021

(Anesth Analg. 2020;131:669–676)
One of the major challenges in the fight against coronavirus disease 2019 (COVID-19) is minimizing the possible transmission of the disease to front-line health care providers (HCPs). This is particularly concerning for anesthesiologists and other intensive care providers who are involved in aerosol-generating procedures, such as tracheal intubation. Yet, little is known about the transmission of COVID-19, whether through airborne exposure or droplet/contact exposure. The aim of this study was to investigate the incidence of COVID-19 symptoms and presence of antibodies among HCPs due to work-related exposure.
Postdural Puncture Headache in the Obstetric Population: A New Approach
Authors: Xavier J. , Pinho S. , Silva J. , Nunes C.S. , Cabido H. , Fortuna R. , Araújo R. , Lemos P. , Machado H. 
Published: February 2021

(Reg Anesth Pain Med. 2020;45:373–376)
Compared with the general population, obstetric patients are at a higher risk of postdural puncture headache (PDPH), a headache caused by low cerebrospinal fluid pressure occurring within 5 days of a confirmed or presumed dural puncture. PDPH, among other things, can delay discharge and affect care of the newborn. One emerging method of treating cerebrospinal fluid is peripheral nerve blocks (PNB), including sphenopalatine ganglion block, greater occipital nerve block, and trigger point infiltration. This study aimed to evaluate the efficacy of this approach, to identify factors associated with the need for epidural blood patch (EBP) and to describe the effect of treatment on discharge delay related to PDPH.
Prone Positioning for Pregnant Women With Hypoxemia Due to Coronavirus Disease 2019 (COVID-19)
Authors: Tolcher M.C. , McKinney J.R. , Eppes C.S. , Muigai D. , Shamshirsaz A. , Guntupalli K.K. , Nates J.L. 
Published: February 2021

(Obstet Gynecol. 2020;136:259–261)
In pregnant patients undergoing ventilation, the goal is to achieve relative hypocapnia while also protecting the lungs by maintaining a safe tidal volume and plateau pressures. Mild hypercapnia (partial pressure of carbon dioxide 50 to 60 mm Hg) may be acceptable if needed to protect the lungs. When using strategies with high-positive end-expiratory pressure require continuous monitoring of mother and fetus.
Spinal Anesthesia and COVID-19 Transmission to Anesthetists, Comment on Br J Anaesth. 2020;124:670–675
Authors: Smiley R. 
Published: February 2021

(Br J Anaesth. 2020;125:e247–e248)
The report by Zhong and colleagues in Wuhan, China reported a similar experience of spinal anesthesia in patients with coronavirus disease 2019 (COVID-19) to the experience of clinicians in New York. The report, however, also raises some questions.
Fetal Bradycardia in Response to Maternal Hypothermia
Authors: Spires B.P. , Towers C.V. 
Published: February 2021

(Obstet Gynecol. 2020;135:1454–1456)
There are many causes of fetal bradycardia, defined as baseline fetal heart rate (FHR) of <110 bpm sustained for 10 minutes or longer. Since maternal fever and hyperthermia can cause fetal tachycardia, it may be true that hypothermia can cause fetal bradycardia. This report details 5 cases of fetal bradycardia in response to maternal hypothermia.
French Ambulatory Cesarean: Mother and Newborn Safety
Authors: Dimassi K. , Ami O. , Fauck D. , Simon B. , Velemir L. , Triki A. 
Published: February 2021

(Int J Gynecol Obstet. 2020;148:198–204)
Cesarean delivery involves a longer length of hospital stay, higher rates of morbidity, and greater costs and need for care compared with vaginal delivery. Misgav Ladach cesarean (MLC) is a widely used cesarean procedure, though it may impede future fertility. French Ambulatory Cesarean Section (FAUCS) appears to shorten recovery time. This study aimed to assess the results of FAUCS for maternal and neonatal safety in a unit that introduced FAUCS in January 2018.
Nonobstetric Abdominal Surgery During Pregnancy and Birth Outcomes: A Danish Registry-based Cohort Study
Authors: Rasmussen A.S. , Christiansen C.F. , Ulrichsen S.P. , Uldbjerg N. , Nørgaard M. 
Published: February 2021

(Acta Obstet Gynecol Scand. 2020;99:469–476)
When considering nonobstetric abdominal surgery during pregnancy, a balance must be found between the need for the procedure and maternal and fetal safety. A number of previous studies have helped define the risk of adverse birth outcomes in this setting. This study aims to add to the existing body of literature by examining the association between nonobstetric abdominal surgery and small-for-gestational-age (SGA) neonatal status, preterm birth, and miscarriage outcomes.
Global Interim Guidance on Coronavirus Disease 2019 (COVID-19) During Pregnancy and Puerperium From FIGO and Allied Partners: Information for Health Care Professionals
Authors: Poon L.C. , Yang H. , Kapur A. , Melamed N. , Dao B. , Divakar H. , McIntyre H.D. , Kihara A.B. , Ayres-de-Campos D. , Ferrazzi E.M. , Di Renzo G.C. , Hod M. 
Published: February 2021

(Int J Gynecol Obstet. 2020;149:273–286)
The International Federation of Gynecology and Obstetrics (FIGO) recently issued guidelines for the management of all pregnant patients during the coronavirus disease 2019 (COVID-19) pandemic, including patients with COVID-19 infection and patients with exposure to the virus. These guidelines should be used along with local guidelines and guidelines from other appropriate organizations.
Fetoscopic Tracheal Occlusion for Severe Congenital Diaphragmatic Hernia: The State of the Evidence
Authors: Thom E.A. 
Published: February 2021

(Obstet Gynecol. 2020;135:509–510)
Congenital diaphragmatic hernia affects 1 in 3000 neonates in the United States. In this condition, the fetal diaphragm is not completely formed and abdominal organs move upward, restricting lung development. This can result in death or long-term complications if not treated before birth.
Nonopioid Versus Opioid Analgesia After Hospital Discharge Following Cesarean Delivery: A Randomized Equivalence Trial
Authors: Dinis J. , Soto E. , Pedroza C. , Chauhan S.P. , Blackwell S. , Sibai B. 
Published: February 2021

(Am J Obstet Gynecol. 2020;222:488.e1–488.e8)
Opioid misuse has risen in the United States in recent years. Women may be overprescribed opioids following cesarean delivery, which may lead to opioid misuse by patients. There is no clear recommendation from the American College of Obstetricians and Gynecologists for opioids prescribed upon discharge after cesarean delivery. This study compared analgesia following cesarean delivery with opioids, ibuprofen and acetaminophen with treatment with only ibuprofen and acetaminophen.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vertical Transmission in Neonates Born to Mothers With Coronavirus Disease 2019 (COVID-19) Pneumonia
Authors: Hu X. , Gao J. , Luo X. , Feng L. , Liu W. , Chen J. , Benachi A. , Luca D. , Chen L. 
Published: February 2021

(Obstet Gynecol. 2020;136:1–3)
Studies on the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have mainly focused on nonpregnant patients. There is a need for studies examining vertical transmission and perinatal infection of SARS-CoV-2. This report focuses on neonatal outcomes from 7 pregnant patients with coronavirus disease 2019 (COVID-19), between the dates of January 20, 2020, and February 20, 2020.
Hemodynamic monitoring with the CardioMEMS HF System
Authors: Falls Candice 
Published: February 2021

Abstract:
Heart failure readmission rates continue to rise and cause economic burden in the US. Advancements in hemodynamic monitoring offer the ability to monitor intracardiac pressures at home and provide data that are used to optimize outpatient management of heart failure, resulting in reduced hospitalization and mortality associated with heart failure.
Impact of the COVID-19 Pandemic on the Clinical Learning Environment: Addressing Identified Gaps and Seizing Opportunities
Authors: Triemstra Justin D. , Haas Mary R.C. , Bhavsar-Burke Indira , Gottlieb-Smith Rachel , Wolff Margaret , Shelgikar Anita V. , Samala Renato V. , Ruff Allison L. , Kuo Kevin , Tam Marty , Gupta Amit , Stojan Jennifer , Gruppen Larry , Ellinas Herodotos 
Published: February 2021

The clinical learning environment (CLE) encompasses the learner’s personal characteristics and experiences, social relationships, organizational culture, and the institution’s physical and virtual infrastructure. During the COVID-19 pandemic, all 4 of these parts of the CLE have undergone a massive and rapid disruption. Personal and social communications have been limited to virtual interactions or shifted to unfamiliar clinical spaces because of redeployment. Rapid changes to the organizational culture required prompt adaptations from learners and educators in their complex organizational systems yet caused increased confusion and anxiety among them. A traditional reliance on a physical infrastructure for classical educational practices in the CLE was challenged when all institutions had to undergo a major transition to a virtual learning environment.
However, disruptions spurred exciting innovations in the CLE. An entire cohort of physicians and learners underwent swift adjustments in their personal and professional development and identity as they rose to meet the clinical and educational challenges they faced due to COVID-19. Social networks and collaborations were expanded beyond traditional institutional walls and previously held international boundaries within multiple specialties. Specific aspects of the organizational and educational culture, including epidemiology, public health, and medical ethics, were brought to the forefront in health professions education, while the physical learning environment underwent a rapid transition to a virtual learning space. As health professions education continues in the era of COVID-19 and into a new era, educators must take advantage of these dynamic systems to identify additional gaps and implement meaningful change. In this article, health professions educators and learners from multiple institutions and specialties discuss the gaps and weaknesses exposed, opportunities revealed, and strategies developed for optimizing the CLE in the post–COVID-19 world.
Association of Pregnancy Intentions With Substance Use During Early Pregnancy
Authors: Young-Wolff Kelly C. , Slama Natalie , Sarovar Varada , Conway Amy , Tucker Lue-Yen , Goler Nancy , Terplan Mishka , Ansley Deborah , Adams Sara R. , Armstrong Mary Anne 
Published: February 2021

Objectives:
The goal of this study was to evaluate the association between pregnancy intentions and substance use in early pregnancy among pregnant women receiving prenatal care in a large, integrated healthcare system.

Methods:
The sample comprised 29,787 Kaiser Permanente Northern California pregnant women (12.1% aged <25, 36.4% non-Hispanic White) screened for prenatal substance use in 2018 via a self-reported questionnaire and urine toxicology test given as part of standard prenatal care (at ∼8 weeks gestation). Multivariable logistic regression models tested for associations of pregnancy intentions with prenatal substance use (any use and specific substances) by self-report and/or a positive urine toxicology test.

Results:
Adjusting for covariates, women with an unintended pregnancy (23.9% of the sample) had higher odds of any prenatal substance use than women with an intended pregnancy (28.8% vs 16.1%; adjusted odds ratio [aOR] = 1.80, 95% confidence interval [CI]:1.67–1.93). Having an unintended pregnancy was also associated with higher odds of using alcohol (14.4% vs 10.4%; aOR = 1.73, 95%CI:1.59–1.89), cannabis (15.6% vs 5.6%; aOR = 1.91, 95%CI:1.73–2.11), nicotine (3.8% vs 1.3%; aOR = 2.33, 95%CI:1.92–2.82), pain medication (2.3% vs 1.2%; aOR = 1.64, 95%CI:1.32–2.03), and stimulants (0.8% vs 0.3%; aOR = 1.85, 95%CI:1.23–2.79) early in pregnancy.

Discussion:
Having an unintended pregnancy was associated with higher odds of substance use during early pregnancy. Connecting women of reproductive age with health education about pregnancy prevention and recognition of early signs of pregnancy, effective contraception, and early screening and interventions for prenatal substance use may help to reduce prenatal substance use and its associated consequences.
COVID-19 and rheumatoid arthritis
Authors: D'Silva Kristin M. , Wallace Zachary S. 
Published: February 2021

Purpose of review
The coronavirus disease 2019 (COVID-19) pandemic has caused significant morbidity and mortality worldwide. Patients with rheumatoid arthritis (RA) face unique challenges during the pandemic, including concerns regarding infection risk, drug shortages, limited access to care, social isolation, and mental health. This review will examine the multifaceted impacts of the COVID-19 pandemic on patients living with RA.

Recent findings
In patients with RA, risk factors for severe COVID-19 outcomes include older age and comorbidities, similar to those in the general population. Glucocorticoids, but not other classes of disease-modifying antirheumatic drugs (DMARDs), appear to be associated with a higher risk of severe COVID-19 outcomes. RA patients have been affected by changes in access to care, telemedicine, drug shortages, anxiety, and social isolation, which may contribute to disease flares.

Summary
Glucocorticoids, but not other DMARDs, are associated with a higher risk of severe COVID-19 outcomes in RA patients. Further studies are needed to explore the impact of specific DMARDs on COVID-19 outcomes, understand the broader implications of the COVID-19 pandemic on RA disease activity, and optimize the use of telemedicine in RA management.
Technique, Time Demand, Radiation Exposure, and Outcomes of Skin-anchored Intraoperative 3D Navigation in Minimally Invasive Posterior Cervical Laminoforaminotomy
Authors: Vaishnav Avani S. , Louie Philip , Gang Catherine H. , Iyer Sravisht , McAnany Steven , Albert Todd , Qureshi Sheeraz A. 
Published: February 2021

Study Design:
This was a retrospective review.

Objective:
The objective of this study was to describe our technique and evaluate the time demand, radiation exposure, and outcomes of minimally invasive posterior cervical laminoforaminotomy (MI-PCLF) using skin-anchored intraoperative navigation (ION).

Background:
Although bone-anchored trackers are most commonly used for ION, a novel technique utilizing noninvasive skin-anchored trackers has recently been described for lumbar surgery and has shown favorable results. There are currently no reports on the use of this technology for cervical surgery.

Methods:
Time demand, radiation exposure, and perioperative outcomes of MI-PCLF using skin-anchored ION were evaluated.

Results:
Twenty-one patients with 36 operative levels were included. Time for ION setup and operative time were a median of 34 and 62 minutes, respectively. Median radiation to the patient was 2.5 mGy from 10 seconds of fluoroscopy time. Radiation exposure to operating room personnel was negligible because they are behind a protective lead shield during ION image acquisition. There were no intraoperative complications or wrong-level surgeries. One patient required a repeat ION spin, and in 2 patients, ION was abandoned and standard fluoroscopy was used.

Conclusions:
Skin-anchored ION for MI-PCLF is feasible, safe, and accurate. It results in short operative times, minimal complications, low radiation to the patient, and negligible radiation to operating room personnel.