Miracle-dz/UniFAR-FTUs huggingface dataset:
Urgent action needed to improve vitamin D status among older people in England!

BACKGROUND the importance of vitamin D for bone health is well known, but emerging evidence also suggests that adequate vitamin D status may also be protective against non-communicable diseases. In the UK, government initiatives highlighting the importance of adequate vitamin D among older people have been in place since 1998. OBJECTIVES the aim of this analysis is to assess vitamin D status in people aged > or =65, living in private households in England, 2005 and make comparisons with the Health Survey for England (HSE) 2000 and the National Diet and Nutrition Survey (NDNS), 1994. We also examine associations of hypovitaminosis D [serum 25(OH)D <50 nmol/l] with demographic, geographic, lifestyle and health risk factors. DESIGN AND SETTING a nationally representative sample of older people living in England in 2005. PARTICIPANTS 2,070 adults aged > or =65, living in private households taking part in the HSE 2005. RESULTS in the HSE 2005, mean serum 25(OH)D levels were 53 and 49 nmol/l in men and women, respectively, these levels are significantly lower than currently recommended at > or =75 nmol/l. Prevalence of vitamin D deficiency [25(OH)D <25 nmol/l] in people aged > or =65 in 2005 was 13% in women and 8% in men. Nearly two thirds (57%) of women and half of men (49%) had serum 25(OH)D <50 nmol/l. Only 16% of men and 13% of women aged > or =65 years had serum 25(OH)D levels > or =75 nmol/l. There is no improvement in vitamin D status in 2005 compared to 2000 and a significant decline in vitamin D status among men in 2005 in comparison to the 1994/1995 NDNS results. The odds of hypovitaminosis D increased by age group from those aged 75-79 to aged > or =85. Season of taking a blood sample, obesity, dark skin pigmentation, not taking vitamin supplements, cigarette smoking, poor general health and longstanding illness were all significant predictors (P < 0.05) of serum 25(OH)D status in adjusted regression models. CONCLUSIONS poor vitamin D status of older people continues to be a public health problem in England. Hypovitaminosis D is associated with many risk factors and poor health outcomes. There is now an urgent need for a uniform policy on assessment and dietary supplementation of vitamin D in older people to prevent poor vitamin D status and its negative consequences.
Disability support workers’ experience of interaction with a person with profound intellectual disability

Abstract Background The primary communication partner for many people with profound intellectual disability (PID) who are living in supported accommodation is their disability support worker (DSW). The experiences of DSWs in interacting with people with PID have received limited attention in the literature. Method The nature of interactions between people with PID and DSWs was explored from the perspective of three DSWs through an analysis of interview data using a phenomenological approach. Results It was evident from the data that communicating in a way that was perceived to be the preferred style of the person with PID was important to the DSWs. This style, however, was often perceived to be in conflict with their employing organisation’s policy and preferred practice. Conclusion The descriptions in this study have implications for the conceptualisation of best practice in interacting with people with PID. Further research on interactions involving behaviours that may be perceived as inconsistent with concepts of age‐appropriate interactions and professional boundaries is recommended.
Comparison Between 4.0-mm Stainless Steel and 4.75-mm Titanium Alloy Single-Rod Spinal Instrumentation for Anterior Thoracoscopic Scoliosis Surgery

Study Design. Retrospective review of a consecutive, single surgeon case series. Objective. To compare minimum 2-year postoperative outcomes between 4.0-mm stainless steel and 4.75-mm titanium alloy single-rod anterior thoracoscopic instrumentation for the treatment of thoracic idiopathic scoliosis. Summary of Background Data. Advances in anterior thoracoscopic spinal instrumentation for scoliosis have attempted to mitigate the postoperative complications of rod failure, pseudarthrosis, and deformity progression. Biomechanical data suggest that the 4.75-mm titanium construct has a lower risk of fatigue failure compared to the 4.0-mm stainless steel construct. Methods. Sixty-four consecutive anterior thoracoscopic spinal instrumentation cases in patients with thoracic scoliosis performed by a single surgeon and with minimum 2-year follow-up were retrospectively reviewed. The first 34 cases used a 4.0-mm stainless steel (SS) construct, whereas the subsequent 30 cases used a 4.75-mm titanium (Ti) alloy instrumentation system. The first 10 SS cases and the first 5 Ti cases were excluded from the statistical comparison to account for a potential learning curve effect. A multivariate analysis of variance (P < 0.05) was used to compare radiographic, perioperative, and postoperative complication data between patients surgically treated with the 2 different instrumentation systems. Results. Patients in the SS group (n = 24) underwent surgery from 2000 to 2001, whereas patients in the Ti group (n = 25) underwent surgery from 2002 to 2004. The mean age at surgery, gender ratio, length of hospitalization, estimated blood loss, and operative time were not statistically different between the 2 patient groups (P > 0.13). The average follow-up in the SS group was, however, significantly longer than in the Ti group (4.0 ± 1.4 years vs. 2.3 ± 1.0 years; P = 0.001). Preop main thoracic Cobb angles were similar between the 2 groups (P = 0.62); however, the 2-year main thoracic Cobb was significantly smaller (P = 0.03) and the 2-year percent correction was significantly greater in the Ti group (P = 0.03). Five patients (21%) in the SS group had a pseudarthrosis, 3 (13%) experienced rod failure, and 2 (8%) required a revision posterior spinal fusion. In the Ti group, 2 patients (8%) had a pseudarthrosis, and no patient experienced rod failure or required a revision procedure. Conclusion. Although the average follow-up in the Ti group was significantly shorter than in the SS group, the 4.75-mm titanium alloy construct resulted in improved maintenance of deformity correction at 2-years postop and a lower incidence of instrumentation-related complications (pseudarthrosis, rod breakage, and surgical revisions) compared to the 4.0-mm stainless steel construct. Improved outcomes with the titanium alloy construct are likely because of the mechanical properties of the implant, refined patient selection criteria, and greater surgical experience gained with time.
The potential role of statins in contrast nephropathy.

BACKGROUND Administration of contrast agents may result in an acute reduction in renal function and occasionally end-stage renal disease. Risk factors for contrast-induced nephropathy (CN) are preexisting renal dysfunction, diabetes and reduced effective arterial volume. Hydration and use of nonionic contrast agents have been reported to ameliorate CN. Reactive oxygen species may have a role in the pathogenesis of CN. Statins decrease free oxygen radicals in animals. We retrospectively tested the hypothesis that administering statins prior to cardiac catheterization decreases the incidence of CN. METHODS A total of 1,002 patients were studied. Patients with a stable baseline serum creatinine (SCr) > or = 1.5 mg/dl who had cardiac catheterization between July 1997 and June 2002, were included in the study. None of the patients were taking statins before admission. 250 patients were started on a statin before the procedure and 752 patients were not. The SCr was followed for 7 days after the procedure looking for an acute decrement in renal function, dialysis requirement and survival. RESULTS The baseline characteristics, SCr, GFR, amount of intravenous fluids and contrast were similar in both groups. The post cath SCr (2.26 vs 3.1 mg/dl, p = 0.001) was significantly better in the statin group. Length of stay (2.72 vs 3.32 days, p = 0.01) and number of patients with acute renal failure (43 (17.2%) vs 168 (22.3%) patients, p = 0.028) were significantly lower in the statin group. Dialysis requirement within 7 days and 28-day survival were similar in both groups. CONCLUSION Prophylactic administration of statins along with hydration may be associated with less CN induced by a nonionic, low-osmolality contrast.
Noninvasive assessment of myocardial anisotropy in vitro and in vivo using Supersonic Shear Wave Imaging

The knowledge of the myocardial fiber architecture is deemed essential and yet to be nondestructively investigated for myocardial mechanics and its association with the progression of myocardial diseases. In this study, Supersonic Shear Wave Imaging (SSI) was performed for its first time to noninvasively assess the fiber orientation (i.e., anisotropy) in in vitro porcine (N=5) and in vivo open-chest ovine (N=1) hearts. The SSI technique combined with the coherent plane-wave compounding method was performed to achieve both high echocardiographic image quality and ultrafast frame rate (>8000 fps). An 8 MHz linear array probe (pitch= 0.2 mm) was mounted on a customized rotation device, which allowed 360° rotation at 5° increments. The probe was initially aligned (±90° inclination) with the longitudinal axis in the local cardiac coordinates. The variation of the myocardial fiber orientation across the wall was observed in both in vitro and in vivo cases. Myocardial fibers were oriented gradually from the left diagonal (upper left to bottom right) near the epicardium (100% wall thickness) to the right diagonal (upper right to bottom left) near the endocardium with the midwall region dominated by the circumferential fibers. This finding was in good agreement with the literature and histology and has demonstrated the feasibility of SSI in mapping myocardial anisotropy.
Interaction of trichohyalin with intermediate filaments: three immunologically defined stages of trichohyalin maturation.

"Trichohyalin" is a 220-kD protein found in trichohyalin granules that are present as major differentiation products in the medulla and inner root sheath cells of human hair follicles. It was unclear whether this protein served as an intermediate filament precursor in the inner root sheath or as an intermediate-filament-associated (matrix) protein. We have produced a panel of monoclonal antibodies (AE15-17) to this protein and used them to trace its fate during inner root sheath differentiation. These studies have allowed us to define three immunologically distinct forms of this trichohyalin protein. They are 1) the AE15-positive form, which is found throughout all trichohyalin granules; 2) the AE16-positive form, which is localized as discrete punctae on the surface of trichohyalin granules; and 3) the AE17-positive, intermediate-filament-bound form, which associates with the inner root sheath filaments with a regular, 400-nm periodicity. From these results we suggest that the 220-kD trichohyalin protein is an intermediate-filament-associated protein that may play a role in the lateral aggregation, precise alignment, and stabilization of inner root sheath filament bundles.
Prevalence of Iron Deficiency in Swedish Adolescents

ABSTRACT: The prevalence of iron deficiency was determined in Goteborg, Sweden, in a sample of 15− to 16-y-old girls (n = 220) and boys (n = 207) using serum ferritin (SF). In a recent study in women on the relationship between SF and stainable bone marrow iron, it was established that at a cutoff value for SF of <16 Mg/L in 75% of women with no iron stores SF concentration was below this value (sensitivity 75%), whereas in 98% of iron-replete women it was above this cutoff value (specificity 98%). The present study showed that in 40% of the girls and 15% of the boys SF was below this cutoff value, indicating iron deficiency. Low SF concentration was associated with significant decreases in transferrin saturation, Hb concentration, mean corpuscular Hb, and mean corpuscular volume. The results from this cross-sectional study showed that, with decreasing SF, the decrease of values for these parameters occurred already before SF had reached the level 16 Mg/L, suggesting that SF can be validly used as a single criterion of iron deficiency. Using the cutoff value SF < 16 μg/L, the figures for the prevalence of iron deficiency in adolescents in different countries were compared and found to be rather similar in Australia, Canada, the United States, and Sweden. High iron requirements combined with the present low-energy life-style leading to an insufficient supply of dietary iron may be a reasonable main explanation for the paradoxical, high prevalence of iron deficiency in adolescents in affluent societies.
Identification of VanN-Type Vancomycin Resistance in an Enterococcus faecium Isolate from Chicken Meat in Japan

ABSTRACT Five VanN-type vancomycin-resistant Enterococcus faecium strains were isolated from a sample of domestic chicken meat in Japan. All isolates showed low-level resistance to vancomycin (MIC, 12 mg/liter) and had the same pulsed-field gel electrophoresis profile. The vancomycin resistance was encoded on a large plasmid (160 kbp) and was expressed constitutively. The VanN-type resistance operon was identical to the first resistance operon to be reported, with the exception of a 1-bp deletion in vanTN and a 1-bp substitution in vanSN.
Circumsporozoite genotyping of global isolates of Plasmodium vivax from dried blood specimens

The prevalence and global distribution of two circumsporozoite (CS) genotypes of Plasmodium vivax (VK210 and VK247) were determined by genetic analysis of isolates from 234 malaria-infected patients. Whole blood specimens were collected on filter paper from patients infected with malaria in Thailand, Mexico, Papua New Guinea, Peru, Afghanistan (Pakistan), India, and western Africa and from 50 asymptomatic smear-negative controls. Following extraction of DNA from the filter paper samples, the CS gene was amplified by the polymerase chain reaction and genotyped by using oligoprobes specific for the VK210 and VK247 repeat epitopes. The sensitivity of genotyping from a single blood dot was 95.2%. The VK247 CS genotype was identified in the blood of patients from all seven study areas and was the predominant form present in samples from Thailand (83%) and Papua New Guinea (90%). In contrast, VK247 DNA was present in only 9% of isolates from Mexico. Individuals infected with both genotypes simultaneously were identified in all study areas except Mexico and were particularly common in Thailand (58%) and Papua New Guinea (60%). These findings indicate that the VK247 genotype of P. vivax is widely distributed but that its prevalence varies geographically. In addition, we conclude that use of samples of whole blood on filter paper is a practical and sensitive method for determining the genotypes of large numbers of malaria isolates collected in field settings.
Health-related quality of life parameters as prognostic factors in a nonmetastatic breast cancer population: an international multicenter study.

PURPOSE The purpose of this research was to evaluate whether baseline health-related quality of life (HRQOL) parameters are prognostic factors for survival in locally advanced breast cancer patients. Although the literature highlights the important role of HRQOL parameters in predicting survival in advanced metastatic disease, little evidence exists for earlier stages. PATIENTS AND METHODS The overall sample consisted of 448 patients randomly assigned to receive cyclophosphamide, epirubicin, and fluorouracil versus epirubicin, cyclophosphamide, and granulocyte colony-stimulating factor. Patients were enrolled in 12 countries. HRQOL baseline scores were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. The Cox proportional hazards regression model was used for both univariate and multivariate analyses of survival. In addition, a bootstrap resampling technique was used to assess the stability of the outcomes. Bootstrap results were then applied for model averaging purposes as a means to account for the observed model selection uncertainty. RESULTS The final multivariate model retained inflammatory breast cancer (T4d) as the only factor predicting overall survival (OS) with a hazard ratio of 1.375 (95% CI, 1.027 to 1.840; P =.03). The presence of inflammatory breast cancer lowers the median survival time from 6.6 to 4.2 years (36% reduction). None of the preselected HRQOL variables were prognostic for OS or disease-free survival, in either the univariate or multivariate analysis. CONCLUSION Our findings suggest that baseline HRQOL parameters have no prognostic value in a nonmetastatic breast cancer population.
Spanish Registry of Patients With Alpha-1 Antitrypsin Deficiency; Comparison of the Characteristics of PISZ and PIZZ Individuals

Abstract Alpha-1 antitrypsin deficiency (AATD) is associated with an increased risk of pulmonary emphysema and liver disease. The growing interest in this deficiency in Spain led to the development of the Spanish Registry of Patients with Alpha-1 Antitrypsin Deficiency (REDAAT) in 1993. At present, the REDAAT is a network of more than 350 health care professionals and the database includes a total of 511 individuals. The adult population included consists of 469 individuals (91.8% of the total) and their phenotype distribution is: 348 Pi*ZZ (74.2%), 100 Pi*SZ (21.3%) and 21 carriers of rare variants (4.5%). The most frequent diagnosis is lung disease (74.6%). Patients with chronic obstructive pulmonary disease (COPD) registered in the REDAAT constitute approximately 15% of the expected cases of AATD-related COPD in Spain. Pi*ZZ showed more severe impairment in lung function and younger age at baseline compared with Pi*SZ. The mean decline in FEV1 in the Pi*ZZ subgroup was –23 ml/year (SD:142.8), being –18 ml/year (SD:108.8) in Pi*SZ. Forty-five percent of the Pi*ZZ individuals received augmentation therapy. A total of 61 deaths was recorded. The characteristics of the REDAAT population demonstrate some differential trends compared to other series: distribution of phenotypes, inclusion of children and patients treated with replacement therapy. Patients with the Pi*SZ phenotype were older and had milder lung function impairment. The most important challenge of this registry is to collect good quality long-term data that will allow better understanding of the natural history of the disease in real life.
Dynamic QT interval analysis in uraemic patients receiving chronic haemodialysis

Objective To analyse the duration of the QT interval and its relationship with heart rate changes in patients with uraemia, before and during haemodialysis. Methods QT and RR intervals were measured automatically using a dedicated algorithm with 24-h Holter recordings in 29 patients (15 women) receiving chronic haemodialysis. QT corrected for heart rate (QTc) and the slope of QT/RR linear regression were calculated. Arterial blood pressure (ABP) was measured before and during haemodialysis. Plasma concentrations of K+, Mg2+ and Ca2+ were assessed before and after haemodialysis. Results ABP decreased significantly from baseline (102.7 ± 11.0 mmHg) during the first (100.6 ± 8.8 mmHg, P < 0.05), second (95.6 ± 10.6 mmHg, P < 0.05), and third (94.9 ± 10.3 mmHg, P < 0.05) hours of haemodialysis. QTc was longer during haemodialysis than during a 4-h period of no dialysis (447 ± 28 ms compared with 429 ± 22 ms, P < 0.001), and increased progressively during haemodialysis, with the greatest value during the last hour of haemodialysis (454 ± 32 ms compared with 426 ± 22 ms, P < 0.001). QT/RR slopes and correlation coefficients were lower during haemodialysis than during the period of no dialysis (0.13 ± 0.08 compared with 0.20 ± 0.07, P < 0.001 and 0.48 ± 0.30 compared with 0.81 ± 0.20, respectively; P < 0.001), suggesting a reduced ability to adapt the QT interval in response to changes in heart rate. The effects of haemodialysis on QT interval and the QT/RR relationship were greater in women than in men. QTc variations during dialysis were not correlated with changes in ABP, but were inversely related to changes in Ca2+ concentration (r2 = 0.35; P = 0.001). Conclusions In patients with uraemia, the haemodialysis session induces a progressive increase in QT interval and modifies its relationship with heart rate. These effects may predispose some individuals to ventricular arrhythmias at the end of and immediately after the haemodialysis session.
Urethane inhibits cardiovascular responses mediated by the stimulation of alpha-2 adrenoceptors in the rat.

Clonidine and oxymetazoline (4.0 microgram/kg i.v. or i.a.) evoked a marked bradycardia in either methylatropine-pretreated conscious or pentobarbital-anesthetized (55 mg/kg i.p.), vagotomized rats. Urethane (1.2 g/kg i.p.) inhibited by more than 50% this effect which is mediated through the stimulation of peripheral and/or central neuronal alpha-2 adrenoceptors. However, in adrenalectomized rats only the inhibition of oxymetazoline by urethane was significantly less pronounced. In pithed rats in which the adrenal glands were either left untouched or surgically removed, urethane significantly attenuated the clonidine or oxymetazoline-induced decreases in experimental neural sympathetic tachycardia although it neither changed the base-line nor the experimentally elevated heart rate. Urethane, in contrast to pentobarbital, increased plasma epinephrine concentrations in intact but not in adrenalectomized or in pithed rats. Elevation of plasma epinephrine did not result from the low arterial pressure level associated with urethane anesthesia since the increase of this parameter with vasopressin did not abolish the effect of urethane. Furthermore, guanethidine-pretreated rats, when anesthetized with urethane, exhibited a higher heart rate and plasma adrenaline value than those anesthetized with pentobarbital. The elevated heart rate was decreased by either propranolol or adrenalectomy. The bradycardia produced by injecting clonidine into the lateral cerebral ventricles of either intact or adrenalectomized rats was markedly less in urethane- than in pentobarbital-anesthetized animals. Whereas in pentobarbital-anesthetized rats the peak heart rate effects of i.v. or i.c. v. clonidine were similar, in urethane-anesthetized animals the effects of clonidine were more inhibited when it was given centrally than when it was given peripherally. In pithed rats, the cumulative dose-pressor response curves elicited by the relatively selective alpha-2 adrenoceptor agonists, B-HT 930 and M-7, were depressed by urethane significantly more than those produced by the relatively selective alpha-1 adrenoceptor agonists, phenylephrine and cirazoline, or by angiotensin II. Urethane also decreased the pressor responses evoked by clonidine, oxymetazoline and norepinephrine which stimulate both alpha-1 and alpha-2 adrenoceptors. However, the extent of this inhibition was less than that of B-HT 920 and M-7 but greater than that of cirazoline and phenylephrine. These results show that urethane inhibits cardiovascular responses that are mediated by peripheral and central alpha-2 adrenoceptors. Furthermore, urethane increases the central drive to the adrenal medulla and this leads to the secretion of epinephrine. This may be partly responsible for the inhibitory activity of urethane on oxymetazoline-induced bradycardia. Although the basic mechanism by which urethane impairs responses mediated by alpha-2 adrenoceptors remains to be determined, it is advised that urethane anesthesia should be avoided, particularly for cardiovascular studies.