Miracle-dz/UniFAR-FTUs huggingface dataset:
Serum Interleukins Nitric Oxide Anti-Ro(+) and Anti-M3 Muscarinic Acetylcholine Receptor Auto Antibodies Levels in Patients with Primary Sjogren' Syndrome

Introduction Primary Sjögren’s syndrome (pSS) is an autoimmune disease characterized by the lymphocytic infiltration to lachrymal and salivary glands conducing to an impaired secretory activity leading to the most important manifestations of the disease, keratoconjunctivitis sicca [1] and xerostomia [2]. B cell hyper reactivity is manifested by the presence of hyper gamma globulinemia and auto antibodies mainly Abstract *Borda E, Ganzinelli S, Reina S
Oral Sildenafil Is an Effective and Specific Pulmonary Vasodilator in Patients With Pulmonary Arterial Hypertension

Background— The prognosis of patients with severe pulmonary hypertension (PHT) is poor. To determine prognosis and guide therapy, an acute hemodynamic trial of selective pulmonary vasodilators, usually inhaled nitric oxide (iNO), was performed. We hypothesized that oral sildenafil, a phosphodiesterase-5 inhibitor, is a safe and effective alternative to iNO. Methods and Results— We studied 13 consecutive patients (mean±SEM, 44±2 years of age; 9 women) referred for consideration of heart-lung transplantation or as a guide to medical therapy. All but one were functional class III or IV. Patients had primary PHT (n=9), pulmonary arterial hypertension (n=2), or secondary PHT (n=2). Hemodynamics and serum cyclic guanosine-monophosphate levels (cGMP) were measured at baseline and at peak effects of iNO (80 ppm), sildenafil (75 mg), and their combination. The decrease in pulmonary vascular resistance was similar with iNO (−19±5%) and sildenafil (−27±3%), whereas sildenafil+iNO was more effective than iNO alone (−.
Distributionally Robust Optimization under Distorted Expectations

Optimal Decision Making Under Distorted Expectation with Partial Distribution Information Decision makers who are not risk neutral may evaluate expected values by distorting objective probabilities to reflect their risk attitudes, a phenomenon known as distorted expectations. This concept is widely applied in behavioral economics, insurance, finance, and other business domains. In “Distributionally Robust Optimization Under Distorted Expectations,” Cai, Li, and Mao study how decision makers using distorted expectations can optimize their decisions when only partial information about objective probabilities is available. They show that decision makers who are ambiguity averse can optimize their decisions as if they are risk averse with their risk attitudes characterized by a convex distortion function. This finding demonstrates why even non–risk-averse decision makers, such as those studied in the celebrated cumulative prospect theory, may consider it optimal to take risk-averse decisions when facing uncertainty about objective probabilities. Leveraging this finding, the authors show that a large class of distributionally robust optimization problems involving the use of distorted expectations can be tractably solved as convex programs.
Prognostics of outcome of total knee replacement : on patient selection and intraoperative issues

In this thesis first we show that patients after total hip replacement are more satisfied than patients after total knee replacement (TKR). The indication to perform TKR is important. We studied the reason for orthopedic surgeons to recommend TKR. It seemed that the radiological osteoarthritis and age were most important. We compared Dutch orthopedic surgeons with those from other countries. Also we studied how well the oldest old patients (85+) perform with or without total joint replacement. In part 2 of the thesis more technical issues are addressed. A RCT studying the effect of fibrin sealant on postoperative knee function. No beneficial effect could be shown for the fibrin sealant. A Cochrane review and meta-analysis studying whether to sacrifice or retain the posterior cruciate ligament in TKR. It seemed there was no clinical difference between the two. Finally a RCT studying two different kinds of warming blankets applied during total joint replacement showed no evident difference between the two.
Editorial: Heart Failure in Type 2 Diabetes – The “Forgotten” Complication

Diabetes, particularly type 2 diabetes (T2DM), was recognized as the new “worldwide pandemic” of the 21 st century, with an estimated 8.8% of the adult population (~425 million subjects) afflicted by this condition in 2017 [1]. In the same time, diabetes represents a massive public health issue, being one of the major causes of morbidity and mortality in the modern societies, with high social and economic costs. It is estimated that chronic diseases (including diabetes) have surpassed infectious diseases as the first cause of premature mortality worldwide [2]. In addition, healthcare expenditure related to diabetes in USA reached a staggering 322-377 billion USD [1,2], with a worldwide estimate of 727 billion USD in 2017 according to the latest IDF data [1]. It was long time established that cardiovascular disease (CVD) represents the first cause of death and probably the main cause of disability in subjects with T2DM, with some estimates indicating an 80% excess mortality due to CVD in T2DM [3]. Progresses in the treatment of T2DM and associated CVD risk factors (especially hypertension and dyslipidemia) have led to a continuous decline in the CVD associated morbidity and mortality in diabetes subjects [4,5]. Still, a recent analysis of data from the Swedish National Diabetes Register have shown that T2DM subjects continue to have a 2-4 fold increased risk of death from any cause, death from CVD and death from coronary heart disease (CHD) compared with non-diabetic subjects [4]. This could be explained by the fact that frequently T2DM subjects have asymptomatic / unrecognized CVD, including silent myocardial ischemia and heart failure (HF).
A study on knowledge and practices of over the counter medications among 1st year medical students

Background: Self-medication is widely practiced worldwide and often considered as a component of self-care. Selfmedication assumes a special significance among the medical students as they are the future medical practitioners and have a potential role in counselling the patients about the advantages and disadvantages of self-medication. Self-medication assumes a special significance among the medical students as they are the future medical practitioners. Medical students also differ from the general population because they are well-exposed to the knowledge about diseases and drugs. Therefore the present study was taken up to assess the extent of knowledge and practices of over the counter (OTC) drugs among the first year medical students in a tertiary care teaching hospital.Methods: A descriptive, cross sectional, non-interventional, observational study was conducted from November 2017 to January 2018 among 246 first year medical students. The data analyzed using descriptive statistics with percentages and averages using Statistical Package for Social Science (SPSS). Results: In the present study, it was found that 86% students practiced self-medication. Most common conditions for taking self-medication with OTC was fever (89%) followed by cough and cold (75%). 15% of them experienced adverse reactions on OTC self-medicated drugs. The main source of information during self-medication was reading material (56.3%) followed by advice from seniors/pharmacist (43.7%). Conclusions: Self-medication is widely practiced among undergraduate medical students. In this situation, we should educate the students about advantages and disadvantages of self-medication of over the counter drugs.
Patient’s Knowledge of Basic Medication Information in Saudi Arabia

Objective: To explore the Patients and Basic Knowledge of Medications in Saudi Arabia. Methods: It is a 4-months cross-sectional survey of patient and basic knowledge of medicines. The survey consisted of twopart, demographic information and second part forty-nine questions divided into four domains. It included domain 1: Primary or essential information about patient medication, domain 2: patient information about the drug-related problem, domain 3: patient information about drug-related cost and domain 4: patient’s perception about medications. Medline Plus health information and DailyMed-INH elements information from National Institute of Health United State of America were used. The 5-point Likert response scale system was used. The questions were open and closed-ended. The survey distributed through social media and at 500-bed pediatrics and maternity hospital in Asir region, at ambulatory care pharmacy. The authors did the patients interview with electronic survey documentation. The survey was made in an electronic format and it analyzed domain one Primary or necessary information about patient medication through survey monkey system. Results: The total responders were (614) patients with Saudi 564 (96.1%) and Non-Saudi was 23 (3.9%) nationalities. The gender distribution 523 (85.2%) were females and 91 (14.8%) were males. The most type of medications used was anti-diabetic and anti-hypertension medicines, Skin medications and drugs for Respiratory Diseases. The responders showed poor knowledge either they do not know or weak information about the generic name of Medicines 300 (54.8%), the trade name 246 (46.8%). While adequate knowledge both complete and incomplete information of drug strength 324 (60.9%) and dosage form of medication 377 (70.6%). The patients showed adequate knowledge about medications with both complete information and incomplete information about drug indication 456 (77.8%), how to use medications 496 (84.78%), the administration time 493 (84.71%), the potential to adhere medication 431 (73.9%) and the time to stop drugs 391 (67.1%). The majority of responders used health care providers 346 (57%), drug bulletin 341 (56.2%), Internet 221 (36.4%) and Relatives and friends 137 (22.57%) as sources of drug information. Conclusion: The finding showed indigent essential drug information knowledge. Targeting of public awareness of necessary information about their medications and patient counseling system will prevent drug misadventures and drug-related morbidity and mortality in Saudi Arabia. Key words: Patient, Knowledge, Medications, Ministry of Health, Saudi Arabia.
A Review on Ethnobotanical Study of Traditional Medicinal Plants Used for Treatment of Liver Problems in Ethiopia

Traditional medicinal plants are used for human ailments treatment throughout the world primary health care need practiced typically liver problems by indigenous medical practitioners. This review was employed with the objective of compiling and documenting ethnobotanical studies on the use of medicinal plants, associated with the treatment of liver problems from different ethnic groups in Ethiopia. By using published and unpublished research articles, a total of 46 journals meeting inclusion criteria were used for preparations most commonly used route of application 99 (88.39%) followed by dermal and oral 4 (3.57%) and dermal application 3 (2.68%). The healers used different method of preparation for application such as crushing, concoction, decoction, chewing, powdering, etc. This review indicated that the liver problem is common disease in Ethiopia. Adapting a recommended diagnostic and treatment using physical diagnosis by indigenous healers/ practitioners attempted curing liver problem implementing prevention and control policies in the general population needs an urgent attention in the country.
The prevalence of polymorphisms of thiopurine smethyltransferase gene In Iranian alopecia areata patients

Azathioprine therapy was recently used to treat dermatologic conditions such as alopecia areata (AA). Previous reports showed that thiopurine s-methyltransferase (TPMT) activities in human red blood cell are associated with a polymorphism in this gene. Therefore, patients carrying mutant allele of TPMT may show severe myelosuppression when they are treated with standard doses of Azathioprine drugs. This study aimed to evaluate the TPMT gene amongst Alopecia areata patients and healthy adult in Iranian populations. TPMT gene polymorphisms were investigated in 1285 Iranian healthy adult blood donors and 632 patients with Alopecia Areata Universalis (AU). Tetra Arms PCR, Real-Time PCR and Sequencing were used to evaluate the presence of allele-specific polymorphisms of TPMT gene (TPMT *2(c.238 GC,), TPMT *3A (c.460 GA and c.719 AG), TPMT *3B (c.460 GA), and TPMT *3C (c.719 AG). Results were shown that the TPMT*2 allele is associated with a low enzymatic activity that was detected in 22.51% (863 in 1917) of Iranian individuals. Heterozygous genotypes were in 827 (43.14%) subjects (232 AA and 595 healthy), and homozygous genotypes were in 18 (0.94%) individuals (3 AA and 15 healthy). The normal allele (wild-type) was found in 55.92% of the studied individuals (20.70% AA and 35.21% healthy). According to a higher frequency of TPMT polymorphism in Iranian population in comparison with other population, determination of TPMT genotype in may have the clinical benefit to thiopurine dosage selection and treat patients as well.
Rothamsted Repository Download

Wheat is the staple food crop in temperate countries and increasingly consumed in developing countries, displacing traditional foods. However, wheat products are typically low in bioavailable iron and zinc, contributing to deﬁciencies in these micronutrients in countries where wheat is consumed as a staple food. Two factors contribute to the low contents of bioavailable iron and zinc in wheat: the low concentrations of these minerals in white ﬂour, which is most widely consumed, and the presence of phytates in mineral-rich bran fractions. Although high zinc types of wheat have been developed by conventional plant breeding (biofortiﬁcation), this approach has failed for iron. However, studies in wheat and other cereals have shown that transgenic (also known as genetically modiﬁed; GM) strategies can be used to increase the contents of iron and zinc in white ﬂour, by converting the starchy endosperm tissue into a ‘sink’ for minerals. Although such strategies currently have low acceptability, greater understanding of the mechanisms which control the transport and deposition of iron and zinc in the developing grain should allow similar effects to be achieved by exploiting naturally induced genetic variation. When combined with conventional biofortiﬁcation and innovative processing, this approach should provide increased mineral bioavailability in a range of wheat products, from white ﬂour to wholemeal.
Changes in disease activity, disability and mortality of inflammatory arthritis in in the new millennium compared with the 10 years before

Inflammatory polyarthritis and its subset rheumatoid arthritis (RA) are characterized by synovial inflammation and hyperplasia, autoantibody production, cartilage and bone destruction, and systemic features, including cardiovascular, pulmonary, psychological, and skeletal disorders (1,2). In contrast to osteoarthritis, which is also associated with cartilage and bone destruction but generally considered as noninflammatory arthritis and with hardly any treatment options that modify the course (3-5), outcomes of inflammatory polyarthritis and RA can be improved by administration of appropriate therapy. Nevertheless, a number of studies comparing changes in the long-term outcome of treatment for patients with inflammatory polyarthritis during the mid-1990s have achieved inconsistent conclusions (6,7). Furthermore, there are suggestions that RA is becoming less severe (8,9). Thus, it would be of interest to investigate whether any improvements in long-term outcome are associated with less severe disease or with the changes in treatment strategy.
EXPERIENCES OF AFRICAN AMERICAN MOTHERS FOLLOWING INFANT DEATH

This paper describes, explains and explores the concept of susceptibility. The perception of susceptibility influences a person’s actions regarding healthcare. An understanding of the concept of susceptibility is proposed to assist in reducing health disparities in the African American community. Concept analysis was conducted as developed by Walker and Avant. Data were derived from dictionaries and literature searches in the CINAHL and MEDLINE databases. The inclusive years for the search were 2000-2016 which resulted twelve articles. Susceptibility has four defining attributes: openness, sensitivity, tendency, and at risk. Antecedents of susceptibility include predisposition of an incident or event when accessibility and likelihood are present. Consequences of susceptibility include poor health outcomes, decreased quality of life, and increased disparity. Susceptibility was explored and found to be vital in combating health disparities among African Americans. By understanding susceptibility and how an individual’s perception of susceptibility affect health care choices, researchers can contribute in the treatment of illnesses or diseases and improve health outcomes.
Effectiveness of an education program on heart failure patients knowledge concerning self-care in Baghdad Teaching Hospitals

Heart failure is a serious illness that affects mostly the elderly. Characterized by gradual deterioration of the heart muscle and affects the quality of life of those living with it. It has been shown that disease progression is slower with appropriate self-care. A quasi-experimental study design was carried out in baghdad Teaching Hospital. A non-probability (purposive) study sample of (60) patients, (30) for the study group and (30) for the control group in coronary care unit for the period from30th/October/2017 to 30th/April/2018. Using the questionnaire as instrument for data collection, it’s designed to assess the patients knowledge pre and after application of the education program. The post-test done after two weeks, data were analyzed by using descriptive and inferential data analysis. The results of study reveal that the level of knowledge concerning self-care showed (76%) of the study group and (93.3%) of the control group were unacceptable. After implementation the education program the level of knowledge showed (97%) of the study group and (33%) of the control group were acceptable. The study concluded that the knowledge of the study group were higher than it were in pre education program.
Evaluation of Mobile Apps Targeted to Parents of Infants in the Neonatal Intensive Care Unit: Systematic App Review

Background Parents of preterm infants increasingly use their mobile phone to search for health information. In a recent review, websites targeted toward parents with infants in the neonatal intensive care unit (NICU) were found to have poor to moderate quality educational material; however, there is a dearth of literature regarding mobile apps for NICU parents. Objective This study aimed to identify and evaluate apps targeting parents of infants in the NICU for quality of information, usability, and credibility. Methods We systematically searched the Apple App Store and Google Play using 49 key terms (eg, “preterm infant”) from July 26 to August 18, 2017. English apps targeting NICU parents that cost less than $20 were included. Apps for health care professionals, e-books/magazines, or nonrelevant results were excluded. In total, 3 tools were used for evaluation: Mobile Application Rating Scale (MARS) to measure quality; Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-AV) to measure the app’s content usability; and Trust it or Trash It to measure credibility. Results The initial search yielded 6579 apps, with 49 apps eligible after title and description screening. In total, 27 apps met the eligibility criteria with 9 apps available in both app stores; of those, the app with the most recent update date was chosen to be included in the analysis. Thus, 18 unique apps were included for final analysis. Using MARS, 7 apps (7/18, 39%) received a good score on overall quality (ie, 4.0 out of 5.0), with none receiving an excellent score. In addition, 8 apps (8/18, 44%) received a PEMAT-AV score between 51% and 75% on the understandability subscale, and 8 apps (8/18, 44%) scored between 76% and 100% on the actionability subscale. Trust It or Trash It deemed 13 apps (13/18, 72%) as trash for reasons including no identification of sources or lack of current information, with only 5 (5/18, 28%) deemed trustworthy. Reviewer’s expert evaluation found 16 apps contained content that matched information provided by multiple sources; however, most apps did not meet other objective measurement items to support credibility. When comparing the MARS overall quality and subjective quality scores with trustworthiness of apps, there was no statistically significant difference. A statistically significant difference was found between the 2 MARS quality scores, indicating that, on average, apps were ranked significantly lower on subjective quality compared with overall quality measures. Conclusions This evaluation revealed that of the available apps targeting NICU parents, less than half should be considered as acceptable educational material. Over two-thirds of the apps were found to have issues regarding credibility and just over a quarter were considered good quality. The apps currently available for NICU parents are lacking and of concern in terms of quality and credibility.
Glutathione

Glutathione is a simple sulfur compound composed of three amino acids and the major non-protein thiol in many organisms, including plants. The functions of glutathione are manifold but notably include redox-homeostatic buffering. Glutathione status is modulated by oxidants as well as by nutritional and other factors, and can influence protein structure and activity through changes in thiol-disulfide balance. For these reasons, glutathione is a transducer that integrates environmental information into the cellular network. While the mechanistic details of this function remain to be fully elucidated, accumulating evidence points to important roles for glutathione and glutathione-dependent proteins in phytohormone signaling and in defense against biotic stress. Work in Arabidopsis is beginning to identify the processes that govern glutathione status and that link it to signaling pathways. As well as providing an overview of the components that regulate glutathione homeostasis (synthesis, degradation, transport, and redox turnover), the present discussion considers the roles of this metabolite in physiological processes such as light signaling, cell death, and defense against microbial pathogen and herbivores.