Miracle-dz/UniFAR-FTUs huggingface dataset:
Cellular immune responses of older adults to four influenza vaccines: Results of a randomized, controlled comparison

ABSTRACT Cellular immunity is important for protection against the serious complications of influenza in older adults. As it is unclear if newer influenza vaccines elicit greater cellular responses than standard vaccines, we compared responses to 2 standard and 2 newer licensed trivalent inactivated vaccines (TIVs) in a randomized trial in older adults. Non-frail adults ≥ 65 y old were randomly assigned to receive standard subunit, MF59-adjuvanted subunit, standard split-virus or intradermal split-virus TIV. Peripheral blood mononuclear cells (PBMC) harvested pre- and 3-weeks post-vaccination were stimulated with live A/H3N2 virus. PBMC supernatants were tested for interleukin 10 (IL-10) and interferon gamma (IFN-γ), and lysates for granzyme B (GrB). Flow cytometry identified CD4+ and CD8+ T- cells expressing intracellular IL-2, IL-10, IFN-γ, GrB, or perforin. Differences following immunization were assessed for paired subject samples and among vaccines. 120 seniors participated, 29-31 per group, which were well matched demographically. Virus-stimulated PBMCs were GrB-rich before and after vaccination, with minimal increases evident. Immunization did not increase secretion of IFN-γ or IL-10. However, cytolytic effector T-cells (CD8+GrB+perforin+) increased significantly in percentage post-vaccination in all groups, to similar mean values across groups. CD4+GrB+perforin+ T-cells also increased significantly after each vaccine, to similar mean values among vaccines. Vaccination did not increase the low baseline percentages of CD4+ or CD8+ T-cells expressing IFN-γ, IL-2 or IL-10 . In conclusion, participants had pre-existing cellular immunity to H3N2 virus. All 4 vaccines boosted cellular responses to a similar but limited extent, particularly cytolytic effector CD8+ T-cells associated with clinical protection against influenza.
Experience of Attending Sexual Health Education, Knowledge and Healthcare Attitude of Nurse Clinicians

Purpose: This study aimed to identify if participating in a sexual education program, influences knowledge, and healthcare attitude among attitudes of nurse clinicians in Korea. Methods: A cross-sectional study was conducted with 210 Korean nurse clinicians. Data were collected through self-reported questionnaires from July to August, 2011 from five hospitals in S and I cities. Data were analyzed using t-test, Pearson correlations, and multiple linear regression with SPSS/WIN 21.0. Results: This study reported that the majority of nurse clinicians had attended sexual programs about sexual harassment, reproductive system and function. There were significant correlations between experience of attending sexual education(r=.32, p=.003) and sexual knowledge(r=.14, p=.047) with sexual healthcare attitude. Sexual education on the job(β=.13, p=.004), supplementary sexual education(β=.17, p=.009), sexual knowledge(β=.16, p=.048), and obstetrics and gynecology department carrier(β=.29, p<.001) explained 14.0% of sexual healthcare attitude. Conclusion: This study’s results demonstrate that advanced and continuous sexual health program is necessary for nurse clinicians. Proper sexual knowledge and positive attitude may promote nursing intervention and counseling concerning patients’ sexual problems.
Knowledge, attitude and practices of adolescent secondary school students in Uvwie Local Government Area of Delta State of HIV/AIDS.

INTRODUCTION: Adolescents have a tendency to engage in high risk sexual and drug-use behaviour; and with a poor health-seeking behaviour, they continue to present the highest number of new cases of HIV reported in Africa. OBJECTIVE: To assess the knowledge, attitude and practise of adolescent secondary school students towards AIDS. METHOD: A cross sectional study was carried out on 358 senior secondary students selected by multistage sampling. A researcher administered semi-structured questionnaire was used for data collection. RESULTS: All had heard of AIDS, of which 40% cited the media as source of information. Seventy four percent knew the cause to be a virus, 63% could differentiate between AIDS and HIV, over 85% knew of transmission through sex, mother to child, contaminated blood, and contaminated needles; 59% cited kissing. Weight loss was the most common symptom (85%) mentioned. Over 76% knew AIDS to be untreatable. Over 75% knew methods to prevent spread of which 23% cited sex with a virgin, 61% did not know anyone infected with the virus, 58% felt infected persons should not be allowed to stay in the community, 61 % agreed to continue a relationship with an infected friend, 83% agreed to care for an infected relative. Of 22% who agreed they were sexually active, 66% and 12% had one and multiple partners respectively. Regarding protection, 30% used condom always, 48 % sometimes and 23 % never. Twenty-one percent had ever had sex under influence of alcohol or marijuana. 55% were willing to be tested, however none had been tested. CONCLUSION: Senior secondary school students in Uvwie have a fairly good knowledge of AIDS, and poor attitude towards people living with AIDS. Few are sexually active and are engaged in unsafe sex. KEYWORDS: AIDS, secondary school students, condom use, knowledge, HIV risk behaviour, sexual practices.
Soluble F proteins exacerbate pulmonary histopathology after vaccination upon respiratory syncytial virus challenge but not when presented on virus-like particles

ABSTRACT Respiratory syncytial virus (RSV) fusion (F) protein is suggested to be a protective vaccine target although its efficacy and safety concerns remain not well understood. We investigated immunogenicity, efficacy, and safety of F proteins in a soluble form or on virus-like particle (F-VLP). F VLP preferentially elicited IgG2a antibody and T helper type 1 (Th1) immune responses whereas F protein induced IgG1 isotype and Th2 responses. Despite lung viral clearance after prime or prime-boost and then RSV challenge, F protein immune mice displayed weight loss and lung histopathology and high mucus production and eosinophils. In contrast, prime or prime-boost vaccination of F VLP induced effective protection, prevented infiltration of eosinophils and vaccine- enhanced disease after challenge. This study provides insight into developing an effective and safe RSV vaccine candidate.
Protective Effect of Topical Antibiotics in Breast Augmentation

Background: Previous studies indicate that antibacterial lavage and/or use of topical antibiotics may reduce infection in breast implant surgery and perhaps also reduce occurrence of capsular contracture. A retrospective analysis was performed to evaluate this effect. Methods: The study participants included all women (n = 436) who underwent breast augmentation during two different time periods: 2000 to 2002 (n = 218) and 2005 to 2007 (n = 218). During the first period (2000 to 2002), cephalothin (Keflin), was added to the saline/epinephrine solution, which was used to irrigate the implant pocket and filled into the outer lumen of the saline/gel implants. In the second period (2005 to 2007), only saline/epinephrine was used. All women were operated on at the same clinic and by the same surgeon. Recorded postoperative complications included occurrence of infection, seroma, and capsular contracture. Results: Medical records were identified for 414 women (94.9 percent): 2000 to 2002 (n = 203) and 2005 to 2007 (n = 211); 99.8 percent of all implants were placed in the submuscular position and 99.8 percent of all incisions were periareolar. Frequency of infection in the 2005 to 2007 cohort (12.8 percent) exceeded substantially the frequency among the 2000 to 2002 cohort (6.7 percent; p = 0.044), as did the frequency of seroma (7.6 percent versus 2.9 percent, respectively; p = 0.036). There was no significant difference in development of capsular contraction between the two groups (8.1 percent versus 5.9 percent; p = 0.393). Conclusion: The authors’ data support the use of topical antibiotics in cosmetic breast surgery, because significant increases of both infections and seroma were seen in patients not treated with topical antibiotics compared with a cohort of similar patients where topical antibiotics were used.
Characterization of T-cell immune responses in clinical trials of the candidate RTS,S malaria vaccine

ABSTRACT The candidate malaria vaccine RTS,S has demonstrated 45.7% efficacy over 18 months against all clinical disease in a phase-III field study of African children. RTS,S targets the circumsporozoite protein (CSP), which is expressed on the Plasmodium sporozoite during the pre-erythrocyte stage of its life-cycle; the stage between mosquito bite and liver infection. Early in the development of RTS,S, it was recognized that CSP-specific cell-mediated immunity (CMI) was required to complement CSP-specific antibody-mediated immunity. In reviewing RTS,S clinical studies, associations between protection and various types of CMI (CSP-specific CD4+ T cells and INF-γ ELISPOTs) have been identified, but not consistently. It is plausible that certain CD4+ T cells support antibody responses or co-operate with other immune-cell types to potentially elicit protection. However, the identities of vaccine correlates of protection, implicating either CSP-specific antibodies or T cells remain elusive, suggesting that RTS,S clinical trials may benefit from additional immunogenicity analyses that can be informed by the results of controlled human malaria infection studies.
Medical factors and patterns of adjustment to breast cancer

Dimensions of emotional adjustment, perceived health status and role function were compared by three medical groups: breast conserving versus non‐breast conserving surgery; positive versus negative nodes; and post‐surgical adjuvant therapy. Intact data series were obtained at 7–10 days, at 1, 2, 3 and 6‐months, and 1 year post‐surgery for 93 women. The overall mean scores for measures of emotional adjustment, perceived health status, and role function did not differ significantly between breast‐conserving and non‐breast‐conserving groups. However, there was a significant change over time with both surgical groups showing improved adjustment. Although there were no statistically significant differences between the node status groups in mean scores on the adjustment variables, the overall patterns over time were analogous to that of the surgical groups. In comparing post‐surgical adjuvant therapy groups, significant differences in mean scores on the adjustment outcomes were noted mainly between the chemotherapy versus no adjuvant therapy groups at 3 and 6 months post‐surgery.
Free Flap Breast Reconstruction in Advanced Age: Is It Safe?

Background: Due to perceived medical and surgical risk, patients of advanced age may not be offered free flap breast reconstruction. The purpose of this study was to determine whether complications are actually higher in patients of advanced age. Methods: A review of 1031 muscle-sparing free transverse rectus abdominis musculocutaneous, deep inferior epigastric perforator, and superficial inferior epigastric artery flaps over 15 years was performed. There were 976 patients younger than 65 years and 55 patients aged 65 and older. Population variables, operative variables, and outcome variables were compared. Statistical analysis included chi-square, Fisher's exact, Mann-Whitney, and two-sample t tests. Results: The mean age was 47 years (range, 24 to 79 years). The older group had a higher American Society of Anesthesiologists status (2.1 versus 1.9; p = 0.05), a higher prevalence of hypertension (38 percent versus 18 percent; p < 0.001), a higher average body mass index (30 versus 28; p = 0.039), and lower rates of preoperative (28 percent versus 13 percent; p = 0.016) and postoperative (17 percent versus 2 percent; p = 0.003) chemotherapy. In the older group, more blood transfusions (7 percent versus 2 percent; p = 0.03) were administered and the coupler was used less often (13 percent versus 32 percent; p = 0.009). There was no difference in length of stay (3.5 days), medical complications (4 percent), surgical complications (32 percent), take-backs (1 percent), or revisions (19 percent). Conclusions: Despite higher rates of hypertension, higher American Society of Anesthesiologists status, higher body mass index, and higher rates of blood transfusion, the 65 years and older group had outcomes equal to those of the general population. Thus, free flap breast reconstruction in patients of advanced age is safe, and should be offered when indicated.
Time interval of revaccination with 23-valent pneumococcal polysaccharide vaccine more than 5 years does not affect the immunogenicity and safety in the Japanese elderly

ABSTRACT In the previous study, revaccination with 23-valent pneumococcal polysaccharide vaccine (PPSV23) in a total of 161 elderly subjects (≥70 years of age) who had received the initial vaccination at least 5 years before (range: 5 to11 years) showed an acceptable safety profile and induction of immune responses to the serotypes in PPSV23. The optimal interval between the initial vaccination and revaccination with PPSV23 is of interest to protect elderly from pneumococcal disease over the long-term. In this post-hoc analysis, we analyzed that the immunogenicity and safety of revaccination with PPSV23 by time interval after the initial vaccination. The level of serotype-specific immunoglobulin G (IgG) geometric mean concentrations (GMCs) and opsonophagocytic killing activity (OPA) geometric mean titers (GMTs) at 4 weeks after revaccination with PPSV23 in each subgroup based on time interval (5, 6, 7, 8 and 9–11 years) after the initial vaccination were comparable to those after the primary vaccination and vaccine-induced serotype-specific IgG and OPA levels were similar regardless of the time interval after the initial vaccination. There was no difference in the safety profiles among the subgroups. In conclusion, administration of a second dose of PPSV23 at least 5 years after the initial vaccination was immunogenic and well-tolerated in the elderly ≥70 years of age regardless of the time interval after the initial vaccination.
The effect of Multi Convergent Therapy on the psychopathology, mood and performance of Chronic Fatigue Syndrome patients: A preliminary study

Objectives: Multi Convergent Therapy combines approaches such as Cognitive Behaviour Therapy and Graded Exercise Therapy in an holistic treatment of Chronic Fatigue Syndrome. Initial follow-up data showed that patients were benefiting from this individualised form of therapy. The objective of the present study was to evaluate this Multi Convergent approach, developed at a specialised Chronic Fatigue Syndrome Outpatient clinic in Cardiff, and compare it to Relaxation Therapy and control groups using multiple outcome measures. Design: Thirty-five participants fitting the Centre for Disease Control criteria for Chronic Fatigue Syndrome were recruited from two outpatient clinics and members of our existing patient panel. Patients were assigned to Multi Convergent Therapy (N=12), Relaxation Therapy (N=14) or recruited as controls (N=9). Methods: Each patient completed a battery of mood and performance tasks along with comprehensive set of questionnaires at baseline, post-treatment and at six-month follow-up. These measures had been validated in previous studies on untreated patients and matched healthy controls. Results: Patients attending the Multi Convergent Therapy clinic showed statistically significant improvements in many of our measures. Most importantly we have produced data indicating that Multi Convergent Therapy provides improvements in objective measures of psychomotor performance and cognition. Discussion: The outcomes of this small study are encouraging. Multi Convergent Therapy has not only produced results indicating significant improvements in standardised questionnaire based measures but also in objective cognitive performance tasks. The next step would be to assess Multi Convergent Therapy at the primary medical care level, with a greater number of patients to further evaluate its efficacy as a treatment for Chronic Fatigue Syndrome.
Functional fitness in elderly Norwegians measured with the Senior Fitness Test

Abstract Objectives: To evaluate the Senior Fitness Test in healthy older people in Norway. A secondary aim is to evaluate the use of European measures in the sub-tests compared with the American standards. Design: An explorative, descriptive study of a convenient sample of independent, healthy older people. People more than 60 years old were recruited through elderly centres and social contact groups in an urban area. Result: A total of 172 older people, 48 males and 124 females, were tested. There were significant differences between age groups with declining function with increasing age in leg strength, endurance and mobility. A cut-off point in performance, with start of declining function, was established around 70 years of age. Significant differences in arm curl and in 6-Minute Walk Test (6MWT) in favour of men were noted. Men were also stronger than women in the chair stand test; women, however, were more flexible. Conclusion: The Senior Fitness Test is a practical test for clinical use. The use of slightly heavier weights resulted in slightly fewer repetitions in strength tests, but the results revealed that the tests showed similar changes with increasing age and between the age groups, with no adverse events, indicating that these new scores for the arm curl test can be normative for a Norwegian sample of elderly people.
Effect of Support Groups on Family Caregivers to the Frail Elderly

RÉSUMÉ Cet article présente les résultats d'évaluation d'un projet d'ateliers de soutien destiné aux aidantes naturelles de personnes âgées. L'évaluation des effets repose sur un devis quasi-expérimental avec mesures répétées (n = 120). Les résultats montrent que la participation aux ateliers de soutien n'a pas réduit le fardeau subjectif des aidantes et qu'elle a au contraire contribué à l'accroître. Par ailleurs, elle semble avoir contribué à stabiliser leur niveau de symptômes dépressifs. Ces effets, observés à la fin des ateliers de soutien, persistent trois mois après la fin de l'intervention. Différentes explications de ces résultats contradictoires sont considérées en discussion. ABSTRACT This paper reports on a project aimed at creating support groups for caregivers of the frail elderly and assessing their impact on participants. The effect evaluation was based on a quasi-experimental design with repeated measures (n = 120). The results show that participation in support groups did not lower the caregivers' subjective burden, and indeed contributed to its increase. Conversely, such participation appears to have had a stabilizing effect on their level of depressive symptoms. Both these effects, reported at the end of the support group experience, persisted three months later. Various possible explanations of these contradictory results are discussed.
Piston diameter in stapes surgery. Does it have a bearing

Aims and Objectives: This prospective randomized controlled trial was done to study the effect of piston diameter on hearing outcomes after stapedotomy. Materials and Methods: All the patients diagnosed to have otosclerosis were included in the study. A total of 52 patients were studied ranging in age from 18 to 50 years. The subjects were randomized into two groups, that is, 0.4 mm piston (group A) and 0.6 mm piston (group B). The subjects were taken up for small fenestra stapedotomy using either a 0.4 or 0.6 mm piston. The main outcome measures were hearing improvement, air-bone gap closure, and overclosure of air-bone gap. Results: There was no statistical difference in hearing improvement in two different piston diameters, 0.4 and 0.6 mm at speech frequencies. In group A, the air-bone gap improvement in the third follow-up was not significant ( P > 0.05), whereas group B showed a statistically significant improvement ( P = 0.003). The mean overclosure of air-bone gap was better in patients with 0.4 mm piston at speech frequencies and also at 250 Hz. Significantly, overclosure of air-bone gap at higher frequencies (4 and 8 KHz) was seen only with a smaller sized piston. (0.4 mm). Discussion: We analyzed the effect of piston diameter on the hearing results after small fenestra stapedotomy by using similar surgical procedure and similar prosthesis in all patients. Conclusion: There is evidence to suggest that 0.4 mm piston may be better suited for providing optimum hearing results.
Depressed mitochondrial biogenesis and dynamic remodeling in mouse tibialis anterior and gastrocnemius induced by 4‐week hindlimb unloading

Mitochondrial dynamics is highly involved in muscle atrophy, the slow twitch muscle as soleus, preferentially affected by hindlimb unloading (HU), was well characterized by mitochondrial dysfunction in biogenesis. However, the fast twitch muscles like tibialis anterior (TA) and gastrocnemius (GAS), which are the most massive parts of the hindlimb muscles, are less elucidated on mitochondrial adaptations responding to HU. To investigate the mitochondrial dynamic responses and the involved molecules mediating atrophy in TA and GAS, we studied a 4‐week HU mouse model. We found GAS was preferentially affected to atrophy by unloading compared with TA. Furthermore, the depressed mitochondrial biogenesis occurred, accounting for mitochondrial loss in GAS by unloading. PGC‐1α, as well as its transcriptional/post‐translational modification regulators, such as p‐CREB, SIRT1, and p‐AMPK, were consistently reduced in response to unloading in GAS. Molecules relevant to autophagy, mitochondrial fusion, and fission, were compromised following unloading both in TA and GAS. These results suggested that TA exhibited resistance to unloading induced muscle atrophy while GAS presented significant mitochondrial loss, which might be due to the mitochondrial biogenesis suppressed by the inactivation of PGC‐1α. However, both in TA and GAS muscles, a similar sedentary mitochondrial dynamics of mitochondrial fusion and fission was induced by unloading though TA exhibited little muscle atrophy. © 2012 IUBMB, IUBMB Life, 64(11): 901–910, 2012
Association of fractures with the incidence of amyotrophic lateral sclerosis

Abstract Objective: Elevated bone turnover observed in ALS patients suggests poor bone health and increased fracture risk. We therefore evaluated the relationship of fracture to subsequent ALS risk. Methods: We followed 4,529,460 Swedes from 1987 to 2010 and identified ALS and fractures from the Swedish National Patient Register. We examined associations of ALS risk with all fractures, osteoporotic and non-osteoporotic fractures, and traumatic and non-traumatic fractures among individuals aged 30–80 years. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). We analysed the association of ALS with time since fracture using a Poisson regression model. Results: All fractures (HR: 1.51, 95% CI 1.39–1.65) as well as osteoporotic (HR: 1.59, 95% CI 1.41–1.79), non-osteoporotic (HR: 1.46, 95% CI 1.31–1.63), traumatic (HR: 1.50, 95% CI 1.37–1.63), and non-traumatic (HR: 1.80, 95% CI 1.35–2.40) fractures were associated with a higher incidence of ALS. Increased ALS incidence was associated with fractures occurring from one (HR: 2.33, 95% CI 2.04–2.66) to 18 (HR: 1.19, 95% CI 1.01–1.43) years before ALS diagnosis. Conclusions: Poor bone health may be related to ALS. These findings may offer insight into ALS pathophysiology.