bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Differences of Endowed Professorship in Obstetrics and Gynecology Departments at Top Academic Institutions [A72]
Authors: Russell Colin B. , Burns Courtney , Griffith Kent , Johnson Timothy R. , Jagsi Reshma 
Published: June 2022

INTRODUCTION:
Barriers to gender equality permeate academic medicine. A recent study demonstrated that women are less likely to hold endowed professorships in internal medicine from top schools. Given the resources and prestige that accompany endowed professorships, this designation can gauge diversity within medicine’s leaders. We assessed endowed professorships within obstetrics and gynecology departments at leading American medical schools.

METHODS:
Obstetrics and gynecology faculty lists were obtained from the top 25 academic institutions, as determined by 2020 National Institutes of Health (NIH) ranking. Data on faculty position, endowed professorship/chair, gender, graduate degrees held, graduation year, publication and citation numbers, H-index, and NIH funding as a principal investigator were collected from departments or publicly available sources (e.g., institutional websites, Scopus [Elsevier], NIH Reporter). Multivariable regression models were constructed to explain holding endowed professorships.

RESULTS:
Of the 680 total professors, 400 (58.8%) were women and 280 (41.2%) were men. From these groups, 64 (49.2%) women and 66 (50.8%) men held endowed professorships. On multivariable analysis, there were no significant differences between men and women in attainment of endowed professorships (P=.83). Faculty with non-MD doctorates (P=.006) and rank of associate professor (P<.001) were less likely to have endowed chairs. Those in the top two quartiles of number of publications (P<.001) and in the highest funding quartile (P=.004) were more likely to have endowed professorships. Endowed professorships were not significantly related to decade of graduation (P=.86).

CONCLUSION:
Despite previous findings of gender inequity among endowed professorships from internal medicine departments, obstetrics and gynecology departments at leading institutions show no significant role of gender at the level of endowed chairs.
Ob-gyn Wellness Overall and by Gender in a Large Integrated Health Care System During the Pandemic [A73]
Authors: Gregg Laurie C. , Cobb Jill Kacher , Stults Cheryl D. , Dillon Ellis , Deng Sien 
Published: June 2022

INTRODUCTION:
Pre-pandemic research indicated that 35-45% of physicians had symptoms of burnout. We examined the wellness of obstetrician-gynecologist (ob-gyn) clinicians twice during the pandemic.

METHODS:
Surveys were distributed in the summer and fall of 2020 to clinicians at eight medical groups and 17 hospitals affiliated with Sutter Health across Northern California. Bivariate analyses (e.g., chi-square test for categorical variables) and multivariate logistic regression models were used to test for statistical significance.

RESULTS:
A total of 7,732 surveys were completed with 488 respondents from obstetrics and gynecology (393 women, 86 men, 5 missing gender). Burnout was more common among women than men (summer: 37.9% vs. 10%, P=.007; fall: 35.7% vs. 17.3%, P=.017). Fewer women than men believed their concerns would be acted upon (summer: 43.7% vs. 69.7%, P=.011: fall: 57.3% vs. 76.5%, P=.018). More women than men indicated that caregiving responsibilities impacted work (summer: 33.1% vs. 6.2%, P=.004; fall: 36.1% vs. 8.3%, P=.013). Compared to all specialties, a higher proportion of ob-gyn clinicians reported needing mental health support (summer: 19.4% vs. average 13.3%; fall 22.6% vs. average 14.6%). After adjusting for sex and age, ob-gyns still showed a higher odds of desire for mental health support than most other specialties.

CONCLUSION:
Women in obstetrics and gynecology experience more negative impacts with regards to wellness, feeling heard, and caregiving responsibilities when compared to their male colleagues. Compared to other specialties, more ob-gyn clinicians desired mental health support. Wellness efforts in our specialty should focus on addressing concerns, caregiving responsibilities, and mental health access.
Relugolix Combination Therapy Improves Uterine Fibroid Symptoms Independent of Fibroid Location [A77]
Authors: Venturella Roberta , Lukes Andrea S. , Stewart Elizabeth A. , Proehl Sarah , Zhao Xin , Al-Hendy Ayman 
Published: June 2022

INTRODUCTION:
In the Phase 3, replicate, institutional review board-approved LIBERTY 1 and 2 studies, relugolix combination therapy (Relugolix CT; once daily relugolix 40 mg, estradiol 1 mg, norethindrone acetate 0.5 mg) improved uterine fibroid (UF)-associated heavy menstrual bleeding (HMB), pain, and quality of life (QoL). We report the impact of location (submucosal, intramural, or subserosal) of the largest fibroid on treatment outcomes through 24 weeks.

METHODS:
Premenopausal women were randomized to relugolix combination therapy or placebo for 24 weeks. Location of the largest fibroid was investigator-defined using ultrasound; FIGO type 0/1 fibroids were excluded. Menstrual blood loss (MBL) volume was measured by alkaline hematin method (responders: MBL volume < 80mL and ≥50% reduction from baseline over last 35 days of treatment). Pain and other UF-associated symptoms were evaluated using the Numerical Rating Scale and UF-QoL Questionnaire (Symptom Severity) in this post-hoc analysis.

RESULTS:
In the relugolix combination therapy (N=253) and placebo (N=256) groups, the largest fibroid was categorized by location as subserous (N=50 and N=58), intramural (N=115 and N=130), submucosal (N=46 and N=43) or “other/unknown” (N=119 and N=106). Baseline characteristics, including MBL volume, pain and QoL scores, were similar between subgroups. In all fibroid subgroups, women randomized to relugolix combination therapy had comparable responder rates of 76.0%, 79.1%, 80.4%, and 65.6% at week 24 that were higher than with placebo: 24.1%, 16.2%, 14.0%, and 16.0% (all nominal P<.0001). Across all subgroups, women randomized to relugolix combination therapy experienced significant reductions in MBL volume, UF-associated pain and symptom severity versus placebo.

CONCLUSION:
Relugolix combination therapy improves HMB and other UF-associated symptoms independent of the location of the largest fibroid.
Real-world Effectiveness of Elagolix When Used in Combination With Hormonal Contraceptives [A79]
Authors: Levy Barbara , Fairbrothers David L. , McKenna Kelsey , Westhoff Carolyn , Cross Sarah , Frakes Eli 
Published: June 2022

INTRODUCTION:
Real-world data on the use of elagolix, an oral gonadotropin-releasing hormone (GnRH) receptor antagonist, in combination with hormonal contraceptives (HC) is limited. This analysis evaluated endometriosis-associated pain in women treated with elagolix (150 mg once daily or 200 mg twice daily) in combination with HCs in routine clinical practice.

METHODS:
This retrospective chart review utilized Dorsata data available via their clinical and claims data network (Athena EMR and Surescripts). The primary outcome was the change in endometriosis pain in women receiving elagolix concomitantly with HCs (progesterone only oral contraceptives [POPs], long-acting reversible contraception [LARC], or estrogen containing combined oral contraceptives [COCs]) at the first follow-up visit vs baseline (elagolix initiation).

RESULTS:
Women (N=193) had a mean age of 28.5 years, and most (75.1%) had received previous endometriosis-related treatment. Overall, endometriosis pain was reported as better in 79.3% (n=153) of women who received elagolix concomitantly with HCs and specifically in 72.7% of women receiving COC (n=24), 79.2% of women receiving LARC (n=76), and 80.5% of women receiving POP (n=33). Documented discontinuations included anxiety/depression (n=4), mood changes (n=2), nausea (n=1), and other (n=2) or increased (n=2) pain. This study was limited geographically and by sample size.

CONCLUSION:
This analysis demonstrated that women taking elagolix for endometriosis-associated pain had improvement regardless of the HC used. Future studies are needed on the safety and efficacy of concomitant use of elagolix with specific hormonal contraceptives.
Brief Mindfulness Video to Reduce Pelvic Exam-Related Anxiety and Pain [A89]
Authors: Collins Marielle H. , Kho Kimberly A. , Evans Monty H. , Trombello Joseph M. , Carmody Thomas , Greer Tracy L. 
Published: June 2022

INTRODUCTION:
Purpose: Pelvic examinations frequently cause anxiety and discomfort for women, which may lead to avoidance of medical appointments. This study evaluated the efficacy of a brief mindful movement video in reducing pelvic exam anxiety and pain.

METHODS:
Women (n=90) scheduled for pelvic examination were recruited at an outpatient gynecology clinic and randomized to mindfulness intervention (5-minute mindful movement video [n=44]) or control (educative materials [n=46]) groups. Upon arrival, women completed baseline measurements of anxiety and pain (visual analogue scale [VAS]). They then completed group specific activities and rated anxiety prior to pelvic exam. After exam, participants rated exam pain, post-exam anxiety, and completed questionnaires assessing intervention acceptability.

RESULTS:
Fifty-two percent of women who presented for pelvic examination reported clinically significant anxiety (i.e., VAS >34). Analysis of covariance controlling for baseline anxiety found clinically anxious individuals who received the intervention reported significantly lower anxiety before pelvic examination (P=<.001, partial η2=.232) and after (P=.006, partial η2=.165) compared to control. Analysis of covariance controlling for baseline pain found individuals who received the intervention rated pelvic examination as significantly less painful (P=< .01, partial η2=.075) compared to control. Intervention participants reported high interest, acceptability, and helpfulness of the mindful movement video.

CONCLUSION:
A 5-minute mindful movement video viewed prior to pelvic examination significantly lowered anxiety for individuals with clinically significant anxiety and reduced perceived painfulness of pelvic examination. This study demonstrates the ability to integrate a brief mindfulness intervention into the flow of a medical clinic and reduce pelvic exam anxiety and pain.
The Effect of the COVID-19 Pandemic on Access to Hysterectomy within One Hospital System [A101]
Authors: Chaoul Jessica , Sifri Yara , Nyein Ethan , Khalil Susan 
Published: June 2022

INTRODUCTION:
This study seeks to study how the pandemic affected access to hysterectomy within one tertiary care hospital system, specifically evaluating racial breakdown.

METHODS:
This study is a retrospective observational study within one hospital system. Institutional review board (IRB) approval was exempt. All hysterectomy cases were compiled for 7 months before the COVID-19 pandemic, during the pandemic, and 7 months after. The records for each patient were accessed to find patient demographics.

RESULTS:
Of the 840 hysterectomies performed in 7 months prior to the pandemic, 37.66% were performed on patients identifying as “White,” 27.77% on “Black/African-American” patients, 20.26% on “Hispanic” patients, and 7.63% on “Asian American” patients. Of the 54 hysterectomies performed during the pause on elective surgeries, 50.00% were performed on patients identifying as “White,” 35.19% on “Black/African-American” patients, 7.41% on “Hispanic” patients, and 7.41% on “Asian American” patients. There was a significant 12.85% (P<.001, CI 5.36-20.35) decrease in cases performed on those identifying as “Hispanic” during the pandemic. Of the 860 hysterectomies performed in the 7 months after the pandemic, 40.93% were performed on those identifying as “White,” 29.07% on “African-American” patients, 14.88% on “Hispanic” patients, and 8.02% on “Asian-American” patients.

CONCLUSION:
The racial percentages did drastically change during the COVID-19 pandemic. The percentage of hysterectomy cases performed on those identifying as “White” increased 12.34%. The percentage of hysterectomies performed on those identifying as “Hispanic” decreased 12.85%. This shift in racial breakdown in hysterectomy cases performed before and during the pandemic may allow a glimpse into how hospitals prioritized certain gynecologic surgeries as “elective.”
Post-treatment Efficacy and Safety Follow-up in Women with Uterine Fibroids Treated for 52 Weeks With Linzagolix [A108]
Authors: Taylor Hugh S. , Donnez Jacques , Bestel Elke , Humberstone Andrew , Garner Elizabeth 
Published: June 2022

INTRODUCTION:
We previously reported safety and efficacy results from the PRIMROSE 1 and 2 trials of linzagolix in the treatment of women with heavy menstrual bleeding associated with uterine fibroids (UFs), which showed maintenance of treatment effect for up to 52 weeks of dosing. Here we report post-treatment follow-up of key efficacy and safety results from weeks 64 and 76.

METHODS:
PRIMROSE1 and PRIMROSE2 were two randomized, double-blind, placebo-controlled phase 3 trials investigating the efficacy and safety of linzagolix 100 mg and 200 mg once daily, with or without hormonal add-back therapy (ABT) in the treatment of UFs for 52 weeks. Participants were followed for up to 6 months (week 76) after completion of treatment.

RESULTS:
At week 64, improvements in pain, hemoglobin, health-related quality of life, and uterine and fibroid volumes, observed at 24 and 52 weeks, were diminished but a beneficial difference from baseline was maintained. In patients with amenorrhea at week 52, the median (95% CI) time to first uterine bleeding was 30 (SD 27; SD 32) and 31 (SD 29; SD 32) days in PRIMROSE 1 and 2, respectively. At week 76, participants had full or partial recovery of lumbar spine bone mineral density (BMD): with 53%, 52% and 64% for 100 mg, 100 mg+ABT and 200 mg+ABT, respectively in PRIMROSE1 and 59%, 80% and 67% in PRIMROSE2.

CONCLUSION:
Linzagolix effects persisted following treatment discontinuation, although there was partial return to baseline for all measured efficacy endpoints. BMD also improved. The return to menstruation was rapid.
Disparities in HPV Vaccination Among Young Women From the 2017-2019 National Survey of Family Growth [A110]
Authors: Cahoon Sigita , Sriprasert Intira , Nguyen Brian 
Published: June 2022

INTRODUCTION:
While human papillomavirus (HPV) vaccination is recommended for all individuals through age 26, uptake remains limited. As minorities are disproportionately affected by cervical cancer, characterizing HPV vaccination disparities among young women is necessary to guide prevention of HPV.

METHODS:
We analyzed weighted survey data from young female respondents (aged 15-25 years) from the 2017-2019 US National Survey of Family Growth (NSFG), comparing sociodemographic characteristics of HPV vaccine recipients versus unvaccinated women. We summarize self-reported probabilities of HPV vaccination in the next 12 months, examining factors linked to vaccination likelihood via bivariate analyses.

RESULTS:
Approximately half (49.9%; n=864/1786) of women reported receiving the vaccine. Among unvaccinated women, 52.1% reported being “not at all likely” to become vaccinated in the next 12 months; only 5% reported being “very likely.” Hispanic (41.4%) and non-Hispanic Black (43.0%) women were less likely to be vaccinated than non-Hispanic White (54.7%) women (P<.01), as were respondents who did not speak English at home (37.3% vs 51.1%, P=.02). Unvaccinated women who had never had sex were less likely to get vaccinated than women reporting prior intercourse (56.4% vs 42.9%, P=.03). HPV vaccination was more common among those with higher education, higher income, health insurance, and those previously tested for sexually transmitted infections (STIs) or a Pap smear (P<.05) in the last 12 months.

CONCLUSION:
The HPV vaccine remains underutilized among young women, particularly among non-English speaking, Hispanic and non-Hispanic Black women and uninsured women. Providers of STI testing and cervical cancer screening should continue offering HPV vaccination, regardless of intercourse history.
Management of Nonrelaxing Pelvic Floor Dysfunction and Pain: Identifying the Gaps [A111]
Authors: Young Riley , Cope Adela , Green Isabel 
Published: June 2022

INTRODUCTION:
Nonrelaxing pelvic floor dysfunction (PFD) is a condition characterized by tension of the pelvic floor musculature, often resulting in pelvic pain. The objective of this study was to review patient-reported pain outcomes following treatment of nonrelaxing pelvic floor dysfunction to identify gaps in current evidence.

METHODS:
A systematic review of the following databases from inception to July 2020 was performed: Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus. Two authors reviewed titles and abstracts for relevance, and full articles were obtained and evaluated for inclusion. Studies were included if they assess interventions for nonrelaxing PFD characterized by pelvic pain. The third author was consulted in instances of disagreement.

RESULTS:
Of the 1,184 abstracts identified and reviewed, 36 full text articles were reviewed. Treatments for nonrelaxing PFD included biofeedback, botulinum toxin injections, electrical stimulation, intravaginal diazepam, massage, osteopathy, psychiatric interview, physical therapy, sacral nerve stimulation, trigger point injection, and combined therapies. Nineteen studies assessed the effectiveness of treatment based on patient reported pain outcomes. All studies demonstrated an improvement in pelvic pain. Several limitations were identified including varied pre-treatment diagnostic evaluation, small sample size, retrospective and single arm design, heterogeneity in treatment administration within and between studies, lack of standardized pain assessments, and limited long term outcome data.

CONCLUSION:
Nonrelaxing PFD is a debilitating condition. There is a paucity of high-quality clinical trials evaluating the effectiveness of pelvic floor muscle dysfunction treatments. Although preliminary studies support multi-modal treatment options, robust trials assessing patient-centered outcomes are necessary.
Endowed Chairs and Professorships: A New Frontier in Gender Equity
Authors: Thorndyke Luanne E. , Milner Robert J. , Jaffe Laurinda A. 
Published: June 2022

Purpose
Endowed chairs and professorships are prestigious and financially important awards that symbolize individual faculty recognition. However, data about the gender distribution of these positions are lacking. The purpose of this study was to examine the gender distribution of endowed positions at U.S. medical schools and identify strategies that have been used to promote investiture of women into these positions.

Method
The authors interrogated the websites for all U.S. medical schools for publicly available data. Of 38 schools that listed schoolwide information, they analyzed data from the 30 with at least 10 endowed positions. Then, they conducted interviews with deans of the 10 schools with the highest percentages of women holding endowed positions (“top 10”) to understand the strategies they used to increase gender equity in this area.

Results
The percentage of endowed positions held by women at the 30 schools analyzed ranged from 10.8% to 34.6%, with a mean of 21.6%. Themes that emerged from interviews with deans included (1) intentionality to identify women candidates in the selection process, (2) monitoring the numbers of women holding endowed positions, (3) inclusion of endowed positions as part of larger institutional goals on gender equity and diversity, (4) use of endowed positions to recruit, retain, and recognize women faculty, (5) purposeful fundraising to increase the number of endowed positions, and (6) institutional investment of resources to develop women faculty.

Conclusions
Analysis of the gender distribution of endowed positions across 30 representative U.S. medical schools revealed a significant gender disparity. Interviews with deans at the top 10 schools revealed strategies that they have used to promote equity in this important area. Implementation of a systematic national reporting process could provide schools with comparative data to gauge their progress.
Treatment Failure in Femoral Neck Fractures in Adults Less Than 50 Years of Age: Analysis of 492 Patients Repaired at 26 North American Trauma Centers
Authors: Collinge Cory A. , Finlay Andrea , Rodriguez-Buitrago Andres , Beltran Michael J. , Mitchell Phillip M. , Mir Hassan R. , Gardner Michael J. , Archdeacon Michael T. , Tornetta Paul ,   on behalf of the Young Femoral Neck Working Group
Published: June 2022

Objectives:
To assess the operative results of femoral neck fractures (FNFs) in young adults in a large multicenter series, specifically focusing on risk factors for treatment failure.

Design:
Large multicenter retrospective cohort series.

Setting:
Twenty-six North American Level 1 trauma centers.

Patients:
Skeletally mature patients younger than 50 years with displaced and nondisplaced FNFs treated between 2005 and 2017.

Intervention:
Operative repair of FNF.

Main outcome measurements:
The main outcome measure is treatment failure: nonunion and/or failed fixation, osteonecrosis, malunion, and need for subsequent major reconstructive surgery (arthroplasty or proximal femoral osteotomy). Logistic regression models were conducted to examine factors associated with treatment failure.

Results:
Of 492 patients with FNFs studied, a major complication and/or subsequent major reconstructive surgery occurred in 45% (52% of 377 displaced fractures and 21% of 115 nondisplaced fractures). Overall, 23% of patients had nonunion/failure of fixation, 12% osteonecrosis type 2b or worse, 15% malunion (>10 mm), and 32% required major reconstructive surgery. Odds of failure were increased with fair-to-poor reduction [odds ratio (OR) = 5.29, 95% confidence interval (CI) = 2.41–13.31], chronic alcohol misuse (OR = 3.08, 95% CI = 1.59–6.38), comminution (OR = 2.63, 95% CI = 1.69–4.13), multiple screw constructs (vs. fixed-angle devices, OR = 1.95, 95% CI = 1.30–2.95), metabolic bone disease (OR = 1.77, 95% CI = 1.17–2.67), and increasing age (OR = 1.03, 95% CI = 1.01–1.06). Women (OR = 0.57, 95% CI = 0.37–0.88), Pauwels angle ≤50 degrees (type 1 or 2; OR = 0.64, 95% CI = 0.41–0.98), or associated femoral shaft fracture (OR = 0.19, 95% CI = 0.10–0.33) had lower odds of failure.

Conclusions:
FNFs in adults <50 years old remain a difficult clinical and surgical problem, with 45% of patients experiencing major complications and 32% undergoing subsequent major reconstructive surgery. Risk factors for complications after treatment of displaced FNFs were numerous.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.