Miracle-dz/UniFAR-FTUs huggingface dataset:
Psychiatric disorders in HIV-positive individuals in urban Uganda

AIMS AND METHOD The study examined the prevalence of psychiatric disorders in people with HIV/AIDS attending the AIDS Support Organisation (TASO) clinic at Mulago Hospital, Kampala, Uganda and the preparedness of AIDS counsellors to deal with mental disorders. Forty-six patients were interviewed using the Mini International Psychiatric Interview to ascertain DSM-IV diagnoses. All 15 counsellors working at the clinic were interviewed. RESULTS The total prevalence of psychiatric disorder was 82.6 (38 out of 46 patients). Depressive and anxiety disorders were common. Non-affective psychoses were present in eight patients (17.4%), bipolar affective disorder in eight (17.4%) and major depression with melancholic features in five (10.9%); 8 (13%) had current suicidal thoughts. None of the people with psychiatric disorders were receiving mental health treatment. The prevalence of disorder as estimated by the counsellors ranged from 0 to 33%. Only one counsellor had received any formal training in mental disorders and only two thought that they could deal with these if they arose. The attitudes of counsellors towards people with mental disorders were mixed, but most believed that they should be trained to provide care. CLINICAL IMPLICATIONS There is a need to provide additional mental health services to the TASO clinic through appropriate training of TASO counsellors to improve their awareness of psychiatric disorders, delivery of some psychological therapies and liaison with the psychiatric services at Mulago Hospital, in addition to public mental health education. The psychiatric disorders experienced by those attending the clinic might put them at greater risk of contracting HIV/AIDS.
A Suggested Approach to Simplify and Improve Cervical Screening in the United States

Abstract Cervical cancer prevention strategies in the United States have become complicated and even controversial, despite advanced understanding of carcinogenic human papillomavirus (HPV) infection as the necessary causal agent. Twenty years ago, etiologic and methodologic studies had already yielded 2 powerful preventive approaches. There are excellent vaccines to prevent the most carcinogenic types of HPV infection; reduced HPV endemicity will ultimately prevent a large fraction of cervical precancer and cancers. For prevention of cervical cancer in the interim, sensitive HPV tests that target women at risk of cancer, by detection of the DNA/RNA of approximately a dozen carcinogenic HPV types, permit early diagnosis and treatment of precancers. Although HPV vaccines and tests have continued to improve, implementation of these new HPV-based prevention methods has been relatively slow in the United States and in most places worldwide. Increasing vaccination rates is the clearest and most vital long-term priority. But, for decades to come, screening will also be important. To promote useful discussion, this commentary will raise some current critical issues in simplifying and speeding the rational introduction of HPV molecular methods into US cervical screening.
Biomarkers p16, Human Papillomavirus and p53 Predict Recurrence and Survival in Early Stage Squamous Cell Carcinoma of the Vulva

Objective Vulvar squamous cell carcinoma (VSCC) develops through 2 distinct molecular pathways, one involving high-risk human papillomavirus (HPV) infection and the other through early p53 suppressor gene mutation. We sought to evaluate the influence of p53 mutation, HPV status, and p16 expression on local recurrence and disease-specific mortality in early stage VSCC. Materials and Methods We performed a retrospective chart review of all patients with stage I VSCC at the Maine Medical Center from 1998 to 2007 (n = 92). Tumor size, depth of invasion, lymphatic/vascular space invasion, and growth pattern were recorded. Paraffin-embedded tissue blocks were stained by immunohistochemistry for p16 and p53; high-risk HPV was detected by polymerase chain reaction assay. Margin distance was determined by a gynecologic pathologist. Survival analyses were conducted to examine predictors of VSCC recurrence and disease-specific mortality. Results Age, depth of invasion, lymphatic/vascular space invasion, growth pattern, and margin status were not significant predictors of recurrence or disease-specific mortality. Tumor size of greater than 4.0 cm indicated a 4-fold increase in disease-specific mortality but did not significantly increase recurrence. p16-Positive patients were less likely to recur and had no VSCC-related deaths. Human papillomavirus–positive patients were less likely to recur and had no VSCC-related deaths. p53-positive patients were 3 times more likely to recur and nearly 7 times more likely to die from vulvar cancer. Conclusions Our findings suggest that HPV and the surrogate biomarker p16 indicate a less aggressive type of vulvar cancer. p53 positivity was associated with poor prognosis and significantly increased both recurrence and disease-specific mortality.
Limited Literacy and Poor Health: The Role of Social Mobility in Germany and the United States

The Organization for Economic Cooperation and Development (OECD) implemented the Program for the International Assessment of Adult Competencies (PIAAC) to provide policymakers with nationally representative profiles of knowledge, skills, and competencies. Results among participating countries indicate that the United States and Germany stand out as having the strongest relationship between literacy skills and self-reported health. Our analysis addresses factors that could mediate the particularly strong link between low literacy and poor health in these two countries and possible remedies for the problem. In particular, PIACC results also reveal that the United States and Germany share the most entrenched multigenerational literacy problem among the countries in the PIAAC survey. In spite of the many social differences that currently distinguish Germany and the United States, these countries share the lowest level of social mobility for education. Promoting social mobility by making higher education more accessible for those whose parents did not have the chance to access it might thus not only promote literacy and social capital, but indirectly also promote public health. Given the PIACC findings, the concept of social mobility and opportunities to dissolve the educational stratification merit more attention in public health research.
Physical fitness and health-related fitness as indicators of a positive health state

University of Liverpool, United KingdomSUMMARYThis article focuses on the concept of positive healthand, in particular, recognizes the importance of phys-ical fitness.It is argued that measures of physical fitness areindicators of positive health and such measures areidentified under their discrete headings of agility,flexibility, power, speed and reaction time, strength,cardiovascular capacity, body composition andposture.The theme of health-related fitness is explored, withrecognition of its increasing importance for healthpromotion in schools, the community and commerce.Evidence is presented that highlights the generalacceptance of the importance of certain fitnesscomponents in the assessment of the positive health ofpopulations. In addition, an alternative method ofassessing fitness is discussed, arising from the authors'recognition of its potential as an inexpensive, easilyadministered indicator of one aspect of positive health.The case for using subjective indicators of positivehealth is also presented—the argument being thatsubjective health could be a possible mediator in theattainment of positive health.
Multimodal Vulvar and Peripheral Sensitivity Among Women With Vulvodynia: A Case–Control Study

Objective To assess differences in vulvar and peripheral sensitivity between women with and without vulvodynia. Methods Women with vulvodynia (n = 41) and age-matched controls (n = 43) seen in the outpatient setting were evaluated via surveys, clinical examination, and multimodal sensory testing (pressure, heat, cold, vibration, and electrical stimulation). The relationships between sensitivity to various sensory modalities and case/control status, as well as by vulvodynia subgroups, were assessed using logistic regression. Results Women with vulvodynia were more sensitive to pressure and to electrical stimuli than were control women at the vulva (median, 22 vs 230 g and 0.495 vs 0.769 mA, respectively; P < 0.001 for each) and at the thumb (median, 2500 vs 4250 g and 0.578 vs 0.764 mA, respectively; P = 0.006 for pressure, P < 0.001 for electrical stimulation). Heat, cold, and vibration detection thresholds did not differ significantly between these groups (P > 0.025). Those reporting spontaneous pain versus provoked pain had greater pressure sensitivity to the thumb (median, 1850 vs 2690 g; P = 0.020) and greater electrical sensitivity at the introitus (0.450 vs 0.608 mA; P = 0.011), and those with primary versus secondary vulvodynia had substantially greater pressure sensitivity to the thumb (median, 2438 vs 3125 g, P = 0.004). However, having localized versus generalized vulvodynia was not associated with differences in pressure or electrical sensitivity. Conclusions Sensitivities to pressure and electrical stimuli are greater among vulvodynia cases than among controls and support 2 previously defined subgroups—those reporting spontaneous pain versus those whose pain only occurred when provoked, and those with primary versus secondary vulvodynia.
Lecture notes on epidemiology and public health medicine

months after the bombings and thus excluded the effects of radiation doses received by fathers during the period of spermatogenesis-ie immediately before conception-whereas we reported an association with the dose estimated to have been received by fathers in the 90 days before conception. Referring again to table 4 of our paper,6 it will be seen that only in the studies of chronic exposure is it likely that the father was irradiated in the immediate preconceptional period and that these studies yield equivocal results. James' post-hoc comparison ofthe children born to mothers and fathers who had received
Loop Electrosurgical Excision Procedure Instead of Cold-Knife Conization for Cervical Intraepithelial Neoplasia in Women With Unsatisfactory Colposcopic Examinations: A Systematic Review and Meta-Analysis

Objectives This meta-analysis compared loop electrosurgical excision procedure (LEEP) with cold-knife conization (CKC) for treating cervical intraepithelial neoplasia (CIN) in patients with unsatisfactory colposcopic examinations. Material and Methods A literature search on MEDLINE, EMBASE, Cochrane Systematic Reviews, CENTRAL, Web of Science, and Scopus databases was conducted from inception until April 2015. We included clinical trials and cohort studies comparing CKC with LEEP for treating CIN. The primary outcome was a combined end point of persistent CIN (<6 months after conization) and recurrent CIN (>6 months). Secondary outcomes included procedural, pathologic, and long-term outcomes. Pooled relative risk (RR) and weighted mean difference (WMD) were used to report binary and continuous outcomes, respectively. Results Among 26 studies, the incidence of persistent and recurrent disease after LEEP was comparable with that after CKC (15.6% vs 7.38%; RR = 1.35; 95% CI = 1.00–1.81). Loop electrosurgical excision procedure was faster, caused less intraoperative bleeding, and resulted in shorter hospital stay (WMD, 9.5 minutes [95% CI = 6.4–12.6 minutes]; WMD, 42.4 mL [95% CI = 21.3–106 mL]; and WMD, 1.5 days [95% CI = 1.1–1.8 days], respectively). Loop electrosurgical excision procedure cones were shallower with overall less volume and weight than CKC (WMD, 5.1 mm [95% CI = 3.2–7.1 mm]; 2.6 mm3 [95% CI = 0.6–5.7 mm3]; and 2.6 g [95% CI = 1.4–3.7 g], respectively). During follow-up, LEEP was associated with less cervical stenosis and fewer unsatisfactory examinations; however, this was not statistically significant (RR, 0.5 [95% CI = 0.1–1.5]; RR, 0.7 [95% CI = 0.4–1.2], respectively). Conclusions Loop electrosurgical excision procedure is an acceptable alternative to CKC in women with CIN and unsatisfactory colposcopic examinations. Close follow-up is necessary for prompt detection and treatment of persistent or recurrent disease.
The Influence of Parental Communication and Perception of Peers on Adolescent Sexual Behavior

The authors used the theory of planned behavior to examine the influence of parents and peers on early adolescent sexual attitudes, self-efficacy to limit sexual behavior, and behavioral intentions to have vaginal intercourse. Adolescents (N = 212) provided self-reports of their perception of parent and peer attitudes regarding sexual behavior. The authors used bivariate and regression analyses to examine the relation between parent and peer attitudes with adolescent sexual attitudes, self-efficacy to limit sexual behavior, and behavioral intentions to have vaginal intercourse. Although there were gender differences, the analyses revealed the importance of both parents and peers on adolescent sexual attitudes, self-efficacy to limit sexual behavior, and intentions to have vaginal sex in the next year.
Seroprevalence and risk factors for human immunodeficiency virus, hepatitis B and C viruses infections among blood donors at the Bolgatanga Regional Hospital in Bolgatanga, Ghana.

This study sought to determine the seroprevalence of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B surface antigen (HBsAg) among blood donors at Bolga-tanga Regional Hospital, Ghana by blood group type, sex and age and also determining the asso-ciation, if any, in the occurrence of the pathogens. The study population consisted of 4146 con-secutive donors, 3920(94.5%) males and 226(5.5%) females, who donated blood between Janu-ary 2004 through December 2007. Their age ranged from 17 to 58 years, and most (49.1%) were between 17-27 years. The seroprevalence of HIV, HBsAg and HCV among the subjects was found to be 4.05%, 12.64% and 3.57%, respectively. A higher prevalence of HBsAg was found among males 12.81% (502/3920) than in females 9.73% (22/226). There were no significant sex differences in the occurrence of HIV and HCV (p > 0.05 in each case). The age-specific preva-lence of HBsAg decreased from 13.67% in donors aged 17-27 years through 8.68% in the 38-47 age group to 0.00% in the 58-67 year age group. Rh-negative blood group donors and Rh-positive group donors had similar prevalence rates of these viral infections. Whereas the highest seroprevalence of HBsAg was seen in blood group B (16.28%) and the lowest in blood group AB (0.00%), for HCV and HIV, the highest seroprevalence (5.88%) was seen in blood group A and the lowest in blood group AB (0.00%) among the Rh-negative group. The high seroprevalence of blood-borne infections in blood donated at Bolgatanga Regional Hospital calls for rigorous screening of blood donors, especially the younger population, for HBV, HCV and HIV and the establishment of strict guidelines for blood transfusions. Hepatitis positivity in the study popula-tion was statistically not associated with ABO blood groups.
“Let's Get This Party Started!”: An Analysis of Health Risk Behavior on MTV Reality Television Shows

Past research has examined portrayals of risk behavior in various media, including television, advertising, and film. To address an underexplored area, this study analyzed drinking, smoking, and sexual activities in MTV reality programming popular among adolescent viewers from 2004 to 2011. Cast members’ demographic attributes were also examined in relation to their risk behaviors. Results demonstrated that drinking and casual sexual behaviors were pervasive among cast members. Smoking and more intense sexual behaviors were also present, but to a smaller degree. Men and young adult cast members were more likely to engage in risk behaviors than women and teenage cast members. Also, ethnic/racial minority characters were shown drinking more often than were White cast members. Interpretations of these findings are discussed based in social cognitive theory and the concept of super peers. Implications for future research are provided.
Rescue and Worsening of Congenital Heart Block‐Associated Electrocardiographic Abnormalities in Two Transgenic Mice

Transgenic Murine Models of CHB. Introduction: Congenital heart block (CHB) is a passively acquired autoimmune disease considered to be due to the transfer of maternal autoantibodies, anti‐SSA/Ro –SSB/La, to the fetus resulting in atrioventricular (AV) block and sinus bradycardia. We previously established a murine model for CHB where pups born to immunized wild‐type (WT) mothers exhibited electrocardiographic abnormalities similar to those seen in CHB and demonstrated inhibition of L‐type Ca channels (LTCCs) by maternal antibodies. Here, we hypothesize that overexpression of LTCC should rescue, whereas knockout of LTCC should worsen the electrocardiographic abnormalities in mice.
Direct Visual Inspection of the Cervix With Lugol Iodine for the Detection of Premalignant Lesions

Objective. To evaluate the feasibility and efficiency of direct visual inspection after Lugol iodine painting in detecting cervical premalignant and malignant lesions. Materials and Methods. This study included 1,012 women recruited from gynecology outpatient clinic screened for premalignant or malignant lesions of the cervix. All women underwent cervical smear test, direct visual inspection of the cervix after painting with acetic acid (DVI-A) and after painting with Lugol iodine (DVI-LI). Abnormal test results were referred for colposcopy and biopsy. Results. Cervical smears were abnormal in 24 women (2.4%). Direct visual inspection of the cervix after painting with acetic acid test was abnormal in 92 women (9.1%). Direct visual inspection after Lugol iodine painting test was abnormal in 93 women (9.2%). There were 106 women (10.5%) referred for colposcopy, with 88 women (8.8%) having biopsies taken. Biopsies showed premalignant and malignant lesions in 44 cases only. There were 35 low-grade squamous intraepithelial lesion, 5 high-grade squamous intraepithelial lesion, and 4 cervical cancers. Test efficiency parameters particularly sensitivity, specificity, and positive and negative predictive values of DVI-LI were 97.7%, 94.8%, 46.2%, and 99.9%, respectively; those of cytology were 22.7%, 97.6%, 41.7%, and 96.6%, respectively, and those of DVI-A were 90.9%, 94.6%, 43.5%, and 99.6%, respectively. Conclusions. Direct visual inspection after Lugol iodine painting is feasible and easy to perform with superior sensitivity to cervical cytology and DVI-A in detecting cervical premalignant and malignant lesions. Direct visual inspection after Lugol iodine painting can be used as an efficient primary screening tool with a satisfactory low biopsy rate in low resources settings.
Left Atrial Stiffness Relates to Left Ventricular Diastolic Dysfunction and Recurrence After Pulmonary Vein Isolation for Atrial Fibrillation

Left Atrial Stiffness and Atrial Fibrillation. Introduction: An increased left atrial (LA) stiffness reflects the structural remodeling and deterioration of the LA function. This study was designed to estimate LA stiffness by measuring a combination of the strain and LA pressure in patients undergoing pulmonary vein isolation (PVI) of atrial fibrillation (AF) and to evaluate the influence of the LA stiffness on the cardiac function, serum markers, and recurrence of AF after PVI.
Cost of Outreach for HIV Prevention Among Drug Users and Youth at Risk

SUMMARY Economic evaluation has become an increasingly important component in determining the effectiveness of HIV prevention programs. One type of intervention that governmental and nongovernmental organizations have supported to prevent the spread of HIV is outreach. We conducted a cost analysis at eight sites that provide outreach services to two populations at high risk for HIV infection: injection drug users and street youth. We assessed the potential benefit of HIV prevention through outreach services by comparing outreach costs with the medical costs of treating an HIV infected individual. The average cost of outreach services was $13.30 per contact. The cost per contact for services to street youth was 78% higher than for drug users. Comparing the cost per contact with HIV treatment costs, if only two in 10,000 contacts reduce their high-risk behavior so as to avoid transmission of HIV, outreach would yield a net benefit. These results provide evidence that outreach programs compare favorably to o.
Multinucleated giant cells in HIV‐associated benign lymphoepithelial cyst‐like lesions of the parotid gland on FNAC

Benign lymphoepithelial cyst‐like lesion (BLEL), a previously rare lesion of the parotid gland consisting of marked lymphoid hyperplasia with accompanying squamous‐lined cysts, has been described in patients with the acquired immune deficiency syndrome (AIDS) or AIDS risk factors. Histologically, these cysts are lined by a squamous or cuboidal epithelium. The lumen contains a pale homogenous material with foamy macrophages and lymphocytes with the cyst wall having germinal centers and a dense infiltrate of lymphoid cells. On FNAC, the aspirates are mostly cystic with the presence of reactive lymphoid tissue, numerous histiocytes, and metaplastic cell clusters. Multinucleated giant cells (MGCs) are also rarely seen in such lesions. We report a case of HIV‐associated BLEL with numerous large sized multinucleated giant cells. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.
Incidence and Costs of Cervical Intraepithelial Neoplasia in a US Commercially Insured Population

Objective: This study aimed to estimate incidence, cost per episode of care, and US population burden of cervical intraepithelial neoplasia (CIN). Materials and Methods: For women continuously enrolled in a US health plan from January 1, 1999 to December 31, 2004, medical claims were used to identify potential CIN diagnosis. Presence and grade of CIN (CIN 1, CIN 2,3, or no CIN) were verified in medical records for a randomly selected subset (n = 254). Incidence, costs, and population burden were calculated. Results: Annual incidence for CIN 1 and CIN 2,3 was 1.6 and 1.2 per 1,000 women, respectively. Incidence was highest among women aged 21 to 30 years (3.3 and 3.6 per 1,000) and women aged 31 to 40 years (2.9 and 2.7 per 1,000). Costs per episode of care were higher for CIN 2,3 ($1,634 vs $1,084). Estimated annual burden per 1,000 US women was $1,059 for CIN 1 and $1,803 for CIN 2,3. Conclusions: We estimate that 412,000 women in the United States are diagnosed with CIN annually, with an associated cost of approximately $570 million.