Encapsulation in an alginate–goats’ milk–inulin matrix improves survival of probiotic Bifidobacterium in simulated gastrointestinal conditions and goats’ milk yoghurt

In this work, a new encapsulating matrix, alginate–goats’ milk–inulin, was used to encapsulate Bifidobacterium animalis subsp. lactis BB‐12. The addition of inulin resulted in capsules with a compact structure, and a higher probiotic cell count under simulated gastrointestinal conditions and in probiotic goats’ milk yoghurt during refrigerated storage. Encapsulation of the probiotic bacteria led to slower post‐acidification yoghurts. The results of this study showed that the alginate–goats’ milk–inulin matrix has potential to be used as a new encapsulation material to encapsulate probiotics for use in goats’ milk‐based probiotic fermented dairy products, avoiding the cross‐contamination caused by using capsules based on cows’ milk

Prevalence, severity and impacts of breathlessness in Indian adults: An exploratory, nationally representative, cross-sectional online survey

There are no known estimates of the prevalence, severity and impacts from breathlessness in low- and middle-income countries. This study aimed to explore the prevalence, severity, self-attributed underlying conditions and impacts of breathlessness limiting exertion in community-dwelling adults in India. This exploratory, population-based online survey recruited a pre-planned sample of 3,000 adult respondents stratified by age, sex and rurality (quotas as per the 2011 Indian National Census). Measures included: demographics; breathlessness limiting exertion (modified Medical Research [mMRC] scale); health-related quality of life (EQ-5D-5L); and disability (World Health Organisation’s Disability Assessment Schedule 2.0 12-item questionnaire [WHODAS-12]). Respondents (n = 3,046) had a mean age of 38 years (SD 15); 57% were male, 59% lived in rural areas and 33% had completed 12th grade. Breathlessness limiting exertion (mMRC ≥1) was reported by 44%, mostly attributed to poor nutrition (28%), lung conditions excluding tuberculosis (17%) or anaemia (13%). Compared to those without breathlessness, a higher proportion of people with breathlessness (mMRC ≥1) reported problems across all EQ-5D-5L dimensions. Most people reporting breathlessness (81%) indicated the symptom had adversely affected their normal activities. Disability scores (WHODAS-12 total and individual domains) increased as breathlessness worsened. To conclude, in India, conservative estimates indicate 626 million people live with breathlessness of whom 52 million people live with severe breathlessness. The symptom is associated with poorer health-related quality of life and marked disability, including reduced ability to perform daily activities

India Breathlessness Survey and 2011 Census of India Populations and variables used to create a sample weight.

India Breathlessness Survey and 2011 Census of India Populations and variables used to create a sample weight.</p

Mean (SD) and median (IQR) of the World Health Organisation Disability Assessment Schedule 2.0 12-item (WHODAS-12) and its individual domains and breathlessness measured on the modified Medical Research Council (mMRC) breathlessness scale for 3,046 respondents to an online survey in India [unweighted data].

Mean (SD) and median (IQR) of the World Health Organisation Disability Assessment Schedule 2.0 12-item (WHODAS-12) and its individual domains and breathlessness measured on the modified Medical Research Council (mMRC) breathlessness scale for 3,046 respondents to an online survey in India [unweighted data].</p

Proportion of moderate-to-extreme problems by quality of life (EQ-5D-5L) dimensions and level of breathlessness (modified Medical Research [mMRC] breathlessness scale) reported by 3,046 community-dwelling adults in an online survey for India [weighted data].

Proportion of moderate-to-extreme problems by quality of life (EQ-5D-5L) dimensions and level of breathlessness (modified Medical Research [mMRC] breathlessness scale) reported by 3,046 community-dwelling adults in an online survey for India [weighted data].</p

Quality of Life (EQ-5D-5L) by level of breathlessness (measured on the modified Medical Research Council [mMRC] breathlessness scale) for 3,046 respondents to an online survey in India [unweighted data].

Quality of Life (EQ-5D-5L) by level of breathlessness (measured on the modified Medical Research Council [mMRC] breathlessness scale) for 3,046 respondents to an online survey in India [unweighted data].</p

Inclusivity in global research form.

There are no known estimates of the prevalence, severity and impacts from breathlessness in low- and middle-income countries. This study aimed to explore the prevalence, severity, self-attributed underlying conditions and impacts of breathlessness limiting exertion in community-dwelling adults in India. This exploratory, population-based online survey recruited a pre-planned sample of 3,000 adult respondents stratified by age, sex and rurality (quotas as per the 2011 Indian National Census). Measures included: demographics; breathlessness limiting exertion (modified Medical Research [mMRC] scale); health-related quality of life (EQ-5D-5L); and disability (World Health Organisation’s Disability Assessment Schedule 2.0 12-item questionnaire [WHODAS-12]). Respondents (n = 3,046) had a mean age of 38 years (SD 15); 57% were male, 59% lived in rural areas and 33% had completed 12th grade. Breathlessness limiting exertion (mMRC ≥1) was reported by 44%, mostly attributed to poor nutrition (28%), lung conditions excluding tuberculosis (17%) or anaemia (13%). Compared to those without breathlessness, a higher proportion of people with breathlessness (mMRC ≥1) reported problems across all EQ-5D-5L dimensions. Most people reporting breathlessness (81%) indicated the symptom had adversely affected their normal activities. Disability scores (WHODAS-12 total and individual domains) increased as breathlessness worsened. To conclude, in India, conservative estimates indicate 626 million people live with breathlessness of whom 52 million people live with severe breathlessness. The symptom is associated with poorer health-related quality of life and marked disability, including reduced ability to perform daily activities.</div

Impact of breathlessness measured on the modified Medical Research Council (mMRC ≥1; n = 1,351) on respondents’ everyday activities reported in an online survey for India [unweighted data].

Impact of breathlessness measured on the modified Medical Research Council (mMRC ≥1; n = 1,351) on respondents’ everyday activities reported in an online survey for India [unweighted data].</p