1,420 results on '"Kwizera, A"'
Search Results
2. A survey to document toxic hazards in the zone surrounding volcanoes national park, a habitat for mountain gorillas, an endangered wildlife species in Rwanda
- Author
-
Kwizera, Enock, Rumbeiha, Wilson K, Nishimwe, Kizito, and Nziza, Julius
- Subjects
Veterinary Sciences ,Agricultural ,Veterinary and Food Sciences ,Life on Land ,chemicals ,wildlife ,mountain gorillas ,VNP ,pesticides ,pharmaceuticals ,poisonous plants ,toxicants ,Veterinary sciences - Abstract
IntroductionIn recent years, Volcanoes National Park has seen a rise in its wildlife population, primarily due to the diligent efforts of the Rwandan government in safeguarding endangered species, notably the mountain gorillas (Gorilla beringei spp. beringei). This population growth has led to a pressing need for more expansive habitats, ensuring these creatures have ample space, sustenance, and shelter for their wellbeing. Consequently, there are planned park expansion activities on the horizon. However, before initiating this expansion, a critical prelude involves identifying potential threats, particularly toxic substances stemming from agricultural activities in the surrounding environment of Volcanoes National Park.MethodsTo address this concern, a comprehensive study was conducted, aimed at pinpointing potential toxic hazards and assessing the awareness of the local population regarding the harm these hazards pose to wildlife species. Data was collected from individuals with no prior knowledge of the study using a pre-tested questionnaire. The questionnaire was divided into three sections: socio-demographic issues, potential toxic hazards assessment, and a section to determine awareness and risk of potential toxic hazards to humans, animals, and the environment. Respondents were selected based on specific criteria, which included being 18 years or older and residing within the National Volcano Park (NVP) area.ResultsThe study's findings revealed four main categories of potential toxic hazards, which include household chemicals, pharmaceutical products, agricultural pesticides, and poisonous plants. These hazards could jeopardize the health and survival of wildlife species if they consume or come into contact with them. Furthermore, the study exposed an inadequacy in the knowledge and skills of the local community in preventing these toxic hazards, which can result in death of wildlife species and ecosystem contamination and degradation.ConclusionStudy results also underscored the significance of education and training in enhancing the awareness of local communities concerning these toxic threats. Therefore, it is imperative to implement immediate measures to mitigate the adverse effects of these toxic hazards on wildlife species, especially in light of the planned park expansion.
- Published
- 2024
3. Vaginal colonization with virulent and methicillin resistant Staphylococcus aureus among Ugandan women in Labour
- Author
-
Freddie Bwanga, Claudine Mukashyaka, David Patrick Kateete, Josephine Tumuhamye, Alfred Okeng, Emmanuel Aboce, Olive Namugga, Richard Kwizera, Halvor Sommerfelt, and Victoria Nankabirwa
- Subjects
Staphylococcus aureus ,Vaginal colonization ,Virulence factors ,Virulence genes ,Female genital tract ,MRSA ,Microbiology ,QR1-502 - Abstract
Abstract Background Staphylococcus aureus (S. aureus) often colonizes the human skin, upper respiratory and genital tracts. In the female genital tract, it can be passed on to the newborn during vaginal delivery leading to either ordinary colonization, or neonatal infections notably umbilical stump sepsis, scalded skin syndrome, arthritis, or bacteraemia/sepsis. These infections are mediated by staphylococcal virulence factors such as (i) Staphylococcal Enterotoxins A, B, C, D, and E encoded by the sea, seb, sec, sed, see genes, (ii) Exfoliative Toxins A and B encoded by the eta and etb genes, (iii) Toxic Shock Syndrome Toxin 1 (TSST-1) encoded by the tst gene, (iv) Panton-Valentine Leukocidin (PVL) encoded by the pvl gene, and (v) Hemolysins alpha and delta encoded by the hla and hld genes, respectively. We determined the prevalence of S. aureus possessing one or more virulence factor genes and of methicillin resistant Staphylococcus aureus (MRSA) in this population. Methods This was a cross-sectional study, which used 85 S. aureus isolates from the Chlorohexidine (CHX) clinical trial study in Uganda. The isolates had been obtained by culturing vaginal swabs (VS) from 1472 women in labour, frozen at minus 80oC, then thawed, sub-cultured, and tested for the selected virulence genes sea, seb, sec, sed, see eta, etb, tst, pvl, hla and hld, and for the methicillin resistance determining gene (mecA). Data were analyzed using SPSS version 20. Results Of the 85 S. aureus isolates 13 (15.3%) were positive for one or more virulence factor genes, as follows: pvl 9/85 (10.6%), hld 5/85 (5.9%), sea 1/85 (1.2%) and seb genes 1/85 (1.2%). The other virulence genes (sec, sed, see, eta, etb, hla and tst) were not detected in any of the isolates. MRSA was detected in 55.3% (47/85) of the isolates, but only two of these carried the pvl virulence gene. Conclusion This study demonstrated that 15% of the S. aureus colonizing the female lower genital tract of mothers in labour in central Uganda carried one or more virulence genes, mostly pvl, indicating potential for newborn infection with S. aureus acquired in the maternal birth canal. More than half of the isolates were MRSA.
- Published
- 2024
- Full Text
- View/download PDF
4. Ebola transmission dynamics: will future Ebola outbreaks become cyclic?
- Author
-
Niyukuri, David, Sinigirira, Kelly Joelle Gatore, Kwizera, Jean De Dieu, and Adam, Salma Omar Abd-Almageid
- Subjects
Quantitative Biology - Populations and Evolution - Abstract
The Ebola Virus Disease (EVD) can persist in some body fluids after clinical recovery. In Guinea and the Democratic Republic of the Congo, there are well-documented cases of EVD reemergence that were associated with previous outbreaks. In many cases, male EVD survivors were associated with the re-introduction of new outbreaks. This has shown that even after controlling an EVD outbreak, a close biomedical monitoring of survivors and contacts is critical to avoiding future outbreaks. Thus, in order to explore the main features of EVD transmission dynamics in the context of re-emergence, we used a compartmental model by considering vaccination around EVD contacts. Analytical and numerical analyses of the model were conducted. The model is mathematically and epidemiologically well-posed. We computed the reproductive number (R0) and the disease equilibrium points (disease-free equilibrium and endemic equilibrium) for the re-emerging outbreak. The stability analysis of the model around those equilibrium points was performed. The model undergoes a backward bifurcation at R0 close to 1, regardless R0 < 1, the disease will not be eradicated. This means that R0 cannot be considered as an intervention control measure in our model.
- Published
- 2023
5. Vaginal colonization with virulent and methicillin resistant Staphylococcus aureus among Ugandan women in Labour
- Author
-
Bwanga, Freddie, Mukashyaka, Claudine, Kateete, David Patrick, Tumuhamye, Josephine, Okeng, Alfred, Aboce, Emmanuel, Namugga, Olive, Kwizera, Richard, Sommerfelt, Halvor, and Nankabirwa, Victoria
- Published
- 2024
- Full Text
- View/download PDF
6. Factors affecting nutritional status among children aged below five years in Rwanda’s Western and Southern Provinces
- Author
-
Sunday, Francois Xavier, Ilinde, Delice Niyigena, Izabayo Rudatinya, Patrick, Kwizera, Philemon, Kanimba, Philbert, Rutayisire, Reverien, and Umugwaneza, Maryse
- Published
- 2024
- Full Text
- View/download PDF
7. HIV-1 virion lysis following centrifugation improves the sensitivity of the Fourth-Generation HIV Ag/Ab combo assay
- Author
-
Wandera, Allan, Ssekatawa, Kenneth, Kato, Charles Drago, Kwizera, Eliah, Mujinya, Pastori, and Siida, Robert
- Published
- 2024
- Full Text
- View/download PDF
8. Characteristics and outcomes of patients admitted to intensive care units in Uganda: a descriptive nationwide multicentre prospective study
- Author
-
Atumanya, Patience, Agaba, Peter. K., Mukisa, John, Nakibuuka, Jane, Kwizera, Arthur, and Sendagire, Cornelius
- Published
- 2024
- Full Text
- View/download PDF
9. Access to family planning services and associated factors among young people in Lira city northern Uganda
- Author
-
Kigongo, Eustes, Tumwesigye, Raymond, Anyolitho, Maxson Kenneth, Musinguzi, Marvin, Kwizera, Gad, Achan, Everlyne, Nabasirye, Caroline Kambugu, Udho, Samson, Kabunga, Amir, and Omech, Bernard
- Published
- 2024
- Full Text
- View/download PDF
10. MGFEEN: a multi-granularity feature encoding ensemble network for remote sensing image classification
- Author
-
Jean Bosco, Musabe, Jean Pierre, Rutarindwa, Muthanna, Mohammed Saleh Ali, Jean Pierre, Kwizera, Muthanna, Ammar, and Abd El-Latif, Ahmed A.
- Published
- 2024
- Full Text
- View/download PDF
11. Shared structural features of Miro binding control mitochondrial homeostasis
- Author
-
Covill-Cooke, Christian, Kwizera, Brian, López-Doménech, Guillermo, Thompson, Caleb OD, Cheung, Ngaam J, Cerezo, Ema, Peterka, Martin, Kittler, Josef T, and Kornmann, Benoît
- Published
- 2024
- Full Text
- View/download PDF
12. Factors affecting nutritional status among children aged below five years in Rwanda’s Western and Southern Provinces
- Author
-
Francois Xavier Sunday, Delice Niyigena Ilinde, Patrick Izabayo Rudatinya, Philemon Kwizera, Philbert Kanimba, Reverien Rutayisire, and Maryse Umugwaneza
- Subjects
Children under five years ,Nutritional status ,Stunting ,Undernutrition ,Underweight ,Wasting ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background The state of a child’s nutrition is a critical indicator of their overall health and wellbeing. Public health still faces challenges from undernutrition, especially in developing nations across the globe. In Rwanda, around 33% of children aged under five years suffer from chronic undernutrition. Many factors, such as poverty, illiteracy, poor WASH practices, improper child feeding practices, and insufficient healthcare, are the leading causes of undernutrition. The study aims to assess infant and young child feeding practices, WASH, food security, and their association with the nutritional status of children under five years in Rwanda’s Western and Southern provinces. Methods A community-based cross-sectional study design was applied to study factors affecting the nutritional status of children under five years in 439 households in the Karongi, Nyabihu, and Nyamagabe districts of Rwanda. The study assessed anemia, stunting, underweight, and wasting indicators, and collected data was analyzed using SPSS version 25. Results The study findings indicate that among the children surveyed, 29.2% (128) were identified as stunted, 5.9% (26) were underweight, 2.3% (10) suffered from wasting, and 20.9% (31) had anemia. Factors associated with these conditions included larger household size [AOR = 2.108; 95% CI (1.016–4.371)], positively associated with stunting. Additionally, children from households where the head was above 60 years old were more likely to exhibit stunting [AOR = 4.809; 95% CI (1.513, 15.283)]. Furthermore, a high household dietary diversity score was positively linked to being underweight [AOR = 6.061; 95% CI (1.535,23.942)]. Conclusion Household characteristics like size, dietary diversity, and the age of the household head affect children’s nutritional status. Improving these conditions would enhance children’s nutritional status.
- Published
- 2024
- Full Text
- View/download PDF
13. HIV-1 virion lysis following centrifugation improves the sensitivity of the Fourth-Generation HIV Ag/Ab combo assay
- Author
-
Allan Wandera, Kenneth Ssekatawa, Charles Drago Kato, Eliah Kwizera, Pastori Mujinya, and Robert Siida
- Subjects
Centrifugation ,HIV-1 virion lysis ,Sensitivity ,Fourth-generation combo assay ,Medicine ,Biology (General) ,QH301-705.5 ,Science (General) ,Q1-390 - Abstract
Abstract Objective Fourth-generation HIV Ag/Ab Combo assay is used for HIV screening of blood for transfusion in developing countries, however, the sensitivity of the assay is questionable during the acute phase of HIV infection. Thus, the study aimed to determine the effect of combining centrifugation with HIV-1 virion lysis on the sensitivity of the fourth-generation HIV Ag/Ab combo assay. Results When the 50 HIV-1 antibody-negative samples were run on the fourth-generation HIV Ag/Ab combo assay, 8 (16%) were positive following centrifugation, 13 (26%) were positive following lysis while 25 (50%) were positive after combining centrifugation with HIV-1 virion lysis.
- Published
- 2024
- Full Text
- View/download PDF
14. Responsive Complementary Feeding Practices in Rural Muhanga District of Rwanda: A Mixed Methods Study
- Author
-
Jeanine Ahishakiye, Lenneke Vaandrager, Eric Matsiko, Philemon Kwizera, and Maria Koelen
- Subjects
infant feeding ,mother‐child interaction during feeding ,responsive feeding ,Rwanda ,Public aspects of medicine ,RA1-1270 - Abstract
ABSTRACT Background Responsive feeding among infants and young children (IYC) determines their food acceptance and adequate dietary intake, which enhances growth and developmental opportunities. However, little is known about responsive feeding practices among IYC in Rwanda. This study explored the status and barriers of responsive feeding practices among mothers from rural areas of Muhanga District in Rwanda. Method This descriptive longitudinal and exploratory mixed methods study was conducted among 29 mothers from 2 rural health centers in Muhanga District. Mothers were interviewed, and their interactions with children during lunch meals at 6, 9, and 12 months were observed. The interviews were recorded, transcribed, and thematically analyzed using Atlas.ti software. Results The study shows that the number of mothers who reported to verbally encourage their children to eat during feeding increased with the child's age. Less than half of mothers, at all three time points of data collection (at 6, 9, and 12 months), reported and were observed allowing their children to self‐feed, smiling and talking to them during feeding. The perceived major barriers to mother–child interaction during feeding were lack of time due to the burden of other responsibilities, and poverty. In addition, fear of messing up and food waste were barriers to child self‐feeding opportunities. Conclusion Findings indicate that responsive feeding was less practiced among study mothers due to lack of time, poverty, and fear of food waste during child self‐feeding. Nutrition interventions in this community should consider raising awareness of responsive feeding practices through education and encouraging mothers to devote sufficient time to interact with their children during feeding episodes.
- Published
- 2024
- Full Text
- View/download PDF
15. Dietary Diversity and Nutritional Status Among Rwandan Women Engaged in Agriculture: A Cross‐Sectional Study
- Author
-
Sunday François Xavier, Philemon Kwizera, Yves Didier Umwungerimwiza, Rutayisire Reverien, Kanimba Philbert, Ilinde Niyigena Delice, and Maryse Umugwaneza
- Subjects
agriculture ,dietary diversity ,nutritional status ,Rwanda ,women ,Public aspects of medicine ,RA1-1270 - Abstract
ABSTRACT Background Dietary diversity is crucial for nutritional adequacy, particularly among women of reproductive age who have increased nutritional needs due to menstruation, pregnancy, and lactation. This is especially important in addressing anemia in Rwanda, which poses significant health risks for both mothers and children. This study assessed the dietary diversity, nutritional status, and related factors among Rwandan women engaged in agriculture. Methods In 2022, a cross‐sectional study in Nyamagabe, Karongi, and Nyabihu districts, Rwanda, focused on high malnutrition rates. Agriculture households with children under 5 were sampled using a multistage method. Data, including nutritional status via MUAC and dietary diversity via 24‐h recall, were collected digitally through Kobo Collect. Results The study included 439 respondents, with a mean age of 33 years. Among participants, 359 (81.8%) had low dietary diversity, with Nyamagabe having the highest proportion at 39%. Anemia prevalence was 22.1%, with Karongi having the highest at 10.7%. Factors associated with higher odds of high dietary diversity included the education of the household head (adjusted OR = 6.4, 95% CI: 1.05–39.7), age of women (adjusted OR = 3.03, 95% CI: 1.1–7.8), and wealth status (adjusted OR = 1.66, 95% CI: 0.51–5.4). Conversely, the occupation of women (adjusted OR = 0.13, 95% CI: 0.001–0.19), reading skills (adjusted OR = 0.27, 95% CI: 0.1–0.72), and family size (adjusted OR = 0.63, 95% CI: 0.35–1.1) were associated with lower odds of lower dietary diversity. Conclusion The findings highlight a significant nutritional challenge among Rwandan women, with low dietary diversity, significant rates of anemia, and food insecurity. The study calls for an urgent need for targeted nutritional interventions to improve dietary diversity and address micronutrient deficiencies among women in agriculture to enhance maternal health and child development, thereby contributing to broader public health goals.
- Published
- 2024
- Full Text
- View/download PDF
16. Identifying Novel COVID-19 Rumours Through a Multi-channel Approach
- Author
-
Tibbels, Natalie J., Dosso, Abdul, Kwizera, Amata, Benie, William, Massingue, Felisberto, Nana, Marjorie, Naugle, Danielle A., Lewis, Monique, editor, Govender, Eliza, editor, and Holland, Kate, editor
- Published
- 2024
- Full Text
- View/download PDF
17. Characteristics and outcomes of patients admitted to intensive care units in Uganda: a descriptive nationwide multicentre prospective study
- Author
-
Patience Atumanya, Peter. K. Agaba, John Mukisa, Jane Nakibuuka, Arthur Kwizera, and Cornelius Sendagire
- Subjects
Low-income country ,Intensive care unit ,Patient characteristics ,Risk factors ,Mortality ,Medicine ,Science - Abstract
Abstract Intensive care unit (ICU) mortality rates have decreased over time. However, in low-and lower-middle income countries (LMICs), there remains an excess ICU mortality with limited understanding of patient characteristics, treatments, and outcomes from small single centre studies. We aimed therefore, to describe the characteristics, therapies and outcomes of patients admitted to all intensive care units in Uganda. A nationwide prospective observational study including all patients admitted Uganda’s ICUs with available daily charts was conducted from 8th January 2018 to 1st April 2018. Socio-demographics and clinical characteristics including worst vital signs in the first 24 h of admission were recorded with calculation of the National Early Warning Score (NEWS-2) and quick Sequential Organ Function Assessment (qSOFA) score. ICU interventions were recorded during the ICU stay and patients were followed up to 28 days in ICU. The primary outcome was 28 day ICU mortality. Three-hundred fifty-one patients were analysed with mean age 39 (24.1) years, 205 (58.4%) males with 197 (56%) surgical admissions. The commonest indication for ICU admission was postoperative care (42.9%), 214 (61%) had at least one comorbidity, with hypertension 104 (48.6%) most prevalent and 35 (10%) HIV positive. The 28 day ICU mortality was 90/351 (25.6%) with a median ICU stay of 3 (1–7) days. The highest probability of death occurred during the first 10 days with more non-survivors receiving mechanical ventilation (80% vs 34%; p
- Published
- 2024
- Full Text
- View/download PDF
18. Access to family planning services and associated factors among young people in Lira city northern Uganda
- Author
-
Eustes Kigongo, Raymond Tumwesigye, Maxson Kenneth Anyolitho, Marvin Musinguzi, Gad Kwizera, Everlyne Achan, Caroline Kambugu Nabasirye, Samson Udho, Amir Kabunga, and Bernard Omech
- Subjects
Access ,Contraception ,Family planning ,Youths ,Young people ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Access to family planning services among young people is crucial for reproductive health. This study explores the access and associated factors among young people in Lira City, Northern Uganda. Methods and materials A mixed-methods study was conducted in March to April 2022. Quantitative data were collected using a structured questionnaire from 553 participants aged 15–24 years. Qualitative data were obtained through in-depth interviews and focus group discussions. Data analysis included univariate, bivariate, and multivariate analyses for quantitative data, while interpretative phenomenological analysis was used for qualitative data. Results Overall, 31.7% of the respondents had a good perceived access to family planning services, with 64.6% reporting perceived availability of FP methods. Challenges included lack of privacy (57.7%), fear of mistreatment (77.2%), and decision-making difficulties (66.2%). Among females, good perceived access to FP services was less likely among urban residents (AOR: 0.22, 95% CI: 0.09–0.53), Christian respondents (AOR: 0.51, 95% CI: 0.01–0.36), Muslim respondents (AOR: 0.07, 95% CI: 0.01–0.55) and respondents with poor attitude to FP services (AOR: 0.39, 95% CI: 0.24–0.64), but more likely among respondents with a sexual a partner (AOR: 4.48, 95% CI: 2.60–7.75). Among males, good perceived access to FP services was less likely among respondents living with parents (AOR: 0.19, 95% CI: 0.05–0.67) but more likely among respondents with good knowledge of FP services (AOR: 2.28, 95% CI: 1.02–5.32). Qualitative findings showed that three themes emerged; knowledge of family planning methods, beliefs about youth contraception and, friendliness of family planning services. Conclusion The study revealed a substantial gap in perceived access to family planning services among young people in Lira City. Barriers include privacy concerns, fear of mistreatment, and decision-making difficulties. Tailored interventions addressing urban access, religious beliefs for females, and knowledge enhancement for males are essential. Positive aspects like diverse FP methods and physical accessibility provide a foundation for targeted interventions. Youth-friendly services, comprehensive sexual education, and further research are emphasized for a nuanced understanding and effective interventions in Northern Uganda.
- Published
- 2024
- Full Text
- View/download PDF
19. The initiative for medical equity and global health (IMEGH) resuscitation training program: A model for resuscitation training courses in Africa
- Author
-
Eugene Tuyishime, Alain Irakoze, Celestin Seneza, Bernice Fan, Jean Paul Mvukiyehe, Jackson Kwizera, Noah Rosenberg, and Faye M Evans
- Subjects
Resuscitation training ,Low-resource setting ,Rwanda ,Medicine ,Medicine (General) ,R5-920 - Abstract
In high-income countries, outcomes following in hospital cardiac arrest have improved over the last two decades due to the introduction of rapid response teams, cardiac arrest teams, and advanced resuscitation training. However, in low-income countries, such as Rwanda, outcomes are still poor. This is due to multiple factors including lack of adequate resuscitation training, few trainers, and lack of equipment.To address this issue, the Initiative for Medical Equity and Global Health Equity (IMEGH), a training organization founded in 2018 by 5 local anesthesiologists has regularly taught resuscitation courses such as Basic Life Support, Advanced Cardiac Life Support, and Pediatric Advanced Life Support in hospitals throughout Rwanda. The aims of the organization include developing a sustainable model to offer context relevant resuscitation training courses, building a cadre of local instructors to teach on the courses, as well as engaging funding partners to help support the effort. From October 2018 until September 2022, 31 courses were run in 11 hospitals across Rwanda training 1,060 healthcare providers (mainly of non-physician anesthetists, nurses, midwives, and general practitioners). Ongoing challenges include lack of local protocols, inability to tracking resuscitation outcomes, and continued inaccessibility by many healthcare providers. Despite these challenges, the IMEGH program is an example of a successful context-relevant model and has potential to inform the design of resuscitation programs in other similar settings. This article describes the development of the IMEGH program, accomplishments as well as lessons learned, challenges, and next steps for expansion.
- Published
- 2024
- Full Text
- View/download PDF
20. MGFEEN: a multi-granularity feature encoding ensemble network for remote sensing image classification.
- Author
-
Musabe Jean Bosco, Rutarindwa Jean Pierre, Mohammed Saleh Ali Muthanna, Kwizera Jean Pierre, Ammar Muthanna, and Ahmed A. Abd El-Latif 0001
- Published
- 2024
- Full Text
- View/download PDF
21. Respiratory support with standard low-flow oxygen therapy, high-flow oxygen therapy or continuous positive airway pressure in adults with acute hypoxaemic respiratory failure in a resource-limited setting: protocol for a randomised, open-label, clinical trial – the Acute Respiratory Intervention StudiEs in Africa (ARISE-AFRICA) study
- Author
-
Étienne Audureau, Arthur Kwizera, Cornelius Sendagire, Daphne Kabatoro, Armand Mekontso Dessap, Charles Olaro, Darius Owachi, Jackson Kansiime, George Kateregga, Doreen Nanyunja, and Doreen Nyakato
- Subjects
Medicine - Abstract
Rationale Acute hypoxaemic respiratory failure (AHRF) is associated with high mortality in sub-Saharan Africa. This is at least in part due to critical care-related resource constraints including limited access to invasive mechanical ventilation and/or highly skilled acute care workers. Continuous positive airway pressure (CPAP) and high-flow oxygen by nasal cannula (HFNC) may prove useful to reduce intubation, and therefore, improve survival outcomes among critically ill patients, particularly in resource-limited settings, but data in such settings are lacking. The aim of this study is to determine whether CPAP or HFNC as compared with standard oxygen therapy, could reduce mortality among adults presenting with AHRF in a resource-limited setting.Methods This is a prospective, multicentre, randomised, controlled, stepped wedge trial, in which patients presenting with AHRF in Uganda will be randomly assigned to standard oxygen therapy delivered through a face mask, HFNC oxygen or CPAP. The primary outcome is all-cause mortality at 28 days. Secondary outcomes include the number of patients with criteria for intubation at day 7, the number of patients intubated at day 28, ventilator-free days at day 28 and tolerance of each respiratory support.Ethics and dissemination The study has obtained ethical approval from the Research and Ethics Committee, School of Biomedical Sciences, College of Health Sciences, Makerere University as well as the Uganda National Council for Science and Technology. Patients will be included after informed consent. The results will be submitted for publication in peer-reviewed journals.Trial registration number NCT04693403.Protocol version 8 September 2023; version 5.
- Published
- 2024
- Full Text
- View/download PDF
22. Using single-dose liposomal amphotericin B for cryptococcal meningitis induction therapy: nurse pearls and practical perspectives [version 1; peer review: 2 approved]
- Author
-
Richard Kwizera, Cynthia Ahimbisibwe, Jane Frances Ndyetukira, David B. Meya, and Carol Namujju
- Subjects
Liposomal amphotericin B ,Cryptococcal meningitis ,Research nurse ,Clinical research ,eng ,Medicine ,Science - Abstract
Background In Uganda where the burden of HIV-associated cryptococcal meningitis is high, conventional amphotericin B deoxycholate has been standard to manage patients with cryptococcal meningitis in research settings. However, liposomal amphotericin B (AmBisome) is now available via the efforts of UNITAID. We sought to describe our nursing experience using AmBisome within a clinical trial for cryptococcal meningitis. Methods We describe the experience of using single-dose 10mg/kg liposomal amphotericin B from the perspective of a research nurse in Uganda. Second, we described the process of preparing and administering amphotericin. Third, we assessed the nursing time required for the administration of daily amphotericin B versus single-dose liposomal amphotericin. Fourth, we discuss the major challenges faced while using liposomal amphotericin B. Results We provide estimates for the nursing time required for reconstituting, filtering, diluting and administering liposomal amphotericin B and a visual aid for nursing tasks. Based on five trained nurses, the process of reconstitution and filtration lasts an average of 52 minutes (Range: 40 to 60 minutes), to reconstitute a mean of 11 (range: 8 to 15) 50mg vials (median weight 55kg). Overall, less nursing time was required for single-dose administration than for daily amphotericin B dosing. From a nursing perspective, liposomal amphotericin B was preferable to amphotericin B deoxycholate due to its reduced infusion reactions and other toxicities. Conclusions Single-dose liposomal amphotericin B is a better alternative to daily amphotericin B. In addition to less toxicity, nosocomial infections, reduced hospital stay, and the potential for lower hospitalisation costs, the nursing implications should not be discounted. Quality nursing care is a finite resource in low- and middle-income countries, and single-dose amphotericin B reduced the nursing time required for the care of patients with cryptococcal meningitis.
- Published
- 2024
- Full Text
- View/download PDF
23. Fatal meningoencephalitis associated with Ebola virus persistence in two survivors of Ebola virus disease in the Democratic Republic of the Congo: a case report study
- Author
-
De Weggheleire, Anja, Soke, Gnakub N, Pallawo, Raymond, Ibrahima, Gouressy, Epaso Gelege, Victor, Kombe-Ngwama, John, Kahambwe-Ekoko, Grace, Mossoko Gbe, Mathias, Adikey Limne, Pierre-Céleste, Yuma-Kibondo, Etienne, Kinganda-Lusamaki, Eddy, Amuri Aziza, Adrienne, Tutu Tshia N'kasar, Yannick, Mumbere Kalemekwa, Elias, Kitsa-Mutsumbirwa, Divine, Mulopo-Mukanya, Noella, Mbelu-Matulu, Fyfy, Kavira-Muhindo, Marie-Anne, Kwizera Sendegeya, Jacques, Kavunga-Membo, Hugo, Mukadi-Bamuleka, Daniel, Edidi-Atani, François, Morales-Betoulle, Maria E, Legand, Anaïs, Nkuba-Ndaye, Antoine, Bulabula-Penge, Junior, Mbala-Kingebeni, Placide, Crozier, Ian, Mambu-Mbika, Fabrice, Whitmer, Shannon, Tshiani Mbaya, Olivier, Hensley, Lisa E, Kitenge-Omasumbu, Richard, Davey, Richard, Mulangu, Sabue, Fonjungo, Peter N, Wiley, Michael R, Klena, John D, Peeters, Martine, Delaporte, Eric, van Griensven, Johan, Ariën, Kevin K, Pratt, Catherine, Montgomery, Joel M, Formenty, Pierre, Muyembe-Tamfum, Jean-Jacques, and Ahuka-Mundeke, Steve
- Published
- 2024
- Full Text
- View/download PDF
24. A systematic review of fungi isolated from formalin-preserved human and animal cadavers: A potential health concern to exposed students and technicians
- Author
-
Kwizera, Richard and Naluzze, Joan
- Published
- 2024
- Full Text
- View/download PDF
25. Methanol Crude Peel Extract of P. granatum Prevents Oxidative Damage in Kidneys of Rats Exposed to Highly Active Antiretroviral Therapy
- Author
-
Kwizera E, Ssekatawa K, Aja PM, Miruka CO, Wandera A, Mpumbya JR, Siida R, Shehu D, and Salihu TS
- Subjects
haart ,oxidative stress ,nephrotoxicity ,punica granatum ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Eliah Kwizera,1 Kenneth Ssekatawa,2,3 Patrick Maduabuchi Aja,1 Conrad Ondieki Miruka,1 Allan Wandera,1 Jackie Rachael Mpumbya,1 Robert Siida,1 Dayyabu Shehu,1 Tijjani Shinkafi Salihu1 1Department of Biochemistry, Faculty of Biomedical Sciences, Kampala International University-Western Campus, Bushenyi, Uganda; 2Department of Science, Technical and Vocational Education, Makerere University, Kampala, Uganda; 3Africa Center Excellence in Materials Product Development and Nanotechnology (MAPRONANO ACE), Makerere University, Kampala, UgandaCorrespondence: Kenneth Ssekatawa, Email kssekatee@gmail.comBackground: Highly Active Antiretroviral Therapy (HAART) has been linked to oxidative damage to kidney cells leading to renal disease in people living with HIV/AIDS on HAART treatment. The toxic effects of HAART affect the patients’ quality of life leading to poor adherence to their regimen. Therefore, the purpose of this study was to investigate the nephron-protective activity of methanol crude peel extract of Punica granatum (MPEPG) in HAART-administered Wistar rats.Methods: Thirty male albino Wistar rats weighing between 180– 200g were randomly divided into six groups of five rats each. Group one served as normal control and was given distilled water only. Group two serves as a negative control and was given HAART at a dosage of 64 mg/kg. Groups 3 and 4 were given 100 and 400 mg/kg of MPEPG, respectively, while groups 5 and 6 were given MPEPG dosages of 100 and 400 mg/kg along with HAART, respectively, for 40 days. The rats were sacrificed under halothane anaesthesia, and the kidneys were removed for histological evaluation, while blood samples were analyzed for biochemical parameters.Results: In the HAART (TLD) treated group, there was a significantly high amount of MDA and a lower level of the antioxidant enzymes SOD and CAT. Biochemical analysis revealed that animals treated with HAART (TLD) had significantly higher levels of urea and creatinine, which are biomarkers of kidney damage than the normal control animals. In contrast, all the kidney function markers were returned to normal levels in the HAART-treated group after administration of methanol crude peel extract of P. granatum. The kidney tissues of animals given HAART had considerable structural damage as revealed by histopathological studies. When HAART-exposed rats were treated with MPEPG, both the biochemical and histological results significantly improved.Conclusion: Methanol crude peel extract of P. granatum provided effective protection against kidney oxidative injury brought on by HAART because of its anti-oxidant and free radical scavenging properties.Keywords: HAART, oxidative stress, nephrotoxicity, Punica granatum
- Published
- 2024
26. In-situ cryo-immune engineering of tumor microenvironment with cold-responsive nanotechnology for cancer immunotherapy
- Author
-
Ou, Wenquan, Stewart, Samantha, White, Alisa, Kwizera, Elyahb A., Xu, Jiangsheng, Fang, Yuanzhang, Shamul, James G., Xie, Changqing, Nurudeen, Suliat, Tirada, Nikki P., Lu, Xiongbin, Tkaczuk, Katherine H. R., and He, Xiaoming
- Published
- 2023
- Full Text
- View/download PDF
27. Evaluating patient factors, operative management and postoperative outcomes in trauma laparotomy patients worldwide: a protocol for a global observational multicentre trauma study
- Author
-
Michael F Bath, Justin Davies, Andy J M Leather, Tom Bashford, Ramani Moonesinghe, Kokila Lakhoo, Katharina Kohler, Ross Davenport, Arthur Kwizera, Andrew Conway Morris, Max Marsden, Joachim Amoako, Brandon George Smith, Peter John Hutchinson, David J Clark, Thomas Weiser, Timothy Hardcastle, Zane Perkins, Laura Hobbs, Ravi Naidoo, and Yannick Nördin
- Subjects
Medicine - Abstract
Introduction Trauma contributes to the greatest loss of disability-adjusted life-years for adolescents and young adults worldwide. In the context of global abdominal trauma, the trauma laparotomy is the most commonly performed operation. Variation likely exists in how these patients are managed and their subsequent outcomes, yet very little global data on the topic currently exists. The objective of the GOAL-Trauma study is to evaluate both patient and injury factors for those undergoing trauma laparotomy, their clinical management and postoperative outcomes.Methods We describe a planned prospective multicentre observational cohort study of patients undergoing trauma laparotomy. We will include patients of all ages who present to hospital with a blunt or penetrating injury and undergo a trauma laparotomy within 5 days of presentation to the treating centre. The study will collect system, patient, process and outcome data, following patients up until 30 days postoperatively (or until discharge or death, whichever is first). Our sample size calculation suggests we will need to recruit 552 patients from approximately 150 recruiting centres.Discussion The GOAL-Trauma study will provide a global snapshot of the current management and outcomes for patients undergoing a trauma laparotomy. It will also provide insight into the variation seen in the time delays for receiving care, the disease and patient factors present, and patient outcomes. For current standards of trauma care to be improved worldwide, a greater understanding of the current state of trauma laparotomy care is paramount if appropriate interventions and targets are to be identified and implemented.
- Published
- 2024
- Full Text
- View/download PDF
28. Immune cell phenotype and function patterns across the life course in individuals from rural Uganda
- Author
-
Angela Nalwoga, Marjorie Nakibuule, Romin Roshan, Moses Kwizera Mbonye, Wendell Miley, Denise Whitby, Robert Newton, Rosemary Rochford, and Stephen Cose
- Subjects
immune parameters ,immune phenotypes ,Epstein-Barr virus T cell responses ,Uganda ,lifecourse ,Immunologic diseases. Allergy ,RC581-607 - Abstract
BackgroundTo determine the pattern of immune cell subsets across the life span in rural sub-Saharan Africa (SSA), and to set a reference standard for cell subsets amongst Africans, we characterised the major immune cell subsets in peripheral blood including T cells, B cells, monocytes, NK cells, neutrophils and eosinophils, in individuals aged 3 to 89 years from Uganda.MethodsImmune phenotypes were measured using both conventional flow cytometry in 72 individuals, and full spectrum flow cytometry in 80 individuals. Epstein-Barr virus (EBV) IFN-γ T cell responses were quantified in 332 individuals using an ELISpot assay. Full blood counts of all study participants were also obtained.ResultsThe percentages of central memory (TCM) and senescent CD4+ and CD8+ T cell subsets, effector memory (TEM) CD8+ T cells and neutrophils increased with increasing age. On the other hand, the percentages of naïve T (TN) and B (BN) cells, atypical B cells (BA), total lymphocytes, eosinophils and basophils decreased with increasing age. There was no change in CD4+ or CD8+ T effector memory RA (TEMRA) cells, exhausted T cells, NK cells and monocytes with age. Higher eosinophil and basophil percentages were observed in males compared to females. T cell function as measured by IFN-γ responses to EBV increased with increasing age, peaking at 31-55 years.ConclusionThe percentages of cell subsets differ between individuals from SSA compared to those elsewhere, perhaps reflecting a different antigenic milieu. These results serve as a reference for normal values in this population.
- Published
- 2024
- Full Text
- View/download PDF
29. Re-estimation of the burden of serious fungal diseases in Uganda
- Author
-
Felix Bongomin, Richard Kwizera, Martha Namusobya, Norman van Rhijn, Irene Andia-Biraro, Bruce J. Kirenga, David B. Meya, and David W. Denning
- Subjects
Infectious and parasitic diseases ,RC109-216 - Abstract
Background: It is of utmost importance to monitor any change in the epidemiology of fungal diseases that may arise from a change in the number of the at-risk population or the availability of local data. Objective: We sought to update the 2015 publication on the incidence and prevalence of serious fungal diseases in Uganda. Methods: Using the Leading International Fungal Education methodology, we reviewed published data on fungal diseases and drivers of fungal diseases in Uganda. Regional or global data were used where there were no Ugandan data. Results: With a population of ~45 million, we estimate the annual burden of serious fungal diseases at 4,099,357 cases (about 9%). We estimated the burden of candidiasis as follows: recurrent Candida vaginitis (656,340 cases), oral candidiasis (29,057 cases), and esophageal candidiasis (74,686 cases) in HIV-infected people. Cryptococcal meningitis annual incidence is estimated at 5553 cases, Pneumocystis pneumonia at 4604 cases in adults and 2100 cases in children. For aspergillosis syndromes, invasive aspergillosis annual incidence (3607 cases), chronic pulmonary aspergillosis (26,765 annual cases and 63,574 5-year-period prevalent cases), and prevalence of allergic bronchopulmonary aspergillosis at 75,931 cases, and severe asthma with fungal sensitization at 100,228 cases. Tinea capitis is common with 3,047,989 prevalent cases. For other mycoses, we estimate the annual incidence of histoplasmosis to be 646 cases and mucormycosis at 9 cases. Conclusion: Serious fungal diseases affect nearly 9% of Ugandans every year. Tuberculosis and HIV remain the most important predisposition to acute fungal infection necessitating accelerated preventive, diagnostic, and therapeutic interventions for the management of these diseases.
- Published
- 2024
- Full Text
- View/download PDF
30. ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping and respiratory support strategies
- Author
-
Grasselli, Giacomo, Calfee, Carolyn S., Camporota, Luigi, Poole, Daniele, Amato, Marcelo B. P., Antonelli, Massimo, Arabi, Yaseen M., Baroncelli, Francesca, Beitler, Jeremy R., Bellani, Giacomo, Bellingan, Geoff, Blackwood, Bronagh, Bos, Lieuwe D. J., Brochard, Laurent, Brodie, Daniel, Burns, Karen E. A., Combes, Alain, D’Arrigo, Sonia, De Backer, Daniel, Demoule, Alexandre, Einav, Sharon, Fan, Eddy, Ferguson, Niall D., Frat, Jean-Pierre, Gattinoni, Luciano, Guérin, Claude, Herridge, Margaret S., Hodgson, Carol, Hough, Catherine L., Jaber, Samir, Juffermans, Nicole P., Karagiannidis, Christian, Kesecioglu, Jozef, Kwizera, Arthur, Laffey, John G., Mancebo, Jordi, Matthay, Michael A., McAuley, Daniel F., Mercat, Alain, Meyer, Nuala J., Moss, Marc, Munshi, Laveena, Myatra, Sheila N., Ng Gong, Michelle, Papazian, Laurent, Patel, Bhakti K., Pellegrini, Mariangela, Perner, Anders, Pesenti, Antonio, Piquilloud, Lise, Qiu, Haibo, Ranieri, Marco V., Riviello, Elisabeth, Slutsky, Arthur S., Stapleton, Renee D., Summers, Charlotte, Thompson, Taylor B., Valente Barbas, Carmen S., Villar, Jesús, Ware, Lorraine B., Weiss, Björn, Zampieri, Fernando G., Azoulay, Elie, and Cecconi, Maurizio
- Published
- 2023
- Full Text
- View/download PDF
31. Development and validation of quantitative PCR assays for HIV-associated cryptococcal meningitis in sub-Saharan Africa: a diagnostic accuracy study
- Author
-
Goodall, J, Mawoko, N, Milburn, J, Mmipi, R, Muthoga, C, Ponatshego, P, Rulaganyang, I, Seatla, K, Tlhako, N, Tsholo, K, April, S, Bekiswa, A, Boloko, L, Bookholane, H, Crede, T, Davids, L, Goliath, R, Hlungulu, S, Hoffman, R, Kyepa, H, Masina, N, Maughan, D, Mnguni, T, Moosa, S, Morar, T, Mpalali, M, Naude, J, Oliphant, I, Sayed, S, Sebesho, L, Shey, M, Swanepoel, L, Chasweka, M, Chimang’anga, W, Chimphambano, T, Dziwani, E, Gondwe, E, Kadzilimbile, A, Kateta, S, Kossam, E, Kukacha, C, Lipenga, B, Ndaferankhande, J, Ndalama, M, Shah, R, Singini, A, Stott, K, Zambasa, A, Banda, T, Chikaonda, T, Chitulo, G, Chiwoko, L, Chome, N, Gwin, M, Kachitosi, T, Kamanga, B, Kazembe, M, Kumwenda, E, Kumwenda, M, Maya, C, Mhango, W, Mphande, C, Msumba, L, Munthali, T, Ngoma, D, Nicholas, S, Simwinga, L, Stambuli, A, Tegha, G, Zambezi, J, Ahimbisibwe, C, Akampurira, A, Alice, A, Cresswell, F, Gakuru, J, Kiiza, D, Kisembo, J, Kwizera, R, Kugonza, F, Laker, E, Luggya, T, Lule, A, Musubire, A, Muyise, R, Namujju, O, Ndyetukira, J, Nsangi, L, Okirwoth, M, Sadiq, A, Tadeo, K, Tukundane, A, Williams, D, Atwine, L, Buzaare, P, Collins, M, Emily, N, Inyakuwa, C, Kariisa, S, Mwesigye, J, Niwamanya, S, Rodgers, A, Rukundo, J, Rwomushana, I, Ssemusu, M, Stead, G, Boyd, K, Gondo, S, Kufa, P, Makaha, E, Moyo, C, Mtisi, T, Mudzingwa, S, Mwarumba, T, Zinyandu, T, Dromer, F, Johnstone, P, Hafeez, S, Mbangiwa, Tshepiso, Sturny-Leclère, Aude, Lechiile, Kwana, Kajanga, Cheusisime, Boyer-Chammard, Timothée, Hoving, Jennifer C, Leeme, Tshepo, Moyo, Melanie, Youssouf, Nabila, Lawrence, David S, Mwandumba, Henry, Mosepele, Mosepele, Harrison, Thomas S, Jarvis, Joseph N, Lortholary, Olivier, and Alanio, Alexandre
- Published
- 2024
- Full Text
- View/download PDF
32. Building Global Partnerships: A Qualitative Exploration of In-Person Training for HealthCare Simulation Educators Working in Low-Resource Settings
- Author
-
Gower, Shelley, Mossenson, Adam, Ndekezi, Jackson Kwizera, and Livingston, Patricia
- Published
- 2024
- Full Text
- View/download PDF
33. Towards a Geospatial Household Natural Hazard Resilience Model in Rwanda.
- Author
-
Brian M. Tomaszewski, Timothy Scott, Jennifer Schneider 0001, Rebekah Walker, Gaspard Rwanyiziri, Jean Francois Christian Kwizera, and Anthony Vodacek
- Published
- 2023
- Full Text
- View/download PDF
34. The socio-politics of (Re)constructing home in a post-displacement context in rural Zimbabwe
- Author
-
Mudefi, Elmon, Akpan, Wilson, and Kwizera, Alice Stella
- Published
- 2024
- Full Text
- View/download PDF
35. Prevalence, correlates and treatment needs of dental caries in patients attending a diabetic clinic in rural southwestern Uganda: a cross-sectional study
- Author
-
Wilfred Arubaku, Deusdedit Tusubira, Frank Ssedyabane, Steffany Chamut, Brittany Anne Seymour, Mark J. Siedner, Vallence Niyonzima, Juliet Nabbanja, Nathan Kakongi, Godfrey Kwizera, and Samuel Maling
- Subjects
Dental caries ,Diabetes ,Treatment needs ,Glycemic control ,Uganda ,Dentistry ,RK1-715 - Abstract
Abstract Background Diabetes mellitus is a complex heterogeneous metabolic disorder known to lead to several pathogenic disorders, and has a bidirectional relationship with oral health conditions. This study aimed at estimating the prevalence, treatment needs and correlates of dental caries among adult patients attending a diabetic clinic in Uganda. Methods This was a cross-sectional study that used questionnaires to collect data on socio-demographic factors, diabetes history, oral health status, dental health care, dietary factors, lifestyle factors, and dental examination guided by the modified World Health Organization oral health questionnaire for adults. Results We enrolled 239 participants, prevalence of dental caries was 71.6%, treatment need was nearly 100%, and mean DMFT was 3.82 (SD = 5.46). Dental caries experience was associated with being widowed. Conclusion We found a high prevalence of dental caries experience and large treatment need among our participants. We recommend integration of oral health care into routine diabetic services in rural sub Saharan Africa.
- Published
- 2023
- Full Text
- View/download PDF
36. A survey to document toxic hazards in the zone surrounding volcanoes national park, a habitat for mountain gorillas, an endangered wildlife species in Rwanda
- Author
-
Enock Kwizera, Wilson K. Rumbeiha, Kizito Nishimwe, and Julius Nziza
- Subjects
chemicals ,wildlife ,mountain gorillas ,VNP ,pesticides ,pharmaceuticals ,Veterinary medicine ,SF600-1100 - Abstract
IntroductionIn recent years, Volcanoes National Park has seen a rise in its wildlife population, primarily due to the diligent efforts of the Rwandan government in safeguarding endangered species, notably the mountain gorillas (Gorilla beringei spp. beringei). This population growth has led to a pressing need for more expansive habitats, ensuring these creatures have ample space, sustenance, and shelter for their wellbeing. Consequently, there are planned park expansion activities on the horizon. However, before initiating this expansion, a critical prelude involves identifying potential threats, particularly toxic substances stemming from agricultural activities in the surrounding environment of Volcanoes National Park.MethodsTo address this concern, a comprehensive study was conducted, aimed at pinpointing potential toxic hazards and assessing the awareness of the local population regarding the harm these hazards pose to wildlife species. Data was collected from individuals with no prior knowledge of the study using a pre-tested questionnaire. The questionnaire was divided into three sections: socio-demographic issues, potential toxic hazards assessment, and a section to determine awareness and risk of potential toxic hazards to humans, animals, and the environment. Respondents were selected based on specific criteria, which included being 18 years or older and residing within the National Volcano Park (NVP) area.ResultsThe study's findings revealed four main categories of potential toxic hazards, which include household chemicals, pharmaceutical products, agricultural pesticides, and poisonous plants. These hazards could jeopardize the health and survival of wildlife species if they consume or come into contact with them. Furthermore, the study exposed an inadequacy in the knowledge and skills of the local community in preventing these toxic hazards, which can result in death of wildlife species and ecosystem contamination and degradation.ConclusionStudy results also underscored the significance of education and training in enhancing the awareness of local communities concerning these toxic threats. Therefore, it is imperative to implement immediate measures to mitigate the adverse effects of these toxic hazards on wildlife species, especially in light of the planned park expansion.
- Published
- 2024
- Full Text
- View/download PDF
37. Plasmonic random laser on an optical fiber tip
- Author
-
Khatri, Dipendra S., Li, Ying, Chen, Jiyang, Stocks, Anna Elizabeth, Kwizera, Elyahb Allie, Huang, Xiaohua, Argyropoulos, Christos, and Hoang, Thang
- Subjects
Physics - Optics ,Physics - Applied Physics - Abstract
Random lasing occurs as the result of a coherent optical feedback from multiple scattering centers. Here, we demonstrate that plasmonic gold nanostars are efficient light scattering centers, exhibiting strong field enhancement at their nanotips, which assists a very narrow bandwidth and highly amplified coherent random lasing with a low lasing threshold. First, by embedding plasmonic gold nanostars in a rhodamine 6G dye gain medium, we observe a series of very narrow random lasing peaks with full-width at half-maximum ~ 0.8 nm. In contrast, free rhodamine 6G dye molecules exhibit only a single amplified spontaneous emission peak with a broader linewidth of 6 nm. The lasing threshold for the dye with gold nanostars is two times lower than that for a free dye. Furthermore, by coating the tip of a single-mode optical fiber with gold nanostars, we demonstrate a collection of random lasing signal through the fiber that can be easily guided and analyzed. Time-resolved measurements show a significant increase in the emission rate above the lasing threshold, indicating a stimulated emission process. Our study provides a method for generating random lasing in the nanoscale with low threshold values that can be easily collected and guided, which promise a range of potential applications in remote sensing, information processing, and on-chip coherent light sources., Comment: 13 pages, 5 figures, submitted
- Published
- 2020
38. Mixed methods study protocol for combining stakeholder-led rapid evaluation with near real-time continuous registry data to facilitate evaluations of quality of care in intensive care units [version 3; peer review: 2 approved]
- Author
-
Mavuto Mukaka, Arjen M Dondorp, Bharath Kumar Tirupakuzhi Vijayaraghavan, Arthur Kwizera, Cassia Righy, Bruce Biccard, Cornelius Sendagire, Christopher Pell, Dilanthi Gamage Done, David Thomson, Farah Nadia, Duncan Wagstaff, Hem Panaru, Giovanni Putoto, Diptesh Aryal, Jorge Salluh, Abi Beane, John Amuasi, Krishnarajah Nirantharakumar, Krishna Gokhale, Maryam Shamal Ghalib, Madiha Hashmi, Marcus Schultz, C. Louise Thwaites, Moses Siaw-frimpong, Rashan Haniffa, Mohammed Basri Mat-Nor, Ronnie P Kaddu, Rajendra Surenthirakumaran, Srinivas Murthy, Aasiyah Rashan, Snehal Pinto Pereira, Suneetha Ramani Moonesinghe, Steve Harris, Tiffany E Gooden, Sutharshan Vengadasalam, Wangari Waweru-Siika, Luigi Pisani, Vrindha Pari, Aniruddha Ghose, Yen Lam Minh, Timo Tolppa, Swagata Tripathy, and Ishara Udayanga
- Subjects
rapid evaluation ,quality of care ,intensive care ,critical illness ,low- and middle-income countries ,learning health systems ,eng ,Medicine ,Science - Abstract
Background Improved access to healthcare in low- and middle-income countries (LMICs) has not equated to improved health outcomes. Absence or unsustained quality of care is partly to blame. Improving outcomes in intensive care units (ICUs) requires delivery of complex interventions by multiple specialties working in concert, and the simultaneous prevention of avoidable harms associated with the illness and the treatment interventions. Therefore, successful design and implementation of improvement interventions requires understanding of the behavioural, organisational, and external factors that determine care delivery and the likelihood of achieving sustained improvement. We aim to identify care processes that contribute to suboptimal clinical outcomes in ICUs located in LMICs and to establish barriers and enablers for improving the care processes. Methods Using rapid evaluation methods, we will use four data collection methods: 1) registry embedded indicators to assess quality of care processes and their associated outcomes; 2) process mapping to provide a preliminary framework to understand gaps between current and desired care practices; 3) structured observations of processes of interest identified from the process mapping and; 4) focus group discussions with stakeholders to identify barriers and enablers influencing the gap between current and desired care practices. We will also collect self-assessments of readiness for quality improvement. Data collection and analysis will be led by local stakeholders, performed in parallel and through an iterative process across eight countries: Kenya, India, Malaysia, Nepal, Pakistan, South Africa, Uganda and Vietnam. Conclusions The results of our study will provide essential information on where and how care processes can be improved to facilitate better quality of care to critically ill patients in LMICs; thus, reduce preventable mortality and morbidity in ICUs. Furthermore, understanding the rapid evaluation methods that will be used for this study will allow other researchers and healthcare professionals to carry out similar research in ICUs and other health services.
- Published
- 2023
- Full Text
- View/download PDF
39. Costs of integrating hypertension care into HIV care in rural East African clinics
- Author
-
Shade, Starley B, Osmand, Thomas, Kwarisiima, Dalsone, Brown, Lillian B, Luo, Alex, Mwebaza, Betty, Mwesigye, Aine Ronald, Kwizera, Enos, Imukeka, Haawa, Mwanga, Florence, Ayieko, James, Owaraganise, Asiphas, Bukusi, Elizabeth A, Cohen, Craig R, Charlebois, Edwin D, Black, Douglas, Clark, Tamara D, Petersen, Maya L, Kamya, Moses R, Havlir, Diane V, and Jain, Vivek
- Subjects
Public Health ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Cardiovascular ,Clinical Research ,Health Services ,HIV/AIDS ,Clinical Trials and Supportive Activities ,Behavioral and Social Science ,Infectious Diseases ,Hypertension ,Prevention ,7.1 Individual care needs ,Management of diseases and conditions ,Infection ,Good Health and Well Being ,Ambulatory Care Facilities ,HIV Infections ,Humans ,Noncommunicable Diseases ,Rural Population ,HIV ,hypertension ,integration ,microcosting ,noncommunicable diseases ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveSub-Saharan Africa faces twin epidemics of HIV and noncommunicable diseases including hypertension. Integrating hypertension care into chronic HIV care is a global priority, but cost estimates are lacking. In the SEARCH Study, we performed population-level HIV/hypertension testing, and offered integrated streamlined chronic care. Here, we estimate costs for integrated hypertension/HIV care for HIV-positive individuals, and costs for hypertension care for HIV-negative individuals in the same clinics.DesignMicrocosting analysis of healthcare expenditures within Ugandan HIV clinics.MethodsSEARCH (NCT: 01864603) conducted community health campaigns for diagnosis and linkage to care for both HIV and hypertension. HIV-positive patients received hypertension/HIV care jointly including blood pressure monitoring and medications; HIV-negative patients received hypertension care at the same clinics. Within 10 Ugandan study communities during 2015-2016, we estimated incremental annual per-patient hypertension care costs using micro-costing techniques, time-and-motion personnel studies, and administrative/clinical records review.ResultsOverall, 70 HIV-positive and 2355 HIV-negative participants received hypertension care. For HIV-positive participants, average incremental cost of hypertension care was $6.29 per person per year, a 2.1% marginal increase over prior estimates for HIV care alone. For HIV-negative participants, hypertension care cost $11.39 per person per year, a 3.8% marginal increase over HIV care costs. Key costs for HIV-positive patients included hypertension medications ($6.19 per patient per year; 98% of total) and laboratory testing ($0.10 per patient per year; 2%). Key costs for HIV-negative patients included medications ($5.09 per patient per year; 45%) and clinic staff salaries ($3.66 per patient per year; 32%).ConclusionFor only 2-4% estimated additional costs, hypertension care was added to HIV care, and also expanded to all HIV-negative patients in prototypic Ugandan clinics, demonstrating substantial synergy. Our results should encourage accelerated scale-up of hypertension care into existing clinics.
- Published
- 2021
40. Fungal diseases in Africa: Closing the gaps in diagnosis and treatment through implementation research and advocacy
- Author
-
Bongomin, Felix, Ekeng, Bassey E., Kwizera, Richard, Salmanton-García, Jon, Kibone, Winnie, van Rhijn, Norman, Govender, Nelesh P., Meya, David B., Osaigbovo, Iriagbonse I., Hamer, Davidson H., Oladele, Rita, and Denning, David W.
- Published
- 2023
- Full Text
- View/download PDF
41. Scaphoid Arterial supply: A Review
- Author
-
O. Kubwimana, J. P. Rugambwa, I. Kwizera, A. M. Buteera, and J. Gashegu
- Subjects
arteries ,hand ,scaphoid ,avascular necrosis ,Medicine - Abstract
Scaphoid, the boat-shaped carpal bone, is largely covered by articular cartilage. It has a much more complex arterial supply than previously reported, moreover, this arterial pattern has been hypothesized to lead to avascular necrosis after fractures Scaphoid blood supply has long been documented as scarce; it arises from the radial artery giving palmar and dorsal branches. There is high-grade evidence reporting two main arteries entering from the distal half of the scaphoid and middle to lower-grade evidence reporting several arteries scattered over the entire scaphoid and anastomosis of the radial artery with intercarpal arteries. Dorsal arteries are slightly larger in diameter and many more than volar ones. The scaphoid shape is associated with variations in arterial supply patterns. Scaphoid surgery preserving vascular supply is the gold standard. Scaphoid blood supply is not as poor as previously documented, as current evidence supports even proximal pole vascularization. We recommend surgery to preserve the blood supply and foster research in this area.
- Published
- 2023
- Full Text
- View/download PDF
42. Resuscitation team training in Rwanda: A mixed method study exploring the combination of the VAST course with Advanced Cardiac Life Support training
- Author
-
Tuyishime, Eugene, Mossenson, Adam, Livingston, Patricia, Irakoze, Alain, Seneza, Celestin, Ndekezi, Jackson Kwizera, and Skelton, Teresa
- Published
- 2023
- Full Text
- View/download PDF
43. Respiratory Support Techniques for COVID-19-Related ARDS in a Sub-Saharan African Country: A Multicenter Observational Study
- Author
-
Kwizera, Arthur, Kabatooro, Daphne, Atumanya, Patience, Tumukunde, Janat, Kalungi, Joyce, Mwanje, Arthur Kavuma, Obua, Daniel, Agaba, Peter, Sendagire, Cornelius, Nakibuuka, Jane, Owachi, Darius, Dünser, Martin W., Alenyo-Ngabirano, Anne, Olaro, Charles, Kyobe-Bosa, Henry, Kirenga, Bruce J., Nakiyingi, Lydia, Kiwanuka, Noah, Kateete, David Patrick, Joloba, Moses, Sewankambo, Nelson, and Summers, Charlotte
- Published
- 2023
- Full Text
- View/download PDF
44. Improving mycetoma case detection through the training of community health workers in Northern Uganda: protocol for a stepped-wedge cluster-randomized trial
- Author
-
Winnie Kibone, Andrew Weil Semulimi, Richard Kwizera, and Felix Bongomin
- Subjects
Infectious and parasitic diseases ,RC109-216 - Abstract
Introduction: The World Health Organization acknowledges the need for countries to incorporate neglected tropical disease care into their routine health care system. However, low detection rates and late presentation of mycetoma to health facilities have been observed in endemic countries, including Uganda. Objective: To empower community health workers (CHWs) in Northern Uganda to recognize and refer suspects of mycetoma to health facilities. Design: This will be a stepped-wedge cluster-randomized trial based in Gulu and Pader districts over a period of 9 months with sequential crossover from intervention phase to the control phase at different time points until both districts are exposed to the intervention. Methods and Analysis: The study will leverage on the ongoing partnership between Northern Uganda Medical Mission and the Uganda Ministry of Health that has trained over 300 CHWs in Gulu and Pader. The study evaluation will be done using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The expected outcome of the study is increased detection and referral of suspects of mycetoma. Data will be analyzed using STATA 17.0 and Friedman statistics or Analysis of Variance to determine increase in case identifications and referrals. Ethics and Registration: The study was approved by Mulago Hospital Research and Ethics Committee (MHREC 2406) and registered with Pan African Clinical Trial Registry (PACTR202301534749787). Dissemination: The results from this trial will be published in a peer-reviewed journal. In addition, the findings will be shared at conferences, with funders, and at other research meetings.
- Published
- 2023
- Full Text
- View/download PDF
45. Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries
- Author
-
Mwayi Kachapila, Mark Monahan, Adesoji O. Ademuyiwa, Yakubu Momohsani Adinoyi, Bruce M. Biccard, Christina George, Dhruva N. Ghosh, James Glasbey, Dion G. Morton, Osaheni Osayomwanbo, Rupert Pearse, Tracy E. Roberts, Atul Suroy, Saidu Yusuf Yakubu, Raymond Oppong, Aneel Bhangu, Maria Lorena Aguilera, Philip Alexander, Sara W. Al-Saqqa, Giuliano Borda-Luque, Ainhoa Costas-Chavarri, Thomas M. Drake, Faustin Ntirenganya, J. Edward Fitzgerald, Stuart J. Fergusson, J.C. Allen Ingabire, Lawani Ismaïl, Hosni Khairy Salem, Anyomih Theophilus Teddy Kojo, Marie Carmela Lapitan, Richard Lilford, Andre L. Mihaljevic, Dion Morton, Alphonse Zeta Mutabazi, Dmitri Nepogodiev, Adewale O. Adisa, Riinu Ots, Francesco Pata, Thomas Pinkney, Tomas Poškus, Ahmad Uzair Qureshi, Antonio Ramos-De la Medina, Sarah Rayne, Catherine A. Shaw, Sebastian Shu, Richard Spence, Neil Smart, Stephen Tabiri, Ewen M. Harrison, Azmina Verjee, Emmy Runigamugabo, Chetan Khatri, Midhun Mohan, Zahra Jaffry, Afnan Altamini, Andrew Kirby, Kjetil Søreide, Gustavo Recinos, Jen Cornick, Maria Marta Modolo, Dushyant Iyer, Sebastian King, Tom Arthur, Sayeda Nazmum Nahar, Ade Waterman, Michael Walsh, Arnav Agarwal, Augusto Zani, Mohammed Firdouse, Tyler Rouse, Qinyang Liu, Juan Camilo Correa, Peep Talving, Mengistu Worku, Alexis Arnaud, Vassilis Kalles, Basant Kumar, Sunil Kumar, Radhian Amandito, Roy Quek, Luca Ansaloni, Ahmed Altibi, Donatas Venskutonis, Justas Zilinskas, Tomas Poskus, John Whitaker, Vanessa Msosa, Yong Yong Tew, Alexia Farrugia, Elaine Borg, Zineb Bentounsi, Tanzeela Gala, Ibrahim Al-Slaibi, Haya Tahboub, Osaid H. Alser, Diego Romani, Sebestian Shu, Piotr Major, Aurel Mironescu, Matei Bratu, Amar Kourdouli, Aliyu Ndajiwo, Abdulaziz Altwijri, Mohammed Ubaid Alsaggaf, Ahmad Gudal, Al Faifi Jubran, Sam Seisay, Bettina Lieske, Irene Ortega, Jenifa Jeyakumar, Kithsiri J. Senanayake, Omar Abdulbagi, Yucel Cengiz, Dmitri Raptis, Yuksel Altinel, Chia Kong, Ella Teasdale, Gareth Irwin, Michael Stoddart, Rakan Kabariti, Sukrit Suresh, Katherine Gash, Ragavan Narayanan, Mayaba Maimbo, Besmir Grizhja, Shpetim Ymeri, Gezim Galiqi, Roberto Klappenbach, Diego Antezana, Alvaro Enrique Mendoza Beleño, Cecilia Costa, Belen Sanchez, Susan Aviles, Claudio Gabriel Fermani, Rubén Balmaceda, Santiago Villalobos, Juan Manuel Carmona, Daniel Hamill, Peter Deutschmann, Simone Sandler, Daniel Cox, Ram Nataraja, Claire Sharpin, Damir Ljuhar, Demi Gray, Morgan Haines, Dush Iyer, Nithya Niranjan, Scott D'Amours, Morvarid Ashtari, Helena Franco, Ashrarur Rahman Mitul, Sabbir Karim, Nowrin F. Aman, Mahnuma Mahfuz Estee, Umme Salma, Joyeta Razzaque, Tasnia Hamid Kanta, Sayeeda Aktar Tori, Shadid Alamin, Swapnil Roy, Shadid Al Amin, Rezaul Karim, Muhtarima Haque, Amreen Faruq, Farhana Iftekhar, Margaret O'Shea, Greg Padmore, Ramesh Jonnalagadda, Andrey Litvin, Aliaksandr Filatau, Dzmitry Paulouski, Maryna Shubianok, Tatsiana Shachykava, Dzianis Khokha, Vladimir Khokha, Fernande Djivoh, Francis Dossou, Djifid Morel Seto, Dansou Gaspard Gbessi, Bruno Noukpozounkou, Yacoubou Imorou Souaibou, Kpèmahouton René Keke, Fred Hodonou, Ernest Yemalin Stephane Ahounou, Thierry Alihonou, Max Dénakpo, Germain Ahlonsou, Alemayehu Ginbo Bedada, Carlos Nsengiyumva, Sandrine Kwizera, Venerand Barendegere, Philip Choi, Simon Stock, Luai Jamal, Georges Azzie, Sameer Kushwaha, Tzu-Ling Chen, Chingwan Yip, Irene Montes, Felipe Zapata, Sebastian Sierra, Maria Isabel Villegas Lanau, Maria Clara Mendoza Arango, Ivan Mendoza Restrepo, Ruben Santiago Restrepo Giraldo, Edgar Domini, Robert Karlo, Jakov Mihanovic, Mohamed Youssef, Hossam Elfeki, Waleed Thabet, Aly Sanad, Gehad Tawfik, Ahmed Zaki, Noran Abdel-Hameed, Mohamed Mostafa, Muhammad Fathi Waleed Omar, Ahmed Ghanem, Emad Abdallah, Adel Denewar, Eman Emara, Eman Rashad, Ahmad Sakr, Rehab Elashry, Sameh Emile, Toqa Khafagy, Sara Elhamouly, Arwa Elfarargy, Amna Mamdouh Mohamed, Ghada Saied Nagy, Abeer Esam, Eman Elwy, Aya Hammad, Salwa Khallaf, Eman Ibrahim, Ahmed Saidbadr, Ahmed Moustafa, Amany Eldosouky Mohammed, Mohammed Elgheriany, Eman Abdelmageed, Eman Abd Al Raouf, Esraa Samir Elbanby, Maha Elmasry, Mahitab Morsy Farahat, Eman Yahya Mansor, Eman Magdy Hegazy, Esraa Gamal, Heba Gamal, Hend Kandil, Doaa Maher Abdelrouf, Mohamed Moaty, Dina Gamal, Nada El-Sagheer, Mohamed Salah, Salma Magdy, Asmaa Salah, Ahmed Essam, Ahmed Ali, Mahmoud Badawy, Sara Ahmed, Mazed Mohamed, Abdelrahman Assal, Mohamed Sleem, Mai Ebidy, Aly Abd Elrazek, Diaaaldin Zahran, Nourhan Adam, Mohamed Nazir, Adel B. Hassanein, Ahmed Ismail, Amira Elsawy, Rana Mamdouh, Mohamed Mabrouk, Lopna Ahmed Mohamed Ahmed, Mohamed Hassab Alnaby, Eman Magdy, Manar Abd-Elmawla, Marwan Fahim, Bassant Mowafy, Moustafa Ibrahim Mahmoud, Meran Allam, Muhammad Alkelani, Noran Halim El Gendy, Mariam Saad Aboul-Naga, Reham Alaa El-Din, Alyaa Halim Elgendy, Mohamed Ismail, Mahmoud Shalaby, Aya Adel Elsharkawy, Mahmoud Elsayed Moghazy, Khaled Hesham Elbisomy, Hend Adel Gawad Shakshouk, Mohamed Fouad Hamed, Mai Mohamed Ebidy, Mostafa Abdelkader, Mohamed Karkeet, Hayam Ahmed, Israa Adel, Mohammad Elsayed Omar, Mohamed Ibrahim, Omar Ghoneim, Omar Hesham, Shimaa Gamal, Karim Hilal, Omar Arafa, Sawsan Adel Awad, Menatalla Salem, Fawzia Abdellatif Elsherif, Nourhan Elsabbagh, Moustafa R. Aboelsoud, Ahmed Hossam Eldin Fouad Rida, Amr Hossameldin, Ethar Hany, Yomna Hosny Asar, Nourhan Anwar, Mohamed Gadelkarim, Samar Abdelhady, Eman Mohamed Morshedy, Reham Saad, Nourhan Soliman, Mahmoud Salama, Eslam Ezzat, Arwa Mohamed, Arwa Ibrahim, Alaa Fergany, Sara Mohammed, Aya Reda, Yomna Allam, Hanan Adel Saad, Afnan Abdelfatah, Aya Mohamed Fathy, Ahmed El-Sehily, Esraa Abdalmageed Kasem, Ahmed Tarek Abdelbaset Hassan, Ahmed Rabeih Mohammed, Abdalla Gamal Saad, Yasmin Elfouly, Nesma Elfouly, Arij Ibrahim, Amr Hassaan, Mohammed Mustafa Mohammed, Ghada Elhoseny, Mohamed Magdy, Esraa Abd Elkhalek, Yehia Zakaria, Tarek Ezzat, Ali Abo El Dahab, Mohamed Kelany, Sara Arafa, Osama Mokhtar Mohamed Hassan, Nermin Mohamed Badwi, Ahmad Saber Sleem, Hussien Ahmed, Kholoud Abdelbadeai, Mohamed Abozed Abdullah, Muhammad Amsyar Auni Lokman, Suraya Bahar, Anan Rady Abdelazeam, Abdelrahman Adelshone, Muhammad Bin Hasnan, Athirah Zulkifli, Siti Nur Alia Kamarulzamil, Abdelaziz Elhendawy, Aliang Latif, Ahmad Bin Adnan, Shahadatul Shaharuddin, Aminah Hanum Haji Abdul Majid, Mahmoud Amreia, Dina Al-Marakby, Mahmoud Salma, Mohamad Jeffrey Bin Ismail, Elissa Rifhan Mohd Basir, Citra Dewi, Mohd Ali, Aya Yehia Ata, Maha Nasr, Asmaa Rezq, Ahmed Sheta, Sherif Tariq, Abd Elkhalek Sallam, Abdelrhman K.Z. Darwish, Sohaila Elmihy, Shady Elhadry, Ahmed Farag, Haidar Hajeh, Abdelaziz Abdelaal, Amro Aglan, Ahmed Zohair, Mahitab Essam, Omar Moussa, Esraa El-Gizawy, Mostafa Samy, Safia Ali, Esraa Elhalawany, Ahmed Ata, Mohamed El Halawany, Mohamed Nashat, Samar Soliman, Alaa Elazab, Mostada Samy, Mohamed A. Abdelaziz, Khaled Ibrahim, Ahmed mohamed Ibrahim, Ammar Gado, Usama Hantour, Esraa Alm Eldeen, Mohamed Reda loaloa, Arwa Abouzaid, Mostafa Ahmed Bahaa Eldin, Eman Hashad, Fathy Sroor, Doaa Gamil, Eman Mahmoud Abdulhakeem, Mahmoud Zakaria, Fawzy Mohamed, Marwan Abubakr, Elsayed Ali, Hesham Magdy, Menna Tallah Ramadan, Mohamed Abdelaty Mohamed, Salma Mansour, Hager Abdul Aziz Amin, Ahmed Rabie Mohamed, Mahmoud Saami, Nada Ahmed Reda Elsayed, Adham Tarek, Sabry Mohy Eldeen Mahmoud, Islam Magdy El Sayed, Amira Reda, Martina Yusuf Shawky, Mohammed Mousa Salem, Shahinaz Alaa El-Din, Noha Abdullah Soliman, Muhammed Talaat, Shahinaz Alaael-Dein, Ahmed Abd Elmoen Elhusseiny, Noha Abdullah, Mohammed Elshaar, Aya AbdelFatah Ibraheem, Hager Abdulaziz, Mohammed Kamal Ismail, Mona Hamdy Madkor, Mohamed Abdelaty, Sara Mahmoud Abdel-Kader, Osama Mohamed Salah, Mahmoud Eldafrawy, Ahmed Zaki Eldeeb, Mostafa Mahmoud Eid, Attia Attia, Khalid Salah El-Dien, Ayman Shwky, Mohamed Adel Badenjki, Abdelrahman Soliman, Samaa Mahmoud Al Attar, Farrag Sayed, Fahd Abdel Sabour, Mohammed G. Azizeldine, Muhammad Shawqi, Abdullah Hashim, Ahmed Aamer, Ahmed Mahmoud Abdelraouf, Mahmoud Abdelshakour, Amal Ibrahim, Basma Mahmoud, Mohamed Ali Mahmoud, Mostafa Qenawy, Ahmed M. Rashed, Ahmed Dahy, Marwa Sayed, Ahmed W. Shamsedine, Bakeer Mohamed, Ahmad Hasan, Mahmoud M. Saad, Khalil Abdul Bassit, Nadia Khalid Abd El-Latif, Nada Elzahed, Ahmed El Kashash, Nada Mohamed Bekhet, Sarah Hafez, Ahmed Gad, Mahmoud Elkhadragy Maher, Ahmed Abd Elsameea, Mohamed Hafez, Ahmad Sabe, Ataa Ahmed, Ahmed Shahine, Khaled Dawood, Shireen Gaafar, Reem Husseiny, Omnia Aboelmagd, Ahmed Soliman, Nourhan Mesbah, Hossam Emadeldin, Amgad Al Meligy, Amira Hassan Bekhet, Doaa Hasan, Khaled Alhady, Ahmad Khaled Sabe, Mahmoud A. Elnajjar, Majed Aboelella, Ward Hamsho, Ihab Hassan, Hala Saad, Galaleldin Abdelazim, Hend Mahmoud, Noha Wael, Ahmedali M. Kandil, Ahmed Magdy, Shimaa Said Elkholy, Badr Eldin Adel, Kareem Dabbour, Saged Elsherbiney, Omar Mattar, Abdulshafi Khaled Abdrabou, Mohammed Yahia Mohamed Aly, Abdelrahman Geuoshy, Ahmedglal Elnagar, Saraibrahim Ahmed, Ibrahem Abdelmotaleb, Amr Ahmed Saleh, Manar Saeed, Shady Mahmoud, Badreldin Adel Tawfik, Samar Adel Ismail, Esraay Zakaria, Mariam O. Gad, Mohamed Salah Elhelbawy, Monica Bassem, Noha Maraie, Nourhan Medhat Elhadary, Nourhan Semeda, Shaza Rabie Mohamed, Hesham Mohammed Bakry, A.A. Essam, Dina Tarek, Khlood Ashour, Alaa Elhadad, Abdulrahman Abdel-Aty, Ibrahim Rakha, Sara Mamdouh Matter, Rasha Abdelhamed, Omar Abdelkader, Ayat Hassaan, Yasmin Soliman, Amna Mohamed, Sara Ghanem, Sara Amr Mohamed Farouk, Eman Mohamed Ibrahim, Esraa El-Taher, Merna Mostafa, Mohamed Fawzy Mahrous Badr, Rofida Elsemelawy, Aya El-Sawy, Ahmad Bakr, Ahmad Abdel Razaq Al Rafati, Sten Saar, Arvo Reinsoo, Nebyou Seyoum, Tewodros Worku, Agazi Fitsum, Matti Tolonen, Ari Leppäniemi, Ville Sallinen, Benoît Parmentier, Matthieu Peycelon, Sabine Irtan, Sabrina Dardenne, Elsa Robert, Betty Maillot, Etienne Courboin, Alexis Pierre Arnaud, Juliette Hascoet, Olivier Abbo, Amir Ait Kaci, Thomas Prudhomme, Quentin Ballouhey, Céline Grosos, Laurent Fourcade, Tolg Cecilia, Colombani Jean-Francois, Francois-Coridon Helene, Xavier Delforge, Elodie Haraux, Bertrand Dousset, Roberto Schiavone, Sebastien Gaujoux, Jean-Baptiste Marret, Aurore Haffreingue, Julien Rod, Mariette Renaux-Petel, Jean-François Lecompte, Jean Bréaud, Pauline Gastaldi, Chouikh Taieb, Raquillet Claire, Echaieb Anis, Nasir Bustangi, Manuel Lopezv, Aurelien Scalabre, Maria Giovanna Grella, Aurora Mariani, Guillaume Podevin, Françoise Schmitt, Erik Hervieux, Aline Broch, Cecile Muller, Dickson Bandoh, Francis Abantanga, Martin Kyereh, Hamza Asumah, Eric Kofi Appiah, Paul Wondoh, Adam Gyedu, Charles Dally, Kwabena Agbedinu, Michael Amoah, Abiboye Yifieyeh, Frank Owusu, Mabel Amoako-Boateng, Makafui Dayie, Richmond Hagan, Sam Debrah, Micheal Ohene-Yeboah, Joe-Nat Clegg-Lampety, Victor Etwire, Jonathan Dakubo, Samuel Essoun, William Bonney, Hope Glover-Addy, Samuel Osei-Nketiah, Joachim Amoako, Niiarmah Adu-Aryee, William Appeadu-Mensah, Antoinette Bediako-Bowan, Florence Dedey, Mattew Ekow, Emmanuel Akatibo, Musah Yakubu, Hope Edem Kofi Kordorwu, Kwasi Asare-Bediako, Enoch Tackie, Kenneth Aaniana, Emmanuel Acquah, Richard Opoku-Agyeman, Anthony Avoka, Kwasi Kusi, Kwame Maison, Frank Enoch Gyamfi, Gandau Naa Barnabas, Saiba Abdul-Latif, Philip Taah Amoako, Anthony Davor, Victor Dassah, Enoch Dagoe, Prince Kwakyeafriyie, Elliot Akoto, Eric Ackom, Ekow Mensah, Ebenezer Takyi Atkins, Christian Lari Coompson, Nikolaos Ivros, Christoforos Ferousis, Vasileios Kalles, Christos Agalianos, Ioannis Kyriazanos, Christos Barkolias, Angelos Tselos, Georgios Tzikos, Evangelos Voulgaris, Dimitrios Lytras, Athanasia Bamicha, Kyriakos Psarianos, Anastasios Stefanopoulos, Ioannis Patoulias, Dimitrios Sfougaris, Ioannis Valioulis, Dimitrios Balalis, Dimitrios Korkolis, Dimitrios K. Manatakis, Georgios Kyrou, Georgios Karabelias, Iason-Antonios Papaskarlatos, Kolonia Konstantina, Nikolaos Zampitis, Stylianos Germanos, Aspasia Papailia, Theodosios Theodosopoulos, Georgios Gkiokas, Magdalini Mitroudi, Christina Panteli, Thomas Feidantsis, Konstantinos Farmakis, Dimitrios Kyziridis, Orestis Ioannidis, Styliani Parpoudi, Georgios Gemenetzis, Stavros Parasyris, Christos Anthoulakis, Nikolaos Nikoloudis, Michail Margaritis, Maria-Lorena Aguilera-Arevalo, Otto Coyoy-Gaitan, Javier Rosales, Luis Tale, Rafael Soley, Emmanuel Barrios, Servio Tulio Torres Rodriguez, Carlos Paz Galvez, Danilo Herrera Cruz, Guillermo Sanchez Rosenberg, Alejandro Matheu, David Monterroso Cohen, Marie Paul, Angeline Charles, Justin Chak Yiu Lam, Man Hon Andrew Yeung, Chi Ying Jacquelyn Fok, Ka Hin Gabriel Li, Anthony Chuk-Him Lai, Yuk Hong Eric Cheung, Hong Yee Wong, Ka Wai Leung, Tien Seng Bryan Lee, Wai Him Lam, Weihei Dao, Stephanie Hiu-wai Kwok, Tsz-Yan Katie Chan, Yung Kok Ng, T.W.C. Mak, Chi Chung Foo, James Yang, Ankur Bhatnagar, Vijaid Upadhyaya, Uday Muddebihal, Wasim Dar, K.C. Janardha, Neerav Aruldas, Fidelis Jacklyn Adella, Anthonius Santoso Rulie, Ferdy Iskandar, Jonny Setiawan, Cicilia Viany Evajelista, Hani Natalie, Arlindawati Suyadi, Rudy Gunawan, Herlin Karismaningtyas, Lusi Padma Sulistianingsih Mata, Ferry Fitriya Ayu Andika, Afifatun Hasanah, T. Ariani Widiastini, Nurlaila Ayu Purwaningsih, Annisa Dewi Fitriana Mukin, Dina Faizatur Rahmah, Hazmi Dwinanda Nurqistan, Hasbi Maulana Arsyad, Novia Adhitama, Wifanto Saditya Jeo, Nathania Sutandi, Audrey Clarissa, Phebe Anggita Gultom, Matthew Billy, Andreass Haloho, Nadya Johanna, Felix Lee, Radin Mohd Nurrahman Radin Dorani, Martha Glynn, Mohammad Alherz, Wennweoi Goh, Haaris A. Shiwani, Lorraine Sproule, Kevin C. Conlon, Miklosh Bala, Asaf Kedar, Luca Turati, Federica Bianco, Francesca Steccanella, Gaetano Gallo, Mario Trompetto, Giuseppe Clerico, Matteo Papandrea, Giuseppe Sammarco, Rosario Sacco, Angelo Benevento, Luisa Giavarini, Mariano Cesare Giglio, Luigi Bucci, Gianluca Pagano, Viviana Sollazzo, Roberto Peltrini, Gaetano Luglio, Arianna Birindelli, Salomone Di Saverio, Gregorio Tugnoli, Miguel Angel Paludi, Pietro Mingrone, Domenica Pata, Francesco Selvaggi, Lucio Selvaggi, Gianluca Pellino, Natale Di Martino, Gianluca Curletti, Paolo Aonzo, Raffaele Galleano, Stefano Berti, Elisa Francone, Silvia Boni, Laura Lorenzon, Annalisa lo Conte, Genoveffa Balducci, Gianmaria Confalonieri, Giovanni Pesenti, Laura Gavagna, Giorgio Vasquez, Simone Targa, Savino Occhionorelli, Dario Andreotti, Giacomo Pata, Andrea Armellini, Deborah Chiesa, Fabrizio Aquilino, Nicola Chetta, Arcangelo Picciariello, Mohamed Abdelkhalek, Andrea Belli, Silvia De Franciscis, Annamaria Bigaran, Alessandro Favero, Stefano M.M. Basso, Paola Salusso, Martina Perino, Sylvie Mochet, Diego Sasia, Francesco Riente, Marco Migliore, David Merlini, Silvia Basilicò, Carlo Corbellini, Veronica Lazzari, Yuri Macchitella, Luigi Bonavina, Daniele Angelieri, Diego Coletta, Federica Falaschi, Marco Catani, Claudia Reali, Mariastella Malavenda, Celeste Del Basso, Sergio Ribaldi, Massimo Coletti, Andrea Natili, Norma Depalma, Immacolata Iannone, Angelo Antoniozzi, Davide Rossi, Daniele Gui, Gerardo Perrotta, Matteo Ripa, Francesco Ruben Giardino, Maurizio Foco, Erika Vicario, Federico Coccolini, Gabriela Elisa Nita, Nicoletta Leone, Andrea Bondurri, Anna Maffioli, Andrea Simioni, Davide De Boni, Sandro Pasquali, Elena Goldin, Elena Vendramin, Eleonora Ciccioli, Umberto Tedeschi, Luca Bortolasi, Paola Violi, Tommaso Campagnaro, Simone Conci, Giovanni Lazzari, Calogero Iacono, Alfredo Gulielmi, Serena Manfreda, Anna Rinaldi, Maria Novella Ringressi, Beatrice Brunoni, Giuseppe Salamone, Mirko Mangiapane, Paolino De Marco, Antonella La Brocca, Roberta Tutino, Vania Silvestri, Leo Licari, Tommaso Fontana, Nicolò Falco, Gianfranco Cocorullo, Mostafa Shalaby, Pierpaolo Sileri, Claudio Arcudi, Isam Bsisu, Khaled Aljboor, Lana Abusalem, Aseel Alnusairat, Ahmad Qaissieh, Emad Al-Dakka, Ali Ababneh, Oday Halhouli, Taha Yusufali, Hussein Mohammed, Justus Lando, Robert Parker, Wairimu Ndegwa, Mantas Jokubauskas, Jolanta Gribauskaite, Justas Kuliavas, Audrius Dulskas, Narimantas E. Samalavicius, Kristijonas Jasaitis, Audrius Parseliunas, Viktorija Nevieraite, Margarita Montrimaite, Evelina Slapelyte, Edvinas Dainius, Romualdas Riauka, Zilvinas Dambrauskas, Andrejus Subocius, Linas Venclauskas, Antanas Gulbinas, Saulius Bradulskis, Simona Kasputyte, Deimante Mikuckyte, Mindaugas Kiudelis, Tomas Jankus, Steponas Petrikenas, Matas Pažuskis, Zigmantas Urniežius, Mantas Vilčinskas, Vincas Jonas Banaitis, Vytautas Gaižauskas, Edvard Grisin, Povilas Mazrimas, Rokas Rackauskas, Mantas Drungilas, Karolis Lagunavicius, Vytautas Lipnickas, Dovilè Majauskyté, Valdemaras Jotautas, Tomas Abaliksta, Laimonas Uščinas, Gintaras Simutis, Adomas Ladukas, Donatas Danys, Erikas Laugzemys, Saulius Mikalauskas, Elena Zdanyte Sruogiene, Petras Višinskas, Reda Žilinskienė, Deividas Dragatas, Andrius Burmistrovas, Zygimantas Tverskis, Arturas Vaicius, Ruta Mazelyte, Antanas Zadoroznas, Nerijus Kaselis, Greta Žiubrytė, Finaritra Casimir Fleur Prudence Rahantasoa, Luc Hervé Samison, Fanjandrainy Rasoaherinomenjanahary, Todisoa Emmanuella Christina Tolotra, Cornelius Mukuzunga, Chimwemwe Kwatiwani, Nelson Msiska, Feng Yih Chai, Siti Mohd Desa Asilah, Khuzaimah Zahid Syibrah, Pui Xin Chin, Afizah Salleh, Nur Zulaika Riswan, April Camilla Roslani, Hoong-Yin Chong, Nora Abdul Aziz, Keat-Seong Poh, Chu-Ann Chai, Sandip Kumar, Mustafa Mohammed Taher, Nik Ritza Kosai, Dayang Nita Abdul Aziz, Reynu Rajan, Rokayah Julaihi, Durvesh Lacthman Jethwani, Muhammad Taqiyuddin Yahaya, Nik Azim Nik Abdullah, Susan Wndy Mathew, Kuet Jun Chung, Milaksh Kumar Nirumal, R. Goh Ern Tze, Syed Abdul Wahhab Eusoffee Wan Ali, Yiing Yee Gan, Jesse Ron Swire Ting, Samuel S.Y. Sii, Kean Leong Koay, Yi Koon Tan, Alvin Ee Zhiun Cheah, Chui Yee Wong, Tuan Nur'Azmah Tuan Mat, Crystal Yern Nee Chow, Prisca A.L. Har, Yishan Der, Fitjerald Henry, Xinwei Low, Ya Theng Neo, Hian Ee Heng, Shu Ning Kong, Cheewei Gan, Yi Ting Mok, Yee Wen Tan, Kandasami Palayan, Mahadevan Deva Tata, Yih Jeng Cheong, Kuhaendran Gunaseelan, Wan Nurul 'Ain Wan Mohd Nasir, Pigeneswaren Yoganathan, Eu Xian Lee, Jian Er Saw, Li Jing Yeang, Pei Ying Koh, Shyang Yee Lim, Shuang Yi Teo, Nicole Grech, Daniela Magri, Kristina Cassar, Christine Mizzi, Malcolm Falzon, Nihaal Shaikh, Ruth Scicluna, Stefan Zammit, Sean Mizzi, Svetlana Doris Brincat, Thelma Tembo, Vu Thanh Hien Le, Tara Grima, Keith Sammut, Kurt Carabott, Ciskje Zarb, Andre Navarro, Thea Dimech, Georgette Marie Camilleri, Isaac Bertuello, Jeffrey Dalli, Karl Bonavia, Samantha Corro-Diaz, Marisol Manriquez-Reyes, Amina Abdelhamid, Abdelmalek Hrora, Sarah Benammi, Houda Bachri, Meryem Abbouch, Khaoula Boukhal, Redouane Mammar Bennai, Abdelkader Belkouchi, Mohamed Sobhi Jabal, Chaymae Benyaiche, Maarten Vermaas, Lucia Duinhouwer, Javier Pastora, Greta Wood, Maria Soledad Merlo, Akinlabi Ajao, Omobolaji Ayandipo, Taiwo Lawal, Abdussemiu Abdurrazzaaq, Muslimat Alada, Abdulrasheed Nasir, James Adeniran, Olufemi Habeeb, Ademola Popoola, Ademola Adeyeye, Ademola Adebanjo, Opeoluwa Adesanya, Adewale Adeniyi, Henry Mendel, Bashir Bello, Umar Muktar, Adedapo Osinowo, Thomas Olagboyega Olajide, Oyindamola Oshati, George Ihediwa, Babajide Adenekan, Victor Nwinee, Felix Alakaloko, Adesoji Ademuyiwa, Olumide Elebute, Abdulrazzaq Lawal, Chris Bode, Mojolaoluwa Olugbemi, Alaba Adesina, Olubukola Faturoti, Oluwatomi Odutola, Oluwaseyi Adebola, Clement Onuoha, Ogechukwu Taiwo, Omolara Williams, Fatai Balogun, Olalekan Ajai, Mobolaji Oludara, Iloba Njokanma, Roland Osuoji, Stephen Kache, Jonathan Ajah, Jerry Makama, Ahmed Adamu, Suleiman Baba, Mohammad Aliyu, Shamsudeen Aliyu, Yahaya Ukwenya, Halima Aliyu, Tunde Sholadoye, Muhammad Daniyan, Oluseyi Ogunsua, Lofty-John Anyanwu, Abdurrahaman Sheshe, Aminu Mohammad, Samson Olori, Philip Mshelbwala, Babatunde Odeyemi, Garba Samson, Oyediran Kehinde Timothy, Sani Ali Samuel, Anthony Ajiboye, Isaac Amole, Olajide Abiola, Akin Olaolorun, Torhild Veen, Arezo Kanani, Kristian Styles, Ragnar Herikstad, Johannes Wiik Larsen, Jon Arne Søreide, Elisabeth Jensen, Mads Gran, Eirik Kjus Aahlin, Tina Gaarder, Peter Wiel Monrad-Hansen, Pål Aksel Næss, Giedrius Lauzikas, Joachim Wiborg, Silje Holte, Knut Magne Augestad, Gurpreet Singh Banipal, Michela Monteleone, Thomas Tetens Moe, Johannes Kurt Schultz, Taher Al-Taher, Ayah Hamdan, Ayman Salman, Rana Saadeh, Aseel Musleh, Dana Jaradat, Soha Abushamleh, Sakhaa Hanoun, Amjad Abu Qumbos, Aseel Hamarshi, Ayman, Taher, Israa Qawasmi, Khalid Qurie, Marwa Altarayra, Mohammad Ghannam, Alaa Shaheen, Azher Herebat, Aram Abdelhaq, Ahmad Shalabi, Maram Abu-Toyour, Fatema Asi, Ala Shamasneh, Anwar Atiyeh, Mousa Mustafa, Rula Zaa'treh, Majd Dabboor, Enas Alaloul, Heba Baraka, Jehad Meqbil, Alaa Al-Buhaisi, Mohamedraed Elshami, Samah Afana, Sahar Jaber, Said Alyacoubi, Yousef Abuowda, Tasneem Idress, Eman Abuqwaider, Sara Al-Saqqa, Alaa Bowabsak, Alaa El Jamassi, Doaa Hasanain, Hadeel Al-Farram, Maram Salah, Aya Firwana, Marwa Hamdan, Israa Awad, Ahmad Ashour, Fayez Elian Al Barrawi, Ahmed Al-Khatib, Maha Al-Faqawi, Mohamed Fares, Amjad Elmashala, Mohammad Adawi, Ihdaa Adawi, Reem Khreishi, Rose Khreishi, Ahed Ghaben, Najwa Nadeem, Muhammad Saqlain, Jibran Abbasy, Abdul Rehman Alvi, Noman Shahzad, Kamran Faisal Bhopal, Zainab Iftikhar, Muhammad Talha Butt, Syed Asaat Ul Razi, Asdaq Ahmed, Ali Khan Niazi, Ibrahim Raza, Fatima Baluch, Ahmed Raza, Ahmad Bani-Sadar, Muhammad Adil, Awais Raza, Mahnoor Javaid, Muhammad Waqar, Maryam Ali Khan, Mohammad Mohsin Arshad, Mohammadasim Amjad, Gustavo Miguel Machain Vega, Jorge Torres Cardozo, Marcelo O´Higgins Roche, Gustavo Rodolfo Pertersen Servin, Helmut Alfredo Segovia Lohse, Larissa Ines Páez Lopez, Ramón Augusto Melo Cardozo, Fernando Espinoza, Angel David Pérez Rojas, Diana Sanchez, Camila Sanchez Samaniego, Shalon Guevara Torres, Alexander Canta Calua, Cesar Razuri, Nadia Ortiz, Xianelle Rodriguez, Nahilia Carrasco, Fridiz Saravia, Hector Shibao Miyasato, María Valcarcel-Saldaña, Ysabel Esthefany Alejos Bermúdez, Juan Carpio, Walter Ruiz Panez, Pedro Angel Toribio Orbegozo, Carolina Guzmán Dueñas, Kevin Turpo Espinoza, Ana Maria Sandoval Barrantes, Jorge Armando Chungui Bravo, Lorena Fuentes-Rivera, Carmen Fernández, Bárbara Málaga, Joselyn Ye, Ricardo Velasquez, Jannin Salcedo, Ana Lucia Contreras-Vergara, Angelica Genoveva Vergara Mejia, Maria Soledad Gonzales Montejo, Marilia Del Carmen Escalante Salas, Willy Alcca Ticona, Marvin Vargas, George Christian Manrique Sila, Robinson Mas, Arazzelly del Pilar Paucar, Armando José Román Velásquez, Alina Robledo-Rabanal, Ludwing Alexander Zeta Solis, Kenny Turpo Espinoza, José Luis Hamasaki Hamaguchi, Erick Samuel Florez Farfan, Linda Alvi Madrid Barrientos, Juan Jaime Herrera Matta, John Jemuel V. Mora, Menold Archee P. Redota, Manuel Francisco Roxas, Maria Jesusa B. Maño, Marie Dione Parreno-Sacdalan, Christel Leanne Almanon, Maciej Walędziak, Rafał Roszkowski, Michał Janik, Anna Lasek, Dorota Radkowiak, Mateusz Rubinkiewicz, Cristina Fernandes, Jose Costa-Maia, Renato Melo, Liviu Muntean, Aurel Sandu Mironescu, Lucian Corneliu Vida, Mariuca Popa, Hogea Mircea, Mihaela Vartic, Bogdan Diaconescu, Matei Razvan Bratu, Ionut Negoi, Mircea Beuran, Cezar Ciubotaru, Norbert Uzabumwana, Dieudonne Duhoranenayo, Elio Jovine, Nicola Zanini, Giovanni Landolfo, Murad Aljiffry, Faisal Idris, Mohammed Saleh A. Alghamdi, Ashraf Maghrabi, Abdulmalik Altaf, Aroub Alkaaki, Ahmad Khoja, Abrar Nawawi, Sondos Turkustani, Eyad Khalifah, Adel Albiety, Sarah Sahel, Reham Alshareef, Mohammed Najjar, Ahmed Alzahrani, Ahmed Alghamdi, Wedyan Alhazmi, Ghiath Al Saied, Mohammed Alamoudi, Muhammed Masood Riaz, Mazen Hassanain, Basmah Alhassan, Abdullah Altamimi, Reem Alyahya, Norah Al Subaie, Fatema Al Bastawis, Afnan Altamimi, Thamer Nouh, Roaa Khan, Milan Radojkovic, Ljiljana Jeremic, Milica Nestorovic, Jia Hao Law, Keith Say Kwang Tan, Ryan Choon Kiat Tan, Joel Kin Tan, Lau Wen Liang Joel, Xue Wei Chan, Faith Qi Hui Leong, Choon Seng Chong, Sharon Koh, Kai Yin Lee, Kuok Chung Lee, Kent Pluke, Britta Dedekind, Puyearashid Nashidengo, Mark Ian Hampton, Johanna Joosten, Sanju Sobnach, Liana Roodt, Anthony Sander, James Pape, Niveshni Maistry, Phumudzo Ndwambi, Kamau Kinandu, Myint Tun, Frederick Du Toit, Quinn Ellison, D.C. Grobler, Sule Burger, Lawrence Bongani Khulu, Rachel Moore, Vicky Jennings, Astrid Leusink, Nazmie Kariem, Juan Gouws, Kathryn Chu, Heather Bougard, Fazlin Noor, Angela Dell, Stephanie Van Straten, Arvin Khamajeet, Serge Kapenda Tshisola, Kalangu Kabongo, Victor Kong, Yoshan Moodley, Frank Anderson, Thandinkosi Madiba, Flip du Plooy, Leila Hartford, Gareth Chilton, Parveen Karjiker, Matlou Ernest Mabitsela, Sibongile Ruth Ndlovu, Maria Badicel, Robert Jaich, Jaime Ruiz-Tovar, Luis Garcia-Florez, Jorge L. Otero-Díez, Virginia Ramos Pérez, Nuria Aguado Suárez, Javier Minguez García, Sara Corral Moreno, Maria Vicenta Collado, Virginia Jiménez Carneros, Javier García Septiem, Mariana Gonzalez, Antonio Picardo, Enrique Esteban, Esther Ferrero, Eloy Espin-Basany, Ruth Blanco-Colino, Valeria Andriola, Lorena Solar García, Elisa Contreras, Carmen García Bernardo, Janet Pagnozzi, Sandra Sanz, Alberto Miyar de León, Asnel Dorismé, Joseluis Rodicio, Aida Suarez, Jessica Stuva, Tamara Diaz Vico, Laura Fernandez-Vega, Carla Soldevila-Verdeguer, Fatima Sena-Ruiz, Natalia Pujol-Cano, Paula Diaz-Jover, José Maria Garcia-Perez, Juan Jose Segura-Sampedro, Cristina Pineño-Flores, David Ambrona-Zafra, Andrea Craus-Miguel, Patricia Jimenez-Morillas, Angela Mazzella, A.B. Jayathilake, S.P.B. Thalgaspitiya, L.S. Wijayarathna, P.M.S.N. Wimalge, Hakeem Ayomi Sanni, Ogheneochuko Okenabirhie, Anmar Homeida, Abobaker Younis, Omer Abdelbagi Omer, Mustafa Abdulaziz, Ali Mussad, Ali Adam, Ida Björklund, Sandra Ahlqvist, Anders Thorell, Fredrik Wogensen, Arestis Sokratous, Michaela Breistrand, Hildur Thorarinsdottir, Johanna Sigurdadottir, Maziar Nikberg, Abbas Chabok, Maria Hjertberg, Peter Elbe, Deborah Saraste, Wiktor Rutkowski, Louise Forlin, Karoliina Niska, Malin Sund, Dennis Oswald, Georgios Peros, Rafael Bluelle, Katharina Reinisch, Daniel Frey, Adrian Palma, Dimitri Aristotle Raptis, Lucius Zumbühl, Markus Zuber, Roger Schmid, Gabriela Werder, Antonio Nocito, Alexandra Gerosa, Silke Mahanty, Lukas Werner Widmer, Julia Müller, Alissa Gübeli, Grzegorz Zuk, Osman Bilgin Gulcicek, Talar Vartanoglu, Emin Kose, Servet Rustu Karahan, Mehmet Can Aydin, Nuri Alper Sahbaz, Ilkay Halicioglu, Halil Alis, Ipek Sapci, Can Adıyaman, Ahmet Murat Pektaş, Turgut Bora Cengiz, Ilkan Tansoker, Vedatcan Işler, Muazzez Cevik, Deniz Mutlu, Volkan Ozben, Berk Baris Ozmen, Sefa Bayram, Sinem Yolcu, Berna Buse Kobal, Ömer Faruk Toto, Haluk Cem Çakaloğlu, Kagan Karabulut, Vahit Mutlu, Bahar Busra Ozkan, Saban Celik, Anil Semiz, Selim Bodur, Enisburak Gül, Busra Murutoglu, Reyyan Yildirim, Bahadir Emre Baki, Ekin Arslan, Mehmet Ulusahin, Ali Guner, Nathan Walker, Nikhita Shrimanker, Simon Cole, Ryan Breslin, Ravi Srinivasan, Mohamed Elshaer, Kristina Hunter, Ahmed Al-Bahrani, Ignatius Liew, Nora Grace Mairs, Alistair Rocke, Lachlan Dick, Mobeen Qureshi, Debkumar Chowdhury, Naomi Wright, Clare Skerritt, Dorothy Kufeji, Adrienne Ho, Tharindra Dissanayake, Athula Tennakoon, Wadah Ali, Shujing Jane Lim, Charlene Tan, Stephen O'Neill, Catrin Jones, Stephen Knight, Dima Nassif, Abhishek Sharma, Oliver Warren, Rebecca White, Aia Mehdi, Nathan Post, Eliana Kalakouti, Enkhbat Dashnyam, Frederick Stourton, Ioannis Mykoniatis, Chelise Currow, Francisca Wong, Ashish Gupta, Veeranna Shatkar, Joshua Luck, Suraj Kadiwar, Alexander Smedley, Rebecca Wakefield, Philip Herrod, James Blackwell, Jonathan Lund, Fraser Cohen, Ashwath Bandi, Stefano Giuliani, Giles Bond-Smith, Theodore Pezas, Neda Farhangmehr, Tomas Urbonas, Miklos Perenyei, Philip Ireland, Natalie Blencowe, Kirk Bowling, David Bunting, Lydia Longstaff, Kenneth Keogh, Hyunjin Jeon, Muhammad Rafaih Iqbal, Shivun Khosla, Anna Jeffery, James Perera, Ahmad Aboelkassem Ibrahem, Tariq Alhammali, Yahya Salama, Shaun Oram, Thomas Kidd, Fraser Cullen, Christopher Owen, Michael Wilson, Seehui Chiu, Hannah Sarafilovic, Jennifer Ploski, Elizabeth Evans, Athar Abbas, Sylvia Kamya, Norzawani Ishak, Carly Bisset, Cedar Andress, Ye Ru Chin, Priya Patel, David Evans, Aidan Haslegrave, Adam Boggon, Kirsten Laurie, Katie Connor, Thomas Mann, Anahita Mansuri, Rachel Davies, Ewen Griffiths, Aized Raza Shahbaz, Calvin Eng, Farhat Din, Ariadne L'Heveder, Esther H.G. Park, Ramanish Ravishankar, Kirsten McIntosh, Jih Dar Yau, Luke Chan, Susan McGarvie, Lingshan Tang, Hui Lim, Suhhuey Yap, Jay Park, Zhan Herr Ng, Shahrukh Mirza, Yun Lin Ang, Luke Walls, Chloe Roy, Simon Paterson-Brown, Julian Camilleri-Brennan, Kenneth Mclean, Michelle S. D'Souza, Savva Pronin, David Ewart Henshall, Eunice Zuling Ter, Dina Fouad, Ashish Minocha, William English, Catrin Morgan, Dominic Townsend, Laura Maciejec, Shareef Mahdi, Onyinye Akpenyi, Elisabeth Hall, Hanaan Caydiid, Zakaria Rob, Tom Abbott, Hew D. Torrance, Robin Johnston, Mohammed Akil Gani, Gianpiero Gravante, Shivanchan Rajmohan, Kiran Majid, Shiva Dindyal, Christopher Smith, Madanmohan Palliyil, Sanjay Patel, Luke Nicholson, Neil Harvey, Katie Baillie, Sam Shillito, Suzanne Kershaw, Rebecca Bamford, Peter Orton, Elke Reunis, Robert Tyler, Wai Cheong Soon, Guled M. Jama, Dharminder Dhillon, Khyati Patel, Shayanthan Nanthakumaran, Rachel Heard, Kar Yan Chen, Behrad Barmayehvar, Uttaran Datta, Sivesh K. Kamarajah, Sharad Karandikar, Sobhana Iftekhar Tani, Eimear Monaghan, Philippa Donnelly, Michael Walker, Jehangirshaw Parakh, Sarah Blacker, Anil Kaul, Arjun Paramasivan, Sameh Farag, Ashrafun Nessa, Salwa Awadallah, Jieqi Lim, James Chean Khun Ng, Ravi P. Kiran, Alice Murray, Eric Etchill, Mohini Dasari, Juan Puyana, Nadeem Haddad, Martin Zielinski, Asad Choudhry, Celeste Caliman, Mieshia Beamon, Therese Duane, Mamta Swaroop, Jonathan Myers, Rebecca Deal, Erik Schadde, Mark Hemmila, Lena Napolitano, Kathleen To, Alex Makupe, Joseph Musowoya, Niels Van Der Naald, Dayson Kumwenda, Alex Reece-Smith, Kars Otten, Anna Verbeek, Marloes Prins, Alibeth Andres Baquero Suarez, Ruben Balmaceda, Chelsea Deane, Emilio Dijan, Mahmoud Elfiky, Laura Koskenvuo, Aurore Thollot, Bernard Limoges, Carmen Capito, Challine Alexandre, Henri Kotobi, Julien Leroux, Kalitha Pinnagoda, Nicolas Henric, Olivier Azzis, Olivier Rosello, Poddevin Francois, Sara Etienne, Philippe Buisson, Sophian Hmila, Joe-Nat Clegg-Lamptey, Osman Imoro, Owusu Emmanuel Abem, Dimitrios Papageorgiou, Vasiliki Soulou, Sabrina Asturias, Lenin Peña, Donal B. O’Connor, Alberto Realis Luc, Alfio Alessandro Russo, Andrea Ruzzenente, Antonio Taddei, Camilla Cona, Corrado Bottini, Giovanni Pascale, Giuseppe Rotunno, Leonardo Solaini, Marco Maria Pascale, Margherita Notarnicola, Mario Corbellino, Michele Sacco, Paolo Ubiali, Roberto Cautiero, Tommaso Bocchetti, Elena Muzio, Vania Guglielmo, Eugenio Morandi, Patrizio Mao, Emilia De Luca, Farah Mahmoud Ali, Justas Žilinskas, Kestutis Strupas, Paulius Kondrotas, Robertas Baltrunas, Juozas Kutkevicius, Povilas Ignatavicius, Choy Ling Tan, Jia Yng Siaw, Sir Young Yam, Ling Wilson, Mohamed Rezal Abdul Aziz, John Bondin, Carmina Diaz Zorrilla, Anass Majbar, Danjuma Sale, Lawal Abdullahi, Olabisi Osagie, Omolara Faboya, Adedeji Fatuga, Agboola Taiwo, Emeka Nwabuoku, Marte Bliksøen, Zain Ali Khan, Jazmin Coronel, Cesar Miranda, Idelso Vasquez, Luis M. Helguero-Santin, Jennifer Rickard, Adesina Adedeji, Saleh Alqahtani, Max Rath, Michael Van Niekerk, Modise Zacharia Koto, Roel Matos-Puig, Leif Israelsson, Tobias Schuetz, Mahmut Arif Yuksek, Meric Mericliler, Mehmet Uluşahin, Bernhard Wolf, Cameron Fairfield, Guo Liang Yong, Katharine Whitehurst, Natalie Redgrave, Caroluce K. Musyoka, James Olivier, Kathryn Lee, Michael Cox, Muhamed M.H. Farhan-Alanie, Rory Callan, Chali Chibuye, Tebian Hassanein Ahmed Ali, Syrine Rekhis, Muna Rommaneh, Zi Hao Sam, Thays Brunelli Pugliesi, Gabriel Pardo, and Ruth Blanco
- Subjects
abdominal surgery ,cost-effectiveness analysis ,global surgery ,high fraction of inspired oxygen ,low-and middle-income countries ,surgical site infection ,Anesthesiology ,RD78.3-87.3 - Abstract
Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was $216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with $195 for low FiO2 leading to a −$11 (95% CI: −$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was $1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.
- Published
- 2023
- Full Text
- View/download PDF
46. Resuscitation team training in Rwanda: A mixed method study exploring the combination of the VAST course with Advanced Cardiac Life Support training
- Author
-
Eugene Tuyishime, Adam Mossenson, Patricia Livingston, Alain Irakoze, Celestin Seneza, Jackson Kwizera Ndekezi, and Teresa Skelton
- Subjects
Non-technical skills ,Resuscitation skills ,Global health ,Rwanda ,Low-resource settings ,Specialties of internal medicine ,RC581-951 - Abstract
Introduction: The influence of non-technical skills training on resuscitation performance in low-resource settings is unknown. This study investigates combining the Vital Anaesthesia Simulation Training Course with Advanced Cardiac Life Support training on resuscitation performance in Rwanda. Methods: Participants in this mixed method study are members of resuscitation teams in three district hospitals in Rwanda. The intervention was participation in a 2-day Advanced Cardiac Life Support course followed by the 3-day Vital Anaesthesia Simulation Training Course. Quantitative primary endpoints were time to initiation of cardiopulmonary resuscitation, time to epinephrine administration, and time to defibrillation. Qualitative data on workplace implementation were gathered during focus groups held 3-months post-intervention. Results: Forty-seven participants were recruited. Quantitative data showed a statistically significant decrease in time to cardiopulmonary resuscitation, epinephrine administration, and defibrillation from pre- to post-Advanced Cardiac Life Support, with times of [43.3 (49.7) seconds] versus [16.5 (20) sec], p =
- Published
- 2023
- Full Text
- View/download PDF
47. Investigating Metabolic and Molecular Ecological Evolution of Opportunistic Pulmonary Fungal Coinfections: Protocol for a Laboratory-Based Cross-Sectional Study
- Author
-
Israel Kiiza Njovu, Pauline Petra Nalumaga, Lucas Ampaire, Edwin Nuwagira, James Mwesigye, Benson Musinguzi, Kennedy Kassaza, Kabanda Taseera, James Kiguli Mukasa, Joel Bazira, Jacob Stanley Iramiot, Andrew Baguma, Felix Bongomin, Richard Kwizera, Beatrice Achan, Michael J Cox, Jason S King, Robin May, Elizabeth R Ballou, and Herbert Itabangi
- Subjects
Medicine ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
BackgroundFungal-bacterial cocolonization and coinfections pose an emerging challenge among patients suspected of having pulmonary tuberculosis (PTB); however, the underlying pathogenic mechanisms and microbiome interactions are poorly understood. Understanding how environmental microbes, such as fungi and bacteria, coevolve and develop traits to evade host immune responses and resist treatment is critical to controlling opportunistic pulmonary fungal coinfections. In this project, we propose to study the coexistence of fungal and bacterial microbial communities during chronic pulmonary diseases, with a keen interest in underpinning fungal etiological evolution and the predominating interactions that may exist between fungi and bacteria. ObjectiveThis is a protocol for a study aimed at investigating the metabolic and molecular ecological evolution of opportunistic pulmonary fungal coinfections through determining and characterizing the burden, etiological profiles, microbial communities, and interactions established between fungi and bacteria as implicated among patients with presumptive PTB. MethodsThis will be a laboratory-based cross-sectional study, with a sample size of 406 participants. From each participant, 2 sputa samples (one on-spot and one early morning) will be collected. These samples will then be analyzed for both fungal and bacterial etiology using conventional metabolic and molecular (intergenic transcribed spacer and 16S ribosomal DNA–based polymerase chain reaction) approaches. We will also attempt to design a genome-scale metabolic model for pulmonary microbial communities to analyze the composition of the entire microbiome (ie, fungi and bacteria) and investigate host-microbial interactions under different patient conditions. This analysis will be based on the interplays of genes (identified by metagenomics) and inferred from amplicon data and metabolites (identified by metabolomics) by analyzing the full data set and using specific computational tools. We will also collect baseline data, including demographic and clinical history, using a patient-reported questionnaire. Altogether, this approach will contribute to a diagnostic-based observational study. The primary outcome will be the overall fungal and bacterial diagnostic profile of the study participants. Other diagnostic factors associated with the etiological profile, such as incidence and prevalence, will also be analyzed using univariate and multivariate schemes. Odds ratios with 95% CIs will be presented with a statistical significance set at P
- Published
- 2023
- Full Text
- View/download PDF
48. WHO O2CoV2: oxygen requirements and respiratory support in patients with COVID-19 in low-and-middle income countries—protocol for a multicountry, prospective, observational cohort study
- Author
-
Jie Li, Rashan Haniffa, Yaseen M Arabi, Srinivas Murthy, Sylvie Chevret, Ludovic Reveiz, Christophe Guitton, Janet Diaz, Devasahayam J Christopher, John C Marshall, Neill Adhikari, Rob Fowler, Leticia Kawano-Dourado, Arthur Kwizera, Tim Baker, Djillali Annane, Pauline Convocar, Elisabeth Riviello, Madiha Hashmi, Jonathan AC Sterne, Jorge Salluh, Diptesh Aryal, Pryanka Relan, Richard Kojan, Wangari Waweru-Siika, Chiori Kodama, Neale Batra, Sara Dominguez Rodriguez, Martha Gartley, Ewan Goligher, Devachandran Jayakumar, Richard H Kallet, Armand Mekontso-Dessap, Christian Paletta, Ingrid Lara Rendon, Bruno Martins Tomazini, Bharath Kumar Tirupakuzhi Vijayaraghavan, Fernando Zampieri, Gasim Amrahli, John Appiah, Kieran Bligh, Mohammed Derow, Laura Alejandra Velez Ruiz Gaitan, Itziar Carrasco Garcia, Bridget Griffith, Rashidatu Kamara, Gary Kuniyoshi, Maria Mendes, Dina Pfeifer, Cinzia DeBrito Procopio, Matthieu Rolland, Amadou Seck, Elizabeth Stanway, Julie Viry, and Pushpa Wijesinghe
- Subjects
Medicine - Abstract
Introduction SARS-CoV-2 has been identified as the cause of the disease officially named COVID-19, primarily a respiratory illness. COVID-19 was characterised as a pandemic on 11 March 2020. It has been estimated that approximately 20% of people with COVID-19 require oxygen therapy. Oxygen has been listed on the WHO Model List of Essential Medicines List and Essential Medicines List for Children for almost two decades. The COVID-19 pandemic has highlighted, more than ever, the acute need for scale-up of oxygen therapy. Detailed data on the use of oxygen therapy in low-and-middle income countries at the patient and facility level are needed to target interventions better globally.Methods and analysis We aim to describe the requirements and use of oxygen at the facility and patient level of approximately 4500 patients with COVID-19 in 30 countries. Our objectives are specifically to characterise type and duration of different modalities of oxygen therapy delivered to patients; describe demographics and outcomes of hospitalised patients with COVID-19; and describe facility-level oxygen production and support. Primary analyses will be descriptive in nature. Respiratory support transitions will be described in Sankey plots, and Kaplan-Meier models will be used to estimate probability of each transition. A multistate model will be used to study the course of hospital stay of the study population, evaluating transitions of escalating respiratory support transitions to the absorbing states.Ethics and dissemination WHO Ad Hoc COVID-19 Research Ethics Review Committee (ERC) has approved this global protocol. When this protocol is adopted at specific country sites, national ERCs may make require adjustments in accordance with their respective national research ethics guidelines. Dissemination of this protocol and global findings will be open access through peer-reviewed scientific journals, study website, press and online media.Trial registration number NCT04918875.
- Published
- 2023
- Full Text
- View/download PDF
49. Extreme Sub-Wavelength Light Confinement in Plasmonic Film-Coupled Nanostar Resonators
- Author
-
Charchi, Negar, Li, Ying, Huber, Margaret, Kwizera, Elyahb Allie, Huang, Xiaohua, Argyropoulos, Christos, and Hoang, Thang Ba
- Subjects
Physics - Optics ,Physics - Applied Physics - Abstract
Confining light in extreme subwavelength scales is a tantalizing task. In this work, we report a study of individual plasmonic film-coupled nanostar resonators where plasmonic optical modes are trapped in ultrasmall volumes. Individual gold nanostars, separated from a flat gold film by a thin dielectric spacer layer, exhibit a strong light confinement within the sub-10 nm volume of the nanostar's tips and the film. Through dark field scattering measurements of many individual nanostars, a statistical observation of the scattered spectra is obtained and compared with extensive simulation data to reveal the origins of the resonant peaks. We observe that an individual nanostar on a flat gold film can result in a resonant spectrum with single, double or multiple peaks. Further, these resonant peaks are strongly polarized under white light illumination. Our simulation data revealed that the resonant spectrum of an individual film-coupled nanostar resonator is related to the symmetry of the nanostar, as well as the orientation of the nanostar relative to its placement on the gold substrate. Our results demonstrate a simple method to create an ultrasmall mode volume plasmonic platform which could be useful for applications in sensing or enhanced light-matter interactions., Comment: 16 pages, 7 figures, submitted
- Published
- 2019
50. In-situ cryo-immune engineering of tumor microenvironment with cold-responsive nanotechnology for cancer immunotherapy
- Author
-
Wenquan Ou, Samantha Stewart, Alisa White, Elyahb A. Kwizera, Jiangsheng Xu, Yuanzhang Fang, James G. Shamul, Changqing Xie, Suliat Nurudeen, Nikki P. Tirada, Xiongbin Lu, Katherine H. R. Tkaczuk, and Xiaoming He
- Subjects
Science - Abstract
Cryosurgery can represent a therapeutic option for breast cancer treatment. Here the authors report a strategy combining cryosurgery with cold-responsive nanoparticles loaded with the chemotherapeutic drug irinotecan and PD-L1-targeting siRNA, inducing anti-tumor immune responses in preclinical breast cancer models.
- Published
- 2023
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.