bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare provider knowledge, attitudes, and preferences in management of genitourinary syndrome of menopause in the Mid-South
Authors: Morris Joshua , Clark Cassidy , Reed Laura , Pace Diane , Cao Xueyuan , Khanna Pallavi 
Published: September 2021

Abstract

Objective:
This study explored the clinical management practices of healthcare providers who treat menopausal women in an urban Mid-South area. The study specifically examined their knowledge of prescribing and counseling related to the care of women who present with complaints or clinical findings of genitourinary syndrome of menopause.

Methods:
An electronic questionnaire was distributed to healthcare providers involved in the care of women undergoing menopausal transition spanning a variety of medical specialties. The questionnaire was distributed to academic program directors, coordinators, and ListServ administrators to forward to targeted respondents. Items included demographic questions, clinical knowledge, management practices, and preferences. Statistical analysis for associations between demographics was performed using Chi-squared tests and between age groups with Kruskal Wallis tests.

Results:
The final sample contained 106 healthcare providers. Respondents were demographically diverse and encompassed multiple levels of professional training including Attendings, Trainees (Residents and Fellows), as well as Advanced Practice Registered Nurses. Significant differences were noted in many areas examined in our questionnaire, comprising knowledge, management, counseling, and prescribing practices surrounding the treatment of genitourinary syndrome of menopause when accounting for training level, specialty, and years in practice. Among all respondents, 10.4% reported rarely or never discussing menopausal symptoms with their patients. Most respondents (76.4%) stated they had prescribed topical therapies for genitourinary syndrome of menopause, with over 90% of practitioners prescribing lubricants/moisturizers and estradiol cream; however, only 55% reported being familiar with the US Food and Drug Administration's boxed warning on low-dose vaginal estrogen. Nearly half of the respondents (49%) reported being uncomfortable counseling about the boxed warning on low-dose vaginal estrogen.

Conclusion:
This study identifies gaps in Mid-South healthcare providers’ awareness of the boxed warning on low-dose vaginal estrogen as well as their comfort level in providing counseling regarding the risks, benefits, and alternatives to vaginal estrogen. Integrated practice between physicians and Advanced Practice Registered Nurses can lead to a significant benefit to patients experiencing menopause as shared experience and knowledge are shared between each group. Our survey does reveal gaps in knowledge and practice for optimal outcomes for patients experiencing genitourinary syndrome of menopause. These results will be useful in providing continuing education to providers and more effective communication, evaluation, and treatment to patients.
Prevalence and risk factors for menopausal symptoms in middle-aged Chinese women: a community-based cross-sectional study
Authors: Wang Xueyin , Wang Linhong , Di Jiangli , Zhang Xiaosong , Zhao Gengli 
Published: September 2021

Abstract

Objectives:
To examine the prevalence and risk factors of menopausal symptoms in middle-aged Chinese women.

Methods:
A cross-sectional, community-based study recruited 6,745 women aged 40 to 55 years in the eastern, central, and western regions of China during 2018. Menopausal status was categorized into reproductive stage (defined as regular menstruation or subtle changes in menstrual cycle characteristics), menopausal transition (the beginning of a persistent difference of 7 d in the length of consecutive cycles, or the last menstruation having occurred no more than 12 mo), or postmenpause (the end of the 12 mo period of amenorrhea) according to the Stages of Reproductive Aging Workshop classification. Menopausal symptoms were determined by the modified Kupperman Menopausal Index (KMI) questionnaire and considered nonmenopausal symptoms (total KMI score<15) and menopausal symptoms (total KMI score≥15). Demographic, lifestyle, physical, and menopausal characteristics were collected by face-to-face interviews. Logistic regression models were used to identify factors associated with the risk of menopausal symptoms.

Results:
Among all participants, the mean age was 46.9 years, and 15.7% (1,001/6,364) of participants reported experiencing menopausal symptoms. The prevalence of menopausal symptoms was 9.3% (303/3,256), 23.9% (293/1,227), and 21.5% (405/1,881) in the reproductive stage, menopausal transition, and postmenopausal stage, respectively. Overall, the three most prevalent menopausal symptoms were insomnia (44.7%), fatigue (40.4%), and mood swings (37.2%). The multivariable logistic regression model showed that menopausal status, residence, nulliparity, and chronic diseases were associated with the risk of menopausal symptoms (all P < 0.05). Women during menopausal transition (OR = 2.66, 95% CI: 2.21-3.20) or postmenopause (OR = 2.26, 95% CI: 1.82-2.80) had significantly increased risk of menopausal symptoms compared with those in the reproductive stage.

Conclusions:
Menopausal status, residence, nulliparity, and chronic diseases were associated with menopausal symptoms in middle-aged Chinese women.
Mind the gap: primary care physicians and gynecologists’ knowledge about menopause and their attitudes to hormone therapy use in Jamaica
Authors: Harrison Giselle M. , Medley Natalie N. , Carroll Kamali N. , Simms-Stewart Donnette A. , Wynter Shaun H. , Fletcher Horace M. , Rattray Carole A. 
Published: September 2021

Abstract

Objectives:
The study objective was to evaluate physicians’ knowledge, attitude, and practices toward menopause and hormone therapy.

Methods:
This study was a cross-sectional study using a stratified sample of physicians across the four health regions in Jamaica, between September and October 2017. A total of 145 physicians (75% response rate) completed a questionnaire to assess knowledge and attitudes toward menopause and prescribing hormonal therapy. Univariate and bivariate analyses were used to describe and compare the knowledge, attitudes, and practices in participants.

Results:
The majority of physicians (66%) self-reported a moderate level of knowledge of menopausal treatment options. Self-reported knowledge was associated with years in practice (P < 0.0001) and level of experience (P < 0.0001). Those who identified as having good and moderate knowledge were likely to discuss treatment options with patients (P < 0.005), while physicians with good knowledge were more likely to prescribe hormone therapy (P < 0.05). Correct responses regarding common menopause symptoms were noted in >60% physicians; however, there was a precipitous fall in correct responses regarding findings related to the Women's Health Initiative (<45%). More consultant grade physicians were confident and less confused about prescribing hormone therapy (P < 0.05) compared to junior grade physicians. When stratified by level of experience, knowledge level was the factor that discouraged physicians from seeing symptomatic menopausal patients (P < 0.05).

Conclusions:
This study highlights the gaps in knowledge and practices and a need for carefully designed curricula to provide individualized, risk-mitigated training in menopause healthcare.

Video Summary:

http://links.lww.com/MENO/A814.
Conjunctival Autofluorescence and Cytological Changes in Pterygium
Authors: S Pai Sangeetha Vijayam , Kishore Alisha , Sen Seema , Sharma Namrata , Tandon Radhika 
Published: September 2021

Purpose:
The purpose of this study was to evaluate the presence and pattern of autofluorescence and its related cytological changes in pterygium.

Methods:
Eighty-six patients with unilateral pterygium and 76 controls were recruited. We graded pterygium, looked for autofluorescence, performed cytology of the nasal conjunctiva, repeated evaluation after 6 months, compared findings with controls, and assessed the progression of pterygium from photographs with the help of ImageJ software.

Results:
Autofluorescence was present in 51% of cases with pterygium. Autofluorescence at the leading edge (65.9%) was the predominant pattern seen. In total, 83.3% of grade 3 pterygia, 64.7% of grade 2 pterygia, and 28.9% of grade 1 pterygia (P value <0.0005) had autofluorescence. Impression cytology showed conjunctival epithelial cells in 60% of cases, significant squamous metaplasia in grade 3 pterygia (45%) compared with grade 2 pterygia (11.8%), and normal conjunctival epithelial cells in grade 1 pterygia (P value < 0.0005).

Conclusions:
The presence and pattern of conjunctival autofluorescence and cytological changes, especially squamous metaplasia, are linked to the severity or grade of pterygium.
Summary of the 2020 focused updates to U.S. asthma management guidelines: What has changed and what hasn't?
Authors: Mammen Jennifer R. , McGovern Colleen M. 
Published: September 2021

ABSTRACT
Despite the availability of effective medications, the majority of pediatric and adult patients with persistent asthma have uncontrolled symptoms. This has been attributed to patient nonadherence and poor self-management, but clinicians also contribute through inaccurate assessment of asthma and lack of familiarity with best practice guidelines for medication management. Thus, improving patient outcomes will require improving clinical management by health care providers, including utilization of evidence-based practice guidelines. In this report, we briefly summarize key points of the national guidelines for asthma management and delineate important changes enacted by 2020 Expert Panel Report-4 updates. These include revised recommendations on the use of fractional exhaled nitric oxide testing, indoor allergen mitigation, bronchial thermoplasty, adjunctive immunotherapy, and important modifications to medication management that are likely to have widespread impact on prescribing throughout the United States. In particular, for all patients aged five years and older taking stepwise therapy levels 3–4, it is now recommended to use Single Maintenance and Reliever Therapy, whereas the use of intermittent inhaled corticosteroids (ICSs) administered at the same time as short-acting beta agonist is recommended for step 2 to reduce symptom burden, improve control, and minimize total ICS dose.
Associations Between Fatigue, Sleep Disturbance, Physical Activity, and Quality of Life for Children With Cancer
Authors: Wu Wei-Wen , Tang Chia-Chun , Jou Shiann-Tarng , Yu Tsung-Hsien 
Published: September 2021

Background
Fatigue, sleep disturbance, and physical inactivity have been increasingly recognized as health issues that negatively affect quality of life (QoL) for children with cancer. Existing studies focus either on children receiving treatment or in survivorship, but not on both populations in a study. This causes difficulty in examining differences of these issues between treatment statuses and identifying associations of these issues with QoL.

Objective
The aims of this study were to examine differences in fatigue, sleep disturbance, physical activity, and QoL between on- and off-treatment children and to identify their associations with QoL.

Methods
The correlational study was conducted with 100 children with cancer 7 to 12 years old. Descriptive, bivariate, and multivariate regression analyses were used.

Results
Participants undergoing treatment had higher degrees of fatigue (P = .002), physical inactivity (P = .004), and QoL distress (P = .001) than those in survivorship. Mean sums (SDs) of sleep disturbance were 47.15 (8.23) and 48.48 (7.13) in the on- and off-treatment groups. Age (P = .000), sex (P = .023), fatigue (P = .000), and sleep disturbance (P = .004) were significantly associated with QoL distress.

Conclusions
This study is unique in that a frame of reference is addressed to gain insight into the distinct developmental issues of school-aged children undergoing cancer treatment and in survivorship. More studies are needed.

Implications for Practice
Interventions to increase QoL should target children who are younger, male, and have higher levels of fatigue and sleep disturbance. Diagnosis and treatment of sleep disturbance should be considered as part of routine activities.
Psychiatry in the Time of COVID: Credibility, Uncertainty, and Self-Reflection
Authors: Adler David A. , Erlich Matthew D. , Goldman Beth , Berlant Jeffrey , Edwards Matthew L. , First Michael B. , Oslin David W. , Siris Samuel G. , Talley Rachel M. , Wagner Elizabeth S. ,   Psychopathology Committee of the Group for Advancement of Psychiatry
Published: September 2021

Abstract
Public trust in the credibility of medicine and physicians has been severely tested amid the COVID-19 pandemic and growing sociopolitical fissures in the United States. Physicians are being asked to be ambassadors to the public of scientific information. Psychiatrists have an opportunity to help the public understand and accept a “new normal” during a time of such uncertainty. Using a case example, we review the impact of uncertainty and fear on scientific and medical credibility. Although the pandemic provides an opportunity for systemic change, the consequences of any change remain unknown. To help patients navigate the uncertainty, we conclude by offering four guidelines to clinicians: the public has little interest in understanding the scientific method; we need to acknowledge that we do not have all the answers; credibility and trustworthiness are linked to our ability to be trusted, believable messengers; and we can retain scientific credibility while acknowledging uncertainty.
Predicting Alcohol Use From Genome-Wide Polygenic Scores, Environmental Factors, and Their Interactions in Young Adulthood
Authors: Kandaswamy Radhika , Allegrini Andrea , Nancarrow Alexandra F. , Cave Sophie Nicole , Plomin Robert , von Stumm Sophie 
Published: September 2021

ABSTRACT

Objective
Alcohol use during emerging adulthood is associated with adverse life outcomes, but its risk factors are not well known. Here, we predicted alcohol use in 3153 young adults aged 22 years from a) genome-wide polygenic scores (GPS) based on genome-wide association studies for the target phenotypes number of drinks per week and Alcohol Use Disorders Identification Test scores, b) 30 environmental factors, and c) their interactions (i.e., G × E effects).

Methods
Data were collected from 1994 to 2018 as a part of the UK Twins Early Development Study.

Results
GPS accounted for up to 1.9% of the variance in alcohol use (i.e., Alcohol Use Disorders Identification Test score), whereas the 30 measures of environmental factors together accounted for 21.1%. The 30 GPS by environment interactions did not explain any additional variance, and none of the interaction terms exceeded the significance threshold after correcting for multiple testing.

Conclusions
GPS and some environmental factors significantly predicted alcohol use in young adulthood, but we observed no GPS by environment interactions in our study.
Validity of measures for life space mobility and physical activity in older adults with lower-limb amputation
Authors: Esfandiari Elham , Miller William C , Tao Gordon , Imam Bita , Misaghi Ehsan , Lindstrom Heather , Payne Michael W.C. 
Published: September 2021

Background:Older adults with lower-limb amputations (LLAs) often experience lack of confidence and poor balance, which limits their mobility. There are few validated measures for assessing these outcomes in the LLA population.Objectives:To assess the validity of the Life Space Assessment (LSA) and the Physical Activity Scale for the Elderly (PASE) for older adults with LLA.Study design:Secondary analyses of cross-sectional data.Methods:Sixty-eight older adults with LLA across Canada were recruited to complete the LSA and the PASE. Validity was assessed via correlations with the Activities-specific Balance Confidence (ABC), Four-Square Step Test (FSST), and Two-Minute Walk Test (2-MWT).Results:As hypothesized, the LSA was positively correlated with the ABC (ρ= 0.36, 95% confidence interval [CI] [0.17, 0.62]) and 2-MWT (r = 0.49, 95% CI [0.27, 0.70]) and negatively correlated with FSST (ρ= −0.39, 95% CI [−0.56, −0.10]). The PASE was positively correlated with the ABC (ρ= 0.34, 95% CI [0.10, 0.56]) and 2-MWT (ρ= 0.32, 95% CI [0.05, 0.52]), and negatively correlated with FSST (ρ= −0.36, 95% CI [−0.53, −0.07]).Conclusions:The LSA has validity in measuring life space mobility. The PASE captures the physical activity with weaker support of validity in older adults with LLA.Clinical relevance:The LSA and PASE are quick low-cost tools for clinicians to assess mobility-related functional health and physical activity, respectively, in older adults with LLA. However, the PASE may contain activities that are not common among older adults with LLA.
Upper limb prosthesis users: A longitudinal cohort study
Authors: Resnik Linda , Borgia Matthew , Cancio Jill , Heckman Jeffrey , Highsmith Jason , Levy Charles , Webster Joseph 
Published: September 2021

Background:
No previous studies have followed prosthesis users with upper limb loss or limb deficiency using their own prostheses to assess change over time.

Objectives:
(1) To describe prostheses and terminal device types used at baseline and 1-year follow-up; (2) to examine changes in functional outcomes and device satisfaction over time; and (3) to examine whether changes in outcomes varied across level of amputation and type of prosthesis used.

Study Design:
Multisite, observational time series design with in-person functional performance and self-report data collected at baseline and 1-year follow-up.

Methods:
Baseline and follow-up outcome scores were compared using Wilcoxon signed-rank tests. Analyses were stratified by amputation level, time since amputation, prosthesis type, and change in device type. Published minimal detectable change (MDC) values were used to determine whether detectable change in outcome measures occurred.

Results:
The longitudinal cohort consisted of 64 participants (mean age 64 years, 56% body-powered users). The only significant differences in outcome measures between baseline and follow-up (after adjustment for false discovery) were hours/day of prosthesis use, which increased from 6.0 (4.4) to 7.3 (5.3) hours (P = 0.0022). Differences in prosthesis use intensity remained significant in analyses stratified by amputation level, time since amputation, prosthesis type, and change in device type. Between 14 and 20% of the sample had change in one or more outcome measures that was greater than the known MDC.

Conclusions:
Most participants had stable outcomes over a year's time, whereas 14–20% experienced either improvement or decline in one or more tests indicating the importance of annual follow-up visits.
A Scoping Literature Review of Simulation Training Program Curriculum Standards
Authors: O'Rourke Jenny , Brown Michelle , Elias Mary Ellen , Podolej Gregory S. , Cardell Annemarie , Golden Antoinette , Gurevich-Gal Raya , Roszczynialski Kelly N. , Tayeb Baraa , Wong Nelson 
Published: September 2021

Summary Statement
Simulation educator training is well supported in the literature and endorsed by the Society of Simulation in Healthcare as well as the International Nursing Association for Clinical Simulation and Learning. Despite growth of domestic and international training programs, there is a lack of consensus regarding curriculum standards. Our aim was to identify core curricular components of comprehensive simulation training programs. A scoping literature review of all relevant publications from 2000 to 2020 was conducted using a 6-step design. A team of 10 multidisciplinary, international simulation educators independently reviewed all citations with discrepancies resolved by third-person review. Of the initial 320 identified unique publications, a total of 15 articles were included, all published within the last 6 years. Four themes were identified: domains (n = 6), competencies (n = 3), objectives (n = 8), and other characteristics (n = 3). The findings support a greater understanding of the core curricular content across simulation training programs to support standardization.
Attitude and Behavior of People Towards Visiting the Hospital During the Pandemic
Authors: shamsundar Manaswi , Choudhary Shaista 
Published: September 2021

AbstractIntroductionVisiting the hospital is important as a part of check-up in avoiding the major risks of unknown and serious diseases irrespective of any pandemic. Our study aims to understand the attitude and behaviour of common people towards visiting the hospital during COVID-19 pandemic in two major hotspot states of India namely Maharashtra and Karnataka.MethodologyA cross-sectional study was conducted between July-august 2021 among the population of two states. A total of 636 respondents completed the survey and returned electronically. Data were analysed using suitable statistical tools to achieve the objective of the study.Results74.8% of the respondents were not ready to visit the hospitals during the COVID-19 pandemic unless the symptoms were serious. On the other hand, 25.2% of the of respondents were willing to go to the hospitals. The top three reasons for the reduction in visits are fear of getting infected in the hospitals by COVID-19 patients (72.6%), fear of stepping out of home (31.1%) and fear of COVID-19 infection by the lab equipment (24.5%).ConclusionOverall the study revealed that there was a reduction in number of visits to the hospitals for common diseases in people after the pandemic started. But the people were still willing to go to the hospitals if they noticed any major symptoms or symptoms related to COVID-19. Our findings may be useful to develop strategies to address concerns in order to ensure that people don’t get any serious illness because of the fear of COVID-19.
Elucidation of Master Allostery Essential for Circadian Clock Oscillation in Cyanobacteria
Authors: Furuike Y. , Mukaiyama A. , Ouyang D. , Ito-Miwa K. , Simon D. , Yamashita E. , Kondo T. , Akiyama S. 
Published: September 2021

AbstractSpatio-temporal allostery is the source of complex but ordered biological phenomena. To identify the structural basis for allostery that drives the cyanobacterial circadian clock, we crystallized the clock protein KaiC in four distinct states, which cover a whole cycle of phosphor–transfer events at Ser431 and Thr432. The minimal set of allosteric events required for oscillatory nature is a bidirectional coupling between the coil-to-helix transition of the Ser431-dependent phospho-switch in the C-terminal domain of KaiC and ADP release from its N-terminal domain during ATPase cycle. An engineered KaiC–protein oscillator consisting of a minimal set of the identified master allosteric events exhibited mono-phosphorylation cycle of Ser431 with a temperature-compensated circadian period, providing design principles for simple post-translational biochemical circadian oscillators.One Sentence SummaryCoupling between a phospho-switch and KaiC ATPase-dependent nucleotide exchange drives the cyanobacterial circadian clock.