Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of Health Literacy Education on Self-Care in Pregnant Women: A Randomized Controlled Clinical Trial

ABSTRACT Background: Prenatal care reduces the risk of adverse pregnancy outcomes. The present study aimed to determine the effect of health literacy education on self-care in pregnant women. Methods: The present randomized controlled clinical trial was conducted at two comprehensive health service centers in Pakdasht (Tehran province, Iran) during January-June 2016. Out of the ten comprehensive health service centers in the city, two centers were selected using a simple randomized sampling and randomly assigned to a control group and an intervention group. From each center, 40 pregnant women were recruited into the study. Dedicated questionnaires on self-care and health literacy during pregnancy were developed by the author as data collection tool. The validity and reliability of the questionnaires were confirmed using the test-retest reliability method and by the opinion of ten experts, respectively. The questionnaires were completed before the intervention, and at 1 and 2 months after the intervention. The intervention consisted of four 45-minute educational sessions and group counseling. The data were analyzed using the SPSS software (version 16.0) with the independent t test, Chi-square test, Mann-Whitney test, and repeated measures ANOVA. P<0.05 was considered statistically significant. Results: There was no significant difference between the groups before the intervention. However, 1 month after the intervention, there was a significant difference (P<0.001) in the mean scores of the total self-care and total health literacy between the control and intervention groups (65±6.23 versus 76.77±4.28 and 30.95±4.63 versus 40±3.54). Similarly, there was a significant difference (P<0.001) between the mean scores 2 months after the intervention. Conclusion: Intervention for the promotion of physical and mental self-care during pregnancy should emphasize on increasing health literacy in computational comprehension, reading comprehension, and behavior. Trial Registration Number: IRCT2017030415650N8
Long-term safety and efficacy of formoterol fumarate inhalation solution in patients with moderate-to-severe COPD

Background Formoterol fumarate inhalation solution (FFIS; Perforomist®) is a long-acting β2-agonist (LABA) marketed in the US as a nebulized COPD maintenance treatment. Because long-term LABA use was associated with a potential increased risk of exacerbation or death in asthma patients, the US Food and Drug Administration (FDA) requested a postmarketing commitment study to evaluate long-term safety in COPD patients. Methods This was a multicenter, randomized, double-blind, placebo-controlled, noninferiority study. Patients (N=1,071; mean age, 62.6 years; 48.5% male; 89.7% white) with moderate-to-severe COPD on stable COPD therapy received FFIS (20 µg; n=541) or placebo (n=530) twice daily. The primary end point was the combined incidence of respiratory death, first COPD-related ER visit, or first COPD exacerbation-related hospitalization during 1 year post randomization. Noninferiority to placebo was concluded if the two-sided 90% CI of the HR of FFIS to placebo was <1.5. Secondary end points included spirometry. Results The planned 1-year treatment period was completed by 520 patients; 551 discontinued prematurely (FFIS: 45.7%; placebo: 57.4%). The median treatment duration was approximately 10 and 7 months for FFIS and placebo, respectively. Among 1,071 randomized patients, 121 had ≥1 primary event (FFIS: 11.8%; placebo: 10.8%). The estimated HR of a primary event with FFIS vs placebo was 0.965 (90% CI: 0.711, 1.308), demonstrating that FFIS was noninferior to placebo. No respiratory deaths were observed in the FFIS group. Adverse events were similar for FFIS vs placebo (patients with ≥1 treatment-emergent adverse events: 374 [69.1%] vs 369 [69.6%], respectively). Compared with placebo, FFIS demonstrated statistically greater improvements from baseline in trough FEV1, FVC, percent predicted FEV1, and patient-reported outcomes (Transition Dyspnea Index). Conclusions Nebulized FFIS was noninferior to placebo with respect to safety in patients with moderate-to-severe COPD. Additionally, fewer treatment withdrawals and larger lung function improvements were observed with FFIS compared with placebo when added to other maintenance COPD therapies.
Qualitative study of patient views on a ‘telephone-first’ approach in general practice in England: speaking to the GP by telephone before making face-to-face appointments

Objective To understand patients’ views on a ‘telephone-first’ approach, in which all appointment requests in general practice are followed by a telephone call from the general practitioner (GP). Design Qualitative interviews with patients and carers. Setting Twelve general practices in England. Participants 43 patients, including 30 women, nine aged over 75 years, four parents of young children, five carers, five patients with hearing impairment and two whose first language was not English. Results Patients expressed varied views, often strongly held, ranging from enthusiasm for to hostility towards the ‘telephone-first’ approach. The new system suited some patients, avoiding the need to come into the surgery but was problematic for others, for example, when it was difficult for someone working in an open plan office to take a call-back. A substantial proportion of negative comments were about the operation of the scheme itself rather than the principles behind it, for example, difficulty getting through on the phone or being unable to schedule when the GP would phone back. Some practices were able to operate the scheme in a way that met their patients’ needs better than others and practices varied significantly in how they had implemented the approach. Conclusions The ‘telephone-first’ approach appears to work well for some patients, but others find it much less acceptable. Some of the reported problems related to how the approach had been implemented rather than the ‘telephone-first’ approach in principle and suggests there may be potential for some of the challenges experienced by patients to be overcome.
Characterization and influence of hydroxyapatite nanopowders on living cells

Nanomaterials, such as hydroxyapatite nanoparticles show a great promise for medical applications due to their unique properties at the nanoscale. However, there are concerns about the safety of using these materials in biological environments. Despite a great number of published studies of nanoobjects and their aggregates or agglomerates, the impact of their physicochemical properties (such as particle size, surface area, purity, details of structure and degree of agglomeration) on living cells is not yet fully understood. Significant differences in these properties, resulting from different manufacturing methods, are yet another problem to be taken into consideration. The aim of this work was to investigate the correlation between the properties of nanoscale hydroxyapatite from different synthesis methods and biological activity represented by the viability of four cell lines: A549, CHO, BEAS-2B and J774.1 to assess the influence of the nanoparticles on immune, reproductive and respiratory systems.
Switching to anastrozole plus goserelin vs continued tamoxifen for adjuvant therapy of premenopausal early-stage breast cancer: preliminary results from a randomized trial

Purpose To assess the efficacy, safety, and quality-of-life impact of switching adjuvant treatment in hormone receptor-positive primary breast cancer patients who are still premenopausal after 2–3 years of tamoxifen therapy to anastrozole plus goserelin as compared with continuing tamoxifen over a total period of 5 years. Patients and methods Hormone receptor-positive, premenopausal, lymph node-positive, or tumor size ≥4 cm breast cancer patients who had received tamoxifen for 2–3 years were randomly assigned to continue tamoxifen treatment (TAM group) or switch to adjuvant anastrozole plus goserelin (ADD group) and continue treatment for another 2–3 years (total treatment duration 5 years). Endpoints evaluated were adverse events (AEs), changes in bone mineral density, quality of life, and disease-free survival-related events. Results A total of 62 patients (33 in the ADD group and 29 in the TAM group) were evaluated. Grade 3–4 drug-related AEs occurred in five patients (15.2%) in the ADD group vs none in the TAM group. In the ADD group, arthralgias were the most common AEs (5/33 patients; 15.2%), and three patients in this group were discontinued because of AEs. Treatment was temporarily suspended due to AEs in three patients (9.1%) in the ADD group and one patient (3.4%) in the TAM group. Compared with continuing TAM therapy, switching to anastrozole plus goserelin did not result in any worsening of bone mineral density or quality of life. During a median follow-up of 34 months, five patients (15.2%) in the ADD group had disease-free survival events vs four patients (13.8%) in the TAM group. Conclusion For early-stage breast cancer patients who remain premenopausal following 2–3 years of adjuvant tamoxifen therapy, switching to anastrozole plus goserelin therapy was safe with tolerable adverse effects. However, it did not show superior efficacy compared to remaining on tamoxifen treatment. Trial Registration ClinicalTrials.gov (identifier NCT01352091).
Evaluating ivosidenib for the treatment of relapsed/refractory AML: design, development, and place in therapy

Improvements in the last decade in understanding the molecular mechanisms underlying acute myeloid leukemia (AML) have emphasized that treatment regimens should be personalized with agents that can selectively target genetic abnormalities if present. Neomorphic mutations in isoform 1 of isocitrate dehydrogenase (IDH1) result in the formation of the onco-metabolite R-2-hydroxyglutarate, which drives leukemic transformation by affecting processes such as chromatin remodeling, the cellular defense against oxidative stress and cell survival. Preclinical studies with small molecule inhibitors have validated mutant IDH1 as a molecular target, and a recent Phase 1 clinical trial with the first mutant IDH1 inhibitor ivosidenib has prompted approval by the US Food and Drug Association for the treatment of patients with IDH1-mutated AML in the relapsed and refractory setting due to impressive results. This approval has given a group of patients, that otherwise has a very poor prognosis and limited options, new hope, and it is to be expected that more indications for ivosidenib will follow soon. These developments highlight the potential of precision medicine in AML, with more agents currently under evaluation in clinical trials. Although the first reports have also already emerged describing acquired resistance for these mutant IDH inhibitors, combination treatment might overcome this problem, which could drastically change the treatment landscape of AML over the next few years.
Flavonoids in Ecuadorian Oreocallis grandiflora (Lam.) R. Br.: Perspectives of Use of This Species as a Food Supplement

Oreocallis grandiflora (Lam.) R. Br. is an Ecuadorian species belonging to the Proteaceae family, commonly known as cucharillo (Loja and Zamora provinces), cucharilla (Sierra region), gañal (Bolívar province), and algil (Chimborazo province). Its leaves and flowers, collected during blooming, are traditionally used for oral administration to treat liver diseases, vaginal bleeding, and ovary/uterus inflammation and as digestive, diuretic, and hypoglycemic remedy. Related literature does not report any scientific evidences regarding the chemical composition of the used parts of this species (leaves and flowers), while few indications are reported about the healthy properties of their preparations. Based on these premises, the present research was performed with the objectives to fill the gaps of the chemical and biological knowledge about this species, enriching the knowledge related to the plant biodiversity of Amazonian Ecuador and to the ethnobotanical tradition of Andean communities. Chemical and biological investigation (in vitro antioxidant and anti-inflammatory activity) of flower and leaf hydroalcoholic extracts shed a light on the functional metabolites putatively involved in healthy properties of the O. grandiflora traditional preparations. The chemical fingerprinting achieved by HPTLC and 1HNMR analyses showed the presence of flavonoids, subsequently quantitatively estimated by AlCl3 complexation assay and HPLC-DAD. Silica gel chromatography allowed the isolation of the main compounds of the flower extract: quercetin 3-O-β-glucuronide and myricetin 3-O-β-glucuronide. RP-HPLC-DAD-MS analyses showed the presence of quercetin 3-O-rutinoside and isorhamnetin 3-O-rutinoside, in addition to the above-mentioned molecules, in the leaf extract. Regarding the antioxidant (DPPH test, a radical scavenging assay) and anti-inflammatory (WST-1 assay, an oxidative burst test) activities, leaf extract showed the most promising results when compared to the positive controls. The same extract, however, exhibited a higher cytotoxicity compared to the flower extract, indicating the latter preparation as the most interesting anti-inflammatory crude drug.
Agar Extraction By-Products from Gelidium sesquipedale as a Source of Glycerol-Galactosides

Alkaline treatment is a common step largely used in the industrial extraction of agar, a phycocolloid obtained from red algae such as Gelidium sesquipedale. The subsequent residue constitutes a poorly valorized by-product. The present study aimed to identify low-molecular-weight compounds in this alkaline waste. A fractionation process was designed in order to obtain the oligosaccharidic fraction from which several glycerol-galactosides were isolated. A combination of electrospray ion (ESI)-mass spectrometry, 1H-NMR spectroscopy, and glycosidic linkage analyses by GC-MS allowed the identification of floridoside, corresponding to Gal-glycerol, along with oligogalactosides, i.e., (Gal)2–4-glycerol, among which α-d-galactopyranosyl-(1→3)-β-d-galactopyranosylα1-2–glycerol and α-d-galactopyranosyl-(1→4)-β-d-galactopyranosylα1-2–glycerol were described for the first time in red algae.
Evaluation of deep vein thrombosis prophylaxis in a general hospital

Abstract Background Venous thromboembolism (VTE) is a cause for growing concern in hospitals, has great impact on morbidity and mortality in clinical and surgical patients, and is the leading cause of preventable hospital deaths. Although there are risk assessment models for hospital inpatients, prophylaxis is still underused or is administered incorrectly. Objectives To assess the risk profile for VTE in recently hospitalized clinical and surgical patients and evaluate the thromboprophylactic measures implemented in the first 24 hours of hospitalization. Methods Cross-sectional study conducted in a large general hospital in the state of São Paulo, Brazil, between March and July 2015. Padua and Caprini scores were used for risk stratification of clinical and surgical patients, respectively, while thromboprophylactic measures were analyzed for compliance with the recommendations contained in the 8th and 9th Consensus of the American College of Chest Physicians. Results A total of 592 patients (62% clinical and 38% surgical) were assessed. Risk stratification revealed a need for chemoprophylaxis in 42% of clinical patients and 81% of surgical patients (51% high risk and 30% moderate risk). However, 54% of high-risk clinical patients, 85% of high-risk surgical patients, and 4% of moderate-risk surgical patients, who were free from contraindications, were actually given the correct prophylaxis in the first 24 hours of hospitalization. Conclusions There is a need to improve patient safety in relation to VTE in the first hours of hospitalization, since there is underutilization of chemoprophylaxis, especially in high-risk clinical patients and moderate-risk surgical patients.
Silver sulfadiazine nanosuspension-loaded thermosensitive hydrogel as a topical antibacterial agent

Background Silver sulfadiazine (AgSD) is widely employed as an antibacterial agent for surface burn management. However, the antibacterial activity of AgSD was restrained because of the lower drug solubility and possible cytotoxicity. Objective This study aimed to formulate stable silver sulfadiazine/nanosuspensions (AgSD/NSs) with improved AgSD solubility and prepare a suitable carrier for AgSD/NS delivery. Nanotechnology was used to overcome the low drug dissolution rate of AgSD, while the new carrier loaded with AgSD/NS was assumed to decrease the possible cytotoxicity, enhance antibacterial activity, and promote wound healing. Methods AgSD/NSs were prepared by high pressure homogenization method. Poloxamer 407-based thermoresponsive hydrogels were prepared by cold method as carriers of AgSD/NS to obtain AgSD/NS-loaded thermoresponsive hydrogel. Scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) were used to measure the physicalchemical properties of AgSD/NSs and AgSD/NS-loaded gel. The cytotoxicity of the AgSD/NS-loaded gel was evaluated using methyl thiazolyltetrazolium assay with L929 mouse fibroblast cell lines. In vitro antibacterial activities of AgSD/NSs and AgSD/NS loaded gel were also measured. Results Stable AgSD/NSs with an average particle size of 369 nm were formulated while 1.5% P407 was selected as a stabilizer. The optimized AgSD/NS thermoresponsive hydrogel exhibited the gelation temperature of approximately 30°C. A significant improvement in solubility was observed for AgSD nanoparticles (96.7%) compared with AgSD coarse powders (12.5%). The results of FTIR and XRD revealed that the physicochemical properties of AgSD/NS were reserved after incorporating into the hydrogel. The cell viability after incubation with AgSD/NS-loaded thermoresponsive hydrogel improved from 60.7% to 90.6% compared with incubation with AgSD/NS directly. Drug release profiles from the thermoresponsive hydrogel increased compared with the commercial AgSD cream, implying less application frequency of AgSD cream clinically. In vitro antibacterial studies manifested that AgSD nanocrystallization significantly enhanced the antibacterial activity compared with the AgSD coarse powder. Conclusion The combination of AgSD nanosuspensions and thermoresponsive hydrogel effectively improved the AgSD antibacterial activity and decreased the cytotoxicity. This study also suggested that a poloxamer thermoresponsive hydrogel could be used as a delivery system for other nanocrystals to decrease possible nanotoxicity.
Elevation of immunoglobulin levels is associated with treatment failure in HIV-infected children in Vietnam

Background HIV-infected children suffer from higher levels of treatment failure compared to adults. Immunoactivation, including humoral immunoactivation reflected by increased immunoglobulin levels, is believed to occur early during HIV infection. Therefore, we wanted investigate alteration in immunoglobulin levels in association with treatment response in HIV-infected children. Methods A nested case-control study was conducted using clinical data collected from 68 HIV-infected children enrolled at the National Hospital of Pediatrics, Vietnam. Results The results showed that immunoglobulin levels, CD4 T-cell counts, CD4 T-cell percentage, and HIV load were significantly higher in the treatment-failure group than the treatment-success group at treatment initiation. IgG and IgA levels were negatively correlated with CD4 T-cell counts (P=0.049 and P<0.01, respectively) and positively correlated with HIV load (P=0.04 and P=0.02, respectively). In addition, IgG and IgA levels were independently associated with treatment response, analyzed by Cox regression analysis (HR 1.19 [P=0.049] and HR 1.69 [P<0.01], respectively). Conclusion Elevation of IgA levels occurred early during HIV infection, and might have a prognostic role in treatment response.
Association of Strength and Physical Functions in People with Parkinson's Disease

Background Parkinson's disease is responsible for decrease of activities of daily living and mobility limitations. Association of strength with physical capacities and disease time can improve training methodologies and predict changes in physical fitness for this population, since the control center of movements and strength is the same. Objective Therefore, the aim of this study is to analyze if there are correlation between strength with functional tests (the sit-to-stand, the six-minute walk, and the timed-up-go) and disease time in people with Parkinson's disease. Results All functional tests correlations are significant, p < 0.05. The strength is positively correlated with the sit-to-stand and the six-minute walk. The strength is negatively correlated with the timed-up-go. Conclusion There are a correlation between strength with functional tests in people with PD, and changes in strength assessment can be used as predictor to changes in aerobic capacity.
Ethyl Rosmarinate Protects High Glucose-Induced Injury in Human Endothelial Cells

Ethyl rosmarinate (RAE) is one of the active constituents from Clinopodium chinense (Benth.) O. Kuntze, which is used for diabetic treatment in Chinese folk medicine. In this study, we investigated the protective effect of RAE on high glucose-induced injury in endothelial cells and explored its underlying mechanisms. Our results showed that both RAE and rosmarinic acid (RA) increased cell viability, decreased the production of reactive oxygen species (ROS), and attenuated high glucose-induced endothelial cells apoptosis in a dose-dependent manner, as evidenced by Hochest staining, Annexin V–FITC/PI double staining, and caspase-3 activity. RAE and RA both elevated Bcl-2 expression and reduced Bax expression, according to Western blot. We also found that LY294002 (phosphatidylinositol 3-kinase, or PI3K inhibitor) weakened the protective effect of RAE. In addition, PDTC (nuclear factor-κB, or NF-κB inhibitor) and SP600125 (c-Jun N-terminal kinase, or JNK inhibitor) could inhibit the apoptosis in endothelial cells caused by high glucose. Further, we demonstrated that RAE activated Akt, and the molecular docking analysis predicted that RAE showed more affinity with Akt than RA. Moreover, we found that RAE inhibited the activation of NF-κB and JNK. These results suggested that RAE protected endothelial cells from high glucose-induced apoptosis by alleviating reactive oxygen species (ROS) generation, and regulating the PI3K/Akt/Bcl-2 pathway, the NF-κB pathway, and the JNK pathway. In general, RAE showed greater potency than RA equivalent.