Publications by authors named "Thomas Engels"

Introduction: In South-Kivu, the health system is underfunded due to numerous constraints. Several initiatives have been tested but are insufficient for increasing and sustaining health financing.

Purpose Of Research: Analyze the health financing system in South-Kivu, through a mapping as well as quantitative and qualitative analysis of health financing mechanisms.

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Introduction: Equity in the access and use of health services is critical if countries are to make progress towards universal health coverage and address the systematic exclusion of the most vulnerable groups. The purpose of this study was to assess if the Co-ordinated Approach To Community Health programme implemented by Sightsavers was successful in reaching the poorest population, women, and people living with disabilities in Kasungu district, Malawi.

Methods: Between April and September 2017, data on socio-economic status, household characteristics and functional disability were collected from patients attending at eye camps in Kasungu district, Malawi.

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Flight speed is positively correlated with body size in animals. However, miniature featherwing beetles can fly at speeds and accelerations of insects three times their size. Here we show that this performance results from a reduced wing mass and a previously unknown type of wing-motion cycle.

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Wing damage attenuates aerial performance in many flying animals such as birds, bats and insects. Insect wings are especially light in order to reduce inertial power requirements for flight at elevated wing flapping frequencies. There is a continuing debate on the factors causing wing damage in insects, including collisions with objects, mechanical stress during flight activity, and aging.

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Insect wings are hybrid structures that are typically composed of veins and solid membranes. In some of the smallest flying insects, however, the wing membrane is replaced by hair-like bristles attached to a solid root. Bristles and membranous wing surfaces coexist in small but not in large insect species.

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Insect wings can undergo significant deformation during flapping motion owing to inertial, elastic and aerodynamic forces. Changes in shape then alter aerodynamic forces, resulting in a fully coupled fluid-structure interaction (FSI) problem. Here, we present detailed three-dimensional FSI simulations of deformable blowfly () wings in flapping flight.

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Poor vision due to unaddressed refractive error in children is considered to be a public health problem in many low- and middle-income countries. Research shows that correcting refractive error with spectacles could have a positive impact on school attendance and academic performance for children. The aim of this study was to estimate the cost of integrating vision screening and provision of spectacles in existing school health programmes in Cambodia and Ghana.

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Flapping flight is one of the most costly forms of locomotion in animals. To limit energetic expenditures, flying insects thus developed multiple strategies. An effective mechanism to reduce flight power expenditures is the harvesting of kinetic energy from motion of the surrounding air.

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The shape and function of insect wings tremendously vary between insect species. This review is engaged in how wing design determines the aerodynamic mechanisms with which wings produce an air momentum for body weight support and flight control. We work out the tradeoffs associated with aerodynamic key parameters such as vortex development and lift production, and link the various components of wing structure to flight power requirements and propulsion efficiency.

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Purpose: Prevalence of visual impairment (VI) and access to services can vary significantly across and between different population groups. With renewed focus on universal health coverage and leaving no one behind, it is important to understand factors driving inequitable eye health. This paper presents results from five population-based surveys where prevalence of VI and cataract surgical coverage (CSC) were measured and examined for differences by sex, economic-status, and disability.

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The aerial performance of flying insects ultimately depends on how flapping wings interact with the surrounding air. It has previously been suggested that the wing's three-dimensional camber and corrugation help to stiffen the wing against aerodynamic and inertial loading during flapping motion. Their contribution to aerodynamic force production, however, is under debate.

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Background: Cataract is the leading cause of avoidable blindness globally. It is estimated that 89% of people with visual impairment live in low- and middle-income countries where the cost of cataract surgery represents a major barrier for accessing these services. Developing self-sustaining healthcare programs to cater the unmet demands warrants a better understanding of patients' willingness to pay (WTP) for their services.

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Mechanical properties of insect wings are essential for insect flight aerodynamics. During wing flapping, wings may undergo tremendous deformations, depending on the wings' spatial stiffness distribution. We here show an experimental evaluation of wing stiffness in three species of flies using a micro-force probe and an imaging method for wing surface reconstruction.

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Background: The Global Trachoma Mapping Project (GTMP) was implemented with the aim of completing the baseline map of trachoma globally. Over 2.6 million people were examined in 1,546 districts across 29 countries between December 2012 and January 2016.

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The natural wind environment that volant insects encounter is unsteady and highly complex, posing significant flight-control and stability challenges. It is critical to understand the strategies insects employ to safely navigate in natural environments. We combined experiments on free flying bumblebees with high-fidelity numerical simulations and lower-order modeling to identify the mechanics that mediate insect flight in unsteady winds.

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Aerodynamic ground effect in flapping-wing insect flight is of importance to comparative morphologies and of interest to the micro-air-vehicle (MAV) community. Recent studies, however, show apparently contradictory results of either some significant extra lift or power savings, or zero ground effect. Here we present a numerical study of fruitfly sized insect takeoff with a specific focus on the significance of leg thrust and wing kinematics.

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Article Synopsis
  • Stroke is increasingly recognized as a public health issue in low- and middle-income countries, particularly in Morocco, where understanding the link between socioeconomic status and stroke prevalence can inform prevention and management strategies.
  • A large survey was conducted to collect data on stroke prevalence and risk factors, with neurological diagnoses confirmed by specialists. A wealth index was created based on household characteristics and logistic regression analysis was used to explore the socioeconomic-stroke relationship.
  • The study found that people from both the poorest and richest households had lower stroke prevalence compared to those in the middle wealth group, highlighting that deprived urban households face a significantly higher stroke risk, likely due to greater behavioral risk factors.
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Introduction: To evaluate the meaning of urodynamic parameters in patients with pouch incontinence.

Materials And Methods: Thirteen urodynamic studies in patients with an ileal nipple as the efferent segment of an ileocecal pouch or ileum/ileocecal-augmented bladder were performed. The recorded parameters included pouch capacity, leak point pressure/volume, maximum pouch pressure, compliance, static and dynamic closure pressure, and functional length.

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The formation of the immunological synapse between T cells and antigen-presenting cells (APC) begins within minutes of contact and can take hours for full T-cell activation. Although early phases of the synapse have been extensively studied for a select number of proteins, later phases have not yet been examined in detail. We studied the signaling network in stable synapses by measuring the simultaneous localization of 25 signaling and structural molecules over 2 h at the level of individual synapses using multi-epitope ligand cartography (MELC).

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Background: Left ventricle (LV) remodeling after anterior wall myocardial infarction leads to increased LV volumes, myocardial stress, and, ultimately, heart failure (HF). Patients have high morbidity and mortality risk, and treatment remains limited. Percutaneous ventricular restoration (PVR) therapy using the Parachute device, a fluoropolymer membrane stretched over a nitinol conical frame, is a novel approach to partition off the damaged myocardium.

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Although many examples of highly cost-effective interventions to control neglected tropical diseases exist, our understanding of the full economic effect that these diseases have on individuals, households, and nations needs to be improved to target interventions more effectively and equitably. We review data for the effect of neglected tropical diseases on a population's health and economy. We also present evidence on the costs, cost-effectiveness, and financing of strategies to monitor, control, or reduce morbidity and mortality associated with these diseases.

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Background: Patients testing positive for myocardial ischemia but without significant coronary artery (CA) stenosis in coronary angiography (CXA) are characterized as having "small vessel disease" (SVD). The aim of our study was to identify these patients by stress perfusion cardiac magnetic resonance (CMR).

Methods: 317 patients with suspected myocardial ischemia and clinical indication for CXA were scanned < 72 h before CXA in a whole-body 1.

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Background: Assessing myocardial first-pass wash-in during pharmacological induced stress allows detection of perfusion deficits and indicates stenotic coronary arteries (CA). The aim of our study was to demonstrate clinical relevance of contrast-enhanced stress magnetic resonance imaging (CMR) by predicting necessity of CA intervention.

Methods: 738 patients with scheduled coronary angiography (CXA) were scanned in a 1.

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Background: Cardiac magnetic resonance (CMR) has developed into a routine examination in many centers in cardiology. However, there is little knowledge about its applicability in outpatients as a diagnostic tool for cardiovascular diseases. We report about the experiences in a high-volume cardiac imaging center and in a "mobile setting" in Germany and provide routinely used examination protocols.

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