BACKGROUND: The revised Patients\' Attitudes Towards Deprescribing (rPATD) questionnaire was developed to capture beliefs and perceptions of patients about deprescribing. In general, handling of missing data is underreported in survey studies. Underlying mechanisms related to missing data may impact the findings from survey studies.
OBJECTIVE: The aim of this study was to assess the missing data in studies using the rPATD questionnaire through a systematic review and datasets from two studies.
METHODS: First, this review updated a systematic review on the rPATD (and other versions). We searched Medline via OVID, EMBASE, Scopus, Web of Science until 31st January 2023. Missing data reporting and methods to handle them were collected. Second, data from two deprescribing studies were analyzed using three methods of missing data handling: complete case analysis, personal mean substitution, and multiple imputation. We compared the scores from each domain and the associations of the domains with two questions from the rPATD to highlight how using different methods can influence the interpretation of study findings.
RESULTS: We identified 49 studies: 31 (63 %) from this study and 18 (37 %) from the original systematic review. The question or domain with the most missing data could be identified in 9 studies (18.4 %). Missing data management was reported in 19 studies (38.8 %). In one case analysis, the \"Burden\" domain was significantly associated with the question \"I would like to try stopping one of my medicines to see how I feel without it\" using complete case analysis (p = 0.044) or multiple imputation (p = 0.038), but not when using personal mean substitution (p = 0.057).
CONCLUSIONS: Missing data and methods used to handle missing data were underreported in studies using the rPATD questionnaire. The methods should be chosen carefully as our analyses from two distinct studies suggest that they may impact the interpretation of the findings from the questionnaire.

The International Lymphoma Radiation Oncology Group (ILROG) defined involved-site radiotherapy (ISRT) guidelines. These rules offer a certain variability that allows for autonomous decision-making in diverse clinical settings. However, this flexibility also gives rise to conflicts about the selection of treatment fields in the daily decision-making process. The aim of this study was to show the extent of interobserver variability when ILROG-ISRT recommendations were used in different clinical scenarios.
The 10-question survey used in our study consisted of two parts (part A and part B) and was prepared by four senior radiation oncologists experienced in the haemato-oncology field. The results were presented by stratifying according to clinical experience (<10 years, ≥10 years). Binomial tests (one-sided) were conducted to assess whether answers for each group and the whole group reached a consensus.
Twenty-six radiation oncologists, 13 of whom had less than 10 years of experience and 13 seniors, participated in the survey. Eighty per cent of respondents thought ILROG did not bring sufficient solutions for all clinical scenarios but offered solutions in some cases. In different case-based scenarios, the consensus among the respondents decreased down to 38%. Senior radiation oncologists were found to have more doubts about the adequacy of current guidelines.
ILROG guidelines allow for a high degree of variability in real-life clinical scenarios and different interpretation of the recommendations may lead to increased toxicity and recurrences. Therefore, there is a need for refinement in ISRT delineation strategies. On behalf of the Turkish Society for Radiation Oncology Hematological Oncology, Pediatric Oncology and TBI Study Group, we are planning to carry out further educational contouring sessions to detect the interobserver variability in real-life contouring cases.

OBJECTIVE: To enhance evidence-based knowledge on long-term sequalae in patients with surgically corrected obstructing Müllerian anomalies.
METHODS: This long-term case-control study included patients with menstrual outflow obstruction due to congenital anomalies of the uterus or vagina, who were at least 18 years old, and for whom 2 years had elapsed since the first surgery at the start of this study. The control group consisted of women without current gynecological problems. Patients underwent a surgical correction at the Radboud University Medical Center Nijmegen between 1980 and 2013. Of 78 patients approached, 38 (49%) were included in this study. The control group consisted of 54 females. The main outcome measures were pain and health state. The following questionnaires were used: Visual Analogue Scale pain scores, European Quality of Life-5 Dimensions questionnaire (EQ-5D-3L) and the adapted Endometriosis Health Profile questionnaire (EHP-30).
RESULTS: Patients had higher actual and maximum abdominal pain scores compared with controls (11 vs 0 [P = 0.007] and 48 vs 21 [P = 0.035], respectively). Based on the EQ-5D-3L scores, patients had more pain and discomfort (P = 0.005), more mood problems (P = 0.023), and a poorer subjective health state (P = 0.002) and self-rated health state (P = 0.031). Based on the EHP-30, patients had a significant poorer self-rated health state on four out of five subscales.
CONCLUSIONS: In this study, following surgically corrected menstrual obstruction, patients had statistically significant higher abdominal pain scores and a poorer self-rated health state compared with controls.

Cortaderia selloana (pampas grass), native to South America, is a widespread invasive plant in several regions of the World, including the south of the Atlantic Arc (Europe), where it has been used as an ornamental species. Citizens may help to spread it, e.g., planting it in their gardens, but on the other hand, when they are aware of its invasiveness, can contribute to control it and prevent its spread. An online survey was performed to better understand the perception and knowledge of Portuguese and Spanish citizens, regarding pampas grass. The influence of education and occupation, along with age, gender and country of residence, on the knowledge and perceptions of respondents was analysed. The questionnaire was answered by 486 and 839 citizens in Portugal (PT) and Spain (ES), respectively. Most respondents were between 41 and 64 years old, mostly women in Portugal and equally women and men in Spain, with higher education and working mostly in the services sector. The majority of respondents in both countries recognized the plant, knew it is invasive and were able to name it, alerting to a possible bias of the target audience toward citizens already aware of the invasiveness of the pampas grass. Fewer respondents were aware of the legislation that limits its use, and most were unable to identify particular characteristics of the species. The results showed that respondents\' occupation in PT and education in ES influenced their knowledge and perception about pampas grass. This study confirms that education and raising awareness regarding invasive species is of utmost importance, as respondents identified academic training and projects with a strong focus on public awareness as the main sources of knowledge regarding pampas grass. Better informed citizens can be part of the solution rather than part of the problem, especially regarding invasive species with such ornamental interest as pampas grass.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s10530-023-03025-3.

BACKGROUND: Foot health problems can affect quality of life and general health producing a source of discomfort and pain. Low levels of foot health-related quality of life (HRQoL) are present in patients with foot disabilities, such as hallux valgus, plantar fasciitis, or minor toe deformities.
OBJECTIVE: The objective was to analyze the foot health status in patients with and without foot problems in a rural population and its relationship with quality of life.
METHODS: A prospective case-control study was developed with a sample of 152 patients, 76 subjects with podiatric pathologies and 76 without, in a rural population. HRQoL was measured through the SF-36 Health Questionnaire in the Spanish version.
RESULTS: The case group had a mean age of 49.18 ± 14.96 and the control group 44.16 ± 11.79. Regarding the score of the lowest levels of quality of life related to foot problems, the case group compared to the controls showed: for physical function (79.86 ± 26.38 vs. 92.63 ± 11 0.17, p < 0.001); for the physical role (73.68 ± 41.00 vs. 88.48 ± 27.51, p < 0.0022); for body pain (45.81 ± 27.18 vs. 73.68 ± 41.00, p < 0.035); and for general health (60.36 ± 30.58 vs. 68.71 ± 18.52, p < 0.047). The differences between groups were analyzed using the Mann-Whitney U test, which showed statistical significance (P < 0.05).
CONCLUSIONS: In the rural population, people with foot pathologies present a worse quality of life compared to those who do not present foot pathology, especially for the health domains: physical function, physical role, body pain and health general.

Forest degradation is a major issue worldwide. The study area, situated in the lower Himalayan foothills of northern India, is also witnessing the same. A ground survey of the area revealed that socio-economic factors are a major cause of forest degradation. Therefore, sustainable forest management is required to maintain forest resources and health. This study aims to develop the most suitable and agreeable alternatives for ensuring the sustainability of forest use, increase economic benefits, and improve the living conditions of the people surrounding the forest area. This study uses the analytical hierarchy process (AHP) as a decision-making method. A pre-test was conducted prior to the main survey, which helped validate the questionnaires and deliver more reliable survey responses. The authors identified three criteria (C) and nine indicators (I).The pre-tested criteria and indicators arranged in hierarchical order were prioritized by applying the AHP. A list of 36 alternatives (A) was prepared in ascending order to select the best alternatives and was used to make suitable judgments for enhancing forest management efficiency. C, I, and A were developed based on a literature review, pre-test, and questionnaire-based field survey that recorded the preferences of different stakeholders. The survey was conducted in 77 fringe villages surrounding the forest and responses were collected from 302 respondents. The overall AHP implementation was simplified using \"Super Decisions.\" The results advocate adopting valid options such as afforestation, agro-forestry, plantation, forest boundary demarcation, capital investment, and others to strengthen the sustainable development of the region. Furthermore, some of the major findings were shared with decision-making authorities (forest officials and village representatives). The stakeholders realized the need to accelerate participatory forest management practices, capacity building, and training of the local populations, together with other options to improve their livelihoods.

BACKGROUND: Digital dermatitis (DD) is a contagious bovine foot disease causing painful lesions, lameness, and reduced animal welfare. Previous studies indicate a complex aetiology of the disease. The aim of this study was to compare DD negative and DD positive herds to identify factors associated with DD in Norwegian dairy herds by analysing data obtained in a questionnaire and data recorded in the Norwegian Dairy Herd Recording System (NDHRS). The questionnaire was e-mailed to the owners of all 380 herds recorded with DD in 2019 and to 1530 randomly selected herds with no recordings of DD. Altogether 559 dairy herds were included in the final study population, of which 113 was classified as DD positive (≥ one cow recorded with DD in NDHRS) and 446 as DD negative. When stratified by housing system, the ratio between DD positive and negative herds was 108/281 in free stalls and 5/165 in tie stalls. Multilevel logistic regression was used to model the association between potential risk factors and variables related to the detection and diagnosis of DD, and the outcome in the free-stall population. Geographical area (county) was included in the model as a random effect.
RESULTS: In the final study population 108/113 (96%) of the DD positive herds were housed in free stalls versus 5/113 (4%) in tie stalls. The free-stall herds\' DD status was associated with purchase of cattle during the last 5 years (baseline: 0 animals, OR = 2.30 for category 12-27 animals, OR = 4.34 for 28-52 animals, and OR = 5.39 for  ≥ 53 animals). The DD status was also associated with claw trimming frequency (Baseline: 1 < 2/year, OR = 0.41 for category  < 1/year, and OR = 4.09 for  ≥ 3/year), whether the claw trimming was done by a certified professional trimmer or not (baseline:  ≤ 90% of the cows, OR = 3.98 for category  ≥ 90% of the cows), cleaning of feet in the chute before trimming (baseline: no cleaning, OR = 1.98 for category cleaning), and alley flooring (baseline: slatted floor, OR = 2.36 for category solid floor).
CONCLUSIONS: Digital dermatitis was far more frequent in Norwegian dairy herds housed in free stalls versus those housed in tie stalls. In the free-stall herds purchase of cattle, increasing trimming frequency, use of certified professional trimmer, cleaning of the feet in the chute, and solid flooring in the alleys were associated with increased odds of recorded DD.

Bilateral amputees are disadvantaged as they lack healthy leg support. We present the rare case of a bilateral transtibial amputee (BTA), in which we compared the first South Korean-made microprocessor-controlled prosthesis (MPA) to a conventional prosthetic ankle (CPA) with gait analysis and a patient questionnaire for long-term outcomes. A 70-year-old man presented with bilateral transtibial amputations from injury. Assessments were performed after wearing an MPA for 1 month and 1 year with three-dimensional gait analysis. Satisfaction, mobility, and pain were evaluated using the Korean version of the Prostheses Evaluation Questionnaire (K-PEQ). The spatiotemporal parameters of both sides showed increased stability from the CPA to 1 month (mMPA) and 1 year (yMPA). We observed an increased single support time, decreased step width, and almost normal stance-swing time ratio. In kinematic parameters, the ankle range of motion (ROM) was bilaterally increased at mMPA and yMPA. Unfortunately, the MPA gait showed insufficient ankle plantarflexion during the terminal stance that failed to generate push-up power. As the MPA adaptation time increased, the symmetry ratio improved to a balanced value. The questionnaire-based investigations of satisfaction, mobility, and pain revealed excellent results. The MPA proved helpful for ankle mobility in the BTA, and the questionnaire showed good satisfaction and mobility in varied terrain.

Clitoral adhesions are characterized by adherence of preputial tissue to the glans clitoris and can be managed using a non-surgical approach in order to relieve symptoms of sexual dysfunction.
To evaluate efficacy and patient satisfaction associated with the non-surgical lysis procedure in order to determine if it is an appropriate treatment for symptomatic clitoral adhesions.
The non-surgical lysis procedure is performed by using a fine Jacobsen mosquito forceps to separate the plane between the prepuce and the glans of the clitoris, removing smegma and/or keratin pearls from underneath the adhesions and allowing for visualization of the entire glans. A chart review of 61 women that were treated for clitoral adhesions using the non-surgical lysis procedure at 1 sexual medicine practice was performed and an online survey was sent to these patients.
Encrypted survey responses were used to evaluate patient satisfaction as well as self-reported improvement in sexual functioning and pain before and after the procedure.
41 survey responses were received out of 61 eligible (67% response rate). A large majority reported improvement in pain (76%), sexual arousal (63%), and ability to achieve orgasm (64%) and no participants reported worsening in these symptoms. Of the 16 women that reported the inability to orgasm from external clitoral stimulation prior to the procedure, 6 (38%) were able to do so afterwards. Seventy-one percent of respondents reported improvement in their satisfaction with sex and 83% reported being satisfied with their decision to have the procedure. Ninety-three percent of participants reported that they would recommend this procedure to a friend with clitoral adhesions.
The results of this study will help clinicians to recognize the non-surgical lysis procedure as a treatment option for clitoral adhesions.
This study is the first of its kind assessing a cohort of patients undergoing the non-surgical lysis procedure for clitoral adhesions. Its limitations include a small sample size from 1 clinic and lack of validated instrument to evaluate sexual function and pain before and after the procedure.
Providers should regularly examine the clitoris of patients with symptoms of sexual dysfunction in order to determine if they have clitoral adhesions. The non-surgical lysis procedure may be a viable therapeutic option for these patients that has demonstrated both satisfaction and symptom relief. Myers MC, Romanello JP, Nico E, et al. A Retrospective Case Series on Patient Satisfaction and Efficacy of Non-Surgical Lysis of Clitoral Adhesions. J Sex Med 2022;19:1412-1420.

[This corrects the article DOI: 10.3389/fnut.2022.845030.].