bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Exploration of Chlorophyll Content of Various Plants in City Forest of Malabar Malang
Authors: Latifa Roimil , Hadi Samsun , Nurrohman Endrik 
Published: May 2020

Abstract

This current research aimed at investigating chlorophyll content of various plants growing in the city forest of Malabar Malang. Descriptive quantitative method was employed as the research design. This research was conducted from April to August 2019 in city forest of Malabar and Biology Laboratory University of Muhammadiyah Malang. The data were analyzed by means of Microsoft Excel. There were three steps of the research, as follows: a) surveying the research location; b) taking samples of each leaf; and c) laboratory testing. Laboratory testing comprised some stages, as below: a) weighing each leaf sample at 0.3 gram, grounded and dissolved in 80% acetone; b) filtering by utilizing filter paper, and c) testing by means of spectrophotometer with the wavelengths of 645λ and 663λ, respectively to result in absorbance value. The results of absorbance value were tabulated into a specific formula to find out the content of chlorophyll a, chlorophyll b, and the total chlorophyll of each leaf sample. This current research has revealed that regarding the average scores, chlorophyll a has been found the highest in Averrhoa bilimbi leaf (35.848 µg/ml) and the lowest is in Averrhoa carambola leaf (17.857 µg/ml). The average score of chlorophyll b has been found the highest in Tabebuya leaf (58.862 µg/ml) and the lowest is in nortflok pine leaf (9.124 µg/ml). As for the total average of chlorophyll content, the highest content was extracted from Tabebuya leaf (91.737 µg/ml), and the lowest is found in nortflok pine leaf (28.517 µg/ml).
Serviço Nacional de Saúde: Dos Desafios da Atualidade às Transformações Necessárias
Authors: Sakellarides Constantino 
Published: May 2020

Após uma década de evidentes dificuldades, o Serviço Nacional de Saúde necessita de um significativo investimento público para o seu desenvolvimento. Isso significa repor e acrescentar recursos ao Serviço Nacional de Saúde. Mas quer dizer também adquirir as capacidades necessárias à gestão da sua transformação. Os desafios de saúde não são hoje os mesmos de há 40 anos: (i) Observa-se um considerável aumento da prevalência das pessoas com morbilidade múltipla, de evolução prolongada, requerendo uma utilização contínua de serviços de saúde; (ii) É necessário atrasar e atenuar a expressão da morbilidade múltipla; (iii) Neste contexto, é particularmente importante uma forte aposta na integração dos cuidados, gerindo o percurso das pessoas através do serviços de que necessitam. As transformações indispensáveis para responder a estes desafios são complexas e muito exigentes: (i) Há que reconhecer que uma gestão efetiva das necessárias ‘mudanças adaptativas de proximidade’, requer um elaborado enquadramento analítico, estratégico, de boa governança e governação, que ainda não temos; (ii) É preciso ativar, no conjunto da sociedade portuguesa, fatores indutores e facilitadores de mudança – arquiteturas, processo e instrumentos colaborativos; (iii) Uma forte consciência coletiva da natureza dos desafios de saúde da atualidade e uma acrescida capacidade em gerir mudanças socialmente complexas, permitirá organizar uma direção estratégica para o Serviço Nacional de Saúde, capaz de atuar efetivamente em domínios críticos para o seu desenvolvimento – financiamento, gestão de infraestruturas e recursos, desenvolvimento organizacional no âmbito da administração pública portuguesa, uma política para as profissões de saúde e a articulação com os setores social e privado. Sem um investimento imediato e significativo na capacidade de gerir as mudanças necessárias, as dificuldades do Serviço Nacional de Saúde em corresponder a aquilo que os portugueses precisam, não deixarão de se acentuar nos próximos anos.
Sensor-based Characterization of Daily Walking: A New Paradigm in Pre-frailty/Frailty Assessment
Authors: Kumar Danya Pradeep , Toosizadeh Nima , Mohler Jane , Ehsani Hossein , Mannier Cassidy , Laksari Kaveh 
Published: May 2020

Abstract
Background: Frailty is a highly recognized geriatric syndrome resulting in decline in reserve across multiple physiological systems. Impaired physical function is one of the major indicators of frailty. The goal of this study was to evaluate an algorithm that discriminates between frailty groups (non-frail and pre-frail/frail) based on gait performance parameters derived from unsupervised daily physical activity (DPA). Methods: DPA was acquired for 48 hours from older adults (≥65 years) using a tri-axial accelerometer motion-sensor. Continuous bouts of walking for 20s, 30s, 40s, 50s and 60s without pauses were identified from acceleration data. These were then used to extract qualitative measures (gait variability, gait asymmetry, and gait irregularity) and quantitative measures (total continuous walking duration and maximum number of continuous steps) to characterize gait performance. Association between frailty and gait performance parameters was assessed using multinomial logistic models with frailty as the dependent variable, and gait performance parameters along with demographic parameters as independent variables. Results: 126 older adults (44 non-frail, 60 pre-frail, and 22 frail, based on the Fried index) were recruited. Step- and stride-times, frequency domain gait variability, and continuous walking quantitative measures were significantly different between non-frail and pre-frail/frail groups (p<0.05). Among the five different durations (20s, 30s, 40s, 50s and 60s), gait performance parameters extracted from 60s continuous walks provided the best frailty assessment results. Using the 60s gait performance parameters in the logistic model, pre-frail/frail group (vs. non-frail) was identified with 76.8% sensitivity and 80% specificity. Discussion: Everyday walking characteristics were found to be associated with frailty. Along with quantitative measures of physical activity, qualitative measures are critical elements representing the early stages of frailty. In-home gait assessment offers an opportunity to screen for and monitor frailty.Trial registration: The clinical trial was retrospectively registered on June 18th, 2013 with ClinicalTrials.gov, identifier NCT01880229.
Meeting Psychosocial Needs to Improve Health: A Prospective Cohort Study
Authors: Snowden Austyn , Young Jenny , Savinc Jan 
Published: May 2020

Abstract

Background Optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention. Method Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, median 84 days later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models with heteroscedasticity-consistent standard errors. Results Participants were White British with median age between 50-64 years. Cancer type and stage were varied. EQ-5D utility scores improved at follow-up by 0.121 [0.0891-0.153], p<.001, and VAS scores improved by 7.81 [5.88-9.74], p<.001. The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants had both a statistically significant and clinically meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants, this study has shown for the first time that it is possible to capture a clinically meaningful improvement as a function of reducing someone’s personally identified concerns
Insecticide resistance in Anopheles stephensi in Somali Region, eastern Ethiopia
Authors: Yared Solomon , Gebressielasie Araya , Damodaran Lambodhar , Bonnell Victoria , Lopez Karen , Janies Daniel , Carter Tamar 
Published: May 2020

Abstract
Background The movement of malaria vectors into new areas is a growing concern in the efforts to control malaria. The recent report of Anopheles stephensi in eastern Ethiopia has raised the necessity to understand the insecticide resistance status of the vector in the region to better inform vector-based interventions. The aim of this study was to evaluate insecticide resistance in An. stephensi in eastern Ethiopia using two approaches: 1) World Health Organization (WHO) bioassay tests in An. stephensi; and 2) genetic analysis of insecticide resistance genes in An. stephensi in eastern Ethiopia. Methods Mosquito larvae and pupae were collected from Kebri Dehar. Insecticide susceptibility of An. stephensi was tested withmalathion 5%, bendiocarb 0.1%, propoxur 0.1%, deltamethrin 0.05%, permethrin 0.75%, Pirimiphos-methyl 0.25% and DDT 4%, according to WHO standard protocols. In this study, the knockdown resistance locus (kdr) in the voltage gated sodium channel (vgsc) and ace1R locus in the acetylcholinesterase gene (ace-1) were analysed in An. stephensi. Results All An. stephensi samples were resistant to carbamates, with mortality rates of 23% and 21% for bendiocarb and propoxur, respectively. Adult An. stephensi was also resistant to pyrethroid insecticides with mortality rates 67% for deltamethrin and 53% for permethrin. Resistance to DDT and malathion was detected in An. stephensi with mortality rates of 32% as well as An. stephensi was resistance to pirimiphos-methyl with mortality rates 14%. Analysis of the insecticide resistance loci revealed the absence of kdr L1014F and L1014S mutations and the ace1R G119S mutation. Conclusion Overall, these findings support that An. stephensi is resistant to several classes of insecticides, most notably pyrethroids. However, the absence of the kdr L1014 gene may suggest non-target site resistance mechanisms. Continuous insecticide resistance monitoring should be carried out in the region to confirm the documented resistance and exploring mechanisms conferring resistance in An. stephensi in Ethiopia.
Human Immunodeficiency Virus is a Driven Factor of Human Papilloma Virus among Women: Evidence from a Cross-sectional Analysis in Yaoundé, Cameroon
Authors: SOSSO Samuel Martin , Tchouaket Michel Carlos Tommo , Fokam Joseph , Simo Rachel Kamgaing , Torimiro Judith , Tiga Aline , Lobe Elise Elong , Ambada Georgia , Nange Achille , Semengue Ezechiel Ngoufack Jagni , Nka Alex Durand , Tala Valère , Chenwi Collins , Abba Aissatou , Ka'e Aude Christelle , Yagai Bouba , Colizzi Vittorio , Ndjolo Alexis 
Published: May 2020

Abstract
Background: Human papillomavirus (HPV) is the leading cause of cervical cancers, causing 270.000 deaths annually worldwide of which 85% occur in developing countries with an increasing risk associated to HIV infection. This study aimed at comparing HPV’s positivity and genotype distribution in women according to their HIV status and determinants. Methods: A comparative study was carried out in 2012 at the Chantal BIYA International Reference Centre (CIRCB) among 278 women enrolled consecutively at the General Hospital and the Gynaeco-Obstetric and Paediatric Hospital of the City of Yaoundé. HPV genotyping was performed by real-time PCR, HIV serological screening by serial algorithm, CD4 T cell phenotyping by flow cytometry and HIV viral load by Abbott m2000RT. Statistical analyses were performed using Microsoft Excel 2016 and Graph Pad version 6.0 software; with P<0.05 considered statistically significant. Results: Globally, mean age was 37 ±3 years; median CD4-count for HIV+ was 414 cells/mm 3 [IQR: 264.75-588] and median viremia was 50 RNA copies/mL [IQR: <40-8288]. Overall HPV rate was 38.49% (107/278); 58.88% for single women vs. others (28.97% married, 2.80% divorced, 9.34% for widows), OR: 2.164; p=0.0319. Following HIV status, HPV rate was 43.48% (80/184) among HIV+ vs. 28.72% (27/94) among HIV- (OR: 1.937; p<0.0142); HPV genotypes among HIV+ vs. HIV- were respectively distributed as follows: genotype 16 (3.75% vs. 0.00%, p=0.57), genotype 18 (3.75% vs. 3.70%, p=1.00), co-infection 16 and others (8.75% vs. 7.40%, p=1.00), co-infection 18 and others (8.75% vs. 11.11%, p=0.71), co-infection 16, 18 and others (2.50% vs. 0.00%, p=1.00) and other genotypes (72.50% vs. 77.78%, p=0.80). Among HIV+ participants, HPV rate following CD4 was 62.88% (61/97) for CD4<500 vs. 35.71% (20/56) for CD4≥500 (OR: 3.05; p=0.0012) while HPV rate following HIV viremia was 42.71% (41/96) with <1000 RNA copies/ml vs. 66.00% (33/50) with >1000 RNA copies/ml (OR= 0.384; p =0.009). Conclusion: In Yaoundé, HPV rate appear to be very high, with higher rates of genotypes other than 16 and 18. In the event of HIV infection, the risk of HPV positivity is two times higher, favoured essentially by immunodeficiency. Thus, HIV-infected women should be closely monitored to prevent the emergence of cervical cancer.
Dihydrolipoic acid protects against lipopolysaccharide-induced behavioral deficits and neuroinflammation via regulation of Nrf2/HO-1/ NLRP3 signaling in rat
Authors: Bian Hetao , Wang Gaohua , Huang Junjie , Liang Liang , Zheng Yage , Wei Yanyan , Wang Hui , Xiao Ling , Wang Huiling 
Published: May 2020

Abstract
Background: Recently, depression has been identified as prevalent and severe mental disorder. However, the mechanisms underlying the depression risk remain elusive. The neuroinflammation and NLRP3 inflammasome activation are known to be involved in the pathology of depression. Dihydrolipoic acid (DHLA) has been reported as a strong antioxidant and exhibits anti-inflammatory properties in various diseases, albeit the direct relevance between DHLA and depression is yet unknown. The present study aimed to investigate the preventive effect and potential mechanism of DHLA in the Lipopolysaccharide (LPS)-induced sickness behavior in rats. Methods: Adult male Sprague–Dawley rats were utilized. LPS and DHLA were injected intraperitoneally every 2 days and daily, respectively. Fluoxetine (Flu) was injected intraperitoneally daily. PD98059, an inhibitor of ERK, was injected intraperitoneally one hour before DHLA injection daily. Small interfering ribonucleic acid (siRNA) for nuclear factor erythroid 2-like (Nrf2) was injected into the bilateral hippocampus 14 days before the DHLA injection. Depression-like behavior tests were performed. Western blot and immunofluorescence staining detected the ERK/Nrf2/HO-1/ROS/NLRP3 pathway-related proteins.Results: The DHLA and fluoxetine treatment exerted preventive effects in LPS-induced sickness behavior rats. The DHLA treatment increased the expression of ERK, Nrf2, and HO-1 but decreased the ROS generation levels and reduced the expression of NLRP3, caspase-1, and IL-1b in LPS-induced sickness behavior rats. PD98059 abolished the effects of DHLA on preventive effect as well as the levels of Nrf2 and HO-1 proteins. Similarly, Nrf2 siRNA reversed the preventive effect of DHLA administration via the decreased expression of HO-1.Conclusions: These findings suggested that DHLA exerted a preventive effect via ERK/Nrf2/HO-1/ROS/NLRP3 pathway in LPS-induced sickness behavior rats. Thus, DHLA may serve as a potential therapeutic strategy for depression.
IgG anti-hinge antibodies against IgG4 F(ab’)2 fragments generated using pepsin are useful diagnostic markers for rheumatoid arthritis: implications of the possible roles of metalloproteinases and IgG subclasses in generating of immunogenic hinge epitopes.
Authors: Ota Toshiyuki , Ota Shun-ichiro , Uchino Ayumi , Nagano Shuji 
Published: May 2020

Abstract
Background Pepsin agglutinators, discovered over 50 years ago, have been recently referred to as anti-hinge antibodies (AHAs) because of their reaction with the IgG hinge epitope. AHAs have different reactivity for each hinge epitope generated by each protease that cleaves the hinge region at different sites. Moreover, AHAs have different reactivity against different hinge epitopes derived from each IgG subclass even when the same protease is used. Since the expression of matrix metalloproteinase-3 (MMP-3) is enhanced in rheumatoid arthritis (RA), AHA production could also be increased. The purpose of this study was to determine whether the levels of AHAs against IgG hinge epitopes produced by MMP-3 are elevated in RA. Methods The serum levels of IgG or IgA AHAs against the IgG1/IgG4 F(ab’) 2 fragments, generated by either MMP-3 or pepsin, was measured using ELISA in 111 patients with RA and 81 healthy controls (HC). Receiver operating characteristic (ROC) analysis was used for obtaining optimal cutoff values and cutoff values indicating high specificity (>95%) of the AHA. The targeted epitope of a specific AHA was investigated through inhibition ELISA. Results Seven AHAs were statistically higher in RA patients than HC, except IgG AHA against IgG1 F(ab’) 2 , which was generated by MMP-3 proteolytic cleavage. The areas under the ROC curve were of 0.66--0.80, although the sensitivities at high specificity were low (5.4--24.3%). The cumulative number of positive AHAs in each individual was statistically higher in RA patients than HC, suggesting the extreme extent of AHA repertoires in RA. Inhibition studies revealed that IgG AHAs against IgG4 F(ab’) 2 fragments generated by pepsin cross-reacted with IgG1 F(ab’) 2 fragments generated by pepsin. Although the development of IgA AHAs in RA seems to be remarkable and specific, multivariate logistic regression analysis identified the IgG AHA against IgG4 F(ab’) 2 fragments generated by pepsin as an independent variable for RA diagnosis, even in RA patients who were negative for both RF and ACPA (odds ratio 1.18, 95% CI: 1.06−1.32; P =0.003).Conclusion In RA patients, we observed diversification and amplification of AHA repertoires and diagnostic utility of the specific AHA against IgG4 F(ab’) 2 fragments generated by pepsin but not MMP-3.
Health and Adverse Childhood Experiences Among Homeless Youth
Authors: Barnes Andrew J. , Gower Amy L. , Sajady Mollika , Lingras Katherine A. 
Published: May 2020

Abstract
Background and Objectives Homelessness is associated with health problems and with adverse childhood experiences (ACEs). The risk of chronic health conditions for homeless compared to housed youth, and how this risk interacts with ACEs remains unclear. This study investigated the relationship between ACEs, housing, and child health, and whether: 1) ACEs and health vary by housing context; 2) ACEs and homelessness confer independent health risks; and 3) ACEs interact with housing with regard to adolescent health.Methods Using data from 119,254 8th-11th graders, we tested independent and joint effects of ACEs and past-year housing status (housed, family homelessness, unaccompanied homelessness) on overall health and chronic health conditions, controlling for sociodemographic covariates.Results The prevalence of ACEs varied by housing status, with 34.1% of housed youth experiencing ≥1 ACE vs. 56.3% of family-homeless and 85.5% of unaccompanied-homeless youth. Health status varied similarly. Homelessness and ACEs were independently associated with low overall health and chronic health conditions, after adjusting for covariates. Compared to housed youth, both family-homeless youth and unaccompanied-homeless youth had increased odds of low overall health and chronic physical and/or mental health conditions. All ACE x housing-status interactions were significant (all p<0.001), such that ACE-related health risks were moderated by housing status.Conclusions ACEs and housing status independently predict health status during adolescence beyond other sociodemographic risks. Being homeless unaccompanied is also riskier than being homeless with family, and every additional ACE increases this risk. Clinicians and health systems should advocate for policies that include stable housing as a protective factor.
Outcomes of a 12-month patient-centred medical home model in improving patient activation and self-management behaviours among primary care patients presenting with chronic diseases in Sydney, Australia: A before-and-after study.
Authors: John James , Tannous Kathy , Jones Amanda 
Published: May 2020

Abstract
Background: Studies report that increased patient activation is associated with increased patient engagement with the health care system, better adherence to treatment protocols, and improved health outcomes. This study aims to evaluate outcomes based on a 12-month Patient-Centred Medical Home (PCMH) model called ‘WellNet’ on activation levels of patients with one or more chronic diseases in general practices across Sydney, Australia.Methods: A total of 636 patients aged 40 years and above with one or more chronic conditions consented to participate in the WellNet program delivered across six general practices in Northern Sydney, Australia. The WellNet treatment includes a team-based care with general physicians and trained chronic disease management care coordinators collaborating with patients in designing a patient-tailored care plan with improved self-management support and care navigation according to the level of risk and health care needs. Level of patient activation was measured using the validated PAM 13-item scale at baseline and follow-up. A before and after case-series design was employed to determine adjusted differences between baseline and 12-months using repeated measures analysis of covariance (ANCOVA). Multiple imputation was used to compute missing follow-up scores using Markov Chain Monte Carlo (MCMC) algorithm known as fully conditional specification (FCS). Additionally, backward stepwise multivariate regression models were employed to identify significant predictors of activation at follow-up.Results: Of the 626 patients, 420 reported their PAM scores at follow-up. The mean (SD) baseline PAM score was 57.9 (13.0). The adjusted model showed significant mean difference in PAM scores of 6.5 (95% CI 5.0-8.1; p-value<0.001) after controlling for baseline covariates. Multivariate regression models showed that older age (B = -0.14; 95% CI -0.28, -0.01), baseline activation score (B = 0.48; 95% CI 0.37, 0.59), and private insurance (uninsured patients) (B = -3.41; 95% CI -6.50, -0.32) were significant predictors of patient activation at follow-up.Conclusion: The WellNet study is the first of its kind in Australia to report on changes in the patient activation levels among patients with one or more chronic diseases. PCMH has the potential to improve patient activation and engagement which can lead to long-term health benefits and sustained self-management behaviours.