Miracle-dz/UniFAR-FTUs huggingface dataset:
Features of Swedish municipal elderly and psychiatric group dwelling care after the 1990s healt care reformations

1 LIST OF PUBLICATIONS . 3 CONTENTS . 4 LIST OF ABBREVIATIONS . 6 INTRODUCTION . 7 DISPOSITION OF THE THESIS.8 BACKGROUND.11 DEVELOPMENTS IN PSYCHIATRY – A SOCIETAL PERSPECTIVE . 11 THE 1990S – REFORMATION OF ELDERLY AND MENTAL HEALTH CARE.14 ASPECTS OF ELDERLY AND PSYCHIATRIC CARE PROVISION.18 CARE PROVIDERS’ JOB SATISFACTION.20 ASPECTS OF THE CARE PROVIDER-CLIENT RELATIONSHIP . 21 USERS/CLIENTS AND CARE PROVIDERS IN AN ENVIRONMENT.24 THE STUDY . 27 RATIONALE FOR THE STUDY . 27 PURPOSE OF THE STUDY.27 METHODS.28 PARTICIPANTS AND PROCEDURES . 28 METHODS OF DATA COLLECTION.30 RESEARCH INTERVIEWS.33 METHODS OF DATA ANALYSIS . 34 ETHICAL CONSIDERATIONS.37 FINDINGS.38 PAPER I.38 PAPER II . 38 PAPER III . 38 PAPER IV.39 PAPER V . 39 PAPER VI.40 METHODOLOGICAL CONSIDERATIONS.40 REFLECTION.44 MORAL AND ETHICAL ASPECTS AND NURSING CARE.45
Genome-level determination of Plasmodium falciparum blood-stage targets of malarial clinical immunity in the Peruvian Amazon.

BACKGROUND Persons with blood-stage Plasmodium falciparum parasitemia in the absence of symptoms are considered to be clinically immune. We hypothesized that asymptomatic subjects with P. falciparum parasitemia would differentially recognize a subset of P. falciparum proteins on a genomic scale. METHODS AND FINDINGS Compared with symptomatic subjects, sera from clinically immune, asymptomatically infected individuals differentially recognized 51 P. falciparum proteins, including the established vaccine candidate PfMSP1. Novel, hitherto unstudied hypothetical proteins and other proteins not previously recognized as potential vaccine candidates were also differentially recognized. Genes encoding the proteins differentially recognized by the Peruvian clinically immune individuals exhibited a significant enrichment of nonsynonymous nucleotide variation, an observation consistent with these genes undergoing immune selection. CONCLUSIONS A limited set of P. falciparum protein antigens was associated with the development of naturally acquired clinical immunity in the low-transmission setting of the Peruvian Amazon. These results imply that, even in a low-transmission setting, an asexual blood-stage vaccine designed to reduce clinical malaria symptoms will likely need to contain large numbers of often-polymorphic proteins, a finding at odds with many current efforts in the design of vaccines against asexual blood-stage P. falciparum.
Effect of Influenza A(H5N1) Vaccine Prepandemic Priming on CD4+ T-Cell Responses

Abstract Introduction. Previous priming with avian influenza vaccines results in more rapid and more robust neutralizing antibody responses upon revaccination, but the role CD4+ T cells play in this process is not currently known. Methods. Human subjects previously enrolled in trials of inactivated influenza A(H5N1) vaccines and naive subjects were immunized with an inactivated subunit influenza A/Indonesia/5/05(H5N1) vaccine. Neutralizing antibody responses were measured by a microneutralization assay, and hemagglutinin (HA)-specific and nucleoprotein (NP)-specific CD4+ T-cell responses were quantified using interferon γ enzyme-linked immunosorbent spot assays. Results. While vaccination induced barely detectable CD4+ T-cell responses specific for HA in the previously unprimed group, primed subjects had readily detectable HA-specific memory CD4+ T cells at baseline and mounted a more robust response to HA-specific epitopes after vaccination. There were no differences between groups when conserved NP-specific CD4+ T-cell responses were examined. Interestingly, neutralizing antibody responses following revaccination were significantly higher in individuals who mounted a CD4+ T-cell response to the H5 HA protein, a correlation not observed for NP-specific responses. Conclusions. These findings suggest that prepandemic vaccination results in an enriched population of HA-specific CD4+ T cells that are recruited on rechallenge with a drifted vaccine variant and contribute to more robust and more rapid neutralizing antibody responses.
Mass screening and treatment on the basis of results of a Plasmodium falciparum-specific rapid diagnostic test did not reduce malaria incidence in Zanzibar.

BACKGROUND Seasonal increases in malaria continue in hot spots in Zanzibar. Mass screening and treatment (MSAT) may help reduce the reservoir of infection; however, it is unclear whether rapid diagnostic tests (RDTs) detect a sufficient proportion of low-density infections to influence subsequent transmission. METHODS Two rounds of MSAT using Plasmodium falciparum-specific RDT were conducted in 5 hot spots (population, 12 000) in Zanzibar in 2012. In parallel, blood samples were collected on filter paper for polymerase chain reaction (PCR) analyses. Data on confirmed malarial parasite infections from health facilities in intervention and hot spot control areas were monitored as proxy for malaria transmission. RESULTS Approximately 64% of the population (7859) were screened at least once. P. falciparum prevalence, as measured by RDT, was 0.2% (95% confidence interval [CI], .1%-.3%) in both rounds, compared with PCR measured prevalences (for all species) of 2.5% (95% CI, 2.1%-2.9%) and 3.8% (95% CI, 3.2%-4.4%) in rounds 1 and 2, respectively. Two fifths (40%) of infections detected by PCR included non-falciparum species. Treatment of RDT-positive individuals (4% of the PCR-detected parasite carriers) did not reduce subsequent malaria incidence, compared with control areas. CONCLUSIONS Highly sensitive point-of-care diagnostic tools for detection of all human malaria species are needed to make MSAT an effective strategy in settings where malaria elimination programs are in the pre-elimination phase.
Access to quality postgraduate education through distance education in Ethiopia

This paper examines the role of cross-border distance education institutions in providing access to quality postgraduate education in Ethiopia, using the Indira Gandhi National Open University (IGNOU) as a case study. It draws on the development of distance education and it further explores the potential of a distance education programme delivery system in an Ethiopian context. In addition, the study explores the policy gap between conventional and distance education in relation to international postgraduate distance education. Two instruments were used to gather relevant data, namely: interviews and document analysis. Three quality indicators, coherence, efficiency and the impact of distance education, were used as tools of analysis. DOI: 10.5901/jesr.2015. v5n1p159
A product of RpfB and RipA joint enzymatic action promotes the resuscitation of dormant mycobacteria

Resuscitation‐promoting factor proteins (Rpfs) are known to participate in reactivating the dormant forms of actinobacteria. Structural analysis of the Rpf catalytic domain demonstrates its similarity to lysozyme and to lytic transglycosylases – the groups of enzymes that cleave the β‐1,4‐glycosidic bond between N‐acetylmuramic acid (MurNAc) and GlcNAc, and concomitantly form a 1,6‐anhydro ring at the MurNAc residue. Analysis of the products formed from mycobacterial peptidoglycan hydrolysis reactions containing a mixture of RpfB and resuscitation‐promoting factor interacting protein (RipA) allowed us to identify the suggested product of their action – N‐acetylglucosaminyl‐β(1→4)‐N‐glycolyl‐1,6‐anhydromuramyl‐l‐alanyl‐d‐isoglutamate. To identify the role of this resulting product in resuscitation, we used a synthetic 1,6‐anhydrodisaccharide‐dipeptide, and tested its ability to stimulate resuscitation by using the dormant Mycobacterium smegmatis model. It was found that the disaccharide‐dipeptide was the minimal structure capable of resuscitating the dormant mycobacterial cells over the concentration range of 9–100 ng·mL−1. The current study therefore provides the first insights into the molecular mechanism of resuscitation from dormancy involving a product of RpfB/RipA‐mediated peptidoglycan cleavage.
Rigidity versus flexibility: the dilemma of understanding protein thermal stability

The role of fluctuations in protein thermostability has recently received considerable attention. In the current literature a dualistic picture can be found: thermostability seems to be associated with enhanced rigidity of the protein scaffold in parallel with the reduction of flexible parts of the structure. In contradiction to such arguments it has been shown by experimental studies and computer simulation that thermal tolerance of a protein is not necessarily correlated with the suppression of internal fluctuations and mobility. Both concepts, rigidity and flexibility, are derived from mechanical engineering and represent temporally insensitive features describing static properties, neglecting that relative motion at certain time scales is possible in structurally stable regions of a protein. This suggests that a strict separation of rigid and flexible parts of a protein molecule does not describe the reality correctly. In this work the concepts of mobility/flexibility versus rigidity will be critically reconsidered by taking into account molecular dynamics calculations of heat capacity and conformational entropy, salt bridge networks, electrostatic interactions in folded and unfolded states, and the emerging picture of protein thermostability in view of recently developed network theories. Last, but not least, the influence of high temperature on the active site and activity of enzymes will be considered.
2006 National report (2005 data) to the EMCDDA by the Reitox National Focal Point: Norway: new developments, trends and in-depth information on selected issues.

This is the fourth annual report to the EMCDDA from the Norwegian Institute for Alcohol and Drug Research (SIRUS) on the drugs situation in Norway. The report has been drawn up in accordance with the new reporting guidelines introduced by the EMCDDA this year. We have endeavoured to follow these as consistently as possible, with the main focus on “new developments” and substantial changes in epidemiology, legislation and organisation. To allow readers to obtain more background information the report contains a number of references to the national report for 2003, and occasional references to the report for 2002.
Structural insights into N‐terminal to C‐terminal interactions and implications for thermostability of a (β/α)8‐triosephosphate isomerase barrel enzyme

Although several factors have been suggested to contribute to thermostability, the stabilization strategies used by proteins are still enigmatic. Studies on a recombinant xylanase from Bacilllus sp. NG‐27 (RBSX), which has the ubiquitous (β/α)8‐triosephosphate isomerase barrel fold, showed that just a single mutation, V1L, although not located in any secondary structural element, markedly enhanced the stability from 70 °C to 75 °C without loss of catalytic activity. Conversely, the V1A mutation at the same position decreased the stability of the enzyme from 70 °C to 68 °C. To gain structural insights into how a single extreme N‐terminus mutation can markedly influence the thermostability of the enzyme, we determined the crystal structure of RBSX and the two mutants. On the basis of computational analysis of their crystal structures, including residue interaction networks, we established a link between N‐terminal to C‐terminal contacts and RBSX thermostability. Our study reveals that augmenting N‐terminal to C‐terminal noncovalent interactions is associated with enhancement of the stability of the enzyme. In addition, we discuss several lines of evidence supporting a connection between N‐terminal to C‐terminal noncovalent interactions and protein stability in different proteins. We propose that the strategy of mutations at the termini could be exploited with a view to modulate stability without compromising enzymatic activity, or in general, protein function in diverse folds where N and C termini are in close proximity.
Parallel Epidemics of Community-Associated Methicillin-Resistant Staphylococcus aureus USA300 Infection in North and South America.

BACKGROUND The community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) epidemic in the United States is attributed to the spread of the USA300 clone. An epidemic of CA-MRSA closely related to USA300 has occurred in northern South America (USA300 Latin-American variant, USA300-LV). Using phylogenomic analysis, we aimed to understand the relationships between these 2 epidemics. METHODS We sequenced the genomes of 51 MRSA clinical isolates collected between 1999 and 2012 from the United States, Colombia, Venezuela, and Ecuador. Phylogenetic analysis was used to infer the relationships and times since the divergence of the major clades. RESULTS Phylogenetic analyses revealed 2 dominant clades that segregated by geographical region, had a putative common ancestor in 1975, and originated in 1989, in North America, and in 1985, in South America. Emergence of these parallel epidemics coincides with the independent acquisition of the arginine catabolic mobile element (ACME) in North American isolates and a novel copper and mercury resistance (COMER) mobile element in South American isolates. CONCLUSIONS Our results reveal the existence of 2 parallel USA300 epidemics that shared a recent common ancestor. The simultaneous rapid dissemination of these 2 epidemic clades suggests the presence of shared, potentially convergent adaptations that enhance fitness and ability to spread.
Business fundamentals for the rehabilitation professional

The world of business is ever changing, with much of the available information becoming quickly out-of-date. "Business Fundamentals for the Rehabilitation Professional, Second Edition" keeps pace with this changing world and provides the health care professional with the latest information to answer the 'what, where, how, and when' questions that come up when transforming a health care practice idea into a successful business. With this updated Second Edition, Tammy Richmond and Dave Powers take the health care professional to the next level of implementing successful business operations by the introduction of applications of management principles, as well as implementation of evidence-based practice guidelines and basics to billing and coding documentation. "Business Fundamentals for the Rehabilitation Professional, Second Edition" addresses how to identify emerging business opportunities, legal and health care regulatory issues, market research and development, and health care operations. New features in the second edition include: new management and operations checklist; an in-depth look at reimbursement, billing, and financial survival; strategic target market promotions; updated templates and tools; review questions; and downloadable worksheets available with text purchase. Keeping the user-friendly format of a workbook, "Business Fundamentals for the Rehabilitation Professional, Second Edition" is the perfect resource for master and doctorate level students preparing for the professional world, as well as rehabilitation professionals and entrepreneurs interested in obtaining knowledge in starting up, managing, expanding, or understanding the health care practice system. Readers will learn: how to create a vision and mission statement; how to develop a business and marketing plan; how to manage finances within the scope of the practice; what are your local state and federal regulations; and what are the small business guidelines.
Unravelling gene interactions to find the cause of artherosclerosis, a multigenic disease, using an artificial neural network

To understand the etiology of multigenic diseases like atherosclerosis, a polymerase chain reaction (PCR) based gene array containing 65 single nucleotide polymorphisms (SNPs) was analyzed. To asses the possibilities of pattern recognition techniques in detecting unfavorable genetic combinations, two approaches were analysed. A selection of these 65 SNPs formed the input both to binary logistic regression models and to self-learning artificial neural networks (ANNs). Repeated analyses showed that both methods performed equally well. Further research to improve the differentiating power of both methods should focus first on decreasing the number of otherwise indeterminable polymorphisms.
Information literacy as a social phenomenon in the nursing environment

In the field of health sciences, information literacy (IL) has become a universal educational outcome (Barnard et al. 2005). There is a great interest in health information and it is proactively sought because people are faced with questions about health in almost every aspect of their lives. There also is an increasing demand for information matched by an increasing choice in services and treatments. Bearing these factors in mind, it is no surprise that many people are unsure of which advice to follow and what treatments or products may be beneficial to them (Kickbusch 2008, 101-102).
Enabling cell–cell communication via nanopore formation: structure, function and localization of the unique cell wall amidase AmiC2 of Nostoc punctiforme

To orchestrate a complex life style in changing environments, the filamentous cyanobacterium Nostoc punctiforme facilitates communication between neighboring cells through septal junction complexes. This is achieved by nanopores that perforate the peptidoglycan (PGN) layer and traverse the cell septa. The N‐acetylmuramoyl‐l‐alanine amidase AmiC2 (Npun_F1846; EC 3.5.1.28) in N. punctiforme generates arrays of such nanopores in the septal PGN, in contrast to homologous amidases that mediate daughter cell separation after cell division in unicellular bacteria. Nanopore formation is therefore a novel property of AmiC homologs. Immunofluorescence shows that native AmiC2 localizes to the maturing septum. The high‐resolution crystal structure (1.12 Å) of its catalytic domain (AmiC2‐cat) differs significantly from known structures of cell splitting and PGN recycling amidases. A wide and shallow binding cavity allows easy access of the substrate to the active site, which harbors an essential zinc ion. AmiC2‐cat exhibits strong hydrolytic activity in vitro. A single point mutation of a conserved glutamate near the zinc ion results in total loss of activity, whereas zinc removal leads to instability of AmiC2‐cat. An inhibitory α‐helix, as found in the Escherichia coli AmiCE. coli structure, is absent. Taken together, our data provide insight into the cell‐biological, biochemical and structural properties of an unusual cell wall lytic enzyme that generates nanopores for cell–cell communication in multicellular cyanobacteria. The novel structural features of the catalytic domain and the unique biological function of AmiC2 hint at mechanisms of action and regulation that are distinct from other amidases.
Incident Detection of High-Risk Human Papillomavirus Infections in a Cohort of High-Risk Women Aged 25-65 Years.

BACKGROUND The risk of incident high-risk human papillomavirus (HR-HPV) infection associated with recent sexual behaviors is undefined in mid-adult women (defined as women aged 25-65 years). METHODS Triannually, 420 female online daters aged 25-65 years submitted vaginal specimens for HPV testing and completed health and sexual behavior questionnaires. The cumulative incidence of and risk factors for incident HR-HPV detection were estimated by Kaplan-Meier and Cox proportional hazards methods. RESULTS The 12-month cumulative incidence of HR-HPV detection was 25.4% (95% confidence interval [CI], 21.3%-30.1%). Current hormonal contraceptive use was positively associated with incident HR-HPV detection. Lifetime number of male sex partners was also positively associated but only among women not recently sexually active with male partners. In analysis that adjusted for hormonal contraceptive use and marital status, women reporting multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership had a hazard of incident HR-HPV detection that was 2.81 times (95% CI, 1.38-5.69 times) that for women who reported no male sex partners in the past 6 months. Thus, among women with multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership, approximately 64% of incident HR-HPV infections were attributable to one of those partners. CONCLUSIONS Among high-risk mid-adult women with recent new male partners, multiple male partners, or male partners who were casual or had ≥1 concurrent partnership, about two thirds of incident HR-HPV detections are likely new acquisitions, whereas about one third of cases are likely redetections of prior infections.
A Longitudinal Hepatitis B Vaccine Cohort Demonstrates Long-lasting Hepatitis B Virus (HBV) Cellular Immunity Despite Loss of Antibody Against HBV Surface Antigen.

BACKGROUND Long-lasting protection resulting from hepatitis B vaccine, despite loss of antibody against hepatitis B virus (HBV) surface antigen (anti-HBs), is undetermined. METHODS We recruited persons from a cohort vaccinated with plasma-derived hepatitis B vaccine in 1981 who have been followed periodically since. We performed serological testing for anti-HBs and microRNA-155 and assessed HBV-specific T-cell responses by enzyme-linked immunospot and cytometric bead array. Study subgroups were defined 32 years after vaccination as having an anti-HBs level of either ≥10 mIU/mL (group 1; n = 13) or <10 mIU/mL (group 2; n = 31). RESULTS All 44 participants, regardless of anti-HBs level, tested positive for tumor necrosis factor α, interleukin 10, or interleukin 6 production by HBV surface antigen-specific T cells. The frequency of natural killer T cells correlated with the level of anti-HBs (P = .008). The proportion of participants who demonstrated T-cell responses to HBV core antigen varied among the cytokines measured, suggesting some natural exposure to HBV in the study group. No participant had evidence of breakthrough HBV infection. CONCLUSIONS Evidence of long-lasting cellular immunity, regardless of anti-HBs level, suggests that protection afforded by primary immunization with plasma-derived hepatitis B vaccine during childhood and adulthood lasts at least 32 years.
The crystal structure of the ligand‐binding region of serine‐glutamate repeat containing protein A (SgrA) of Enterococcus faecium reveals a new protein fold: functional characterization and insights into its adhesion function

Antimicrobial‐resistant and hospital‐adapted Enterococcus faecium represents a clinical problem in immunocompromised patients in hospitals worldwide. Understanding the molecular pathogenesis of E. faecium infections may provide novel therapies to treat or prevent infections. A potential target for novel treatment therapies is the serine‐glutamate repeat containing protein A (SgrA), which is a cell wall‐anchored LPxTG surface protein implicated in binding to fibrinogen and nidogen. Here, we report the X‐ray crystal structure of the N‐terminal ligand‐binding domain of SgrA (rSgrA28–153) to a resolution of 1.79 Å. The structure revealed a new protein fold with significant differences from previously characterized DEv‐IgG‐ and inv‐IgG‐like folds of adhesive proteins known as microbial surface components recognizing adhesive matrix molecules. The structure contains a Lys–Asn–Glu triad with the potential to form a Lys–Asn isopeptide bond. However, even in the absence of a stabilizing intramolecular isopeptide bond, rSgrA28–153 exhibits remarkable properties like resistance to proteases and high thermal stability. The interaction of rSgrA28–153 with fibrinogen, nidogen, laminin, and abiotic surfaces has been characterized and rSgrA28–153 binds to these molecules with high affinity. rSgrA28–153 also binds to the beta chain of fibrinogen and with high affinity and specificity. Strikingly, the presence of 29 surface‐exposed hydrophobic amino acid residues likely play an important role in the selectivity of rSgrA28–153 to bind to different abiotic surfaces. The results obtained from this study have opened new avenues to explore and understand the role of this unique surface adhesin in the pathogenesis of catheter‐related infections.