Sarah E. Edwards

Metabolomic analysis of Ranunculus spp. as potential agents involved in the etiology of equine grass sickness

Identification of toxic or harmful agents continues to be a key goal in agricultural chemistry. This paper reports a metabolomic analysis of Ranunculus repens and related species, which were recently postulated to be cocausative agents in the etiology of equine grass sickness (EGS). Specifically, samples collected at EGS sites were compared with those from non-EGS sites. Furthermore, interspecific and seasonal variations and the species response to edaphic and climatic factors were investigated. (1)H NMR spectroscopy in combination with multivariate data analysis was applied to the crude methanol extracts of the Ranunculus samples, as well as their chloroform fractions. Samples from EGS sites were significantly different from control samples. The metabolite composition varied greatly between different Ranunculus species. No significant changes could be observed between samples collected in different seasons. This work provides strong evidence that Ranunculus is involved in the etiology of EGS and has implications for agricultural management of pastures.

Ethnomedicinal uses of plants in the treatment of paediatric geohelminth infections in Kalat district of Northern Balochistan, Pakistan.

ETHNOPHARMACOLOGICAL RELEVANCEnInfection by intestinal parasitic worms (soil-transmitted helminths or geohelminths) is prevalent in many parts of the world, and poses a particular health risk to children. This paper presents findings from a preliminary study with the primary aim to document indigenous knowledge about the use of herbal medicines in the treatment of intestinal worm infections in children among the local communities of Kalat district of northern Balochistan, Pakistan.nnnMATERIALS AND METHODSnEthnomedicinal data were collected through a triangulation approach, that included participant-observation and rapid appraisal methods. Prior-informed consent (PIC) was obtained from participants before conducting structured and semi-structured interviews and delivering an open ended questionnaire. A total of 94 participants, including 28 men (of whom 7 were traditional healers), and 66 women of four different age groups were interviewed. Results were analyzed using quantitative indices of Use Value citations (UVC) and Disease-Consensus Index (DCI).nnnRESULTSnFewer men than women agreed to be interviewed, thus overall women in the area appeared to have more ethnomedicinal knowledge. The majority of study participants belonged to the older age group (>55 years). A total of 49 plant species, belonging to 47 genera, distributed in 30 families were reported. The families Asteraceae and Lamiaceae were most frequently represented, with four species each. Trees were the most common life form, with seeds the most frequently cited plant part used (29%). Nearly a third (31%) of plant-based remedies reported in the treatment of intestinal worms were administered as a decoction. The highest UVC and DCI was reported for the species Ferula assa-foetida sL. (UVC 0.51, DCI 0.46).nnnCONCLUSIONSnThis study provides previously unreported data on the use of medicinal plants in the treatment of geohelminth infections in children of Kalat. Eight species, Acacia modesta Wall., Asparagus capitatus Baker, Microcephala lamellata (Bunge) Pobed., Nepeta praetervisa Rech.f., Plantago ciliata Desf., Pistacia atlantica Desf., Seriphidium quettense (Podlech) Y.R.Ling and Thymus linearis Benth. are reported here as anthelmintics for the first time. Detailed studies on the anthelmintic activity of chemical constituents of these species are lacking from existing literature. Further phytochemical, pharmacological and toxicity studies are required in order to evaluate the efficacy and safety of these newly reported anthelmintic species. These plants may provide a source of novel anthelmintic drug leads, which are urgently required due to the problem of global anthelmintic resistance.

Developing a framework for the ethical design and conduct of pragmatic trials in healthcare: a mixed methods research protocol

BackgroundThere is a widely recognized need for more pragmatic trials that evaluate interventions in real-world settings to inform decision-making by patients, providers, and health system leaders. Increasing availability of electronic health records, centralized research ethics review, and novel trial designs, combined with support and resources from governments worldwide for patient-centered research, have created an unprecedented opportunity to advance the conduct of pragmatic trials, which can ultimately improve patient health and health system outcomes. Such trials raise ethical issues that have not yet been fully addressed, with existing literature concentrating on regulations in specific jurisdictions rather than arguments grounded in ethical principles. Proposed solutions (e.g. using different regulations in “learning healthcare systems”) are speculative with no guarantee of improvement over existing oversight procedures. Most importantly, the literature does not reflect a broad vision of protecting the core liberty and welfare interests of research participants. Novel ethical guidance is required. We have assembled a team of ethicists, trialists, methodologists, social scientists, knowledge users, and community members with the goal of developing guidance for the ethical design and conduct of pragmatic trials.MethodsOur project will combine empirical and conceptual work and a consensus development process. Empirical work will: (1) identify a comprehensive list of ethical issues through interviews with a small group of key informants (e.g. trialists, ethicists, chairs of research ethics committees); (2) document current practices by reviewing a random sample of pragmatic trials and surveying authors; (3) elicit views of chairs of research ethics committees through surveys in Canada, UK, USA, France, and Australia; and (4) elicit views and experiences of community members and health system leaders through focus groups and surveys. Conceptual work will consist of an ethical analysis of identified issues and the development of new ethical solutions, outlining principles, policy options, and rationales. The consensus development process will involve an independent expert panel to develop a final guidance document.DiscussionPlanned output includes manuscripts, educational materials, and tailored guidance documents to inform and support researchers, research ethics committees, journal editors, regulators, and funders in the ethical design and conduct of pragmatic trials.