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Journal of Tuberculosis Research 2021年第3期9卷 160-171页

作者： muse o. fadeyi Bolaji Ahmed Akinwumi Akindele Adebayo Bakare Modupe Ariyo olalekan onitiju osman El-Tayeb Taofeekat Ali Yasir othman Aderonke Agbaje Damien Foundation Belgium (Nigeria Project) Ibadan Oyo State Nigeria Institute of Human Virology Nigeria (IHVN) Abuja Nigeria Hull university Teaching Hospitals NHS Trust Hull United Kingdom

Introduction: Tuberculosis is one of the leading causes of mortalities attributable to an infectious disease. In a private sector-driven health system such as Nigeria, the private health providers are very important stakeholders in tuberculosis diagnosis and management. Unfortunately, there are few data on the level of contribution of these private health providers to the case finding and notification of tuberculosis in Nigeria. Consequently, this study assessed the contribution of the private providers to the diagnosis and treatment of tuberculosis under the Global Fund Private Public Mix New Funding Model (2nd phase) grant (GF PPM NFM2) in the four implementing states of south west Nigeria. Materials and Methods: This is a retrospective, cross-sectional analysis of the NFM2 programme implementation data collected between January 1, 2019 and December 31, 2020. Data was extracted from the routine registers such as the presumptive TB registers;treatment register of the private health facilities engaged for PPM activities between 2019 and 2020. The data was entered and analyzed using Microsoft excel package. The variables were summarized using appropriate charts and table. Results: Concerning the percentage contribution of the Global Fund Private Public Mix (GF PPM) grant to the total sta

关键词： Private Provider Tuberculosis Diagnosis Notification

AN INSIDE LooK AT LEED:EXPERIENCED PRACTITIoNERS REVEAL THE INNER WoRKINGS oF LEED

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Journal of Green Building 2006年第1期1卷 3-8页

作者： Ashley muse Josette M.Plaut Rocky Mountain Institute Colorado State university

INTRoDUCTIoN LEED is leading the building industry towards a greener future.A clever acronym for Leadership in Energy and Environmental Design,the LEED Rating System is a voluntary,consensus-based,national standard for developing high-performance,sustainable *** *** Building Council(USGBC),a non-profit organization,developed the LEED Rating System in the late 1990s,and it has quickly grown to be the most recognized green building assessment tool in the united *** there are over 20,000 LEED Accredited Professionals nationwide,only a small percent have worked closely on a LEED *** this reason,the inner-workings of LEED remain somewhat *** paper seeks to demystify the LEED process by outlining it in a systematic *** information herein will serve as a good tool and reference for individuals who are,or intend to,work on a project pursuing LEED in the near future.

关键词： LEED nationwide herein

The Use of Sputum Dashboard and Dispatch Riders in Mitigating Delay in Sputum Samples’ Processing—Evidence from an Intervention in Lagos State, Nigeria

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Journal of Tuberculosis Research 2021年第3期9卷 146-159页

作者： muse o.atunbo.un fadeyi Akinwumi Akindele Adebayo Bakare Bolaji Ahmed osman El-Tayeb Taofeekat Ali Yasir othman obioha Udunze Gbolahan Dairo Aderonke Agbaje Damien Foundation Belgium (Nigeria Project) Ibadan Oyo State Nigeria Institute of Human Virology Nigeria (IHVN) Abuja Nigeria Hull university Teaching Hospitals NHS Trust Hull United Kingdom

The act of referring TB presumptive individuals after verbal screening to another health facility/diagnostic centres for testing often results in large loss to follow-up, owing to the many barriers people face in accessing care. The transportation of sputum samples is an efficient method of increasing access to tuberculosis (TB) diagnostics in areas where testing is not currently available. One of the major reasons for the low yield of TB cases in the field was delay in sputum sample transportation to diagnostic laboratories among other factors. Damien Foundation Belgium, carried out a unique sputum riders initiatives in 20 LGAs of Lagos state between Q3-2019 and Q4-2020. A total of 25 sputum dispatch riders across the 20 LGAs in the State who are monitored routinely on an electronic dashboard were engaged for sputum logistics. Therefore, this report highlights how the initiatives have contributed to increased TB case notification in a densely populated metropolitan city in Nigeria. Overall, 48,265 units of sputum samples were transported to the laboratory from the facilities 99.9% of results which were received from the laboratory by the dispatch riders. The contribution of sputum riders to the overall TB case detection by the project progressively increased from 9% when the intervention began to 57% as at Q4 2020. The transportation of sputum samples by motorcycle dispatch riders is an efficient method of increasing access to TB diagnostic services in communities where testing is not currently available.

关键词： Sputum Samples Dispatch Rider Electronic Dashboard Sputum Logistics Tuberculosis

Glucocorticoids-based prodrug design:Current strategies and research progress

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Asian Journal of Pharmaceutical Sciences 2024年第3期19卷 41-78页

作者： Hongbing Liu muse Ji Peifu Xiao Jingxin Gou Tian Yin Haibing He Xing Tang Yu Zhang Department of Pharmaceutics Shenyang Pharmaceutical UniversityShenyang 110016China School of Chinese Materia Medica Shenyang Pharmaceutical UniversityShenyang 110016China

Attributing to their broad pharmacological effects encompassing anti-inflammation,antitoxin,and immunosuppression,glucocorticoids(GCs)are extensively utilized in the clinic for the treatment of diverse diseases such as lupus erythematosus,nephritis,arthritis,ulcerative colitis,asthma,keratitis,macular edema,and ***,longterm use often causes undesirable side effects,including metabolic disorders-induced Cushing's syndrome(buffalo back,full moon face,hyperglycemia,etc.),osteoporosis,aggravated infection,psychosis,glaucoma,and *** notorious side effects seriously compromise patients'quality of life,especially in patients with chronic ***,glucocorticoid-based advanced drug delivery systems for reducing adverse effects have received extensive *** them,prodrugs have the advantages of low investment,low risk,and high success rate,making them a promising *** this review,we propose the strategies for the design and summarize current research progress of glucocorticoid-based prodrugs in recent decades,including polymer-based prodrugs,dendrimer-based prodrugs,antibody-drug conjugates,peptide-drug conjugates,carbohydrate-based prodrugs,aliphatic acid-based prodrugs and so ***,we also raise issues that need to be focused on during the development of glucocorticoid-based *** review is expected to be helpful for the research and development of novel GCs and prodrugs.

关键词： Glucocorticoids Prodrug design Targeted drug delivery Research progress

快眼动睡眠行为障碍与额叶癫痫的鉴别及两者对睡眠参数影响的分析

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快眼动睡眠行为障碍与额叶癫痫的鉴别及两者对睡眠参数影响的分析

作者： Niman Ahmed muse 吉林大学

学位级别：硕士

目的:本研究的主要目的是鉴别睡眠中的发作性事件主要包括:快眼动睡眠行为障碍（RBD）和额叶癫痫（FLE）,分析两者对睡眠相关参数的影响。方法:收集2018年6月至2019年12月间就诊于第一医院神经内科睡眠中心的FLE和RBD患者及年龄性别相... 详细信息

目的:本研究的主要目的是鉴别睡眠中的发作性事件主要包括:快眼动睡眠行为障碍（RBD）和额叶癫痫（FLE）,分析两者对睡眠相关参数的影响。方法:收集2018年6月至2019年12月间就诊于第一医院神经内科睡眠中心的FLE和RBD患者及年龄性别相匹配的正常对照组共36例,每组12例,通过分析临床一般资料,24h EEG和PSG,比较其行为学特点及神经电生理差异。结果:RBD患者及FLE患者之间发病年龄有显著的统计学差异（P＜0.05）。RBD组患者表现为R期与梦境相关的喊叫和拍打（3例）,下肢运动（9例）,上肢摆动（8例）睡眠中含糊讲话7例;癫痫组表现为睡眠2期的发作性觉醒夜间过度运动发作（6例）,睡眠中坐起（5例）,意识障碍（12例）。RBD组显示PSG的RSWA,FLE组24hEEG表现为额区和额颞区的尖波和尖慢波,有1例患者FLE共病RBD患者的电生理检查可见24h EEG即显示尖慢波和PSG中的RSWA。病例组（RBD和FLE患者）与对照组之间的比较的结果显示,病例组和对照组之间SE,N1,WASo存在显著差异（P＜0.05）,微觉醒指数,AHI和PLM指数也存在显著差异（P＜0.010）。RBD与FLE组的组间比较结果显示,RBD组觉醒指数及N1时间高于癫痫组;RBD组的AHI及PLMD值高于癫痫组（P＜0.05）。结论:通过临床特征及PSG和24h-EEG相结合的方法可以有效鉴别RBD和额叶癫痫病,两者均影响睡眠参数及睡眠质量。RBD组对睡眠质量的影响大于额叶癫痫对其影响,RBD常伴有睡眠呼吸暂停低通气和睡眠中周期性肢体运动障碍。

关键词：快眼动睡眠行为障碍额叶癫痫睡眠监测 24h长程脑电图睡眠行为

腹腔镜与开腹脾切断流术治疗肝硬化门脉高压症的对比

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腹腔镜与开腹脾切断流术治疗肝硬化门脉高压症的对比

作者： Zakarie muse Ali 吉林大学

学位级别：硕士

背景:什么是肝硬化,门静脉高压和高血压?肝硬化被认为是结节的组织改变,包括与各种病因继发的一系列改变。作为终末期肝病的后遗症,大量引起肝细胞损伤的病因可导致肝硬化的进一步进展。酒精相关和病毒感染是全球最常见的原因,在大多数... 详细信息

背景:什么是肝硬化,门静脉高压和高血压?肝硬化被认为是结节的组织改变,包括与各种病因继发的一系列改变。作为终末期肝病的后遗症,大量引起肝细胞损伤的病因可导致肝硬化的进一步进展。酒精相关和病毒感染是全球最常见的原因,在大多数情况下,丙型肝炎病毒和酒精性肝硬化在美国较多,包括自身免疫性肝炎,胆管疾病,非酒精性脂肪性肝炎和遗传性疾病,包括血色素沉着症和α-1抗胰蛋白酶缺乏症等原因所导致的肝硬化。肝硬化的自然发展过程通常可以分为两个阶段-代偿期和失代偿期。Child-Pugh(CP)分类的形式,Child-Pugh A类疾病代表代偿性肝硬化,而Child-Pugh B级和C级代表失代偿性疾病。肝脏特异性并发症的进展分为两个阶段,其中包括黄疸,静脉曲张出血,顽固性腹水和肝性脑病,代偿性肝硬化患者与失代偿期肝硬化相比具有相对较好的预后。通过正确的治疗,肝硬化患者可以保持几年的平稳期,中位生存期近十年。当肝硬化患者进展为失代偿期时,其临床过程会导致与代谢和血液动力障碍相关的并发症的发生,预后较差。肝硬化也可导致肝脏进行性发展为肝细胞癌(HCC)。HCC是失代偿期疾病死亡的主要原因。HCC与酒精性肝硬化相比,更常见来源于慢性病毒性肝炎,尽管两者都可能发展为恶性.门静脉高血压是肝硬化最严重的并发症。肝硬化导致门静脉高压的机制主要有以下两种。首先,实质性肝细胞内的慢性炎症会引起瘢痕组织的纤维化和积聚。肝细胞结构紊乱的结果成为门静脉血流的机械障碍。第二,肝硬化通过不同的分子机制诱导血管内皮功能障碍。内脏和门静脉主干最显著地受到这种变化的影响。肝内血管本身变得易于收缩,这会进一步增加门静脉阻力。门静脉高压被描述为门静脉系统压力的病理改变。由于门静脉压的直接测量是创伤性和不切实际的,现在选择肝静脉压力梯度(HVPG)的测量用于门静脉高压的诊断。肝静脉压力梯度是指腹腔下腔静脉和门静脉之间的压力差,通常在1-5mm Hg之间。HVPG超过5mm Hg是门静脉高压的诊断标准,当HVPG增加超过10mm Hg时,与门静脉高压相关的并发症的发生率显着增加(例如,胃食管静脉曲张和临床失代偿期的发展)。此外,HVPG与肝功能衰竭严重程度,曲张静脉大小和静脉曲张出血风险直接相关。门静脉高压是肝硬化的严重并发症。脾功能衰竭是慢性肝病患者的典型并发症,与肝硬化严重程度相关,导致白细胞计数,血小板计数和血红蛋白水平降低。严重的血小板减少症,因为脾功能亢进显着增加自发性出血的风险,并可延误肝硬化患者的诊断或治疗程序,如干扰素治疗,肝活检和肝细胞癌切除术。此外,由于脾功能亢进引起的白细胞减少可引起细菌感染。由于门静脉高压引起的肝硬化患者的脾功能衰竭(血小板减少症,白细胞减少症或两者均有相关的血液学综合征)和脾肿大。脾肿大是门静脉高压的不变特征,导致这些患者可观察到的血小板减少症和粒细胞减少症。如果通过分流手术或肝移植缓解门静脉高压,这些可能会得到改善。脾切除术通常仅适用于门静脉高压导致症状性食管胃静脉曲张的患者.什么原因导致门静脉高血压肝硬化是最常见的,只有美国90%的病例导致门静脉高压计数的各种情况。肝硬化被分类为门静脉高压的主要原因之一,因为门静脉阻塞是肝内性质的。其他原因可分为肝前性和肝后性.先天性原因包括与肿瘤,血吸虫病,先天性肝纤维化和自身免疫疾病如原发性胆汁性肝硬化有关的一系列改变。门静脉的血栓也可导致前列腺癌的发生,可能由新生儿高凝状态或脐血脓毒症引起。在这些病例中,肝脏本身是正常的,这意味着门静脉高压可能在没有肝硬化的情况下发生。慢性肾脏原因很罕见,与肝静脉或右心室内的病理改变有关。肝静脉的血栓形成是称为Budd-Chiari综合征的postinusoidal的最常见的原因,并且由高凝状态或骨髓增生性疾病发展而来。柱状梗阻的其他原因包括下腔静脉腹膜,与肿瘤有关的级联效应,充血性心力衰竭和限制性心包炎。门静脉高血压流行病学世界范围内肝硬化的发生率是未知的。据估计,在欧洲国家,患病率水平相当于美国0.15%,而在亚洲和非洲国家,慢病毒性乙型肝炎病毒感染普遍存在。门静脉高压(PHT)与肝炎后肝硬化的发生率高于世界上任何地方。脾切除术的重要性脾切除术已成为门静脉高压症,慢性肝病,脾功能亢进和肝细胞癌患者的治疗方案。已经描述脾切除术可以减少门静脉血流量并改善全血细胞减少。长期肝功能的变化在腹腔镜脾切除术(LS)后,仍有待进一步研究。另一方面,脾切除术已经成熟,用来改善肝硬化患者、肝细胞癌患者的全血细胞减少症.因此,中国和日本的肝硬化继发性脾功能亢进患者仍然主要进行脾切除术。门静脉高压并发症门静脉高压是慢性肝病最常见且严重的并发症。这种并发症是大多数严重的肝硬化临床症状的病因,如胃食管静脉曲张(GEVs)和门静脉高压性胃病,腹水,自发性细菌性腹膜炎(SBP),肝肾综合征(H

关键词：门脉高压肝硬化腹腔镜脾切除术开腹脾切除术

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心脏孤立纤维瘤的临床及影像特征

心脏孤立纤维瘤的临床及影像特征

作者： Abdikarim Ali muse 吉林大学

学位级别：硕士

Chapter1:Review of literature　　Primary Cardiac solitary fibrous tumors are regarded as a rare disease that accounts for less than 2%of all soft tissue masses.　　Fibroblastic/myofibroblastic tumors are a group of uncommon mesenchymal tumors and solitary fibrous tumors are regarded as one of this group in the early stages.　　Solitary fibrous tumors and hemangiopericytoma (HPC) have been considered as one entity.　　But the development and progression made in the field of immunohistochemistry made it possible to discover the similarity of NAB2-STAT6 fusions that been shared by the solitary fibrous tumors and hemangiopericytoma (HPC) has led to the conclusion that the WHo has classified solitary fibrous tumors and hemangiopericytoma (HPC) as one entity.　　第一章：文献综述。　　原发性心脏孤立性纤维瘤被认为是一种罕见的疾病，在所有软组织肿块中所占比例不到2%。　　纤维母细胞/肌纤维母细胞瘤是一组少见的间叶性肿瘤，早期认为孤立性纤维性肿瘤是其中之一。　　孤立性纤维瘤和血管外皮细胞瘤(HPC)被认为是一个整体。　　但随着免疫组织化学领域的发展和进步，人们有可能发现孤立性纤维细胞瘤和血管外皮细胞瘤(HPC)的NAB2-STAT6融合的相似性，从而得出世界卫生组织将孤立性纤维瘤和血管外皮细胞瘤(HPC)归类为一个实体的结论。

关键词： fibrous,孤立纤维瘤,solitary,recurrence,have,thrombus,tumour,pleural,心脏,影像特征,

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2型糖尿病患者的肾脏病谱：一项单中心研究

2型糖尿病患者的肾脏病谱：一项单中心研究

作者： AMIR muse MoHAMUD 山东大学

学位级别：硕士

背景:糖尿病肾病是终末期肾脏病的主要原因,并与心血管疾病死亡率增加相关。然而,除糖尿病肾病之外,2型糖尿病患者也可能患有非糖尿病肾病。目的:本研究旨在探究通过肾活检明确诊断之后,2型糖尿病患者中非糖尿病肾病的发生率及类型,评... 详细信息

背景:糖尿病肾病是终末期肾脏病的主要原因,并与心血管疾病死亡率增加相关。然而,除糖尿病肾病之外,2型糖尿病患者也可能患有非糖尿病肾病。目的:本研究旨在探究通过肾活检明确诊断之后,2型糖尿病患者中非糖尿病肾病的发生率及类型,评估临床及实验室指标与组织病理学结果的关系,探究非糖尿病肾病的关键预测因素。方法:回顾性分析2015年1月至2020年12月于山东大学齐鲁医院住院期间行经皮肾穿刺活检术的101例2型糖尿病患者的临床资料。结果:肾穿刺结果显示有59例（58.42%）患者为非糖尿病肾病,32例（31.68%）为糖尿病肾病,10例（9.90%）为糖尿病肾病合并非糖尿病肾病。其中,最常见的非糖尿肾病的病理类型为膜性肾病（42%）,其次为局灶性节段性肾小球硬化（11.6%）、IgA肾病（10.1%）。通过单变量分析可以得出,非糖尿病肾病组患者的年龄更大（p＜0.018）,其糖尿病病史更短（p＜0.000）,蛋白尿水平更低（p＜0.030）,但血红蛋白水平较高（p＜0.006）。通过多元逻辑回归分析可以得出,较短的糖尿病病程（oR 0.986;95%CI=0.978-0.993;p=0.000）和高龄（oR 1.080;95%CI=1.028-1.134;p=0.002）是非糖尿病肾病的危险因素。在受试者工作特征曲线分析中,糖尿病病程≤78个月（截断值（0.725,0.313））的曲线下面积最大。结论:2型糖尿病患者的高龄、高血红蛋白水平以及较短的糖尿病病史可能与非糖尿病肾病相关。非糖尿病肾病和糖尿病肾病的治疗方案不同,因而其早期诊断对肾脏预后具有积极意义。然而,对于非糖尿病肾病的危险因素分析,仍需开展更多大型多中心随机前瞻性研究。

关键词： 2型糖尿病非糖尿病肾病糖尿病肾病肾活检

Investigating the Influence of Glaucoma on the Quality of Life among Adult Patients

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International Journal of Clinical Medicine 2024年第2期15卷 88-100页

作者： Paul Mwale Karen Tabalasa Abdishakur A. muse Ke Min Department of ophthalmology Zhongnan Hospital of Wuhan University Wuhan China

Background: Research exploring the influence of glaucoma on quality of life has gained momentum in recent years. Numerous studies have investigated the multifaceted aspects of quality of life in glaucoma patients, utilizing various assessment tools and methodologies. objective: To determine the influence that glaucoma has on the quality of life among adult patients. Study site: kitwe teaching eye hospital, Zambia. Method: It was a cross-sectional study that was conducted from 30th June 2022 to 17th April 2023. The study included 106 diagnosed glaucoma patients who were above the age of 55 years. Data was collected using validated 25-item national eye institute visual function Questionnaire (NEI VFQ-25). The data was analyzed using SPSS version 26 and Microsoft excel to present frequencies and percentages that generated graphical presentation. Results: 62% of the participants worry about their eye sight most of the time, 26% sometimes and 12% a little time. 9% of the participants had little difficulty to read ordinary prints, 14% moderate difficulties and 58% extremely difficult. 40% of the participants could drive despite glaucoma damaging their eyes while 60% could not. Majority of the patients said it was difficult noticing things around them while walking or sitted in one place. There was a significant difference between effects of glaucoma on patients and the existing relationship between glaucoma and quality of life (ANoVA, p = 0.019 and ANoVA, p = 0.023). Conclusion: This study has demonstrated the magnitude of impact that glaucoma has on the Quality of Life (QoL) in diagnosed patients and the relationship between glaucoma and the Quality of Life. Due to the progressive visual loss, the amount of activities these patients would perform is negatively affected especially where social and economic activities are concerned which also affects their monthly earnings for those living in middle to low-income countries. Therefore, social welfare a

关键词： Glaucoma Quality of Life Glaucoma Patients

Compressive and Flexural Strength of Recycled Reactive Powder Concrete Containing Finely Dispersed Local Wastes

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open Journal of Civil Engineering 2018年第1期8卷 12-26页

作者： Demiss Belachew Asteray Walter odhiambo oyawa Stanley muse Shitote Civil Engineering Department Pan African University Institute for Basic Science Technology and Innovation Hosted at Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya Addis Ababa Science and Technology university Addis Ababa Ethiopia Commission for university Education Nairobi Kenya Civil and Structural Engineering Department Moi University Eldoret Kenya

The main objective of this experimental study is to investigate the behavior of Recycled Reactive Powder Concrete (RRPC) developed from finely dispersed local waste raw materials. In this study, RRPC was developed by utilizing local wastes (finely dispersed waste glass powder, waste fly ash and waste ceramic powder) together with Portland cement, fine sand, admixture, steel fibers and water through full replacement of silica fume as well as quartz powder for sustainable construction practice. In this study, all raw materials for making RRPC were analyzed for X-Ray Fluorescence analysis. For sustainability of local construction works, this study employed standard curing method at ambient temperatures instead of steam curing at higher temperatures. Moreover, hand mixing was used throughout the study. To evaluate the structural performances of the developed RRPC mixes, compressive and flexural strengths of RRPC were investigated experimentally and compared with the control mix. The experimental results indicated that replacing the silica fume fully by finely dispersed local waste glass powder (GP) and fly ash (FA) is a promising approach for local structural construction applications. Accordingly, a mean compressive strength of 62.9 MPa and flexural strength of 8.8 MPa were developed using 50% GP-50% FA at 28thdays standard curing. In this study, 17.56% larger compressive strength and 30.6% flexural strength improvements were observed as compared to the control mix.

关键词： Local Wastes Recycled Reactive Powder Concrete Compressive Strength Flexural Strength Standard Curing