Miracle-dz/UniFAR-FTUs huggingface dataset:
An Evaluation of a Group Nutritional Program in a Population of Obese Individuals with Psychiatric Disabilities

Individuals with serious mental illnesses are at high risk for obesity. The increased risk of obesity and comorbid medical conditions among individuals with serious mental illnesses has increased the need to seek and utilize effective treatments to address obesity in this population. In efforts to address the need for effective treatment, Eli Lilly and Company developed the Solutions for Wellness program. The aim of this study was to examine if the Solutions for Wellness nutritional program was effective in increasing wellness knowledge and increasing healthy lifestyle choices within a small sample of obese individuals with serious mental illnesses. The nutritional program was assessed using a multiple-case repeated measures design with multiple measures before, during, and after the intervention. The results show the potential for obese individuals with serious mental illnesses to be active in learning and making healthy lifestyle changes to improve their health and mental well-being. The results of this study suggest that individuals with serious mental illnesses consider interventions to address health concerns important, and they have the ability and motivation to make healthy lifestyle choices to improve overall wellness. EVALUATION OF A GROUP NUTRITIONAL PROGRAM vi
Distinct Pattern of Metastases in Patients with Invasive Lobular Carcinoma of the Breast

Abstract Background Invasive lobular carcinoma (ILC) comprises around 10 – 15% of invasive breast cancers. Few prior studies have demonstrated a unique pattern of metastases between ILC and the more common invasive ductal carcinoma (IDC). To our knowledge, such data is limited to first sites of distant recurrence. We aimed to perform a comparison of the metastatic pattern of ILC and IDC at first distant recurrence as well as over the entire course of metastatic disease. Methods We used a prospectively collated database of patients with metastatic breast cancer. Breast cancer recurrence or metastases were classified into various sites and a descriptive analysis was performed. Results Among 761 patients, 88 (11.6%) were diagnosed with ILC and 673 (88.4%) with IDC. Patients with ILC showed more frequent metastases to the bone (56.8 vs. 37.7%, p = 0.001) and gastrointestinal (GI) tract (5.7 vs. 0.3%, p < 0.001) as first site of distant recurrence, and less to organs such as lung (5.7 vs. 24.2%, p < 0.001) and liver (4.6 vs. 11.4%, p = 0.049). Over the entire course of metastatic disease, more patients with ILC had ovarian (5.7 vs. 2.1%, p = 0.042) and GI tract metastases (8.0 vs. 0.6%, p < 0.001), also demonstrating reduced tendency to metastasize to the liver (20.5 vs. 49.0%, p < 0.001) and lung (23.9 vs. 51.9%, p < 0.001). All associations but bone held after sensitivity analysis on hormonal status. Although patients presenting with ILC were noted to have more advanced stage at presentation, recurrence-free survival in these patients was increased (4.8 years vs. 3.2 years, p = 0.017). However, overall survival was not (2.5 vs. 2.0 years, p = 0.75). Conclusion After accounting for hormone receptor status, patients with IDC had greater lung/pleura and liver involvement, while patients with ILC had a greater propensity to develop ovarian and GI metastases both at first site and overall. Clinicians can use this information to provide more directed screening for metastases; it also adds to the argument that these two variants of breast cancer should be managed as unique diseases.
A minimally invasive technique for lateral maxillary sinus floor elevation: a Bayesian network study.

OBJECTIVES To describe a minimally invasive technique for lateral maxillary sinus elevation and to identify the relationship between the involved factors. MATERIALS AND METHODS This is a retrospective study on patients treated with an original minimally invasive technique for lateral maxillary sinus elevation in a private dental clinic from 2008 to 2013. Failures, complications, and radiographic measurements were registered 9 months after surgery at the provisional prosthesis delivery. The relationship between demographic and clinical factors was investigated using Bayesian network analyses. RESULTS One hundred and twenty-four patients (147 maxillary sinuses) were treated, and 242 implants were placed. Seven patients dropped out. A total of two implants in two patients failed. Perforation of the sinus membrane occurred in seven patients (6%). Five different complications in five patients were observed. Mean peri-implant marginal bone level 9 months after surgery was 1.10 ± 0.74 mm. Mean vertical bone gain was 7.44 ± 1.95 mm. Perforation was more frequently observed in patients that did not undergo the sedation procedure. Complications (excluding perforation and including implant failure) were more frequent in cases where only bone substitutes were used. CONCLUSIONS This technique can be considered noninvasive, with a low early failure and early complication rate.
Volume stability of hydroxyapatite and β-tricalcium phosphate biphasic bone graft material in maxillary sinus floor elevation: a radiographic study using 3D cone beam computed tomography.

OBJECTIVES The purpose of this study was to confirm volume stability of biphasic calcium phosphate (BCP) through the changes of grafted volume over the time by 3D CT analyzing software program. PATIENTS AND METHODS Fifteen patients, 16 sinuses who were scheduled a staged implantation through sinus floor elevation (SFE)-lateral window technique from 2009 to 2011 were included in the study. Of the 15 patients, eight were male and seven were female (mean age 50.1). For sinus floor augmentation, BCP with local blood was packed loosely into the maxillary sinus and the grafted site was covered with a collagen membrane. For the evaluation of volume change, 3D CBCT scans were taken five times at pre-operatively (To), post-op 1 week (T1), 1 month (T2), 3 months (T3), and 6 months (T4). 3D image processing software (OnDemand3DTM software) was used for this study. The time sequential change was statistically evaluated. RESULT 84.32% grafted BCP is maintained until post-op 6 month (T4), and the average volume loss is 207.7 mm(3) (about 0.21 cc). Statistically, a significant volume change (decreasing) was observed in three groups (T2-T1, T3-T2, T4-T3). CONCLUSION Biphasic calcium phosphate, as a synthetic material, has high volume stability and is a predictable graft material for the successful SFE. Although some limitations of the 3D analyzing software program, it is a fast, simple, relatively accurate and promising approach to quantifying long-term changes in the grafted area.
Understanding the Nurse-Patient Interaction at Komfo Anokye Teaching Hospital. The Patients' Perspectives and Experiences

The nurse–patient interaction, a core of professional nursing practice, shows the relationship that exists between nurses and their patients in the care encounter. This study set out to explore and understand the experiences patients go through during their interactions with nurses and to find ways of enhancing nurse-patient interactions. The study took place at the maternity, adult medical and surgical wards of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. The target population for this study was all patients who were admitted for a week or more and had come for review after discharge at the time of the study. A qualitative exploratory approach was adopted and purposive sampling technique was used to select the desired sample. A semi-structured interview guide was used to elicit information from 12 patients. The data was analyzed using content analysis. The key findings were: nurses were found to be poor communicators, nurses discriminated among patients based on patients‘ social status and ability to pay for services rendered which led to deliberate neglect of patients. Nurses‘ poor attitudes were found to have a negative influence on the nurse/patient interaction. Many nurses had little or no respect for the rights of patients. Supervision was found to be poor leading to patients‘ ill-treatment, especially on night shifts. A few nurses were however described as good, supportive and caring. The inclusion of interpersonal skills, especially communication skills in nursing curricula, in-service training and workshops was recommended to improve the quality nursing care delivery at KATH. University of Ghana http://ugspace.ug. edu.gh
Influence of blinded wound closure on the volume stability of different GBR materials: an in vitro cone-beam computed tomographic examination.

OBJECTIVE To test whether the use of (i) particulated bone substitute + collagen membrane used for guided bone regeneration (GBR) of peri-implant bone defects renders different results from (ii) particulated bone substitute + collagen membrane + fixation pins and from (iii) block bone substitute + collagen membrane with respect to the volume stability of the augmented region during suturing of mucosal flaps. MATERIAL AND METHODS Twenty peri-implant box-shaped bone defects were created in 10 pig mandibles. Every bone defect was augmented once with each of the following GBR procedures: Granulate (particulated xenograft + collagen membrane), Granulate + Pins (particulated xenograft + collagen membrane + fixation pins), and Block (block xenograft + collagen membrane). Cone-beam computed tomography scans were obtained prior and after blinded wound closure. The horizontal thickness (HT) of the augmented region (bone substitute + membrane) was assessed at the implant shoulder (HT0 mm ) and at 1-5 mm apical to the implant shoulder (HT1 mm -HT5 mm ). The changes of HT during flap suturing were calculated as absolute (mm) and relative values (%). Repeated-measures ANOVA was used for statistical analysis. RESULTS Wound closure induced a statistically significant change of HT0 mm and of HT1 mm in all the treatment groups (P ≤ 0.05). The change in HT0 mm measured -42.8 ± 17.9% (SD) for Granulate, -22.9 ± 21.2% (SD) for Granulate + Pins, and -20.2 ± 18.9% (SD) for Block. The reduction in HT0 mm, HT1 mm , HT2 mm, and HT3 mm for the Granulate procedure was significantly higher as compared to the Granulate + Pins and the Block procedures (P ≤ 0.05). There were no statistically significant differences in the change of HT between the Granulate + Pins and the Block procedures (P > 0.05). CONCLUSION Wound closure induced displacement of the bone substitute resulting in a partial collapse of the collagen membrane in the coronal portion of the augmented site. The stability of the bone substitute and collagen membrane was enhanced by the application of fixation pins and by the use of block bone substitute instead of particulated bone substitute.
MORBIDITY PROFILE OF THE UNDER FIVE CHILDREN IN URBAN SLUMS OF ETAWAH DISTRICT.

Background: Children are the backbone of any country and their health is a prime concern of the country. The under five years is an important age group as the morbidity profile of this age group will have a far reaching consequences on the overall development of the country. Objectives: · To find out the morbidity profile of under five children in the urban slums · To find out the co-rrelates of the study. Material and Methods: The present study was a Cross Sectional Study carried out for a period of six months from January 2011 to June 2011. The examination was carried out using a pre designed proforma. Information regarding the immunization and history of any acute illness in last six months was gathered by interview followed by Physical Examination which included anthropometric measurement, that is, weight, height/length, mid arm circumference, head circumference and chest circumference. Result: In the present study, only 33.94 % children were completely immunized. Diarrhea and Upper Respiratory Tract Infections were the most common morbidities reported in the age group of 1-5 years. There were no statistically significant differences in the anthropometric profile of the male and female child. 31.7% of male and 23.2% of female child were underweight as compared to the normal standard weight as per their age. 17.9 % of male and 20.1% female were stunted. Conclusion: The present study hereby concludes that the Diarrheal Diseases and Upper Respiratory tract Infection are the majorities common among the children of under five years in slum dwellers.
Apple Pomace as Potential Source of Natural Active Compounds

Abstract Apple pomace is a waste product of the apple manufacturing industry that has been in the focus of life sciences as it represents a low-cost source of fruit-derived compounds. High fruit consumption is associated with beneficial health effects, and therefore, apple pomace and its constituents raise therapeutic interest. The present work reviews (i) the chemical constituents of apple pomace, (ii) optimized extraction methods of apple pomace compounds, and (iii) biological activities of apple pomace. Current evidence of apple pomace influence on digestion and metabolism, cholesterol and triglyceride homeostasis, diabetes, and sex hormones is summarized. Furthermore, studies regarding its antioxidative, anti-inflammatory, antiproliferative, antibacterial and antiviral effects are presented. The review concludes that apple pomace is an underutilized waste product of the apple industry with the potential of being processed for its nutritional and pharmaceutical value.
Insulin-Like Growth Factor-I Receptor Stimulating Activity Is Associated with Dementia (P1.253)

OBJECTIVE: We investigated whether insulin-like growth factor-I (IGF-I) receptor stimulating activity is associated with prevalent and incident dementia. BACKGROUND: IGF-I is a pleiotropic hormone. Several studies have implicated IGF-I levels in the development of dementia, but evidence remains inconclusive. IGF-I receptor stimulating activity is a more direct measure of biologically available IGF-I than total IGF-I levels and provides novel insights into the role of IGF-I metabolism in dementia. DESIGN/METHODS: IGF-I receptor stimulating activity was measured using an IGF-I kinase receptor activation assay in 1014 persons (56.2% female, mean age 72.3 years) from the Rotterdam Study. Dementia was assessed at baseline (1997-1999) and continuously during follow-up until September 2011. Associations of IGF-I receptor stimulating activity with prevalent dementia were investigated using logistic regression models and with incident dementia using Cox proportional hazards models. All models were adjusted for age and sex, and additionally for hypertension, glucose, waist circumference, APOE -e4 carrier status, total cholesterol, and HDL-cholesterol. We separately investigated Alzheimer disease and subsequently excluded participants with prevalent diabetes mellitus. RESULTS: Thirty participants had prevalent dementia and during 8,589 person-years of follow-up 135 persons developed incident dementia. A higher level of IGF-I receptor stimulating activity was associated with a higher prevalence of dementia (fully adjusted odds ratio 1.47; 95% CI 1.10-1.97) and with higher risk of incident dementia (fully adjusted hazard ratio 1.15; 95% CI 1.00-1.33). Similar associations were found for Alzheimer disease and in persons without diabetes mellitus. CONCLUSIONS: Higher levels of IGF-I receptor stimulating activity are associated with a higher prevalence and to a lesser extent with a higher incidence of dementia. These results suggest that IGF-I increases in response to neuropathological changes in dementia and could reflect a state of IGF-I resistance in dementia. Disclosure: Dr. de Bruijn has nothing to disclose. Dr. Janssen has nothing to disclose. Dr. Brugts has nothing to disclose. Dr. van Duijn has nothing to disclose. Dr. Hofman has received personal compensation in an editorial capacity for the European Journal of Epidemiology. Dr. Koudstaal has nothing to disclose. Dr. Ikram has nothing to disclose.
Involvement of looked after children in making decisions about their present and future care needs

The provision of services for looked after children is an arena, like no other, where agents of the state, rather than parents or the children themselves are making decisions about children's lives. Such decisions include where and with whom looked after children live, what school they attend and the regularity and quality of their contact with their families and friends. The extent to which looked after children are involved in these decision-making processes appears to depend on the assumptions and perceptions of social work practitioners about the ability of children to participate. These assumptions are usually based on age-related concepts of competence and thus younger looked after children, aged eight or under, are unlikely to be involved and therefore have limited opportunity to participate in making decisions about their
Effect of testosterone supplementation on functional mobility, cognition, and other parameters in older men: a randomized controlled trial.

CONTEXT Serum testosterone levels decline significantly with aging. Testosterone supplementation to older men might beneficially affect the aging processes. OBJECTIVE To investigate the effect of testosterone supplementation on functional mobility, cognitive function, bone mineral density, body composition, plasma lipids, quality of life, and safety parameters in older men with low normal testosterone levels. DESIGN, SETTING, AND PARTICIPANTS Double-blind, randomized, placebo-controlled trial of 237 healthy men between the ages of 60 and 80 years with a testosterone level lower than 13.7 nmol/L conducted from January 2004 to April 2005 at a university medical center in the Netherlands. INTERVENTION Participants were randomly assigned to receive 80 mg of testosterone undecenoate or a matching placebo twice daily for 6 months. MAIN OUTCOME MEASURES Functional mobility (Stanford Health Assessment Questionnaire, timed get up and go test, isometric handgrip strength, isometric leg extensor strength), cognitive function (8 different cognitive instruments), bone mineral density of the hip and lumbar spine (dual-energy x-ray absorptiometry scanning), body composition (total body dual-energy x-ray absorptiometry and abdominal ultrasound of fat mass), metabolic risk factors (fasting plasma lipids, glucose, and insulin), quality of life (Short-Form Health 36 Survey and the Questions on Life Satisfaction Modules), and safety parameters (serum prostate-specific antigen level, ultrasonographic prostate volume, International Prostate Symptom score, serum levels of creatinine, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, hemoglobin, and hematocrit). RESULTS A total of 207 men completed the study. During the study, lean body mass increased and fat mass decreased in the testosterone group compared with the placebo group but these factors were not accompanied by an increase of functional mobility or muscle strength. Cognitive function and bone mineral density did not change. Insulin sensitivity improved but high-density lipoprotein cholesterol decreased; by the end of the study, 47.8% in the testosterone group vs 35.5% in the placebo group had the metabolic syndrome (P = .07). Quality-of-life measures were no different except for one hormone-related quality-of-life measure that improved. No negative effects on prostate safety were detected. CONCLUSION Testosterone supplementation during 6 months to older men with a low normal testosterone concentration did not affect functional status or cognition but increased lean body mass and had mixed metabolic effects. TRIAL REGISTRATION isrctn.org Identifier: ISRCTN23688581.
[Workers' Compensation Claims for Needlestick Injuries Among Healthcare Personnel in Hospitals, Doctors' Surgeries and Nursing Institutions].

OBJECTIVE The "Technical rules for biological agents in healthcare and welfare facilities" (TRBA 250) came into force in March 2014 in Germany and deals with protective measures to prevent needlestick injuries (NSI). The present study covers the period of 6 months after TRBA 250 came into force. The study had 2 objectives: to investigate whether hospitals, doctors' surgeries and care facilities differ with respect to the causes of needlestick injuries (NSI) and to collect data on availability and implementation of safety-engineered devices (SED) in these healthcare settings workplaces. METHODS This study analyses workers' compensation claims for NSI, as received by the Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege, BGW) (n=1602). During a telephone interview (response rate 33.3%), the subjects were asked about the course of the accident and the handling of SED at the workplace. Descriptive analyses were performed for hospitals, doctors' surgeries and care facilities (including inpatient care for the elderly and outpatient care). RESULTS In all 3 settings, about half of the NSI did not occur during the invasive procedure, but during the subsequent disposal of the instruments. 30% of all NSI were caused by needles for subcutaneous injections; in care facilities, the proportion was above 50%. SED were involved in 20% of the NSI in hospitals and doctors' surgeries and in 10% of NSI in care facilities. Lack of experience in activating the safety mechanism was the most important cause of failure for NSI with SED. SED were available at the workplace in 80% of hospitals and doctors' surgeries and in 50% of care facilities. CONCLUSION Training on the safe disposal of sharp instruments should be provided to all professional groups who come into contact with such instruments. It is currently not possible to provide a reliable estimate of the risk of infection from subcutaneous needles. As a high proportion of NSI in nursing homes and outpatient care services were caused by subcutaneous needles, training on safe handling practices for disposal of needles is needed in these settings.
Second-hand effects of college drinking and educational experiences: Findings from an analysis of pooled cross-sections

Abstract Aims: Research from several countries has demonstrated the prevalence of exposure to alcohol’s second-hand effects. This study adds to this literature with an examination of the relationships between exposure and grades and school satisfaction among the US college and university students. Methods: The study used pooled cross-sectional data from the four rounds (1993, 1997, 1999 and 2001) of the Harvard School of Public Health College Alcohol Study (N = 53,061). Random samples of students at four-year colleges and universities completed self-report mailed surveys and provided information on the frequency of their exposure to alcohol’s second-hand effects, their own drinking behaviour, college grades, school satisfaction and backgrounds. Findings: Multilevel, multivariate logit analyses showed significant, negative associations between exposure to second-hand effects and both grades and school satisfaction (p < 0.05). These effects were pronounced among abstainers and light drinkers compared to students who consumed alcohol more frequently. Drinking level also moderated the relationship between exposure and satisfaction with college: this association was significantly larger for abstainers and infrequent drinkers (p < 0.05). Conclusions: The majority of students reported exposure to alcohol’s second-hand effects; this exposure was negatively associated with grades and satisfaction with school. Colleges and universities could help reduce the negative consequences of second-hand exposure by providing all students – abstainers and drinkers alike – with information on its negative consequences. They could also create more opportunities for students to live and socialize in alcohol-free settings.