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Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

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Health 2024年第1期16卷 9-21页

作者： Jean Ndibi Abanda Anicet Onana Akoa Désiré Tchoffo ulrich dama Pierre Yassa Yoniene Faculty of Health Sciences University of Lisala (CIREP-UNILIS) Lisala Democratic Republic of the Congo National Order of Medical and Sanitary Professions Yaounde Cameroon School of Health Sciences Catholic University of Central Africa Yaounde Cameroon World Health Organization Maroua Cameroon Faculty of Medicine University Simon Kimbangu Kinshasa Democratic Republic of the Congo

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysi

关键词： Ethics Human Resources Management Cameroonian Health System Medical Nomadism Ineffectiveness High Blood Pressure

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Economic Stress, Precariousness and Risk of High Blood Pressure: A Descriptive Survey of Life Models within Households of the Central Region of Cameroon

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Health 2024年第2期16卷 118-130页

作者： Jean Ndibi Abanda ulrich dama Viviane Foussouo Ndoungue Anicet Onana Akoa Melkior Fobasso Dzeuta Alphonse Tedonge Asobochia Arsène Emilien Messi Ndzengue Désiré Tchoffo Faculty of Health Sciences University of Lisala (CIREP-UNILIS) Lisala Democratic Republic of the Congo National Order of Medical and Sanitary Professions Yaoundé Cameroon School of Health Sciences Catholic University of Central Africa Yaoundé Cameroon World Health Organization Maroua Cameroon Faculty of Health Sciences University of Montagnes Banganté Cameroun Faculty of Medicine University of Bamenda Bamenda Cameroon Faculty of Sciences University of Ebolowa Ebolowa Cameroun

Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliabilit

关键词： Economic Stress Precariousness High Blood Pressure Life Models Households

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Factors of Adherence to Concurrent Tuberculosis Treatment and Antiretroviral Therapy among HIV-TB Co-Infected Individuals in the East Region, Cameroon in the COVID-19 Era: A Retrospective Cohort Study

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Health 2024年第2期16卷 131-147页

作者： François Anicet Onana Akoa ulrich dama Jean Ndibi Abanda Alphonse Tedonge Asobochia Melkior Fobasso Dzeuta Pearl Nsom Mbu Yokyu Zachary Pangwoh Pierre Yassa Yoniene Faculty of Health Sciences University of Lisala (CIREP-UNILIS) Lisala Democratic Republic of the Congo Faculty of Health Sciences Catholic University of Central Africa Yaoundé Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Faculty of Public Health Texila American University Guyana South America Faculty of Medicine University Simon Kimbangu Kinshasa Democratic Republic of the Congo

Context/Objectives: Tuberculosis (TB) and HIV co-infection is a serious health problem in Cameroon. The problems associated with poor adherence to treatment are on the increase worldwide. This problem can be observed in all situations where patients are required to administer their own medication, whatever the type of illness. The general objective of this study was to assess the factors affecting adherence to treatment among HIV-TB co-infected patients in health facilities in the East Region in the COVID context. Method: A retrospective cohort study before and during COVID-19 was conducted in HIV care units in 13 health districts in the East Region of Cameroon. Data were collected using a questionnaire recorded in the Kobo Collect android application, analyzed using SPSS version 25 software and plotted using Excel. Results: The pre-COVID-19 cohort compared to the during-COVID-19 cohort had a 1.90 risk of not adhering to treatment (OR: 1.90, CI {1.90 - 3.37}) and the difference was statistically significant at the 5% level (p-value = 0.029). Frequency of adherence was 65.4% (140/214). Adherence before COVID-19 was 56.9% whereas during COVID-19, it was 74.3%. Conclusion: The implementation of targeted interventions in the COVID-19 context, using evidence-based data and integrating the individual needs of HIV-TB co-infected patients, improved adherence to concurrent anti-tuberculosis treatment and antiretroviral therapy during the COVID-19 Era.

关键词： Factors of Adherence Tuberculosis Treatment Antiretroviral Therapy HIV-TB Co-Infection East Region Cameroon

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The Effect of the COVID-19 Pandemic on Health Service Accessibility for Children under 5 in the Mayo-Tsanaga and Logone & Chari Departments, Far North Cameroon

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健康(英文) 2023年第10期15卷 1047-1058页

作者： ulrich dama Desire Tchoffo Jean Ndibi Abanda François Anicet Onana Akoa Alphonse Tedonge Asobochia Melkior Fobasso Dzeuta Aureol-Le-Rocher Ngako Njiacheu Pierre Yassa Yoniene World Health Organization Maroua Cameroon Faculty of Health Sciences University of Lisala (CIREP-UNILIS) Lisala The Democratic Republic of the Congo National Order of Medical and Sanitary Professions Yaounde Cameroon Faculty of Medicine University of Bamenda Bamenda Cameroon Faculty of Health Sciences Catholic University of Central Africa Yaounde Cameroon Faculty of Medicine University Simon Kimbangu Kinshasa The Democratic Republic of the Congo

Context/objectives: The COVID-19 pandemic has disrupted all programs, potentially impacting access to health services for children under 5 years old. The Far North of Cameroon is one of the northern regions with a prevalence of malnourished children ranging from 5% to 10%. Due to the barrier measures implemented to combat the pandemic, many parents are reluctant to take their children to healthcare facilities. Some of these children were benefiting from the Ambulatory Care Center (ACC) program prior to the COVID-19 outbreak. The main objective of this research is to assess the impact of COVID-19 on access to health services for children under 5 in the Mayo Tsanaga (MT) and Logone & Chari (LC) departments. The implementation of barrier measures could significantly increase the risk of malnutrition among children under 5 years old. Method: A cross-sectional analytical study was conducted in the MT and LC departments, employing both retrospective and prospective approaches. Data was collected through questionnaire, interview guide and a review of existing data prior to the pandemic (DHIS 2). Kobo Collect software was used for data collection, and R software was used for analysis. Results: Children who benefitted from the ACC program during the COVID-19 period were found to have a lower prevalence of malnutrition compared to those who did not benefit (OR: 0.09, CI {0.0 - 0.44}). Conclusion: COVID-19 has led to a decrease in the utilization of health facilities in both departments of the study, resulting in an increase in health issues such as malnutrition among children under 5 years old. Various policies have been implemented to improve attendance at health facilities.

关键词： COVID-19 Impact Health Child under 5 Far North Cameroon

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Perceptions into causes and consequences of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variants

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Rheumatology & Autoimmunity 2023年第1期3卷 1-8页

作者： dama Laxminarayana Sathya Krishna Genomics LLC Winston-SalemNorth CarolinaUSA

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variants are emerging worldwide and pathogenicity varies widely from no symptoms to death.The SARS-CoV-2 is evolving as lineages like Alpha,Beta,Gamma,Epsilon,Iota,Delta,and Omicron in the course of time.The main reasons for such viral evolution are(a)the imperfect nature of SARS-CoV-2 RNA polymerase,and viral exonuclease mediated proofreading functions resulting in the generation of mutations in viral genomes;(b)fusions of the 5′leader sequence to unexpected 3′sites,and transcription regulatory sequences(TRSs)in subgenomic RNAs(sgRNAs),which result in the generation of structural variants and novel open reading frames;(c)these viruses are combated by the host type I interferons(IFNs).In such a process IFNs upregulate viral RNA editing APOBEC3G/F and ADAR1 genes,which induce mutations in viral genomes.These factors play important roles in causing viral evolution and the emergence of more efficient SARS-CoV-2 genomes,which escape the host immune defense system,and vaccine-elicited antibodies and impede therapeutic strategies.The main challenges we now face are how to control future SARS-CoV-2 evolution,the elimination of their deleterious side effects,and the onset of new diseases as aftermaths of SARSCoV-2 infections.Preventive measures like(a)the development of broadly neutralizing antibodies and novel vaccines,therapies based on genomics and proteomics data will help in avoiding,and/or minimizing SARS-CoV-2 infections;(b)targeted therapies,application of patient-based precision medicine methodology can help in achieving the goal and avoiding unwanted deleterious side effects and the onset of SARS-CoV-2 infections mediated several diseases in future.

关键词： gene regulation innate immunity mutations RNA editing enzymes SARS-CoV-2 pathogenesis type I interferons

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Molecular insights into onset of autoimmunity in SARS-CoV-2 infected patients

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Rheumatology & Autoimmunity 2022年第4期2卷 198-202页

作者： dama Laxminarayana Sathya Krishna Genomics LLC Winston‐SalemNorth CarolinaUSA

Some of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infected patients are facing long‐term devastating effects like induction of autoimmune diseases.Here,I discuss molecular mechanisms and risk factors involved in the induction of autoimmune diseases after SARS-CoV-2 infections.Transcript editing genes were upregulated during SARS-CoV-2 infections,which might have edited host gene transcripts and paved the way for autoantigens generation and presented as nonself to generate auto-antibodies followed by auto immunogenicity after SARS-CoV-2 infections.Therefore,some SARS-CoV-2 patients acquire autoimmunity.The transient and/or innocuous autoimmune response in some SARS-CoV-2 infected patients may be due to a lack of repeated production of autoantibodies to host autoantigens and/or viral antigens,which are needed to boost autoimmune response.In the future,SARS-CoV-2 mediated autoimmune disease onset will be a challenging task.Therefore,possible preventive measures and strategies to minimize and/or preclude such SARS-CoV-2 mediated autoimmune diseases have been presented in this commentary.

关键词： autoimmunity cytokine storm mutations RNA editing SARS‐CoV‐2 pathogenesis type I interferons

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Granitic inselbergs of Lara(Panafrican Chain,Far-North Cameroon):Assets for the implementation of geotourism in Mountainous region

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Journal of Mountain Science 2022年第11期19卷 3192-3212页

作者： ZANGMO TEFOGOUM Ghislain NOUHOU dama Zouyane Hyacinthe GOUNTIÉDEDZO Merlin MAFO DONGMO Irène Department of Earth Sciences de la Terre Faculty of ScienceUniversity of MarouaP.O.Box 814 MarouaCameroon Department of Life and Earth Sciences High Teacher Training CollegeUniversity of MarouaP.O.Box 55MarouaCameroon

The locality of Lara(Far-North Region,Cameroon)is made up of a pediplain strewn with coalescent plutons.The interaction of internal and external geological processes has contributed to transform the latter into inselbergs,whose geotouristic values are yet to be studied.Field and laboratory work enabled us to select the geomorphosites through their aesthetic value(particular size and shape)and,geomorphological and geological features.Moreover,it permitted to study and map the geomorphosites using Optic Microscope,Google Earth,GIS software and many other interfaces.Hence,four inselbergs have been selected and studied in the locality of Lara.The petrographic study of these inselbergs shows that granites are the main components of inselbergs and they present a fine to coarse-grained texture,materialized by quartz,micas,plagioclases and alkali feldspars(white and pink in colour).Inselbergs exhibit vertical and parallel networks of diaclases giving them a stratified appearance in some flanks.In addition,on some inselberg limbs and piedmonts,are built tors which contribute to their beauty.The tops of inselbergs,are embellished by several alluring pedestal rocks.On their flanks,shelters of various shapes and sizes(about 12 m length)have developed through the heaps of blocks field.Among the ten shelters selected,some have a fairly high cultural value as they are sacred places for the local population.Moreover,Lara's granitic inselbergs include enclaves(cognate enclaves and xenocrysts)that also significantly improve their geoheritage value.Inselbergs are landforms with high education and aesthetic value that attracted a larger local and foreign population of about 863 visitors between 2017-2019.They constitute an exceptional geoheritage that could attract more tourists in the locality of Lara;but the promotion of geotourism is needed through interpretative panels,marketing of geomorphosites through leaflets,web,media,and geotours,to mention a few.

关键词： Lara Inselbergs Granite geoheritage Geotouristic activities

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A Xyloglucan Backbone 6-O-Acetyltransferase from Brachypodium distachyon Modulates Xyloglucan Xylosylation

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Molecular Plant 2016年第4期9卷 615-617页

作者： Lifeng Liu Mon Mandy Hsia Murali dama John Vogel Markus Pauly Department of Plant & Microbial Biology University of California Berkeley CA 94720 USA U.S. Department of Agriculture Western Regional Research Center Albany CA 94710 USA U.S. Department of Energy Joint Genome Institute Walnut Creek CA 94598 USA

Dear Editor,Plant cells are surrounded and protected by cell walls, which consist primarily of polymers such as cellulose, hemicelluloses, pectic polysaccharides, and the polyphenol lignin. One of the ma- jor hemicelluloses in the primary cell wall is xyloglucan （XyG）, which consists of a β-1,4-glucan backbone containing xylosyl substituents. XyG attaches and partially covers the surface of cellulose microfibrils and is therefore thought to act as a spacer between microfibrils, reducing cellulose aggregation （Pauly et al., 2013）.

关键词： Plant cells surrounded

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Intraorbital Mature Teratoma in Infant

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Open Journal of Modern Neurosurgery 2022年第3期12卷 127-131页

作者： Oumar Diallo Abdoulaye Hima Maiga Bekety Katanga Anthony Mahamadou dama Oumar Coulibaly Daouda Sissoko Alpha Singuepiré Hospital of Mali Bamako Mali Hospital of Niamey Nyamay Niger Hospital of Kara Kara Togo Hospital of Ségou Ségou Mali

Intraorbital mature teratoma is a rare congenital tumor of slow evolution that can compromise vision. Objectives: We describe the clinical and therapeutic aspects of a mature teratoma in childhood with a literature review. Clinical Case: It was a 12-year-old who had a progressive straight monocular exophthalmia with blindness. CT without and with contrast injection showed a double component intracolonic invasive tumor with partial contrast acquisition after injection. This tumor respected the bone walls of the orbit. The treatment was surgical by conjunctival dissection of the tumor and enucleation. This allowed the tumor to be fully excised under an operating microscope. The operating procedures were simple. Anatomopathology confirmed the nature of the tumor by visualizing the presence of a squamous epithelium by the high-magnification (X20) method of hematoxylin and eosin. Conclusion: Mature intraorbital teratoma is an embryonic tumor with early diagnosis the finding in an older child remains rare. Complete surgical excision allows healing.

关键词： Teratoma Mature Micro Surgery

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Infracallosal Aneurysm Rupture Revealed by Chronic Subdural Hematoma: A Case Report

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World Journal of Neuroscience 2022年第3期12卷 112-117页

作者： Mahamadou dama Oumar Diallo Oumar Coulibaly Daouda Sissoko Theodore H. M. Coulibaly Aliou Maiga Youssouf Sogoba Neurosurgery Department University Hospital of Mali Bamako Mali Anesthesiology Department University Hospital of Mali Bamako Mali Siramana Medical-Surgical Clinic Bamako Mali Neurosurgery Department University Hospital Gabriel Touré Bamako Mali

Chronic subdural hematoma (CSDH) is one of the most common entities seen in neurosurgery. We report a case of infracallosal aneurysm revealed by CSDH in a 52 years old woman. She presented 3 days alteration of consciousness in 2019 and repeated in September 2020 a severe headache and dizziness. There was no history of others symptoms, nor head trauma. Routine blood examination and coagulation profile were normal. Emergency computed tomography (TC) showed a left temporoparietal-occipital CSDH. Cerebral Angio CT found a bilobated of A2 aneurysm. The precallosal interhemispheric approach was made and clipping the aneurysm after evacuation of CSDH without complication. CSDH is one of the revealed features of intracerebral aneurysm rupture.

关键词： CSDH Cerebral Hemorrhage Infracallosal Aneurysm SAH

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