Miracle-dz/UniFAR-FTUs huggingface dataset:
A bio-psychosocial intervention program for improving quality of life in breast cancer survivors: Results of a prospective randomized trial

Background: Given the 3.1 million breast cancer survivors in America, quality of life (QoL) is a vital issue. Bio-psychosocialmilieu of survivorship is increasingly important. This study assesses the impact of bio-psychosocial intervention (BPSI) on theQoL of breast cancer survivors utilizing Functional Assessment of Cancer Therapy – Breast (FACT-B) instrument. Methods: A prospective randomized trial was designed; intervention arm included a 4-hour BPSI coping skills class; control armreceived standard of cancer (SOC) and follow up care. Women diagnosed within 2 years of study initiation were eligible. Samplesize was based on 8-point difference in FACT-B score, 90% power, 5% type I error, and 20% attrition. FACT-B questionnaire wasadministered to all patients at baseline and at 6-month intervals. SAS 9.3 software was used to analyze data using Chi-square testfor categorical and Wilcoxon rank sum for ordinal data; linear mixed modeling was used for longitudinal analysis. Results: One hundred and three of 120 (86%) patients were available for analysis. Forty-seven patients were in BSPI arm, and 56received SOC. For BPSI arm vs. SOC arm, the median (interquartile) age [60 (52, 68) vs. 58 (52, 68)yrs. P = . 9135], cancer-stage(0: 1: 2: 3 = 11%: 41%: 35%: 13% vs. 18%: 46%: 22%: 15%, P = .4645), and biology (triple-negative: HER2+ : ER+ =9%: 74%: 17% vs. 8%: 72%: 20%, P = .8454), respectively, was similar. Mean (SE) FACT-B scores in BPSI vs. SOC arms at6 months and 1 year were 115.1 (2.2) vs. 114.6 (2.0) ( P = .8731) and 124.7(2.8) vs. 101.4 (2.4) ( P = .0001). The inter-groupdifference significantly expanded at 1 year ( P = .0001). The 12-month difference persisted when confounding baseline variableswere adjusted for in in multivariate modeling. Conclusion: BPSI coping skills class significantly improved the QoL of breast cancer survivors by one year post-interventiontime point.
Body image during sexual activity in the population of Polish adult women

Introduction Recently it has been shown that body image during sexual activities is a better predictor of the diversity of sexual experience than body image as a psychological trait. To measure contextual body image (as a state) the Body Exposure During Sexual Activity Questionnaire (BESAQ) was developed. Material and methods 845 women aged 18-55 years were included in the study. The original model was first translated into Polish and consulted to create the version to be further validated. The original model was tested using confirmatory factor analysis (CFA). The population was divided in two equal groups – group 1 was used for exploratory factor analysis. Discriminant and convergent validity were checked. Sexual function was assessed by the Changes in Sexual Function Questionnaire. Results The Polish model of BESAQ (BESAQ-PL) consisted of 28 items with 2 lower-order factors. It had a satisfactory goodness of fit – comparative fit index (CFI) = 0.93, Tucker-Lewis index (TLI) = 0.94, root-mean-square error of approximation (RMSEA) = 0.06 and χ2 = 1360.0, df = 337, p< 0.001, excellent internal consistency measured by Cronbach’s α = 0.88 and satisfactory discriminate validity. State body image (BESAQ-PL) did not predict sexual functioning. Face was the most important for self-consciousness during sexual contact in the population of Polish women. Conclusions State body image correlates with sexual functions but is not a major factor influencing sexual performance. Women in Poland are not anxious about body exposure during sexual activity. The BESAQ-PL may be used in the population of Polish women between 18 and 55 years of age.
In-Office Tympanostomy Tube Placement Using Iontophoresis and Automated Tube Delivery Systems

Objectives (1) To evaluate safety, tolerability, and technical success of lidocaine iontophoresis and a tympanostomy tube placement system for adults in an office setting and (2) to meet regulatory evidence requirements for new drugs and devices. Study Design Prospective, multicenter, single arm. Setting Patients were recruited in 8 community-based practices in the United States between June and September 2017. Subjects and Methods This study evaluated tympanic membrane anesthesia and tube placement in 30 adults. Anesthesia was achieved via iontophoresis of a lidocaine/epinephrine solution. Tube placement was conducted using an integrated myringotomy and tube delivery system. Tolerability of tube placement was measured using a patient-reported visual analog scale from 0 mm (no pain) to 100 mm (worst possible pain). Mean pain score was compared to a performance goal of 45 mm, where statistical superiority represents mild pain or less. Technical success and safety through 3 weeks postprocedure were evaluated. Results Twenty-nine (29/30, 96.7%) patients had tube(s) successfully placed in all indicated ears. One patient demonstrated inadequate tympanic membrane anesthesia, and no tube placement was attempted. The mean (SD) pain score of 9.4 (15.7) mm was statistically superior to the performance goal. There were no serious adverse events. Seven nonserious events were related to device, procedure, or drug: inadequate anesthesia (1), vertigo (1), and dizziness (1) at the time of procedure and ear discomfort (1), tube occlusion (2), and medial tube migration (1) postprocedure. Conclusion Lidocaine iontophoresis provides acceptable tympanic membrane anesthesia for safe, tolerable, and successful in-office tube placement using an integrated myringotomy and tube delivery system.
Risk Factors of Breast Cancer in Hadramout Valley and Desert, Yemen

Background: The incidence of breast cancer is on rise in low- and middle-income countries as populations increasingly adopt western lifestyles. Studies on risk factors of cancers including breast cancer are lacking in Yemen. Therefore, this study aimed to determine the risk factors of breast cancer among women registered at Hadramout Valley and Desert Oncology Center (HVDOC). Methods: A case–control study was conducted at HVDOC, Yemen. All women who were registered in HVDOC and diagnosed with breast cancer and confirmed by histopathology during 2011–2015 were selected as cases. Age-matched controls were selected from women who underwent mammography in HVDOC during 2011–2015 and were confirmed to be free of breast cancer. Data were collected using semi-structured questionnaire and clinical data were abstracted from the medical records. Results: A total of 105 patients and 210 controls were included in this study. About 70.5% of cases and 72.4% of control were 50 years old or younger. Compared with married women, divorced women had higher odds of breast cancer [odds ratio (OR) = 2.2]. The odds of breast cancer was higher for women who had never breastfed a child (OR = 1.7). Having hypertension (OR = 2.5), family history of malignancy (OR = 2.4), and postmenopausal status (OR = 2.0) were significantly associated with higher odds of breast cancer in multivariate analysis. Conclusions: The main risk factors for breast cancer among women in Yemen are divorced marital status, never breastfed a child, having hypertension, family history of malignancy, and postmenopause. Regular screening especially among women with high risk is needed.
Angiosarcomaafteradjuvantradiotherapy in high-risksquamouscell carcinoma of the vulva: a case report

Squamous cell carcinoma of the vulva represents 3-5% of gynecological cancers. The incidence is higher in postmenopausal patients; the mean age of women with vulvar cancer is between 64 and 70 years. Radiotherapy plays an increasing role in the treatment of high-risk squamous cell carcinoma of the vulva; associated with surgery it significantly improves prognosis but is also associated with serious late side-effects, such as secondary malignancies. We describe a case of a 75-year-old woman who underwent deep total vulvectomy with inguinal-femoral lymphadenectomy for high-risk, keratinizing variant HPV-negative, squamous cell carcinoma of the vulva, followed by adjuvant concomitant chemo-radiotherapy, at the University Hospital of Pisa in February 2013. Five years later she developed a very large angiosarcoma in the right abdominal wall, at the edge of the previous radiotherapy field, and underwent radical surgery. After four months, she developed bone metastasis of angiosarcoma, also treated with surgery. This experience shows that the use of new technologies allows the delivery of high doses of radiotherapy, significantly correlated with a better prognosis, but also associated with fortunately rare morbidity, such as radiation-induced angiosarcoma. Due to the presence of long, mostly post-menopausal survivors among irradiated patients, screening for second malignancies must be developed for selected high-risk survivor groups.
Comparison of Two Validation Nutrition Tools in Hospitalized Elderly: Full Mini Nutritional Assessment and Short-form Mini Nutritional Assessment

Background: The aim was to determine validity, reliability, and cutoff of full-mini nutritional assessment (MNA) and MNA-short form (SF) also which one was better for the screening of malnutrition in the Iranian hospitalized elderly. Methods: In this cross-sectional validation study, 96 hospitalized elderly ≥60 years selected from two hospitals in Tehran. Anthropometric measures (body mass index [BMI], mid-arm circumference [MAC], calf circumference [CC], abdomen, and waist skinfold thickness) and laboratory tests (albumin and hemoglobin levels, and red blood cell count were performed. Nutrition tools (full-MNA and MNA-SF), cognition tool (mini-mental state examination, depression scale (Geriatric Depression Scale15 and activities of daily living (ADL) index (Modified Barthel-ADL) were administered. Results: The full-MNA scores were significantly correlated to measures of MAC, BMI, waist, and CC. The MNS-SF scores were significantly related to measures of MAC, waist, and CC. Serum albumin showed a poor correlation with both tools. At cutoff 24 in full-MNA had a sensitivity 75% and specificity 77.8% and the MNA-SF considered 62.5% sensitivity and 65.3% specificity at cutoff 10.50 to detect well-nourished from malnourished subjects. The internal consistencies of both tools were >90%. In exploratory factor analysis, six components found for full-MNA and two components for MNA-SF. Known group validity of full-MNA was reflected significant differences between geriatric patients with expected higher full-MNA scores and patients with expected lower scores (BMI ≥24 vs. BMI <24 or bed ulcer or assisted food intake). Conclusions: It seems the Persian version of full-MNA is more appropriate in comparison to MNA-SF for screening malnutrition in the Iranian hospitalized elderly patients.
Serologic evaluation of vaccinated American river otters.

: The Oklahoma Department of Wildlife Conservation acquired 20 American river otters (Lutra canadensis) between 1984 and 1985 for reintroduction into Oklahoma waterways. In 1985, 10 otters were evaluated for serum antibody titers after vaccination with canine distemper virus, canine adenovirus type 2, canine parvovirus (CPV), feline panleukopenia virus (FPV), feline rhinotracheitis virus (FRV), and feline calicivirus. Prevaccination serum-virus neutralization (SVN) antibody to feline rhinotracheitis virus was found in 2 otters and to feline calicivirus in 1 otter. Using an indirect fluorescent antibody (IFA) assay, prevaccination antibody to CPV and FPV was found in 2 otters. A significant increase in SVN antibody titers was found after vaccination of otters with canine adenovirus type 2 (6 of 8 animals) and feline calicivirus (1 of 8 animals). One of 8 otters developed significant antibody titers to CPV and FPV, as measured by IFA assay. Otters did not develop SVN antibody titers to canine distemper virus after vaccination. Antigens of feline leukemia virus, using ELISA, or antibodies to feline infectious peritonitis, using IFA assay, were not found in the 20 otters.
Perception and experience of menopause among primary school teachers in Jos North, North Central Nigeria

Background: As life expectancy increases,most women spent a larger part of their lives in the post-menopausal state,with part of this during the peak of their career for working class women. Perception, attitude and experience of the menopause and its transitional period may differ from one female population to the other. Objective: The objective of this study was to determine the perception and experience of menopause among a group of educated Nigerian career women, and how menopausal symptoms affect their family relationship and work performance. Method: This was a cross sectional study.Two hundred and twenty five post menopausal primary school teachers in Jos North were administered structured questionnaires.The information obtained were analysed using Epi info 2002 statistical software. Results: Most of the women (99.1%) felt that menopause was a natural process of aging.The most frequently reported symptoms were low backache or muscle pains (72.9%),poor memory or forgetfulness (63.6%),hot flushes (51.1%) and tiredness (49.8%). Over half (55.6%) of the women were sexually active with 84.8% of them reporting reduced libido.Over half (56%) of the women studied felt that menopause negatively affected their work performance.Only 8% of the women had heard of hormone replacement therapy. Conclusion: Post-menopausal primary school teachers in Jos North have a positive perception of menopause. Menopausal symptoms are also common and this negatively affects work performance in quite a number of them. Keywords: Perception,Experience,Menopause,Primary school teachers
COMPARISON OF NUMBER OF SURGICAL OPERATIONS AND THEIR CANCELLATION CAUSES IN NAMAZI HOSPITAL BEFORE AND AFTER THE HEALTH TRANSFORMATION PLAN

Background: Surgery cancellation at the last moments is one of the most important causes of inefficiency and waste of hospital resources, which results in operating room disorder, waste of time, wandering and unemployment of personnel, and useless occupation of hospital beds. Therefore, the present study aimed to compare the number of surgical operations and their cancellation causes before and after the healthcare reform. Methods: The present cross-sectional study was conducted in Namazi hospital, Shiraz. The specifications of all the required surgeries were collected from June 22, 2014 to February 20, 2015 through census and were recorded in a researcher-made checklist. The study variables included the number of performed surgical operations per month, number of cancelled surgical operations per month, and their cancellation causes. The data were analyzed using the SPSS statistical software, version 20. Results: The number of surgical operations was increased after the healthcare reform. Besides, the index of surgery cancellation was decreased from 11.73% to 10.94% after the reform. The most common causes of surgery cancellation before the healthcare reform were the factors related to surgeons. On the other hand, the most common causes of surgery cancellation after the healthcare reform were organizational and managerial factors, the most common of which being lack of time in operating rooms. Conclusion: It seems that the reform has been able to reduce surgery cancellation rate to a great extent. Nevertheless, proper planning for elimination of the preventable causes, proper management for use of the maximum capacity of operating rooms, and improvement of surgical operation processes are essential in order to promote the surgery cancellation index.
Morphology and ultrasonography of the pericardial and epicardial adipose tissue in healthy rabbits (Oryctolagus cuniculus).

Rabbits develop a visceral type obesity and therefore is exceptionally suitable as a model for lipid metabolism investigation. Ten clinically healthy New Zealand White rabbits from both genders, weighing from 3.5 to 3.7 kg were used. The blood plasma concentrations of total cholesterol and triglycerides were 1.45 ± 0.15 mmol/L and 0.63 ± 0.01 mmol/L, respectively. The highest amount of pericardial adipose tissue was observed around the free surface of the right ventricle and the apex of the heart. The average mass of pericardial adipose tissue was 3.72 ± 0.24 g (0.1% of body weight and 47% of heart weight). By ultrasonography, pericardia adipose tissue was visualized as a moderately echoic homogeneous structure against the hyperechoic myocardium of the right ventricle. Its thickness was 3.2 ± 0.26 mm. The results of the present study showed that the rabbit was a suitable model for monitoring of quantitative changes in visceral fat depots in mammals, allowing their study in vivo by ultrasonography instead of utilizing dissection.
PWE-104 Gamma-glutamyl transferase but not markers of hepatic fibrosis is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the edinburgh type 2 diabetes study

Introduction Patients with chronic liver disease (CLD) and, in particular, non-alcoholic fatty liver disease (NAFLD) are known to have both higher all-cause mortality and cardiovascular (CV) mortality rates than the general population. Beyond investigation of GGT there has been little exploration of the relationship between CV disease (CVD) and other markers of liver disease (non-specific liver injury, steatosis, steatohepatitis, liver fibrosis or portal hypertension). We examined the association of prevalent and incident CV disease with CLD in a cohort of community-based people with type 2 diabetes (T2DM) in order to determine the relationship between these two important conditions. Method 1066 participants of the Edinburgh Type 2 Diabetes Study, a large, randomly-selected population of patients with T2DM aged 60–75 years were invited for liver assessment. A range of liver disease markers (non-specific liver injury – serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT); steatosis – liver ultrasound; steatohepatitis – serum cytokeratin-18; fibrosis – serum AST to Platelet Ratio Index (APRI), AST:ALT ratio, Enhanced Liver Fibrosis (ELF) panel, Fibrosis-4 Score, NAFLD Fibrosis Score; portal hypertension – platelet count) were measured. Subjects were followed-up using patient and GP questionnaires and record linkage for incident CV events (coronary artery disease (CAD), cerebrovascular disease and peripheral vascular disease). Results At baseline there were 372/1035 patients with prevalent CVD, including 319/1035 with CAD. After mean follow-up of 4.4 years there were 121/1035 incident CVD events, including 76/121 CAD events. There were 30/82 CVD related deaths. However, risk of dying from or developing CVD was no higher in subjects with steatosis than without (HR 1.31 95% CI 0.78–2.20, p > 0.05). The only significant relationship was with GGT (U/L log2incident CVD, adjusted HR 1.18 95% CI 1.00–1.39, p = 0.045; incident CAD, adjusted HR 1.24 95% CI 1.02–2.51, p = 0.032). Conclusion We conducted the first comprehensive population-based study of older people with T2DM and found no association between non-invasive markers of hepatic steatosis, steatohepatitis, or fibrosis with the development of, or mortality from, CVD. Our finding of a significant independent association between GGT and CVD warrants further evaluation as a potentially useful addition to current CV risk prediction models in T2DM. Disclosure of interest None Declared.
Perinatale Morbidität bei Beckenendlage-Kindern in Abhängigkeit vom Geburtsmodus

A retrospective study was made on the perinatal morbidity and mortality of 268 infants born from breech presentation in the years 1984-1986. The fraction of vaginal deliveries changed from 12.8% in 1984 to 41.2% in 1986. Criteria for perinatal morbidity were: frequency of transfers to the pediatric department; Apgar score; and the pH in the umbilical cord arteries (pHU.C.A.). After vaginal delivery from pelvic presentation, the average pHU.C. A. was significantly lower than after cesarean section (p less than 0.05) in infants with a birth weight over 2500 g. Severe acidosis (pHU.C.A. less than 7.1) was equally rare in both groups; mild acidosis (7.1 less than or equal to pHU.C.A. less than or equal to 7.2) was more frequent in the vaginally delivered infants greater than or equal to 2500 g; 18.4% as opposed to 3.4% after cesarean section. It is remarkable, however, that mild acidosis was registered in 13-15% of all deliveries in the years 1984-1986. The different frequencies of transfer to the pediatric department and Apgar scores were not due to the different delivery methods.
PATIENTS WITH DIABETES; THEIR PERCEPTION AND PRACTICES TOWARDS ORAL HEALTH

Objectives: The study aimed at assessing the knowledge, attitudes and practices regarding oral health among patients attending the clinic for diabetes patients at a Tertiary Care Teaching Hospital, Sri Lanka. Methods: A descriptive cross-sectional, questionnaire based study among 427 patients was carried out. The questionnaire consisted of 14 questions to assess knowledge, 16 questions for practices and 16 statements for attitudes regarding oral health. A total score of ≥75% was considered as a ‘good’, 50%-74% was considered as a ‘moderate’ and <50% as a ‘poor’ level of the aspect assessed. Results: Majority (74%) were females aged above 50 years. Of the patients 56% recognized an association between diabetes and oral health. Only 15% knew that they were more prone to oral fungal infections though 89% knew that diabetes resulted in delayed wound healing. Oral cancer (72%) was mainly recognized as a complication of poor oral hygiene. Regarding attitudes, 98% believed that they should be vigilant regarding their oral hygiene. While 29% believed that a dentist should be visited at least twice a year, only one patient practiced this. A majority (93%) believed that brushing teeth twice a day is important for good oral hygiene and 92% claimed to practice this. Conclusions: Overall oral health knowledge and practices among patients were ‘moderate’ and the level of attitudes was ‘good’. Patients expect the clinic to provide regular oral health education and oral examinations.
Standardized Patients Provide a Reliable Assessment of Athletic Training Students' Clinical Skills.

Context: Providing students reliable objective feedback regarding their clinical performance is of great value for ongoing clinical skill assessment. Since a standardized patient (SP) is trained to consistently portray the case, students can be assessed and receive immediate feedback within the same clinical encounter; however, no research, to our knowledge, has documented the reliability of the SP at assessing student performance. Objective: To determine if SPs provide a reliable assessment of athletic training students' performance in obtaining a patient history and completing a physical examination relative to athletic training faculty. Design: Reliability study. Setting: Athletic training simulation lab. Patients or Other Participants: Two SPs and 2 athletic training faculty assessed 35 students (n = 20 junior; n = 15 senior) in athletic training cohorts from a public liberal arts institution in southeast United States. Intervention(s): Athletic training students completed 2 SP encounters per semester.