Miracle-dz/UniFAR-FTUs huggingface dataset:
Topical corticosteroid misuse: observational study to evaluate pattern of abuse and adverse drug reactions

Background: Topical corticosteroids (TC) have a reputation as anti-acne, anti-blemish effects and popularly used as fairness creams. In India, there has been a rise in misuse of TC in last10 years. The present study was conducted to analyse the magnitude of adverse effects of topical corticosteroids abuse in dermatology outpatient department of a tertiary care hospital.Methods: A retrospective observational study was conducted on patients after categorizing them as a TC misuser by dermatologists. The socio-demographic data, chief complaints, details of drugs misuse and adverse drug reaction outcome was collected.Results: A total of 1240 patients was screened, out of which 80 patients misused TC without dermatologist prescription for their skin disease. TC was mainly misused by teenagers (43.8%). Misuse of topical corticosteroids was more common among females (76.3%). Betamethasone valerate (72.5%) was most common TC misused. Most common source of advice of TC misuse was friends (37.5%). Most common purpose of TC misuse was acne (55%) followed by cosmetic purposes (21.3%). The most common morphological varieties of adverse drug reactions were burning and itching sensation (53%) followed by increase severity of acne (44%). Conclusions: TC misuse was more common in teenage females. Most common adverse effect reported is burning and itch sensation followed by increase severity of acne. The study data indicates a significance of problem and requirement of urgent measures to control TC misuse.
Prognostic factors of myringoplasty: study of a 140 cases series and review of the literature

Myringoplasty is one of the most frequent interventions in otology. It aims to restore the eardrum in order to protect against extrinsic contamination by water and to improve hearing. Our study aimed to analyze the factors that may affect anatomical and functional results of myringoplasty or type I tympanoplasty. A retrospective study was performed of a series of 140 cases of myringoplasty over a 6-years period from 2010 to 2015. The approach was post-auricular in 69% of cases and all the patients underwent an underlay technique. Temporal fascia was used in 90.71% of the cases. After an average follow-up of 13 months, the anatomical and functional results were acceptable, with a tympanic closure rate of 88% and an average audiometric gain of 14.22 dB. Several factors affected our results, including the location of the perforation, the active or inactive status of the chronic otitis media, the condition of the opposite ear and the graft material. In light of our results and those of the literature, we believe that the middle ear should be dry at least two months prior to surgery, use of cartilaginous graft material and underlay technique should be preferred and special precautions should be taken in case of anterior or contralateral perforation.
Non-Psychiatric Hospitalization For Patients With Psychotic Disorders: A Mixed-Methods Study

Patients with psychotic disorders face a multitude of medical health disparities in addition to psychological symptoms. They have a higher medical disease burden than the general population and are more likely to have a non-psychiatric hospitalization. In the hospital, these patients have an increased risk of adverse events, readmission and extended length-of-stay. Working with a Health Equity lens and the Quality Health Outcomes Model, we reviewed the literature on adverse events during medical-surgical hospitalizations for these patients and identified differences at the patient, provider and system levels between these patients and the general population. Next, a mixed methods, exploratory sequential study was conducted to: 1) explore the experience of patients with psychotic disorders hospitalized on medical-surgical unit; 2) examine patient characteristics and care processes associated with length-of-stay (primary outcome), adverse events and readmissions (secondary outcomes), among patients with psychotic disorders during non-psychiatric hospitalizations; and 3) integrate qualitative and quantitative data to contextualize factors associated with hospital outcomes among patients with psychotic disorders during non-psychiatric hospitalizations. For Phase 1, interviews were conducted with twenty patients with psychotic disorders on medical-surgical units. Five themes were developed through thematic analysis: 1) managing through hard times, 2) ignored and treated unfairly, 3) actively involved in health, 4) appreciation of caring providers and 5) violence: expected and experienced. In Phase 2, information from these interviews guided variable selection for an analysis of patient hospital records. A general linear model was conducted to examine length-of-stay’s relationship with patient characteristics and care processes. Of patient characteristics, only medical comorbidities were significantly related to length-of-stay. Certain processes of care highlighted by patients from the qualitative sample were found to be associated with length-of-stay like physical restraints (64% longer), psychiatrist consult (20% longer) and outpatient appointment in the previous six months (10% shorter). Results suggest specific patient characteristics and care processes are highly related to length-of-stay and that many of these were important to the patients in the qualitative portion. The use of mixed methods research for hospital outcomes research in this population creates valuable information for educational and clinical settings to improve care for patients with psychotic disorders. Degree Type Dissertation Degree Name Doctor of Philosophy (PhD) Graduate Group Nursing First Advisor Bridgette M. Brawner This dissertation is available at ScholarlyCommons: https://repository.upenn. edu/edissertations/3387
Self-Reported Load Carriage Conditioning Practices of Australian Soldiers

Soldiers are required to carry external loads as part of their occupation. Physical conditioning to carry such loads is vital if injuries are to be avoided and occupational task performance optimised. Soldiers were asked to describe their most recent load carriage physical training session via an online survey. Of the 338 respondents, only 41% reported completing a load carriage conditioning session in the preceding 14 days. The loads carried ranged from a mean Patrol Order load of 15.5 kg (±10.8 kg) to a mean Marching Order load of 36.3 kg (±12.0 kg). Roads (42%) and dirt or grass (39%) constituted the predominant terrains traversed, with the majority of sessions (79%) lasting no more than 2 hours and being of an endurance marching nature (60%). When compared to the recommended load carriage conditioning requirements suggested by the literature, these conditioning sessions were deficient in several areas when relating to the Frequency, Intensity, Time and Type of conditioning required. These results suggest that soldiers may not being optimally conditioned for field and operational load carriage requirements. Keywords—Load carriage, soldier, physical conditioning
Segmental cytomegalovirus colitis mimicking sigmoid tumor in an immunocompetent patient.

Cytomegalovirus (CMV) is a pathogen that tends to provoke opportunistic infections in immunocompromized individuals who have undergone transplantation, are suffering from an inflammatory bowel disease with chronic corticosteroid treatment, or in patients with HIV. Contact with the virus will have taken place in most immunocompetent individuals, as determined by the presence of specific antibodies in the different series ranging between 45% and 100%. Its behavior is usually totally asymptomatic. Exceptional cases of CMV symptomatic infection have been reported in the central nervous system and colon (1). In the latter, it manifests generally in the form of watery diarrhea accompanied or not by rectal bleeding and non-specific abdominal pain.
Knowledge regarding reproductive health among women of reproductive age group in three sub-centre areas of a primary health center, Sarjapur, Bengaluru, Karnataka: a cross sectional study

Background: Reproductive health plays a significant role in a woman’s life. Women of child bearing age group in developing countries suffer ill health due to lack of knowledge on reproductive health issues. The objective of the present study was to assess the knowledge regarding reproductive health among women and the associated socio-demographic factors.Methods: A total of 345 women of age group 15-44 years were recruited using cluster sampling in 15 clusters from among 28 villages under a Primary Health Center from May to July 2017. Data on sociodemographic details and knowledge of reproductive health under the following domains: menstruation, contraception, reproductive tract infections and marriage and pregnancy were collected using a modified interview schedule.Results: The mean age of the study population was 28.59±9.08 years. Majority of them belonged to age group 15-30 years (60%), attained school level education (55.7%), 45% were gainfully employed, married (65.5%) and from middle class (40.6%). It was found that out of 345 study population; only 19% had adequate knowledge on reproductive health. The proportion of women who had adequate knowledge in each domain was marriage and pregnancy (47.5%), menstruation (29.9%), contraception (17.4%) and least being reproductive tract infections (15%). Knowledge on reproductive health was significantly inadequate among women in the age group 31-44 years, illiterate women, who belongs to lower class and students. Only, socio-economic status and occupation were the significant predictors of knowledge.Conclusions: Knowledge regarding reproductive health was inadequate among women in reproductive age group in rural areas.
Outcome Predictors of Augmentation Urethroplasty Using Dorsal Onlay Buccal Mucosal Graft

Background: The incidence and timing of stricture recurrence and factors affecting urethroplasty outcomes remains incompletely characterized. Objective: To evaluate and determine the factors predicting the outcome of dorsal onlay buccal mucosal graft (BMG) urethroplasty. Patients and Methods: We analyzed the records of 115 patients underwent dorsal onlay BMG urethroplasty at Al-Azhar University Hospitals in Cairo, Egypt, from January 2015 to April 2018, with a minimum of 12 months of followup. The risk factors examined were patient age, stricture etiology, site, length, width, diabetes, hypertension, smoking, obesity, previous visual internal urethrotomy (VIU) and urethroplasty, early postoperative complications, extravasation at first periurethral ascending cystourethrogram (ACUG) and stricture width. Results: Average patients age was 38 years. Stricture free rate was 90.4% and mean followup period was 47.5 months (range 12 to 67). Average stricture length was 5.9 cm, average stricture width was 6.3 mm, 63.4% of patients were with previous VIU, and 9.5% were with previous urethroplasty. On univariate analysis, etiology, site of stricture, previous four or more times VIU, DM, obesity, stricture length, postoperative (post op.). wound infection and leakage at first periurethral ACUG were associated with stricture recurrence. On multivariate analysis panurethral stricture (HR 280.6, 95% CI 9.1-8622.8, p =0.001), traumatic stricture (HR 17.1, 95% CI 2.4-123.4, p =0.005) were independent predictors of stricture recurrence. Stricture width, previous urethroplasty, the number of failed endoscopic procedures less than 4 times, smoking, HTN and patient age did not affect the recurrent stricture rate. Conclusion: panurethral and traumatic strictures were independent predictors of stricture recurrence.
Magnetic resonance imaging and the development of vascular targeted treatments for cancer.

The main subject of the work presented in this thesis is the further development of magnetic resonance imaging (MRI) as a non-invasive method of investigating tumour microcirculation. Two different MR techniques were used: dynamic contrast enhanced (DCE)-MRI and Blood Oxygen Level Dependent (BOLD)-MRI. Intravital microscopy was used to help interpret BOLD-MRI results. The ultimate aims were to determine whether MRI methods could be relied upon to define a drug as having vascular disrupting activity and to develop techniques to predict the effectiveness of vascular disruptive agents (VDA). In DCE-MRI, tissue enhancement is continuously monitored over several minutes after intravenous injection of contrast medium. Modelling of contrast agent kinetics generates quantitative parameters related to tissue blood flow rate and permeability, e.g. Ktrans (transfer constant). In a clinical study, patients had DCE-MRI examinations before and 24 hours after cytotoxic chemotherapy to establish whether any acute ami-vascular effects could be detected. No acute reductions in Ktrans were seen. In this project, the acute effects of the VDA, combretastatin A-4-phosphate, were investigated using DCE-MRI in SW1222 tumours in mice. Responses were seen both at a clinically relevant dose and at higher doses, and a dose-response relationship established. BOLD-MRI can detect changes in oxygenation and blood flow within tumours using deoxygenated haemoglobin as an intrinsic contrast agent. Tumours contain a variable proportion of immature vessels, which may explain differential sensitivity to VDAs. In this project, BOLD-MRI was used to assess tumour vessel maturity using consequent vasoreactivity to angiotensin II and carbon dioxide (as air-5%C02 or as carbogen) in an animal model. Intravital microscopy was used to directly observe response to these agents in mouse window chambers. Results suggest that response to vasoactive agents is useful for assessing vascular maturity in tumours but that more sensitive non-invasive imaging methods than BOLD-MRI are required for clinical use.
Subsidized pharmacological treatment for smoking cessation by the Spanish public health system: A randomized, pragmatic, clinical trial by clusters

INTRODUCTION Research has shown that financing drug therapy increases smoking abstinence rates, although most of these studies have been carried out in the private healthcare setting. The aim of this work is to assess the effect of subsidized pharmacological treatment on smoking cessation rates by the Spanish public healthcare system. METHODS A pragmatic, randomized, clinical trial was performed by clusters. Randomization unit was the primary healthcare center and the analysis unit was the patient. Smokers consuming ≥10 cigarettes/day were randomly assigned to an intervention group that received financed pharmacological treatment or to a control group that followed usual care. The main outcome was self-reported or CO-confirmed continuous abstinence at 12 months. The main outcome, continuous abstinence rates (%), were compared between groups at 12 months post-intervention. A model was adjusted using mixed-effect logistic regression. RESULTS A total of 1154 patients were included from 23 healthcare centers. In the intention-to-treat analysis, self-reported abstinence after 12 months in the control and intervention groups, respectively, was 9.6% (37/387) and 15.4% (118/767) (gender-adjusted OR=1.75; 95% CI: 1.1–2.8); for CO-confirmed abstinence the corresponding values were 3.1% (12/387) and 6.4% (49/767) (gender-adjusted OR=1.72; 95% CI: 0.7–4.0). Pharmacological treatment use was 35.1% (136/387) in the control group, and 58.3% (447/767) in the intervention group (adjusted OR=4.25; 95% CI: 1.8–9.9) CONCLUSIONS Subsidizing pharmacological treatment for smoking cessation increases self-reported or CO-confirmed abstinence rates under realistic conditions in the primary care setting of the Spanish public health system.
Circular RNA SMARCA5 inhibits the proliferation, migration, and invasion of non-small cell lung cancer by miR-19b-3p/HOXA9 axis

Background Non-small cell lung cancer (NSCLC) is the main type of lung cancer, remaining a leading cause of cancer-related mortality around the world. Circular RNA SMARCA5 (circSMARCA5) is a novel circular RNA associated with the pathogenesis of several cancers. However, the role of circSMARCA5 in NSCLC remains unknown. In the present study, we aimed to evaluate the functions of circSMARCA5 in NSCLC and the underlying mechanism. Methods The expression pattern of circSMARCA5 was determined using qRT-PCR in NSCLC samples and cell lines. The correlation between miR-19b-3p and circSMARCA5 in NSCLC tissues was detected by qRT-PCR. Cell proliferation was examined utilizing CCK-8 assay. Cell migration and invasion was evaluated using Transwell assay. We used the bioinformatics software TargetScan and miRanda to predict circRNA-miRNA and miRNAi-mRNA interactions. Further, the regulatory role of circSMARCA5 in the malignant development of NSCLC in vivo was examined. Results The results showed that circSMARCA5 was down-regulated in NSCLC tissues as compared to the adjacent normal tissues. Overexpression of circSMARCA5 in NSCLC cell lines significantly inhibited the proliferation, migration, and invasion. Furthermore, circSMARCA5 exerted its tumor-suppressive activity through acting as a sponge for microRNA (miR)-19b-3p. Suppression of miR-19b-3p exhibited inhibitory effects on proliferation, migration, and invasion of NSCLC cell lines, which could be attributed to the regulation of homeobox A9 expression. Finally, overexpression of circSMARCA5 inhibited tumor growth in vivo. Conclusion Collectively, circSMARCA5 executed its inhibitory effects on NSCLC cell lines through miR-19b-3p/HOXA9 axis. The results indicated that circSMARCA5 might be a therapeutic target for the treatment of NSCLC.
Training of oncologists: Results of a global survey.

10526 Background: While several studies have highlighted the global shortages of oncologists and their workload, few have studied the characteristics of current oncology training. Methods: An online survey was distributed through a snowball method via national oncology societies and a pre-existing network of contacts to cancer care providing physicians in 57 countries. Countries were classified into low- or lower-middle-income countries (LMICs), upper-middle-income countries (UMICs), and high-income countries (HICs) based on World Bank criteria. Results: 273 physicians who trained in 57 different countries responded to the survey; 33% (90/273), 32% (87/273), and 35% (96/273) in LMICs, UMICs and HICs respectively. 60% of respondents were practicing physicians and 40% were in training. The proportion of trainees was higher in LMICs (51%; 45/89) and UMICs (42%; 37/84), than HICs (19%; 28/96; P = 0.013). A higher proportion of respondents from LMICs (37%; 27/73) self-fund their core oncology training compared to UMICs (13%; 10/77) and HICs (11%; 10/89; P < 0.001). Respondents from HICs were more likely to complete an accepted abstract, poster and publication from their research activities compared to respondents from UMICs and LMICs (abstract: 37/72 (51%) from HICs, 18/66 (27%) from UMICs, 24/65 (37%) from LMICs, P = 0.014; poster: (42/72 (58%) from HICs, 28/66 (42%) from UMICs, 13/65 (20%) from LMICs, P < 0.001; publication: 43/72 (60%) from HICs, 32/66 (49%) from UMICs, 24/65 (37%) from LMICs, P = 0.029). Respondents identified several barriers to effective training including skewed service to education ratio and burnout. With regards to preparedness for practice, mean scores on a 5-point Likert scale were low for professional tasks like supervision and mentoring of trainees, leadership and effective management of an oncology practice, and understanding of healthcare systems irrespective of country grouping. Conclusions: Investment in training by the public sector would be vital to decreasing the prevalence of self-funding in LMIC. Gaps in research training and enhancement of competencies in research dissemination in LMIC require attention. Instruction on cancer care systems and leadership need to be incorporated in training curricula in both LMICs and HICs.
Effects of interval training on quality of life and cardiometabolic risk markers in older adults: a randomized controlled trial

Purpose To explore the effects of 10 weeks of progressive vigorous interval training as a single intervention on health-related quality of life (HRQoL) and cardiometabolic risk markers in centrally obese 70-year-old individuals. Participants and methods A randomized controlled trial (ClinicalTrials.gov registration no. NCT03450655) including seventy-seven community-dwelling 70-year-old men and women with central obesity defined as > 1 kg visceral adipose tissue for women and > 2 kg for men. Participants randomized to the intervention group were offered a 10-week progressive vigorous interval training program performed three times per week. Control subjects were asked to maintain their daily living and routines throughout the trial. All participants in both groups had received tailored lifestyle recommendations focused on diet and physical activity at one occasion within 12 months prior to trial initiation. Prespecified outcome measures included: changes in HRQoL using the Short Form Health Survey Questionnaire (SF-36), blood pressure; resting heart rate (HR) and blood lipids. All analyses were conducted on an intention-to-treat basis. Results The intervention resulted in significant effects on the SF-36 mental component summary (MCS) score and the mental health (MH) subscale (P< 0.05 for both), when compared to the control group. Specifically, the intervention group increased their MCS score by 6.3 points (95% confidence interval [CI] = 0.3-12.3) and their MH score by 6.0 points (95% CI = 1.7-10.4) compared to the control group. Moreover, significant effects were seen on resting HR, total cholesterol and LDL-cholesterol (P<0.05 for all). Conclusion It was shown that 10 weeks of vigorous interval training as a single intervention was sufficient to improve mental aspects of HRQoL in older individuals with central obesity, which is a critical aspect of healthy ageing. Positive effects were seen also on cardiometabolic risk markers.
Post-operative morbidity and mortality following D2 gastrectomy in a state funded tertiary care centre in South India

Background: Radical gastrectomy with D2 lymphadenectomy is a surgery with significant post-operative morbidity. Pre-operative malnutrition portends a poor post-operative outcome following any gastrointestinal surgery in general. This study aims at finding out whether it is feasible to perform D2 lymphadenectomy in patients presenting with significant malnutrition.Methods: In this single centre study, we retrospectively analysed the post-operative morbidity and mortality data of 46 patients who underwent D2 gastrectomy for operable gastric cancer between October 2016 to April 2019. Almost all the patients who were analysed fulfilled at least one criterion for malnutrition.Results: The morbidity rate was 39.1% and the mortality rate was 6.5% which were a little high when compared to results from other Indian centres but not prohibitive, considering the nutritional status of these patients. Almost 50% of these patients were able to complete adjuvant chemotherapy.Conclusions: D2 gastrectomy can be performed in patients with poor pre-operative nutritional status. If perioperative nutritional requirements are taken care of promptly, the post-operative outcomes can be better.