Miracle-dz/UniFAR-FTUs huggingface dataset:
Families and Larger Systems: A Family Therapist's Guide through the Labyrinth

If individuals cannot adequately be understood without reference to the family system, families themselves are comprehensible only in a broader social context. FAMILIES AND LARGER SYSTEMS is the first single-author book on families and larger systems designed specifically for the practicing therapist. It offers rich descriptions of the difficulties families and larger systems often pose for one another; presents a detailed assessment model for therapists; and provides a careful interviewing format as well as directions for designing creative interventions. Imber-Black offers a consultation model for dealing with families and larger systems who have become embroiled with one another, and methods for longer term work with those families who must engage with larger systems across significant portions of their life cycle, due to illness, handicaps, or poverty. Problems of labeling, stigma, and secrecy in families are addressed, and an entire chapter is devoted to women's issues in families and related systems. Utilizing numerous case illustrations and interview excerpts, Dr, Imber-Black first delineates the problems common to family-larger system situations, analyzing the origins of these interactions, the assessment model and interviewing methods used, and the design and implementation of intervention. In the second half of her book, she presents in-depth discussions of strategies for improving the relationship between families and related systems. Through concrete example and hands-on analysis, Imber-Black shows how the misconceptions, assumptions, and subsequent labeling of family functioning and family members give rise to stalemated situations. FAMILIES AND LARGER SYSTEMS provides a practical guide for all clinicians regardless of theoretical orientation. Therapists who wish to maintain a career in public sector settings, such as mental health clinics, hospitals, and schools, will find in this volume direction for effective work with families and the maintenance of good working relationships with colleagues. Therapists in private practice will discover that Imber-Black's model will aid their conceptualization of cases that have involved multiple therapists or other practitioners. Much of the material presented will also be useful to human services workers, both professional and paraprofessional, in welfare, child welfare, probation, drug counseling, schools and other institutions. The book's ecological viewpoint, which enables such professionals to see their own position in the system, also helps them to avoid the traps of replicating existing patterns, and to position themselves for therapeutic change. Finally, this book will be of interest to human service system administrators and program planners. The case examples offer a seldom seen view of the struggles families and multiple helpers can have with one another, while its theoretical models can be utilized to assess current inter-systematic functioning among larger systems in a community, with implications for program design and burn-out prevention.
Promising Effect of Aromatase Inhibitors on Recurrent Granulosa Cell Tumors

Recurring adult-type granulosa cell tumors of the ovary are usually treated by surgical resection followed by chemotherapy or radiation. However, the results of such treatment are disappointing. We describe 4 patients in whom recurrent ovarian granulosa cell tumors were treated with an aromatase inhibitor, with promising results.
Comparative effectiveness of oxaliplatin vs non-oxaliplatin-containing adjuvant chemotherapy for stage III colon cancer.

BACKGROUND The addition of oxaliplatin to adjuvant 5-fluorouracil (5-FU) improves survival of patients with stage III colon cancer in randomized clinical trials (RCTs). However, RCT participants are younger, healthier, and less racially diverse than the general cancer population. Thus, the benefit of oxaliplatin outside RCTs is uncertain. SUBJECTS AND METHODS Patients younger than 75 years with stage III colon cancer who received chemotherapy within 120 days of surgical resection were identified from five observational data sources-the Surveillance, Epidemiology, and End Results registry linked to Medicare claims (SEER-Medicare), the New York State Cancer Registry (NYSCR) linked to Medicaid and Medicare claims, the National Comprehensive Cancer Network (NCCN) Outcomes Database, and the Cancer Care Outcomes Research & Surveillance Consortium (CanCORS). Overall survival (OS) was compared among patients treated with oxaliplatin vs non-oxaliplatin-containing adjuvant chemotherapy. Overall survival for 4060 patients diagnosed during 2004-2009 was compared with pooled data from five RCTs (the Adjuvant Colon Cancer ENdpoinTs [ACCENT] group, n = 8292). Datasets were juxtaposed but not combined using Kaplan-Meier curves. Covariate and propensity score adjusted proportional hazards models were used to calculate adjusted survival hazard ratios (HR). Stratified analyses examined effect modifiers. All statistical tests were two-sided. RESULTS The survival advantage associated with the addition of oxaliplatin to adjuvant 5-FU was evident across diverse practice settings (3-year OS: RCTs, 86% [n = 1273]; SEER-Medicare, 80% [n = 1152]; CanCORS, 88% [n = 129]; NYSCR-Medicaid, 82% [n = 54]; NYSCR-Medicare, 79% [n = 180]; and NCCN, 86% [n = 438]). A statistically significant improvement in 3-year overall survival was seen in the largest cohort, SEER-Medicare, and in the NYSCR-Medicare cohort (non-oxaliplatin-containing vs oxaliplatin-containing adjuvant therapy, adjusted HR of death: pooled RCTs: HR = 0.80, 95% CI = 0.70 to 0.92, P = .002; SEER-Medicare: HR = 0.70, 95% CI = 0.60 to 0.82, P < .001; NYSCR-Medicare patients aged ≥65 years: HR = 0.58, 95% CI = 0.38 to 0.90, P = .02). The association between oxaliplatin treatment and better survival was maintained in older and minority group patients, as well as those with higher comorbidity. CONCLUSION The addition of oxaliplatin to 5-FU appears to be associated with better survival among patients receiving adjuvant colon cancer treatment in the community.
In vitro maturation in sub fertile women with polycystic ovarian syndrome undergoing assisted reproduction.

BACKGROUND Polycystic ovarian syndrome (PCOS) occurs in 4% to 7% of all women of reproductive age and 20% of women presenting with sub-fertility. A significant proportion of these women will ultimately need assisted reproductive techniques (ART). In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome. A potentially useful intervention for women with PCOS-related infertility involves earlier retrieval of immature oocytes followed by in vitro maturation (IVM). OBJECTIVES To compare live birth rates per woman following in vitro maturation (IVM) with conventional in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) for women with PCOS undergoing ART. SEARCH STRATEGY We searched the Menstrual Disorders and Subfertility Group Specialised Register of controlled trials for any relevant trials from the title, abstract, or keyword sections. Following a search of electronic databases (MEDLINE in all languages) using Ovid software we also performed a manual search of the references of all retrieved articles, sought unpublished papers and abstracts submitted to international conferences, and contacted experts. In addition, we searched the National Institute of Clinical Excellence fertility assessment and treatment guidelines (NICE 2004) and handsearched reference lists of relevant systematic reviews and randomised trials. SELECTION CRITERIA All randomised trials on the intention to perform IVM before IVF or ICSI and conventional IVF or ICSI for sub-fertile women with PCOS. DATA COLLECTION AND ANALYSIS We identified no studies that met the inclusion criteria. MAIN RESULTS There were no trials suitable for inclusion in the review. AUTHORS' CONCLUSIONS There are no randomised controlled trials upon which to base any practice recommendations regarding IVM before IVF or ICSI for women with PCOS. There is an urgent need for randomised trials in this field.
Inhomogeneity of epidemic spreading with entropy-based infected clusters

Considering the difference in the sizes of the infected clusters in the dynamic complex networks, the normalized entropy based on infected clusters (δ*) is proposed to characterize the inhomogeneity of epidemic spreading. δ* gives information on the variability of the infected clusters in the system. We investigate the variation in the inhomogeneity of the distribution of the epidemic with the absolute velocity v of moving agent, the infection density ρ, and the interaction radius r. By comparing δ* in the dynamic networks with δH* in homogeneous mode, the simulation experiments show that the inhomogeneity of epidemic spreading becomes smaller with the increase of v, ρ, r.
Gini Impact Analysis: Measuring Pure Health Inequity before and after Interventions

The aims of the paper are (i) to introduce a framework for reasoning about equity in health distribution before and after interventions, and (ii) to assess various Gini measures applied to healthy life expectancy against explicit normative concerns. Part 1 discusses different ways of measuring pure health inequality and suggests that a modified Gini measure could be used to measure inequity in health before and after treatment. Part 2 introduces a framework for reasoning about distributions of health. Part 3 discusses three normative concerns that any acceptable measure of inequity should satisfy. Part 4 describes the standard Gini measure for measuring pure inequalities in healthy life expectancy. It also examines Wagstaff's Extended Gini measure of health inequity and discusses how it can be used to make priority weights to the worst off explicit. The final section expresses some programmatic worries and possible applications. It is argued that the impact of interventions should be evaluated both in terms of reduced inequity (as measured by the Extended Gini or the Extended Proportional Gini) and improved efficiency (measured by gains in average healthy life expectancy). Measurement of pure health inequity could supplement cost-effectiveness analysis as a basis for fair priority setting.
Phase I/Ib study of olaparib and carboplatin in BRCA1 or BRCA2 mutation-associated breast or ovarian cancer with biomarker analyses.

BACKGROUND Olaparib has single-agent activity against breast/ovarian cancer (BrCa/OvCa) in germline BRCA1 or BRCA2 mutation carriers (gBRCAm). We hypothesized addition of olaparib to carboplatin can be administered safely and yield preliminary clinical activity. METHODS Eligible patients had measurable or evaluable disease, gBRCAm, and good end-organ function. A 3 + 3 dose escalation tested daily oral capsule olaparib (100 or 200mg every 12 hours; dose level1 or 2) with carboplatin area under the curve (AUC) on day 8 (AUC3 day 8), then every 21 days. For dose levels 3 to 6, patients were given olaparib days 1 to 7 at 200 and 400 mg every 12 hours, with carboplatin AUC3 to 5 on day 1 or 2 every 21 days; a maximum of eight combination cycles were permitted, after which daily maintenance of olaparib 400mg every12 hours continued until progression. Dose-limiting toxicity was defined in the first two cycles. Peripheral blood mononuclear cells were collected for polymorphism analysis and polyADP-ribose incorporation. Paired tumor biopsies (before/after cycle 1) were obtained for biomarker proteomics and apoptosis endpoints. RESULTS Forty-five women (37 OvCa/8 BrCa) were treated. Dose-limiting toxicity was not reached on the intermittent schedule. Expansion proceeded with olaparib 400mg every 12 hours on days 1 to 7/carboplatin AUC5. Grade 3/4 adverse events included neutropenia (42.2%), thrombocytopenia (20.0%), and anemia (15.6%). Responses included 1 complete response (1 BrCa; 23 months) and 21 partial responses (50.0%; 15 OvCa; 6 BrCa; median = 16 [4 to >45] in OvCa and 10 [6 to >40] months in BrCa). Proteomic analysis suggests high pretreatment pS209-eIF4E and FOXO3a correlated with duration of response (two-sided P < .001; Pearson's R (2) = 0.94). CONCLUSIONS Olaparib capsules 400mg every 12 hours on days 1 to 7/carboplatin AUC5 is safe and has activity in gBRCAm BrCa/OvCa patients. Exploratory translational studies indicate pretreatment tissue FOXO3a expression may be predictive for response to therapy, requiring prospective validation.
Clinicopathological Feature and Recurrence Pattern of Triple Negative Breast Cancer

Purpose: Triple-negative breast cancers (TNBC; estrogene receptor-negative, progesterone receptor-negative, and human epidermal growth factor receptor-2-negative) are very aggressive tumors with high risk of recurrence and poor prognosis. We have compared the clinical characteristics, recurrence rate and pattern between TNBC and nonTNBC. Methods: A study was done among 879 patients who were diagnosed with breast cancer and received surgery from January 1999 to December, 2005 at Kyungpook National University Hospital. Medical records and pathological reports were reviewed. TNBC was defined as ER(−), PR(−), HER2(−). NonTNBC was defined as having any one of them positive. Results: Of the 879 patients, 81 (9.2%) cases were TNBC. As compared with nonTNBC, TNBC had no significant difference in age of diagnosis (P=0.478), tumor size (P=0.961), axillary lymph node metastasis (P=0.398), stage (P=0.341), histological type (P=0.550), operation method (P=0.053) and chemotherapy (P=0.971). In histological classification TNBC had significantly a high histologic grade, compared to nonTNBC (P＜0.001). The median follow-up period was 53 months. There have been 56 local recurrences, 70 distant metastases, 10 distant metastasis with local recurrence and 66 deaths. There was no significant difference in recurrence rate and mortality rate between the two groups. But, average time to recurrence was significantly shorter in TNBC than nonTNBC. Conclusion: TNBC had shorter time interval to recurrence compared to nonTNBC and had higher histological grade (mostly grade 3). Therefore, in TNBC, careful treatment and follow-up are important. Further long-term investigations with larger groups of patients will be necessary. (J Korean Surg Soc 2010;79:14-19)
Acyclovir for treating primary herpetic gingivostomatitis.

BACKGROUND Primary herpetic gingivostomatitis is a highly contagious infection of the oral cavity which typically affects children but can also occur in adults. Symptoms may vary widely from mild discomfort to life-threatening encephalitis. OBJECTIVES The objective of this review was to evaluate the effectiveness of systemic acyclovir for primary herpetic gingivostomatitis. SEARCH STRATEGY We searched the following databases: Cochrane Oral Health Group's Trials Register (to 22 May 2008); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 2); MEDLINE (1950 to 22 May 2008); and EMBASE (1980 to 22 May 2008). There were no language restrictions. SELECTION CRITERIA Randomised controlled trials comparing acyclovir to placebo in children and young adults < 25 years of age with a diagnosis of primary herpetic gingivostomatitis with or without herpes labialis were considered. DATA COLLECTION AND ANALYSIS Two review authors independently and in duplicate screened and extracted information from, and assessed the risk of bias in the included clinical trials. The Cochrane Collaboration statistical guidelines were followed for data synthesis. MAIN RESULTS Only two clinical trials, one with 72 participants and the other with 20 participants were included in this review. The second study failed to report several methodological items and was inconsistent in its reporting of the outcomes measurement.The first trial, with a moderate risk of bias, showed better results in the acyclovir group compared to the placebo group in children < 6 years of age in reducing the number of individuals with oral lesions (risk ratio (RR) 0.10 (95% confidence interval (CI) 0.02 to 0.38)), new extraoral lesions (RR 0.04 (95% CI 0.00 to 0.65)), difficulty in eating (RR 0.14 (95% CI 0.03 to 0.58)), and drinking difficulties (RR 0.11 (95% CI 0.01 to 0.83)) after 8 days of treatment.Following the onset of treatment, three patients from the placebo group were admitted to hospital for rehydration (P = 0.11). Four children (two from the acyclovir, and two from the placebo group) showed mild gastrointestinal symptoms that resolved spontaneously after 24 to 48 hours without a change in the study treatment. AUTHORS' CONCLUSIONS We found two relevant trials in this systematic review, only one of them could provide some weak evidence that acyclovir is an effective treatment in reducing the number of oral lesions, preventing the development of new extraoral lesions, decreasing the number of individuals with difficulties experienced in eating and drinking and reducing hospital admission for children under 6 years of age with primary herpetic gingivostomatitis.
Dipeptidyl peptidase-4 (DPP-4) inhibitors for type 2 diabetes mellitus.

BACKGROUND In type 2 diabetes mellitus there is a progressive loss of beta-cell function. One new approach yielding promising results is the use of the orally active dipeptidyl peptidase-4 (DPP-4) inhibitors like sitagliptin and vildagliptin. OBJECTIVES To assess the effects of dipeptidyl peptidase-4 (DPP-4) inhibitors for type 2 diabetes mellitus. SEARCH STRATEGY Studies were obtained from computerised searches of MEDLINE, EMBASE and The Cochrane Library. SELECTION CRITERIA Studies were included if they were randomised controlled trials in adult people with type 2 diabetes mellitus and had a trial duration of at least 12 weeks. DATA COLLECTION AND ANALYSIS Two authors independently assessed risk of bias and extracted data. Pooling of studies was performed by means of fixed-effect meta-analysis. MAIN RESULTS Twenty-five studies of good quality were identified, 11 trials evaluated sitagliptin and 14 trials vildagliptin treatment. Altogether, 6743 patients were randomised in sitagliptin and 6121 patients in vildagliptin studies, respectively. Sitagliptin and vildagliptin studies ranged from 12 to 52 weeks duration. No data were published on mortality, diabetic complications, costs of treatment and health-related quality of life. Sitagliptin and vildagliptin therapy in comparison with placebo resulted in an HbA1c reduction of approximately 0.7% and 0.6%, respectively. Data on comparisons with active comparators were limited but indicated no improved metabolic control following DPP-4 intervention in contrast to other hypoglycaemic agents. Sitagliptin and vildagliptin therapy did not result in weight gain but weight loss was more pronounced following placebo interventions. No definite conclusions could be drawn from published data on sitagliptin and vildagliptin effects on measurements of beta-cell function. Overall, sitagliptin and vildagliptin were well tolerated, no severe hypoglycaemia was reported in patients taking sitagliptin or vildagliptin. All-cause infections increased significantly after sitagliptin treatment but did not reach statistical significance following vildagliptin therapy. All published randomised controlled trials of at least 12 weeks treatment with sitagliptin and vildagliptin only reported routine laboratory safety measurements AUTHORS' CONCLUSIONS DPP-4 inhibitors have some theoretical advantages over existing therapies with oral antidiabetic compounds but should currently be restricted to individual patients. Long-term data especially on cardiovascular outcomes and safety are urgently needed before widespread use of these new agents. More information on the benefit-risk ratio of DPP-4 inhibitor treatment is necessary especially analysing adverse effects on parameters of immune function. Also, long-term data are needed investigating patient-oriented parameters like health-related quality of life, diabetic complications and all-cause mortality.
Dietary folate intake and breast cancer risk: European prospective investigation into cancer and nutrition.

BACKGROUND There is limited evidence on the association between dietary folate intake and the risk of breast cancer (BC) by hormone receptor expression in the tumors. We investigated the relationship between dietary folate and BC risk using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS A total of 367993 women age 35 to 70 years were recruited in 10 European countries. During a median follow-up of 11.5 years, 11575 women with BC were identified. Dietary folate intake was estimated from country-specific dietary questionnaires. Cox proportional hazards regression models were used to quantify the association between dietary variables and BC risk. BC tumors were classified by receptor status. Subgroup analyses were performed by menopausal status and alcohol intake. Intake of other B vitamins was considered. All statistical tests were two-sided. RESULTS A borderline inverse association was observed between dietary folate and BC risk (hazard ratio comparing top vs bottom quintile [HRQ5-Q1] = 0.92, 95% CI = 0.83 to 1.01, P trend = .037). In premenopausal women, we observed a statistically significant trend towards lower risk in estrogen receptor-negative BC (HRQ5-Q1 = 0.66, 95% CI = 0.45 to 0.96, P trend = .042) and progesterone receptor-negative BC (HRQ5-Q1 = 0.70, 95% CI = 0.51 to 0.97, P trend = .021). No associations were found in postmenopausal women. A 14% reduction in BC risk was observed when comparing the highest with the lowest dietary folate tertiles in women having a high (>12 alcoholic drinks/week) alcohol intake (HRT3-T1 = 0.86, 95% CI = 0.75 to 0.98, P interaction = .035). CONCLUSIONS Higher dietary folate intake may be associated with a lower risk of sex hormone receptor-negative BC in premenopausal women.
Opportunities-and hard work-ahead.

Correspondence to: Robert N. Hoover, MD, ScD, NCI-Shady Grove, Room 7E412, 9609m Medical Center Drive, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20890 (e-mail: hooverr@mail.nih.gov) or Stephen J. Chanock, MD, NCIShady Grove, Room 7E412, 9609m Medical Center Drive, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20890 (e-mail: chanocks@mail.nih.gov).
Secondary infertility in women: radiologic evaluation

Correspondence: Jeffrey Olpin University of Utah Health Sciences Center, 30 N. 1900 e. #1A71, Salt Lake City, UT 84132, USA Tel +1 801 581 7553 Fax +1 801 581 2414 email jeffrey.olpin@hsc.utah. edu Abstract: Female infertility is a commonly encountered problem that presently accounts for a significant percentage of women seeking gynecologic services. While primary infertility is defined as the inability to conceive or carry a pregnancy successfully to full term, secondary infertility is defined as difficulty in conceiving after already having previously conceived (either carrying a pregnancy to term or a miscarriage). The causes of both primary and secondary female infertility are varied, and include various disorders involving the fallopian tubes, ovaries, uterus, cervix, and peritoneum. Imaging has become an essential tool in the workup of female infertility. Various imaging modalities are commonly employed to evaluate the female reproductive tract. Hysterosalpingography is typically performed as a baseline imaging study in the workup of female infertility. Ultrasound and pelvic magnetic resonance imaging studies are likewise routinely utilized to aid in the diagnosis of female infertility. The appropriate selection of imaging modalities is essential in establishing the etiology of female infertility in a timely, efficient, and cost-effective manner.