Miracle-dz/UniFAR-FTUs huggingface dataset:
Salivary Gluten Degradation and Oral Microbial Profiles in Healthy Individuals and Celiac Disease Patients

ABSTRACT Celiac disease (CD) is a chronic immune-mediated enteropathy induced by dietary gluten in genetically predisposed individuals. Saliva harbors the second highest bacterial load of the gastrointestinal (GI) tract after the colon. We hypothesized that enzymes produced by oral bacteria may be involved in gluten processing in the intestine and susceptibility to celiac disease. The aim of this study was to investigate salivary enzymatic activities and oral microbial profiles in healthy subjects versus patients with classical and refractory CD. Stimulated whole saliva was collected from patients with CD in remission (n = 21) and refractory CD (RCD; n = 8) and was compared to healthy controls (HC; n = 20) and subjects with functional GI complaints (n = 12). Salivary gluten-degrading activities were monitored with the tripeptide substrate Z-Tyr-Pro-Gln-pNA and the α-gliadin-derived immunogenic 33-mer peptide. The oral microbiome was profiled by 16S rRNA-based MiSeq analysis. Salivary glutenase activities were higher in CD patients compared to controls, both before and after normalization for protein concentration or bacterial load. The oral microbiomes of CD and RCD patients showed significant differences from that of healthy subjects, e.g., higher salivary levels of lactobacilli (P < 0.05), which may partly explain the observed higher gluten-degrading activities. While the pathophysiological link between the oral and gut microbiomes in CD needs further exploration, the presented data suggest that oral microbe-derived enzyme activities are elevated in subjects with CD, which may impact gluten processing and the presentation of immunogenic gluten epitopes to the immune system in the small intestine. IMPORTANCE Ingested gluten proteins are the triggers of intestinal inflammation in celiac disease (CD). Certain immunogenic gluten domains are resistant to intestinal proteases but can be hydrolyzed by oral microbial enzymes. Very little is known about the endogenous proteolytic processing of gluten proteins in the oral cavity. Given that this occurs prior to gluten reaching the small intestine, such enzymes are likely to contribute to the composition of the gluten digest that ultimately reaches the small intestine and causes CD. We demonstrated that endogenous salivary protease activities are incomplete, likely liberating peptides from larger gluten proteins. The potentially responsible microbes were identified. The study included refractory CD patients, who have been studied less with regard to CD pathogenesis.
Lives in Distress

This monograph from the School of Nancy deals with muscular disorders associated with thyroid dysfunction. It is perhaps the only book to cover the ground so fully in this field. Good clinical accounts aregiven of the conditions which are undoubtedly due to thyroid disorder, such as acute and chronic thyrotoxic myopathy. There is also a good account of the relationship between thyrotoxicosis and periodic familial paralysis, with its surprisingly high incidence in Japan. No fewer than 250 ot the published cases come from that country, whilst only 30 have been recorded in Europe and the United States altogether. The writers also refer to the association between myasthenia gravis and thyrotoxicosis, and they side with those who do not believe in the so-called see-saw relationship by which myasthenia is said to worsen if the thyrotoxicosis is treated. They find strong support in the literature for the view that the two disorders often behave quite independently of each other. In considering all these conditions the authors base themselves mainly on published material, which they analyse and discuss fully. There is little contribution from their own experience. Their particular interest has been the duration of the ankle jerk in the diagnosis of thyroid dysfunction. They have used the measurement in milliseconds (ms.) from the moment of percussion of the tendon to a point half-way down the relaxation gradient. This empirical end-point was used because the end of relaxation is blurred on the tracing and cannot be precisely defined. Undoubtedly there is a fairly wide overlap, so that 25%/ of hyperthyroid patients are in the doubtful 260-280 ms. range, whilst as many as 30% of myxoedematous patients are in the equally doubtful 320-360 ms. range. The diagnostic value of the test is therefore greater in excluding rather than in proving a given thyroid dysfunction. The authors conclude that the " achillogram " is reliable as radioiodine uptake and better than the B.M. R. and the serum cholesterol. The test is also reliable in a given patient when the results of treatment are being followed over a period. This book has an extensive bibliography, no fewer that 705 references being given. The Anglo-Saxon and German literatures are widely and accurately quoted as well as, of course, the French. As a reference book it will be of great value to the neurologist as well as the endocrinologist.
Comparative evaluation of direct stool smear and Formol-ether Concentration Methods in the identification of Cryptosporidium species

Cryptosporidium is a common cause of diarrhoea in patients with Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). Unfortunately this pathogen is not often checked for in Microbiology laboratories because the formol-ether stool concentration method for identification of Cryptosporidium is cumbersome and may not be routinely undertaken in very busy laboratories and in laboratories with inadequate personnel. This study was therefore carried out to compare the outcome of direct stool examination and formol-ether concentration method with the aim of finding a non-cumbersome method of examining for Cryptosporidium species routinely in stools when it is indicated. Fresh stool specimens of 193 HIV positive and 200 HIV negative patients (control) attending clinic at the Lagos University Teaching Hospital (LUTH) were processed within two hours of collection using direct stool smear and formol-ether concentration methods. Permanently stained slides were prepared using Kinyoun acid-fast stains. Cryptosporidium oocysts were found in 35 (18.1%) of HIV seropositive patients using direct stool smear method and in 36 (18.7%) using formol-ether concentration method. There was no statistical difference between the two methods (p > 0.05, xz = 0.012, df = 1 at 95% confidence limit critical ratio = 3.841). No Cryptosporidium was identified in the control (HIV negative) patients using either method. Cryptosporidium oocysts can be routinely checked for in the Microbiology laboratories using either direct stool smear or formol-ether concentration stool method with comparable sensitivity. KEY WORDS: Cryptosporidium identification, direct stool smear, concentration method. Nigerian Journal of Health and Biomedical Sciences Vol.4(1) 2005: 5-7
Relationships between illness representations, treatment beliefs and the performance of self-care in heart failure: a cross-sectional survey

Background: Self-care is a key principle in the management of chronic heart failure (HF). The common sense model (CSM) of illness cognitions and behaviour provides a theoretical framework within which relationships between beliefs and behaviour can be examined. Aim: The aim of this study was to determine relationships between illness representations, treatment beliefs and the performance of self-care in community HF patients. Methods: A cross-sectional survey was carried out in 169 patients with HF in South East England. Illness representations, treatment beliefs and self-care were measured using an adapted Revised Illness Perception Questionnaire (IPQ-R); the Beliefs about Medicines Questionnaire (BMQ) and the Looking After Yourself with Heart Failure Questionnaire (LAYHFQ), according to the CSM. Relationships between these specific concepts were determined using Pearson’s correlation co-efficients (r) and stepwise multiple regression. Results: Perceived medication knowledge (r=0.51, p≤0.01), beliefs about the necessity of medication (r=0.45, p≤0.01) and illness coherence (r=0.39, p≤0.01) were moderately correlated with self-care. Multiple regression analysis revealed that 46% of the variance in self-care could be explained by illness representations and treatment beliefs (adjusted R2=0.46, F=9.93, p=0.00). Three factors were significant predictors of self-care – medication knowledge (β=0.319, p=0.003), a belief in the illness having serious consequences (β=0.258, p=0.008) and the impact of medication use on lifestyle (β= −0.231, p=0.03). Conclusion: Illness representations and treatment beliefs should be explored in patients with HF in order to inform the development of targeted interventions designed to correct misconceptions and enhance self-care. This has the potential to improve clinical outcomes in this population.
Monitoring the Single-Cell Stress Response of the Diatom Thalassiosira pseudonana by Quantitative Real-Time Reverse Transcription-PCR

ABSTRACT Directly monitoring the stress response of microbes to their environments could be one way to inspect the health of microorganisms themselves, as well as the environments in which the microorganisms live. The ultimate resolution for such an endeavor could be down to a single-cell level. In this study, using the diatom Thalassiosira pseudonana as a model species, we aimed to measure gene expression responses of this organism to various stresses at a single-cell level. We developed a single-cell quantitative real-time reverse transcription-PCR (RT-qPCR) protocol and applied it to determine the expression levels of multiple selected genes under nitrogen, phosphate, and iron depletion stress conditions. The results, for the first time, provided a quantitative measurement of gene expression at single-cell levels in T. pseudonana and demonstrated that significant gene expression heterogeneity was present within the cell population. In addition, different expression patterns between single-cell- and bulk-cell-based analyses were also observed for all genes assayed in this study, suggesting that cell response heterogeneity needs to be taken into consideration in order to obtain accurate information that indicates the environmental stress condition.
Fraqueza muscular esquelética e intolerância ao exercício em pacientes com doença pulmonar obstrutiva crônica

The aim of this study was to evaluate the functional capacity and the performance of respiratory and quadriceps muscles in patients with chronic obstructive pulmonary disease (COPD) and relate them to nutritional status and forced expiratory volume in the first second (FEV1). METHODS: Twelve patients with moderate COPD (70±7 years, FEV1 52±17% predicted, body mass index (BMI) 23±4kg/m2) and seven healthy volunteers (69±8 years, FEV1 127±12% predicted, BMI 27±3kg/m2) were evaluated. All of them underwent body composition analysis, measurement of respiratory muscle strength (maximum inspiratory pressure, MIP, and maximum expiratory pressure, MEP), cardiorespiratory exercise test (CET) and evaluation of palm grip strength, peak torque and total work or endurance of the quadriceps femoris. RESULTS: The patients with COPD had lower values for the free-fat mass (FFM) index (18±1 versus 21±1kg/m2, p<0.05), maximum load attained in the CET (60±20 versus 102±18 watts, p<0.01), MIP (58±19 versus 87±21cmH2O, p<0.05), palm grip strength (38±6 versus 47±5kg, p<0.05), peak torque (103±21 versus 138±18Nm, p<0.05) and total work of the quadriceps femoris (1570±395 versus 2333±568J, p<0.05) when compared with the control group (independent Students t test). There was no correlation between FEV1 and the variables studied, while the FFM correlated with the total work of the quadriceps (Pearson, r=0.6290, p<0.05). CONCLUSIONS: These results indicate that patients with COPD show weakness of the inspiratory and quadriceps muscles and lower functional capacity, when compared with a healthy group. Moreover, they suggest that the degree of airflow obstruction is not a good predictor for quantifying the nutritional and muscle impairments in patients with COPD.
European cardiac nurses’ current practice and knowledge on anticoagulation therapy

Background: Successful management of warfarin, new anti-thrombotic agents and self-monitoring devices requires that health care professionals effectively counsel and educate patients. Previous studies indicate that health care professionals do not always have the knowledge to provide patients with the correct information. Aims: The purpose of this study was to investigate European cardiovascular nurses’ knowledge on the overall management of anticoagulation therapy and examine if this knowledge was influenced by level of education and years in clinical practice. Methods: A questionnaire including 47 items on practice patterns and knowledge on warfarin, new anticoagulants, warfarin-drug and warfarin-food interactions, and self-management of International Normalized Ratio (INR) was distributed to the attendants at a European conference in 2012. Results: The response rate was 32% (n=206), of whom 84% reported having direct patient contact. Warfarin was the most common used oral anticoagulation in daily practice. One third offered their patients both patient self-testing and patient self-management of INR. The mean total score on the knowledge questions was 28±6 (maximum possible score 53). Nurses in direct patient care had a higher mean score (p=0.011). Knowledge on warfarin and medication-interactions were low, but knowledge on warfarin-diet interactions and how to advise patients on warfarin as somewhat better. Conclusion: European cardiac nurses need to improve their knowledge and practice patterns on oral anticoagulation therapy. This area of knowledge is important in order to deliver optimal care to cardiac patients and to minimise adverse effects of the treatment.
Submersion incidents: a review of 39 cases and development of the submersion outcome score

The optimal treatment of the submersion victim continues to be revised and debated. Accurate analysis of therapeutic response to resuscitation after submersion will require a validated prognostic scale. The patient population is very heterogenous, with few cases presenting at many sites. We selected 11 potential predictive variables to be reviewed in 39 submersion incidents. These included the five variables comprising the Orlowski score. Three ‘physiologic’ variables were identified which, in combination, also predict neurologic outcome: pH less than or equal to 7.10, PaO2/PAO2 ratio less than or equal to 0.35, and anion gap greater than or equal to 15 mEq−1. Refinement and validation of a submersion outcome score limited to variables accurately ascertained at presentation will facilitate comparison of treatment protocols.
Active Ammonia Oxidizers in an Acidic Soil Are Phylogenetically Closely Related to Neutrophilic Archaeon

ABSTRACT All cultivated ammonia-oxidizing archaea (AOA) within the Nitrososphaera cluster (former soil group 1.1b) are neutrophilic. Molecular surveys also indicate the existence of Nitrososphaera-like phylotypes in acidic soil, but their ecological roles are poorly understood. In this study, we present molecular evidence for the chemolithoautotrophic growth of Nitrososphaera-like AOA in an acidic soil with pH 4.92 using DNA-based stable isotope probing (SIP). Soil microcosm incubations demonstrated that nitrification was stimulated by urea fertilization and accompanied by a significant increase in the abundance of AOA rather than ammonia-oxidizing bacteria (AOB). Real-time PCR analysis of amoA genes as a function of the buoyant density of the DNA gradient following the ultracentrifugation of the total DNA extracted from SIP microcosms indicated a substantial growth of soil AOA during nitrification. Pyrosequencing of the total 16S rRNA genes in the “heavy” DNA fractions suggested that archaeal communities were labeled to a much greater extent than soil AOB. Acetylene inhibition further showed that 13CO2 assimilation by nitrifying communities depended solely on ammonia oxidation activity, suggesting a chemolithoautotrophic lifestyle. Phylogenetic analysis of both 13C-labeled amoA and 16S rRNA genes revealed that most of the active AOA were phylogenetically closely related to the neutrophilic strains Nitrososphaera viennensis EN76 and JG1 within the Nitrososphaera cluster. Our results provide strong evidence for the adaptive growth of Nitrososphaera-like AOA in acidic soil, suggesting a greater metabolic versatility of soil AOA than previously appreciated.
Alcohol and Other Drug Dependence Severity Among Older Adults in Treatment: Measuring Characteristics and Outcomes

ABSTRACT The number of older adults is increasing, yet little is known about their responses to treatment for substance dependence. While age-appropriate measures have been developed for depression and alcohol screening among older adults, severity and outcome measurement for this population has not been addressed. The purpose of the present study was (1) to add to the limited but growing literature on the older adult's response to treatment, and (2) examine the utility of a well-known measure of severity, the Addiction Severity Index (ASI; McLellan et al., 1992), in measuring baseline acuity and one-year outcomes among older adults in treatment for alcohol and drug dependence. Participants (N = 67) completed the ASI and other measures at baseline and at 6 and 12 months post-treatment. ASI alcohol, drug, family/social, and psychiatric composite scores improved significantly over time. Medical, employment, and legal scores did not change. Continuous abstinence was maintained by 71% at 6 months and 60% at 12 months after discharge. The ASI captured changes in participant functioning over time, indicating it is a useful tool in measuring severity and outcomes among older adults.
Experience of exclusion: A framework analysis of socioeconomic factors affecting cardiac rehabilitation participation among patients with acute coronary syndrome

Background: The Danish public healthcare system provides comprehensive care based on the principle of equal access. However, it is well documented that patients with low socioeconomic position are less likely to participate in cardiac rehabilitation. More knowledge is needed to understand this phenomenon. The aim of the study was to explore the patient experience of barriers to completion of phase II cardiac rehabilitation, and to investigate the impact of socioeconomic factors on completion of cardiac rehabilitation. Methods: The study had a qualitative explorative design using semi-structured individual or dyadic interviews with patients (n = 24) and close relatives (n = 12). Informants were sampled from a quantitative prospective study of 302 patients with acute coronary syndrome and data were analyzed using the framework method. Results: Patients in different socioeconomic groups were challenged by a rigid and non-individualized rehabilitation program. A total of five themes were identified that might explain non-participation in cardiac rehabilitation: exclusion by time and place, exclusion by health beliefs, exclusion from counseling, exclusion by alienation, and exclusion of relatives. The themes were described in a matrix of socioeconomic factors of age, sex, education and employment. Conclusions: Patients in various socioeconomic subgroups felt excluded from cardiac rehabilitation for different reasons. This study supports earlier findings and provides examples of real-life issues that need to be addressed to prevent attrition and encourage participation. Equal access to cardiac rehabilitation can only be reached if the physical and psychological needs of patient and family are met by tailoring therapy to consider age, sex, education and employment groups.
The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis

Background: Nurses are pivotal in the provision of high quality care in acute hospitals. However, the optimal dosing of the number of nurses caring for patients remains elusive. In light of this, an updated review of the evidence on the effect of nurse staffing levels on patient outcomes is required. Aim: To undertake a systematic review and meta-analysis examining the association between nurse staffing levels and nurse-sensitive patient outcomes in acute specialist units. Methods: Nine electronic databases were searched for English articles published between 2006 and 2017. The primary outcomes were nurse-sensitive patient outcomes. Results: Of 3429 unique articles identified, 35 met the inclusion criteria. All were cross-sectional and the majority utilised large administrative databases. Higher staffing levels were associated with reduced mortality, medication errors, ulcers, restraint use, infections, pneumonia, higher aspirin use and a greater number of patients receiving percutaneous coronary intervention within 90 minutes. A meta-analysis involving 175,755 patients, from six studies, admitted to the intensive care unit and/or cardiac/cardiothoracic units showed that a higher nurse staffing level decreased the risk of inhospital mortality by 14% (0.86, 95% confidence interval 0.79–0.94). However, the meta-analysis also showed high heterogeneity (I2=86%). Conclusion: Nurse-to-patient ratios influence many patient outcomes, most markedly inhospital mortality. More studies need to be conducted on the association of nurse-to-patient ratios with nurse-sensitive patient outcomes to offset the paucity and weaknesses of research in this area. This would provide further evidence for recommendations of optimal nurse-to-patient ratios in acute specialist units.
Student experiences of foundation degrees in further and higher education

Abstract The number and variety of foundation degrees offered by UK universities has grown in recent years. Many are delivered off-campus at partner Further Education institutions or through workplace learning, whilst others are partly embedded within existing undergraduate degree programmes at Higher Education institutions. Each route presents Higher Education with new issues and challenges, namely responding to the skills training and pastoral support needed by incoming foundation degree students at different levels of HE. The ability of foundation degree students to make the transition to a university environment will affect their academic performance, and retention and completion rates. This article explores these aspects in relation to foundation degrees offered by two universities and Further Education colleges in southwest England.