Miracle-dz/UniFAR-FTUs huggingface dataset:
The Quality of Life in Care questionnaire: An assessment of feasibility, test–retest reliability and responsiveness in a clinical sample

This study determined the feasibility, test–retest reliability and responsiveness of the Quality of Life in Care (QOLIC), a measure of health-related quality of life (HRQoL) developed specifically for children in public care. Based on the Pediatric Quality of Life Inventory™ (PedsQL™) model, this questionnaire has previously demonstrated good validity and internal reliability. Two forms of the questionnaire are available, a self-completed report for children and a parallel proxy report for completion by carers. Thirty-five children aged between 8 and 17 years, and their carers, completed the PedsQL generic module and QOLIC on two separate occasions. At the second completion, carers and children were asked to rate whether the child's physical and emotional health had changed (improved, got worse or stayed the same) since the first questionnaire was completed to enable test–retest reliability and responsiveness to a change in health to be calculated. Both measures demonstrated good feasibility with missing responses of less than 1%. No floor effects and minimal to moderate ceiling effects were found. Test–retest reliability could not be established due to the small numbers reporting no change in their health status. However, it can be argued that responsiveness is more important, when looking at a changeable population such as this one. Good responsiveness was established for self-reported PedsQL and QOLIC measures, and for the proxy version of QOLIC. Therefore, this study provides further evidence that QOLIC provides a valid and reliable measure of HRQoL. QOLIC is easy to use and therefore has the potential to have a major impact on clinical practice with children in public care. It is recommended that future studies focus on assessing the ability of the measure to differentiate between groups of “looked-after” children.
Factores asociados a mal estado de salud percibido o a mala calidad de vida en personas mayores de 65 años

Fundamento: Hoy en dia, en los paises desarrollados, llegar a una edad avanzada ha dejado de ser algo excepcional, sin embargo muchas personas no logran envejecer con una buena calidad de vida. El presente trabajo tiene como objetivos, contribuir a un mejor conocimiento de los principales factores que influyen en la calidad de vida y la percepcion de la salud de los mayores de 65 anos, asi como determinar que ventajas y desventajas presenta cada uno de los tres instrumentos de medida de la salud y la calidad de vida frente a los otros dos instrumentos utilizados. Metodos: A partir de 911 encuestas a personas mayores de 65 anos no institucionalizadas, realizadas a domicilio, se hizo un analisis multivariante mediante regresion logistica, poniendo en relacion los resultados obtenidos en el Perfil de Salud de Nottingham (PSN), el Euroqol y el EAS con las caracterisiticas sociodemograficas, el nivel de recursos economicos, el grado de apoyo sociofamiliar, el estado de salud fisica y mental y la capacidad funcional. Resultados: Los principales factores que se asocian con la percepcion de un mal estado de salud y mala calidad de vida en el Euroqol y el PSN son los trastornos de ansiedad (Odd Ratios entre 1,8(IC:1,2-2,8) para movilidad y 7,9(IC:4,5-13,9) para Perfil ≠11111), trastornos depresivos (OR:1,8(IC:1,3-2,6) para dolor/malestar- 3,3(IC:2,1-5,1) para aislamiento social), falta de ejercicio (OR:1,4 (IC:1-2,1) para ansiedad/depresion -3,9(IC:2,5-6,2) para actividades cotidianas), dependencia para las actividades basicas de la vida diaria (OR:0,5(IC:0,3-0,9) para reaccion emocional - 4,8(IC:3-7,6) para actividades cotidianas) y dependencia para las actividades instrumentales de la vida diaria (OR:1,5(IC:1,1-2,1) para Escala Visual Analogicac<70 - 7,1(IC:2,9-17,2) para cuidado personal). Conclusiones: La salud mental y la capacidad funcional son los factores que mas influyen en la percepcion del estado de salud y la calidad de vida de las personas mayores. Dado que los tres instrumentos utilizados han obtenido resultados semejantes, el Euroqol ofrece ventajas por su brevedad, incluyendo una valoracion global y por dimensiones.
Tumor-Associated a2 Vacuolar ATPase Acts As a Key Mediator of Cancer-Related Inflammation by Inducing Pro-Tumorigenic Properties in Monocytes

Cancer-related inflammation profoundly affects tumor progression. Tumor-associated macrophages (TAMs) are known regulators of that inflammation, but the factors that initiate cancer-related inflammation are poorly understood. Tumor invasiveness and poor clinical outcome are linked to increased expression of cell surface-associated vacuolar adenosine triphosphatases. The a2 isoform vacuolar adenosine triphosphatase is found on the surface on many solid tumors, and we have identified a peptide cleaved from a2 isoform vacuolar adenosine triphosphatase called a2NTD. a2NTD has properties necessary to induce monocytes into a pro-oncogenic TAM phenotype. The peptide upregulated both pro- and anti-inflammatory mediators. These included IL-1β and IL-10, which are important in promoting inflammation and immune escape by tumor cells. The secretion of inflammatory cytokine IL-1β was dependent on ATP, K+ efflux, and reactive oxygen species, all mediators that activate the inflammasome. These findings describe a mechanism by which tumor cells affect the maturation of TAMs via a nontraditional cytokine-like signal, the a2NTD peptide.
HOUSEHOLDS WITH UNDERNOURISHED CHILDREN AND OVERWEIGHT MOTHERS: IS THIS A CONCERN FOR HAITI?

The coexistence of child malnutrition and adult overweight/obesity typifies rapid nutrition transition and is likely widespread in poor urban populations. This cross-sectional study assessed households’ anthropometric profile and socio-economic characteristics in a shantytown in Haiti. Out of 203 sampled households, 14% had a malnourished child (<10 years) and an overweight mother. Overweight mother households (32%) had a better socio-economic status, irrespective of child nutritional status, than those with malnourished mothers and children (7%), or with malnourished children only (36%). In very poor urban settings, the coexistence of child malnutrition-maternal overweight/obesity may be primarily observed in relatively better-off households.
KLRG1+NKG2A+ CD8 T Cells Mediate Protection and Participate in Memory Responses during γ-Herpesvirus Infection

Functional CD8 T cell effector and memory responses are generated and maintained during murine γ-herpesvirus 68 (γHV68) persistent infection despite continuous presentation of viral lytic Ags. However, the identity of the CD8 T cell subpopulations that mediate effective recall responses and that can participate in the generation of protective memory to a γ-herpesvirus infection remains unknown. During γHV68 persistence, ∼75% of γHV68-specific CD8 T cells coexpress the NK receptors killer cell lectin-like receptor G1 (KLRG1) and NKG2A. In this study, we take advantage of this unique phenotype to analyze the capacity of CD8 T cells expressing or not expressing KLRG1 and NKG2A to mediate effector and memory responses. Our results show that γHV68-specific KLRG1+NKG2A+ CD8 T cells have an effector memory phenotype as well as characteristics of polyfunctional effector cells such us IFN-γ and TNF-α production, killing capacity, and are more efficient at protecting against a γHV68 challenge than their NKG2A−KLRG1− counterparts. Nevertheless, γHV68-specific NKG2A+KLRG1+ CD8 T cells express IL-7 and IL-15 receptors, can survive long-term without cognate Ag, and subsequently mount a protective response during antigenic recall. These results highlight the plasticity of the immune system to generate protective effector and proliferative memory responses during virus persistence from a pool of KLRG1+NKG2A+ effector memory CD8 T cells.
Termination of sporting careers among South African sportswomen

The primary aim of this study was to determine the reasons why sportswomen compete at a high level in sport but terminate their sporting careers soon after school during the tertiary phase and prior to reaching their full potential. The second aim was to explore the impact of gender stereotyping in conjunction with the role of the media on the sportswomen in sport. A qualitative approach was utilized where 40 high level sportswomen completed a questionnaire that was specifically developed to identify the reasons why sportswomen terminate their sporting careers and to explore the role of gender stereotyping and the media. Results indicated that five of the most important reasons for sportswomen terminating their sporting careers are decreased motivation and interest in sport, coaching problems, academic pressure, injuries and politics in sport. A significant number of the subjects agreed that gender stereotyping in sport does exist and that the media contribute to gender inequalities in sport.
Consumer usage of broadband in British households

A survey was conducted to examine the usage of broadband in British households. The findings suggest that there is a correlation between the rate of internet use and consumers' age and broadband adoption. The paper also suggests that broadband consumers differ to narrowband ones in terms of the variety of internet use. Results obtained from discriminate analysis suggest that overall, the discriminate function successfully predicted the outcome for 68.5% of the cases, with accurate predictions being made for 66.3% of the narrowband consumers and 69.5% of the broadband consumers.
A service-oriented approach for developing adaptive distribution chain

This paper presents a service-oriented approach for the development of adaptive distribution chain. The distribution chain presented in this paper achieves all the three objectives of an adaptive chain: first, to achieve variability, this paper proposes an approach that uses iterations to fine tune the modules that make up the distribution chain; second, to achieve visibility, it proposes web services based Service Component Architecture (SCA) for the implementation of the distribution chain. Finally, mathematical modelling and simulation of the distribution chain is proposed for assuring the velocity.
Osteopontin expression and relation to streptococcal disease severity in mice

Abstract Osteopontin (OPN) is a phosphorylated glycoprotein that has been implicated in a number of infectious diseases. However, the role of OPN in Streptococcus pyogenes infection is unknown. To investigate whether OPN is involved in S. pyogenes infection, we first examined the plasma OPN levels after local injection of S. pyogenes. OPN expression was significantly increased at 2 h post-infection and increased thereafter. A correlation was found between plasma OPN levels and the development of S. pyogenes infection. The plasma OPN level in severe S. pyogenes infection was higher than during a normal infection. Levels of OPN were found to correlate with the severity of S. pyogenes infection. We also found that OPN production was suppressed by interleukin-6 and enhanced by tumour necrosis factor-alpha in immunocompetent cells. Collectively, these findings demonstrate that the OPN level may provide clues to the severity of S. pyogenes infection in the early phase of the infection.
Nucleosides from Phlebotomus papatasi Salivary Gland Ameliorate Murine Collagen-Induced Arthritis by Impairing Dendritic Cell Functions

Among several pharmacological compounds, Phlebotomine saliva contains substances with anti-inflammatory properties. In this article, we demonstrated the therapeutic activity of salivary gland extract (SGE) of Phlebotomus papatasi in an experimental model of arthritis (collagen-induced arthritis [CIA]) and identified the constituents responsible for such activity. Daily administration of SGE, initiated at disease onset, attenuated the severity of CIA, reducing the joint lesion and proinflammatory cytokine release. In vitro incubation of dendritic cells (DCs) with SGE limited specific CD4+ Th17 cell response. We identified adenosine (ADO) and 5′AMP as the major salivary molecules responsible for anti-inflammatory activities. Pharmacologic inhibition of ADO A2A receptor or enzymatic catabolism of salivary nucleosides reversed the SGE-induced immunosuppressive effect. Importantly, CD73 (ecto-5′-nucleotidase enzyme) is expressed on DC surface during stage of activation, suggesting that ADO is also generated by 5′AMP metabolism. Moreover, both nucleosides mimicked SGE-induced anti-inflammatory activity upon DC function in vitro and attenuated establishment of CIA in vivo. We reveal that ADO and 5′AMP are present in pharmacological amounts in P. papatasi saliva and act preferentially on DC function, consequently reducing Th17 subset activation and suppressing the autoimmune response. Thus, it is plausible that these constituents might be promising therapeutic molecules to target immune inflammatory diseases.
Nephrotic Syndrome and Subepithelial Deposits in a Mouse Model of Immune-Mediated Anti-Podocyte Glomerulonephritis

Subepithelial immune complex deposition in glomerular disease causes local inflammation and proteinuria by podocyte disruption. A rat model of membranous nephropathy, the passive Heymann nephritis, suggests that Abs against specific podocyte Ags cause subepithelial deposit formation and podocyte foot process disruption. In this study, we present a mouse model in which a polyclonal sheep anti-mouse podocyte Ab caused subepithelial immune complex formation. Mice developed a nephrotic syndrome with severe edema, proteinuria, hypoalbuminemia, and elevated cholesterol and triglycerides. Development of proteinuria was biphasic: an initial protein loss was followed by a second massive increase of protein loss beginning at approximately day 10. By histology, podocytes were swollen. Electron microscopy revealed 60–80% podocyte foot process effacement and subepithelial deposits, but no disruption of the glomerular basement membrane. Nephrin and synaptopodin staining was severely disrupted, and podocyte number was reduced in anti-podocyte serum-treated mice, indicating severe podocyte damage. Immunohistochemistry detected the injected anti-podocyte Ab exclusively along the glomerular filtration barrier. Immunoelectron microscopy localized the Ab to podocyte foot processes and the glomerular basement membrane. Similarly, immunohistochemistry localized mouse IgG to the subepithelial space. The third complement component (C3) was detected in a linear staining pattern along the glomerular basement membrane and in the mesangial hinge region. However, C3-deficient mice were not protected from podocyte damage, indicating a complement-independent mechanism. Twenty proteins were identified as possible Ags to the sheep anti-podocyte serum by mass spectrometry. Together, these data establish a reproducible model of immune-mediated podocyte injury in mice with subepithelial immune complex formation.
Circulating Activated and Effector Memory T Cells Are Associated with Calcification and Clonal Expansions in Bicuspid and Tricuspid Valves of Calcific Aortic Stenosis

We sought to delineate further the immunological significance of T lymphocytes infiltrating the valve leaflets in calcific aortic stenosis (CAS) and determine whether there were associated alterations in circulating T cells. Using clonotypic TCR β-chain length and sequence analysis we confirmed that the repertoire of tricuspid CAS valves contains numerous expanded T cell clones with varying degrees of additional polyclonality, which was greatest in cases with severe calcification. We now report a similar proportion of clonal expansions in the much younger bicuspid valve CAS cases. Peripheral blood flow cytometry revealed elevations in HLA-DR+ activated CD8 cells and in the CD8+CD28nullCD57+ memory-effector subset that were significantly greater in both bicuspid and tricuspid CAS cases with more severe valve calcification. Lesser increases of CD4+CD28null T cells were identified, principally in cases with concurrent atherosclerotic disease. Upon immunostaining the CD8 T cells in all valves were mainly CD28null, and CD8 T cell percentages were greatest in valves with oligoclonal repertoires. T cell clones identified by their clonotypic sequence as expanded in the valve were also found expanded in the circulating blood CD28nullCD8+ T cells and to a lesser degree in the CD8+CD28+ subset, directly supporting the relationship between immunologic events in the blood and the valve. The results suggest that an ongoing systemic adaptive immune response is occurring in cases with bicuspid and tricuspid CAS, involving circulating CD8 T cell activation, clonal expansion, and differentiation to a memory-effector phenotype, with trafficking of T cells in expanded clones between blood and the valve.
Rapid Assessment Procedures for Loiasis

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Outcome of HIV-1-associated cryptococcal meningitis, Denmark 1988–2008

Abstract Introduction: The risk of HIV-1-associated Cryptococcus neoformans meningitis (CM) has decreased and the outcome has improved with the use of combination antiretroviral therapy (cART). Outcome has not been reported in Denmark in the cART era. Methods: A review of all cases of HIV-1-associated CM treated at 2 hospitals in Denmark was carried out. Survival was compared by time-updated Cox proportional hazards analysis. Results: A total of 45 cases were evaluated. Six individuals (13.3%) died within 30 days of being diagnosed with CM. cART was initiated a median of 15 days (range 3–53) after a diagnosis of CM for 12 individuals and did not affect 30-day outcome. Older age, however, was associated with an increased risk of death at 30 days (mortality rate ratio (MMR) 1.16 (95% confidence interval (95% CI) 1.05–1.30) per y increment). Twenty-four (55.8%) of 43 individuals (2 had emigrated) died within the 1st y. Initiation of cART significantly improved 1-y outcome (MMR 0.22, 95% CI 0.06–0.77). Mental status, CD4 T cell count, and antifungal did not affect short- or long-term outcome. Conclusions: We found that long-term survival after HIV-1-associated CM has improved significantly with the use of cART. Short-term mortality was not affected by initiation of cART and remained high.
Upper Limb Rehabilitation following Brain Injury: Complex, Multifaceted and Challenging

Neurological upper limb rehabilitation is influenced by a diverse range of factors within the practice environment. Clinical reasoning is the means by which occupational therapists make sense of such factors in order to make decisions that promote individual occupational goals. However, changes in neurological knowledge, the limited availability of research evidence and the need to maintain a focus on client-centred practice in rehabilitation settings are factors that contribute to clinical reasoning uncertainty. A protocol that aims to structure clinical decision making in the light of such diversity has been developed to guide upper limb rehabilitation after brain injury. As part of a larger study designed to determine the conceptual usefulness of the protocol, 11 expert occupational therapists were asked to describe the challenges that they faced in their practice. Four themes emerged from the focus group data, described in terms of (a) the complexity of domain-specific knowledge and the paucity of evidence for practice; (b) the diversity of upper limb presentation; (c) the need to balance client-centred practice and professional duty of care; and (d) uncertainty regarding clinical decision making. Although the data supported the participants' expertise, they nevertheless articulated a need for guidance in structuring the clinical reasoning and decision making underlying neurological upper limb rehabilitation. Various strategies are described that can be used to guide clinical reasoning, including research evidence, the differentiation of situations requiring the application of artistic or scientific knowledge, reflective and reflexive practice, and the application of system aids such as decision-making protocols.
Epidemiological investigation of a legionellosis outbreak in a Slovenian nursing home, August 2010

Abstract Background: August 2010 marked the beginning of the largest outbreak of legionellosis in a Slovenian nursing home. This article presents our experiences with the outbreak investigation. Methods: In order to collect the necessary patient epidemiological data, we used individual epidemiological questionnaires. Samples were available from 15 patients and were subject to laboratory investigation. Urine and sputum samples were difficult to obtain due to the underlying diseases of the patients. Serological diagnostics constituted an important part of the epidemiological investigation. Sixty-four environmental samples were taken to identify the sources of infection. By genotyping, we assessed the affinity of the allelic profile of Legionella pneumophila serogroup 1 in environmental samples and in patient samples. Results: Legionnaires’ disease was diagnosed in 10 patients based on a combination of various tests. Legionella pneumophila serogroup 1, Legionella pneumophila serogroups 2–14, and Legionella sp. , in concentrations of < 10 to 61,000 CFU/l, were isolated from 51 out of 64 environmental samples. The source of the outbreak was confirmed by genotyping the isolates from patients and the isolates from the water supply system. The 2 isolates had identical allelic profiles corresponding to that of L. pneumophila serogroup 1 allelic profile 2,3,9,10,2,1,6, designated sequence type 23 (according to the European Working Group for Legionella Infections). Conclusion: We describe a Legionella pneumophila serogroup 1 outbreak in a Slovenian nursing home. The source of infection was demonstrated using sequence-based typing. Water flow disturbances were determined as the most probable cause of Legionella growth. Overall, the risk of a Legionella outbreak is underestimated in Slovenia.