Treatment Techniques Research Articles

Identifying behavior change techniques (BCTs) in responsive feeding interventions to prevent childhood obesity-A systematic review.

Complex interventions that include responsive infant feeding components can potentially prevent childhood obesity. To develop a replicable responsive feeding intervention, an understanding of the most effective behavior change techniques (BCTs) and theory is needed. To identify the BCTs and theories used in interventions with responsive feeding components for caregivers of children ≤2 years. PsycINFO, CINAHL, Cochrane Library, EMBASE, and MIDIRS were searched from inception to May 2023. Studies of obesity prevention interventions with a responsive feeding component were included. BCT Taxonomy Version 1 and Michie and Prestwich theory coding method were applied. Eighteen interventions were identified; the number of BCTs ranged from 3 to 11 (mean = 5.5). The most used BCTs were "Instruction on how to perform a behaviour" (17/18) and "Adding objects to the environment" (13/18), which were commonly used in the nine trials demonstrating higher responsive feeding behaviours and the four trials reporting reduced likelihood of overweight or obesity, or rapid weight gain. Fifteen trials reported use of theory. BCT use was low in interventions with responsive feeding components. BCTs are replicable; their use in interventions, alongside theory, will ensure that key determinants of responsive feeding behavior are included in future obesity prevention interventions.

From Tradition to Innovation: An In-Depth Review of Manganese Removal Techniques in Water Treatment

Contamination of water is currently one of the alarming issues all around the planet. Water that is contaminated with manganese (Mn) could potentially give rise to functional and aesthetic complications. Removal of manganese is critical and often has substantial implications for the layout of treatment trains. Precipitation, ion exchange, depth filtration, oxidation, adsorption, biosorption, and biological methods are the traditional chemical, physical, and biological processes for removing Mn (II) from contaminated water. All these treatment processes have some advantages and disadvantages and are based on which the implementation of any process varies. In recent years, the use of biofiltration to eliminate manganese (Mn) from water has grown owing to the progress made in molecular techniques for studying microorganisms found in biological Mn elimination systems. This study aims to contribute to the existing research on Mn occurrence and highlight the historical and current removal strategies used in drinking water treatment. The main objective is to assist future researchers in developing more efficient technologies and clarify the subject matter.

Interventional Management of a Rare Case of Complex Congenital Heart Disease in an Adult Patient: A Case Report

Congenital heart disease (CHD), which accounts for about one-third of all congenital defects and affects approximately 1% of all live births worldwide, has maintained a stable incidence rate while experiencing a decrease in mortality rates since 1990. Despite advancements in fetal cardiac ultrasound examinations and routine pulse oximetry screening of newborns, a significant proportion of CHD patients may still be undiagnosed until adulthood. This oversight can lead to considerable morbidity and mortality due to physical limitations and reduced quality of life. In this case report, we describe a 29-year-old woman who was initially misdiagnosed as having an inoperable case of CHD and was referred to our center with symptoms of palpitations and exertional dyspnea. During her evaluation, she was diagnosed with severe pulmonary hypertension associated with patent ductus arteriosus (PDA), pre-ductal aortic coarctation, ventricular septal defect (VSD), and bicuspid aortic valve, all of which had been overlooked since infancy. Following initial medical treatment for pulmonary hypertension, a simultaneous transcatheter approach was employed, during which the PDA was closed using an occluder device, and the coarctation was repaired concurrently with a self-expanding stent. Eight months later, her VSD was successfully closed using a muscular VSD occluder device through an interventional technique. This case underscores the importance of adult CHD fellowship training, which enables cardiologists specializing in this field to accurately diagnose and treat complex cases of CHD that may have been missed during infancy and early childhood. This timely intervention ultimately led to the complete relief of her symptoms and prevented progression to Eisenmenger syndrome.

Ultraflat Cu(111) foils by surface acoustic wave-assisted annealing

Ultraflat metal foils are essential for semiconductor nanoelectronics applications and nanomaterial epitaxial growth. Numerous efforts have been devoted to metal surface engineering studies in the past decades. However, various challenges persist, including size limitations, polishing non-uniformities, and undesired contaminants. Thus, further exploration of advanced metal surface treatment techniques is essential. Here, we report a physical strategy that utilizes surface acoustic wave assisted annealing to flatten metal foils by eliminating the surface steps, eventually transforming commercial rough metal foils into ultraflat substrates. Large-area, high-quality, smooth 2D materials, including graphene and hexagonal boron nitride (hBN), were successfully grown on the resulting flat metal substrates. Further investigation into the oxidation of 2D-material-coated metal foils, both rough and flat, revealed that the hBN-coated flat metal foil exhibits enhanced anti-corrosion properties. Molecular dynamics simulations and density functional theory validate our experimental observations.

Efficacy of gastric per-oral endoscopic myotomy remains similar after failure of interventional techniques in refractory gastroparesis

Background and aimsGastric per-oral endoscopic myotomy (G-POEM) is a new therapeutic option for the treatment of refractory gastroparesis. However, the outcome of G-POEM after the failure of gastric electrical stimulation (GES) or other pylorus-targeting therapies has been poorly reported. MethodsData were collected from patients referred for G-POEM for refractory gastroparesis. The efficacy in patients with previous interventional techniques was compared to patients naïve to instrumental technique. The primary endpoint was the 6-month clinical success rate, defined as at least a 1-point decrease in the Gastroparesis Cardinal Symptom Index (GCSI). ResultsAmong 48 patients referred for G-POEM, 32 patients had had previous instrumental treatments (66%): 15 (31%) had had GES, and 17 (35%) had had pyloric endoscopic dilation or toxin injection. The technical success rate was 100%. At 6 months, clinical success was achieved in 25/48 patients (52%) and the GCSI decreased from 3.38 (2.94–3.95) to 2.25 (1.11–3.36) (p < 0.001). The 6-month success rate was similar in patients with or without previous instrumental treatment (50.0% vs 56.3%; p = 0.41). The complication rate was also similar in the two groups (6.3% vs 12.5%; p = 0.59), with only one severe adverse event. The only predictive factor for success at 6 months was a higher body mass index (OR = 1.14 [1.01–1.32]; p = 0.05). ConclusionG-POEM is safe and remains effective after GES or previous pyloric treatment failure, with 50% efficacy at 6 months. The therapeutic strategy in refractory gastroparesis remains to be defined.

Approximate P3 equation analysis in multi-layer slab media: steady-state and time-domain based on the diffusion model

This study aimed to establish a steady-state and time-domain solutions for the approximate P3 equation in arbitrary multi-layer slab media for light propagation, based on a diffusion model with an isotropic point source in the first layer and extrapolated boundary conditions. Spatially resolved diffuse reflectance and transmittance were calculated using the steady-state approximation of the P3 equation, whereas temporally resolved diffuse reflectance and transmittance were derived from the time-domain approximation. The validity of the approximate P3 solutions was confirmed by comparing their results with Monte Carlo simulations. In steady-state analysis, the approximate P3 equation demonstrated superior accuracy to the diffusion equation for reflectance, particularly at smaller thicknesses. Accuracy further improved as the absorption coefficient and detection distance increased. For transmittance, the approximate P3 equation closely matched the diffusion equation at low thickness, but divergence occurred with higher absorption. In time-domain analysis, the approximate P3 equation aligned closely with Monte Carlo simulations at peak values, while its numerical values were close approximations of the diffusion equation away from the peak. The potential application of the approximate P3 equation in multi-layer media offers significant advancements for optical non-invasive detection and treatment techniques, enabling the extraction of optical parameters from such media.

Integrated respiratory toxicity of municipal wastewater to human bronchial epithelial cells and 3D bronchospheres

Respiratory symptoms have been reported in wastewater treatment workers and residents living close to sewage treatment plant. However, toxicological research about the respiratory hazards of municipal wastewater is scarce. The present study aims to gain insight into the comprehensive respiratory hazards induced by the contaminant mixtures in municipal wastewater. The integrated respiratory hazards of effluents from four secondary wastewater treatment plants (SWTPs), a tertiary wastewater treatment plant (TTP), and a constructed wetland (CW) were evaluated using normal human bronchial epithelial cells (NHBE) bioassay, and toxicity reduction efficiency of various treatment techniques was analyzed. Effluents caused cytotoxicity, oxidative damage, inflammation response with the increased levels of IL-6 and CXCL8, and impaired barrier integrity with decreased expressions of ZO-1 and occludin in NHBE. Further, the effluents inhibited the development of 3D bronchospheres, increased irregular surface and cell debris, and suppressed the formation of luminal structures. TTP E effluent significantly increased the expression of MUC5AC in bronchospheres. The integrated biomarker response (IBR) of the influent was removed by 40.2% at SWTPs, 18.2% at TTP, and 36.6% at CW, respectively. The IBR of the final effluents from SWTPs, TTP, and CW were 7.2, 7.7, and 7.7, respectively. Significant correlation with toxicity biomarkers was frequently observed for stearyl alcohol, o-cresol, phenanthrene, butylated hydroxytoluene, and dimethyl phthalate. The present study provided human relevant evidence concerning the adverse respiratory effects associated with discharge. The necessity for deep water treatment, performance optimization, and the potential means were suggested for improving water quality and protecting respiratory health.

Construction of piezoelectric fenton-like system over BaTiO3/α-FeOOH for highly efficient degradation of demethylchlortetracycline

Heterogeneous Fenton-like system is a promising technique for wastewater treatment, while Fe2+ regeneration limits its degradation efficiency. Piezoelectric materials can produce free electrons under mechanical stress. Based on this, a piezoelectric Fenton-like system coupling piezoelectric effect and Fenton-like reaction was proposed. Composite material BaTiO3/α-FeOOH was synthesized by sol–gel and hydrothermal method. Under ultrasonic vibration BaTiO3 continuously generated free electrons, which reduced Fe3+ to Fe2+ and realized Fe3+/Fe2+ cycle. The piezoelectric Fenton-like system based on BaTiO3/α-FeOOH was used to remove demethylchlortetracycline (DMCT) from water. The degradation ratio of DMCT can reach 100 % within 5 min, and the coupled system exhibited excellent adaptability and stability. Free radical capture and quantitative detection determined that •OH and •O2− were the main active oxygen species. A comprehensive catalytic mechanism was proposed and supported by energy band structure analysis, finite element method simulation, and Density Functional Theory (DFT) simulation calculations. The piezoelectric electrons generated by BaTiO3 were transfered to α-FeOOH to improve the Fe3+/Fe2+ cycle. In addition, the possible degradation mechanism of DMCT was proposed through Ultra Pressure Liquid Chromatography-Mass Spectrometry (UPLC-MS) measurement and DFT calculation, and the overall pollution toxicity of DMCT was assessed according to toxicity prediction. Overall, this work provided a new insight on coupling effect between piezoelectric effect and Fenton-like reaction.

Enhancing fire performance of glulam beams through thermal treatment, inorganic impregnation, and densification techniques

The present research investigates a novel, environmentally benign modification method for improving the fire performance of Chinese fir that grows quickly and at low density. This wood is known for its susceptibility to burning and rapid loss of load-bearing capacity in fires. After thermal treatment, inorganic impregnation, and densification, Chinese fir was utilized as the fire-exposure surface for glulam beams. Three sides of full-size members were subjected to fire tests lasting 60 and 90 minutes. Considering the gluelines' thermal conductivity, the improved glulam beams' fire performance was thoroughly evaluated using the finite element program ABAQUS. The study found that the composite modification approach enhanced the weight percentage and mass density of the wood laminates by 32.53 % and 67.87 %, respectively. After 60 min of fire exposure, the charring rates on the exposed surface of the members with the modified laminates were 13.5 % and 27.8 % lower than those of standard glulam beams, indicating a considerable improvement in fire resistance. Greater post-fire residual cross-sectional area and improved fire resistance performance were correlated with an increase in the quantity of modified laminates. The composite modified glulam beams showed a noticeable temperature gradient, which was explained by higher density and specific heat capacity and consequently improved overall fire resistance, according to finite element analysis. The corner effect on the glulam beam cross-section became more evident with prolonged heating, while the gluelines had minimal impact on overall heat transfer.

Biomechanical Analysis of a Modified Triangular Osteosynthesis Technique for Treatment of Spinopelvic Dissociation.

The purpose of this study was to evaluate the biomechanical stability of a modified triangular osteosynthesis construct with S1 pedicle screws compared with other described lumbopelvic fixation constructs in a U-type sacral fracture model. U-type sacral fractures were created in validated fourth-generation spinopelvic models. Four different constructs were cyclically loaded with displacement measured in all planes: (1) bilateral L5 pedicle screws with rods attached to iliac bolts, (2) bilateral L5 and S1 pedicle screws with rods attached to iliac bolts, (3) bilateral L5 pedicle screws with rods attached to iliac bolts with a transsacral-transiliac screw, and (4) bilateral L5 and S1 pedicle screws with rods attached to iliac bolts with a transsacral-transiliac screw. The bilateral L5 and S1 pedicle screws with rods attached to iliac bolts with a transsacral-transiliac screw construct had significantly decreased horizontal, vertical, and angular displacement compared with all other constructs. From a biomechanical perspective, a modified triangular osteosynthesis construct with S1 pedicle screws improves stability in fixation of U-type sacral fractures.

Correction: Ultrasonic surface treatment techniques based on cold working: a review

Correction: Ultrasonic surface treatment techniques based on cold working: a review

Clinical outcomes and prognostic factors in patients with nasolacrimal duct obstruction or stenosis using dacryoendoscopy.

To evaluate the effectiveness of dacryoendoscopic-assisted laser dacryoplasty with silicone intubation (DLDI) for the management of nasolacrimal duct obstruction (NLDO) or stenosis, and to identify the factors associated with DLDI failure. This study was designed as a prospective, single-centre cohort study. Patients with NLDO or stenosis who underwent DLDI from December 2019 to December 2021 at Tianjin Eye Hospital were considered for enrolment. The Kaplan-Meier estimator was used to assess the anatomical and functional success rate of DLDI within 2 years follow-up after removal of the silicone stent. Cox proportional hazards regression models were used to identify risk factors for treatment failure. 170, 174 and 178 eyes were included in Groups A (proximal NLDO), B (distal NLDO) and C (nasolacrimal duct stenosis), respectively. The overall anatomical success rate was 84.8% for the entire cohort at the 2-year follow-up. The cumulative anatomical or functional success rate for Groups B and C was significantly higher than that for Group A. In the multivariable model, a higher risk of failed DLDI surgery was associated with a history of chronic dacryocystitis (HR=3.07; p<0.001) and a longer duration of epiphora than 1 year (HR=2.67; p<0.001). Of the 522 eyes, 37 patients (7.1%) had surgery-related complications. DLDI is an effective minimally invasive technique for treatment in patients with distal NLDO or stenosis. Factors associated with a higher risk of reoperation include a longer duration of epiphora and a history of chronic dacryocystitis. NCT05999058.

Correlations between patient-specific parameters and dosimetric indices for personalized breast cancer radiotherapy

Treatment planning parameters in radiotherapy are key elements that dictate the success of treatment outcome. While some parameters are commonly evaluated irrespective of cancer type, others are site-dependent and strongly patient specific. Given the critical influence of planning parameters on personalized therapy, the aim of this study was to evaluate the correlations between the dosimetric indices (conformity, homogeneity and mismatch indices) related to tumor coverage and the patient-specific parameters which encompass parameters pertaining to organs at risk (widths and lengths of heart and ipsilateral lung included in treatment fields, mean/maximum doses to heart, ipsilateral lung, left anterior descending aorta and contralateral breast) and tumor volume. Forty breast cancer patients were divided into two groups according to tumor location: twenty with left-sided (group A) and twenty with right-sided breast cancer (group B). Conformal (3DCRT), intensity modulated (IMRT) and volumetric arc modulated (VMAT) radiotherapy techniques were used for plan creation. Moderate to strong correlations were found for ipsilateral lung parameters for both groups of patients regardless of the treatment technique. Moderate to strong correlations were found for heart parameters in group A patients, while no correlations were observed in group B. The mismatch index presented moderate to strong correlations with tumor volume for all treatment techniques (r = -0.861 3DCRT, r = -0.556 IMRT, r = -0.533 VMAT) particularly in group A. The evaluated correlations indicate the role of dosimetric indices in personalized treatment planning.

A modified approach to portal placement for arthroscopic management of osteochondritis dissecans lesions of the tarsocrural joint in 15 dogs (19 tarsi).

To describe the surgical technique and outcomes of arthroscopic treatment for talar osteochondritis dissecans (OCD) in dogs, using scope and instrument portals placed on the same side of the joint as the lesion. Retrospective case series. Fifteen client-owned dogs (19 tarsi). The records of dogs with talar OCD lesions managed by arthroscopy using this modified approach to portal placement were reviewed. Signalment, owner-completed questionnaires-the Canine Brief Pain Inventory (CBPI) and a visual analog scale (VAS)-together with clinical and imaging data, surgical techniques, and postoperative complications were recorded. Mid- to long-term outcomes (over 6 months) were assessed using orthopedic examinations, osteoarthritis radiographic scores, and owner-completed questionnaires. Visualization of the affected articular structures was adequate in all cases. The multiple OCD fragments identified on CT scans were removed without intraoperative complication in 17 tarsi. Mini-arthrotomy was performed in one dog and mini-tenotomy of the deep digital flexor sheath was performed in another. Minor postoperative complications (synovial cysts) were reported in four cases. Mid- to long-term outcomes were good to excellent in 11 of the 14 dogs with substantial improvement in lameness, CBPI, and VAS scores compared with preoperative results. Degenerative joint disease progression was observed in 10 of the 14 cases. The modified arthroscopic technique resulted in few complications, rapid clinical improvement, and full or acceptable function in most cases. This modified approach to portal placement is an appealing and suitable alternative to the approach described previously for managing tarsal OCD lesions.

The pertinence of resistin gene single nucleotide polymorphism G > A and its expression in oral cancer

Background/aimOral cancer (OC) is the leading cause of fatalities in Pakistan among males due to inadequate oral hygiene and chewing habits. However, genetic susceptibility patterns also play a critical role in disease progression. Since the frequency of Resistin (RETN) SNP (Single nucleotide polymorphism) rs3219175 is unknown; there is a requirement for early diagnosis of the OC. Therefore, the current study aims to determine the frequency of targeted SNP and develop a safe, simple, and fast alternative technique for better treatment using a real-time PCR assay with HRM (high-resolution melting curve) analysis. Materials and methodsA case-control study was conducted on 35 Oral squamous cell carcinomas (OSCC) diagnosed patients and 35 healthy individuals. HRM and RT-PCR results were analysed by the bioinformatics analyses. ResultsThe frequency of RETN SNP rs3219175 genotypes GG and GA in male patients was 16 (46 %) and 5 (14 %) respectively and in females 8 (23 %) and 6 (17 %) respectively. The chi-square test of independence consummated the assessment between males and females in both control and patients. The relation between these variables was significant (p < 0.05). The interaction network of String 8.3 demonstrates strong interactions at a high confidence score, which helps to characterize functional disorders that may be a causative factor for oral pathology. Reactome and KEGG data were acquired to rule out the pathway involvement of the targeted gene. MuPIT software was used to identify the 3D structure or RETN and their expected mutation effect. ConclusionThis study provides baseline data regarding the frequency of RETN SNP rs3219175 among the Pakistani population. For further clarification of their stage in cancer emergence and growth, large-scale studies must be conducted. This study might be helpful in the precision medicine approach and provide better therapeutic for OSCC patients.

Enteric Tube Placement and Management: Tips for Interventional Radiologists

AbstractThere is a significant risk of malnutrition and aspiration among hospitalized patients, particularly the elderly, patients with head and neck malignancy, and those with a chronic debilitating disease. Enteral feeding is preferred over parenteral feeding for patients with functional gastrointestinal tracts but who have impaired swallowing due to its cost-effectiveness, lesser complications, and theoretical benefits such as preserving mucosal architecture and gut-associated lymphoid tissue. While nasogastric and nasojejunal tubes address short-term feeding needs, long-term enteral feeding tubes are crucial for patients requiring nutritional support beyond 4 weeks. Enteric tube placement can be performed surgically, endoscopically, or radiologically, with radiologically inserted gastrostomy emerging as a safe and effective method. This review article discusses various interventional radiological techniques for enteral feeding, including percutaneous gastrostomy, gastrojejunostomy, jejunostomy tube placement, and gastrointestinal tract decompression procedures like cecostomy. It covers procedural considerations, patient selection criteria, technical aspects, and outcomes, drawing on current evidence and clinical experience. The review also addresses emerging trends, advancements, and future directions in interventional radiology for enteral feeding and gastrointestinal tract decompression, aiming to contribute to the ongoing evolution of clinical practice and patient care. Key recommendations from international guidelines are summarized, emphasizing individualized risk assessment for optimal enteral feeding strategies.

Effectiveness of Ozone Treatment and Packaging Techniques in Preserving Taiwanese Domestic Beef During Refrigerated Storage.

This study investigates the efficacy of ozone treatment combined with different packaging methods on the preservation of Taiwanese domestically produced beef during refrigerated storage. The preservation of fresh beef is crucial for ensuring food safety and quality; we do not know whether changing the packaging method can mitigate the negative effects of ozone on meat and even enhance its positive impact. Beef samples were treated with ozone and packaged using the vacuum or PVDC-tray methods, then stored at 4 °C for 7 days. The results show that ozone treatment effectively inhibited microbial (total plate count, Salmonella, and Escherichia coli) growth (p < 0.05). Vacuum packaging maintained lower TBARS values (p < 0.05) and metmyoglobin percentages compared to PVDC-tray packaging (p < 0.05). The L* values of all treatments increased over storage time, with significant differences observed between days 0 and 7. Ozone treatment combined with vacuum packaging demonstrated promising results in inhibiting microbial growth and preserving beef quality during refrigerated storage. These findings contribute to enhancing the safety and shelf life of Taiwanese domestically produced beef, potentially benefiting both producers and consumers.

Viewpoint: Genicular Nerve Hydrodissection for Knee Osteoarthritis Pain Management

Knee pain secondary to knee osteoarthritis is one of the most common reasons for consultation in patients 50 years old and above. Due to limitations of current management options for knee osteoarthritis, studies seeking alternative treatment techniques have emerged, including procedures targeting knee innervation. The effectiveness of nerve hydrodissection for managing neuropathies such as carpal tunnel syndrome has been demonstrated but has not been applied to nerves that innervate the knee to manage osteoarthritis. This article discusses the potential application of ultrasound-guided nerve hydrodissection to the anterior innervation of the knee, known as the genicular nerves, for pain management in patients with osteoarthritis. Keywords: Knee osteoarthritis, knee pain, nerve hydrodissection, genicular nerves, genicular nerve hydrodissection

СОВРЕМЕННОЕ ЛЕЧЕНИЕ РУБЦОВОЙ ДЕФОРМАЦИИ ТКАНЕЙ

The problem of scar treatment is one of the most widespread in modern medicine. Treatment of scar formations is one of the most difficult tasks, as there is no single standard that is favorable in terms of efficacy and safety despite the active development in this area of research. Currently, conservative methods of treatment of scar tissue deformities such as corticosteroid administration, botulinum therapy, cryotherapy, microneedling, as well as surgical excision in combination with therapeutic methods are widely used, due to which the most favorable result is achieved. This study is devoted to the study of various modern methods of correction of hypertrophic and keloid scars that are becoming widespread in medicine, their comparison and identification of important advantages and disadvantages in order to choose the most effective treatment technique. Currently used conservative methods of treatment allow to cope with the problem of scar formations, but due to the high incidence of side effects, there is a tendency to search for the combined use of each of them, including with surgical excision to prevent the development of recurrences and to achieve a pronounced cosmetic effect and satisfaction among patients. Thanks to the constant development of medicine and the improvement of various methods, each patient can receive a personalized treatment approach that is guaranteed to reduce aesthetic discomfort due to the existing pathology, which is the main and important aspect of scar correction.

The need for biopsychosocial menopause care: a narrative review.

Menopause is a reproductive transition affecting half the world's population. Stigma and limited availability of evidence-based treatments that support biopsychosocial well-being mean that this life stage is often associated with challenging symptoms and reduced quality of life (QoL). The aim of this review was to examine the extent literature on psychological and mind-body interventions to manage perimenopausal and postmenopausal symptoms, and apply an interdisciplinary clinical, research, and cultural knowledge framework to guide recommendations for improving QoL and healthy aging in this population. We also aimed to understand the ideal delivery mode for such interventions. Using Scopus, Medline, and PubMed, a review of systematic reviews, guidelines, and randomized controlled trials was undertaken to examine the use of psychological and mind-body interventions to improve menopause-related QoL and symptoms, including hot flushes, depression, anxiety, fatigue, pain, and sleep; conclusions were based on an analysis of this available evidence and linked to clinical and cultural considerations. Empirical support exists for a number of psychological and mind-body approaches to support QoL and symptoms during the menopause transition. The literature also identifies the need for menopause care that is culturally responsive.An online multimodal model of menopause care is thus recommended, incorporating evidence-based treatments (eg, cognitive behavioral therapy, yoga, hypnosis) and treatment techniques (eg, mindfulness, and education including nutrition support), as well as First Nations wisdom. We also recommend financial well-being approaches to support people undergoing menopause. Integrated, multimodal approaches should be available online to remove time, location, and healthcare access barriers, and be designed with diverse consumers to ensure equity for those underserved due to region, LGBTIQ+ assigned female at birth status, and for multicultural and First Nations people.