Brucellosis is an anthropozoonotic disease with an important public health impact. Although the transmission of <em>Brucella</em> from animals to humans can occur in different epidemiological settings of s...Brucellosis is an anthropozoonotic disease with an important public health impact. Although the transmission of <em>Brucella</em> from animals to humans can occur in different epidemiological settings of sub-Saharan African countries, little data has been published on human brucellosis. This study aimed to detect <em>Brucella</em> antibodies and the risk factors associated to brucellosis among high-risk occupational groups of people in the Noun Division of Cameroon. For this study, a structured questionnaire was used to assess risk factors associated with human brucellosis. Thereafter, blood samples were collected from high-risk occupational groups of people in four villages. Plasma was extracted from each sample and<em> Brucella</em> antibodies were detected using Rose Bengal Plate Test (RBPT) and indirect Enzyme-Linked Immunosorbent Assay (i-ELISA). Of the 273 participants enrolled, the overall seroprevalence of <em>Brucella </em>antibodies was 12.45% with RBPT and 10.26% with i-ELISA test. This seroprevalence was significantly (<em>P</em> = 0.04;<em>X</em><sup>2</sup> = 9.73) higher among livestock herdsmen (15.8%), slaughterhouse workers (9.8%), butchers (4.8%), participants having no educational level (14.3%) and those experiencing above 5 years of risky activity (15%). Raw milk consumption (OR: 4.8;<em>P</em> = 0.001), no formal education (OR: 6.4;<em>P</em> = 0.03) and assistance of animal during parturition (OR: 7.2;<em>P</em> < 0.0001) appeared as factors that may increase the risk of <em>Brucella</em> infections. The detection of <em>Brucella </em>antibodies indicates the risk of human brucellosis in some groups of people of the Noun division. Consuming unpasteurized milk, participating in parturition and lacking knowledge on brucellosis appeared as risk factors associated with human brucellosis in western Cameroon. It raises the need of developing and implementing control measures for human and animal brucellosis.展开更多
Objective Asymptomatic carotid stenosis(ACS)is closely associated to the incidence of severe cerebrovascular diseases.Early identifying the individuals with ACS and its associated risk factors could be beneficial for ...Objective Asymptomatic carotid stenosis(ACS)is closely associated to the incidence of severe cerebrovascular diseases.Early identifying the individuals with ACS and its associated risk factors could be beneficial for primary prevention of stroke.This study aimed to investigate a machine-learning algorithm for the detection of ACS among high-risk population of stroke based on the associated risk factors.Methods A novel model of machine learning was utilized to screen the associated predictors of ACS based on 30 potential risk factors.The algorithm of this model adopted a random forest pattern based on the training data and then was verified using the testing data.All of the original data were retrieved from the China National Stroke Screening and Prevention Project(CNSSPP),including demographic,clinical and laboratory characteristics.The individuals with high risk of stroke were enrolled and randomly divided into a training group and a testing group at a ratio of 4:1.The identification of carotid stenosis by carotid artery duplex scans was set as the golden standard.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)was used to evaluate the efficacy of the model in detecting ACS.Results Of 2841 high risk individual of stroke enrolled,326(11.6%)were diagnosed as ACS by ultrasonography.The top five risk fectors contributing to ACS in this model were identified as family history of dyslipidemia,high level of lowdensity lipoprotein cholesterol(LDL-c),low level of high-density lipoprotein cholesterol(HDL-c),aging,and low body.展开更多
文摘Brucellosis is an anthropozoonotic disease with an important public health impact. Although the transmission of <em>Brucella</em> from animals to humans can occur in different epidemiological settings of sub-Saharan African countries, little data has been published on human brucellosis. This study aimed to detect <em>Brucella</em> antibodies and the risk factors associated to brucellosis among high-risk occupational groups of people in the Noun Division of Cameroon. For this study, a structured questionnaire was used to assess risk factors associated with human brucellosis. Thereafter, blood samples were collected from high-risk occupational groups of people in four villages. Plasma was extracted from each sample and<em> Brucella</em> antibodies were detected using Rose Bengal Plate Test (RBPT) and indirect Enzyme-Linked Immunosorbent Assay (i-ELISA). Of the 273 participants enrolled, the overall seroprevalence of <em>Brucella </em>antibodies was 12.45% with RBPT and 10.26% with i-ELISA test. This seroprevalence was significantly (<em>P</em> = 0.04;<em>X</em><sup>2</sup> = 9.73) higher among livestock herdsmen (15.8%), slaughterhouse workers (9.8%), butchers (4.8%), participants having no educational level (14.3%) and those experiencing above 5 years of risky activity (15%). Raw milk consumption (OR: 4.8;<em>P</em> = 0.001), no formal education (OR: 6.4;<em>P</em> = 0.03) and assistance of animal during parturition (OR: 7.2;<em>P</em> < 0.0001) appeared as factors that may increase the risk of <em>Brucella</em> infections. The detection of <em>Brucella </em>antibodies indicates the risk of human brucellosis in some groups of people of the Noun division. Consuming unpasteurized milk, participating in parturition and lacking knowledge on brucellosis appeared as risk factors associated with human brucellosis in western Cameroon. It raises the need of developing and implementing control measures for human and animal brucellosis.
基金Fund supported by the Medical Science and Tech no logy Development Foundatio n(YKK18114)the Gen era I Social Development Medical and Health Project of Nanjing Science and Technology Commission(201803029).
文摘Objective Asymptomatic carotid stenosis(ACS)is closely associated to the incidence of severe cerebrovascular diseases.Early identifying the individuals with ACS and its associated risk factors could be beneficial for primary prevention of stroke.This study aimed to investigate a machine-learning algorithm for the detection of ACS among high-risk population of stroke based on the associated risk factors.Methods A novel model of machine learning was utilized to screen the associated predictors of ACS based on 30 potential risk factors.The algorithm of this model adopted a random forest pattern based on the training data and then was verified using the testing data.All of the original data were retrieved from the China National Stroke Screening and Prevention Project(CNSSPP),including demographic,clinical and laboratory characteristics.The individuals with high risk of stroke were enrolled and randomly divided into a training group and a testing group at a ratio of 4:1.The identification of carotid stenosis by carotid artery duplex scans was set as the golden standard.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)was used to evaluate the efficacy of the model in detecting ACS.Results Of 2841 high risk individual of stroke enrolled,326(11.6%)were diagnosed as ACS by ultrasonography.The top five risk fectors contributing to ACS in this model were identified as family history of dyslipidemia,high level of lowdensity lipoprotein cholesterol(LDL-c),low level of high-density lipoprotein cholesterol(HDL-c),aging,and low body.
文摘目的 观察揿针联合通窍利咽方治疗卒中后吞咽障碍的临床疗效及其对患者吞咽肌群表面肌电信号的影响。方法 将90例卒中后吞咽障碍的患者用随机数字表法平均分为常规组与观察组,每组45例。常规组予常规康复训练及饮食护理,观察组在常规组治疗基础上予揿针联合口服通窍利咽方治疗。比较两组临床疗效,观察两组治疗前后美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)、标准吞咽功能评价量表(standardized swallowing assessment,SSA)、改良曼恩吞咽能力评估量表(Mann assessment of swallowing ability,MASA)和吞咽生活质量量表(swallowing-quality of life,SWAL-QOL)的评分变化,观察两组治疗前后舌骨喉活动度检测指标和吞咽肌群表面肌电信号指标的变化,观察两组治疗前后脑血流动力学指标的变化。比较两组不良反应发生情况。结果 观察组总有效率优于常规组(P<0.05)。治疗后,两组NIHSS和SSA评分均较治疗前下降(P<0.05),MASA和SWAL-QOL评分均较治疗前升高(P<0.05);观察组NIHSS、SSA、MASA和SWAL-QOL评分均优于常规组(P<0.05)。治疗后,观察组舌骨上移、舌骨前移、甲状软骨上移和甲状软骨前移距离均大于治疗前(P<0.05),且舌骨上移和舌骨前移距离均大于常规组(P<0.05)。治疗后,两组空吞与吞咽5 mL温水时吞咽肌群表面肌电信号最大振幅、平均振幅和吞咽时间均较治疗前降低(P<0.05),且观察组上述吞咽肌群表面肌电信号指标均低于常规组(P<0.05)。治疗后,两组患者大脑血管平均血流量、平均血流速度、脉搏波速度、血管特性阻抗和外周阻力均较治疗前改善(P<0.05),且观察组上述脑血流动力学指标均优于常规组(P<0.05)。观察组不良反应发生率低于常规组(P<0.05)。结论 在常规康复训练基础上,揿针联合通窍利咽方治疗卒中后吞咽障碍的临床疗效优于单一中药治疗,可促进神经功能恢复,改善患者吞咽功能和吞咽肌群表面肌电信号,提高脑血流动力学指标,且不良反应发生风险较低。
