bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of COVID-19 on orthopedic surgery residency programs in Algeria: a qualitative study
Authors: Meraghni Nadhir , Derradji Mohamed , Nemmar Rachid , Benkaidali Riad , Boulaioune Soumeya , Kara Zoubir 
Published: February 2023

Introduction:
The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the Algerian orthopedic surgery residency programs. Medical education has been negatively impacted. From an educational standpoint, teaching conferences for residents have been suspended. Grand rounds and in-person meetings have also been cancelled to comply with social distancing recommendations.

Objective:
The purpose of this study was to assess the impact of the COVID-19 pandemic on the orthopedic surgery residents’ education, clinical practice, and well-being.

Materials and methods:
An online cross-sectional survey was shared with orthopedic surgery residents of 6 teaching hospitals in Algiers (Algeria).

Results:
We received 58 responses (response rate: 24.57%). Fifty-four percent of the residents have been deployed on COVID-19 screening’ duties. Nearly 97% of the trainees reported that the COVID-19 pandemic had negatively impacted their surgical training. Most participants referred inadequate supply in personal protective equipment and indicated that the orthopedic surgery-training program should include a session about personal protective equipment every year. Among all the subjects, 54 (93%) perceived an increase in stress levels during the COVID-19 crisis and 90% were concerned about transmitting infection to their family members.

Conclusions:
The COVID-19 pandemic has had a significant impact on the Algerian orthopedic surgery residency programs. The changes in the orthopedic activities have negatively impacted the residents’ learning, especially surgical training and affected their well-being. Adapted measures must be taken to face this unprecedented challenge and ensure the continuity of training for our residents.
Association between metabolically obese but normal weight and cardiovascular diseases in Korean menopausal women
Authors: Choi Han-Gyo , Kim Hye-Jin 
Published: February 2023

Abstract

Objective
The aim of this study was to present useful data for developing effective health management strategies for cardiovascular disease (CVD) prevention in postmenopausal women by investigating health-related behaviors and the prevalence of CVD for different types of obesity classified according to metabolic health status and body mass index criteria.

Methods
Using the 2016 Korean National Health and Nutrition Examination Survey VII-1 data, 1,190 menopausal women aged 50 years or older were analyzed in this cross-sectional study. The participants were divided into four groups as follows: metabolically healthy and normal weight (MHNW), metabolically obese but normal weight (MONW), metabolically healthy but obese, and metabolically obese and obese. Complex-samples general linear analysis, t tests, and logistic regression analysis were used to compare the differences in health-related behaviors and the risk of CVD among the four groups.

Results
The risk for stroke was 3.61 times higher (95% CI, 1.18-11.03) in the MONW group than in the MHNW group.

Conclusions
We found a strong association between the MONW group of obesity and the risk for CVD, particularly stroke, in postmenopausal women. These findings would serve as valuable evidence for developing and implementing interventions to prevent stroke in postmenopausal women in the MONW group.
Network analysis of eating disorder symptoms in women in perimenopause and early postmenopause
Authors: Finch Jody E. , Xu Ziqian , Girdler Susan , Baker Jessica H. 
Published: February 2023

Abstract

Objective
Eating disorders (EDs) are often stereotyped as disorders of adolescence and young adulthood; however, they can occur at any age. Prevalence of EDs at midlife are approximately 3.5% and specific symptoms at midlife can have prevalences as high as 29.3%. Studies also inconsistently suggest that EDs and related symptoms may be more prevalent in midlife aged women during perimenopause compared with midlife aged women at pre-menopause. To date few studies have examined the structure of and associations between ED symptoms in women specifically during perimenopause and early postmenopause. Thus, the purpose of the current study is to investigate the structure of ED symptoms specifically during perimenopause and early postmenopause.

Methods
Participants included 36 participants (45-61 y old) in a larger clinical trial who completed the Eating Disorder Examination Questionnaire (EDE-Q) at a baseline study visit. Network analysis statistical models were used to examine the structure of and associations between ED symptoms assessed via the EDE-Q.

Results
Shape dissatisfaction and weight dissatisfaction were the top 2 central symptoms in the network.

Conclusions
Results corroborate previous studies and indicate that, similar to young adult samples, dissatisfaction with body image is a core feature of ED pathology across the lifespan.
Symptom monitoring improves physical and emotional outcomes during menopause: a randomized controlled trial
Authors: Andrews Robin A. F. , John Bev , Lancastle Deborah 
Published: February 2023

Abstract

Objectives:
A recent systematic review suggested that symptom monitoring can result in reductions in menopausal symptoms and improvements in health-related behaviors. To date, no studies have experimentally investigated whether symptom monitoring could be a beneficial intervention during the menopause transition.

Methods:
One hundred perimenopausal and postmenopausal women (mean age, 46 y; SD, 8 y) were randomized into either a monitoring-intervention or control group. A mixed between/within design was used, with group membership (ie, monitoring-intervention or control) as the between-subjects component and time (ie, baseline and 2-wk follow-up) as the within-subjects component. Dependent variables included symptom reductions and emotional reactions as measured via the Daily Record Keeping form. Secondary outcomes included help-seeking, communication, medical decision making, health awareness, self-efficacy, and health anxiety.

Results:
A linear mixed-effects model demonstrated that the monitoring-intervention group reported a 42% reduction in physical symptoms at follow-up versus a 12% reduction in the control group: ρ = 0.009, β = 6.3, 95% CI (1.5-11). Negative emotions also significantly reduced in the monitoring-intervention group but did not alter in the control group: ρ < 0.001, β = 3.4, and 95% CI (1.6-5.2). These effects remained significant after controlling for potential moderator variables such as trait neuroticism and coping preferences and potential confounders such as medical and demographic characteristics. Variances in other health outcomes were nonsignificant.

Conclusions:
Findings demonstrated that symptom monitoring reduced symptoms and negative emotions within a perimenopausal and postmenopausal sample, and these outcomes endured after controlling for key moderators and covariates. However, symptom monitoring was not related to improvements in health-related behavioral outcomes, which contrasts with previous findings. These findings show that symptom monitoring may be useful within healthcare settings by providing perimenopausal and postmenopausal women with a simple and accessible means of symptom alleviation while they await treatment or medical consultation.
The Women's Health Initiative randomized trials of menopausal hormone therapy and breast cancer: findings in context
Authors: Chlebowski Rowan T. , Aragaki Aaron K. 
Published: February 2023

AbstractImportance and ObjectiveThe menopausal hormone therapy (MHT) association with breast cancer has been controversial for more than 40 years. Most recently, findings from cohort studies have been discordant compared with those from the Women's Health Initiative (WHI) randomized trials. In cohort studies, both estrogen therapy and estrogen plus progestin were associated with higher breast cancer incidence. In contrast, in the WHI randomized trials, findings for estrogen plus progestin are concordant with cohort study reports, whereas estrogen therapy significantly reduced breast cancer incidence. In addition, concerns have been raised regarding the WHI findings from both trials. In this report, we briefly summarize findings for MHT on breast cancer from cohort studies and the WHI randomized trials. The report focus is addressing, point-by-point, concerns raised regarding the WHI findings.MethodsFor cohort studies, we relied on the latest findings from (1) the meta-analysis of the Collaborative Group on Hormonal Factors in Breast Cancer and (2) the Million Women's Study. To identify commentaries and editorials, “Menopause” and “Climacteric” were searched from 2002 to present; PubMed and Google Scholar were searched for commentaries, editorials, and breast cancer, MHT, estrogen, conjugated equine estrogen, estradiol, “hormone replacement therapy,” and “HRT.”Discussion and ConclusionsThirty commentaries challenging WHI findings were identified. All were reviewed, and issues needing response were identified. Findings from the meta-analysis from the Collaborative Group on Hormonal Factors in Breast Cancer and the Million Women Study were summarized and compared with finding in the two WHI randomized trials evaluating estrogen therapy and estrogen plus progestin. Based on the randomized clinical trials, estrogen therapy, for women with prior hysterectomy, decreases breast cancer incidence and mortality. In contrast, estrogen plus progestin increases breast cancer incidence, which persists through two decades. Women considering estrogen plus progestin use for vasomotor symptoms should understand the breast cancer risk.
Multilevel analysis of factors predicting pregnancy loss experiences among pregnant women in Ghana: a further analysis of nationally representative data
Authors: Klu Desmond 
Published: February 2023

Background:
Pregnancy loss experiences due to stillbirths, miscarriages, and abortion among women have a negative effect on maternal health, leading to maternal mortality and strain on the health system. This study, therefore, seeks to examine the individual, proximate, and household factors associated with pregnancy loss experiences among ever pregnant women in Ghana.

Methods:
Data for this study were obtained from the 2014 Ghana Demographic and Health Survey (GDHS) conducted between early September and mid-December 2014. The weighted sample comprised 2321 ever pregnant women aged 15–49 years. Data were analyzed with SPSS version 25 using both descriptive and multilevel logistic regression modelling.

Results:
The study found that 48% of ever pregnant women have experienced pregnancy loss in Ghana. The multilevel regression analysis shows that ever pregnant women aged 25–34 years and 35–49 years had a higher likelihood of losing pregnancy. Pregnant women with secondary/higher education were less likely to lose their pregnancy. pregnant women who reside in urban areas has lower odds of pregnancy loss. Ever pregnant women who were currently married and those who were formerly married were more likely to experience pregnancy loss than never married women. Ever pregnant women who had access to an improved source of drinking water had a higher probability of losing their pregnancy. Interestingly, ever pregnant women who attended antenatal care services 1–3 times and 4 or more times were more likely to experience pregnancy loss.

Conclusion:
Individual, household, and proximate factors, such as pregnant women’s age, educational level, place of residence, religion, marital status, occupational type, household source of drinking water, and a number of antenatal visits, are strong significant predictors of pregnancy loss experiences among pregnant women in Ghana. These factors should be considered in strengthening existing programs and developing new interventions to decrease pregnancy loss and ensure safe motherhood.
Health football beats them all: subgroup analysis of the 3F (Fit&Fun with Football) study on white coat hypertension, sustained hypertension, dippers, nondippers, and on pharmacologically un(treated) arterial hypertension
Authors: Schrader Bastian , Conradi Charis , Lüders Stephan , Vaske Bernhardt , Koziolek Martin , Gehlenborg Eugen , Haller Hermann , Elsässer Albrecht , Schrader Joachim 
Published: February 2023

Background:
The 3F study (Fit&Fun with Football) demonstrated a significant reduction in blood pressure, antihypertensive medication, body weight, stress and depression through health football. Health football could be a popular tool to unleash the full preventive potential of physical activity. This work analyses the effect of health football on hypertensive subgroups dipper, nondipper, white coat hypertension (WCH), sustained hypertension, (un)treated hypertensive patients (UH, TH).

Methods:
A prospective interventional study with 1-year follow-up. Football group (FG): n = 103, ‘health’-football training (1×/week, 90 min) led by licensed football coaches. Physical inactive, hypertensive patients older than 45 years were compared with a control group (CG) (n = 105). Subgroups were divided by ambulatory blood pressure monitoring (ABPM), casual blood pressure (CBP), medication schedule and compared by blood pressure (BP), laboratory results and weight.

Results:
In all three subgroups (WCH vs. sustained hypertension, TH vs. UH, D vs. ND), health football reduced BP and weight significantly compared with the CG, and compared with the admission. An even greater effect in CBP was found in people with WCH than in sustained hypertension (FG: WCH: 141–127 mmHg, sustained Hypertension (SH): 142–132 mmHg; CG: WCH: 141–143 mmHg, SH: 140–141 mmHg). In contrast, the significant reduction in CBP and ABPM was comparable in treated and untreated patients, although antihypertensive drugs were reduced significantly more frequently in FG than in CG. BP reduction in nondippers and dippers was also comparable. In the nondipper group, nocturnal BP was significantly reduced in the FB (122.0–111.5 mmHg), but not in the CG or the dippers.

Conclusion:
All evaluated football subgroups achieved a significant BP reduction (compared with CG). This applied to dipper, nondipper, (un)treated hypertension, WCH and SH. All mentioned subgroups displayed a clear benefit. The even greater reduction in BP in WCH demonstrates the importance of physical activity before the additional prescription of antihypertensive medications, underscoring the recommendations of the ESC and ISH in WCH.
Temporal Variation in Indoor Radon Concentrations Using Environmental Public Health Tracking Data
Authors: Manono Fotso Kamgang Sidoine Lafleur , Monti Michele M. , Salame-Alfie Adela 
Published: February 2023

Abstract
Indoor radon is the second leading cause of lung cancer in the United States (US) after smoking and the number one for lung cancer in non-smokers. Understanding how indoor radon varies during the year reveals the best time to test to avoid underestimating exposure. This study looks at the temporal variation in 13 years of radon concentrations in buildings located in 46 US states and the District of Columbia (DC). In the dataset, radon concentration varies from 3.7 Bq m−3 (Becquerels per cubic meter) to 52,958.1 Bq m−3, with an overall mean of 181.4 Bq m−3. About 35.4% of tests have a radon concentration level equal to or greater than the US Environmental Protection Agency (US EPA) action level 4.0 pCi L−1 (148 Bq m−3).
3
Temporal variation in radon concentrations was assessed using the overall monthly mean radon concentration. The highest concentrations were found in January (203.8 Bq m−3) and the lowest in July (129.5 Bq m−3). Higher monthly mean indoor radon concentrations were found in January, February, and October, and lower in July, August, and June. This result is consistent with findings from other studies and suggests continuing to encourage radon testing throughout the year with an emphasis on testing during the colder months.
Pregnancy, Fetal, and Neonatal Outcomes Among Women With Traumatic Brain Injury
Authors: Adams Rachel Sayko , Akobirshoev Ilhom , Brenner Lisa A. , Katon Jodie G. , Mitra Monika 
Published: February 2023

Objective:
There have been no systematic studies of pregnancy outcomes among women with traumatic brain injury (TBI), potentially limiting informed clinical care for women with such injuries. The purpose of this exploratory study was to evaluate pregnancy and fetal/neonatal outcomes among women with a TBI diagnosis recorded during their delivery hospitalization compared with women without TBI.

Setting:
In this cross-sectional study, we identified women with delivery hospitalizations using 2004-2014 data from the Nationwide Inpatient Sample of the Health Care and Cost Utilization Project.

Participants:
We identified deliveries to women with a TBI diagnosis on hospital discharge records, which included all diagnoses recorded during the delivery, and compared them with deliveries of women without a TBI diagnosis.

Main Measures:
Pregnancy outcomes included gestational diabetes; preeclampsia/eclampsia; placental abruption; cesarean delivery; and others. Fetal/neonatal outcomes included preterm birth; stillbirth; and small or large gestational age.

Design:
We modeled risk for each outcome among deliveries to women with TBI compared with women without TBI, using multivariate Poisson regression. Models included sociodemographic and hospital characteristics; secondary models added clinical characteristics (eg, psychiatric disorders) that may be influenced by TBI.

Results:
We identified 3 597 deliveries to women with a TBI diagnosis and 9 106 312 deliveries to women without TBI. Women with TBI were at an increased risk for placental abruption (relative risk [RR] = 2.73; 95% CI, 2.26-3.30) and associated sequelae (ie, antepartum hemorrhage, cesarean delivery). Women with TBI were at an increased risk for stillbirth (RR = 2.55; 95% CI, 1.97-3.29) and having a baby large for gestational age (RR = 1.30; 95% CI, 1.09-1.56). Findings persisted after controlling for clinical characteristics.

Conclusions:
Risk for adverse pregnancy outcomes, including placental abruption and stillbirth, were increased among women with TBI. Future research is needed to examine the association between TBI and pregnancy outcomes using longitudinal and prospective data and to investigate potential mechanisms that may heighten risk for adverse outcomes.
US Military Healthcare Professionals' Practice, Knowledge, and Misconceptions About Concussion
Authors: Baxi Sangita , Cabreros Irineo , Meredith Lisa S. , Holliday Stephanie Brooks , Martinez Jose , Piquado Tepring 
Published: February 2023

Objective:
To determine the US military healthcare professionals' knowledge and training preferences to improve diagnosis and management of concussion sustained in nondeployed settings.

Participants:
US military healthcare professionals (physicians, physician assistants, and nurse practitioners) completed online surveys to investigate practices, knowledge, and attitudes about concussion diagnosis and treatment, as well as preferences on future training. There were 744 responses from active duty US military healthcare providers, all of whom had cared for at least one patient with mild traumatic brain injury (mTBI) in the previous 24 months.

Results:
The majority of physicians reported they were confident in their ability to evaluate a patient for a new mTBI (82.1%) and order appropriate imaging for mTBI (78.3%). Accuracy of identifying “red flag” symptoms ranged between 28.2% and 92.6%. A Likert scale from 1 (“not at all confident”) to 4 (“very confident”) was used to assess providers' confidence in their ability to perform services for patients with mTBI. With respect to barriers to optimal patient care, nurse practitioners consistently reported highest levels of barriers (90.8%).

Conclusions:
Although US military providers regularly care for patients with concussion, many report experiencing barriers to providing care, low confidence in basic skills, and inadequate training to diagnose and manage these patients. Customized provider education based on branch of service and occupation, and broader dissemination and utilization of decision support tools or practice guidelines, and patient information tool kits could help improve concussion care.
Examining the Relationship Between Sleep Apnea Diagnosis and Suicide Risk in Veterans With Traumatic Brain Injury: A VA TBI Model Systems Study
Authors: Silva Marc A. , Gonzalez Alexandria V. , Tang Xinyu , Carnahan Nicolette D. , Klyce Daniel W. , Liou-Johnson Victoria , Martin Aaron M. , Moberg Jordan M. , Dreer Laura E. 
Published: February 2023

Objective:
Obstructive sleep apnea (OSA) is a common sleep disorder in people with traumatic brain injury (TBI). Although sleep disturbances have been associated with an increased risk of suicide compared with the general population, the relationship between OSA and suicide risk after TBI is not well documented. In this study, we hypothesized that OSA diagnosis would predict suicide risk in veterans with TBI.

Setting:
Five Veterans Affairs (VA) Polytrauma Rehabilitation Centers.

Participants:
Participants were drawn from the VA TBI Model Systems study, with follow-up interviews at year 1 (n = 392), year 2 (n = 444), year 5 (n = 498), or year 10 (n = 252) post-TBI (7.8%-14.5% follow-up attrition).

Design:
This was a retrospective analysis from observational data using logistic regression with repeated measurements. Suicide ideation and suicide attempts were examined as outcomes at each follow-up to evaluate the relationship between OSA and suicide risk after adjusting for other risk factors determined a priori via literature review.

Main Measures:
Suicidal ideation (Patient Health Questionnaire-9 item 9), suicide attempt during the past year (self-reported), and OSA diagnosis (self-reported).

Results:
Contrary to study hypotheses, OSA diagnosis had no statistically significant association with suicide ideation or attempt after accounting for known predictors. However, greater depression symptoms, headache severity, and pre-TBI suicidal ideation and attempts predicted suicide risk at follow-up after accounting for other predictors.

Conclusions:
Results of this study did not support a relationship between OSA and suicide risk, possibly due to methodological limitations of OSA measurement. Future research on this topic should include objective measures of OSA severity and OSA treatment including adherence. Although suicide is a low base rate occurrence, the impact is disastrous and further research is needed to mitigate suicide risk.