Miracle-dz/UniFAR-FTUs huggingface dataset:
Declines in Unintended Pregnancy in the United States, 2008-2011.

BACKGROUND The rate of unintended pregnancy in the United States increased slightly between 2001 and 2008 and is higher than that in many other industrialized countries. National trends have not been reported since 2008. METHODS We calculated rates of pregnancy for the years 2008 and 2011 according to women's and girls' pregnancy intentions and the outcomes of those pregnancies. We obtained data on pregnancy intentions from the National Survey of Family Growth and a national survey of patients who had abortions, data on births from the National Center for Health Statistics, and data on induced abortions from a national census of abortion providers; the number of miscarriages was estimated using data from the National Survey of Family Growth. RESULTS Less than half (45%) of pregnancies were unintended in 2011, as compared with 51% in 2008. The rate of unintended pregnancy among women and girls 15 to 44 years of age declined by 18%, from 54 per 1000 in 2008 to 45 per 1000 in 2011. Rates of unintended pregnancy among those who were below the federal poverty level or cohabiting were two to three times the national average. Across population subgroups, disparities in the rates of unintended pregnancy persisted but narrowed between 2008 and 2011; the incidence of unintended pregnancy declined by more than 25% among girls who were 15 to 17 years of age, women who were cohabiting, those whose incomes were between 100% and 199% of the federal poverty level, those who did not have a high school education, and Hispanics. The percentage of unintended pregnancies that ended in abortion remained stable during the period studied (40% in 2008 and 42% in 2011). Among women and girls 15 to 44 years of age, the rate of unintended pregnancies that ended in birth declined from 27 per 1000 in 2008 to 22 per 1000 in 2011. CONCLUSIONS After a previous period of minimal change, the rate of unintended pregnancy in the United States declined substantially between 2008 and 2011, but unintended pregnancies remained most common among women and girls who were poor and those who were cohabiting. (Funded by the Susan Thompson Buffett Foundation and the National Institutes of Health.).
The Analgesic Effect of Morphine and Dexmedetomidine Intravenous Patient-Controlled Analgesia method to Control Pain After Open Cardiac Surgery: A Randomized Control Trial

Background: After major surgeries, such as abdominal or thoracic surgery, the majority of patients experience moderate to severe pain that may not be optimally controlled. Inadequate pain relief may lead to complications that can hinder rehabilitation and slow recovery. Objectives: Post-operative pain is one of the most common complaints in surgery wards especially in open cardiac surgeries. The current study compared effectiveness of the patient controlled anesthesia (PCA) method, intravenously with morphine (MO) and dexmedetomidin (DEX) to reduce post-operative pain after open cardiac surgery. Patients and Methods: The study was a double blind randomized clinical trial. One hundred candidates for open cardiac surgery were enrolled in the study and randomly assigned into two groups of MO and DEX. The patient-controlled intravenous analgesia (PCIA) pump was administered to all of the subjects, post-recovery, after insertion of catheter and filled with selected MO or DEX. Then visual analogue scale for pain severity was measured and recorded at 2, 4, 6, 8,10,12, 14, 16 and 18 hours post-operatively. SPSS V.16 was used for data analysis. Results: Findings of the study showed a significant difference regarding the level of pain among the patients under treatment of MO and DEX at 2, 4, 6, 8, 10 and 12 hours after the surgery, whereas there was no significant difference at 14, 16 and 18 hours. However, the pain score was lower during the first 12 hours of follow-ups in both groups. Furthermore, intubation time in DEX-PCA group was shorter than that of MO group. It was also observed that the DEX pump group had required less intravenous morphine than MO pump group in the intensive care unit (ICU). Conclusions: The study findings showed that post-operative pain was favorably reduced in both DEX and MO-PCIA groups after open cardiac surgery. Dexmedetomidin provides beneficial effects on pain control after cardiac surgery, with less adverse effects such as nausea, itching, atelectasis, intubation time, respiratory depression and intravenous morphine consumption.
Diabetes Care: Are We Asking the Right Questions?

ABSTRACT: Many patients with diabetes are anxious or fearful about the disease. These negative emotions stem in part from the fact that the patient is responsible for many facets of diabetes management, such as exercise, dietary modification, and blood glucose measurement. For example, failure to adhere to a regimen may engender guilt. Up to 30% of patients with diabetes are depressed, and hemoglobin A1c levels are higher in such patients. Even patients with good metabolic control may not be doing well psychologically. It is thus essential to ask about patients' concerns and fears, identify their psychosocial needs, and provide emotional support.
Working towards a better understanding of Helicobacter pylori-related gastric cancer’s biology

Gastric cancer is a significant cause of cancer-related mortality and morbidity. In terms of disease etiology, it ranks as the fourth and fifth most common contributor of male and female cancer-related death, respectively [1]. A marked geographical variability has been observed for gastric cancer incidence, with the majority of cases reported in Eastern Europe, South America, and Asia [2]. This has been ascribed to environmental ( e.g. , H. pylori infection), dietary, as well as genetic factors [3]. H. pylori is considered as a definite carcinogen by the International Agency for Research on Cancer, and intes-tinal metaplasia has been suggested as the intermediate event in the development of H. pylori -related gastric cancer [4]. However, the molecular mechanism of this event needs to be further elucidated. In this issue of AMOR , a report from Ukraine’s Vinnitsa National Pigorov Memorial Medical University by Sergii Vernygorodskyi attempts to improve our current understanding of the molecular mechanism associated with H. pylori -related gastric carcinogenesis [5]. The investigator found that the activation of CDX2, along with the simultaneous inactivation and a decreased number of genes ( e.g. , SHH , SOX2 , and RUNX3 ) responsible for gastric differentiation, is a probable cause that leads to the ap-pearance of intestinal metaplasia. Therefore, this study serves as an important catalyst to promote further research on the molecular mechanism and programming of gastric cancer cells, in hope of gaining new knowledge in the prevention and treatment of gastric cancer.
Preoperative Intravenous Acetaminophen Improves Recovery Time after Abdominoplasty

Introduction: Abdominoplasty can be a major and difficult procedure for patients. They can have prolonged postoperative pain and difficulty moving and eating. These difficulties can increase the time patients are in the postoperative unit, increase costs, and decrease overall patient satisfaction. This retrospective study compared the recovery time for patients who did and patients who did not receive intravenous (IV) acetaminophen before abdominoplasty. Materials and Methods: Twenty-seven patients were randomly selected for the study. The 12 patients chosen as a control group were given a standard pain regimen without IV acetaminophen. Fifteen patients were given the standard pain regimen, including preoperative IV acetaminophen. The total time in the postanesthesia care unit was recorded from entry to the area to the patients' leaving the facility. The Aldrete score was used for discharge criteria, and the time was recorded once the patient scored 10 out of 10 and had good pain control. Results: The average recovery time for the control group was 117 minutes. The average recovery time for the IV. acetaminophen group was 83 minutes for an improvement in discharge time of 34 minutes. The number of patients discharged from the facility within 90 minutes of arriving in the postoperative care unit increased from 33% to 73%. Conclusions: Compared with patients given standard medical therapy, patients in the preoperative IV acetaminophen group improved discharge times, and more patients were discharged within 90 minutes of arriving in the postoperative care unit.
Musculoskeletal Medicine in Practice: Dry needling for chronic low back pain in a hospital outpatient setting

Abstract This retrospective, descriptive study looked at the clinical outcomes in 107 patients (72% female) with chronic low back pain that had been selected for acupuncture/dry needling treatment following referral to a musculoskeletal clinic in a specialist orthopaedic secondary care centre. Average age was 43.9 (19–79) years and average duration of symptoms of 11.6 (0.5–25) years. 91% had regional low back pain. Outcome was rated excellent in 23% and good in 10% and in these patients there was no requirement to pursue other hospital treatments. Acupuncture was considered to have contributed to the identification of underlying lumbar conditions such as disc, facet or sacroiliac joint pain or segmental instability in a further 18% where further interventions resulted in good or excellent outcomes. In total, 51% of patients were deemed to have benefited from acupuncture treatment either directly or indirectly. Its low cost and safety make acupuncture an attractive treatment option in patients with chronic low back pain.
Oral health status and care needs of elderly patients in long-term care hospital

Objectives: The purpose of this study is to identify oral health status and oral health care needs of elderly patients in long-term care hospital. Methods: Oral health examination was carried out by a dentist and questionnaire was completed by direct individual interview by a dental hygienist for 245 elderly patients in seven long-term care hospitals in Daegu from March 12 to April 16, 2011. Results: Those who need dental care were 188(76.7%) and was done by oral health examination by a dentist. 93 patients(38.0%) wanted dental care and 63 patients(25.3%) need dental care. The most important dental service in the elderly patients was denture and prosthetic service. As demand for denture and prosthetic service exceeds the supply, but only 35.9 percent of the elderly received the dental care service by the estimation of the caregivers. Conclusions: It will be necessary to establish the customized dental care service for the elderly patients in long term care hospitals. The oral health education for the caregivers is very important and the continuing education program must be implemented in the future.
The Loop-Mediated Isothermal Amplification Method Instead of PCR in Detection Goals

Department of Pathobiology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Microbiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Department of Human Anatomy and Cell Science, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada Department of Microbiology, Zanjan University of Medical Sciences, Zanjan, IR Iran Corresponding author: Davoud Afshar, Department of Microbiology, Zanjan University of Medical Sciences, Zanjan, IR Iran. E-mail: davoodafshar@yahoo.com
Analysis of the REMEDIES 4D clinical trial: a redesign of primary care to overcome clinical inertia and improve outcomes

Approximately 29.1 million, or 9.3% of the total US population, currently have diabetes and this number is predicted to increase to 48.2 million by 2050. As the prevalence of diabetes increases, the number of complications associated with diabetes will likely increase as well. Diabetes associated complications can lead to dysfunction or failure of a number of organ systems such as the cardiovascular, cerebral, and renal systems. The key to reducing diabetes complications is to control the patient’s blood glucose, blood pressure, and cholesterol levels as well as providing preventative services. Fewer than 20% of people with diabetes have their blood glucose, blood pressure, and cholesterol levels adequately controlled. This is partly due to the failure to intensify diabetes treatments in a timely manner, also known as clinical inertia. REdesigning MEDication Intensification Effectiveness Study for Diabetes (REMEDIES 4D) was a clinical study aimed at redesigning primary care to overcome this clinical inertia and improve patients’ diabetes outcomes. Certified Diabetes Educators (CDEs) implemented pre-approved, evidence based, medication intensification protocols for a yearlong intervention. These analyses show that the REMEDIES4D intervention improved patients’ blood glucose compared with the usual care group and those in the intervention were more likely to have their diabetes medication intensified; that clinician and medication satisfaction do impact medication adherence and clinical outcomes; and, for these participants, there were no correlations between two measures of cognitive performance with medication adherence and HbA1. This dissertation provided supporting evidence that CDEs in the primary care practice can improve patient’s outcomes and since CDEs focus on clinical and behavioral factors, they can better support patients’ behavioral and clinical goals. These findings are of public health significance since this model of care can be implemented in other community based primary care practices. In these practices, CDEs, a highly educated and underutilized resource, can work with primary care providers to better maintain people with diabetes clinical HbA1c goals, possibly reducing or delaying long term complications of diabetes and improving people with diabetes’ quality of life.
PERSENTASE KASUS TRIPLE NEGATIVE BREAST CANCER DI RUMAH SAKIT UMUM PUSAT (RSUP) SANGLAH TAHUN 2006-2013: STUDI DESKRIPTIF

TRIPLE NEGATIVE BREAST CANCER CASE PERCENTAGE AT SANGLAH GENERAL HOSPITAL IN THE YEAR OF 2006-2013: A DESCRIPTIVE STUDY World Health Organization predicts that there will be a surge in breast cancer patients in Indonesia up to seven times by 2030. Bali Province ranked second highest breast cancer patients diagnosed in Indonesia, which is based on the data in Sanglah General Hospital, every year there were 200 new cases. This research is a descriptive study with secondary data of triple negative breast cancer inpatients in the Department of Surgical Oncology, Sanglah General Hospital from 2006 until 2013. The percentage of triple negative breast cancer case is 14,28 %, 32%, 75 % in 2007, 2008, and 2009 respectively. Number of cases continued to rise in 2010 amounted to 51.85 %, then decreased in 2011 to 16.67 % but no cases in 2013. Most age groups diagnosed as triple negative breast cancer is 41-45 years which the bigest percentage is 33.34%. The number of triple negative breast cancer among other types of breast cancer has increased with the most age groups diagnosed is 41-45 years old.
Left-Sided Acute Appendicitis With Situs Inversus Totalis

Situs inversus totalis is an uncommon anatomic anomaly that complicates diagnosis and management of acute abdominal pain. Thus, awareness of the multiple etiologies, common and uncommon, and their unusual and sometimes confounding presentations is critical for the Emergency Physicians and surgeon alike. We present the case of a 22-year-old man with situs inversus totalis and left-sided acute appendicitis.
Drug treatment in elderly diabetic.

: Diabetes causes greater decline in physical and functional status in elderly diabetic than in a younger one. Also the rise of MI, stroke and hypertension is also higher. In elderly diabetics management is always on challenging task due to atypical disease presentation, classical symptoms often absent, presence of other coexisting conditions delays the diagnosis, dietary advice not followed properly and due to non-compliance of drug therapy. The antidiabetic drugs which are often used are: sulfonylureas, metformin, thiazolidinediones, meglitinides, alpha-glucosidase inhibitors, insulin. Advantages and disadvantages of these drugs are discussed in a nutshell. Moreover control of hypertension, CAD risk reduction and practice pearls eg, lifestyle changes and goals setting for HbA(1c) are important.
Hiperkalciurija u djece

Hypercalciuria is a common metabolic disorder that is characterized by hypersecretion of calcium in the urine. It is defined by the values of calcium excreted in the urine, when those amounts are > 4 mg/kg/24h or > 0.1 to 0.125 mmol/kg/24h calcium excreted, or when the calcium / creatinine ratio is > 0.21 mg/mg (Milliner 2009). It occurs in 5-10% of the general population ( Vezzoli at al. 2008). The frequency is different in different parts of the world, and it is considered that is affected by the interaction of various factors such as geographic area, climatic conditions, food habits and genetic factors (Stojanovic at al. 2007). Hypercalciuria is classified into two major groups, as well as idiopathic and secondary. Idiopathic hypercalciuria is a metabolic disorder that is characterized by excessive excretion of calcium in the urine without the simultaneous presence of hypercalcemia, or elevated levels of serum calcium, and without a known cause of hypercalciuria. It is divided into absorptive within which there are three types, followed by renal and resorptive. The frequency of idiopathic hypercalciuria in children ranges between 2.9 - 10%, and it is equally present in both genders (Stojanovic at al. 2007) . Hypercalciuria can be presented with hematuria, urolithiasis, back pain or abdominal pain, dysuria, incontinence, enuresis or can be finded during the evaluation of urinary infection. Hypercalciuria is considered a major risk factor for the development of urolithiasis. About 80% of kidney stones contain calcium in their composition, and hypercalciuria alone is diagnosed in one third of patients with urolithiasis. Kidneys are often the seat of stones in the developed countries as a result of a diet rich in animal protein, while in developing countries, often formed in the bladder which is associated with poorer socioeconomic conditions. It occurs in all age groups, from newborns to the elderly with a different etiology. The diagnosis of hypercalciuria is based on measuring the amount of excreted calcium in the 24 hour urine and determining the value of the calcium/creatinine ratio, while the first and the most important step in therapy is change of nutrition habits.
The role of physical exercise as a stress-coping resource for persons with functionally incomplete spinal cord injury

The aim of this study was to explore the experience s of persons with incomplete Spinal Cord Injury (SCI) with physical exercise, pe rceived exercise mastery (PEM) and stress. A phenomenologically orientated qualitative study with in-depth interviews was performed. Six persons, 2 females and 4 males, age between 39 to 62 years, participated. Years post-injury ranged from 4 to 40. The main fi nding was that the total physical and psychological demands of everyday life related to f unctional capacities, influenced how exercise mastery was perceived. High PEM occurred when exercise was perceived as building or maintaining physical resources. Reduce PEM occurred when physical progression stagnated, physical resources were over load d, and fatigue developed. Personal differences contributed to stress-accumulation and individual coping strategies were needed.
An overview of the disease model for drug addiction and interventions used to address the current opioid epidemic

America is engulfed in an opioid epidemic. Whether this is depicted through the tens of thousands of lives claimed by the number of drug overdoses each year, the unprecedentedly high and increasing rates of opiate abuse, or the broadening demographic profile of the addict, it is clear that the current issue is one that requires serious attention. As informed by the negative attitudes toward drug addiction that have prevailed since the War on Drugs was declared, it is hypothesized that much of the contemporary predicament is a result of this misinformation that did not resolve, but exacerbated the drug crisis. Despite the concurrent emergence of evidence asserting that addiction is a disease, instead, the idea that drug addiction is a failure prevails. As with many brain diseases, drug addiction displays both pathological alterations in the transmission of signals within the neural circuitries and the morphological defects associated with non-random regions of the brain. The alteration that is observed during opioid tolerance is the desensitization of mu opioid receptors to dopamine, resulting in the need of increased dosage of opiates to achieve the same high. During opioid dependence, key changes that are seen in the locus ceruleus and the mesolimbic reward system increase both the likelihood of an overdose event and withdrawal when an
School Dropout According to the Views of High School Leavers

School dropout is an ongoing problem in Turkish Education System. While the existing studies on dropout in Turkey focus on reasons and intervention models of dropout in the primary school level of compulsory education, there is a shortage of research scrutinizing the dropout phenomenon in high school level. This study aims to determine the reasons of high school dropout from the perspectives of high school students who drop out of high school. The study is based on a qualitative research model, which is completed by a phenomenological approach. The study group is composed of 25 high school leavers who continue apprenticeship training in Vocational Training Centers in 2011-2012 in the four districts (Golcuk, Korfez, Izmit, Gebze) of Kocaeli. The participants were chosen by employing purposive sampling methods. Data were collected using semi-structured interviews, and content analysis was used in data analysis. Restricted by the experiences of participants, the reasons behind high school dropout were determined as academic failure, unwillingness and dislike of school, discipline and health problems. The study also strongly emphasizes the effects of students’ relationships with their friends, teachers-administrators and families on the process of giving the decision to leave school.