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Effectiveness of Contact Tracing of Index Tuberculosis Cases in Nigeria

Advances in Infectious Diseases 2018年第4期8卷 173-199页

作者： Okorie Onuka Ikpeazu Okezie john ahukanna Chukwudi Okebaram Patrick Dakum Aderonke Agbaje Vivian Ibeziako Gidado Mustapha Nkem Chukwueme Emperor Ubochioma Amarachi Okorie Nwafor Charles Chux Anago TB Control Program Ministry of Health Abia State Nigeria Abia State Government House Umuahia Abia State Nigeria Ministry of Health Abia State Nigeria Department of Pharmacology and Therapeutics Abia State University Uturu Nigeria Institute of Human Virology Abuja Nigeria KNCV Abuja Nigeria National TB Control Program Abuja Nigeria School of Midwifery Ministry of Health Umuahia Nigeria GLRA Enugu Enugu Nigeria Clinton Health Access Initiative Abuja Nigeria

Tuberculosis (TB) is a chronic disease that has impacted negatively on human history. The biology of the mycobacterium tuberculosis is complicated and has affected the control as well as elimination of the disease. Nigeria is one of the countries with high incidence and prevalence of TB. The late and low case detection has been a major problem with National TB control program, caused by passive case finding strategy practiced by the country. A shift from the passive and active case search has been recommended for detection of missing cases of TB and improved program performance. The proximity of TB contact is a major determinant of disease transmission. However, maximizing early case detection and prompt treatment of notified cases is very useful in (TB) control especially in high burden countries. The tracking of TB contacts provides a good platform for early diagnosis, educating the household on TB disease and infection control as well as breaking the chain of transmission. The objective of the study is to ascertain effectiveness of contact tracing on Tuberculosis case detection. The study is a retrospective quasi experimental with quantitative arm. The study was conducted in Abia State, one of the South Eastern States of Nigeria. A pre-tested questionnaire was used for data collection and analyzed with SPSS. A total of 168 and 162 index cases of TB were recruited for both intervention and control facilities. The 168 index TB cases yielded 301 TB contacts. The result revealed 55% contact/index ratio, presumptive TB yield of 130 (43.2%) and TB yield of 68 (22.6%). The cases registered in the State increased from 336 to 417 and p value = 0.001, while presumptive TB and BCG vaccination were major predictors. The study shows that tracing contact of index TB cases is an effective and complementary method of finding undetected cases of TB.

关键词： Contact tracing Index TB cases

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A Case Study of Multi Drug-Resistant Tuberculosis (MDR-TB), HIV and Diabetes Mellitus (Dm) Comorbidity: Triple Pathology;Challenges and Prospects

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Advances in Infectious Diseases 2017年第3期7卷 70-79页

作者： Okorie Onuka john ahukanna Chukwudi Okebaram Patrick Dakum Aderonke Agbaje Vivian Ibeziako Gidado Mustapha Nkem Chukwueme Chux Anago Emperor Ubochioma Amarachi Okorie Odume Bethrand Nwafor Charles Abia State Ministry of Health Umuahia Nigeria Department of Pharmacology Abia State University Okigwe Nigeria Institute of Human Virology Abuja Nigeria Challenge KNCV Abuja Nigeria Clinton Health Access Initiative Abuja Nigeria National Tuberculosis and Leprosy Control Program Abuja Nigeria School of Midwifery Umuahia Nigeria Department of Family Medicine National Hospital Abuja Nigeria German Leprosy and Tuberculosis Relief Association Enugu Nigeria

Tuberculosis (TB), diabetes mellitus and HIV co-morbidity is a rare and interrelated health condition with associated high morbidity and mortality especially in developing countries with high prevalence of TB. It has become an emerging concern to epidemiologists and TB control programs due to complexities in its control and management. Managing MDR-TB, DM and HIV comorbidity is challenging, with risk of unfavorable outcome;consequently, close monitoring is necessary. Individuals with weak immunity resulting from diseases such as uncontrolled Diabetes Mellitus (DM) and HIV have a higher risk of developing TB or progression from latent to active TB. We present a 65-year old known diabetic patient who presented to Royal Cross Hospital Ugwueke Abia State, Nigeria with a one-year history of recurrent productive cough with associated night sweats, low grade fever and marked weight loss. A diagnosis of drug-resistant TB with DM/HIV co-morbidity was made and co-managed by experts from the respective clinics and the State TB control program. The patient was declared cured (7 months consecutive negative cultures each taken 30 days apart) after completing 20 months of conventional MDR-TB treatment. The patient showed remarkable clinical improvement including weight gain, good diabetic control and significant increase in CD4 (700 cells). Managing MDR-TB patients with diabetes and HIV is challenging, however, appropriate treatment, psychosocial support, adequate blood sugar control as well as monthly monitoring of patients with requisite investigations are vital in achieving good treatment outcome.

关键词： Co-Morbidity-Diabetes-Multi Drug Resistant TB and HIV

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Challenges and Opportunities in Preserving Key Structural Features of 3D-Printed Metal/Covalent Organic Framework

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Nano-Micro Letters 2024年第8期16卷 362-381页

作者： Ximeng Liu Dan Zhao john Wang Department of Materials Science and Engineering National University of SingaporeSingapore 117574Singapore Department of Chemical and Biomolecular Engineering National University of SingaporeSingapore 117585Singapore National University of Singapore(Chongqing)Research Institute Chongqing 401123People’s Republic of China

Metal-organic framework(MOF)and covalent organic framework(COF)are a huge group of advanced porous materials exhibiting attractive and tunable microstructural features,such as large surface area,tunable pore size,and functional surfaces,which have significant values in various application areas.The emerging 3D printing technology further provides MOF and COFs(M/COFs)with higher designability of their macrostructure and demonstrates large achievements in their performance by shaping them into advanced 3D monoliths.However,the currently available 3D printing M/COFs strategy faces a major challenge of severe destruction of M/COFs’microstructural features,both during and after 3D printing.It is envisioned that preserving the microstructure of M/COFs in the 3D-printed monolith will bring a great improvement to the related applications.In this overview,the 3D-printed M/COFs are categorized into M/COF-mixed monoliths and M/COF-covered monoliths.Their differences in the properties,applications,and current research states are discussed.The up-to-date advancements in paste/scaffold composition and printing/covering methods to preserve the superior M/COF microstructure during 3D printing are further discussed for the two types of 3D-printed M/COF.Throughout the analysis of the current states of 3D-printed M/COFs,the expected future research direction to achieve a highly preserved microstructure in the 3D monolith is proposed.

关键词： Metal-organic frameworks Covalent organic frameworks 3D printing Microstructure Monolith

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The Prevalence of Drug-Resistant Tuberculosis among People Living with HIV (PLHIV) in Abia State

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Advances in Infectious Diseases 2016年第2期6卷 63-69页

作者： Onuka Okorie ahukanna john M. Gidado Gabriel Akang Ubochioma Emperor Enogu Rupert Ibeziako Vivian Emmanuel Meribole Pius Osakwe TB Control Program Ministry of Health Umuahia Nigeria KNCV Abuja Nigeria Institute of Human Virology Abuja Nigeria National TB Control Program Abuja Nigeria World Health Organization Enugu Nigeria

Tuberculosis (TB) is a chronic disease caused by mycobacterium tuberculosis and transmitted from person to person, through inhalation of droplet nuclei aerosolized by coughing of an infected person. It reached epidemic proportions in Europe and North America during the 18th and 19th centuries. The incubation period is 2 - 6 weeks and the control has been complicated with emergence of HIV and drug-resistant TB. In 1993, World Health Organization (WHO) declared TB a global emergency. However, despite the concerted effort of National TB control programs, adoption and implementation of Stop TB strategy, TB has remained a major public health challenge with high mortality rate, especially in developing countries. Methodology: This is a descriptive study, evaluated using the positivist/quantitative approach. The study was conducted at FederalMedical Centre Umuahia, a tertiary specialist hospital with comprehensive TB/HIV treatment services. All the presumptive drug-resistant TB cases and symptomatic PLHIV were screened for HIV and their sputum specimens were tested for tuberculosis using the Gene xpert and the Ziehl- Neelsen technique for detecting Acid Fast bacilli. A pretested structured questionnaire was used tocollect the demographic data and other essential data from the presumptive TB and laboratory registers such as total number of TB presumptive cases registered HIV status, AFB status and rifampicin status within the study period. Result: A total of 493 presumptive TB cases were screened in the study, 49.9% were HIV positive while 50.05% were HIV negative. More so, 77.85% of thescreened cases were AFB negative and 22.15% were AFB positive. Moreover, 11% of the TB/HIV co-infected patients were rifampicin positive. Interestingly among the 493 cases screened with gene xpert machine, 3.6% were rifampicin positive. Furthermore, 3.6% of the HIV negative cases were rifampicin positive while 1.6% of the HIV positive cases were rifampicin positive. Discussion: The data depict lower rifampicin resistance among HIV positiv

关键词： Multidrug Resistant TB among People Living with HIV

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Surgical treatment of inflammatory bowel disease:From the gastroenterologist’s stand-point

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1235-1254页

作者： john K Triantafillidis Inflammatory Bowel Disease Unit “Metropolitan General”HospitalHolargos 15562AtticaGreece Hellenic Society of Gastrointestinal Oncology Haidari 12461AthensGreece

Treatment of ulcerative colitis(UC)and Crohn’s disease(CD)represents,in the majority of cases,a real challenge to the gastroenterologist’s abilities and skills as well as a clinical test concerning his/her levels of medical knowledge and experience.During the last two decades,our pharmaceutical arsenal was significantly strengthened,especially after the introduction of the so-called biological agents,drugs which to a large extent not only improved the results of conservative treatment but also changed the natural history of the disease.However,colectomy is still necessary for some patients with severe UC although smaller compared to the past,precisely because of the improvements achieved in the available conservative treatment.Nevertheless,surgeries to treat colon dysplasia and cancer are increasing to some extent.At the same time,satisfactory improvements in surgical techniques,the pre-and post-operative care of patients,as well as the selection of the appropriate time for performing the surgery have been noticed.Regarding patients with CD,the improvement of conservative treatment did not significantly change the need for surgical treatment since two-thirds of patients need to undergo surgery at some point in the course of their disease.On the other hand,the outcome of the operation has improved through good preoperative care as well as the wide application of more conservative surgical techniques aimed at keeping as much of the bowel in situ as possible.This article discusses the indications for surgical management of UC patients from the gastroenterologist’s point of view,the results of the emerging new techniques such as transanal surgery and robotics,as well as alternative operations to the classic ileo-anal-pouch anastomosis.The author also discusses the basic principles of surgical management of patients with CD based on the results of the relevant literature.The self-evident is emphasized,that is,to achieve an excellent therapeutic result in patients with severe inflammatory bowel disease in today’s era;t

关键词： Inflammatory bowel disease Ulcerative colitis Crohn’s disease Surgery Treatment Ileo-anal-pouch anastomosis Indications Techniques

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A Population Dynamics Approach to the Distribution of Space Debris in Low Earth Orbit

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Communications on Applied Mathematics and Computation 2024年第1期6卷 340-353页

作者： john Jurkiewicz Peter Hinow Department of Mathematical Sciences University of Wisconsin-MilwaukeeMilwaukeeWI53201USA

The presence of the debris in the Earth’s orbit poses a significant risk to human activity in outer space.This debris population continues to grow due to ground launches,the loss of external parts from space ships,and uncontrollable collisions between objects.A computationally feasible continuum model for the growth of the debris population and its spatial distribution is therefore critical.Here we propose a diffusion-collision model for the evolution of the debris density in the low-Earth orbit and its dependence on the ground-launch policy.We parametrize this model and test it against data from publicly available object catalogs to examine timescales for the uncontrolled growth.Finally,we consider sensible launch policies and cleanup strategies and how they reduce the future risk of collisions with active satellites or space ships.

关键词： Population dynamics Space debris Kessler syndrome Diffusion Low-Earth orbit

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Does photobiomodulation require glucose to work effectively?

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Neural Regeneration Research 2024年第5期19卷 945-946页

作者： Jaimie Hoh Kam john Mitrofanis UniversitéGrenoble Alpes Fonds de Dotation ClinatecGrenobleFrance University College London Institute of OphthalmologyUK

A main requirement for cells to function normally is the availability of glucose.Glucose,available either direct from circulation or storage,is converted to the essential energy that cells need to drive critical intrinsic functions.If cells are deprived of glucose,they become dysfunctional and suffer distress.Photobiomodulation,the use of specific wavelengths of light on body tissues,has been shown to promote,through small organelles called mitochondria,the metabolism of glucose to make energy for cells;this energy can be used to improve cell function and survival.In this perspective,we hypothesize that the availability of glucose is central to the core mechanism of photobiomodulation;that photobiomodulation is at its most efficient in stimulating mitochondrial activity and improving cell function when there is glucose readily available.

关键词： metabolism distress stimulating

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Optimizing prediction models for pancreatic fistula after pancreatectomy:Current status and future perspectives

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World Journal of Gastroenterology 2024年第10期30卷 1329-1345页

作者： Feng Yang john A Windsor De-Liang Fu Department of Pancreatic Surgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China Surgical and Translational Research Centre Faculty of Medical and Health SciencesUniversity of AucklandAuckland 1142New Zealand

Postoperative pancreatic fistula(POPF)is a frequent complication after pancre-atectomy,leading to increased morbidity and mortality.Optimizing prediction models for POPF has emerged as a critical focus in surgical research.Although over sixty models following pancreaticoduodenectomy,predominantly reliant on a variety of clinical,surgical,and radiological parameters,have been documented,their predictive accuracy remains suboptimal in external validation and across diverse populations.As models after distal pancreatectomy continue to be pro-gressively reported,their external validation is eagerly anticipated.Conversely,POPF prediction after central pancreatectomy is in its nascent stage,warranting urgent need for further development and validation.The potential of machine learning and big data analytics offers promising prospects for enhancing the accuracy of prediction models by incorporating an extensive array of variables and optimizing algorithm performance.Moreover,there is potential for the development of personalized prediction models based on patient-or pancreas-specific factors and postoperative serum or drain fluid biomarkers to improve accuracy in identifying individuals at risk of POPF.In the future,prospective multicenter studies and the integration of novel imaging technologies,such as artificial intelligence-based radiomics,may further refine predictive models.Addressing these issues is anticipated to revolutionize risk stratification,clinical decision-making,and postoperative management in patients undergoing pancre-atectomy.

关键词： Pancreatic fistula Pancreaticoduodenectomy Distal pancreatectomy Central pancreatectomy Prediction model Machine learning Artificial intelligence

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Optimizing oncolytic virus design:a“Swiss army knife”approach to create a systemically delivered therapeutic

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Signal Transduction and Targeted Therapy 2024年第5期9卷 1791-1792页

作者： Carolina S.Ilkow john Cameron Bell Ottawa Hospital Research Institute 501 Smyth RoadOttawaONK1H 8L6Canada

In a recent paper published in Nature Biotechnology,Chen et al.1 describe a multiplex oncolytic virus platform that coupled with adoptive T cell therapy could solve the problem of repeat,systemic delivery of virus based therapeutics.It is widely accepted that multi-targeted therapeutic approaches attacking several facets of cancer biology are necessary to effectively deal with the tumor heterogeneity that exists within and between patients.

关键词： therapeutic al. targeted

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Nonuniform Dependence on the Initial Data for Solutions of Conservation Laws

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Communications on Applied Mathematics and Computation 2024年第1期6卷 489-500页

作者： john M.Holmes Barbara Lee Keyfitz Department of Mathematics The Ohio State UniversityColumbusOH43210USA

In this paper,we study systems of conservation laws in one space dimension.We prove that for classical solutions in Sobolev spaces H^(s),with s>3/2,the data-to-solution map is not uniformly continuous.Our results appl... 详细信息

关键词： Conservation laws Data-to-solution map Nonuniform dependence

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