bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic or therapeutic administration of Holarrhena floribunda hydro ethanol extract suppresses Complete Freund’s Adjuvant-induced arthritis in Sprague-Dawley rats&nbsp;&nbsp;&nbsp;&nbsp;
Authors: Antwi Stephen , Oduro-Mensah Daniel , Obiri David Darko , Lewis Clara , Oduro-Mensah Ebenezer , Ocloo Augustine , Okine Laud 
Published: December 2020

Abstract
Ethnopharmacological relevance In Ghanaian folk medicine, Holarrhena floribunda has anecdotal use for the treatment of inflammatory conditions. A hydro ethanol extract of the stem bark has previously been shown to be effective in the management of acute inflammation and anaphylaxis in rodents.Aim of the study This study was aimed at evaluating the usefulness of H. floribunda stem bark hydro ethanol extract (HFE) for the management of chronic inflammation in a murine model.Materials and Methods Anti-arthritic effect of the extract was evaluated using Complete Freund’s Adjuvant-induced arthritis in male Sprague-Dawley rats. Using both prophylactic and therapeutic treatment models, parameters assessed included oedema, serology of inflammatory response, radiology, bone tissue histology and haematology. Data were analysed by ANOVA followed by Tukey’s multiple comparisons post hoc test.Results HFE at 50–500 mg/kg dose-dependently [P ≥ 0.0354 (prophylactic) and P ≥ 0.0001 (therapeutic)] inhibited swelling of the injected paw upon prophylactic [≤ 81.26 % (P < 0.0001)] or therapeutic [≤ 67.92 % (P < 0.01)] administration — and prevented spread of arthritis to the contralateral paw. Inflammation alleviation activity of HFE was further demonstrated by decrease in arthritis score, radiologic score and erythrocyte sedimentation rate. HFE at all doses significantly reduced serum IL-1α (P < 0.0197), and 500 mg/kg HFE reduced serum IL-6 (P = 0.0032). In contrast, serum concentrations of IL-10, protein kinase A and cyclic adenosine monophosphate were enhanced (P ≤ 0.0436). HFE consistently showed better prophylactic activity than when administered therapeutically.Conclusions The data demonstrate that HFE suppresses CFA-induced arthritis and modulates regulators of inflammation; including IL-1α, -6 and -10 which also play mediatory roles in several immune response pathways. These make HFE a strong candidate for development as an agent for management and modulation of inflammation and the inflammatory response, including immune response-related adverse events such as seen in severe COVID-19.
Building Community and Medical School Partnerships: Impact on Undergraduate Medical Education and Research
Authors: Nauhria Samal , Derksen Irene , Nauhria Shreya , Basu Amitabha 
Published: December 2020

Abstract
Background: Community service provides avenues for social learning in medical education. Partnerships between medical schools and local healthcare agencies has paved the path for an active participation of a medical student in the community. This seems to have a positive impact on the medical knowledge and skills of students and also leads to a betterment of healthcare services for the community. National accreditation agencies and medical boards have emphasized that medical schools should provide opportunities for such learning to occur in the medical school curriculum. Various medical schools around the globe have adopted this active learning pedagogy and thus we wanted to explore how we can establish such a learning framework at out university.Methods: This was a qualitative study based on feedback from volunteer students who attended the annual health fare conducted in collaboration with local healthcare agencies. Two focus group interviews were recorded, transcribed and coded for thematic analyses.Results: Overall, the students enjoyed learning various clinical procedural skills. This activity was an opportunity to apply the medical knowledge learnt in classrooms. The students developed various competencies like communication skills, professionalism, team work and social responsibility. Prevalent health conditions discovered by the students included diabetes mellitus, hypertension and nutritional imbalance.Conclusions: This study explores how serving the community can bring about an educational change for a medical student. The community service framework promotes social learning, interprofessional education, peer learning and active learning amongst medical students.
Evidence for Use of Damage Control Surgery and Damage Control Interventions in Civilian Trauma Patients: A Systematic Review
Authors: Roberts Derek J. , Bobrovitz Niklas , Zygun David A. , Kirkpatrick Andrew W. , Ball Chad G. , Faris Peter D. , Stelfox Henry T. 
Published: December 2020

Abstract
Background: Although damage control (DC) surgery is widely assumed to reduce mortality in critically injured patients, survivors often suffer substantial morbidity, suggesting that it should only be used when indicated. The purpose of this systematic review was to determine which indications for DC have evidence that they are reliable and/or valid (and therefore in which clinical situations evidence supports use of DC or that DC improves outcomes).Methods: We searched 11 databases (1950-April 1, 2019) for studies that enrolled exclusively civilian trauma patients and reported data on the reliability (consistency of surgical decisions in a given clinical scenario) or content (surgeons would perform DC in that clinical scenario or the indication predicted use of DC in practice), construct (were associated with poor outcomes), or criterion (were associated with improved outcomes when DC was conducted instead of definitive surgery) validity for suggested indications for DC surgery or DC interventions. Results: Among 34,979 citations identified, we included 36 cohort studies and three cross-sectional surveys in the systematic review. Of the 59 unique indications for DC identified, 10 had evidence of content validity [e.g., a major abdominal vascular injury or a packed red blood cell (PRBC) exceeding the critical administration threshold], nine had evidence of construct validity (e.g., unstable patients with combined abdominal vascular and pancreas gunshot injuries or an iliac vessel injury and intraoperative acidosis), and six had evidence of criterion validity (e.g., penetrating trauma patients requiring >10 U PRBCs with an abdominal vascular and multiple abdominal visceral injuries or intraoperative hypothermia, acidosis, or coagulopathy). No studies evaluated the reliability of indications.Conclusions: Few indications for DC surgery or DC interventions have evidence supporting that they are reliable and/or valid. DC should be used with respect for the uncertainty regarding its effectiveness, and only in circumstances where definitive surgery cannot be entertained.
Implementing Healthy Food Environment Policies in New Zealand: Nine Years of Inaction.
Authors: Mackay Sally , Gerritsen Sarah , Sing Fiona , Vandevijvere Stefanie , Swinburn Boyd 
Published: December 2020

Abstract
Background: The INFORMAS Healthy Food Environment Policy Index (Food-EPI) was developed to evaluate the degree of implementation of widely recommended food environment policies by national governments against international best practice, and has been applied in New Zealand in 2014, 2017 and 2020. This paper outlines the 2020 Food-EPI process and compares policy implementation and recommendations with the 2014 and 2017 Food-EPI. Methods: In March-April 2020, a national panel of over 50 public health experts participated in Food-EPI. Experts rated the extent of implementation of 47 ‘good practice’ policy and infrastructure support indicators compared to international best practice, using an extensive evidence document verified by government officials. Experts then proposed and prioritised concrete actions needed to address the critical implementation gaps identified. Progress on policy implementation and recommendations made over the three Food-EPIs was compared. Results: In 2020, 60% of the indicators were rated as having ‘low’ or ‘very little if any’ implementation compared to international benchmarks; less progress than 2017 (47%) and similar to 2014 (61%). Of the nine priority actions proposed in 2014, there was only noticeable action on one (Health Star Ratings). The majority of actions were therefore proposed again in 2017 and 2020. In 2020 the proposed actions were broader, reflecting the need for multi-sectoral action to improve the food environment, and the need for a mandatory approach in all policy areas. Conclusions: There has been little to no progress in the past three terms of government (nine years) on the implementation of policies and infrastructure support for healthy food environments, with implementation overall regressing between 2017 and 2020. The proposed actions in 2020 have reflected a growing movement to locate nutrition within the wider context of planetary health and with recognition of the social determinants of health and nutrition, resulting in recommendations that will require the involvement of many Government entities to overcome the existing policy inertia. The increase in food insecurity due to Covid-19 lockdowns may provide the impetus to stimulate action on food polices.
An Assessment of the Implementation of the Re-structured Community Health Fund in Gairo District in Tanzania
Authors: Maluka Stephen , Asantemungu Raphael 
Published: December 2020

Abstract
While the government of Tanzania has been implementing community health fund (CHF) for more than two decades, the uptake of the scheme has been persistently low due to management and performance problems. As a response, from 2011 a new initiative was adopted that changed the overall structure, management and benefit packages of the CHF. This paper assesses the implementation of the newly re-structured CHF in Gairo District in Morogoro Region. This study employed a descriptive qualitative case study design using three types of data collection techniques, namely individual interviews (n=14), focus group discussions (n=4) and document review. A thematic approach was used to analyse the data. Findings show that the re-structured CHF has improved the pooling and provider payment mechanism compared to the old CHF. Benefit packages have been expanded to include referral services up to regional level. However, stakeholders, including community members, had negative perceptions of the restructured CHF owing to high annual premium rates, low incentive to enrolment officers, weak registration network and poor quality of health care services. In order to improve CHF performance and achieve universal health coverage, the central Government needs to invest more in the improvement of the quality of health care services, particularly availability of drugs and medical supplies. Additionally, the government should make CHF scheme compulsory to all members of the community who do not have alternative health insurance.
Molecular Epidemiology of Staphylococcus aureus in African Children from Rural and Urban Communities with Atopic Dermatitis
Authors: NDHLOVU Gillian , Abotsi Regina , Shittu Adebayo , Abdulgader Shima M , Jamrozy Dorota , Dupont Christopher , Mankahla Avumile , Nicol Mark , Hlela Carol , Levin Micheal , Lunjani Nonhlanhla , Dube Felix Sizwe 
Published: December 2020

Abstract
Background: Staphylococcus aureus has been associated with the exacerbation and severity of atopic dermatitis (AD). Studies have not investigated the colonisation dynamics of S. aureus lineages in African children with AD. We determined the prevalence and population structure of S. aureus in children with and without AD from rural and urban South African settings. Methods: We conducted a study of AD-affected and non-atopic AmaXhosa children from rural Umtata and urban Cape Town, South Africa. S. aureus was screened from skin and nasal specimens using microbiological culture, and S. aureus clonal lineages were determined by spa typing. Logistic regression analyses were employed to assess risk factors associated with S. aureus colonisation. Results: S. aureus colonisation was higher in cases compared to controls (60% vs. 21%, p=0.000) and when stratified for location (54% vs. 13%, p=0.000 and 70% vs. 35%, p=0.005 in Umtata and Cape Town, respectively). Severe AD was associated with higher colonisation compared with moderate AD (86% vs. 52%, p=0.022) among urban cases. Having AD was associated with colonisation in both rural (odds ratio [OR] 7.54, 95% CI 2.92–19.47) and urban (OR 4.2, 95% CI 1.57–11.2) children. In rural children, living in an electrified house that also uses gas (OR 4.08, 95% CI 1.59–10.44) or in a house that uses kerosene and paraffin (OR 2.88, 95% CI 1.22–6.77) for heating and cooking were associated with increased S. aureus colonisation, while exposure to animals (OR 0.3, 95% CI 0.11–0.83) as well living in a house that uses wood and coal (OR 0.14, 95% CI 0.04–0.49) and an outdoor fire (OR 0.31, 95% CI 0.13–0.73) were protective. Among urban children, t272 and t1476 dominant among cases but no single spa type dominated among controls. In urban cases, spa types t002 and t442 isolates were only identified in severe AD and t174 was more frequent in moderate AD while t1476 in severe AD. Conclusion: The strain genotype of S. aureus differed by AD phenotypes and rural-urban living. Continued surveillance of colonising S. aureus lineages is key in understanding alterations in skin microbial composition associated with AD pathogenesis and exacerbation.
Pancytopenia with severe thrombocytopenia in asymptomatic malaria in advanced pregnancy: a case report
Authors: Murewanhema Grant , Musiniwa Tapuwa Carol , Chimhina Maxwell Takura , Madombi Simbarashe , Nyakanda Munyaradzi Innocent , Madziyire Mugove Gerald 
Published: December 2020

Abstract
Background
Malaria in pregnancy is associated with significant morbidity and mortality, and requires early diagnosis and intervention. Plasmodium falciparum is responsible for 98% of malaria cases in Zimbabwe and causes the most severe disease. Abnormal haematological parameters are a frequent finding in patients with malaria; however, they are rarely the sole presenting feature.
Case presentation
We present the case of a 32-year-old woman in her fifth pregnancy, with a history of one previous caesarean section, who presented for caesarean section and was incidentally noted to have severe thrombocytopenia. Subsequent investigations at a tertiary institution revealed a pancytopenia with thrombocytopenia as the most prominent feature in an asymptomatic patient. The unavoidable caesarean section done under platelet cover was eventful, with severe intractable haemorrhage necessitating an emergency hysterectomy. However, the patient made a full recovery with antimalarial treatment and blood product transfusions.
Conclusion
This case is presented to illustrate the need to consider malaria as a differential diagnosis in pregnant patients from malaria-transmitting areas who have thrombocytopenia. Previous studies have shown that thrombocytopenia can be a predictor of malaria in patients who present with fever, and a marker of disease severity, but has no utility in prognostication and follow-up.
Non-verbal IQ and change in restricted and repetitive behaviors throughout childhood in autism: A longitudinal study using the Autism Diagnostic Interview-Revised.
Authors: Courchesne Valérie , Bedford Rachael , Pickles Andrew , Duku Eric , Kerns Connor , Mirenda Pat , Bennett Terry , Georgiades Stelios , Smith Isabel , Ungar Wendy , Vaillancourt Tracy , Zaidman-Zait Anat , Zwaigenbaum Lonnie , Szatmari Peter , Elsabbagh Mayada , Team Pathways 
Published: December 2020

Abstract
Background: Restricted and repetitive behaviors are one of the characteristic features of Autism Spectrum Disorder. This domain of symptoms includes a broad range of behaviors. There is a need to study each behavior individually to better understand the role they each have in the development of autistic children. Moreover, there are currently no longitudinal studies investigating change in these behaviors over development. Methods: The goal of the present study was to explore the association between age and non-verbal IQ (NVIQ) on 15 RRB symptoms included in the Autism Diagnostic Interview-Revised (ADI-R) over time. A total of 205 children with ASD were assessed using the ADI-R at time of diagnosis, at age 6 years, and at age 11 years, and with the addition of the Wechsler Intelligence Scales for Children – Fourth Edition (WISC-IV) at age 8 years.Results: The proportion of children showing each RRB tended to diminish with increasing age (p < 0.001), except for sensitivity to noise and circumscribed interests, where the proportion increased over time. Although there was no significant main effect of NVIQ (p = 0.101), there was a significant interaction between age and NVIQ (p < 0.01). This was mainly driven by Difficulties with change in routine, for which higher NVIQ was associated with the prevalence of the behavior remaining relatively stable with age, while lower NVIQ was associated with the behavior becoming more prevalent with age.Limitations: The study focused on the presence/absence of each RRB but did not account for potential changes in frequency or severity of the behaviors over development. Furthermore, some limitations are inherent to the measures used. The ADI-R relies on parent-report and hence has some level of subjectivity, while the Wechsler intelligence scales can underestimate the intellectual abilities of some autistic children.Conclusions: These results confirm that specific RRBs are differentially linked to age and NVIQ. Studying RRBs individually is a promising approach to better understand how RRBs change over the development of autistic children and are linked to other developmental domains.
Comprehensive Analysis of Aberrantly Expressed Profiles of ncRNAs Revealed lncRNA AGPAT4-IT1 is a Potential Prognostic Marker for Breast Cancer Metastasis
Authors: Zhang Feng chun , yan ning ning , Li Ming jun , Xu Ying chun , Li Xing ya 
Published: December 2020

Abstract
Aims: we investigated the relationship between long non-coding RNAs (lncRNAs) and breast cancer lung metastasis (BCLM). Methods: We performed lncRNA microarray analyses to establish the lncRNA profile of BCLM. Bioinformatics analyses were carried out to analyzed functional roles of identified lncRNAs. Kaplan-meier analysis was conducted to determine the relation between lncRNA AGPAT4-IT1 and prognosis of breast cancer. Results: We found 317 upregulated and 166 downregulated lncRNAs in BCLM group. We showed AGPAT4-IT1 was positively correlated with its parental gene APGAT4. Furthermore, we suggested AGPAT4-IT1 were highly expressed in higher tumour grade and predicted poorer prognosis. Conclusions: These findings provide evidence for exploring the mechanisms of BCLM and indicate AGPAT4-IT1 is a prospective prognostic marker for breast cancer metastasis.
Inhibition of Histamine H3 receptor Attenuates Neuroinflammation and Cognitive Impairments in Alzheimer’s Disease via activating CREB Pathway
Authors: Wang Jiangong , Liu Bin , Xu Yong , Wang Chaoyun , Yang Meizi , Song Mengmeng , Liu Jing , You Jingjing , Sun Fengjiao , Wang Wentao , Yan Haijing 
Published: December 2020

Abstract
BackgroundAlzheimer's disease (AD) is an age-related neurodegenerative disease, which characterized by deposition of amyloid-β (Aβ) plaques, neurofibrillary tangles, neuronal loss, and accompanied by neuroinflammation. Neuroinflammatory processes are well acknowledged to contribute to the progression of AD pathology. Histamine H3 receptor (H3R) is a presynaptic autoreceptor regulating histamine release via negative feedback way. H3R antagonist has been reported to have anti-inflammatory efficacy. However, whether inhibition of H3R is responsible for the anti-neuroinflammation and neuroprotection on APP/PS1 Tg mice remains unclear. MethodsIn this study, microgliosis, astrogliosis, A1 type astrocytes and A2 type astrocytes in APP/PS1 Tg mice were measured by immunostaining by Iba1, GFAP, C3 and S100A10 with and without treatment of thioperamide, an H3R antagonist. Inflammatory response of APP/PS1 Tg mice and effects of thioperamide were studied by measuring levels of pro-inflammatory cytokines (tumor necrosis factor α [TNFα] and interleukin-1β [IL-1β]) and anti-inflammatory cytokines (interleukin-4 [IL-4]). Protein levels of p-CREB and p-P65 NF-kB was tested by western blot to study the mechanism of thioperamide on AD. H89 was applied to study whether the mechanism offered by thioperamide was dependent on CREB activating. The effect of thioperamide and H89 on Aβ deposition was measured by immunostaining and ELISA. The cognitive function was tested by novel object recognition, Y maze and morris water maze. ResultsInhibition of H3R by thioperamide reduced the gliosis and induced a phenotypical switch from A1 to A2 in astrocytes, and ultimately attenuated neuroinflammation in APP/PS1 Tg mice. Additionally, thioperamide rescued the decrease of cyclic AMP response element-binding protein (CREB) phosphorylation and suppressed the phosphorylated nuclear factor kappa B (NF-κB) in APP/PS1 Tg mice. H89, an inhibitor of CREB signaling, abolished these effects of thioperamide to suppress gliosis and proinflammatory cytokine release. Lastly, thioperamide alleviated the deposition of Aβ and cognitive dysfunction in APP/PS1 mice, which were both reversed by administration of H89. ConclusionsTaken together, these results suggested the H3R antagonist thioperamide improved cognitive impairment in APP/PS1 Tg mice via modulation of the CREB-mediated gliosis and inflammation inhibiting, which contributed to Aβ clearance. This study uncovered a novel mechanism involving inflammatory regulating behind the therapeutic effect of thioperamide in AD.
Analysis of Radiotherapy Impact on Survival in Resected Stage I/ii Pancreatic Cancer Patients: A Population-based Study
Authors: Han Dong , Gao Fei , Liu JinLong , Wang Hao , Fu Qi 
Published: December 2020

Abstract
Background: The application of radiotherapy (RT) in pancreatic cancer remains controversial. The aim of the study was to evaluate the efficacy of radiotherapy (neoadjuvant and adjuvant radiotherapy) for resectable I/II pancreatic cancer. Methods: 14977 patients with pancreatic cancer were identified from SEER database from 2004 to 2015. Multivariate analyses were performed to determine factors including RT on overall survival. Overall survival and overall mortality among the different groups were evaluated using the Kaplan-Meier method and Gray’s test. Results: Patients were divided into groups according to whether they received radiotherapy or not. The median survival time of all 14977 patients without RT was 20 months, neoadjuvant RT was 24 months and adjuvant RT was 23 months (p < 0.0001) . Median survival time of 2089 stage I patients without RT was 56 months, significantly longer than those with RT regardless of neoadjuvant or adjuvant RT (no RT: 56 months vs adjuvant RT: 37 months vs neoadjuvant RT: 27 months, P=0.0039). Median survival time of 12888 stage II patients with neoadjuvant RT was 24 months, adjuvant RT 22 months, significantly prolonged than those without radiotherapy(neoadjuvant RT: 24 months vs adjuvant RT: 22 months vs no RT: 17 months, P＜0.0001). Neoadjuvant RT (HR=1.434, P=0.023, 95% CI: 1.051-1.957) was independent risk factors for prognosis of stage I patients, and adjuvant RT (HR=0.904, P < 0.001, 95% CI: 0.861-0.950) predicted better outcomes for prognosis of stage II patients by multivariate analysis. The risk of cancer-related death caused by neoadjuvant RT in stage I and no-RT in stage II patients were significantly higher. Conclusions: The study identified a significant survival advantage for the use of adjuvant RT over surgery alone or neoadjuvant RT in treating stage II pancreatic cancer. RT was not associated with survival benifit in stage I patients.