The Effect of Sex Counseling Based on (Permission, Limited Information, Specific Suggestions, Intensive Therapy) Model on Sexual Satisfaction in Women with Cyclic Mastalgia: A Randomized Controlled Clinical Trial.

BACKGROUND: More than half of the population of women suffer from cyclic mastalgia which can interfere with women's sexual function and affect their sexual satisfaction. The current study was conducted to determine the effect of sexual counseling on sexual satisfaction in women with cyclic mastalgia. MATERIALS AND METHODS: This randomized controlled trial study was performed on 81 women with cyclic mastalgia. The subjects were randomly divided into two groups of intervention (n = 40) and control (n = 41). Intervention was performed as Permission, Limited information, Specific suggestions, Intensive therapy (PLISSIT) sex counseling in four sessions for a maximum of 90 min in the intervention group. The demographic checklist and Index of Sexual Satisfaction (ISS) were used for data collection. Follow-up was performed 1 and 3 months after the intervention. The obtained data were analyzed using repeated-measures test. RESULTS: The intervention and control groups were in good balance in terms of demographic characteristics and sexual satisfaction scores prior to the intervention and no statistically significant differences were observed. There was a statistically significant increase in the mean (SD) score of female sexual satisfaction in the intervention group: 93 (12.52), 101.15 (7.70),101.37 (5.31), (F (1,39) = 27.4, p < 0.001). We also observed a decrease in the mean (SD) score of sexual satisfaction in the control group: 93.39 (13.12), 90.68 (8.41), 90.85 (6.57), (F (1,40) = 11.9, p < 0.001) 1 and 3 months following the intervention. CONCLUSIONS: This study revealed that individual counseling by PLISSIT sex counseling could lead to improvement in sexual satisfaction index in women with cyclic breast pain.

Termination of Repeat Testing in Chemical Laboratories Based on Practice Guidelines: Examining the Effect of Rule-Based Repeat Testing in a Transplantation Center.

BACKGROUND: Although the automation of instruments has reduced the variability of results and errors of analysis, in some laboratories, repeating a test to confirm its accuracy is still performed for critical and noncritical results. However, the importance of repeat testing is not well established yet, and there are no clear criteria for repeating a test. MATERIALS AND METHODS: In this cross-sectional study, all repeated tests for 26 biochemical analytes (i.e., albumin, alkaline phosphatase (ALP), alanine aminotransferase (ALT), amylase, aspartate aminotransferase (AST), bilirubin total (BT), bilirubin direct (BD), blood urea nitrogen (BUN), calcium, chloride (Cl), cholesterol total (CholT), creatine kinase (CK), creatinine (Cr), glucose, gamma-glutamyl transferase (GGT), high-density lipoprotein-cholesterol (HDL-c), iron, lactate dehydrogenase (LDH), LDL-c, lipase, magnesium (Mg), phosphorus (Ph), protein total (ProtT), total iron binding capacity (TIBC), triglyceride (TG), and uric acid) were assessed in both critical and noncritical ranges over two consecutive months (routine subjective test repeats in the first month and rule-based repeats in the second month). To determine the usefulness of test repeats, differences between the initial and verified results were compared with the allowable bias, and repeat testing was considered necessary if it exceeded the allowable bias range. All causes of repeat testing, including linearity flags, delta checks, clinically significant values, and critical values, were also documented. All data, including the cause of repeats, initial and verified results, time, and costs in the two consecutive months, were transferred to Microsoft Excel for analysis. For comparison of data between the months, Student's t-test was used. RESULTS: A total of 7714 repeat tests were performed over two consecutive months. Although a significant decline (38%) was found in repeated tests in the second month (P < 0.001), there was no significant change in the percentage of unnecessary repeats (77% in the first month and 74% in the second month). In both consecutive months, AST and ALT were the most commonly repeated tests, and delta check was the most common cause of repeat testing. Mg, ALP, AST, and lipase showed the highest rates of necessary repeats, respectively (the least stable tests), while albumin, LDL, and CholT tests showed the highest rates of unnecessary repeats, respectively (the most stable tests). The total cost and delay in turnaround time (TAT) due to repeated testing decreased by 32% and 36%, respectively. CONCLUSION: Although repeat testing has been shown to be unnecessary in most cases, having a strict policy for repeat testing appears to be more valuable than avoiding it completely. Each laboratory is advised to establish its own protocol for repeat testing based on its own practice.

The Use of Big Data via 5G to Alleviate Symptoms of Acute Stress Disorder Caused by Quarantine Measures.

This article investigates the role of Big Data in situations of psychological stress such as during the recent pandemic caused by the COVID-19 health crisis. Quarantine measures, which are necessary to mitigate pandemic risk, are causing severe stress symptoms to the human body including mental health. We highlight the most common impact factors and the uncertainty connected with COVID-19, quarantine measures, and the role of Big Data, namely, how Big Data can help alleviate or mitigate these effects by comparing the status quo of current technology capabilities with the potential effects of an increase of digitalization on mental health. We find that, while Big Data helps in the pre-assessment of potentially endangered persons, it also proves to be an efficient tool in alleviating the negative psychological effects of quarantine. We find evidence of the positive effects of Big Data on human health conditions by assessing the effect of internet use on mental health in 173 countries. We found positive effects in 110 countries with 90 significant results. However, increased use of digital media and exclusive exposure to digital connectivity causes negative long-term effects such as a decline in social empathy, which creates a form of psychological isolation, causing symptoms of acute stress disorder.

A Molecular Electron Density Theory Study of the Synthesis of Spirobipyrazolines through the Domino Reaction of Nitrilimines with Allenoates.

The reaction of diphenyl nitrilimine (NI) with methyl 1-methyl-allenoate yielding a spirobipyrazoline has been studied within molecular electron density theory (MEDT) at the MPWB1K/6-311G(d) computational level in dichloromethane. This reaction is a domino process that comprises two consecutive 32CA reactions with the formation of a pyrazoline intermediate. Analysis of the relative Gibbs free energies indicates that both 32CA reactions are highly regioselective, the first one being also completely chemoselective, in agreement with the experimental outcomes. The geometries of the TSs indicate that they are associated to asynchronous bond formation processes in which the shorter distance involves the C1 carbon of diphenyl NI. Despite the zwitterionic structure of diphenyl NI, the appearance of a pseudoradical structure at the beginning of the reaction path, with a very low energy cost, suggests that the 32CA reaction between diphenyl NI, a strong nucleophile, and the allenoate, a moderate electrophile, should be mechanistically considered on the borderline between pmr-type and cb-type 32CA reactions, somewhat closer to the latter.

Risk management, signal processing and econometrics: A new tool for forecasting the risk of disease outbreaks.

This paper takes a novel approach for forecasting the risk of disease emergence by combining risk management, signal processing and econometrics to develop a new forecasting approach. We propose quantifying risk using the Value at Risk criterion and then propose a two staged model based on Multivariate Singular Spectrum Analysis and Quantile Regression (MSSA-QR model). The proposed risk measure (PLVaR) and forecasting model (MSSA-QR) is used to forecast the worst cases of waterborne disease outbreaks in 22 European and North American countries based on socio-economic and environmental indicators. The results show that the proposed method perfectly forecasts the worst case scenario for less common waterborne diseases whilst the forecasting of more common diseases requires more socio-economic and environmental indicators.

Kinetic Spectrophotometric Method for the 1,4-Diionic Organophosphorus Formation in the Presence of Meldrum's Acid: Stopped-Flow Approach.

The kinetics of the reaction between triphenylphosphine (TPP) and dimethyl acetylenedicarboxylate (DMAD) in the presence of Meldrum's acid (MA) for the generation of the 1,4-diionic organophosphorus compound has been investigated using the stopped-flow and UV-VIS spectrophotometry techniques. The first step of the reaction between TPP and DMAD for the generation of (I1) in ethanol was followed by the stopped-flow apparatus. This step was recognized as a fast step. The reaction between the intermediate (I1) and MA showed first-order kinetics, and it was followed by the UV-VIS spectrophotometry technique. The activation parameters for the slow step of the proposed mechanism were determined using two linearized forms of the Eyring equation. From the temperature, concentration and solvent studies, the activation energy (Ea = 20.16 kJ·mol-1) and the related activation parameters (ΔG‡ = 71.17 ± 0.015 kJ·mol-1, ΔS‡ = -185.49 ± 0.026 J·mol-1 and ΔH‡ =17.72 ± 0.007 kJ·mol-1) were calculated. The experimental data indicated that the reaction was zero-order in MA and second-order overall. The proposed mechanism was confirmed with the observed kinetic data obtained from the UV-VIS and stopped-flow techniques.