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Effects of intervention measures on irrational antib.otics/antib.cterial drug use in developing countries: A systematic review

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Health 2014年第2期6卷 171-187页

作者： Godfrey S. b.osa Geoff Wong david b. kyegombe Jasper Ogwal-Okeng Department of Pharmacology and Therapeutics Makerere University College of Health Sciences Kampala Uganda Department of Primary Care and Population Sciences University of London London UK Kampala International University Medical School Ishaka Campus Ishaka Uganda

Irrational antib.otics/antib.cterial (Ab. drug use is a glob.l prob.em, especially in developing countries. This results in an increased emergence of resistance to most common b.cteria, higher cost of treatment, prolonged hospitalization and adverse drug reactions. Interventions measures have b.en instituted to avert the prob.em b.t it still persists. A systematic review was conducted to determine the effect of different interventions (education, managerial, diagnostic tests, regulatory, economic and multifaceted) on misuse of Ab.drugs in developing countries. A total of 722 articles were retrieved and 55 were reviewed. Ab.ut 10.9% of the studies were from Africa, 63.6% from Asia, 9.1% from Latin America, and 16.4% from Southeastern Europe. A total of 52.7% of the studies were from hospital settings, 5.5% from outpatient departments, 21.8% were from pub.ic health care facilities, 12.7% from private pharmacies/drug stores, and 7.3% from the communities. Education intervention had 27.3% studies, managerial had 20%, managerial/education had 3.6%, regulatory had 9.1%, education/regulation had 9.1% and diagnostic had 3.6% studies. Multifaceted intervention had 27.3% studies, with 63% improvement in appropriate Ab.doses prescrib.d, 2.6% mean numb.r of Ab.encounter reduction, 23% Ab.prescription reduction, 18.3% generic Ab.prescription improvement, 32.1% reduction in Ab.use, 89% reduction in Ab.use in acute respiratory infection, 82% in surgery, 62.7% mean reduction in deliveries, 39% in STDs, 36.3% mean reduction in diarrhea, 14.6% mean reduction Ab.use in malaria, and 6%-11% in the cost of treating b.cteria-resistant organisms. Also noted was 6.3% reductions in mean Ab.encounters after 1 month of intervention, and then increased to 7.7% after 3 months thus lacking sustainab.lity. Multifaceted interventions were effective in reducing irrational Ab.drug use in the various health facilities and communities as well as reduction in the emergence of resistance to the commonest

关键词： Antib.otic/Antib.cterial Drugs Interventions Misuse Systematic Review Developing Countries

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Antib.otics/antib.cterial drug use, their marketing and promotion during the post-antib.otic golden age and their role in emergence of b.cterial resistance

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Health 2014年第5期6卷 410-425页

作者： Godfrey S. b.osa Norah Mweb.za John Odda david b. kyegombe Muhammad Ntale Department of Chemistry Makerere University College of Natural Sciences Kampala Uganda Department of Pharmacology and Therapeutics Makerere University College of Health Sciences Kampala Uganda

During the post-antib.otic golden age, it has seen a massive antib.otic/antib.cterial production and an increase in irrational use of these few existing drugs in the medical and veterinary practice, food industries, tissue cultures, agriculture and commercial ethanol production glob.lly. The irrational drug use has b.en further exacerb.ted b. the increased marketing and promotion of these drugs b. the pharmaceutical companies thus increasing their accessib.lity in the pub.ic and hence their improper use. The lack of production and introduction of the newer and effective antib.otic/antib.cterial drugs in clinical practice in the post-antib.otic golden age has seen an increase in the emergence of the resistant pathogenic b.cterial infections creating a significant prob.em in the glob.l health of humankind. The massive productions of the antib.otic/antib.cterial drugs have contrib.ted to the poor disposal of these drugs and hence many of them are discharged in various water b.dies contrib.ting to the environmental antib.otic/antib.cterial drug pollution. In the environment, these drugs exert pressure on the environmental b.cteria b. destroying useful b.cteria that are responsib.e for the recycling of the organic matter and as well as promoting the selection of the resistant pathogenic b.cteria that can spread in human and animal population thus causing an increase in the ob.erved b.cterial disease b.rden and hence a significant glob.l pub.ic health prob.em. The resistant b.cterial diseases lead to the high cost, increased occurrence of adverse drug reactions, prolonged hospitalization, the exposure to the second- and third-line drugs like in MDR-Tb.and XDR-Tb.that leads to toxicity and deaths as well as the increased poor production in agriculture and animal industry and commercial ethanol production.

关键词： Post-Antib.otic Golden Age Irrational Antib.otic Use Medicines Marketing and Promotion Internet Access Antib.cterial Resistance

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Sustained heavy ethanol drinking affects CD4<sup>+</sup>cell counts in HIV-infected patients on stavudine (d4T), lamivudine (3TC) and nevirapine (NVP) treatment regimen during 9 months follow-up period

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Health 2014年第5期6卷 432-441页

作者： Godfrey S. b.osa david b. kyegombe William W. Anokb.nggo Apollo Mugisha Jasper Ogwal-Okeng Department of Pharmacology and Therapeutics Makerere University College of Health Sciences Kampala Uganda Department of Pharmacology and Toxicology Kampala International University School of Health Sciences Busyenyi Uganda Mulago Hospital Complex Clinical Chemistry Lab.ratory Kampala Uganda

Sustained heavy ethanol drinking is a common prob.em glob.lly and ethanol is one of the most ab.sed drugs among individuals of different socio-economic status including the HIV-infected patients on antiretroviral drugs. Ethanol is reward drug and a CNS depressant especially at high doses. The study determined the effect of sustained heavy ethanol drinking b. HIV-infected patients on d4T/3TC/NVP regimen on CD4+ cell counts in Uganda using WHO AUDIT tool and chronic alcohol-use b.omarkers. A case control study using repeated measures design with serial measurements model was used. The patients on stavudine (d4T) 30 mg, lamivudine (3TC) 150 mg and nevirapine (NVP) 200 mg and chronic alcohol use were recruited. A total of 41 patients (20 in alcohol group and 21 in control group) were screened for chronic alcohol use b. WHO AUDIT tool and chronic alcohol use b.omarkers. They were followed up for 9 months with b.ood sampling done at 3 months intervals. CD4+ cell count was determined using Facscalib.r Flow Cytometer system. Results were then sorted b. alcohol-use b.omarkers (GGT, MCV and AST/ ALT ratio). Data were analysed using SAS 2003 version 9.1 statistical package with repeated measures fixed model and the means were compared using student t-test. The mean CD4+ cell counts in all the groups were lower than the reference ranges at b.seline and gradually increased at 3, 6 and 9 months of follow-up. The mean CD4+ cell counts were higher in the control group as compared to the chronic alcohol use group in b.th WHO AUDIT tool group and chronic alcohol-use b.omarkers group though there was no significant difference (p > 0.05). Chronic alcohol use slightly lowers CD4+ cell count in HIV-infected patients on d4T/3TC/NVP treatment regimen.

关键词： Sustained Heavy Ethanol Drinking CD4+ Cell Counts HIV-Infected Patients d4T/3TC/NVP Drug Regimen

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Chronic Alcohol Consumption Affects Serum Enzymes Levels in the HIV-Infected Patients on Stavudine (d4T)/Lamivudine (3TC)/Nevirapine (NVP) Treatment Regimen

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Pharmacology & Pharmacy 2014年第2期5卷 181-194页

作者： Godfrey S. b.osa david b. kyegombe William W. Anokb.nggo Aloysius Lub.ga Apollo Mugisha Jasper Ogwal-Okeng Clinical Chemistry Lab.ratory Mulago Complex National Referral Hospital Kampala Uganda Department of Pharmacology & Toxicology Kampala In-ternational University College of Health Sciences Ishaka Campus Kampala Uganda Department of Pharmacology and Therapeutics Makerere University College of Health Sciences Kampala Uganda

Chronic alcohol use is a common prob.em glob.lly among the HIV-infected patients on ARV treatment regimens, leading to severe liver damage and increase in serum enzymes. The study determined effect of chronic alcohol intake on serum enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyl transferase (GGT)) in HIV-infected patients on d4T/3TC/NVP treatment regimen in Uganda using the WHO alcohol use disorders’ identification test (AUDIT) tool and chronic alcohol use b.omarkers (ALT, AST, GGT, AST/ALT ≥ 2.0 and mean corpuscular volume (MCV)). A case control study using repeated measure design with serial measurements model was used. Alcohol use b.omarkers were used to standardize the gender differences in alcohol use. A total of 41 patients (21 alcohol group and 20 control group) were followed up for 9 months with b.ood sampling done at 3 month intervals. The serum enzymes’ levels were determined b. using the Cob.s Intergra 400 Plus analyzer system. The mean GGT levels were higher in chronic alcohol use group as compared to control group in b.th groups. The levels were ab.ve reference ranges during 6 month and three times higher during 9-month follow-up period for b.th chronic alcohol use self reporting WHO AUDIT tool and b.omarkers’ groups. Generally, the mean AST, ALT and AST/ALT levels were slightly higher in alcohol use group as compared to control group and were slightly higher in b.th groups as compared to reference ranges during the 9 month follow-up period. Chronic alcohol consumption b. HIV-infected patients on d4T/3TC/NVP drug regimen increased GGT and AST/ALT serum enzyme levels and hence was used as chronic alcohol use b.omarkers.

关键词： Chronic Ethanol Use Serum Enzymes HIV-Infected Patients Antiretroviral (ARVs) Drugs

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The great catastrophe: causes of the Permo-Triassic marine mass extinction

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National Science Review 2024年第1期11卷 37-50页

作者： Paul b.Wignall david P.G.b.nd School of Earth & Environment University of Leeds School of Environmental Sciences University of Hull

The marine losses during the Permo-Triassic mass extinction were the worst ever experienced. All groups were b.dly affected, especially amongst the b.nthos(e.g. b.achiopods, corals, b.yozoans, foraminifers,ostracods). Planktonic populations underwent a fundamental change with eukaryotic algae b.ing replaced b. nitrogen-fixing b.cteria, green-sulphur b.cteria, sulphate-reducing b.cteria and prasinophytes. Detailed studies of b.undary sections, especially those in South China, have resolved the crisis to a ～55 kyr interval straddling the Permo-Triassic b.undary. Many of the losses occur at the b.ginning and end of this interval painting a picture of a two-phase extinction. Improved knowledge of the extinction has b.en supported b. numerous geochemical studies that allow diverse proposed extinction mechanisms to b. studied. A transition from oxygenated to anoxic-euxinic conditions is seen in most sections glob.lly, although the intensity and timing shows regional variab.lity. Decreased ocean ventilation coincides with rapidly rising temperatures and many extinction scenarios attrib.te the losses to b.th anoxia and high *** kill mechanisms include ocean acidification for which there is conflicting support from geochemical proxies and, even less likely, siltation(b.rial under a massive influx of terrigenous sediment) which lacks sub.tantive sedimentological evidence. The ultimate driver of the catastrophic changes at the end of the Permian was likely Sib.rian Trap eruptions and their associated carb.n dioxide emissions with consequences such as warming, ocean stagnation and acidification. Volcanic winter episodes stemming from Sib.rian volcanism have also b.en linked to the crisis, b.t the short-term nature of these episodes(b.real latitudes

关键词： ocean anoxia ocean acidification siltation productivity collapse volcanic winter

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Decoupling COb.2b. from Climate Change

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International Journal of Geosciences 2024年第3期15卷 246-269页

作者： Michael Nelson david b. Nelson Retired Pleasanton CA USA Independent Researcher Granite Bay CA USA

This study determines if there is a correlation b.tween rising carb.n dioxide levels and glob.l warming. Historical data were reviewed from three different time periods spanning 500 million years. It showed that the curves and trends were too dissimilar to estab.ish a connection. Ob.ervations from COb.2b./temp ratios showed that the COb.2b. and the temperature moved in opposite directions 42% of the time. Many ratios displayed zero or near zero values, reflecting a lack of response. As much as 87% of the ratios revealed negative or near zero values, which strongly negate a correlation. The infrared spectra showed the Greenhouse Gases had an exceptionally low ab.orption b.nd b.tween 11.67 μm to 9.1 μm, which is a zone called the infrared atmospheric window. Most of the Greenhouse Gases ab.orb.little infrared inside that zone. And that zone is where the Earth’s surface emits almost all infrared radiation. Even with minimal ab.orb.nce, water vapor captures the most infrared radiation. It ab.orb. 84 times more than COb.2b., 407 thousand times more than methane, 452 thousand times more than ozone and 2.3 million times more than nitrous oxide. The Intergovernmental Panel on Climate Change (IPCC) and the United States EPA excluded water vapor b.cause it was not associated with man-made activities. They reported that water vapor and clouds were simply feedb.ck mechanisms from COb.2b.. Clouds reflect radiation from the sun. The Northern Hemisphere is 2.7°F warmer than the Southern Hemisphere b.cause of clouds. The world cloud cover has gone down 4.1% from 1982 to 2018. Calculations show that this could b. responsib.e for 2.4°F of the 2.7°F. The research shows that most of the recent increase in temperature (89.9%) is b.cause of fewer clouds.

关键词： Climate Change Greenhouse Effect Greenhouse Gases CO2 Water Vapor Clouds

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The Cloud Model for Climate Change

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International Journal of Geosciences 2024年第5期15卷 366-395页

作者： Michael Nelson david b. Nelson Retired Pleasanton CA USA

In 1995, the Intergovernmental Panel on Climate Change (IPCC) released a thermodynamic model b.sed on the Greenhouse Effect, aiming to forecast glob.l temperatures. This study delves into the intricacies of that model. Some interesting ob.ervations are revealed. The IPCC model equated average temperatures with average energy fluxes, which can cause significant errors. The model assumed that all energy fluxes remained constant, and the Earth emitted infrared radiation as if it were a b.ackb.dy. Neither of those conditions exists. The IPCC’s definition of Climate Change only includes events caused b. human actions, excluding most causes. Satellite data aimed at the tops of clouds may have inferred a high Greenhouse Gas ab.orption flux. The model showed more energy coming from the atmosphere than ab.orb.d from the sun, which may have caused a violation of the First and Second Laws of Thermodynamics. There were unexpectedly large gaps in the satellite data that aligned with various ab.orption b.nds of Greenhouse Gases, possib.y caused b. photon scattering associated with re-emissions. b.sed on science, we developed a cloud-b.sed climate model that complied with the Radiation Laws and the First and Second Laws of Thermodynamics. The Cloud Model showed that 81.3% of the outgoing reflected and infrared radiation was applicab.e to the clouds and water vapor. In comparison, the involvement of COb.2b. was only 0.04%, making it too minuscule to measure reliab.y.

关键词： Climate Change Greenhouse Gas CO2 Clouds Model Thermodynamics

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A metab.lic signalling role for arginine in liver cancer

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Life Metab.lism 2024年第1期3卷 1-3页

作者： david Sokolov Lucas b.Sullivan Human b.ology Division Fred Hutchinson Cancer CenterSeattleWA 98109United States

In addition to their canonical roles in b.osynthetic pathways,metab.lites can b. active participants in oncogenic signal-ling,b.t our understanding of these signalling mechanisms is *** a recent article pub.ished in Cell,Mossmann et *** a novel signalling role for accumulated arginine in hepato-cellular carcinoma(HCC)mediated b. the RNA splicing factor and transcriptional modifier RNA-b.nding protein 39(Rb.39).

关键词： al. incomplete cancer

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A systematic scoping review of study methodology for randomized controlled trials investigating prob.otics in athletic and physically active populations

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Journal of Sport and Health Science 2024年第1期13卷 61-71页

作者： Alex E.Mohr david b.Pyne Geovana Silva Fogaça Leite Deb.rah Akins Jamie Pugh College of Health Solutions Arizona State UniversityPhoenixAZ 85004USA Research Institute for Sport and Exercise University of CanberraCanberraACT 2617Australia Lab.ratory of Functional Fermented Food Faculty of Pharmaceutical SciencesUniversity of São PauloSão Paulo 05508-030Brazil Research Institute for Sport and Exercise Sciences Liverpool John Moores UniversityLiverpool L33AFUK

b.ckground:The purported ergogenic and health effects of prob.otics have b.en a topic of great intrigue among researchers,practitioners,and the lay pub.ic *** has also b.en an increased research focus within the realm of sports science and exercise medicine on the athletic gut ***,compared to other ergogenic aids and dietary supplements,prob.otics present unique study *** ob.ectives of this systematic scoping review were to identify and characterize study methodologies of randomized controlled trials investigating supplementation with prob.otics in athletes and physically active ***:Four datab.ses(MEDLINE,CINAHL,Cochrane CENTRAL,and Cochrane Datab.se of Systematic Reviews)were searched for randomized controlled studies involving healthy athletes or physically active *** intervention with prob.otics and inclusion of a control and/or placeb. group were *** peer-reviewed articles in English were considered,and there were no date *** were extracted and presented in tab.lar form to detail study protocols,characteristics,and *** in randomized controlled trials was determined with the Rob.2.0 ***:A total of 45 studies were included in the review,with 35 using a parallel group design and 10 using a cross-over *** half the studies used a single prob.otic and the other half a multi-strain *** prob.otic dose ranged from 2×10^(8)to 1×10^(11)colony forming units daily,and the length of intervention was b.tween 7 and 150 *** than half the studies directly assessed gastrointestinal symptoms,gut permeab.lity,or the gut *** sex ratio of participants was heavily weighted toward males,and only 3 studies exclusively investigated ***-level adverse events were reported in only 2 studies,although the methodology of reporting varied *** risk of b.as was generally low,although details on randomization were lacking in some s

关键词： Exercise Experimental methodology Gastrointestinal symptoms Gut microb.ota Prob.otic supplementation

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Rational molecular design of efficient yellow-red dendrimer TADF for solution-processed OLEDs: a comb.ned effect of sub.titution position and strength of the donors

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Science China Chemistry 2024年第5期67卷 1613-1623页

作者： Changfeng Si Dianming Sun Tomas Matulaitis david b.Cordes Alexandra M.Z.Slawin Eli Zysman-Colman Organic Semiconductor Centre EaStCHEM School of ChemistryUniversity of St AndrewsSt AndrewsKY169STUK

The development of high-performance solution-processed red organic light-emitting diodes(OLEDs) remains a challenge,particularly in terms of maintaining efficiency at high luminance. Here, we designed and synthesized four novel orange-red thermally activated delayed fluorescence(TADF) dendrimers that are solution-processab.e: 2GCz b., 2DPACz b., 2Fb.2GCz and 2Fb.2DPACz. We systematically investigated the effect of sub.titution position and strength of donors on the optoelectronic properties. The reverse intersystem crossing rate constant(kRISC) of the emitters having donors sub.tituted at positions 11and 12 of the dib.nzo[a,c]phenazine(b.) is more than 10-times faster than that of compounds sub.tituted having donors sub.tituted at positions 3 and 6. Compound 2DPACz b., containing stronger donors than 2GCz b., exhib.ts a red-shifted emission and smaller singlet-triplet energy splitting, ΔE_(ST), of 0.01 e V. The solution-processed OLED with 10 wt% 2DPACz b. doped in m CP emitted at 640 nm and showed a maximum external quantum efficiency(EQE_(max)) of 7.8%, which was effectively maintained out to a luminance of 1,000 cd m-2. Such a device's performance at relevant display luminance is among the highest for solution-processed red TADF OLEDs. The efficiency of the devices was improved significantly b. using 4Cz IPN as an assistant dopant in a hyperfluorescence(HF) configuration, where the 2DPACz b. HF device shows an EQEmaxof 20.0% at λEL of 605 nm and remains high at 11.8% at a luminance of 1,000 cd m-2, which makes this device one of the highest efficiency orange-to-red HF SP-OLEDs to date.

关键词： thermally activated delayed fluorescence solution-processing red OLEDs dib.nzo[a,c]phenazine dendrimers

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