bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between lower parity and low muscle mass in postmenopausal women: data from KNHANES (2010-2011)
Authors: Ahn So Hyun , Kim Heeyon , In Kim Hye , Yun Bo Hyon , Shin Hye Jung , Roh Yun Ho , Chon Seung Joo , Seo Seok Kyo 
Published: September 2022

Abstract

Objective
This study aimed to investigate whether parity is associated with the prevalence of low muscle mass in postmenopausal women.

Methods
This study was performed using data from the 2010-2011 Korean National Health and Nutrition Examination Survey, which included 1,338 postmenopausal women aged 46 to 70 years. The association between parity and low muscle mass was analyzed after adjusting parity, multiparity, age, body mass index, diabetes mellitus, education level, and Homeostatic Model Assessment of Insulin Resistance and using weighted multiple logistic regression analysis. Modifiable risk factors were evaluated in a susceptible population. Low muscle mass was defined as an appendicular skeletal muscle mass index below 2 SDs with a cutoff value of 5.45 kg/m2.

Results
The low muscle mass group (n = 343) had lower parity, lower body mass index, more frequent previous history of diabetes mellitus, higher Homeostatic Model Assessment of Insulin Resistance, and higher education level compared with the non–low muscle mass group (n = 995). After adjusting for the confounding factors, parity with three births or more was associated with a significantly lower odds of postmenopausal low muscle mass than nulliparity (model 1: odds ratio, 0.32; 95% confidence interval, 0.12-0.87; P = 0.03; model 2: odds ratio, 0.27; 95% confidence interval, 0.11-0.67; P < 0.05). In the subgroup analysis of the lower parity group, moderate aerobic activity was associated with a lower low muscle mass prevalence.

Conclusions
A lower parity is associated with increasing the odds of low muscle mass in postmenopausal Korean women. Moderate aerobic activity may be effective in lowering the odds of low muscle mass in postmenopausal women with lower parity.
Behavioral interventions for improving sleep outcomes in menopausal women: a systematic review and meta-analysis
Authors: Lam Christine M. , Hernandez-Galan Leticia , Mbuagbaw Lawrence , Ewusie Joycelyne Efua , Thabane Lehana , Shea Alison K. 
Published: September 2022

Abstract

Importance
Perimenopausal and postmenopausal women commonly report sleep disruption and insomnia. Behavioral interventions may be safe alternatives for patients who are unwilling to begin pharmacological treatments because of adverse effects, contraindications, or personal preference.

Objective
The primary objective is to assess the efficacy of behavioral interventions on sleep outcomes among perimenopausal and postmenopausal women, as measured using standardized scales and objective methods (polysomnography, actigraphy). The secondary objective is to evaluate the safety of these methods through occurrence of adverse events.

Evidence Review
Searches were performed within MEDLINE (OVID interface, 1946 onward), Embase (OVID interface, 1974 onward), Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Web of Science (Core collection) using a search strategy developed in consultation with a health sciences librarian. Title/abstract and full-text screenings were performed in duplicate, and relevant studies were selected based on inclusion and exclusion criteria set to identify randomized controlled trials evaluating the effects of behavioral interventions on sleep quality. Risk of bias assessments were done using the Cochrane Risk of Bias 2 tool, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of the body of evidence. Data were pooled in a meta-analysis using a random-effects model.

Findings
Nineteen articles reporting results from 16 randomized controlled trials were included, representing a total of 2,108 perimenopausal and postmenopausal women. Overall, behavioral interventions showed a statistically significant effect on sleep outcomes (standardized mean difference [SMD], −0.62; 95% confidence interval [CI], −0.88 to −0.35; I
2 = 93.4%). Subgroup analyses revealed that cognitive behavioral therapy (SMD, −0.40; 95% CI, −0.70 to −0.11; I
2 = 72.7%), physical exercise (SMD, −0.57; 95% CI, −0.94 to −0.21; I
2 = 94.0%), and mindfulness/relaxation (SMD, −1.28; 95% CI, −2.20 to −0.37; I
2 = 96.0%) improved sleep, as measured using both subjective (eg, Pittsburg Sleep Quality Index) and objective measures. Low-intensity (SMD, −0.91; 95% CI, −1.59 to −0.24; I
2 = 96.8) and moderate-intensity exercise (SMD, −0.21; 95% CI, −0.34 to −0.08; I
2 = 0.0%) also improved sleep outcomes. No serious adverse events were reported. Overall risk of bias ranged from some concern to serious, and the certainty of the body of evidence was assessed to be of very low quality.

Conclusions and Relevance
This meta-analysis provides evidence that behavioral interventions, specifically, cognitive behavioral therapy, physical exercise, and mindfulness/relaxation, are effective treatments for improving sleep outcomes among perimenopausal and postmenopausal women.
Trends in osteoporosis medication use in US postmenopausal women: analysis of the National Health and Nutrition Examination Survey 1999-2000 through 2017-2018
Authors: Orces Carlos H. 
Published: September 2022

Abstract

Objective
This study aimed to examine trends in the use of osteoporosis medications in postmenopausal women between 1999-2000 and 2017-2018.

Methods
National Health and Nutrition Examination Survey data were analyzed to describe trends in the use of osteoporosis medications in US women 50 years and older. Joinpoint regression software was used to detect points at which significant changes in the direction and magnitude of the trends occurred over time. Logistic regression models adjusted for potential confounders were assembled to determine the independent association between time period (2007-2008 vs 2017-2018) and osteoporosis medication use.

Results
Of 13,826 postmenopausal women, about 7% reported taking osteoporosis medications. Joinpoint regression demonstrated that the prevalence of women taking osteoporosis medications significantly decreased by −23.3% on average (95% confidence interval [CI], −23.3% to −37.7%) per survey cycle between 2007-2008 and 2017-2018. Similarly, bisphosphonate use decreased by −22.6% on average (95% CI, −38.8% to −2.1%) from 2007 to 2008 onward. Logistic regression demonstrated that, after adjustment for potential confounders including bone mineral density and self-reported hip or spine fractures, postmenopausal women were 61% and 56% less likely to use any osteoporosis medications and bisphosphonates in 2017 to 2018 compared with their counterparts in 2007 to 2008, respectively.

Conclusions
The use of osteoporosis medications in postmenopausal US women has significantly decreased since 2007 to 2008 onward. This finding was mostly attributed to a low prescription rate of bisphosphonate drugs. Moreover, the treatment of osteoporosis in postmenopausal women was suboptimal and decreased over time.
How a Faith-Based Healthcare Organization Is Turning the Tide of Environmental Impact
Authors: Cordola Craig 
Published: September 2022

The healthcare sector's role in every community is inextricably linked to the health of those it serves. As research and media reports point to the significant impact of people on our planet's ecosystems, Ascension has responded by setting several environmental sustainability goals. Our work is defined by three pillars:

Net Zero Places focuses on carbon sources associated with Ascension's physical environments—carbon footprint, operational efficiency of facilities, and sustainable transportation.
Responsible Supply Chain focuses on the flow of goods from procurement to disposition—responsible purchasing, product usage management, recycling, and waste management.
Healthy Communities focuses on the relationship between sustainability and social determinants of health (SDOH)—linking determinants to Ascension's mission to sustain and improve the health of those we serve, especially the poor and vulnerable.

When we think about future generations, we realize that this work cannot wait. That is why we are reimagining today what environmental impact and sustainability could look like through the next decade and beyond. We are setting our corporate sights on net zero carbon and zero waste by 2040 and encourage other healthcare organizations to join us in these efforts. Working together, we can make a difference.
Australian cancer nurses’ experiences of burnout
Authors: Parkinson-Zarb Lauren , Duff Cameron , Wang Ying , Mills Jane 
Published: September 2022

Background
Existing studies that seek to understand nurses’ experiences of burnout are dominated by cross-sectional, quantitative survey designs employing predetermined measures, often overlooking important job-related stressors that can be highly dependent on industry and professional contexts. Cancer nurses are a group of professionals who warrant special attention, as burnout in this profession is often attributed to high job demands and the challenge of caring for a vulnerable cohort of patients. A deeper understanding of the job demands associated with cancer nursing is required to provide insights about the work experiences of cancer nurses and identify aspects that mitigate burnout and stress.

Purpose
This study describes the antecedents of burnout among Australian cancer nurses by focusing on the demands and resources inherent in their work. We aim to build on the existing literature by identifying job resources that may serve to mitigate the antecedents of burnout.

Methodology/Approach
An in-depth interview study of cancer nurses across a spectrum of age and experience in Australian metropolitan public health care services was conducted over a 2-year period that coincided with the COVID-19 pandemic. The job demands and resources model framed this study of job-related factors associated with burnout and conversely job resources that may foster work engagement.

Results
Patient aggression, workload, emotional demands, and abusive peers and managers were reported as distinct job demands, whereas job significance and supportive peers who demonstrated leadership, along with task variety, were identified as job resources.

Conclusion
Australian cancer nurses work in an environment where job demands are increasingly disproportionate to job resources, leading to significant risk of burnout.

Practice Implications
Our study identifies modifiable strategies for improving work conditions for this group who play a critical role in the health care system.
Assessment of Alpha Doses Received by Spa Workers Due to the Inhalation of 214Po and 218Po Radon Progeny
Authors: Misdaq M. A. , Ben el fakir M. , Ouguidi J. 
Published: September 2022

Abstract
In Morocco spas are more and more frequented by bathers for massages, body treatments, and aromatherapy and hair services, among others. Alpha-activities due to 222Rn, 220Rn and their progeny have been evaluated inside spa room atmospheres by means of a technique based on using two types of solid-state nuclear track detectors. 222Rn and 220Rn concentrations ranged between (67 ± 5 and 103 ± 7) Bq m−3 and (5.5 ± 0.4 and 9.8 ± 0.7) Bq m−3 for the studied spa rooms, respectively. The influence of ventilation rate in spa rooms on 222Rn and 220Rn concentrations has been studied. Alpha-activities due to the attached and unattached fractions of 214Po and 218Po radon progeny have been evaluated in various compartments of the respiratory system of spa working personnel. It has been shown that the majority of 214Po and 218Po radon progeny are attached to aerosols inside the considered spa rooms. Alpha-doses to the respiratory tract tissues of spa working personnel due to the energy loss of the emitted alpha-particles were evaluated. It has been shown that alpha-doses to the respiratory system of spa working personnel are influenced by exposure time of workers, mass of respiratory system target tissues, and radon concentration inside the studied spa rooms. The largest value of alpha-dose due to the 214Po and 218Po radon progeny from inhalation of air by female workers working 2,080 hours per year in the studied spa rooms was found equal to 5.16 mSv y−1.
Basic Cyber Security Considerations for Licensees of Radioactive Materials and Registrants of Radiation Producing Devices in an Era of Remote or Hybrid Compliance Inspections
Authors: Emery R. J. , Gillum M. D. , Gutierrez J. M. 
Published: September 2022

Abstract
The onset of the COVID pandemic impacted various regulatory agencies’ ability to safely fulfill their regulatory compliance inspection mandates via on-site inspections. Some agencies shifted to a remote or hybrid inspection process, which necessitates the electronic transmittal of a variety of records that may or may not have been transmitted in this fashion in the past, raising concerns about the records being sent and received securely. Considering this new environment, some basic cyber security diagnostic considerations are described for radiation source permit holders to consider prior to responding to an apparent legitimate regulatory inspection request, both in the current COVID cyber risk environment and the environment likely to exist into the future.
Adjuvanted recombinant zoster vaccine decreases herpes zoster-associated pain and the use of pain medication across 3 randomized, placebo-controlled trials
Authors: Kim Joon Hyung , Johnson Robert , Kovac Martina , Cunningham Anthony L. , Amakrane Mohamed , Sullivan Keith M. , Dagnew Alemnew F. , Curran Desmond , Schuind Anne 
Published: September 2022

Abstract
Herpes zoster (HZ) and HZ-associated pain greatly affect patients' quality of life, particularly in older and immunocompromised adults, for whom comorbidities and polypharmacy are often reported. Three phase III, randomized, placebo-controlled clinical trials have reported the adjuvanted recombinant zoster vaccine (RZV) as highly efficacious in preventing HZ and reducing pain severity in healthy adults ≥50 years old (Zoster Efficacy Study [ZOE]-50 study, NCT01165177) and ≥70 years old (ZOE-70; NCT01165229) and in immunocompromised adults ≥18 years old undergoing autologous hematopoietic stem cell transplantation (ZOE-HSCT; NCT01610414). Here, we investigated efficacy of RZV in reducing (i) the duration of clinically significant pain (Zoster Brief Pain Inventory pain score ≥3) and (ii) HZ-associated pain medication use and duration of use in participants with confirmed HZ (“breakthrough cases”) from the 3 studies. Recombinant zoster vaccine effectively reduced the duration of clinically significant HZ-associated pain during HZ episodes by 38.5% (P-value: 0.010) in the ZOE-HSCT study. Although a similar trend was observed in the ZOE-50 and ZOE-70 studies, the results were not statistically significant because of the high vaccine efficacy (VE) against HZ resulting in rare breakthrough cases. VE in reducing pain medication use (39.6%; P-value: 0.008) and duration of medication use (49.3%, P-value: 0.040) was reported in the ZOE-70 study; corresponding positive VE estimates were observed in the ZOE-50 and ZOE-HSCT studies but were not statistically significant. Data reported here demonstrate efficacy of RZV in reducing HZ-associated pain duration and pain medication use in breakthrough cases, thereby improving quality of life of those with HZ.
Microdosing psilocybin for chronic pain: a case series
Authors: Lyes Matthew , Yang Kevin H. , Castellanos Joel , Furnish Timothy 
Published: September 2022

Abstract
Psychedelic serotonergic agonists such as psilocybin have recently been shown to produce sustained benefit in refractory depression, end of life anxiety, and addiction when administered in hallucinogenic doses and coupled with psychotherapy. Although it has been suggested that similar high-dose protocols may help chronic pain conditions, there are few published clinical trials of psychedelics for pain. The use of these agents in subpsychedelic doses for chronic pain management has received even less attention. This case series details the experiences of 3 individuals who have used low-dose psilocybin to manage chronic neuropathic pain. Although the nature and etiology of each patient's pain vary, they share a common experience, including inefficacy of current therapeutics and decreased quality of life. Through self-administration of psilocybin, these patients have achieved robust pain relief with decreased reliance on traditional analgesic medications. Despite varying preparations and uncertain potencies, the analgesic effects for all 3 patients occurred at doses without a psychedelic experience and with minimal cognitive or somatic adverse effects. Furthermore, the efficacy of pain relief and, in some cases, the duration of the effect were magnified when coupled with functional exercise. In addition, in 1 case, repeated dosing seemed to produce increased relief, suggesting a possible long-term plasticity-mediated effect. These commonalities highlight psilocybin's therapeutic potential in the treatment of chronic pain that warrants further investigation.
O-arm CT for Confirmation of Successful Navigation During Robotic Assisted Bronchoscopy
Authors: Chambers Jefferson , Knox Daniel , Leclair Timothy 
Published: September 2022

Background:
Robotic assisted bronchoscopy (RAB) is designed to increase bronchoscopic accessibility for difficult to reach pulmonary lesions. One limitation to success of RAB is computed tomography (CT) to body divergence. Real time imaging with cone beam CT is increasingly utilized for confirmation of correct navigation and tool-in-lesion during RAB. O-arm CT is a 3-dimensional imaging modality, which has not previously been described for use with RAB. Our purpose is to display the feasibility, ease of use, and high rate of confirmation of tool-in-lesion when using O-arm CT during RAB.

Methods:
Single center, retrospective review of 75 patients undergoing RAB with intraprocedural use of O-arm CT.

Results:
Median patient age was 65 years. Forty-nine percent of cases involved nodules ≤2 cm. Bronchus sign was absent in 44% of cases. Median procedure time was 80 minutes. Median number of O-arm CT runs per case was 2. The median effective dose of radiation was 7.2 millisieverts. Tool-in-lesion was confirmed in 97% (77 of 79) of cases. Definitive diagnosis was reached in 61 to 68 of 79 cases (77% to 86%). There were 2 cases of pneumothorax (2.5%), one of which needed intervention with tube thoracostomy.

Conclusions:
O-arm CT is an effective, and convenient alternative to other 3-dimensional imaging modalities for intraprocedural confirmation of tool-in-lesion during RAB.
The Quality of Care Delivered in a Simulation Center
Authors: Maguire Mary Beth R. , White Anne , Brown Austin 
Published: September 2022

Background:
A standardized survey to describe the quality of care received from prelicensure nursing students during simulation can measure simulation program effectiveness.

Purpose:
The purpose of this study was to compare national Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data with data received from standardized patients (SPs) using a modified HCAHPS survey.

Methods:
SPs completed a modified HCAHPS survey immediately following each in-person simulated encounter. One year of SP responses (N = 385) from one baccalaureate nursing program was compared with the national HCAHPS survey data from the same time.

Results:
All SP responses were less than the national proportions. However, when the level of stringency was adjusted, the responses more similarly aligned to the national proportions.

Conclusions:
Findings suggest HCAHPS data can be used to model correlates of the quality of care SPs receive during simulation events.
Topical Review: Contact Lens Eye Health and Safety Considerations in Government Policy Development
Authors: Lakkis Carol , Lorenz Kathrine Osborn , Mayers Michael 
Published: September 2022

SIGNIFICANCE
As new federal or state policies are introduced in the United States to shape the evolving contact lens market, it has never been more important to amplify the importance of patient health and safety during contact lens wear and promote the value of the eye care professional–patient relationship.
Within the United States, contact lenses are regulated by the Food and Drug Administration as class II or III medical devices that require additional regulatory and professional oversight to keep consumers safe. The contact lens market and broader eye health landscape are rapidly changing. Recently, the U.S. Federal Trade Commission finalized its 10-year review of the Contact Lens Rule, implementing new policies that will shape the contact lens market in the United States for years to come. The purpose of this clinical perspective was to compile and review key data regarding contact lens–related adverse events, including their economic impact on the health care system, to inform government policy development. Although contact lenses provide many benefits to the wearer, a variety of complications can occur ranging from asymptomatic events or mild discomfort to severe sight-threatening adverse events such as microbial keratitis. Patients who do not routinely visit their eye care professional or do not receive the lenses prescribed to them are at a greater risk of contact lens–related adverse events. Nearly 1 million people in the United States experience ocular infections or inflammation annually, resulting in significant health care costs. The economic burden of contact lens–related microbial keratitis in the United States has been estimated to be approximately $175 million annually. The importance of eye care professional oversight of contact lens wear cannot be emphasized enough to key stakeholders, including lawmakers, government regulators, contact lens manufacturers and distributors, and the broader eye health community.