Immunomodulation and Generation of Tolerogenic Dendritic Cells by Probiotic Bacteria in Patients with Inflammatory Bowel Disease

In inflammatory bowel diseases (IBD), the therapeutic benefit and mucosal healing from specific probiotics may relate to the modulation of dendritic cells (DCs). Herein, we assessed the immunomodulatory effects of four probiotic strains including Lactobacillus salivarius, Bifidobacterium bifidum, Bacillus coagulans and Bacillus subtilis natto on the expression of co-stimulatory molecules, cytokine production and gene expression of signal-transducing receptors in DCs from IBD patients. Human monocyte-derived DCs from IBD patients and healthy controls were exposed to four probiotic strains. The expression of co-stimulatory molecules was assessed and supernatants were analyzed for anti-inflammatory cytokines. The gene expression of toll-like receptors (TLRs), IL-12p40 and integrin \u3b1v\u3b28 were also analyzed. CD80 and CD86 were induced by most probiotic strains in ulcerative colitis (UC) patients whereas only B. bifidum induced CD80 and CD86 expression in Crohn's disease (CD) patients. IL-10 and TGF-\u3b2 production was increased in a dose-independent manner while TLR expression was decreased by all probiotic bacteria except B. bifidum in DCs from UC patients. TLR-4 and TLR-9 expression was significantly downregulated while integrin f8 was significantly increased in the DCs from CD patients. IL-12p40 expression was only significantly downregulated in DCs from CD patients. Our findings point to the general beneficial effects of probiotics in DC immunomodulation and indicate that probiotic bacteria favorably modulate the expression of co-stimulatory molecules, proinflammatory cytokines and TLRs in DCs from IBD patients

A clinical competence approach to examine British and Finnish nurses' attitudes towards the rapid response system model: A study in two acute hospitals

Supplementary data are available online at: https://www.australiancriticalcare.com/article/S1036-7314(21)00039-4/fulltext#supplementary-material .Background: Nurses' clinical competence involves an integration of knowledge, skills, attitudes, thinking ability, and values, which strongly affects how deteriorating patients are managed. Objectives: The aim of the study was to examine nurses' attitudes as part of clinical competence towards the rapid response system in two acute hospitals with different rapid response system models. Methods: This is a comparative cross-sectional correlational study. A modified “Nurses' Attitudes Towards the Medical Emergency Team” tool was distributed among 388 medical and surgical registered nurses in one acute hospital in the UK and one in Finland. A total of 179 nurses responded. Statistical analyses, including exploratory factor analysis, Mann–Whitney U tests, Kruskal–Wallis tests, chi-square tests, and univariate and multivariate regression analyses, were used. Findings: Generally, nurses had positive attitudes towards rapid response systems. British and Finnish nurses' attitudes towards rapid response system activation were divided when asked about facing a stable (normal vital signs) but worrisome patient. Finnish nurses relied more on intuition and were more likely to activate the rapid response system. Approximately half of the nurses perceived the physician's influence as a barrier to rapid response system activation. The only sociodemographic factor that was associated with nurses activating the rapid response system more freely was work experience ≥10 years. Conclusions: The findings are beneficial in raising awareness of nurses' attitudes and identifying attitudes that could act as facilitators or barriers in rapid response system activation. The study suggests that nurses' attitudes towards physician influence and intuition need to be improved through continuing development of clinical competence. When the system model included “worrisome” as one of the defined parameters for activation, nurses were more likely to activate the rapid response system. Future rapid response system models may need to have clear evidence-based instructions for nurses when they manage stable (normal vital signs) but worrisome patients and should acknowledge nurses’ intuition and clinical judgement.This work was supported by the Doctoral Position at the University of Eastern Finland (2019), Finnish Cultural Foundation North Savo region Funds (2017–2018), the Finnish Nursing Education Foundation (2016), the Otto A.Malm Donations Funds (2016), University of Eastern Finland, Department of Nursing Science (2016), and the Marja-Terttu Korhonen's Fund (2016)

Identifying teamwork-related needs of the medical emergency team: Nurses' perspectives

© 2021 The Authors. Background The role of medical emergency team (MET) in managing deteriorating patients and enhancing patient safety is greatly affected by teamwork. Aims To identify teamwork-related needs of the MET from MET nurses' perspectives. To assess the associations between MET nurses' perceptions of teamwork and their work experience and education. Study design A quantitative, descriptive correlational design. Methods Registered intensive care unit (ICU) nurses (n = 50) who were members of the MET in an acute tertiary care hospital answered a modified version of the team assessment questionnaire in 2017. Data were analysed using descriptive statistics, the Kruskal-Wallis test, and the univariate analysis of variance method. The reporting of this study adheres to the strengthening the reporting of observational studies (STROBE) guidelines. Results Participants showed least agreement with the items presenting leadership skills (mean = 2.6, SD = 0.68). Approximately 50% nurses disagreed that the MET had adequate resources, training, and skills. The majority of nurses (80%) felt that their responsibilities as a MET member interfered with taking care of their own ICU patients. Many nurses (64%) felt that they did not have a voice in MET's decision-making process. Approximately 50% nurses felt that they were not recognized for their individual contribution, and they were uncertain regarding MET's policies for dealing with conflicts. The amounts of MET nurses' work experience and education were associated with MET skills and function, respectively. Conclusion Key teamwork elements of the MET that need improvements include decision-making and conflict resolution skills, valuing team members, and team leadership. Practicing shared mental models, implementing the TeamSTEPPS curricula at hospitals for training ICU nurses, and simulation-based team-training programmes may be beneficial in improving teamwork of MET members. Relevance to clinical practice This study revealed key teamwork elements of the MET that need improvements. Our findings may contribute to improve teamwork, thereby optimizing MET function, and enhancing patient outcomes.Finnish Cultural Foundation North Savo region Funds. Grant Numbers: 2017, 2018; Finnish Nursing Education Foundation. Grant Number: 2016; Marja-Terttu Korhonen's Fund; Otto A. Malm Donations Funds; University of Eastern Finland. Grant Number: 201

British and Finnish nurses’ attitudes, practice, and knowledge on deteriorating patient in-service education: A study in two acute hospitals

Supplementary material is available online at: https://www.sciencedirect.com/science/article/pii/S1471595321001293?via%3Dihub#sec0190 .Aim: The aim was to assess both nurses’ attitudes about in-service education, and the impact had by attending in-service education on nurses’ management and knowledge of deteriorating patients. Background: In-service education cannot reach its best potential outcomes without strong leadership. Nurse managers are in a position of adopting leadership styles and creating conditions for enhancing the in-service education outcomes. Design: We conducted a comparative cross-sectional study between British and Finnish nurses (N = 180; United Kingdom: n = 86; Finland: n = 94). Methods: A modified “Rapid Response Team Survey” was used in data collection. A sample of medical and surgical registered nurses were recruited from acute care hospitals. Self-reporting, self-reflection, and case-scenarios were used to assess nurses’ attitudes, practice, and knowledge. Data were analyzed by Mann-Whitney-U and Chi-square tests. Results: Nurses’ views on education programs were positive; however, low confidence, delays caused by hospital culture, and fear of criticism remained barriers to post education management of deteriorating patients. Nurses’ self-reflection on their management of deteriorating patients indicates that 20–25% of deteriorating patients are missed. Conclusion: Nurse managers should promote a no-blame culture, mitigate unnecessary hospital culture and routines, and facilitate in-service education focusing on identification and management of deteriorating patients, simultaneously improving nurses’ confidence.This work was supported by the Doctoral Position at the University of Eastern Finland [2019], Finnish Cultural Foundation North Savo region Funds [2017,2018]; the Finnish Nursing Education Foundation [2016]; the Otto A.Malm Donations Funds [2016]; University of Eastern Finland, Department of Nursing Science [2016], and the Marja-Terttu Korhonen's Fund [2016]

The effect of intestinal microbiota metabolites on HT29 cell line using MTT method in patients with colorectal cancer

Aim: The aim of this study was to evaluate the effect of intestinal microbiota metabolites in colorectal cancer patients on HT29 cell line using MTT assay. Background: Colorectal cancer is one of the most common malignant tumors. Human guts harbor abundant microbes that adjust many aspects of the host physiology. Increasing studies suggest that gut microbiota play a significant role in the incidence and expansion of CRC, as a result of virulence factors, bacterial metabolites, or inflammatory pathways. Methods: In this cross-sectional study, 60 biopsy samples including 30 cancerous and 30 adjacent healthy tissues were collected from patients with CRC during 2017. Biopsy samples were first cultured on Thioglycollate broth medium for 24hr after which the microbiota metabolites were filtered and stored at -20 C degrees for further evaluation. HT29 cells were treated by microbiota metabolites at different times (3, 6, 12, 18h) and its viability was assessed by MTT assay. Results: The cells treated with microbiota metabolites showed increased viability and proliferation in time-dependent analysis by MTT assay, but there was not significant differences between the two groups. Conclusion: It seems that microbial metabolites are able to induce proliferation and increase cell viability and thus induce colorectal cancer

The rate and importance of Clostridium difficile in colorectal cancer patients

Aim: The aim of this study was to analyze the Clostridium difficile and their toxins in cancerous tissues in comparison to their adjacent healthy tissues in patients with colorectal cancer (CRC) in Iran. Background: Intestinal infection or colonization by microbial pathogens and their released metabolites may have a role in the exacerbation of CRC. Methods: A total of 60 biopsy samples from 30 cancerous and 30 adjacent healthy tissues were collected from patients with CRC. Biopsies were homogenized and cultured in cycloserine cefoxitin fructose agar-agar medium to investigate the presence of C. difficile. DNA was extracted, PCR was performed on pure colonies for bacteria detection, and toxin genes were evaluated in each bacterium positive cases. Real-time PCR was performed on extracted DNA for quantitative comparison of Clostridium difficile in healthy and tumor tissues in CRC patients. Results: Clostridium difficile was isolated from 18 of the cancerous tissue (60) and 6 of their healthy adjacent tissue (20) in the culture medium, but toxin genes were positive just in one sample in both groups. Real-time PCR showed the colonization in all samples. Conclusion: This study showed a higher prevalence of Clostridium difficile in cancerous lesions in comparison to healthy tissues. We suggest that the investigation of the rate of CD of colorectal cancer patients before surgery is critical for patients. Further studies with more samples size to study the importance of this bacterium and its toxins in the investigation of colorectal cancer patients survey is recommended

MPTP-Treated Zebrafish Recapitulate ‘Late-Stage’ Parkinson’s-like Cognitive Decline

The zebrafish is a promising model species in biomedical research, including neurotoxicology and neuroactive drug screening. 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) evokes degeneration of dopaminergic neurons and is commonly used to model Parkinson’s disease (PD) in laboratory animals, including zebrafish. However, cognitive phenotypes in MPTP-evoked experimental PD models remain poorly understood. Here, we established an LD50 (292 mg/kg) for intraperitoneal MPTP administration in adult zebrafish, and report impaired spatial working memory (poorer spontaneous alternation in the Y-maze) in a PD model utilizing fish treated with 200 µg of this agent. In addition to conventional behavioral analyses, we also employed artificial intelligence (AI)-based approaches to independently and without bias characterize MPTP effects on zebrafish behavior during the Y-maze test. These analyses yielded a distinct cluster for 200-µg MPTP (vs. other) groups, suggesting that high-dose MPTP produced distinct, computationally detectable patterns of zebrafish swimming. Collectively, these findings support MPTP treatment in adult zebrafish as a late-stage experimental PD model with overt cognitive phenotypes. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Funding: The experiments were implemented using the equipment and unique scientific installation “Biological collection–Genetic biomodels of neuropsychiatric disorders” (No. 493387) of the Federal State Budgetary Scientific Institution “Scientific Research Institute of Neurosciences and Medicine” theme no. AAAA-A21-121011990039-2 (2021–2025). The study partially used the facilities and equipment of the Resource Fund of Applied Genetics MIPT (support grant 075-15-2021-684)

Experimental Endometriosis: Review of the Literature Through a Century and the Iranian Experience

Although endometriosis is not a newly discovered disease, it has still remained enigmatic. Understanding the pathophysiology of this disease is still one of the challenges of gynecology and reproductive medicine. Therefore, the subject of endometriosis treatment faces many questions to be answered. Even though this is not considered to be a rare disease, testing novel treatments on subjects is definitely contrary to medical ethics. This is where importance of animal studies is emphasized. History of animal studies on endometriosis dates back to the time when the young John Sampson presented his theory of retrograde flow of menstruation to the gynecologic society of his time to explain the mechanism of endometriosis. However, most of the medical society of that time favored metaplasia as the main mechanism over the new theory. In order to prove Sampson’s theory, animal models were used to induce endometriosis, and that was the first study of experimental endometriosis. Nowadays, although no one uses animals to evaluate Sampson theory of endometriosis, however, experimental endometriosis is widely used to study many different aspects of the disease from pathogenesis to possible options for treatments. Also, since then, various animals and different techniques have been proposed and so there is a huge body of literature on experimental endometriosis. Contrary to many countries, Iranian medical societies have neglected animal models for endometriosis until recently. This review article aims to go through the prominent articles on the subject and introduce different animals and methods to its readers and have a special look at Iranian literature on experimental endometriosis.published versionpeerReviewe