Miracle-dz/UniFAR-FTUs huggingface dataset:
Oral Compared With Intravenous Sedation for First-Trimester Surgical Abortion: A Randomized Controlled Trial

OBJECTIVE: To test the equivalency of oral sedation and intravenous sedation for pain control in first-trimester surgical abortion. METHODS: Women undergoing suction curettage at less than 13 weeks of gestation were randomly assigned to oral sedation, 10 mg of oxycodone and 1 mg of lorazepam, or intravenous sedation, 100 micrograms fentanyl and 2 mg midazolam. All patients received 800 mg of preoperative ibuprofen and a 20-mL paracervical block with 1% lidocaine. The primary outcome was intraoperative pain as measured on a 21-point verbal rating scale that had a range from 0 to 100 (0=no pain and 100=worst pain ever) with an equivalence margin for the treatment group comparison of ±10. RESULTS: Of 130 women, 65 were randomly assigned to oral sedation and 65 to intravenous sedation. The groups differed at baseline by age and preoperative ratings of depression, stress, and anxiety; however, when adjusted for these differences, the primary results were unaffected. Mean intraoperative pain scores, controlling for age and preoperative depression, stress, and anxiety, were 61.2 for oral sedation and 36.3 for intravenous sedation (mean difference 24.9, 95% confidence interval 15.9–33.9). Other findings included no difference in postoperative adverse effects and less satisfaction with pain control with oral sedation compared with intravenous sedation. CONCLUSION: Oral sedation, as studied, is not equivalent to intravenous sedation for pain control during first-trimester surgical abortion. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials. gov, NCT00337792 LEVEL OF EVIDENCE: I
Attitudes Toward Homosexuality in Adolescence: An Italian Study

ABSTRACT This study investigates Italian adolescents’ attitudes toward gay men and lesbians and same-sex marriage, and their beliefs about the origins of homosexuality. The sample consists of 449 subjects (226 males), aged between 14 and 21 years. The principal instruments used are: the Attitudes Toward Lesbians and Gay men (ATLG), the Modern Homonegativity Scale (MHS), and the Attitudes Toward Same-Sex Marriage (ATSM). Results suggest that males show a more negative attitude than females toward homosexuals. Furthermore data reveal that respondents with a lack of personal direct contact with gay people have less positive attitudes toward homosexual people and same-sex marriage. The data in this study suggest that homophobia could be deeply rooted in a traditional value system that refutes gender equality.
Challenging the Black Church Narrative: Race, Class, and Homosexual Attitudes

ABSTRACT In recent years, scholars have pointed to the Black church as the driving force behind Blacks’ more conservative lesbian, gay, bisexual, and transgendered (LGBT) attitudes. Although evidence suggests a robust association between religiosity and LGBT attitudes, contemporary scholarship has not examined the role of class or the extent to which religiosity actually explains these trends. Using the 2004–2014 waves of the General Social Survey, we find that class moderates in the effect of race on negative LGBT attitudes, resulting in a noticeably larger gap between middle-class Blacks and Whites than in the top or the bottom of the class distribution. Although religiosity and moralization explain a portion of racial differences in homosexual attitudes across class groups, we find that neither fully accounts for the more conservative attitudes of the Black middle class. We conclude by discussing the shortcomings of these narratives for understanding Blacks’ more conservative LGBT attitudes.
Recent Suicide Attempts Across Multiple Social Identities Among Gay and Bisexual Men: An Intersectionality Analysis

ABSTRACT This study draws from intersectionality to describe variations in recent suicide attempts (RSA) among gay and bisexual men (GBM) across sociodemographics. Using survey data, logistic regression modeling explored RSA in two analytical stages: (1) the individual effects of each sociodemographic were measured; (2) two-way interaction terms between sociodemographics were tested and added to the models created in stage A. In stage A, only education and income achieved significance. In stage B, the study found that (a) education and income interacted significantly such that the odds of RSA increased for those with a lower income and a lower education; (b) sexual orientation and partnership status interacted, resulting in decreased odds among bisexual men in heterosexual partnerships; and (c) income and education interacted with geography; the effects of these variables were significant only among urban men. These findings suggest that GBM are at unequal risk of RSA according to intersecting sociodemographics.
Nonobstetric Risk Factors for Symptomatic Pelvic Organ Prolapse

OBJECTIVE: To identify possible nonobstetric risk factors for symptomatic pelvic organ prolapse in the general female population. METHODS: This was a population-based, cross-sectional study derived from a sample of 5,489 Stockholm women, 30 to 79 years old, who answered a validated questionnaire for the identification of symptomatic prolapse. The 454 women whose answers indicated the presence of such prolapse and the 405 randomly selected control participants with answers that gave no indication of prolapse received a 72-item questionnaire, which probed into a priori suspected risk factors. Only those women with intact uteri and no prior surgery for incontinence or prolapse were included. Multivariable logistic regression models estimated prevalence odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: In addition to age and parity, overweight (prevalence OR for body mass index [kg/m2] 26–30 compared with 19–25 was 1.9, 95% CI 1.2–3.1), history of conditions suggestive of deficient connective tissue (varicose veins/hernia/hemorrhoids, prevalence OR for positive history compared with no history 1.8, 95% CI 1.2–2.8), family history of prolapse (prevalence OR for positive history compared with no history 3.3, 95% CI 1.7–6.4), heavy lifting at work (prevalence OR for 10 kg or more compared with no heavy lifting 2.0, 95% CI 1.1–3.6), and presence of constipation, hard stools, or difficult evacuation (prevalence OR relative to normal bowel habits 2.1, 95% CI 1.4–3.3) all were linked independently, significantly, and positively to the presence of symptomatic prolapse. CONCLUSION: In this nonconsulting population, age and parity were the dominating risk factors, but significant independent associations with markers suggestive of congenital susceptibility (family history and conditions signaling weak connective tissue) and nonobstetric strain on the pelvic floor (overweight/obesity, heavy lifting, and constipation) imply that individual predisposition and lifestyle/environment also may play an important role. The causal direction of the association with bowel habits remains uncertain, and the link to family history could be partly because of information bias. LEVEL OF EVIDENCE: II
Adolescent Sexual Behavior During Periods of Increase and Decrease in the Abortion Rate

OBJECTIVE: To study changes in adolescent sexual behavior in periods of increase (1994–2000) and decrease (2001–2007) in the abortion rate. METHODS: School surveys with self-administered questionnaires were carried out annually among eighth graders (mean age 14.8 years) and ninth graders (mean age 15.8 years) (N=286,665) in 1996/1997 and 2006/2007. Schools participated biennially. The proportions of respondents reporting noncoital (kissing, light petting, heavy petting) and coital (ever had sexual intercourse, intercourse at least 10 times, at least three partners) sexual experience and nonuse of contraception were studied. RESULTS: Among adolescents, both coital and noncoital sexual experiences and the proportion of those not using contraception increased between 1996–1997 and 2000–2001 (P for trend <.01, all) and decreased from 2000–2001 onward (P<.001, all), except the proportion of at least 10 coital events, which did not decrease. Among sexually experienced adolescents, a similar increase in coital experiences (intercourse at least 10 times from 38.2% to 41.5%, at least three partners from 27.8% to 30.7%, P<.001) and in not using contraception (from 17.2% to 19.1%, P=.002) was seen before 2000–2001, but after that the only significant change was a further increase in the proportion of those reporting intercourse at least 10 times (from 41.5% to 47.8%, P<.001). CONCLUSION: The proportion of adolescents reporting noncoital sexual experiences, intercourse, or not using contraception increased in the 1990s and decreased in the 2000s, reflecting the changes in the abortion rate. However, as the abortion rate decreased, the intensity of sexual activity further increased among sexually experienced adolescents, suggesting that the fall in the abortion rate may be due to contraception and more effective sexual education. LEVEL OF EVIDENCE: III
18-Year Experience in the Management of Men With a Complaint of a Small Penis

In many cultures, the erect penis has been a symbol of masculine qualities. Because of this symbolism, a penis that is less than average size can cause insecurity or embarrassment. This series reports the authors’ 18-year experience in the management of 60 men with a complaint of a small penis. For 44 of these 60 men, counseling was sufficient; the other 16 had surgery, and of these, 9 were satisfied with the result. Despite limitations, the authors conclude that those men who already achieve a penis length of no less than 7.5 cm (2.95 in) in erection, have only limited benefit from penis-enhancing surgery. This particular patient category should therefore be dissuaded from surgery.
Chordoid glioma of the third ventricle: A report of two cases, one with ultrastructural findings

Chordoid glioma, which generally occurs in adults, is a rare CNS tumor arising in the anterior part of the third ventricle. We report two cases of chordoid glioma of the third ventricle in a 42‐year‐old woman and a 51‐year‐old man, respectively. Both tumors showed essentially the same histological and immunohistochemical features; the tumors were composed of cords and nests of epithelioid, GFAP‐immunoreactive cells in a mucinous stroma with lymphoplasmacytic infiltrates at the tumor periphery. Ultrastructural examination in one case revealed that the tumor cells were characterized by the presence of hemidesmosomes and associated focal basal lamina formation, intermediate junctions, microvilli and cilia, and intercellular microrosettes with microvilli. Of interest was that small blood vessels with fenestrated endothelial cells were present in the stroma. In the brain, the presence of fenestrated endothelial cells is a feature of the circumventricular organs (except the subcommissural organ), among which the organum vasculosum of the lamina terminalis is located in the anterior part of the third ventricular floor that is lined by specialized ependymal cells known as tanycytes. These findings further strengthen the hypothesis that chordoid glioma may represent a peculiar clinicopathological subtype of ependymoma (chordoid ependymoma) originating from the lamina terminalis area.
Beliefs About Women's Vibrator Use: Results From a Nationally Representative Probability Survey in the United States

Women's vibrator use is common in the United States, although little is known about beliefs about its use. Elicitation surveys and interviews informed the development of a 10-item scale, the Beliefs About Women's Vibrator Use Scale, which was administered to a nationally representative probability sample of adults ages 18 to 60 years. Most women and men held high positive and low negative beliefs about women's vibrator use. Women with positive beliefs reported higher Female Sexual Function Index scores related to arousal, lubrication, orgasm, satisfaction, and pain (indicating less pain).
Motivations and Sexual Attitudes, Experiences, and Behavior of Sexuality Professionals

This study examined the motivations for entering the field and sexual attitudes, experiences, and behavior of an international group of sexuality professionals. Participants were 252 individuals attending the XVII World Congress of Sexology who completed a questionnaire in English, Spanish or French. Most participants’ reported professional rather than personal motivations for entering the field in addition to interest. On average, participants reported little sexual communication with their parents as children. About one-third had experienced unwanted sexual activity as a child. Participants were mostly accepting of a range of sexual activities, although they were less accepting of some behaviors than of others. Twelve of the participants who had engaged in sexual activity with a casual or anonymous partner in the previous 2 years had not used a condom consistently. Participants reported high sexual satisfaction and good sexual communication with their partner. Nevertheless, 45% of the women and 35% of the men reported regularly experiencing one or more sexual problems. Few participants reported that their profession affected their sexual functioning negatively; in contrast most reported that it had positive effects on their sexual functioning. These results suggest that there are few differences between sexuality professionals and the general public.
A Qualitative Evaluation of Online Chat Groups for Women Completing a Psychological Intervention for Female Sexual Dysfunction

Because of the embarrassment that can surround female sexual dysfunctions, online interventions offer an anonymous and private treatment alternative. Recently, an online cognitive-behavioral treatment for female sexual dysfunctions was evaluated. Although significant improvements were observed in sexual functioning, the treatment was primarily a behavioral intervention because of difficulties with engaging participants in cognitive therapy over e-mail. To address this limitation, the use of chat groups was incorporated into a new online treatment for female sexual dysfunctions—the PursuingPleasure program. Thirty-eight women participated in the PursuingPleasure chat groups. The goals of the chat groups were to address and overcome challenges as women progressed through PursuingPleasure and to create a social support network where group therapy processes could be used. The chat groups aimed to address misunderstandings, monitor changes, and receive feedback. A qualitative analysis of the chat groups revealed that they helped to facilitate the cognitive-affective aspects of the program, as well as fulfill their other intended functions. This study demonstrates how the use of chat groups in the online treatment of female sexual dysfunctions is a useful addition to Internet-based treatment. Feedback suggests that the chat groups were one of the most helpful aspects of the program, although a small group of women reported finding the groups unhelpful.
Female Partners of Men Who Use Pornography: Are Honesty and Mutual Use Associated With Relationship Satisfaction?

The authors discuss findings pertaining to male pornography use and female partners’ relationship satisfaction and distress. The authors investigated honesty regarding pornography use and mutual consumption between partners, along with honesty and mutual use as predictors of satisfaction. Female participants (N = 340) in committed relationships completed the Pornography Distress Scale and Couples Satisfaction Index online. Participants reporting more honesty showed higher satisfaction and lower levels of distress, and participants disclosing mutual use showed lower levels of distress, although no differences were reported in satisfaction. Honesty regarding pornography use significantly predicted relationship dissatisfaction. Directions for future research and counseling implications are discussed.
Acetaminophen Use in Pregnancy and Risk of Birth Defects: Findings From the National Birth Defects Prevention Study

OBJECTIVE: To investigate whether exposure during the first trimester of pregnancy to single-ingredient acetaminophen increases the risk of major birth defects. METHODS: Data from the National Birth Defects Prevention Study, a population-based, case–control study, were used. Women who delivered between January 1, 1997, and December 31, 2004, and participated in the telephone interview were included. Type and timing of acetaminophen use were assigned based on maternal report. Women reporting first-trimester acetaminophen use in a combination product were excluded, resulting in a total of 11,610 children in the case group and 4,500 children in the control group for analysis. RESULTS: The prevalence of first-trimester single-ingredient–acetaminophen use was common: 46.9% (n=5,440) among women in the case group and 45.8% (n=2,059) among women in the control group (P=.21). Overall, acetaminophen was not associated with an increased risk of any birth defect. Among women reporting a first-trimester infection and fever, use of acetaminophen was associated with a statistically significantly decreased odds ratio (OR) for anencephaly or craniorachischisis (adjusted OR 0.35, 95% confidence interval [CI] 0.08–0.80), encephalocele (adjusted OR 0.17, 95% CI 0.03–0.87), anotia or microtia (adjusted OR 0.25, 95% CI 0.07–0.86), cleft lip with or without cleft palate (adjusted OR 0.44, 95% CI 0.26–0.75), and gastroschisis (adjusted OR 0.41, 95% CI 0.18–0.94). CONCLUSION: Single-ingredient–acetaminophen use during the first trimester does not appear to increase the risk of major birth defects. It may decrease the risk of selected malformations when used for a febrile illness. LEVEL OF EVIDENCE: II
Incidencia de labio leporino y paladar hendido en la Maternidad del Hospital Clínico de la Universidad de Chile y en las maternidades chilenas participantes en el Estudio Colaborativo Latino Americano de Malformaciones Congénitas (ECLAMC) período 1991-1999

Background: ECLAMC is a registry, aimed to assess the incidence of congenital malformations, that started in 1967 and Chile incorporated to it in 1969. Aim: To report the incidence of cleft lip/palate, updated to 1999 in the University of Chile Maternity Hospital and other Chilean hospitals participating in the ECLAMC. Patients and methods: A review of the ECLAMC database that registers all births or stillbirths of more than 500 g. Results: The incidence of orofacial cleft, at the University of Chile Maternity Hospital, in the period 1991-1999 was 17.8 per 10000 (12.6 for cleft lip and 5.2 for cleft palate). The incidence in the rest of participating hospitals was 12.04 and 4.6 respectively. Males had a higher incidence of cleft lip and 80% of children with cleft palate, had other malformations, most of them as part of a syndrome (13 and 18 trisomy, holoproscencephalia, Pierre Robin, Apert en EE syndromes, anencephaly etc). In three of 12 children with cleft lip but without cleft palate, there was a relative with the same malformation. Conclusions: It is proposed that both entities, cleft lip with or without cleft palate and cleft palate without cleft lip, are two etiopathogenically different conditions (Rev Med Chile 2001; 129: 285-93).
Transplantation of human bone marrow stromal cell‐derived Schwann cells reduces cystic cavity and promotes functional recovery after contusion injury of adult rat spinal cord

The aim of this study was to evaluate whether transplantation of human bone marrow stromal cell‐derived Schwann cells (hBMSC‐SC) promotes functional recovery after contusive spinal cord injury of adult rats. Human bone marrow stromal cells (hBMSC) were cultured from bone marrow of adult human patients and induced into Schwann cells (hBMSC‐SC) in vitro. Schwann cell phenotype was confirmed by immunocytochemistry. Growth factors secreted from hBMSC‐SC were detected using cytokine antibody array. Immunosppressed rats were laminectomized and their spinal cords were contused using NYU impactor (10 g, 25 mm). Nine days after injury, a mixture of Matrigel and hBMSC‐SC (hBMSC‐SC group) was injected into the lesioned site. Five weeks after transplantation, cresyl‐violet staining revealed that the area of cystic cavity was smaller in the hBMSC‐SC group than that in the control group. Immunohistochemstry revealed that the number of anti‐growth‐associated protein‐43‐positive nerve fibers was significantly larger in the hBMSC‐SC group than that in the control group. At the same time, the number of tyrosine hydroxylase‐ or serotonin‐positive fibers was significantly larger at the lesion epicenter and caudal level in the hBMSC‐SC group than that in the control group. In electron microscopy, formation of peripheral‐type myelin was recognized near the lesion epicenter in the hBMSC‐SC group. Hind limb function recovered significantly in the hBMSC‐SC group compared with the control group. In conclusion, the functions of hBMSC‐SC are comparable to original Schwann cells in rat spinal cord injury models, and are thus potentially useful treatments for patients with spinal cord injury.
Intravenous immunoglobulin therapy prevents development of autoimmune encephalomyelitis and suppresses activation of matrix metalloproteinases

Although intravenous immunoglobulin (IVIG) has been reported to improve the status of expanded disability status scale (EDSS) of multiple sclerosis (MS) patients and reduce the annual relapse rate, some studies did not find its beneficial effects. In the present study, using an animal model for MS, we found that prophylactic, but not therapeutic, treatment successfully suppressed the disease development. During the search for factors involved in the disease suppression by IVIG, we obtained evidence suggesting that IVIG exerts its function, at least in part, by suppressing activation of matrix metalloproteinases (MMP)‐2 and ‐9. Gelatin zymography revealed that gelatinase activities were suppressed by IVIG treatment in the spinal cord, but not in plasma. This finding raises the possibility that IVIG blocks MMP activities at the interface between the blood stream and CNS. With in situ zymography, we also observed that gelatinase activities were expressed mainly in astrocytes in the inflamed spinal cord of control rats and that this expression was attenuated by the treatment. These findings provide useful information to set optimal conditions for IVIG treatment of MS and to obtain more beneficial effects.
A qualitative evaluation of an NHS Weight Management Programme for obese patients in Liverpool

Purpose – The increasing prevalence of obesity in the UK has been of concern for some time. This is particularly true in Liverpool and in response the Liverpool Weight Management Programme (LWMP) was devised. It offers a service involving dietitians and other expert agencies working towards facilitating dietary and lifestyle changes in obese NHS patients in Liverpool via a 12-week education programme. This qualitative study aims to investigate patients' experiences of the LWMP. Design/methodology/approach – Informed volunteers participated in focus groups exploring their experiences following the programme. Focus groups were audio recorded and transcribed verbatim, then analysed following a thematic approach utilising constant comparison analysis to allow a qualitative view of the LWMP to be formed. Findings – Participants described an increase in immediate self-confidence during the LWMP, as opposed to coercion and pressure experienced elsewhere. The results also show the implementation of dietary change.