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Community Based management of Severe Acute malnutrition: The mSF Experience from an Urban Slum Setting in Bangladesh

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Food and Nutrition Sciences 2020年第6期11卷 578-589页

作者： Engy Ali Pascale Delchevalerie Zubair Shams Petra Alders Rony Zachariah Luxembourg Operational research Unit (LuxOR) Medical Department Médecins Sans Frontières—Operational Centre Brussesl Luxembourg Luxembourg medical Department Médecins Sans Frontières—Operational Centre Brussels Brussels Belgium Bangladesh mission Médecins Sans Frontières—Operational Centre Brussels Dhaka Bangladesh

Background: Until recently, the experience on implementing community based management of acute malnutrition (CmAm) among children has been largely based in African settings. While the government in Bangladesh is yet t... 详细信息

Background: Until recently, the experience on implementing community based management of acute malnutrition (CMAM) among children has been largely based in African settings. While the government in Bangladesh is yet to scale up CMAM approach, there is still paucity of knowledge on the experience of CMAM within the complex milieu of an urban slum context. In Kamrangirchar slum, Dhaka, Bangladesh, this paper describes a CMAM programme performance and outcomes run by Médecins Sans Frontières (MSF)/Doctors without Borders, in light to performance indicators set by MSF and the Sphere minimum standards. Methods: This was a descriptive retrospective study using routinely collected programme data of children admitted with severe acute malnutrition between May 2010 and November 2011. Kamrangirchar is an urban slum of a large migrant population in Dhaka, Bangladesh. Results: There was a total of 640 new admissions, of whom 333 (52%) were males. The median age was 18 months (Inter-quartile range (IQR) 12 - 41). 599 children had a reported nutritional outcome at discharge from ambulatory therapeutic feeding centre (ATFC), this included: cure rate of 69% with an average length of stay of 68.8 (SD ± 46.0) days and average weight gain of 3.8 g/kg/day (SD ± 2.7). The lost-to-follow-up rate was 18% and 5% reported to the programme that they will leave the slum and go back to their villages. These performance indicators did not meet the threshold level indicators set by MSF and Sphere standards. Conclusions:mily:Verdana;"> Our experience highlights the need for developing more adapted and contextualised indicators for as

关键词： Severe Acute malnutrition Community Based management Nutrition Outcomes Urban Slum Bangladesh

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The Efficacy of Psychosocial Interventions for Adults in Contexts of Ongoing man-made Violence—A Systematic Review

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Health 2014年第6期6卷 504-516页

作者： Kaz de Jong Jeroen W. Knipscheer Nathan Ford Rolf J. Kleber Department of Clinical and Health Psychology Utrecht University Utrecht The Netherlands médecins sans frontières Doctors without Borders (Amsterdam Office) Amsterdam The Netherlands médecins sans frontières Doctors without Borders (International Office) Geneva Switzerland

Compared to psychosocial programs implemented in post-conflict settings those executed in areas of ongoing conflicts may have different effects. Their evidence of efficacy has never been systematically reviewed. We searched Pubmed, PsychInfo and the Dutch Tropical Institute Literature Portal from inception to31 January 2013 to identify studies on community-oriented psychosocial and psychiatric/clinical services for adults during ongoing manmade conflict or its direct aftermath. Of 6358 articles screened, 16 met our inclusion criteria. The interventions varied from psycho-educational to psychotropic drugs. The review is presented using outcome indicators such as PTSD, anxiety, depression, physical health, functioning and well being. A substantial improvement of some outcome was found though the small number of studies and their heterogeneity did not justify strong conclusions. PTSD symptoms improved significantly by treatments that included exposure (such as narrative exposure therapy). A number of studies (eight) showed notable improvement of the client’s functioning through counseling interventions. Depression and anxiety both improved considerably using that culturally adapted interventions (two studies), whereas non-culturalized interventions did not. We found a notable lack of studies on the efficacy of medication and on preferred western, evidence-based interventions for PTSD such Eye movement Desensitization. To measure outcomes only two studies applied locally-developed diagnostic labels and validated instruments. Future research should encourage the use of robust research methods that are culturally valid, including mixed-methods research to combine measurable outputs with qualitative research aimed at improved understanding from the client’s perspective.

关键词： Psychosocial mental Health Programmes Systematic Review Conflict Post-Conflict War Violence PTSD

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From single to combinatorial therapies in spinal cord injuries for structural and functional restoration

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Neural Regeneration research 2025年第3期20卷 660-670页

作者： Ernesto Doncel-Pérez Gabriel Guízar-Sahagún Israel Grijalva-Otero Hospital Nacional de Parapléjicos de Toledo Servicio de Salud de Castilla La Mancha(SESCAM)ToledoSpain medical research Unit for Neurological Diseases UMAE Hospital de EspecialidadesCentro Médico Nacional Siglo XXIIMSSCiudad de MéxicoMéxico

Spinal cord injury results in paralysis, sensory disturbances, sphincter dysfunction, and multiple systemic secondary conditions, most arising from autonomic dysregulation. All this produces profound negative psychosocial implications for affected people, their families, and their communities;the financial costs can be challenging for their families and health institutions. Treatments aimed at restoring the spinal cord after spinal cord injury, which have been tested in animal models or clinical trials, generally seek to counteract one or more of the secondary mechanisms of injury to limit the extent of the initial damage. most published works on structural/functional restoration in acute and chronic spinal cord injury stages use a single type of treatment: a drug or trophic factor, transplant of a cell type, and implantation of a biomaterial. Despite the significant benefits reported in animal models, when translating these successful therapeutic strategies to humans, the result in clinical trials has been considered of little relevance because the improvement, when present, is usually insufficient. Until now, most studies designed to promote neuroprotection or regeneration at different stages after spinal cord injury have used single treatments. Considering the occurrence of various secondary mechanisms of injury in the acute and sub-acute phases of spinal cord injury, it is reasonable to speculate that more than one therapeutic agent could be required to promote structural and functional restoration of the damaged spinal cord. Treatments that combine several therapeutic agents, targeting different mechanisms of injury, which, when used as a single therapy, have shown some benefits, allow us to assume that they will have synergistic beneficial effects. Thus, this narrative review article aims to summarize current trends in the use of strategies that combine therapeutic agents administered simultaneously or sequentially, seeking structural and functional restoratio

关键词： neural regeneration neuroprotection spinal cord injury repair spinal cord injury treatments structural restoration of spinal cord injury

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many faces of neuronal activity manipulation in Drosophila

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Neural Regeneration research 2025年第9期20卷 2574-2576页

作者： Amber Krebs Steffen Kautzmann Christian Klämbt Institut für Neuro-und Verhaltensbiologie MünsterGermany

Animals exhibit complex responses to external and internal *** information is computed by interconnected neurons that express numerous ion channels,which modulate the neuronal membrane *** can neuronal activity orchestrate complex motor patterns or allow learning from previous experience?To answer such questions,we need the ability not only to record,but also to modulate neuronal activity in both space(e.g.,neuronal subsets)and time.

关键词： manipulation potential. neuronal

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A Framework for Assessing Import Costs of medical Supplies and results for a Tuberculosis Program in Karakalpakstan,Uzbekistan

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Health Data Science 2021年第1期2021卷 120-132页

作者： Stefan Kohler Norman Sitali Nicolas Paul Heidelberg Institute of Global Health Faculty of Medicine and University HospitalHeidelberg UniversityHeidelbergGermany médecins sans frontières BerlinGermany Institute of Social medicine Epidemiology and Health EconomicsCharité–Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt-Universität zu BerlinBerlinGermany

*** of medical supplies is common,but limited knowledge about import costs and their structure introduces uncertainty to budget planning,cost management,and cost-effectiveness analysis of health *** aimed to estimate the import costs of a tuberculosis(TB)program in Uzbekistan,including the import costs of specific imported *** developed a framework that applies costing and cost accounting to import ***,transport costs,customs-related costs,cargo weight,unit weights,and quantities ordered were gathered for a major shipment of medical supplies from the médecins sans frontières(mSF)Procurement Unit in Amsterdam,the Netherlands,to a TB program in Karakalpakstan,Uzbekistan,in ***,air freight,land freight,and customs clearance cost totals were ***,total import costs were allocated to different cargos(standard,cool,and frozen),items(e.g.,TB drugs),and units(e.g.,one tablet)based on imported weight and *** sources were order invoices,waybills,the local mSF logistics department,and an mSF standard product *** shipment contained 1.8 million units of 85 medical items of standard,cool,and frozen *** average import cost for the TB program was 9.0%of the shipment *** cost varied substantially between cargos(8.9–28%of the cargo value)and items(interquartile range 4.5–35%of the item value).The largest portion of the total import cost was caused by transport(82–99%of the cargo import cost)and allocated based on imported ***(14%)of the 69 items imported as standard cargo were associated with 85%of the standard cargo import *** cargo items could be grouped based on contributing to import costs predominantly through unit weight(e.g.,fluids),imported quantity(e.g.,tablets),or the combination of unit weight and imported quantity(e.g.,items in powder form).*** cost of importing medical supplies to a TB program in Karakalpakstan,Uzbekistan,was sizable,variable,an

关键词： imported items cargo

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Aetiology of Vesico Vaginal Fistula (VVF)—Observation in Patients managed at CCBRT (Comprehensive Community Based Rehabilitation in Tanzania) Hospital, Dar es Salaam, Tanzania. January to march 2016

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Open Journal of Obstetrics and Gynecology 2017年第6期7卷 649-677页

作者： Peter majinge Veronika Siebenkotten-Branca Babanding Daffeh Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) Dar es Salaam Tanzania mèdecins sans frontières (mSF) (Aerzte Ohne Grenzen—Doctors without Borders) Berlin Germany Serekunda General Hospital Kanifing The Gambia

In this manuscript the authors have studied the various causes of vesico-vaginal fistula (VVF) and described etiology, clinical characteristics, and surgical outcome of VVF patients managed at CCBRT. They show that out of 155 patients 104 had surgery for VVF, 25 for stress incontinence (SI), 7 for perineal tears, 6 for recto-vaginal fistula (RVF) and 5 for other reasons, such as urethral strictures and bladder stones. They found a rate of 37 (35.58% out of 104 patients) with definitely iatrogenic fistula and therefore support the observation also made by others that there is a shift in etiology of VVF.

关键词： Obstetric Fistula iatrogenic fistula Vesico-Vaginal Fistula Etiology Cesarean Section

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Enhanced Adherence Counselling, Support Groups and Viral Load Suppression amongst HIV-Positive Adolescents in a Tertiary Health Care Facility in Cameroon

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Advances in Infectious Diseases 2022年第4期12卷 685-702页

作者： Agbor Nyenty Agbornkwai André Izacar Gaël Bita Stephane Amatagana mabouna Ismaila Esa Ajong Brian Ngongheh Ateh Stanislas Ketum Derek Akateh Yannick Lechedem Ngunyi Arnold Agwe Tanah Gisele Christian miangu Wolloh Grace Tadzong-Awasum Catholic University of Central Africa Yaounde Cameroon médecins sans frontières Belgique Bangui Central African Republic ministry of Public Health Yaounde Cameroon Cameroon Baptist Convention Health Board Yaounde Cameroon University of Buea Buea Cameroon

Background: Globally, HIV viral load suppression rate, which is an indirect measure of the efficacy of antiretroviral (ART) medication, is 47% and 52% in Africa. In Cameroon, the viral load (VL) suppression rate is 44.7% and poor adherence is widely documented as being responsible for the large gap in VL Suppression. Enhanced adherence counselling (EAC) sessions, and enrolment and participation in support groups are specific interventions to improve ART adherence and improve viral load suppression. Purpose: This study assesses the uptake and contribution of support groups and EAC sessions in the management of adolescents with unsuppressed VL results at Centre Hospitalier d’Essos, Yaounde. methods: A retrospective correlational quantitative patient files review was conducted for 138 files of HIV positive adolescents aged between 10 - 19 years with HIV VL above 1000 copies/ml enrolled in care between January 2009 and December 2019. Data from the questionnaire was entered into CSPRO version 7.4. and analyzed by using SPSS version 25.0. results: A total of 138 participants (75 females and 63 males) with a mean age of 15 ± 3 years were included in our study. Sixty-nine (50%) participants were in World Health Organization (WHO) stage I;32.6% were in Stage II;13.0% and 4.3% were in stages III and IV, respectively. Thirty (21.7%) had a history of tuberculosis and 76% of the adolescents were being cared for primarily by their parents. The charts of the adolescents revealed that there was an association between completion of EAC sessions in adolescents with unsuppressed VL and eventual VL suppression (R.R = 2.5;CI 0.848 - 6.162;p = 0.033). However, there was no significant association between support group enrolment and active participation, and eventual VL Suppression. Furthermore, combining EAC and support group interventions was strongly associated with eventual VL Suppression in this group of initially unsuppressed adolescents (R.R = 7.5;C.I 2.544 - 22.360;p Conclusion: S

关键词： High Viral Load Enhanced Adherence Counselling Support Groups HIV Adolescents

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Emerging progress: photochemical transformation of nitroso compounds

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Science China Chemistry 2025年第1期68卷 118-133页

作者： Ze-Le Chen Qiang-Qiang Li Armido Studer Jun Xuan Anhui Province Key Laboratory of Chemistry for Inorganic/Organic Hybrid Functionalized materials School of Chemistry & Chemical Engineering Anhui University Organisch-Chemisches Institut Universitat Münster

Nitroso compounds have emerged as highly valuable reaction partners or reagents in organic synthesis due to their rich *** versatile profile of these compounds allows them to function as electrophiles, nucleophiles, diradicals, and radical acceptors in diverse transformations. In recent years, notable progress has been made in harnessing photochemical reactions with nitroso compounds to prepare N,O-containing structures using mild and eco-friendly conditions. Various nitroso compounds like nitrosoarenes, acyloxy nitroso compounds, N-nitrosoamines and nitrites have received significant attention for their ability to introduce NO moieties into complex molecules that are otherwise difficult to access. In this review, we provide an overview of the recent advancements in the visible light-induced conversion of nitroso compounds, with particular emphasis on their role as bifunctional reagents and acceptors of radicals, carbenes and nitrenes.

关键词： nitroso compounds photochemistry radical reaction carbene transformation nitrosoarenes

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Evidence supporting the relationship between maternal asthma and risk for autism spectrum disorders

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Neural Regeneration research 2025年第4期20卷 1101-1102页

作者： Hadley Osman Paul Ashwood Department of medical microbiology and Immunology and the M.I.N.D.InstituteUniversity of California at DavisSacramentoCAUSA

During pregnancy,maternal immune activation(mIA),due to infection,chronic inflammatory disorders,or toxic exposures,can result in lasting health impacts on the developing *** has been associated with an increased risk of neurodevelopmental disorders,such as autism spectrum disorder(ASD)in the *** is characterized by increased repetitive and stereotyped behaviors and decreased *** of 2020,1 in 36 children are diagnosed with ASD by the age of 8 years,with ASD rates continuing to increase in prevalence in USA(Tamayo et al.,2023).Post-mortem brain studies,biomarker and transcriptomic studies,and epidemiology studies have provided compelling evidence of immune dysregulation in the circulation and brain of individuals diagnosed with ***,the etiology of ASD is largely unknown,however,genetic components and environmental factors can contribute to increased *** allergic asthma(mAA),a form of mIA,has been identified as a potential risk factor for developing neurodevelopmental disorders(Patel et al.,2020).Asthma is a chronic inflammatory condition driven by a T-helper type(TH)2 immune response.

关键词： disorders epidemiology fetus

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Translocator protein and neurodegeneration: insights from Alzheimer’s disease

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Neural Regeneration research 2025年第4期20卷 1090-1091页

作者： Arpit Kumar Pradhan Rainer Rupprecht Gerhard Rammes Klinik für Anaesthesiologie und Intensivmedizin der Technischen Universität münchen Klinikum rechts der IsarMunichGermany Graduate School of Systemic Neurosciences Ludwig-Maximilians-Universität MünchenMartinsriedGermany Department of Psychiatry and Psychotherapy University RegensburgRegensburgGermany

The 18 kDa translocator protein(TSPO)located on the outer mitochondrial membrane regulates several key cellular processes including mitochondrial homeostasis,cholesterol transport,apoptosis,cell proliferation,and maintenance of mitochondrial health(Rupprecht et al.,2022,2023).TSPO is expressed in both peripheral organs and the central nervous system,with a more pronounced expression in tissues that produce *** main reason why TSPO has garnered so much attention is because it plays a key role in neurosteroidogenesis by transferring cholesterol from the outer to the inner mitochondrial membrane,which is the rate-limiting step in neurosteroid synthesis.A cholesterol-recognizing amino acid consensus domain has been identified in the cytosolic C terminus of the TSPO protein by both in vitro and site-directed mutagenesis experiments(Li et al.,2001).However,the role of TSPO in the process of neurosteroid synthesis has been challenged by several studies,particularly TSPO knockout models,which suggest that TSPO removal does not affect the phenotype or the system’s viability(Tu et al.,2014).However,ligands targeting TSPO have been shown to enhance levels of neurosteroids which suggests that neurosteroidogenesis is one of the major functional roles mediated by the TSPO protein.

关键词： cholesterol organs

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