Miracle-dz/UniFAR-FTUs huggingface dataset:
IMMUNE REGULATORY MECHANISMS OF THE RESPIRATORY MUCOSA

Asthma and other allied allergic diseases represent a significant burden to health care and are recognized as endemic in the Western World. While a diverse array of effective pharmacopoeia provides reprieve from symptoms, no preventive or curative therapies are currently available. This is in part due to the paucity of understanding how allergic diseases develop. Recently, remarkable progress has been made in this regard, largely due to the discovery of regulatory mechanisms that control responsiveness to antigen in the airway. Indeed, to understand fully why people develop asthma requires an understanding of both allergic sensitization and tolerance. Work presented in this thesis contributes to our knowledge of inhalation tolerance. Using a classical mouse model of allergic airways inflammation, we show in Chapter 2 that inhalation tolerance is a persistent and active process as it prevents the generation of airway eosinophilia, antigenspecific IgE and airway hyperresponsiveness upon secondary immunogenic challenge, independently of IL-lO or IFN-y. Building on these observations, in Chapter 3 we show in a mucosal model of allergic sensitization that inhalation tolerance cannot be broken with the expression of GM-CSF, a potent growth factor and cytokine that has been associated with asthma and allergy in both human and animal subjects. However, concomitant expression of decorin, a natural inhibitor of TGF-f3, reverses inhalation tolerance, thus implicating TGF-f3 as putatively important in regulating responsiveness in the airway. In Chapter 4, we identify an alternative mode of tolerance. We show that chronic exposure to innocuous antigen in sensitized mice does not lead to chronic inflammation but to abrogated eosinophilia that can, nevertheless, be reversed with the expression of GM-CSF. Collectively, these findings enrich our understanding of tolerance and provide a framework for new discoveries that may, ultimately, lead to novel and powerful therapies for allergic disease. AHR airway hyperresponsiveness APC antigen presenting cell CCR CC chemokine receptor CD cluster of differentiation Abbreviations CTLA-4 cytotoxic T lymphocyte-associated antigen 4 DC dendritic cell DNA deoxyribonucleic acid dsRNA double stranded ribonucleic acid EAE experimental allergic encephalomyelitis GM-CSF granulocyte macrophage colony stimulating factor HDM house dust mite IBD inflammatory bowel disease ICOS inducible costimulator IFN interferon Ig immunoglobulin IL interleukin LPS -lipopolysaccharide MBP myelin basic protein MHC major histocompatibility complex MIP macrophage inflammatory protein MLN mediastinal lymph nodes OVA ovalbumin PAMP pathogen associated molecular pattern TCR T cell receptor TGF-f3 transforming growth factor f3 TH-T helper TNF-a. tumor necrosis factor a T R T regulatory iv
Recognition and assessment of critical illness

Abstract Early recognition of patients at risk of catastrophic deterioration leads to early treatment and improved prognosis. Delayed identification of critically ill patients and their delayed referral to intensive care are causes of increased mortality. Systematic assessment of patients at risk is a prerequisite for early recognition of critical illness. The assessment of the critically ill patient should follow the ‘Airway Breathing Circulation' format. A blocked airway, raised respiratory rate and a systolic blood pressure that is smaller than the heart rate are signs of critical illness. Confusion and raised respiratory rate are the signs that most strongly indicate critical illness and are the most often missed during assessment. The assessment of critical illness is supplemented by risk factors, which result from concomitant chronic conditions, and haematological and biochemical tests, ECGs and radiographs. Lactate has a particular role in triage of patients with sepsis. For those clinicians inexperienced in critical care, simple scoring systems allow rapid assessment of the degree of physiological abnormality and the associated risk.
Generalized exanthematous reaction with pustulosis induced by topical corticosteroids

A 27-year-old man presented with a history of acne after beginning his research for the graduate dissertation in a chemical laboratory. His work involved manipulation of o-dichlorobenzene once a day and no contact with any other chemical substances except acetone. 3 months after starting this work, he had begun to show initial manifestations of acne and had then accidental hand contact with o-dichlorobenzene because of a broken vial. Soon after this episode, acne symptoms worsened, prompting him to seek medical advice. On examination, there were open comedones and straw-coloured cysts on the cheeks and malar crescent. No lesions were apparent on the forehead, the neck or the chest. Blood tests were normal and there was no evidence of other diseases. The patient was removed from further exposure, treated with systemic antibiotic therapy, and after 3 months showed evident improvement. In order to help confirm the role of o-dichlorobenzene exposure, passive diffusion samplers (Radiello, Aquaria, Milano, Italy) were placed in the laboratory for the duration of the work shift, desorbed with CS2 and then analysed by means of gas chromatography coupled with mass spectrometry. O-dichlorobenzene present in the air was in the range of 0.8–2.2 p.p.b. , that is hundreds of times lower than the ACGIH TLVTWA of 25 p.p.m.
The influence of user involvement on the learning of mental health nursing students

This comparative study investigates the effect of user involvement in classroom work on mental health students' learning while undertaking the Diploma in Higher Education and Nursing programme. Recent policy recommendations suggest there should be user involvement in all aspects of the nursing curriculum. However, there appears to be a dearth of literature evaluating the outcomes of this on student learning. In this study, triangulation of methods was utilised; this consisted of classroom observation, student questionnaires and focus group discussion to evaluate the user involvement. A user-centred measurement tool was developed from earlier work that provided a measure on three dimensions: the use of terminology and jargon, empathetic understanding, and an individualised approach when identifying and responding to clients' needs. The outcomes indicated that students who were given an experience of user involvement in classroom work differed from those in the same cohort who had not been exposed to similar user input - they were less likely to rely on the use of professional terminology and jargon, more able to empathise with clients' distressing experiences, less likely to use defensive 'distancing' and more likely to take an individualised approach to assessment and intervention. This supported the intended aims of the project: that user involvement would enable students to take a more user-centred approach to mental health assessment.
Non-contact control of two-photon absorption.

In this experimental work, we address the issue of the control of two-photon absorption in a Doppler broadened medium of Rb85 atoms under the ladder level coupling 5S1/2→5P3/2→5D3/2. Here, suppression and enhancement of two-photon absorption are executed by applying an auxiliary laser beam, which is not physically propagating in the same line of the pump-probe combination. Instead, the auxiliary beam, which is in resonance with the Rb85 D2 transition, is at a finite distance from the line of propagation of the pump-probe combination. The resonant auxiliary beam produces an atomic beam in the vapor cell, and when it reaches the pump-probe path, it creates an asymmetry in the population of ground state hyperfine components. This asymmetry is responsible for controlling two-photon absorption. We present here results obtained by us along with a qualitative explanation of the physical principles behind the control mechanism.
Lessons Learned from a Very Small Pilot Study

This report describes the lessons learned from a very small (three-family, nine-person) pilot study of the feasibility of in-home educational intervention for persons with diabetes in rural African American families. Lessons learned included the need to liberalize sample criteria, appreciation of the difficulties of scheduling visits with working rural families and maintaining standard intervals between visits, documentation of the learning needs of people with prior diabetes education, realizing that Caucasian nurses were accepted into African American homes and gaining insights into communication styles, finding that children were enthusiastic participants, and that even small studies produced some diffusion beyond the participants. The families all exhibited the self-reliance considered characteristic of rural families. Investigators without experience in rural nursing or research are urged to seek consultation and to pilot their study for feasibility and logistics.
Young People's Experiences of Receiving Individual Packages of Care in South Australia

The aim of this study was to explore the role that professional foster care – and specifically Individual Packages of Care (IPC) in South Australia – plays in providing an alternative care option for young people who are unable to live with their birth parents due to issues of abuse or neglect, but who also, due to behavioural concerns, are not well suited to a traditional foster care placement. Participants in the study were nine young people who had previously lived in an IPC placement. The findings highlight participants’ experiences of living in the context of an IPC placement, experiences that were at times challenging, but which also provided opportunities for growth and positive change that may not have been possible in a traditional foster care placement.
Effects of poor sanitation on public health: Case of Yopougon town (Abidjan)

Effects of poor environmental hygiene on population health were studied in the precarious living quarters of Doukoure, the village of Niangon-adjame and the viable living quarters of millionaire’s in Yopougon town. This study included sanitation, water sources, as well as, population health. It appears that excreta management is from self-purification works (WC with septic tank) (60%), collective purification work (gutter storm water, sewer) (26%), anarchic connections (30%) and defecation in nature relatively less important (2%) for all living quarters visited. Furthermore, almost 90% of the populations have access to the drinking water, which is rather used. In Doukoure’s living quarters and Niangon-Adjame’s village, public tap water (7%) and traditional wells (3%) are used for domestic needs. Data collected in 15 health centers in the town on 125 446 cases of morbidity, revealed that malaria is much contracted by populations with 58% cases against 14% for diarrhea and 28% for acute respiratory infections. Under-five children are much affected with 24% of the patients among which 43% were cases of the diarrheic diseases. Also, malaria and respiratory infections are more important during rainy seasons, in contrast to diarrheal diseases caused by poor hygiene of people. Key words: Public health, malaria, diarrhea, respiratory infections, sanitation, risk
11C-Methionine-PET: A novel and sensitive tool for monitoring of early response to treatment in multiple myeloma

Multiple myeloma (MM) remains an essentially incurable hematologic malignancy. However, new treatment modalities and novel drugs have been introduced and thus additional tools for therapy monitoring are increasingly needed. Therefore, we evaluated the radiotracers 11C-Methionine (paraprotein-biosynthesis) and 18F-FDG (glucose-utilization) for monitoring response to anti-myeloma-therapy and outcome prediction. Influence of proteasome-inhibition on radiotracer-uptake of different MM cell-lines and patient-derived CD138+ plasma cells was analyzed and related to tumor-biology. Mice xenotransplanted with MM.1S tumors underwent MET- and FDG-μPET. Tumor-to-background ratios before and after 24 h, 8 and 15 days treatment with bortezomib were correlated to survival. Treatment reduced both MET and FDG uptake; changes in tracer-retention correlated with a switch from high to low CD138-expression. In xenotransplanted mice, MET-uptake significantly decreased by 30–79% as early as 24 h after bortezomib injection. No significant differences were detected thus early with FDG. This finding was confirmed in patient-derived MM cells. Importantly, early reduction of MET- but not FDG-uptake correlated with improved survival and reduced tumor burden in mice. Our results suggest that MET is superior to FDG in very early assessment of response to anti-myeloma-therapy. Early changes in MET-uptake have predictive potential regarding response and survival. MET-PET holds promise to individualize therapies in MM in future.
Tactile Displays of Pulse Oximetry in Integrated and Separated Configurations

Vibrotactile displays have been trialled in a variety of cognitively demanding domains, including healthcare. Previous work suggests that vibrotactile displays can be used to inform clinicians of patient status, particularly when the displays are alarm-style alerts in surgical or critical care. The goal of the present study is to evaluate how well a common measure of patient well-being—pulse oximetry—can be communicated via an upper-arm vibrotactile prototype. Pulse oximetry includes two important vital signs: heart rate and oxygen saturation. Two displays were tested in a between-subjects design: (1) the Separated display presented heart rate first, followed by oxygen saturation; and (2) the Integrated display communicated both vital signs simultaneously. Participants identified five ranges of heart rate and three levels of oxygen saturation with very high accuracy (>90%), regardless of display type. Although participants’ identification accuracy improved marginally with practice, their initial high level of performance was achieved with minimal training. Findings will inform a broader program of research in which we aim to test whether vibrotactile displays might be useful as a part of multi-modal patient monitoring.
The point correlation dimension of R-R intervals predicts sudden cardiac death among high-risk patients

An algorithm for the correlation dimension, the PD2, accurately tracks dimension in nonstationary data. Low-dimensional PD2s predict ventricular fibrillation (VF) in experimental myocardial infarction in animals. The authors now demonstrate in 61 electrocardiographic recordings from ambulatory high-risk cardiac patients that low-dimensional chaos in the heartbeat intervals, as represented by a reduction in PD2 below 1.2 dimensions, precedes lethal VF by a mean of 12 hours. This PD2-reduction occurs only in those high-risk patients who actually experience PD2-reduction had a high sensitivity (100%) and specificity (83%) in predicting VF among the high-risk patients. In contrast, the standard deviations of the same heartbeat intervals provided no such discrimination. In symptomatic extremely-high-risk patients, each having a history of syncope and episodic ventricular tachycardia, but who did not experience VF that day, PD2s<1.2 were observed in 9 of 10 subjects. This latter result suggests that VF-prediction and VF-occurrence may be separated by days not just hours. It is concluded that the PD2 of heartbeat intervals may provide an important diagnostic test and early warning signal for sudden cardiac death. <<ETX>>
Hyperbaric Spinal Ropivacaine A Comparison to Bupivacaine in Volunteers

Background: Ropivacaine is a newly introduced local anesthetic that may be a useful alternative to low-dose bupivacaine for outpatient spinal anesthesia. However, its relative potency to bupivacaine and its dose-response characteristics are unknown. This double-blind, randomized, crossover study was designed to determine relative potencies of low-dose hyperbaric spinal ropivacaine and bupivacaine and to assess the suitability of spinal ropivacaine for outpatient anesthesia. Methods: Eighteen healthy volunteers were randomized into three equal groups to receive one spinal administration with bupivacaine and a second with ropivacaine, of equal-milligram doses (4, 8, or 12 mg) of 0.25% drug with 5% dextrose. The duration of blockade was assessed with (1) pinprick, (2) transcutaneous electrical stimulation, (3) tolerance to high tourniquet, (4) electromyography and isometric force dynamometry, and (5) achievement of discharge criteria. Differences between ropivacaine and bupivacaine were assessed with linear and multiple regression. P < 0.05 was considered significant. Results: Ropivacaine and bupivacaine provided dose-dependent prolongation of sensory and motor block and time until achievement of discharge criteria (R 2 ranges from 0.33-0.99; P values from < 0.001 through 0.01). Spinal anesthesia with ropivacaine was significantly different from bupivacaine and was approximately half as potent for all criteria studied. A high incidence of back pain (28%; P = 0.098) was noted after intrathecal ropivacaine was given. Conclusion: Ropivacaine is half as potent and in equipotent doses has a similar profile to bupivacaine with a higher incidence of side effects. Low-dose hyperbaric spinal ropivacaine does not appear to offer an advantage over bupivacaine for use in outpatient anesthesia.
Protesting patients: a study of complaints submitted to a Family Health Service Authority

The issue of complaints is a topical one. It is of interest to the Government who espouses a consumerist philosophy and to health care consumer groups who are keen to ensure that effective mechanisms for the redress of grievances are in place. The complaints machinery is currently being reviewed and debated by interested parties and the main suggestions for change are set out in this paper. It is suggested that the factors which impede reform are professional self regulation, which limits lay involvement in the assessment of matters complained about, and the new managerialism which, through its emphasis on consumerism, has the paradoxical effect of reinforcing the control of managers. If complaints procedures are to be reformed it is paramount that we have an insight into what people complain about. To this end this paper presents an analysis of the letters of complaint submitted to one Family Health Service Authority in the early 1990s.
Topical Capsaicin in Painful Diabetic Neuropathy: Controlled Study With Long-Term Follow-Up

Objective –We conducted an 8-wk controlled study with topical 0.075% capsaicin in subjects with chronic severe painful diabetic neuropathy who were unresponsive or intolerant to conventional therapy. Capsaicin is an alkaloid found in capsicum peppers and produces desensitization to noxious thermal, chemical, and mechanical stimuli when applied topically. Research Design and Methods In 22 randomly assigned subjects, either capsaicin or vehicle cream was applied to painful areas 4 times/day. Pain measurements were recorded at baseline and at 2-wk intervals for 8 wk. Results –Capsaicin treatment was more beneficial than vehicle treatment in the overall clinical improvement of pain status, as measured by physician's global evaluation (P = 0.038) and by a categorical pain severity scale (P = 0.057). Decrease in mean pain intensity by a visual analogue scale was 16% in capsaicin-treated and 4.1' in vehicle-treated subjects. Mean pain relief on visual analogue scale was 44.6 and 23.2', respectively. In a follow-up open-label study, – 50' of subjects reported improved pain control or were cured, and 25' each were unchanged or worse. A burning sensation at the application site was noted by some subjects but both its magnitude and duration decreased with time. Conclusions –Results from this preliminary study suggest that topical 0.075' capsaicin may be of value in subjects with diabetic neuropathy and intractable pain.
Selective β-Cell Loss and α-Cell Expansion in Patients with Type 2 Diabetes Mellitus in Korea

In the presence of obesity, β-cell mass needs to be increased to compensate for the accompanying demands and maintain euglycemia. However, in Korea, the majority of type 2 diabetic patients are nonobese. We determined the absolute masses, relative volumes, and ratio of α- and β-cell in the pancreas and islets in normal and diabetic Korean subjects to correlate these findings with the clinical characteristics. Whole pancreases procured from organ donors were divided into 24 parts (control 1, n = 9). Tissue was also obtained by surgical resection after 35 partial pancreatectomies: in 25 diabetic patients, 10 age- and body mass index (BMI)-matched patients of benign or malignant pancreatic tumor without diabetes mellitus (DM) (control 2). Morphometric quantifications were performed. In control 1, the relative volume of β-cells was 2.1 ± 0.9%, and the total β-cell mass was 1.3 ± 0.3 g. The relative volume of β-cells was found to be variable (control 1, 2.1 ± 0.9%; control 2, 1.9 ± 0.7%; DM, 1.4 ± 1.0%; P < 0.
Adjusting the focus of mental health nursing: Incorporating service users' experiences of recovery

Mental health nursing is currently torn by passionate debate about its proper focus and function, with the two dominant 'camps' competing for ascendancy. Although both traditions stress the need to involve service users in their own care, the hegemonic nature of these professional theories tends to relegate the expertise of those who experience mental health problems. This paper considers service users' views and experiences, particularly their accounts of recovery, and finds a place for both approaches. Users also highlight the importance of strategies for social inclusion (facilitating access to roles, responsibilities, relationships and communities) an area of work that has not been prioritised by mental health nurses in either approach. Service users differ from each other and have a range of different roles in different settings. In developing their own strategies for living they need choices, multiple perspectives, a range of approaches and skills. It is not for us to create single models or fixed ways of acting upon them, but for service users to use a range of resources - including the different strategies that nurses make available - in ways most useful to them. In providing the most helpful environment for recovery, mental health nursing theorists must move from competition to cooperation, from criticising others to self-criticism. We must also incorporate strategies for social inclusion, but if we are to promote diversity in communities, we must first embrace diversity in our own area of work.
Predictors of Long Term Care Facility Use among the Elderly

ABSTRACT This research uses data from the Manitoba Longitudinal Study on Aging and multiple logistic regression analysis to assess the impact of twenty-eight sociodemographic and health status variables on nursing home admission. The results indicate that 1) all the short-term predictors continue to be significantly associated with facility bed use in the long run, suggesting that the high risk elderly can be identified relatively early; 2) the key sociodemographic characteristics are better predictors of admission than health and physical functioning characteristics; and 3) time itself appears to change the relationship of the study variables to admission. RÉSUMÉ La présente recherche s'appuie sur les données fournies par le Manitoba Longitudinal Study on Aging (Étude longitudinale sur le vieillissement faite au Manitoba) et l'analyse de la régression logistique multiple pour évaluer l'incidence de 28 variables sociodémographiques ainsi que de l'état de santé à l'admission en maison de retraite. Les résultats obtenus indiquent 1) que les critères de prédiction à court terme continuent d'être associés à l'utilisation des lits, ce qui permet de croire que le dépistage des cas à risques élevés est possible, 2) que les caractéristiques sociodémographiques constituent des critères de prédiction supérieurs aux caractéristiques physiques et à l'état de santé, 3) que le passage du temps semble affecter le rapport entre les variables de l'étude et l'admission en maison de retraite.