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The Prevalence of Stroke Survivors in Urban Slums in Enugu, Nigeria

open Journal of Preventive Medicine 2019年第6期9卷 51-67页

作者： oluchi Stella Ekenze Ezeala-Adikaibe Birinus Adikaibe onodugo obinna Chime Peter orjioke Casmir onodugo Pauline Nkiruka Mbadiwe Nkeiruka onyekonwu Chinwe Ijoma Nkemdilim Uchenna okoye Julius Uwabunkeonye obumneme-Anyim Ijeoma Nnenne Ekochin Fintan ernest okwundu nwazor Emmanuel Uzodimma Iwuozo Department of Medicine University of Nigeria Teaching Hospital Enugu Nigeria Department of Medicine Enugu State University of Science and Technology Teaching Hospital Enugu Nigeria Department of Pediatrics University of Nigeria Teaching Hospital Enugu Nigeria Department of Medicine Federal Medical Center Owerri Nigeria Federal Medical Center Makurdi Nigeria

Background: Stroke is one of the commonest non-communicable diseases and the commonest cause of death in adult neurology wards. Stroke preva-lence in sub Saharan Africa has dramatically increased over the past decades possibly due to changing life styles, poverty, poor health infrastructures which had led to increased risk factors for stroke. Poor nutrition and lack of access to standard medical care, predispose to high rates of stroke morbidity and mor-tality hence possible low prevalence. Little is known about the prevalence of stroke in people with low socio-economic status in Nigeria. objectives: The main objective of this study was to determine the prevalence of stroke in two urban slums in south east Nigeria. Materials and Methods: This was a cross sectional descriptive study carried out in two slums in Enugu, South East Nige-ria. Participants were screened using a stroke specific questionnaire and further examined by two independent neurologists for evidence of focal neurological deficits. Analysis was done by SPSS version 22. Results: A total of 1440 par-ticipants were surveyed in the study;769 (53.4) females and 671 (46.6%) males. About 22.3% (321) screened positive for various neurological diseases out of which 17 (5.3%) had evidence for stroke giving an overall prevalence of 1.2% (males 9 (1.3%) vs females 8 (1%) p = 0.6). The mean age of stroke sur-vivors was 60.1 years, similar in males and females (p = 0.6). The odds ratio for stroke from 40 years showed progress increment doubling between 60 and 70 years and tripled between 40 and 70 years. Age, lower level of education, positive history of hypertension, sickle cell disease, leg swelling and use of snuff positively are correlated with clinical diagnosis of stroke. Conclusion: The prevalence of stroke in two urban slums in Enugu metropolis was 12/1000. Hypertension, diabetes, use of snuff, and low levels of education were signifi-cant risk factors for stroke. Public health educational measures, promoti

关键词： Stroke Prevalence Nigeria

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Risk Factors, Clinical Features, Baseline Alanine Aminotransferase and CD4⁺ Count of Children with HIV Co-Infection with Hepatitis B and C at a Tertiary Hospital in Southwest Nigeria

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International Journal of Clinical Medicine 2016年第4期7卷 280-291页

作者： M. o. Durowaye S. K. ernest I. A. ojuawo Department of Paediatrics Federal Medical Centre Lokoja Nigeria Department of Paediatrics and Child Health University of Ilorin Ilorin Nigeria

Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and hepatitis C but the risk factors and clinical presentation have not been much addressed especially in children. Methodology: This was a prospective cross sectional study that determined the prevalence, risk factors, clinical features, baseline CD4+ count, CD4+ percentage, and alanine aminotransferase (ALT) of newly diagnosed, HAART na?ve HIV co-infection among children who were managed at a Tertiary Hospital in Ilorin, Nigeria. Result: of the 60 HIV- infected children recruited, 11.7% had HIV co-infection with HBV or HCV. Children with co-infec- tions (mean age 8.43 ± 2.37 years) were significantly older than their HIV mono-infected counterparts (mean age 5.25 ± 3.96 years) (p = 0.011). There was no significant difference between HIV monoinfection and HIV co-infection with respect to gender (p = 0.758), ethnicity (p = 0.707), religion of parents (p = 0.436), family type (p = 0.184), social class (p = 0.535), previous transfusion (p = 0.053), scarification (p = 0.612), female genital mutilation (p = 0.778), and sharing of clippers (p = 0.806). The mean BMI, immunological staging (p = 0.535), baseline ALT (p = 0.940), and mean baseline CD4+ count (p = 0.928) were comparable. However, the body mass index of HIV co-infec- ted children decreased with age up till age 10 years. Conclusion: There were no risk factors, nor clinical features predictive of co-infection identified in this study. Co-infection did not negatively impact baseline, CD4+ count and ALT.

关键词： Co-Infection Hepatitis B Hepatitis C Human Immunodeficiency Virus Acquired Immunodeficiency Syndrome HIV HBV HCV Alanine Aminotransferase ALT Highly Active Antiretroviral Therapy HAART Monoinfection CD4+ Risk Factors for Co-Infection Transmission Hepatitis B Surface Antigen HBVsAg

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Sociology and Degrowth： Visions of Social Change, Entropy and Evolution in a Waydown Era

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Sociology Study 2011年第3期1卷 212-220页

作者： ernest Garcia Universitat de Valencia Spain

In the last few years, different sources pointed to a same message： industrial civilization had entered into an overshoot mode; the natural limits to growth had been already surpassed. This frontier does not wait for us in the future; it already belongs to our past. If population and the economy are truly beyond the limits, then current visions and theories of social change would be deeply perturbed. If the development era is approaching its end, then many sociological theories on current societies will share the same destiny： sustainable development doctrines between them. It is worth to examine theories that explicitly look at the social world which at least are not incompatible with it. Four different approaches are discussed in this context： governance of complexity, post-development and alternative local development, utopian sceneries of a prosperous waydown, visions of collapse and the die-off. As a conclusion, the paper accepts an evolutionary perspective supports that there are some potentials for conscious social change, but it does not justify the belief in a particular only line of history. This conclusion does not satisfy the desire of knowing the future; nevertheless it may be the only one possible. The future is not written. Neither in history nor in evolution; not even in the mixture of history and evolution that conforms us as inhabitants of the Earth.

关键词： Degrowth environmental sociology sustainability complexity post-development

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老人与海

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作者： (美)海明威(ernest Hemingway)

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Improving testicular examinations on paediatric patients in the emergency department:A quality improvement study to improve early diagnosis of testicular torsion

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Asian Journal of Urology 2022年第2期9卷 152-156页

作者： ernest M.Cheng Juanita N.Chui Murray Crowe Andrew Cooke Department of Emergency Medicine St George HospitalKogarahNSWAustralia Sydney Medical School University of SydneyCamperdownNSWAustralia St George Clinical School University of New South WalesKogarahNSWAustralia

objective:Male paediatric patients presenting with abdominal and/or testicular pain are common in the emergency *** a time-sensitive diagnosis,the importance of early recognition,referral,and definitive management is *** or delayed diagnoses and management of testicular torsion can result in significant long-term sequelae including impaired fertility and psychological *** this quality improvement study,we utilised educational posters aiming to improve awareness of testicular torsion as a differential for abdominal pain and therefore,improve the quality of testicular examinations performed in the emergency ***:observational pre-and post-intervention study was conducted at a tertiary hospital emergency department.A pre-interventional retrospective review of the electronic medical records was *** male patients under 16-years-old presenting with“abdominal pain”or“testicular problem”were *** assessed the rate of testicular examination and the quality of the examination based on four domains:Cremasteric reflex,lie,swelling,and *** posters targeting both patients and clinicians were placed around the emergency *** review of the electronic medical records post-intervention was performed assessing the same ***:A total of 235 presentations were analysed with 124 in the pre-intervention group and 111 in the post-intervention *** rate of documented testicular examinations increased by 14%(p=0.032).The quality of testicular examinations also improved from an average of 0.85 domains documented to 2.29 post-intervention(poup analysis found doctors in training had a greater improvement in both rate and quality of documented testicular ***:our study demonstrated the value of continuing education in promoting awareness of testicular torsion in the emergency *** found a clear improvement in the quality of clinical documentation

关键词： Testicular torsion Testicular examination Emergency department Quality improvement Urological emergency

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Navigated liver surgery:State of the art and future perspectives

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Hepatobiliary & Pancreatic Diseases International 2022年第3期21卷 226-233页

作者： Paschalis Gavriilidis Bjørn Edwin Egidijus Pelanis ernest Hidalgo Nicola de’Angelis Riccardo Memeo Luca Aldrighetti Robert P Sutcliffe Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery Queen Elizabeth University Hospitals Birmingham NHS Foundation TrustB152THUK The Intervention Centre and Department of HPB Surgery Oslo University Hospital and Faculty of MedicineUniversity of OsloOsloNorway Department of Hepato-Pancreatico-Biliary Surgery and Transplantation Hospital Universitari Vall d’HebronBarcelonaSpain Department of Digestive Surgery University Hospital Henri Mondor(AP-HP)94010 Creteil and University of Paris EstCreteilFrance Department of Hepatobiliary and Pancreatic Surgery Miulli HospitalAcquaviva delle FontiBari 70021Italy Division of Hepatobiliary Surgery San Raffaele HospitalVia Olgettina 60Milan 20132Italy

Background:In recent years,the development of digital imaging technology has had a significant influence in liver *** ability to obtain a 3-dimensional(3D)visualization of the liver anatomy has provided surgery with virtual reality of simulation 3D computer models,3D printing models and more recently holograms and augmented reality(when virtual reality knowledge is superimposed onto reality).In addition,the utilization of real-time fluorescent imaging techniques based on indocyanine green(ICG)uptake allows clinicians to precisely delineate the liver anatomy and/or tumors within the parenchyma,applying the knowledge obtained preoperatively through digital *** combination of both has transformed the abstract thinking until now based on 2D imaging into a 3D preoperative conception(virtual reality),enhanced with real-time visualization of the fluorescent liver structures,effectively facilitating intraoperative navigated liver surgery(augmented reality).Data sources:A literature search was performed from inception until January 2021 in MEDLINE(Pub Med),Embase,Cochrane library and database for systematic reviews(CDSR),Google Scholar,and National Institute for Health and Clinical Excellence(NICE)***:Fifty-one pertinent articles were retrieved and *** different types of digital imaging technologies and the real-time navigated liver surgery were estimated and ***:ICG fluorescent imaging techniques can contribute essentially to the real-time definition of liver segments;as a result,precise hepatic resection can be guided by the presence of ***,3D models can help essentially to further advancing of precision in hepatic surgery by permitting estimation of liver volume and functional liver remnant,delineation of resection lines along the liver segments and evaluation of tumor *** liver transplantation and especially in living donor liver transplantation(LDLT),3D printed models of the donor’s live

关键词： Navigated Hepatic surgery 3D Computer assistance Image guidance Image guided surgery Indocyanine green 3D print Visual simulation Virtual reality Augmented reality Real-time navigated liver surgery

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Effects of Medicines and Supplements on Spontaneous Pregnancy and Semen Parameters in Male Infertility:A Systematic Review Update and Network Meta-Analysis

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Engineering 2022年第9期16卷 198-209页

作者： Jian Li Qi Wu ernest Hung Yu Ng Ben Willem J.Mol Xiao Ke Wu Chi Chiu Wang Department of obstetrics and Gynecology First Affiliated HospitalHeilongjiang University of Chinese MedicineHarbin 150040China Department of obstetrics and Gynecology The Affiliated Hospital of Gui Zhou Medical UniversityGuiyang 550004China Department of obstetrics and Gynaecology Prince of Wales HospitalThe Chinese University of Hong KongHong Kong 999077China Department of obstetrics and Gynecology Obstetrics and Gynecology HospitalFudan UniversityShanghai 30009China Department of obstetrics and Gynaecology Queen Mary HospitalThe University of Hong KongHong Kong 999077China Department of obstetrics and Gynaecology Monash UniversityClaytonVIC 3168Australia Heilongjiang Provincial Hospital Harbin Institute of TechnologyHarbin 150036China Reproduction and Development Laboratory Li Ka Shing Institute of Health SciencesThe Chinese University of Hong KongHong Kong 999077China i School of Biomedical SciencesThe Chinese University of Hong KongHong Kong 999077China The Chinese University of Hong Kong–Sichuan University Joint Laboratory of Reproductive Medicine Hong Kong 999077China

In this study,we used a network meta-analysis(NMA)to compare the effectiveness of medicines and supplements for idiopathic male infertility and to identify the best ***,Excerpta Medica Database(EMBASE),ovid,and China National Knowledge Infrastructure(CNKI),were searched for the period from January 1990 to June 2021 using the keywords"male infertility,""medical therapy,""supplement/nutrient therapy,"and related *** controlled trials(RCTs)investigating medicines(mainly follicle-stimulating hormone(FSH),androgen,and clomiphene/tamoxifen)or supplements(mainly zinc,selenium,vitamin C or E,carnitine,coenzyme Q10(CoQ10),or combined treatment)for idiopathic infertile men were selected for *** reporting items for systematic reviews and meta-analysis(PRISMA)was used for data extraction,and a risk-of-bias tool and grades of recommendation,assessment,development,and evaluation(GRADE)system adapted to the NMA were employed to assess the quality of the *** primary outcomes were live birth and spontaneous pregnancy rate(SPR).The secondary outcomes were sperm parameters(including concentration,progressive motility,and morphology)and side *** total,65 RCTs involving 7541 men with sperm abnormalities but normal hormone levels were included.A total of 36 studies reported SPR but only three reported live birth *** quality of the included studies was found to be moderate to *** with a placebo or being untreated,carnitine plus vitamins significantly improved SPR(relative risk(RR)=3.7,95%confidence interval(95%CI),1.6-8.5);fatty acids significantly increased sperm concentrations(mean difference(MD)=12.5×10^(6)mL-1,95%CI,3.1×10^(6)-22.0×10^(6));and selective estrogen receptor modulator(SERM)plus CoQ10 significantly improved sperm progressive motility(MD=11.0%,95%CI,0.1%-21.9%)and normal sperm morphology(MD=11.0%,95%CI,4.6%-17.4%).The most optimal intervention was carnitine plus vitamins and fatty acids for SPR a

关键词： Male infertility Medicine Supplement Spontaneous pregnancy rate Sperm parameters

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Excerpt from The old Man and the Sea

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考试与评价（英语高考专刊） 2016年第12期 48-49页

作者： ernest Hemingway

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Pretreatment neutrophil-to-lymphocyte ratio predicts worse survival outcomes and advanced tumor staging in patients undergoing radical cystectomy for bladder cancer

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Asian Journal of Urology 2017年第4期4卷 239-246页

作者： Yu Guang Tan ernest Eu Weber Lau Kam on Hong Hong Huang Department of Urology Singapore General HospitalSingapore

objective:To determine the role of neutrophil-to-lymphocyte ratio(NLR)in prognosticating survival outcomes in patients with advanced/metastatic urothelial bladder ***:We retrospectively reviewed 84 patients undergoing radical cystectomy(RC)for UCB from January 2002 to June *** was computed(median:5 days)prior to *** patients received neoadjuvant *** was analyzed as a continuous variable and a cut-off point of 2.7 was obtained,with a statistical receiver operating characteristics of *** curves,multivariate Cox proportional hazard and logistics regression models were used to predict NLR association with survival ***:The median follow-up period was 30.1 months(range:3.2e161.7)owing to high recurrence rate and subsequent mortalities,compared to the median 64.7 months in patients alive at the end of study ***2.7 was associated with worse survival outcomes(5-year disease-specific survival:22%vs 58%,p Z 0.017,95%CI:1.193e6.009;5-year overall survival:23%vs 60%,p Z 0.008,95%CI:1.322e6.147).Furthermore,on multivariate analyses,higher NLR was independently associated with higher recurrence rate(p Z 0.007,HR Z6.999,95%CI:1.712e28.606),higher T staging(p Z 0.021,HR Z 3.479,95%CI:1.212e9.990)and lymph node involvement(p Z 0.009,HR Z 4.534,95%CI:1.465e14.034).

关键词： Bladder cancer Neutrophil-tolymphocyte ratio Radical cystectomy Bladder carcinoma

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Scaling up impact of malaria control programmes: a tale of events in Sub-Saharan Africa and People’s Republic of China

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Infectious Diseases of Poverty 2012年第1期1卷 61-75页

作者： ernest Tambo Ahmed Adebowale Adedeji Fang Huang Jun-Hu Chen Shui-Sen Zhou Ling-Hua Tang National Institute of Parasitic Disease Chinese Center for Disease Control and PreventionWHO Collaborating Centre on MalariaSchisostomiasis and FilariasisKey Laboratory of Parasite and Vector BiologyMinistry of Health207 Rui Jin Er RdShanghai 200025People’s Republic of China School of Medicine&Pharmacy Houdegbe North American University PK10Route de Porto-Novo06 BP 2080CotonouRépublique du Bénin Department of Pharmacology and Toxicology Kampala International University Western CampusP.O.Box 71IshakaBushenyiUganda

This review aims at providing synthetic information with scientific evidence on the trends in the malaria events from 1960 to 2011,with the hope that it will help policy makers to take informed decisions on public health issues and intervention designs on malaria control towards elimination in both Sub-Sahara Africa and in the People’s Republic of China by highlighting the achievements,progress and challenges in research on moving malaria from epidemic status towards *** findings showed that since 1960,malaria control programmes in most countries have been disjointed and not ***,during the last decade,the causal factors of the unprecedented and substantial decline in malaria morbidity and mortality rates in most vulnerable groups in these endemic areas are multifaceted,including not only the spread of malaria and its related effects but also political and financial willingness,commitment and funding by governments and international *** benefits of scaling up the impact of malaria coverage interventions,improvement of health system approaches and sustained commitment of stakeholders are highlighted,although considerable efforts are still necessary in Sub-Sahara ***,novel integrated control strategies aiming at moving malaria from epidemic status to control towards elimination,require solid research priorities both for sustainability of the most efficient existing tools and intervention coverage,and in gaining more insights in the understanding of the epidemiology,pathogenesis,vector dynamics,and socioeconomic aspects of the *** conclusion,political commitment and financial investment of stakeholders in sustaining the scaling up impact of malaria control interventions,networking between African and Chinese scientists,and their Western partners are urgently needed in upholding the recent gains,and in translating lessons learnt from the Chinese malaria control achievements and successes into practical interve

关键词： malaria funding scaling up interventions health system Sub-Sahara Africa People’s Republic of China

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