Miracle-dz/UniFAR-FTUs huggingface dataset:
A multicentre study on knowledge and attitude of nurses in northern Nigeria concerning female genital mutilation

Abstract Objective To determine the knowledge and attitude of nurses in northern Nigeria concerning female genital mutilation (FGM). Methods Cross-sectional study in which 350 nurses working in three tertiary health institutions in northern Nigeria were assessed, using a self-administered questionnaire, with regard to their knowledge of, and attitude to, FGM. Results Two hundred and sixty-five respondents (76%) were female, 190 (54%) were married. Most (249; 71%) were Muslims, and 228 (65%), of Hausa/Fulani ethnicity. Their ages ranged from 18–60 years with a mean of 29.3 ± 8.9. Among the respondents, 318 (91%) had heard of FGM; of these 127 (40%) knew no particular type of FGM. Only 155 (49%) could identify ‘Angurya’ and ‘Gishiri’ cuts as forms of FGM. Two hundred and forty-five (77%), 231 (73%) and 200 (63%), respectively, identified haemorrhage; risk of HIV, hepatitis, and tetanus; and painful sexual intercourse as possible complications of FGM. Thirteen (4%) would perform it and also would have it done on their daughters. Conclusion The nurses studied had a high level of awareness of FGM and a good general knowledge of complications associated with FGM. However, only half knew what ‘Angurya’ and ‘Gishiri’ cuts were. A few would perform FGM.
Pain during medical abortion, the impact of the regimen: A neglected issue? A review

Abstract Objectives To evaluate pain and other early adverse events associated with different regimens of medical abortion up to nine weeks of amenorrhoea. Methods The literature was searched for comparative studies of medical abortion using mifepristone followed by the prostaglandin analogue misoprostol. Publications, which included pain assessment were further analysed. Results Of the 1459 publications on medical abortion identified, only 23 comparative, prospective trials corresponded to the inclusion criteria. Patients in these studies received different dosages of mifepristone in combination with different dosages of misoprostol administered via diverse routes or at various intervals. Information on pain level was reported in 12/23 papers (52%), information regarding systematic administration of analgesics in 12/23 articles (52%) and information concerning analgesia used was available for only 10/23 studies (43%). Conclusions Neither pain nor its treatment are systematically reported in clinical trials of medical abortion; this shortcoming reflects a neglect of the individual pain perception. When data are mentioned, they are too inconsistent to allow for any comparison between different treatment protocols. Standardised evaluation of pain is needed and the correlation between the dosage of misoprostol and the intensity of pain must be assessed in future studies. Chinese Abstract 摘要 目的 为了评价停经9周药物流产不同方案相关的疼痛及其它早期不良反应。 方法 检索米非司酮联合前列腺素类似物米索前列醇进行药物流产的对照研究的相关文献。 已发表的文献中疼痛评估被进一步分析。 结果在1459项药物性流产研究中，仅有23项对照性、前瞻性的研究符合纳入标准。 在这些研究中病人接受了不同剂量的米非司酮及米索前列醇，给药途径及给药时间间隔也不同。 其中12/23篇文献（52%）报道了有关疼痛程度的信息，12/23篇文献（52%）报道了镇痛药系统性管理的有关信息，10/23（43%）篇文献（52%）报道了镇痛剂使用的有关信息。 结论：药物流产临床试验过程中无论是疼痛还是其治疗都没有被系统报道。 这反映了对个人痛苦感受的忽视。 被提及的数据完全不匹配，因此不同治疗方案之间无法进行比较。 标准化疼痛评估以及米非司酮剂量和疼痛程度的相关性需要在将来的研究中进行。
Monitoring the menstrual cycle: Comparison of urinary and serum reproductive hormones referenced to true ovulation

Abstract Objective The aim of the study was to examine relationships and interindividual variations in urinary and serum reproductive hormone levels relative to ultrasound-observed ovulation in menstrual cycles of apparently normally menstruating women. Methods This was a prospective study of normally menstruating women (no known subfertility), aged 18–40 years (n = 40), who collected daily urine samples and attended the study centre for blood samples and transvaginal ultrasound during one complete menstrual cycle. Serum luteinising hormone (LH), progesterone, estradiol, urinary LH, pregnanediol-3- glucuronide (P3G) and estrone-3-glucuronide were measured. Ultrasound was conducted by two physicians and interpreted by central expert review. Results Menstrual cycle length varied from 22 to 37 days (median 27 days). Ovulation by ultrasound ranged from day 8 to day 26 (median day 15). Serum and urinary hormone profiles showed excellent agreement. Estrogen and LH hormone peaks in urine and serum showed a range of signal characteristics across the study group before and after ovulation. The rise in estrogen and LH always occurred before ovulation; the progesterone rise from baseline always occurred after ovulation. Conclusions Urinary and serum reproductive hormones showed excellent agreement and may be used interchangeably. The beginning of the surge in serum and urinary LH was an excellent predictor of ovulation. The rise in progesterone and P3G above baseline was a consistent marker of luteinisation confirming ovulation. Both LH and progesterone surges delivered clear, sharp signals in all volunteers, allowing reliable detection and confirmation of ovulation. Chinese Abstract 摘要 目的 检验正常行经女性在月经周期中,尿液与血清生殖激素水平与经阴道超声所观察到的排卵的关系及个体差异。 方法 这是一个对年龄为18-40岁( n = 40)的正常行经妇女(无已知生育能力低下) 进行的前瞻性研究，在一个完整的月经周期中，受试者采集自己的尿样并到研究中心采集血样和进行阴道超声测试。 检测血清黄体生成素(LH),孕酮,雌二醇,尿液LH,雌酮3葡糖苷酸(P3G)及3-葡糖苷酸孕二酮水平。 由两名医生进行超声检查,中心专家评审判读结果. 结果 月经周期长度22至37天不等(中位时间为27天)。 超声所监测到的排卵从第八天至第26天不等(中位时间为第15天)。 血清和尿液的荷尔蒙的描绘显示了高度的契合。 尿液和血清中雌激素和LH荷尔蒙的峰值在研究受试者群体中表现出排卵前后的一系列信号特征。 雌激素和LH水平往往在排卵前升高；孕酮从基线值升高往往发生在排卵后。 结论 尿液和血清中的生殖激素表明了高度的一致性,且可能可交换使用。 血清和尿液中LH波峰的出现是对排卵期极佳的预测。 孕酮和P3G超出基线值的升高是黄素化的一致性标记，这证实了排卵。 LH和孕酮的波峰在受试者中都表达了清晰尖锐的信号,使得排卵期的可靠探测和确证成为可能。 关键词 雌二醇；雌酮-3-葡糖苷酸(E3G)；黄体生成素(LH)；排卵；3-葡糖苷酸孕二醇(P3G)；孕酮；生殖激素；经阴道超声
AIDS instruction in US schools of social work: 20 years into the epidemic

A survey of 108 accredited master of social work (MSW) programs was conducted to examine curriculum attention to acquired immune deficiency syndrome (AIDS). More than half of the programs (57.4%) offer no HIV/AIDS courses; more than three quarters (87%), however, do provide HIV/AIDS internship experiences. Interestingly, urban schools of social work, areas with higher rates of reported AIDS cases, and larger schools of social work do not offer more formal opportunities for HIV/AIDS education compared to rural schools, areas with lower rates of reported cases, and smaller schools of social work. Students wanting more formal instruction in HIV/AIDS issues, therefore, may not find more opportunities in larger urban schools. Institutes of higher education can be proactive in the continued need for offering HIV/AIDS educational opportunities.
Yes we can! Successful examples of disallowing ‘conscientious objection’ in reproductive health care

Abstract Reproductive health care is the only field in medicine where health care professionals (HCPs) are allowed to limit a patient’s access to a legal medical treatment – usually abortion or contraception – by citing their ‘freedom of conscience. ’ However, the authors’ position is that ‘conscientious objection’ (‘CO’) in reproductive health care should be called dishonourable disobedience because it violates medical ethics and the right to lawful health care, and should therefore be disallowed. Three countries – Sweden, Finland, and Iceland – do not generally permit HCPs in the public health care system to refuse to perform a legal medical service for reasons of ‘CO’ when the service is part of their professional duties. The purpose of investigating the laws and experiences of these countries was to show that disallowing ‘CO’ is workable and beneficial. It facilitates good access to reproductive health services because it reduces barriers and delays. Other benefits include the prioritisation of evidence-based medicine, rational arguments, and democratic laws over faith-based refusals. Most notably, disallowing ‘CO’ protects women’s basic human rights, avoiding both discrimination and harms to health. Finally, holding HCPs accountable for their professional obligations to patients does not result in negative impacts. Almost all HCPs and medical students in Sweden, Finland, and Iceland who object to abortion or contraception are able to find work in another field of medicine. The key to successfully disallowing ‘CO’ is a country’s strong prior acceptance of women’s civil rights, including their right to health care.
Effect on quality of life of switching to combined oral contraception based on natural estrogen: an observational, multicentre, prospective phase IV study (ZOCAL Study)

Abstract Objectives: This observational, multicentre, prospective phase IV study examined change in health-related quality of life (QOL) from baseline to 6 months in women initiating combined oral contraception (COC) based on natural estrogen. Methods: Eligible women attending a baseline and 6-month gynaecology appointment belonged to one of three groups: group 1 used barrier contraception (condoms) and elected to continue this method; group 2 used condoms and elected to switch to COC based on natural estrogen; group 3 used COC based on ethinylestradiol and elected to switch to COC based on natural estrogen. The Spanish Society of Contraception (SEC)-QOL scale assessed health-related QOL. Secondary outcomes included symptoms of premenstrual syndrome, intermenstrual bleeding, duration and intensity of menstrual bleeding, contraception continuation rate, and tolerability. Results: A total of 857 women were enrolled and 785 completed the study. Group 2 (n = 224 completed) had significantly lower SEC-QOL global and dimension scores at baseline and significantly greater increases in SEC-QOL from baseline to 6 months compared with groups 1 (n = 72) and 3 (n = 489). Group 3 reported a similar SEC-QOL score to that of group 1 at baseline but showed significantly greater improvement in SEC-QOL global and psychological scores from baseline to 6 months. Among women receiving COC based on natural estrogen, the contraception continuation rate was 713/780 (91.4%); treatment-related adverse events were reported by 13/780 (1.7%). Conclusions: Improved SEC-QOL after 6 months was found in women who were dissatisfied with their current contraception at baseline and chose to switch to COC based on natural estrogen.
The operation room as a hostile environment for surgeons: Physical complaints during and after laparoscopy

Abstract Due to suboptimal ergonomic conditions during laparoscopic procedures, surgeons are exposed to physical strain on the upper extremity. The primary objective of this study was to assess the prevalence of physical complaints among laparoscopic surgeons and to assess the factors that influence these complaints. A questionnaire was distributed in a university hospital to all surgeons who perform laparoscopic procedures. Participants were asked to answer questions related to experience, physical complaints during or after laparoscopic procedures and the possible causes of their complaints. Fifty-five out of 92 (60%) surgeons completed the questionnaire. In this group, 40 surgeons (73%) reported physical complaints during or after laparoscopic procedures, mainly involving neck, lower back, shoulders and thumbs. Significantly more surgeons reported complaints in the dominant upper extremity compared to the non-dominant side. Poor table height adjustment, bad monitor positioning and suboptimal design of instrument handles were reported as important causes of complaints. Physical complaints of the dominant upper extremity are common among laparoscopic surgeons, especially less experienced surgeons. The dominant upper extremity appears to be more involved than the non-dominant side. More awareness and implementation of ergonomic guidelines is needed.
Analysis of 10,811 Cases with Acute Ischemic Stroke from Korean Stroke Registry: Hospital-Based Multicenter Prospective Registration Study

Department of Neurology, Hallym University College of Medicine; Department of Neurology, Eulji University School of Medicine; Department of Neurology, University of Ulsan College of Medicine; Department of Neurology, Inje University College of Medicine; Department of Neurology, Seoul National University Boramae Hospital; Department of Neurology, Inha University College of Medicine; Department of Neurology, Seoul National University College of Medicine; Department of Neurology, Chonnam National University Medical School; Department of Neurology, Gachon Medical School; Department of Neurology, Kyunghee University College of Medicine; Department of Neurology, Pusan National University College of Medicine; Department of Neurology, Soonchunhyang University College of Medicine; Department of Neurology, Korea University College of Medicine; Department of Neurology, Ewha Womans University College of Medicine; Department of Neurology, Yonsei University College of Medicine; Department of Neurology, Hanyang University College of Medicine; Department of Neurology, Sungkyunkwan University School of Medicine; Department of Neurology, Dong-A University College of Medicine; Department of Neurology, National Health Insurance Corporation Ilsan Hospital; Department of Neurology, KwangMyungSungAe Hospital; Department of Neurology, Bundang Seoul National University Hospital
A Randomized Control Trial of Right-Heart Catheterization in Critically Ill Patients

We investigated the impact of right-heart catheterization (RHC) on physiological status and stay in the intensive care unit. Thirty three of 148 potentially eligible patients were randomized. Fifty-two otherwise eligible patients were excluded because the attending physician felt that RHC was ethically mandated. Ten of 16 (63%) patients randomized to RHC, and 9 of 17 (53%) to no RHC, died (difference: −10%; 95% confidence interval {CI}, −43% to 24%). Mean number of days in the intensive care unit were 10.3 for RHC and 8.1 for no RHC (difference, −2.2; CI, −10.2 to 5.8). The lowest modified APACHE score achieved after randomization was 10.8 for RHC and 8.1 for no RHC (difference, −3.8; CL, −7.0 to −0.6), and the mean modified APACHE score was 14.4 for RHC and 11.1 for no RHC (difference, −3.3; CI, −6.47 to −0.2). Physiological measures in this trial showed statistically significantly differences in favor of patients not receiving RHC. Confidence intervals around other outcomes include clinically important differnces in favor of both RHC and control groups. Although other controlled trials of RHC are ccrucial, investigators face major practical difficulties.
Percutaneous use of ePTFE/FEP-covered metallic stent for palliation of malignant biliary obstruction

Abstract Introduction: Placement of self-expanding metallic stents has been a standard palliative treatment for patients with inoperable biliary malignancy, aiming at improving quality of life via a minimally invasive procedure. This study aimed to evaluate the efficacy of percutaneous placement of expanded polytetrafluoroethylene/fluorinated ethylene propylene-covered metallic stents for palliation of inoperable biliary malignancy. Material and methods: Between February 2012 and April 2013, 11 patients with inoperable malignant biliary obstruction were treated with stent implantation. Serum bilirubin and liver enzyme levels were measured before/immediately after stent placement and at one, three, and six months. Patient survival and stent patency were calculated using Kaplan-Meier analysis. Results: No migration occurred. Patients showed clinical improvement immediately and one month after stent placement, with a significant reduction in mean serum bilirubin level (p < 0.05). At six months, bilirubin levels were <1.5 mg/dL in all cases. One patient developed acute liver failure four days after stent implantation, leading to death. Survival rates were 90% at three months and 70% at six months. Primary patency rates were 100%, 100%, and 90% at one, three, and six months, respectively. Conclusion: Percutaneous placement of expanded polytetrafluoroethylene/fluorinated ethylene propylene-covered metallic stents offered an effective palliative therapy for patients with inoperable biliary malignancy.
A close correlation between plasma and serum levels of brain-derived neurotrophic factor (BDNF) in healthy volunteers

Abstract Objective. Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophic family found in both the central and the peripheral nervous system. Blood BDNF levels are considered as a state marker for depression. Methods. We investigated serum and plasma levels of BDNF levels in 103 healthy volunteers (M/F: 39/64, age: 37±12 years) using ELISA methods. Results and Conclusions. Serum BDNF levels were 14-fold higher than plasma BDNF levels, and a close relationship was found between serum and plasma BDNF levels.
Seasonality of self-destructive behaviour: Seasonal variations in demographic and suicidal characteristics in Van, Turkey

Abstract Objective. Seasonality is one of the most interesting but still elusive issue in suicide research. Linkages of seasonality in suicides to possible contributors such as gender, type of method used, and climatic factors have received attention in different cultures. We aimed at evaluating seasonal trends in suicidal behaviour according to demographic characteristics, reasons for self-destructive behaviour and means preferred in suicide. Methods. Our aim was to assess the seasonal variation in self-destructive behaviour in terms of completed and attempted suicides in a 3-year time period from 2008 to 2010 in Van, Turkey. A total of 1448 cases were registered over a 3-year time period in the city. Seasonal deviations in demographic characteristics, reasons for suicide, and methods of suicide were evaluated. Results. Seasonal distribution of both completed and attempted suicides by gender did not significantly deviate. On the other hand, we found a significant decline in self-destructive behaviours among those who were single and student in the spring. We found a peak in self-destructive behaviours in the autumn among Individuals who suffer from psychological problems. Conclusions. Subjects with psychological difficulties were more prone to commit suicide in autumn. Seasonal differences in methods of suicide used by suicidal subjects were not significant.
Study of variations of bony pattern and presence of wormian bone at pterion in dry human skulls

Pterion is an important bony landmark of skull present on norma larteralis. Variations of bony pattern at pterion are common and are of clinical importance. Present study was carried out in Department of Anatomy IIMS & R to find out variations at pterion in dry human skull of north Indian origin. We utilized 60 dry human skulls for the study. The pattern of pterion and presence of sutural was observed. Spheno parietal was the commonest type of pterion in both left (86.7%) and right (91.7%) side of skull, stellate type was found in (5%) of skulls and frontotemporal was found in 3.3% of left and right each. Sutural bone was present in 5% skulls on the left side. Variation in pattern of pterion and presence of sutural bones are important from surgical and radiological point of view.
Reflections on a participatory project: The rewards and challenges for the lead researchers

Abstract Background Participatory action research (PAR) offers potential for people with an intellectual disability to have an active voice in service provision. However, ensuring their meaningful engagement is not without challenges. Guided by PAR, a recent project to develop a quality of life tool provided learning opportunities for the lead researchers. This paper addresses 3 issues raised by Ramcharan, Grant, and Flynn (2004) in relation to participation of people with intellectual disability in research. Method Informed by reflective practice, this paper draws on a combination of field notes and written reports to critically examine the 3 issues related to effective participation. Results Although the project achieved its goal of people with intellectual disability authoring a quality of life tool, there was variation in participants' contribution. With both data collection and analysis, prior experience and confidence influenced the participation of co-researchers. The financial and the practical support of the contracting organisation were crucial to enabling people to take part. Conclusions For researchers interested in PAR, planning well whilst maintaining flexibility would appear to be key to achieving maximum participation.
Using responsibility analysis to evaluate fatal accident risk for drivers in Québec who used drugs

The difficulty in accident risk evaluation with respect to drug use is sampling and data collection. Other problems can be attributed to the difficulty of precisely identifying the drug an individual uses and evaluating its effects. Methods to analyze responsibility have been developed to circumvent these problems, but accident risk does not seem to be estimated correctly using these methods. The present study, carried out using a sample of driver deaths from 1999 through 2002, concludes that the estimated odds ratio corresponds to the risk of being responsible for an accident rather than the accident risk itself. Alcohol is the drug most frequently detected, but cannabis, benzodiazepines and cocaine were also found in the deceased drivers. The use of more than one drug at a time seemed very common in the population that was studied. Comparable results were found in blood and urine samples.
Guide for calculating and interpreting effect sizes and confidence intervals in intellectual and developmental disability research studies

Abstract This paper includes a nontechnical description of methods for calculating effect sizes in intellectual and developmental disability studies. Different hypothetical studies are used to illustrate how null hypothesis significance testing (NHST) and effect size findings can result in quite different outcomes and therefore conflicting results. Whereas NHST uses probability levels (e.g., p < .05) to evaluate the results of studies, effect size analyses focus on the magnitude of differences between groups or contrasting conditions and the strength of the relationship among variables of interest to report and interpret study results. Two families of effect sizes are described (mean difference, correlation coefficients) that are likely to be applicable to most intellectual and developmental disability studies. Sources of information on effect size calculators are included to provide researchers ready-available data analysis procedures for computing effect sizes and confidence intervals for different types of research designs and studies.
The Dilemma of Using Humans as Research Subjects: An Assessment of Risks and Benefits

According to The Belmont Report, the prior assessment of potential risks and benefits is essential in determining whether a subject ought to participate in research. This article will present a review of the risks and benefits to which research subjects are exposed, followed by a short summary of the philosophical and ethical thinking underlying these issues. The application of the principles of beneficence and nonmaleficence to the issues of minimizing risk and maximizing benefit might be achieved more effectively by changes in how the consent information letter is usually organized.