bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association Between Medical Distrust and the Intention to Initiate Preexposure Prophylaxis (PrEP) in HIV-Seronegative Cisgender Women of Color Within the DC Area [ID: 1377701]
Authors: Hull Shawnika , Alade Tami , Moriarty Patricia , Scott Rachel , Sinks Hannah , Zack Jennifer 
Published: May 2023

INTRODUCTION:
Black cisgender women bear a disproportionate burden of the U.S. human immunodeficiency virus (HIV) epidemic, compared to women of other racial groups. Preexposure prophylaxis (PrEP) is a highly effective prevention tool. Evidence indicates that Black women are interested in initiating PrEP, but low utilization persists in this population. Historical mistreatment of women of color and the resulting distrust erect barriers to open communication and shared decision-making with health care providers.

METHODS:
Using an IRB-approved questionnaire, we surveyed 186 consenting adults (83% Black, 9% White, 3% American Indian/Alaskan Native, 4% Other), who were PrEP eligible, HIV seronegative, cisgender women, recruited from family planning and obstetrics and gynecology specialty clinics in Washington, DC. We tested the interaction of patient racial identification and group-based medical mistrust on intentions to use PrEP, as mediated by intentions to discuss PrEP with a health care provider during the imminent clinical interaction.

RESULTS:
Results indicate significant moderated mediation of the interaction between race and distrust on intention to initiate PrEP at 3 months (index −0.3093, SE 0.1886, 95% CI [–0.7455,–0.0122]) and 12 months (index −0.3248, SE 0.1987, 95% CI [–0.7827,–0.0040]) through anticipated discussion with a provider.

CONCLUSION:
When distrust is low, Black women had stronger intentions to utilize PrEP (relative to women of other racial groups). This was explained by stronger intentions to discuss PrEP with the provider during the clinical visit. This relationship was nonsignificant at moderate and high levels of distrust. These results underscore the critical importance of provider-initiated discussion of PrEP with women to improve health equity.
A Randomized Trial on the Effectiveness of Five Water-Based Personal Lubricants in Premenopausal and Postmenopausal Women [ID: 1376759]
Authors: Krychman Michael , Abakah-Phillips Temitayo , Hood Sarah , Palacios Santiago , Savania Nina 
Published: May 2023

INTRODUCTION:
Vaginal dryness is generally associated with postmenopausal women; however, it may occur at all ages. Personal lubricants can relieve discomfort associated with vaginal dryness, although clinical data supporting the efficacy of many lubricants are limited.

METHODS:
An open-label, parallel-design study was performed in heterosexual women in monogamous relationships, aged 18–65 years with mild-to-moderate vaginal dryness and dyspareunia. The study population (n=174) included an approximate 50:50 ratio of premenopausal to postmenopausal women. The randomization schedule was stratified by menopausal status. Participants were randomized to use one of five water-based lubricants and instructed to use their lubricant during vaginal intercourse at least once a week over a 4-week period. The Female Sexual Function Index (FSFI) measured sexual functioning after 4 weeks of use as an indicator of lubricant performance. The total FSFI comprises six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain reduction. A greater than 4-point increase in total FSFI is considered clinically important.

RESULTS:
An increase in FSFI total score of greater than 4 points was found for all lubricants in the total population and for four of five lubricants in the premenopausal subgroup, as indicated by the mean differences to baseline. The number of participants in sexual function (total FSFI >26.55) after treatment was significantly greater than the number in sexual function before treatment for both subgroups (premenopausal, 19.3–78.4%; postmenopausal, 22.3–75.3%; P<.0001 for both).

CONCLUSION:
These lubricants can be used not only to relieve symptomatology of vaginal dryness and dyspareunia, but to enhance overall sexual satisfaction regardless of menopausal status.
A Look at Social Media and Misinformation in Regard to Abortion [ID: 1379920]
Authors: Potter Kaylee , Bauer Callie Cox , Laiwalla Rahim , Lanza Shannon 
Published: May 2023

INTRODUCTION:
Social media is an increasingly utilized source for medical information. There is a paucity of data for the amount and source of medical misinformation on social media for women's health topics. Our study aimed to define the rate of medical misinformation for abortion on Instagram and evaluate its source.

METHODS:
Open-source posts through the platform Instagram were collected using a web-scraper program. Posts met the following preset parameters; greater than or equal to 250 likes, posted January 1, 2022 to July 11, 2022, and containing at least one prespecified hashtag: #AbortionPill, #AbortionFacts, #UnplannedPregnancy. Posts were analyzed for poster self-identification as a physician, nonphysician provider, or nonmedical provider and for presence and accuracy of medical content.

RESULTS:
Ninety-seven percent of posts were from nonmedical providers, 1.5% from physicians and 1.5% from nonphysician providers. Of posts containing medical information, 63.5% were accurate, and 36.5% contained misinformation. Seventy-nine percent of posts with inaccurate information were from nonmedical providers, 10.5% from physicians, and 10.5% from nonphysician providers. 47.9% of all posts were pro-abortion, 34.8% were anti-abortion, and 17.3% took no stance. Of posts containing medical misinformation, 84.2% were anti-abortion, and 15.8%, pro-abortion.

CONCLUSION:
This study demonstrates that social media is being used to distribute accurate and inaccurate medical information by both medical providers and nonmedical providers and from both pro- and anti-abortion beliefs. It demonstrates the responsibility of the physician to share medically accurate information when participating in social media and opens the question of the effect this misinformation may have on patient experience and care.
Development of a Pap-Hub to Ensure Up-to-Date Cervical Cancer Screening and Follow-Up [ID: 1375247]
Authors: Looby Anna Ayers , Asche Steve , Carlson Kathryn , Chandra Abhishek , Das Kamalini 
Published: May 2023

INTRODUCTION:
Complex American Society for Colposcopy and Cervical Pathology guidelines for cervical cancer screening compound challenges in ensuring proper follow-up for patients. We describe a “Pap-Hub” system for coordinating up-to-date screening and follow-up for patients and report preliminary outcomes on 10 years of data.

METHODS:
A retrospective analysis of Pap smear screening and follow-up data was conducted for patients in two health care systems (A and B) using the “Pap-Hub.” Clinician and patient surveys were administered to detail thoughts on systems effect on care coordination.

RESULTS:
Institution A managed 99,708 patients over 3 years. 76,842 patients (77%) had all recommended screening, follow-up, and or HPV vaccinations. Of these patients, 56,910 (74%) were screened and 60,744 (79%) completed their vaccination series. Institution B managed 81,795 patients over 3 years. 61,484 (75%) had all recommended screening, follow-up, and or HPV vaccinations. Of these patients, 46,630 (76%) were screened, and 46,756 (76%) completed their vaccination series. Screening rates at both institutions equaled or exceeded national rates each year. 50 patient survey responses have been completed. Forty-four patients (88%) reported that the system made results “much easier to understand” compared to electronic messages or letters. Ten percent (n=5) and 76% (n=38) of patients felt that it made them “more likely” or “much more likely” to follow up, respectively.

CONCLUSION:
The Pap-Hub system simplifies cervical cancer screening and follow-up. With ongoing data analysis and increasing patient and clinician survey responses, we aim to describe the scope of its effect for over 200,000 patients over 10 years.
Gender and Race Discrepancies in Resident Research Output at a Tertiary Care Center [ID: 1374349]
Authors: McNitt Megan , Ayyash Mariam , Gear Gabrielle , Swain Monique 
Published: May 2023

INTRODUCTION:
The Accreditation Council for Graduate Medical Education requires residents to complete scholarly activity prior to graduation, but this does not necessarily translate into peer-reviewed publications. However, level of scholarly activity has been directly linked to successful fellowship match, and those who identify as women, African American, Hispanic, or Native American (underrepresented in medicine [URiM]) are not well represented in fellowship positions. We therefore evaluated for race and gender-based discrepancy in scholarly activity as it relates to research involvement.

METHODS:
An IRB-approved (#15746) survey was sent to all residents at a tertiary hospital. This survey asked residents to share demographic information, when they got involved with research, number of first-author articles, and experience with presentations. Chi-square analysis was used.

RESULTS:
Analysis demonstrated that women began researching earlier than men (P=.0027). However, this did not translate to a significant increase in poster presentations (P=.270), oral presentations (P= .0522), or number of first-author publications (P=.492). When broken down by race, URiM men were exposed to research later than White men, White women, and URiM women (P<.005). There was no difference in poster presentations (P=.350) or first-author publications (P=.718), but White and URiM men had more experience giving oral presentations at conferences compared to their female colleagues (P<.005).

CONCLUSION:
The responses demonstrate that there is not a lack of involvement in research leading to less research output. In fact, despite earlier introduction to research, women have similar research outcomes as their peers. Therefore, effort needs to be placed on ensuring access to resources that assist with publishing research.
Online CME Effectively Improves Obstetrician–Gynecologists' Clinical Knowledge and Confidence Related to Cytomegalovirus [ID: 1368765]
Authors: Larkin Amy , Misiuta Iwona 
Published: May 2023

INTRODUCTION:
We sought to determine whether an online continuing medical education (CME) series could improve the clinical knowledge and confidence of obstetrician–gynecologists related to cytomegalovirus (CMV).

METHODS:
Two online, 30-minute panel discussions, with educational effects assessed for matched learners completing all pre/post questions. The McNemar's test assessed differences from pre to post (P<.05 are statistically significant). The activities launched in March and April 2022, and data were collected for 3 months for each activity.

RESULTS:
Overall, 50–51% of obstetrician–gynecologists demonstrated improvements. For activity 1 (N=147), 31% improved at recognizing the burden of CMV (P<.01, 44% need additional education); 20% improved at selecting CMV acquisition risk reduction strategies (P<.01, 25% need additional education); 24% improved at identifying complications of congenital CMV (P<.01, 26% need additional education); 51% increased confidence at educating pregnant women about CMV risk reduction (P<.01), with an average confidence shift of +78% among those who improved. For activity 2 (N=130), 32% improved at recognizing the lifecycle of CMV (P<.01, 32% need additional education); 24% improved at selecting factors associated with CMV seropositivity (P<.01, 35% need additional education); 15% improved at identifying common complications of CMV at birth (P<.01, 35% need additional education); 48% increased confidence at understanding of the role of CMV serostatus in pregnant patients (P<.01), with an average confidence shift of +79% among those who improved.

CONCLUSION:
This study demonstrates the success of an online, serial learning initiative at improving clinical knowledge and confidence of obstetrician–gynecologists related to CMV. Continued gaps were identified for future education.
Advance Care Planning in Obstetrics: Effectiveness of a Didactic Intervention on Provider Comfort and Knowledge [ID: 1373348]
Authors: Johnson Corey , Oliver Emily , Ramsey Frederick , Rose Marisa 
Published: May 2023

INTRODUCTION:
Within obstetrics care, it can be difficult to discuss death and advances directives (AD). Recent maternal illnesses and deaths secondary to COVID-19 highlight the importance of these conversations. There is little available research regarding AD in obstetrics, especially within medical education. This study aimed to establish a baseline of obstetric provider comfort and knowledge with this material, provide education, and then reassess comfort and knowledge.

METHODS:
Institutional review board committee approval was waived for this study. A pre-intervention survey, including a unique identifier to allow for pairing of pre/post-surveys, was emailed to residents of a large university obstetrics and gynecology department with questions assessing comfort and knowledge of AD. The intervention was a 45-minute lecture covering definitions and local state laws relating to AD. A postsurvey, with identical questions to the presurvey, was sent 2 weeks after the intervention. Only paired responses were analyzed, using paired t test.

RESULTS:
Twenty-three residents (96% of program) participated in the presurvey; 17 (71%) participated in the postsurvey. All were matched to presurvey responses and analyzed. In the presurvey, 41% of respondents were usually or always comfortable identifying surrogate decision makers, which increased to 82% in the postsurvey, a 41% difference (P=.01). With regards to the knowledge-based questions, the mean correct response was 56% in the presurvey and 87% in the postsurvey, a 31% difference (P<.001).

CONCLUSION:
A simple didactic intervention showed improvement in comfort and knowledge surrounding topics of AD for ob-gyn residents. Additional research relating to patient awareness of AD during pregnancy could be explored.
Development of a Departmental Resident Educational Program to Increase Knowledge and Confidence Related to Obstetric Anal Sphincter Injuries [ID: 1375536]
Authors: Patel Reena , Anna Zdroik , Matthews Catherine 
Published: May 2023

INTRODUCTION:
Obstetric anal sphincter injuries (OASIS) have been reported in up to 35% of vaginal deliveries; thus, understanding these injuries is a critical part of obstetrics and gynecology training. Formal educational programs with incorporated simulation training can have an advantageous effect, particularly when provided as part of residency education. This project seeks to evaluate the positive effect of departmental resident education related to OASIS, on confidence and knowledge of obstetrics and gynecology residents at Wake Forest University.

METHODS:
A structured OASIS curriculum was developed by the urogynecology program, including 2 hours of didactic lecture followed by stepwise simulation with swine models to demonstrate and practice anatomic repair techniques. Participants completed pre- and post-class surveys including skill confidence assessments via Likert scale (range 1–10), and standardized knowledge assessments adapted from ACOG Obstetric Laceration Repair Module, along with educational experience reports. These items were scored and analyzed.

RESULTS:
In August 2022, 16 residents (4 per residency year) participated. Prior to education, mean confidence level with techniques was 4.2 among all areas (range 1.6–7.4), with mean knowledge assessment score 64% (range 33–100%). Post-education, confidence improved across several domains including effectively applying perineal support (7.3–7.9), identifying lacerations and performing rectal examinations (6.1–8.0), and OASIS repair (1.9–5.4) (P<.05). Knowledge assessment scores remained similar, at 70% (P>.05). In qualitative analysis, all individuals reported beneficial aspects of the program.

CONCLUSION:
Introduction of an OASIS curriculum including repair simulation utilizing an animal model, increased resident skill confidence. Future research will investigate longitudinal data to improve outcomes.
Resident Perception of Obstetrics and Gynecology Pelvic Anatomy Curriculum: A National Survey [ID: 1377994]
Authors: Holtzman Sharonne , Friedman Frederick , Ghofranian Atoosa , Nentin Farida , Sifri Yara 
Published: May 2023

INTRODUCTION:
As a surgical subspeciality, mastering pelvic anatomy for the ob-gyn resident is imperative in performing successful surgical procedures. The objective of this study was to conduct a national survey to examine the ob-gyn resident perspective on their residency's pelvic anatomy curriculum.

METHODS:
An 18-question survey was distributed to all 241 Accreditation Council for Graduate Medical Education program coordinators. The survey was circulated electronically on four different dates, and all information was collected anonymous. All statistical analysis was done using SPSS 2.0.

RESULTS:
A total of 180 (31.0%) residents responded out of 582 possible residents from the 28 programs that responded to our survey. The majority of residents, 172 (95.5%), were between the ages 25 and 34, 155 (86.1%) identified as female, and 25 (69.4%) programs were academic. Out of the respondents, 104 (58.10%) experienced formal education on pelvic anatomy and 138 (77.53%) had a formal surgical simulation. There were 159 (88.83%) residents who had protected lecture time for pelvic anatomy, and only 100 (62.9%) found the lectures to be educational. On a scale of 1–10, the average was 7.5 when residents were asked whether they felt that obstetrics and gynecology programs should have time in an anatomy lab and 9.0 when asked if they felt that formal training in anatomy lab would help them become a better surgeon. On multivariable analysis, residents who had formal education on pelvic anatomy and a surgical simulation curriculum felt that their residency program was more likely to adequately train them in all aspects of obstetrics and gynecology (P<.05).

CONCLUSION:
Pelvic anatomy education is a important for ob-gyn residents. Only 60% of programs have a formal pelvic anatomy curriculum and 89% had formal lectures on pelvic anatomy, with most residents finding pelvic anatomy lectures to be unhelpful. Residency programs should consider adding hands-on anatomy program to their curriculum to adequately train their residents in the field of obstetrics and gynecology.
Analysis of Current Medical Student Mistreatment on the Obstetrics and Gynecology Clerkship [ID: 1342315]
Authors: Hazen Nicholas , Leffler Grace , Nunn Sophia 
Published: May 2023

INTRODUCTION:
At our institution, there are a high proportion of mistreatment reports by medical students stemming from interactions with residents during their obstetrics and gynecology training. There is minimal published data on this issue. This project reviewed and categorized mistreatment reports from medical students during their obstetrics and gynecology rotations to identify factors contributing to medical student mistreatment in this setting and establish a basis for targeted interventions.

METHODS:
After receiving IRB approval, student responses from post-rotation surveys were compiled from the three most recent academic years. The responses were de-identified and compiled into a database encompassing all student responses to mistreatment questions. The study authors used an existing taxonomy for unprofessional behavior, established by Cullen et al, to classify responses in the database into categories. Up to three categories could be selected per response.

RESULTS:
9.2% (34/369) of students documented some form of mistreatment while on their obstetrics and gynecology rotation. Of the responses evaluating individual residents, 2.0% (86/4248) reported mistreatment. Of responses where mistreatment was reported, 48.33% were categorized as “Ineffective or negligent teaching/mentoring,” 25.00% as “Indirect abuse, aggression, or disrespect,” and 21.67% as “Ineffective or incomplete communication.” All of the remaining categories comprised less than 15% of the total. Category proportions were similar when looking at responses related to individual residents and to the rotation overall.

CONCLUSION:
Most concerns stemmed from perceived neglect from residents and staff, rather than overt bad-acting. Interventions to reduce this type of perceived mistreatment should focus on enhancing student engagement and interaction, effective teaching, and clear communication between students, residents, and staff.
Virtual Platform Adaptation of Perinatal Depression Support Group: A Quality Improvement Study [ID: 1365608]
Authors: White Samantha , Brescia Sara , Gurram Padmalatha , McCumiskey Karen , Mover Kelly 
Published: May 2023

INTRODUCTION:
Group therapy interventions have shown to improve scores on postpartum depression and anxiety inventories. Our institution underwent transition from in-person (IP) to virtual platform (VP) over the course of the COVID-19 pandemic. The study's objective is to examine whether VP has similar participation rates and outcomes as IP.

METHODS:
This is a retrospective study of women who attended the perinatal mood disorders (PMD) support group. Between January 2019 and June 2021, the group transitioned from IP to VP sessions. Participants attending both IP and VP sessions were excluded. The participation rates and outcomes of IP and VP support groups were compared. Edinburgh Postnatal Depression Score (EPDS) and Mills Inventory (MI) were used to assess clinical improvement. P value of .05 is considered significant.

RESULTS:
One hundred thirty-seven women (85 [62%] IP and 52 [38%] VP) participated. Baseline characteristics were similar (P>.05). Most of the participants were 1–6 months postpartum (P=.38). The average number of sessions attended by IP was 3.86 versus 3.76 by VP (P=.41). The preintervention average EPDS scores were 15.56 in IP versus 14.76 in VP (P=.79), and MI scores were 52.48 (IP) versus 46.06 in VP (P=.07). The EPDS and MI mean scores decreased postintervention. The average decrease in EPDS score is 5.08 in IP versus 6 in VP (P=.36). The average decrease in MI score is 17.86 in IP versus 15.56 in VP (P=.25).

CONCLUSION:
The VP has similar participation and outcomes as IP format. The VP is a feasible and effective method of delivering support to women with PMD.