bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary care service use by end-of-life cancer patients: a nationwide population-based cohort study in the United Kingdom
Authors: Gao Wei , Gulliford Martin , Morgan Myfanwy , Higginson Irene J 
Published: March 2020

Abstract
Background End of life(EoL) care becomes more complex and increasingly takes place in the community, but there is little data on the use of general practice(GP) services to guide care improvement. This study aims to determine the trends and factors associated with GP consultation, prescribing and referral to other care services amongst cancer patients in the last year of life. Methods A retrospective cohort study of cancer patients who died in 2000-2014, based on routinely collected primary care data(the Clinical Practice Research DataLink, CPRD) covering a representative sample of the population in the United Kingdom. Outcome variables were number of GP consultations(primary), number of prescriptions and referral to other care services(yes vs no) in the last year of life. Explanatory variables included socio-demographics, clinical characteristics and the status of palliative care needs recognised or not. The association between outcome and explanatory variables were evaluated using multiple-adjusted risk ratio(aRR). Results Of 68,523 terminal cancer patients, 70% were aged 70+, 75% had comorbidities and 45.5% had palliative care needs recognised. In the last year of life, a typical cancer patient had 43 GP consultations(Standard deviation(SD): 31.7; total=3,031,734), 71.5 prescriptions(SD: 68.0; total=5,074,178), and 21(SD: 13.0) different drugs; 58.0% of patients had at least one referral covering all main clinical specialities. More comorbid conditions, prostate cancer and having palliative care needs recognised were associated with more primary care consultations, more prescriptions and a higher chance of referral(aRRs 1.07-2.03). Increasing age was related to fewer consultations(aRRs 0.77-0.96), less prescriptions(aRR 1.09-1.44), and a higher chance of referral(aRRs 1.08-1.16) but less likely to have palliative care needs recognised(aRRs 0.53-0.89). Conclusions GPs are very involved in end of life care of cancer patients, most of whom having complex care needs, i.e. older age, comorbidity and polypharmacy. This highlights the importance of enhancing primary palliative care skills among GPs and the imperative of greater integration of primary care with other healthcare professionals including oncologists, palliative care specialists, geriatricians and pharmacists. Research into the potential of deprescribing is warranted. Older patients have poorer access to both primary care and palliative care need to be addressed in future practices.
Socio-demographic, environmental and behavioural factors of diarrhoea among under-five children in Rural Ethiopia: further analysis of the 2016 Ethiopian demographic and health survey
Authors: Ferede Melkamu Molla 
Published: March 2020

Abstract
Background: Diarrhoea is one of the major contributors to deaths among under-five children in Ethiopia. Studies conducted in different countries showed that rural children are highly affected by diarrhoea than urban children. Thus, the purpose of this study was to identify the socio-demographic, environmental and behavioural associated factors of the occurrence of diarrhoea among under-five children in rural Ethiopia. Methods: Data for the study was drawn from the 2016 Ethiopia Demographic and Health Survey. A total of 8,041 under-five children were included in the study. Data was analysed using SPSS version 23. Binary logistic regression was used for the analysis of the data to assess the association of occurrence of diarrhoea with socio-demographic, environmental and behavioural associated factors among under-five children. Results: Children aged 6-11 months (AOR: 3.5; 95% CI: 2.58-4.87), 12-23 months (AOR: 3.1; 95% CI: 2.33-4.04) and 24-35 months (AOR: 1.7; 95% CI: 1.26-2.34) were significantly associated with diarrhoea. Diarrhoea was also significantly associated with male children (AOR: 1.3; 95% CI: 1.05-1.58), children in Afar region (AOR: 1.92; 95% CI: 1.01-3.64), Somali region (AOR: .42; 95% CI: (.217-.80), Gambela region (AOR: 2.12; 95% CI: 1.18, 3.81), households who shared toilet facilities with other households (AOR: 1.4; 95% CI: 1.09-1.77), fourth birth order (AOR: .1.81; 95% CI: 1.17-2.79), fifth and above birth order (AOR: 1.85; 95% CI: 1.22, 2.81) and the interaction of older mothers with three or more under-five children (AOR: 4.7; 95% CI: 1.64-13.45). Conclusion: The age of a child, sex of a child, region, birth order, toilet facilities shared with other households and the interaction effect of number of under-five children with mother’s current age are identified as associated factors for diarrhoea occurrence among under-five children in rural Ethiopia. The findings carry implications for the need for planning and implementing appropriate prevention strategies that target rural under-five children.
Cerebrospinal fluid of chronic osteoarthritic patients induced interleukin-6 release in human glial cell-line T98G
Authors: Liu Weiling , Li Chunmei , Tan Francis Chee Kuan , Neo Hong Jye , Chan Yiong Huak , Low Chian-Ming , Lee Tat Leang 
Published: March 2020

Abstract
Background Chronic osteoarthritic pain is not well understood in terms of its pathophysiological mechanism. Activated glial cells are thought to play a role in the maintenance of chronic pain. T98G glioblastoma cell line was previously observed to release higher amounts of interleukin-6 (IL-6) when treated with cerebrospinal fluid (CSF) from patients with another chronic pain condition, post-herpetic neuralgia. In this study, we investigated the ability of CSF from patients diagnosed with knee osteoarthritis suffering from chronic pain, to trigger the release of pro-inflammatory cytokines, IL-6, IL-1beta and tumour necrosis factor alpha (TNF-α) from T98G. Characterization of upstream signalling was also explored. Methods 15 osteoarthritis patients undergoing total knee replacement due to chronic knee pain and 15 patients without pain undergoing other surgeries with spinal anaesthesia were prospectively recruited. CSF was collected during anaesthesia. CSF were added to cultured T98G cells in the presence of lipopolysaccharide. IL-6, IL-1β and TNF-α release from T98G cells were measured using enzyme immunoassay. Antibody array and western blotting were performed using CSF-triggered T98G cell lysates to identify possible signalling targets. Age, gender and pain scores were recorded. Mann-Whitney U test was used to compare IL-6 release and protein expression between groups. Association between IL-6 and pain score was analysed using linear regression. Results Significant higher levels of IL-6 were released by T98G cells when induced by osteoarthritis patients' CSF in presence of lipopolysaccharide. IL-6 levels showed positive association with pain score (adjusted B estimate= 10.1 (95% Confidence Interval 4.3-15.9); p= 0.001). Antibody array conducted with 6 pooled T98G cell lysate induced with osteoarthritis pain patient CSF identified greater than 2-fold proteins including STE20-related kinase adaptor protein and spleen tyrosine kinase. Further validation done using western blotting of individual CSF-triggered T98G cell lysate showed non-significant increase. Conclusion Higher IL-6 release from T98G when triggered by OA CSF, in the presence of lipopolysaccharide, suggest presence of "unknown molecule" in CSF that may be crucial in the maintenance phase of chronic pain in our osteoarthritis population. Further studies on the signalling pathways involved in pain and relevance of IL-6 release from T98G in other pain models are needed.
Associations between individual perceptions of PM2.5 pollution and pulmonary function in Chinese middle-aged and elderly residents
Authors: Chen Qi , Zhang Jiayao , Xu Yan , Sun Hong , Ding Zhen 
Published: March 2020

Abstract
Background: PM2.5 pollution has become a major public health concern in urban China. Understanding the residents’ individual perceptions toward haze pollution is critical for policymaking and risk communication. However, the perceptions of middle-aged and elderly residents, who particularly vulnerable to haze pollution, are poorly understood. In this study, we aimed to explore their risk perceptions of haze pollution and investigate its relationship with health status and pulmonary function parameters.
Methods: A cross-sectional study of 400 randomly sampled individuals (aged 40 to 90 years) was conducted in Wuxi, a typical PM2.5-polluted city in Jiangsu Province, China (during 2015-2017, daily average concentration of PM2.5 was 52.73 μg/m3). Each participant’s demographic and health information, individual perception and pulmonary function outcomes were collected to explore the relationships between perception factors and personal characteristics and pulmonary function parameters, using linear models.
Results: We found that the mean values for controllability (4.99 ± 2.78) and dread of risk to oneself (levels of fear for haze-related harm to oneself) (6.9 ± 2.45) were the lowest and the highest values, respectively, in our study. Education and average family income were positively related with all individual perception factors, while age was negatively associated. A history of respiratory disease was positively associated with all individual perception factors except controllability. Significant positive associations were observed between PEF (coefficients ranged from 0.18 to 0.22) and FEF75% (coefficients ranged from 0.18 to 0.29) with a variety of individual perception factors.
Conclusions: There were a lack of concern and knowledge, weak self-protection consciousness and a strong dread of PM2.5 pollution among the middle-aged and elderly residents in Wuxi. Their individual perceptions were associated with age, education levels, average family income, history of respiratory disease, PEF and FEF75%. Our findings may help policymakers develop effective policies and communication strategies to mitigate the hazards of haze among older residents.
Rural Chronic Disease Research Patterns In The United Kingdom, United States, Canada, Australia And New Zealand: A Systematic Integrative Review
Authors: Disler Rebecca , Glenister Kristen , Wright Julian 
Published: March 2020

Abstract
Background
People living in rural communities commonly experience significant health disadvantages. Geographical barriers and reduced specialist and generalist services impact access to care when compared with metropolitan context. Innovative models of care have been developed for people living with chronic diseases in rural areas with the goal of overcoming these inequities. This review aims to describe the state of knowledge regarding innovative models of care and clinical outcomes for people living with chronic disease in rural areas in developed countries where a metropolitan comparator is included.
Methods
An integrative systematic review was undertaken. P referred R eporting I tems for S ystematic Reviews and M eta- A nalyses (PRISMA) method was used to understand data on clinical outcomes for people living with chronic disease in rural compared with metropolitan contexts and their models of care in Australia, New Zealand, United States, Canada and the United Kingdom
Results
Literature searching revealed 620 articles published in English between 2000 and 2019. 160 were included in the review including 68 from the United States, 59 from Australia and New Zealand (5), 21 from Canada and 11 from the United Kingdom and Ireland. 53% (84) focused on cardiovascular disease; 27% (43) diabetes mellitus; 8% (12) chronic obstructive pulmonary disease; and 13% (27) chronic kidney disease. Mortality was only reported in 10% (16) of studies and only 18% (29) reported data on Indigenous populations.
Conclusions
This integrated review reveals published literature on common chronic health issues pertaining to rural and remote populations is largely descriptive. Only a small number of publications focus on mortality and comparative health outcomes from health care models in both urban and non-urban populations. Innovative service models and telehealth are together well represented in the published literature but data on health outcomes is relatively sparse. There is significant scope for further directly comparative studies detailing the effect of service delivery models on the health outcomes of urban and rural populations. We believe that such data would further knowledge in this field and help to break the deadly synergy between increased rurality and poorer outcomes for people with chronic disease.
Neuroprotective effect of astrocyte-derived IL-33 in neonatal hypoxic-ischemic brain injury
Authors: Jiao Mengya , Li Xiangyong , Chen Liying , Wang Xiaodi , Yuan Baohong , Liu Tao , Dong Qun , Mei Hanfang , Yin Hui 
Published: March 2020

Abstract
Background: Interleukin-33 (IL-33) is a well-recognized pleiotropic cytokine which plays crucial roles in immune regulation and inflammatory responses. Recent studies suggest that IL-33 and its receptor ST2 are involved in the pathogenesis of neurological diseases. Here, we explore the effect of IL-33/ST2 signaling in neonatal hypoxic-ischemic (HI) brain injury and elucidate the underlying mechanisms of action.Methods: The brain HI model was established in neonatal C57BL/6 mice by left common carotid artery occlusion with 90 min hypoxia, and treated with IL-33 at a dose of 0.2 μg/day i.p. for three days. TTC staining and neurobehavioral observation were used to evaluate the HI brain injury. Immunofluorescence and flow cytometry were applied to determine the expression of IL-33 and its receptor ST2 on brain CNS cells, cell proliferation and apoptosis. OGD experiment was used to assay the viability of astrocytes and neurons. RT-qPCR was used to measure the expression of neurotrophic factor-associated genes.Results: The expression level of IL-33 was markedly enhanced in astrocytes 24 h after cerebral HI in neonatal mice. Exogenous delivery of IL-33 significantly alleviated brain injury 7 d after HI, whereas ST2 deficiency exacerbated brain infarction and neurological deficits post HI. Flow cytometry analyses demonstrated high levels of ST2 expression on astrocytes, and the expression of ST2 was further elevated after HI. Intriguingly, IL-33 treatment apparently improved astrocyte response and attenuated HI-induced astrocyte apoptosis through ST2 signaling pathways. Further in vitro studies revealed that IL-33-activated astrocytes released a series of neurotrophic factors, which are critical for raising neuronal survival against oxygen glucose deprivation. Conclusions: The activation of IL-33/ST2 signaling in the ischemic brain improves astrocyte response, which in turn affords protection to ischemic neurons in a glial-derived neurotrophic factor-dependent manner.
Dissection of the mutation accumulation process during bacterial range expansions
Authors: Bosshard Lars , Peischl Stephan , Ackermann Martin , Excoffier Laurent 
Published: March 2020

Abstract
Background

Recent experimental work has shown that the evolutionary dynamics of bacteria expanding across space can differ dramatically from what we expect under well-mixed conditions. During spatial expansion, deleterious mutations can accumulate due to inefficient selection on the expansion front, potentially interfering with and modifying adaptive evolutionary processes.

Results

We used whole genome sequencing to follow the genomic evolution of 10 mutator Escherichia coli lines during 39 days (∼1650 generations) of a spatial expansion, which allowed us to gain a temporal perspective on the interaction of adaptive and non-adaptive evolutionary processes during range expansions. We used elastic net regression to infer the positive or negative effects of mutations on colony growth. The colony size, measured after three day of growth, decreased at the end of the experiment in all 10 lines, and mutations accumulated at a nearly constant rate over the whole experiment. We find evidence that beneficial mutations accumulate primarily at an early stage of the experiment, leading to a non-linear change of colony size over time. Indeed, the rate of colony size expansion remains almost constant at the beginning of the experiment and then decreases after ∼12 days of evolution. We also find that beneficial mutations are enriched in genes encoding transport proteins, and genes coding for the membrane structure, whereas deleterious mutations show no enrichment for any biological process.

Conclusions

Our experiment shows that beneficial mutations target specific biological functions mostly involved in inter or extra membrane processes, whereas deleterious mutations are randomly distributed over the whole genome. It thus appears that the interaction between genetic drift and the availability or depletion of beneficial mutations determines the change in fitness of bacterial populations during range expansion.
Contralateral C7 Transfer to Axillary and Median Nerves in Rats with Total Brachial Plexus Avulsion
Authors: Liu Yuzhou , Xiao Feng , Zhuang Yongqing , lao jie 
Published: March 2020

Abstract
Background: Contralateral cervical 7 nerve (cC7) was used to repair two recipient nerves simultaneously for patients with total brachial plexus avulsion (TBPA). Objective: To evaluate the effect of cC7 transfer to axillary and median nerves in rats with TBPA. Methods: Eighty S-D rats were divided into 4 groups randomly on average. Group A: cC7 － median nerve, Group B: cC7 － axillary nerve, Group C: cC7 － median and axillary nerves, Group D: TBPA without repair. The evaluation tools included behavioral tests, electromyogram (EMG), measurement of cross-sectional area of muscle fiber, nerve fiber count and gene expression assay. Results: The effective rates of EMG were 90% and 70% in Flexor Carpi Radialis (FCR) in Group A and C, while 70% and 60% in deltoid (DEL) in Group B and C, respectively. In behavioral test, the differences of effective rates between groups were not significant. The mean cross-sectional area of FCR in Group A or C was significantly larger than that in Group D. Either the number of median or axillary nerve fibers in Group A, B or C was statistically more than that in Group D. No matter for FCR or DEL, there were no significant differences in the ratios of relative expression of Muscle Atrophy F-box （ MAFBOX ） and Muscle RING Finger 1 （ MURF1 ） among these groups. Conclusion: Compared with cC7 transfer to median nerve, cC7 transfer to both median and axillary nerves did not affect median nerve recovery. The deltoid muscle also could be restored. The recovery proportion of axillary nerve was less than that of median nerve.
Preoperative SCC-Ag as a predictive marker for the use of adjuvant chemotherapy in cervical squamous cell carcinoma with intermediate-risk factors
Authors: Guo Hong-tao , Bi Xue-han , Lei Ting , Lv Xiao , Yao Guang , Chen Yao , Liu Chang 
Published: March 2020

Abstract
Purpose: For cervical cancer patients whose tumors display a combination of intermediate risk factors, postoperative radiation with or without adjuvant chemotherapy is suggested for them. However, who should be administered with adjuvant chemotherapy is unknown. The current study was designed to explore the clinical value of squamous cell carcinoma antigen (SCC-Ag) in guiding the use of adjuvant chemotherapy in cervical cancer patients. Materials and Methods: A retrospective study of 301 cervical cancer patients treated by surgery and adjuvant treatment from March 2006 to March 2016 was performed. All patients were divided into two groups according to receiving adjuvant chemotherapy or not. Overall survival (OS), disease-free survival (DFS) were compare between patients who did and did not receive adjuvant radiotherapy. Multivariate analysis was employed to detect clinical factors associated with disease-free survival, local recurrence-free survival and distant metastasis-free survival. Results: For patients with high pre-treatment SCC-Ag level, DFS and OS in adjuvant chemo-radiotherapy group were higher than that in adjuvant radiotherapy group. Besides, the rates of distant metastasis were found lower in patients who did receive adjuvant chemotherapy than those who did not. For patients with low pre-treatment SCC-Ag level, the 5-year OS and DFS were similar between groups of adjuvant chemo-radiotherapy and adjuvant radiotherapy. Multivariable analysis indicated adjuvant chemotherapy was independent predictors of DFS and distant metastasis-free survival (DMFS) in patients with high SCC-Ag level. Conclusion: SCC-Ag can serve as an indication for the administration of adjuvant chemotherapy in cervical cancer patients.
Therapeutic effects of different treatment periods against ischemic stroke and toxicology study of Angong Niuhuang Pill in rats
Authors: Chen Jianzhao , Chai Yushuang , He Yuanfeng , Huang Jisheng , Wan Ting , Lu Yuan , Peng Zilun , Li Wenjuan , Ning Na , Guo Qiuping 
Published: March 2020

Abstract
Background : Angong Niuhuang Pill (ANP) is one of the most famous drugs to treat stroke in China, but there is no definite treatment period in drug instruction. In this study, we used middle cerebral artery occlusion (MCAO) model to evaluate its therapeutic effects of different treatment periods and studied its toxic effect in rats. Methods : Protective effect of ANP was observed in the cerebral ischemia-reperfusion model in rats; ANP (270 mg/kg) three different treatment period included 1 day, 4 days and 7 days. The observation period was 30 days. Therapeutic effect was evaluated by detecting neurological function, cerebral infraction volume, brain histology and cytokines. Three dose including 550, 1640, 4910 mg/kg were studied in toxicology study. The administration period was 30 days. Toxic effect was evaluated by detecting appearance, behavior, excrement character, food-intake, body weight, hematological parameters and biomarkers such as TBA, GSTα, Cystatin C, clusterin, GSH, S-100B and MBP. Results : Seven days treatment period of ANP had better effect than 1 day and 4 days treatment periods in rat MCAO model from neurological function scores, the volume of cerebral infarction, brain histology and the serum content of IL-1β, TNF-α and NO; the brain content of IL-1β and NO. The results of 30 days multiple dose toxicology study showed no animal death in all groups; in ANP 4910 mg/kg group, the kidney and liver coefficient increased about 10%, the body weight grew more slowly, the TBA increased slightly. There was no abnormal change in histology. These all recovered after drug withdraw for 8 weeks. Conclusion: Seven days treatment period of ANP had more protective effect than 1 day and 4 days treatment periods in ischemic stroke rat. No observed adverse effect level (NOAEL) of ANP was 1640 mg/kg; the safety margin of ANP was 270-1640 mg/kg. These data provided reference to modify drug instruction.