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Treatment and prevention of epilepsy in onchocerciasis-endemic areas is urgently needed

Infectious Diseases of Poverty 2024年第1期13卷 85-89页

作者： robert Colebunders Joseph Nelson Siewe Fodjo Olivia Kamoen Luis-Jorge Amaral Amber Hadermann Chiara Trevisan Mark J.Taylor Julia Gauglitz Achim Hoerauf Yasuaki Sato Katja Polman Maria-Gloria Basanez Dan Bhwana Thomson Lakwo Gasim Abd-Elfarag Sebastien D.Pion Global Health Institute University of AntwerpAntwerpBelgium Department of Neurology Heilig Hart ZiekenhuisLierBelgium Department of Public Health Institute of Tropical MedicineAntwerpBelgium Liverpool School of Tropical Medicine LiverpoolUK Department of Computer Science University of AntwerpAntwerpBelgium Institute of Medical Microbiology Immunology and ParasitologyUniversity Hospital BonnBonnGermany German Center for Infection Research(DZIF) Partner Site Bonn-CologneBonnGermany School of Global Humanities and Social Sciences Nagasaki UniversityNagasakiJapan MRC Centre for Global Infectious Disease Analysis and London Centre for Neglected TropicalDisease Research Department of Infectious Disease EpidemiologySchool of Public HealthImperial College LondonLondonUK National Institute for Medical Research TangaTanzania Vector Control Division Ministry of HealthKampalaUganda School of Public Health University of JubaJubaSouth Sudan Access for Humanity JubaSouth Sudan French National Research Institute for Sustainable Development MontpellierFrance

Background There is increasing epidemiological evidence supporting the association between onchocerciasis and seizures, reinforcing the concept of onchocerciasis-associated epilepsy (OAE). The aim of this paper is to provide an update on the new knowledge about OAE and to propose recommendations to the World Health Organization how to address this public health *** text During the 2nd International Workshop on OAE held on 19-21 September, 2023, in Antwerp, Belgium, participants recognised OAE as a substantial yet neglected public health problem, particularly in areas of sub-Saharan Africa where onchocerciasis remains hyperendemic. Evidence from prospective population-based studies suggest that strengthening onchocerciasis elimination efforts leads to a significant reduction of OAE incidence. There is a need to validate an OAE case definition to estimate the burden of disease and identify onchocerciasis-endemic areas requiring intensification of onchocerciasis elimination programmes and integration of epilepsy care. It is expected that raising awareness about OAE will boost the population uptake of ivermectin. The implementation of a community-based epilepsy treatment programme offering free anti-seizure medications (ASMs) has shown high effectiveness in reducing the frequency of seizures and improving the overall quality of life of people with *** To reduce OAE burden, enhanced collaboration between onchocerciasis and mental health programmes at community, national, and international levels is required. Urgent efforts are needed to ensure the uninterrupted provision of free ASMs in onchocerciasis-endemic areas. Furthermore, OAE should be included in the quantification of the onchocerciasis disease burden.

关键词： Onchocerciasis Morbidity Burden of disease Prevention Ivermectin Epilepsy Nodding syndrome Treatment Children Policy

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From river blindness control to elimination:bridge over troubled water

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Infectious Diseases of Poverty 2018年第1期7卷 215-229页

作者： robert Colebunders Maria-Gloria Basanez Katja Siling Rory J.Post Anke Rotsaert Bruno Mmbando Patrick Suykerbuyk Adrian Hopkins Global Health Institute University of AntwerpAntwerpBelgium London Centre for Neglected Tropical Disease Research Imperial College LondonLondonUK Institute of Tropical Medicine AntwerpBelgium London School of Hygiene&Tropical Medicine LondonUK Liverpool John Moores University LiverpoolUK National Institute for Medical Research TangaTanzania Neglected and Disabling diseases of Poverty Consultant GravesendKentUK

Background:An estimated 25 million people are currently infected with onchocerciasis(a parasitic infection caused by the filarial nematode Onchocerca volvulus and transmitted by Simulium vectors),and 99%of these are in sub-Saharan *** African Programme for Onchocerciasis Control closed in December 2015 and the World Health Organization has established a new structure,the Expanded Special Project for the Elimination of Neglected Tropical Diseases for the coordination of technical support for activities focused on five neglected tropical diseases in Africa,including onchocerciasis ***:In this paper we argue that despite the delineation of a reasonably well-defined elimination strategy,its implementation will present particular difficulties in *** aim to highlight these in an attempt to ensure that they are well understood and that effective plans can be laid to solve them by the countries concerned and their international ***:A specific concern is the burden of disease caused by onchocerciasis-associated epilepsy in hyperendemic zones situated in countries experiencing difficulties in strengthening their onchocerciasis control *** difficulties should be identified and programmes supported during the transition from morbidity control to interruption of transmission and elimination.

关键词： Onchocerciasis Control Elimination Monitoring&evaluation Community drug distributors Epilepsy Prevalence Incidence

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Levels of Empathy among Dental Students in Five Chilean Universities

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Health 2016年第1期8卷 32-41页

作者： Víctor Patricio Díaz-Narváez Aracelis Calzadilla Núñez Doris Carrasco Alex Bustos Alejandro Zamorano Henry Silva Elizabeth López Tagle Joyce Hubermann robert Utsman Alejandro Reyes Reyes Faculty of Dentistry Universidad San Sebastián Santiago Chile Universidad Autónoma de Chile Santiago Chile Department of Child and Adolescent Psychiatry Felix Bulnes Hospital Santiago Chile Department of Restorative Dentistry School of Dentistry Universidad de Concepción Concepción Chile Department of Prevention and Public Health Faculty of Dentistry Universidad de Concepción Concepción Chile School of Dentistry Universidad Finis Terrae Santiago Chile School of Dentistry Universidad Andrés Bello Santiago Chile School of Dentistry Faculty of Medicina-Clínica Alemana Universidad del Desarrollo Santiago Chile School of Health Sciences Universidad Latinoamericana de Ciencia y Tecnología (ULACIT) San José Costa Rica School of Psychology Universidad Santo Tomas Concepción Chile

Aim: To compare empathic levels among dental students of five Dental Faculties in Chile. Material and Methods: Empathic orientation of dental students was measured using the Jefferson Scale of Physician Empathy, the Spanish version for students (S version), validated in Chile and culturally adapted to dental students. The data were compared using analysis of variance trifactorial (model III) and by a discriminant analysis. Results: It was found that differences exist between universities empathic orientation, courses, and gender. Conclusions: The results showed a great variability of empathetic guidance values on the factors studied. Discriminant test confirm the similarity and differences found among faculties from the data matrix provided by the scale used. It is not possible in this investigation to explain the variability found.

关键词： Empathy Jefferson Scale of Physician Empathy Empathic Levels Empathy Components

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Effects of metoclopramide on gastric motility measured by short-term bio-impedance

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World Journal of Gastroenterology 2009年第38期15卷 4763-4769页

作者： María-Raquel Huerta-Franco Miguel Vargas-Luna Kathleen M Capaccione Etna Yaez-Roldán Ulises Hernández-Ledezma Ismael Morales-Mata Teodoro Córdova-Fraga Department of Applied Science and Labor Research DCS-Campus LeónUniversity of Guanajuato Department of Physical Engineering DCI-Campus LeónUniversity of Guanajuato robert Wood Johnson Medical School The University of Medicine and Dentistry of New Jersey

AIM:To analyze the accuracy of short-term bio-impedance as a means of measuring gastric ***: We evaluated differences in the short-term electrical bio-impedance signal from the gastric region in the following conditions: (1) fasting state, (2) after the administration of metoclopramide (a drug that induces an increase in gastric motility) and (3) after food ingestion in 23 healthy volunteers. We record-ed the real component of the electrical impedance signal from the gastric region for 1000 s. We performed a Fast Fourier Transform (FFT) on this data and then compared the signal among the fasting, medicated, and postprandial conditions using the median of the area under the curve, the relative area under the curve and the main peak ***: The median of the area under the curve of the frequency range in the region between 2-8 cycles per minute (cpm) decreased from 4.7 cpm in the fasting condition to 4.0 cpm in the medicated state (t=3.32, P=0.004). This concurred with the decrease seen in the relative area under the FFT curve in the region from 4 to 8 cpm from 38.3% to 26.6% (t=2.81, P=0.012) and the increase in area in the region from 2 to 4 cpm from 22.4% to 27.7%, respectively (t=-2.5, P=0.022). Finally the main peak position also decreased in the region from 2 to 8 cpm. Main peak activity in the fasting state was 4.72 cpm and declined to 3.45 cpm in the medicated state (t=2.47, P=0.025). There was a decrease from the fasting state to the postprandial state at 3.02 cpm (t=4.0, P=0.0013). CONCLUSION: Short-term electrical bio-impedance can assess gastric motility changes in individuals experiencing gastric stress by analyzing the area medians and relative areas under the FFT curve.

关键词： Bio-impedance Fast Fourier Transform Gastric motility Metoclopramide Postprandial

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Empathy Levels of Dental Students of Central America and the Caribbean

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Health 2015年第12期7卷 1678-1686页

作者： Víctor Patricio Díaz-Narváez Ana María Erazo Coronado Jorge Luis Bilbao Farith González Mariela Padilla Madeline Howard Guadalupe Silva Joel Arboleda Mirian Bullen robert Utsman Elizabeth Fajardo Luz Marina Alonso Marcos Cervantes Facultad de Odontología Universidad San Sebastián Santiago Chile Universidad Autónoma de Chile Santiago Chile Universidad Metropolitana Barranquilla Colombia Facultad de Medicina Universidad Libre Seccional Barranquilla y Fundación Universitaria San Martín Sede Puerto Colombia Barranquilla Colombia Facultad de Odontología Universidad de Cartagena Cartagena Colombia Universidad Latinoamericana de Ciencia y Tecnología San José Costa Rica Facultad de Odontología Universidad de Costa Rica San José Costa Rica Universidad Central del Este San Pedro de Macorís República Dominicana Facultad de Odontología Universidad de Panamá Ciudad de Panamá República de Panamá Faculty of Health Sciences Universidad del Tolima Ibagué Colombia División de Salud Universidad del Norte Barranquilla Colombia Facultad de Ciencias Sociales Universidad del Norte Barranquilla Colombia

Objective: The aim of this study is to check whether there are differences in the distribution of empathy levels in dental students from nine faculties of dentistry Colombia, Panama, Costa Rica and Dominican Republic. Methods: The levels of empathy and matrices of empathy construct matrices are estimated dental students by using the Jefferson Scale of Physician Empathy, the Spanish version for students (S version) culturally validated in Colombia, Panama, Costa Rica and Dominican Republic measured by arbitrator criteria. Cronbach α is estimated. Data of empathic orientation of the studied factors between faculties are analyzed and compared by ANOVA and Duncan test and matrices of empathy construct using discriminant analysis. Results: We find that there are differences in levels of empathy between universities, courses, gender and interaction between the Dental Faculty (University) and Course. The comparison between matrices shows unexplained variances and differences observed between the levels of empathy in student populations. Conclusions: Variability in empathy is observed in the studied factors and among student populations. The variability is an empirical finding, but is not possible in this work, to explain why.

关键词： Empathy Jefferson Scale of Physician Empathy (JSPE) Levels of Empathy

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Empathy Gender in Dental Students in Latin America: An Exploratory and Cross-Sectional Study

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Health 2015年第11期7卷 1527-1535页

作者： Víctor Patricio Díaz-Narváez Ana María Erazo Coronado Jorge Luis Bilbao Farith González Mariela Padilla Madeline Howard María Guadalupe Silva Mirian Bullen Fredy gutier.ez Teresa Varela de Villalba Mercedes Salcedo Rioja Joyce Huberman Doris Carrasco robert Utsman School of Dentistry Universidad San Sebastián Santiago Chile Associate Investigator Universidad Autónoma de Chile Santiago Chile Universidad Metropolitana Barranquilla Colombia School of Medicine Universidad Libre Seccional Barranquilla y Fundación Universitaria San Martín Sede Puerto Colombia Barranquilla Colombia School of Dentistry Universidad de Cartagena Campus de la Salud Barrio Zaragocilla Cartagena Colombia School of Health Sciences Universidad Latinoamericana de Ciencia y Tecnología San José Costa Rica School of Dentistry Universidad de Costa Rica San Pedro de Montes de Oca San José Costa Rica Institute for Scientific Research Universidad Central del Este San Pedro de Macorís Dominican Republic School of Dentistry Universidad de Panamá Panama City Panama Facultad de Estomatología roberto Beltrán Universidad Peruana Cayetano Heredia Lima Peru School of Medicine Universidad Católica de Córdoba Córdoba Argentina Department of Pediatric Dentistry School of Dentistry Universidad Nacional Mayor de San Marcos Lima Peru School of Dentistry Faculty of Clinical Medicine Universidad del Desarrollo Santiago Chile School of Dentistry Universidad de Concepción Concepción Chile Investigation of the School of Health Sciences Universidad Latinoamericana de Ciencia y Tecnología San José Costa Rica

Background: It is well-founded that empathy is an attribute that increases the likelihood of good communication between health professionals and patients, and it is usual that there is the conviction that empathy levels are higher in women than in men. Aims: A study comparing levels of empathy gender of students in 18 schools of dentistry from six Latin American countries was conducted. Method: An exploratory cross-sectional study of which empathy levels were measured by the Jefferson Scale of Empathy for dental students (S version) and these levels were compared between genders by t-student test, after verification of normal distribution and homoscedasticity. Results: Variability was found in the results of the comparisons. In some cases, empathy levels were higher in women, others in men and in most of them there were no differences between genders. Conclusions: The observed results do not support the belief that women are more empathetic than men. However, more studies must be performed in more powers and countries to verify that the results described constitute a scientific fact and not just a feature of dental students specifically in the countries studied.

关键词： Empathy Gender Dental Students

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Report of the first international workshop on onchocerciasis-associated epilepsy

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Infectious Diseases of Poverty 2018年第1期7卷 238-242页

作者： robert Colebunders Michel Mandro Alfred K.Njamnshi Michel Boussinesq An Hotterbeekx Joseph Kamgno Sarah O’Neill Adrian Hopkins Patrick Suykerbuyk Maria-Gloria Basanez Rory J.Post Belen Pedrique Pierre-Marie Preux Wilma A.Stolk Thomas B.Nutman Richard Idro Global Health Institute University of AntwerpAntwerpBelgium Provincial Health Division of Ituri BuniaDemocratic Republic of the Congo Department of Neurology Yaounde Central Hospital/University of Yaounde 1Brain Research Africa Initiative(BRAIN)YaoundeCameroon Institut de Recherche pour le Developpement(IRD) MontpellierFrance Centre for Research on Filariasis and other Tropical Diseases(CRFilMT) and Faculty of Medicine and Biomedical SciencesUniversity of Yaounde 1YaoundeCameroon Department of Public Health Institute of Tropical MedicineAntwerpBelgium Neglected and Disabling Diseases of Poverty Consultant KentUK London Centre for Neglected Tropical Disease Research Imperial College LondonLondonUK London School of Hygiene&Tropical Medicine and Liverpool John Moores University LondonUK Drugs for Neglected Diseases initiative GenevaSwitzerland Preux Pierre-Marie INSERMUniversity LimogesCHU LimogesUMR_S 1094Tropical NeuroepidemiologyInstitute of Neuroepidemiology and Tropical NeurologyCNRS FR 3503 GEIST87000 LimogesFrance Department of Public Health Erasmus MCUniversity Medical Centre RotterdamRotterdamThe Netherlands Laboratory of Parasitic Diseases National Institutes of HealthBethesdaMarylandUSA Makerere University College of Health SciencesKampalaUganda

Background:Recently,several epidemiological studies performed in Onchocerca volvulus-endemic regions have suggested that onchocerciasis-associated epilepsy(OAE)may constitute an important but neglected public health problem in many countries where onchocerciasis is still *** text:On October 12-14th 2017,the first international workshop on onchocerciasis-associated epilepsy(OAE)was held in Antwerp,*** workshop was attended by 79 participants from 20 different *** research findings strongly suggest that *** is an important contributor to epilepsy,particularly in meso-and hyperendemic areas for *** with *** is associated with a spectrum of epileptic seizures,mainly generalised tonic-clonic seizures but also atonic neck seizures(nodding),and stunted *** is characterised by an onset of seizures between the ages of 3-18 *** working groups discussed topics such as how to 1)strengthen the evidence for an association between onchocerciasis and epilepsy,2)determine the burden of disease caused by OAE,3)prevent OAE,4)improve the treatment/care for persons with OAE and affected families,5)identify the pathophysiological mechanism of OAE,and 6)deal with misconceptions,stigma,discrimination and gender violence associated with *** OAE Alliance was created to increase awareness about OAE and its public health importance,stimulate research and disseminate research findings,and create partnerships between OAE researchers,communities,advocacy groups,ministries of health,non-governmental organisations,the pharmaceutical industry and funding ***:Although the exact pathophysiological mechanism underlying OAE remains unknown,there is increasing evidence that by controlling and eliminating onchocerciasis,OAE will also ***,OAE constitutes an additional argument for strengthening onchocerciasis elimination *** the high numbers of people with epilepsy

关键词： Onchocerciasis Epilepsy Nodding syndrome Nakalanga syndrome Prevalence Burden of disease Africa

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Prevalence of epilepsy in the onchocerciasis endemic middle belt of Ghana after 27 years of mass drug administration with ivermectin

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Infectious Diseases of Poverty 2023年第4期12卷 106-106页

作者： Kenneth Bentum Otabil Blessing Ankrah Emmanuel John Bart-Plange Emmanuel Sam Donkoh Fiona Amoabil Avarikame Fredrick Obeng Ofori-Appiah Theophilus Nti Babae Prince-Charles Kudzordzi Vera Achiaa Darko Joseph Ameyaw Joseph Gyekye Bamfo Raji Abdul Sakibu Daniel Antwi-Berko Joseph Nelson Siewe Fodjo María-Gloria Basáñez Henk D.F.H.Schallig robert Colebunders NeTroDis Research Group Centre for Research in Applied Biology School of Sciences University of Energy and Natural Resources Sunyani Ghana Department of Biological Science School of Sciences University of Energy and Natural Resources Sunyani Ghana Global Health Institute University of Antwerp Antwerp Belgium Department of Medical Laboratory Science School of Sciences University of Energy and Natural Resources Sunyani Ghana STU Clinic Sunyani Technical University Sunyani Ghana Happy Family Hospital Nkoranza Ghana Tain District Hospital Nsawkaw Ghana Department of Infectious Disease Epidemiology MRC Centre for Global Infectious Disease Analysis (MRC GIDA) and London Centre for Neglected Tropical Disease Research School of Public Health Imperial College London London UK Department of Medical Microbiology Experimental Parasitology Unit Amsterdam University Medical Centres Academic Medical Centre at the University of Amsterdam Amsterdam The Netherlands

BackgroundIn onchocerciasis-endemic areas with high ongoing Onchocerca volvulus transmission,a high prevalence of epilepsy has been *** study aimed to determine the prevalence and clinical characteristics of epilepsy in the Bono Region of Ghana following 27 years of implementation of ivermectin mass drug administration(MDA).MethodsBetween October 2020 and August 2021,cross-sectional surveys were conducted in nine communities in the Tain District and Wenchi Municipality of the Bono Region of *** the first stage,a random door-to-door approach was used to screen the population for epilepsy using a pre-tested *** suspected of having epilepsy were invited for a second-stage neurological examination for case *** *** microfilarial infection status and Ov16 seropositivity were also ***-five confidence intervals(95%CI)for prevalence values were calculated using the Wilson Score *** the 971 participants,500(51.5%)were females,and the median age(interquartile range)was 26(15‒43)*** participants(1.4%,95%CI:1.0‒2.0)were diagnosed as having epilepsy with generalized seizures being the most frequent seizure type(85.7%,12/14).The overall microfilarial prevalence of *** was 10.3%(November 2020)and 9.9%(August 2021);the Ov16 seroprevalence was 22.2%(June 2021).Only 63.2%took ivermectin in the last round of MDA distribution in March *** 1.4%prevalence of epilepsy in the Bono region is similar to the median epilepsy prevalence in sub-Saharan ***,the persistent microfilarial prevalence and low ivermectin study coverage call for the Ghana Onchocerciasis Elimination Programme to step up its efforts to ensure that the gains achieved are consolidated and improved to achieve the elimination of onchocerciasis by 2030.

关键词： Onchocerca volvulus Microflaria Onchocerciasis-associated epilepsy Seizure Ivermectin Mass drug administration Coverage

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心血管疾病病死率与血清25-羟基维生素D浓度相关性研究

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成都医学院学报 2013年第2期8卷 131-134页

作者：刘隆健魏敏陈明 Shelley R Hankins Ana E.Nùez robert A Watson Perry J Weinstock Craig J.Newschaffer Howard J Eisen 邹强杨书陈卫中德雷塞尔大学公共卫生学院成都医学院公共卫生系成都610083 重庆医科大学第一附属医院德雷塞尔大学医学院费城Abington Memorial医院宾夕法尼亚州费城19001 Cooper大学医院新泽西州camden08103

目的研究心衰死亡、心血管疾病死亡和过早死亡与血清25-羟基维生素D[25(OH)D]浓度的相关性。方法在第3次美国健康和营养调查中,1988～1994年为基线数据,纳入35岁以上参与者13 131名(男性6130名,女性7 001名),随访至2000年12月31日。结... 详细信息

目的研究心衰死亡、心血管疾病死亡和过早死亡与血清25-羟基维生素D[25(OH)D]浓度的相关性。方法在第3次美国健康和营养调查中,1988～1994年为基线数据,纳入35岁以上参与者13 131名(男性6130名,女性7 001名),随访至2000年12月31日。结果随访8年期间,共有3 266人死亡(24.9%),其中心衰死亡101人,心血管疾病死亡1 451人,早死1 066人。心衰死亡者中有37%血清25(OH)D水平低于20ng/mL,非心衰死亡者为26%(P<0.001)。多元Cox模型显示,血清25(OH)D水平低于20ng/mL的心衰死亡风险是超过30ng/mL的2.06倍(95%CI:1.01～4.25)(P<0.001),过早死亡风险为1.40倍(95%CI:1.17～1.68;P<0.001);血清25(OH)D浓度20～29ng/mL的过早死亡风险是超过30ng/mL的1.11倍(95%CI:0.93～1.33)。结论血清25(OH)D水平不足的成年人死于心血管病、心衰和过早死亡的风险较高。

关键词： 25-羟基维生素D 心衰心血管疾病病死率

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The Effect of Signal Propagation Delay on the Measured Vibration in Planetary Gearboxes

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Journal of Dynamics, Monitoring and Diagnostics 2022年第1期1卷 9-18页

作者： Marc Hilbert Wade A.Smith robert B.Randall LIACS Leiden UniversityRapenburg 702311 EZLeidenThe Netherlands School of Mechanical and Manufacturing Engineering University of New South WalesUNSWSydneyNSW2052Australia

Modulation of the gear mesh vibration is a major field of research for the condition monitoring of planetary *** modulation creates sidebands around the gearmesh frequency in the vibration spectrum,and the distribution of these sidebands has been researched in numerous *** publications on the subject assume that the effect of the time varying signal propagation delay between the main vibration source–the gear mesh point(s)–and the(usually fixed)transducer can be *** paper investigates the validity of this *** do so,a planetary gearbox with a transducer mounted on the(fixed)ring gear is studied,and the effect of the propagation delay is modelled as a phase modulation of the gear mesh *** expressions are then derived for the distribution and strength of the modulation sidebands,and these expressions are applied to quantify the effect of the propagation delay on five industrial *** results show that the amplitude of the sidebands is negligible and would not interfere with condition assessment based on analysis of the modulation of the gear mesh frequency,and thus the propagation delay can be neglected for practical purposes.

关键词： gear diagnostics phase modulation planetary gearbox propagation delay

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