Complémentarité des filières sorgho sucré et canne à sucre en Haïti : évaluation des conditions de développement sectoriel d'une innovation

Nous analysons comment l'introduction du sorgho sucré en Haïti pourrait se traduire en une innovation réussie. L'hypothèse est que le caractère multifonctionnel du sorgho sucré permet de combiner différentes utilisations : alimentaire (graines, fourrages), énergétique (production de bioéthanol ou de gel pour la cuisson et cogénération) et production d'alcool de bouche, dont certaines sont complémentaires de la filière canne. Nous mobilisons un référentiel analytique de filière pour évaluer in itinere les conditions de développement sectoriel d'une introduction variétale. Les données proviennent d'enquêtes à dire d'experts. Les résultats montrent en quoi le fonctionnement de la filière canne à sucre détermine des contraintes spécifiques qui conditionnent le choix des variétés de sorgho. Ils montrent aussi une complémentarité entre la valorisation alimentaire du sorgho sucré sous forme de grain et la production d'alcool. Ils interrogent les conditions de valorisation des grains et des coproduits du sorgho sucré pour l'alimentation animale. Ils invalident enfin son usage énergétique pour la production de bioéthanol. (Résumé d'auteur

Ten Years of Experience Training Non-Physician Anesthesia Providers in Haiti.

Surgery is increasingly recognized as an effective means of treating a proportion of the global burden of disease, especially in resource-limited countries. Often non-physicians, such as nurses, provide the majority of anesthesia; however, their training and formal supervision is often of low priority or even non-existent. To increase the number of safe anesthesia providers in Haiti, Médecins Sans Frontières has trained nurse anesthetists (NAs) for over 10 years. This article describes the challenges, outcomes, and future directions of this training program. From 1998 to 2008, 24 students graduated. Nineteen (79%) continue to work as NAs in Haiti and 5 (21%) have emigrated. In 2008, NAs were critical in providing anesthesia during a post-hurricane emergency where they performed 330 procedures. Mortality was 0.3% and not associated with lack of anesthesiologist supervision. The completion rate of this training program was high and the majority of graduates continue to work as nurse anesthetists in Haiti. Successful training requires a setting with a sufficient volume and diversity of operations, appropriate anesthesia equipment, a structured and comprehensive training program, and recognition of the training program by the national ministry of health and relevant professional bodies. Preliminary outcomes support findings elsewhere that NAs can be a safe and effective alternative where anesthesiologists are scarce. Training non-physician anesthetists is a feasible and important way to scale up surgical services resource limited settings

Antipsychotic dose escalation as a trigger for Neuroleptic Malignant Syndrome (NMS): literature review and case series report

Background: “Neuroleptic malignant syndrome” (NMS) is a potentially fatal idiosyncratic reaction to any medication which affects the central dopaminergic system. Between 0.5% and 1% of patients exposed to antipsychotics develop the condition. Mortality rates may be as high as 55% and many risk factors have been reported. Although rapid escalation of antipsychotic dose is thought to be an important risk factor, to date it has not been the focus of a published case series or scientifically defined. <p/>Aims: To identify cases of NMS and review risk factors for its development with a particular focus on rapid dose escalation in the 30 days prior to onset. <p/>Methodology: A review of the literature on rapid dose escalation was undertaken and a pragmatic definition of “rapid dose escalation” was made. NMS cases were defined using DSM-IV criteria and systematically identified within a secondary care mental health service. A ratio of titration rate was calculated for each NMS patient and “rapid escalators” and “non rapid escalators” were compared. <p/>Results: 13 cases of NMS were identified. A progressive mean dose increase 15 days prior to the confirmed episode of NMS was observed (241.7mg/day during days 1-15 to 346.9mg/day during days 16-30) and the mean ratio of dose escalation for NMS patients was 1.4. Rapid dose escalation was seen in 5/13 cases and non rapid escalators had markedly higher daily cumulative antipsychotic dose compared to rapid escalators. <p/>Conclusions: Rapid dose escalation occurred in less than half of this case series (n=5, 38.5%), although there is currently no consensus on the precise definition of rapid dose escalation. Cumulative antipsychotic dose – alongside other known risk factors - may also be important in the development of NMS

A new elasmobranch fauna from the early Miocene of Sharbithat (Sultanate of Oman) reveals the teeth of an ancient fantail stingray

Here we describe a new elasmobranch assemblage consisting of isolated dental material from the Aquitanian near-shore marine deposits of the Shuwayr and Warak formations at Sharbithat, in eastern Sultanate of Oman. The faunal composition clearly indicates affinities to other early Miocene elasmobranch-bearing localities worldwide. This assemblage is predominantly composed of large and common pelagic sharks as well as teeth attributable to a new species of fantail stingray, Taeniurops tosii, as old as the oldest undisputable fossil records of Taeniurops. The study of this fossil assemblage presented here improves the knowledge of the ancient elasmobranchs that frequented the eastern Arabian coasts during the closure of the Neotethys and the birth of the Arabian Sea. DOI: 10.1344/GeologicaActa2022.20.

Evidences for a Paleocene marine incursion in southern Amazonia (Madre de Dios Sub-Andean Zone, Peru)

This article presents new biostratigraphic dating, facies analysis, organic geochemical data and Nd–Sr isotopic provenance from five outcrops of southern Amazonia (MD-85, MD-177 MD-184, MD-255 and MD-256) to document for the first time the presence of a shallow marine ingression in the Paleocene of southern Amazonia basin. The co-occurrence of a selachian assemblage encompassing Potobatis sp., Ouledia sp., and Pristidae indet. with the ostracod Protobuntonia sp. and the charophytes Peckichara cf. varians meridionalis, Platychara perlata, and Feistiella cf. gildemeisteri suggests a Paleocene age for the studied deposits (most likely Thanetian but potentially Danian). Fifteen facies have been recognized and have been grouped into three facies assemblages. Facies association A corresponds to the sedimentary filling of a tide-influenced meandering channel formed in the fluvial–tidal transition zone. Facies association B is related to more distal tidal-flats, little channelized tidal inlets and saltmarsh deposits. Facies association C corresponds to a stressed shallow marine environment such as a bay or a lagoon. The d13CTOC value (- 23.4‰) of MD-184 is enriched in 13C compared to the other samples suggesting the presence of substantial amounts of marine organic matter in MD-184. The d13CTOC values of samples from other outcrops (- 27.3 to - 29.8‰) indicate a mixed organic matter origin, from terrestrial to brackish environments. The analyzed sediments have similar Nd–Sr isotopic compositions as those of the Cenozoic sediments of the Altiplano (eNd(0) values from - 6.2 to - 10.7 and 87Sr/86Sr compositions from 0.712024 to 0.719026) indicating a similar volcanic source. This multidisciplinary dataset documents the presence of a tide-dominated estuary sourced by the proto-Western Cordillera debouching into a shallow marine bay during Paleocene times. This transgression might be explained by subsidence created in response to the proto-Western Cordillera loading. Similar to Miocene marine incursions affecting the Pebas megawetland, Paleogene marine incursions in the Amazonian foreland basin associated with Andean uplift may have played a role in the Neotropical biodiversity dynamics in favoring biogeographical isolation and promoting allopatric speciation for terrestrial organisms

Influence of mechanical strains on electromagnetic signals of a microstrip antenna. FEM/BIM model

A hybrid numerical technique is proposed for a characterization of the radar cross section of a microstrip patch antenna residing in a dielectric filled cavity which is loaded by a sinusoidal mechanical pressure. A new 3D hexahedral finite element is developed in order to take into account the deformed shape of the antenna within the electromagnetic computations. The numerical tool combines the finite element and boundary integral methods to formulate a system for the solution of the fields at the aperture and those inside the cavity. In this work, numerical examples are presented for demonstrating the ability and the validity of the hexahedral element

Comparison of glottic views and intubation times in the supine and 25 degree back-up positions

Background: We explored whether positioning patients in a 25° back-up sniffing position improved glottic views and ease of intubation. Methods: In the first part of the study, patients were intubated in the standard supine sniffing position. In the second part, the back of the operating table was raised 25° from the horizontal by flexion of the torso at the hips while maintaining the sniffing position. The best view obtained during laryngoscopy was assessed using the Cormack and Lehane classification and Percentage of Glottic Opening (POGO) score. The number of attempts at both laryngoscopy and tracheal intubation, together with the use of ancillary equipment and manoeuvres were recorded. The ease of intubation was indirectly assessed by recording the time interval between beginning of laryngoscopy and insertion of the tracheal tube. Results: Seven hundred eighty one unselected surgical patients scheduled for non-emergency surgery were included. In the back-up position, ancillary laryngeal manoeuvres, which included cricoid pressure, backwards upwards rightward pressure and external laryngeal manipulation, were required less frequently (19.6 % versus 24. 6 %, p = 0.004). The time from beginning of laryngoscopy to insertion of the tracheal tube was 14 % shorter (median time 24 versus 28 s, p = 0.031) in the back-up position. There was no significant difference in glottic views. Conclusions: The 25° back-up position improved the ease of intubation as judged by the need for fewer ancillary manoeuvres and shorter time for intubation. Trial registration: ClinicalTrials.gov Identifier: NCT02934347 registered retrospectively on 14th Oct 2016