bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge and attitude on sex among medical students of a Malaysian university: A comparison study
Authors: Sidi Hatta , Loh Sit Fong , Mahadevan Raynuha , Puteh Sharifah Ezat Wan , Musa Ramli , Wong Chia Yee , Hadi Ammar Amsyar Abdul , Sa'aid Siti Hajara , Amali Zulfahmi , Abidin Murnira , Das Srijit , Saharom Mohamed Hatta , Zakaria Hazli 
Published: April 2013

AbstractIntroductionThe objective of this study was to determine the relationship between clinical/socio‐demographic factors with knowledge and attitude on sex among medical students of the National University of Malaysia (UKM).MethodsA cross‐sectional study assessing 452 students using a self‐administered questionnaire of knowledge and attitude was performed and had a response rate of 80%.ResultsThe majority of respondents were Malays (56%), females (57.5%), lived in urban areas (66.4%), had a median family income of RM3000 and perceived themselves as moderately religious (60%). The overall score on knowledge about sex was 21.7 of 35 (a higher score indicates better knowledge about sex). It was noted that 73.2% of students felt that they did not receive adequate training in medical school to deal with patients' sexuality and sexual problems, while 51.5% felt uncomfortable talking to patients about these issues. Students in the clinical year were more knowledgeable than those in pre‐clinical years (22.67 versus 20.71, P < 0.001). No significant differences were found in terms of their backgrounds, such as being from urban or rural areas (P = 0.349) and between genders (P = 0.286). Only 54.9% of students had a satisfactory level of knowledge on sex (>22 marks [median score]).DiscussionThe students' attitude on sex was considered conservative as the majority of them disagreed on premarital sex, masturbation, abortion, homosexuality and oral sex. Gender and religiosity have a large influence on attitudes on controversial sexual issues, whereas clinical status plays a small role. Knowledge on sex among UKM medical students is inadequate and their attitudes on sex are considered conservative. Integration of sexual medicine and health modules in the medical curriculum is crucial for students to more effectively address patients' sexual problems and promote non‐judgmental attitudes towards patients.
Quality of life in Malaysian colorectal cancer patients
Authors: Wan Puteh Sharifa Ezat , Saad Natrah Mohd. , Aljunid Syed Mohd , Abdul Manaf Mohd Rizal , Sulong Saperi , Sagap Ismail , Ismail Fuad , Muhammad Annuar Muhd Azrif 
Published: April 2013

AbstractIntroductionThe rapidly increasing of incidence colorectal cancer (CRC) in Malaysia and the introduction of new treatments that prolong survival advocating treatment outcome measures such as patients' quality of life (QOL) are evaluated in this study. The study aims to determine QOL in CRC patients according to cancer stage and age.MethodsA cross‐sectional study was performed from June to December 2011 at four public tertiary hospitals. The European Organization for Research and Treatment in Cancer (EORTC) Quality of Life Questionnaire Core‐30 (EORTC QLQ C‐30) questionnaire was used through face‐to‐face interview and the medical records of 160 respondents were reviewed.ResultsThe mean age of respondents was 58.47 ± 12.04 years with 57.5% of respondents being male and 42.5% female. The majority of respondents were in CRC stages III and IV. Median global health status (GHS) score was 83.33 (IQR 16.67). Sikhs and Indians had a higher median GHS score compared to other ethnicities (Kruskal–Wallis, χ2 = 12.12, p = 0.007). Emotional, cognitive and social functions were higher in respondents with earlier stage of disease (Kruskal‐Wallis, χ2 = 6.06, 6.36, 10.58, p = 0.048, 0.042, 0.005). Median pain, dyspnea, diarrhea and financial implication scores were significantly higher in advanced stage of disease (Kruskal‐Wallis, χ2 = 9.31, 6.26,6.77, 7.28, p = 0.010, 0.044,0.034,0.026). Median diarrhea score (p = 0.012) was significantly different between age groups.DiscussionEmotional, cognitive and social functions deteriorate with advanced stage of disease. Patients with advanced stage disease experience more pain, dyspnea, diarrhea and financial implications. A systematic screening program to detect cases as early as possible is essential nationwide.
Reliability and validity of theMalay version of Attitudes toward Lesbians and Gay Men (MVATL/MVATG): A study on a group of medical students inMalaysia
Authors: Ng Chong Guan , Tan Lee Khing , Gill Jesjeet Singh , Koh Ong Hui , Jambunathan Stephen , Pillai Subash Kumar , Sidi Hatta 
Published: April 2013

AbstractIntroductionThis study aims to examine the validity and reliability of theMalay version of Attitudes toward Lesbians and Gay Men (MVATL/MVATG) among a group of medical students inMalaysia.MethodsIt is a cross‐sectional study of 173 medical students in the Faculty of Medicine, University of Kuala Lumpur,Malaysia. The participants were given theMVATL/MVATG, Index of Attitudes toward Homosexuals (IATH), Homosexuality Attitude Scale (HAS) and the English version of Attitude toward Lesbians and Gay Men. Two weeks later, these students were given theMVATLGagain.ResultsSignificant correlation was found between the individual scores ofMVATLandMVATGwithIATHandHASin the results. The scale was able to differentiate Muslim and Non‐Muslim subjects. The internal consistency (Cronbach's alpha) of both theMVATLandMVATGwere good, at 0.76 and 0.82, respectively. The parallel form reliability (Pearson's correlation) ofMVATLwas 0.0.73 and 0.74 forMVATG. The test‐retest reliability ofMVATL/MVATGwas good (Intraclass correlation coefficient,ICC = 0.67 forMVATLand 0.60 forMVATG).DiscussionTheMVATLGdemonstrated good psychometric properties in measuring attitudes toward homosexuality among a group of medical students inMalaysia and it could be used as a simple instrument on young educated Malaysian adults.
Loneliness and depression among the elderly in an agricultural settlement: Mediating effects of social support
Authors: Wan Mohd Azam Wan Mohd Yunus , Din Normah Che , Ahmad Mahadir , Ghazali Shazli Ezzat , Ibrahim Norhayati , Said Zaini , Ghazali Ahmad Rohi , Shahar Suzana , Razali Rosdinom , Maniam T. 
Published: April 2013

AbstractIntroductionLoneliness has long been known to have strong association with depression. The relationship between loneliness and depression, however, has been associated with other risk factors including social support. The aim of this paper is to describe the role of social support in the association between loneliness and depression.MethodsThis cross‐sectional study examined the mediating effects of social support among 161 community‐based elderly in agricultural settlement of a rural area in Sungai Tengi, Malaysia. Subjects were investigated with De Jong Gierveld Loneliness Scale, Geriatric Depression Scale and Medical Outcome Survey Social Support Survey. Data were analyzed using Pearson correlation, linear and hierarchical regression.ResultsResults indicated that social support partially mediated the relationship between loneliness and depression.DiscussionThis suggests that social support affects the linear association between loneliness and depression in the elderly.
Relationships between social support and depression, and quality of life of the elderly in a rural community in Malaysia
Authors: Ibrahim Norhayati , Din Normah Che , Ahmad Mahadir , Ghazali Shazli Ezzat , Said Zaini , Shahar Suzana , Ghazali Ahmad Rohi , Razali Rosdinom 
Published: April 2013

AbstractIntroductionThis study aimed to examine the role of social support and depression in predicting the quality of life among the elderly living in a rural Federal Land Development Authority (FELDA) community in Malaysia.MethodsA total of 162 elderly settlers of FELDA Sungai Tengi, aged 60 years and above, were selected by universal sampling method in this cross‐sectional study. Three standardized instruments – the 12‐item Short Form (SF‐12), 15‐item Geriatric Depression Scale (GDS‐15) and Medical Outcome Study Social Support (MOS‐Social Support) – were used to assess for quality of life, depression and social support.ResultsQuality of life of the elderly people in this community was high, especially in terms of physical components as compared to mental components. The mean scores for emotional role in the SF‐12 was relatively the highest (90.74 ± 21.59) with social functioning being the lowest (30.35 ± 22.29). The results also showed that the mean value was higher for physical component summary (74.40) as compared to mental component summary (51.51). Approximately 23.5% suffered mild depression and only 2.5% had severe depression.DiscussionThis study showed that the elderly FELDA settlers have a high quality of life, mainly on the physical components of life and low rate of severe depression, a positive indicator of their psychological well‐being. Social support in the form of emotional/informational support, and depression were significant factors related to their good quality of life.
Externalizing and internalizing syndromes in relation to school truancy among adolescents in high‐risk urban schools
Authors: Nik Jaafar Nik Ruzyanei , Tuti Iryani Mohammad Daud , Wan Salwina Wan Ismail , Fairuz Nazri Abdul Rahman , Kamal Nor Azlin , Prakash Reddy Jaya , Shah Shamsul Azhar 
Published: April 2013

AbstractIntroductionTo examine the relationship between externalizing/internalizing syndromes and school truancy among Form Four (10th grade) students attending “high‐risk” schools in Kuala Lumpur.MethodsThis is a cross‐sectional study conducted upon 16‐year‐old adolescents attending three high‐risk schools in Kuala Lumpur. A total of 373 students completed self‐administered questionnaires on the sociodemographic variables and externalizing/internalizing syndromes. The number of truant‐days per student during the study period was obtained from the school records.ResultsThe mean internalizing score, externalizing score and total problem score of those who were truant were found to be significantly higher (P < 0.05) than those who were non‐truant. Multiple logistic regressions showed externalizing syndrome (odds ratio [OR] = 1.044; confidence interval [CI] = 1.012–1.078, P = 0.018) significantly predicts truancy but not the internalizing syndrome. Two other psychosocial factors, namely, having divorced parents (OR = 2.495, CI = 1.058–5.886, P = 0.037) and did not understand or were uncertain of the purpose of schooling (OR = 2.621, CI = 1.265–5.433, P = 0.010) were also showed to be stronger predictors of truancy compared to externalizing/internalizing syndromes.DiscussionTruancy has significant association to externalizing syndrome, in addition to other significant psychosocial variables like parental and schooling factors. This finding indicated the need for comprehensive assessment of students presenting with truant behavior, including the identification of associated psychological and behavioral problems which highlights the roles of mental health professionals in tackling truancy.
Pharmacokinetics and pharmacodynamics of ponesimod, a selective S1P1 receptor modulator, in the first‐in‐human study
Authors: Brossard Patrick , Derendorf Hartmut , Xu Jian , Maatouk Haidar , Halabi Atef , Dingemanse Jasper 
Published: April 2013

AimsThis study investigated the tolerability, safety, pharmacokinetics and pharmacodynamics of ponesimod, a novel oral selective sphingosine‐1‐phosphate (S1P1) receptor modulator in development for the treatment of auto‐immune diseases.MethodsThis was a double‐blind, placebo‐controlled, ascending, single‐dose study. Healthy male subjects received doses of 1–75 mg or placebo control.ResultsPonesimod was well tolerated. Starting with a dose of 8 mg, transient asymptomatic reductions in heart rate were observed. Ponesimod pharmacokinetics were dose proportional. The median time to maximal concentration ranged from 2.0 to 4.0 h, and ponesimod was eliminated with a mean half‐life varying between 21.7 and 33.4 h. Food had a minimal effect on ponesimod pharmacokinetics. Doses of ≥8 mg reduced total lymphocyte count in a dose‐dependent manner. Lymphocyte counts returned to normal ranges within 96 h. A pharmacokinetic/pharmacodynamic model was developed that adequately described the observed effects of ponesimod on total lymphocyte counts.ConclusionsSingle doses of ponesimod up to and including 75 mg were well tolerated. The results of this ascending single‐dose study indicate an immunomodulator potential for ponesimod and a pharmacokinetic/pharmacodynamic profile consistent with once‐a‐day dosing.
Bisphosphonate use and risk of colorectal cancer: a systematic review and meta‐analysis
Authors: Bonovas Stefanos , Nikolopoulos Georgios , Bagos Pantelis 
Published: April 2013

AimA growing body of evidence suggests that bisphosphonates may have chemopreventive potential against colorectal cancer. Our aim was to examine this association through a meta‐analysis of observational studies.MethodsA comprehensive search for relevant articles published up to October 2012 was performed, reviews of each study were conducted and data were abstracted. Prior to meta‐analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using the random effects and the fixed effects models. Subgroup and sensitivity analyses were also performed.ResultsEight large population‐based epidemiological studies (one case‐control, two nested case‐control analyses within a cohort and five cohort studies), involving more than 630 000 participants, contributed to the analysis. We found no evidence of publication bias. However, significant heterogeneity was detected among the cohort studies. The analysis revealed a significant protective association between bisphosphonate use and colorectal cancer risk (fixed RR = 0.85, 95% CI 0.80, 0.90, random RR = 0.85, 95% CI 0.75, 0.96). When the analysis was stratified into subgroups according to study design, the association was inverse in both case‐control and cohort studies, but only in the former was it statistically significant. The sensitivity analysis confirmed the stability of our results. Furthermore, we found evidence for a dose effect; Long term bisphosphonate use was associated with a 27% decrease in the risk of developing colorectal cancer as compared with non‐use (RR = 0.73, 95% CI 0.57, 0.93).ConclusionOur findings support a protective effect of bisphosphonates against colorectal cancer. However, further evidence is warranted.
D(T)PACE as salvage therapy for aggressive or refractory multiple myeloma
Authors: Gerrie Alina S. , Mikhael Joseph R. , Cheng Lu , Jiang Haiyan , Kukreti Vishal , Panzarella Tony , Reece Donna , Stewart Keith A. , Trieu Young , Trudel Suzanne , Chen Christine I. 
Published: April 2013

SummaryDexamethasone ± thalidomide with infusion of cisplatin, doxorubicin, cyclophosphamide, and etoposide [D(T)PACE] is generally reserved as salvage therapy for aggressive multiple myeloma (MM) or plasma cell leukaemia (PCL) resistant to conventional therapies. The efficacy and durability of this potentially toxic regimen in this setting is unclear. We identified 75 patients who received D(T)PACE for relapsed/refractory MM at two tertiary care centres: Princess Margaret Hospital, Toronto and Mayo Clinic Arizona. At time of D(T)PACE, 16 patients had PCL and three patients had leptomeningeal disease. Patients were heavily pretreated (median three prior regimens, range 1–12; prior autologous stem cell transplant [ASCT] 33%). Overall response rate was 49% (very‐good partial response 16%, partial response 33%) with stable disease in an additional 36%. Median progression‐free survival (PFS) was 5·5 months (95% confidence interval [CI]:4·3–9·8); overall survival (OS) 14·0 months (95% CI:8·7–19·3). Thirty‐five patients proceeded to ASCT or clinical trial, with median PFS for this subset of 13·4 months (95% CI:7·7–20·1) and OS 20·5 months (95% CI:14·8–63·8). D(T)PACE is an effective salvage therapy for heavily pretreated MM patients. Although the overall response rate of 49% in this poor prognosis cohort is reasonable, the PFS is short, suggesting the best role for D(T)PACE is in bridging to definitive therapy, such as transplantation.
Immature dendritic cells in multiple myeloma are prone to osteoclast‐like differentiation through interleukin‐17A stimulation
Authors: Tucci Marco , Stucci Stefania , Savonarola Annalisa , Ciavarella Sabino , Cafforio Paola , Dammacco Franco , Silvestris Franco 
Published: April 2013

SummaryInterleukin 17A (IL17A), a cytokine involved in allergy, inflammation and osteoclastogenesis, was investigated in multiple myeloma (MM) to assess its role in the osteoclast (OC)‐like activity of marrow immature dendritic cells (iDCs). Comparing nine MM patients with control subjects affected by monoclonal gammopathy of undetermined significance, we found high IL17A expression in the marrow plasma of MM patients in parallel with its deposits within the stromal matrix. Increased expression of the IL17A receptor (IL17RA) was also found in primary myeloma iDCs, which underwent OC‐like transdifferentiation after IL17A stimulation. To assess the role of IL17A, we measured the activity of the IL17/IL17RA pathway in IL17A‐transdifferentiated iDCs and the expression of functional OC genes by Western blotting and real‐time polymerase chain reaction. These cells showed increased RNA transcription of genes enrolled in the maturation of OCs, while NFATC1 and FOS were induced by IL17A, independently of NFKB1 phosphorylation. Moreover, the concurrent phosphorylation of the Lip isoform of CEBPB and the down‐regulation of MAFB supported the activation of IL17RA pathway in OC‐like transdifferentiated iDCs that was apparently unrelated to TNFRSF11A signalling. These data emphasize the involvement of iDCs in MM hyperactive osteoclastogenesis and suggest that their bone resorption activity is also regulated, at least in vitro, by IL17RA.
Malignancies and monoclonal gammopathy in Gaucher disease; a systematic review of the literature
Authors: Arends Maarten , van Dussen Laura , Biegstraaten Marieke , Hollak Carla E. M. 
Published: April 2013

SummaryGaucher disease is an autosomal, recessively inherited, lysosomal storage disease, which has been associated with gammopathies and malignancies. This report represents the results of a systematic review of the literature on the prevalence of monoclonal gammopathies and malignancies in Gaucher disease. A PubMed search identified 365 studies, of which 80 reported on concomitant Gaucher disease and malignancies and/or gammopathies (15 cohort/cross sectional studies, and 65 case reports/series). Based on these studies, we conclude that compared to the general population, Gaucher patients have an increased risk of cancer in general [pooled relative risk of 1·70 (95% confidence interval 1·27–2·31)], and multiple myeloma and haematological malignancies in particular (estimated risk between 25·0 and 51·1 and 3·5 and 12·7, respectively). In addition, an increased risk has been reported for hepatocellular carcinoma and renal cell carcinoma. Several factors have been hypothesized to play a role in the pathophysiology. These include: splenectomy, immune dysregulation, endoplasmic reticulum stress, genetic modifiers, altered iron metabolism and insulin resistance.
Interplay between coagulation and vascular inflammation in sickle cell disease
Authors: Sparkenbaugh Erica , Pawlinski Rafal 
Published: April 2013

SummarySickle cell disease is the most common inherited haematological disorder that leads to the irreversible damage of multiple organs. Although sickling of red blood cells and vaso‐occlusion are central to the pathophysiology of sickle cell disease, the importance of haemolytic anaemia and vasculopathy has been recently recognized. A hypercoagulable state is another prominent feature of sickle cell disease and is mediated by activation of both intrinsic and extrinsic coagulation pathways. Growing evidence demonstrates that coagulation may not only contribute to the thrombotic complications, but also to vascular inflammation associated with this disease. This article summarizes the role of vascular inflammation and coagulation activation, discusses potential mechanisms responsible for activation of coagulation and reviews recent data demonstrating the crosstalk between coagulation and vascular inflammation in sickle cell disease.
B‐cell lymphoma, unclassifiable, with features intermediate between diffuse large B‐cell lymphoma and burkitt lymphoma: study of 39 cases
Authors: Perry Anamarija M. , Crockett David , Dave Bhavana J. , Althof Pamela , Winkler Lisa , Smith Lynette M. , Aoun Patricia , Chan Wing C. , Fu Kai , Greiner Timothy C. , Bierman Phillip , Gregory Bociek Robert , Vose Julie M. , Armitage James O. , Weisenburger Dennis D. 
Published: April 2013

SummaryB‐cell lymphoma, unclassifiable (B‐UCL), with features intermediate between diffuse large B‐cell lymphoma and Burkitt lymphoma, is a poorly characterized entity. Therefore, we investigated cases of B‐UCL treated by the Nebraska Lymphoma Study Group (NLSG). We searched the NLSG registry for years 1985–2010 for cases of B‐UCL. Immunohistochemical stains and fluorescence in situ hybridization studies for MYC, BCL2 and BCL6 gene rearrangements were performed. Among the 39 cases studied, 54% were male and 46% were female, with a median age of 69 years. The majority of patients presented with advanced‐stage disease (62%) and had high (3–5) International Prognostic Index (IPI) scores (54%). The median overall survival (OS) was only 9 months and the 5‐year OS was 30%. Patients with low IPI scores (0–2) had a better survival than those with high scores (3–5). The cases were genetically heterogeneous and included 11 ‘double‐hit’ lymphomas with rearrangements of both MYC and BCL2 or BCL6. None of the immunohistochemical or genetic features was predictive of survival. This B‐cell lymphoma is a morphologically‐recognizable entity with a spectrum of genetic abnormalities. New and better treatments are needed for this aggressive lymphoma.
Family ecology of young children with cerebral palsy
Authors: LaForme Fiss A. , Chiarello L. A. , Bartlett D. , Palisano R. J. , Jeffries L. , Almasri N. , Chang H‐J. 
Published: April 2013

AbstractBackgroundFamily ecology in early childhood may influence children's activity and participation in daily life. The aim of this study was to describe family functioning, family expectations of their children, family support to their children, and supports for families of young children with cerebral palsy (CP) based on children's gross motor function level.MethodsParticipants were 398 children withCP(mean age = 44.9 months) and their parents residing in theUSAandCanada. Parents completed four measures of family ecology, theFamilyEnvironmentScale (FES),FamilyExpectations ofChild (FEC),FamilySupport toChild (FSC) andFamilySupport Scale (FSS).ResultsThe median scores on theFESindicated average to high family functioning and the median score on theFSSindicated that families had helpful family supports. On average, parents reported high expectations of their children on theFECand strong support to their children on theFSC. On theFES, higher levels of achievement orientation were reported by parents of children in Gross Motor Function Classification System (GMFCS) levelIIthan parents of children in level I, and higher levels of control were reported by parents of children in level I than parents of children in levelIV. On theFEC, parents of children with limited gross motor function (levelV) reported lower expectations than parents of children at all other levels.ConclusionsFamily ecology, including family strengths, expectations, interests, supports and resources, should be discussed when providing interventions and supports for young children withCPand their families.