Analyse multicritère pour la priorisation des interventions en matière d’approvisionnement en eau en milieu rural au Sénégal : cas de la région de Diourbel

De nombreux programmes et projets visant l’accès aux ressources en eau sont initiés au Sénégal pour satisfaire une demande en eau qui se fait de plus en plus pressante, notamment en milieu rural. L’insuffisance des moyens financiers impose que ces projets soient échelonnés dans le temps. En amont des études de faisabilité technique et économique, il est nécessaire d’établir des priorités d’intervention. Cette étude présente une analyse multicritère d’aide à la décision pour prioriser les besoins d’intervention en matière d’approvisionnement en eau en milieu rural au Sénégal. Le cas de la région de Diourbel est étudié. Après avoir identifié les objectifs relatifs à l’approvisionnement en eau au niveau de la région, six critères quantitatifs et qualitatifs permettant de mesurer les degrés d’atteinte de ces objectifs sont définis. Ces critères permettent d’évaluer la priorité en matière de projets de développement éventuels. Il s’agit de critères portant sur la qualité des eaux disponible, la quantité d’eau disponible pour les besoins domestiques, la distance d’accès aux points d’eau, la disponibilité de l’eau pour l’agriculture, et enfin l’acceptabilité des coûts de l’eau ainsi que le potentiel de développement. La démarche a abouti au rangement des huit arrondissements de la région de Diourbel par ordre de priorité d’intervention. Les critères ont été pondérés par des acteurs de la gestion des ressources en eau au Sénégal. Une analyse permet de juger de l’effet des différentes pondérations sur le classement des priorités obtenu. L’analyse du processus dans son ensemble permet de mettre en exergue les difficultés liées à l’utilisation d’une telle démarche dans le contexte sénégalais tout en montrant les avantages que l’on peut en tirer.Many programs and projects for water resources management have been initiated in Senegal to satisfy an increasing demand for water, especially in rural areas. The lack of sufficient funding requires that these projects be spread over time. Therefore, prior to any technical or economic feasibility study, it is necessary to identify the higher priority areas. This study presents a multicriteria analysis for ranking rural subareas in Senegal, in particular in the region of Diourbel, in terms of the priorities of water supply needs. After having identified the objectives related to water supply on the regional scale, six quantitative and qualitative criteria were defined. These criteria pertain to the available water quality, the available quantity of water for domestic needs, the distance to water distribution points, the availability of water for agriculture, the acceptability of water costs and the development potential of a rural subarea. Indicators are proposed for each criterion based on the data available at the time of the study. Criteria weights were obtained from various water resource management stakeholders in Senegal. Our multicriteria analysis led to the ranking of eight districts of the Diourbel region in terms of intervention priority. An analysis enabled us to evaluate the effect of the criteria weights on the district rankings. Our experience with this project has identified the difficulties associated with conducting a multicriteria analysis in the Senegalese context, while emphasizing promising application possibilities

Relationships between density and Young’s modulus with microporosity and physico-chemical properties of Wistar rat cortical bone from growth to senescence

The aim of this study is to assess density and elastic properties of Wistar rat cortical bone from growth to senescence and to correlate them with morphological and physico-chemical properties of bone. During growth (from 1 to 9 months), bone density and Young’s modulus were found to increase from 1659±85 to 2083±13 kg m−3 and from 8±0.8 to 19.6±0.7 GPa respectively. Bone microporosity was found to decrease from 8.1±0.7% to 3.3±0.7%. Physico-chemical investigations exhibited a mineralization of bone matrix and a maturation of apatite crystals, as protein content decreased from 21.4±0.2% to 17.6±0.6% and apatite crystal size and carbonate content increased (c-axis length: from 151 to 173 Å and CO3W%: from 4.1±0.3% to 6.1±0.2%). At adult age, all properties stabilized. During senescence, a slow decrease of mechanical properties was first observed (from 12 to 18 months, ρ=2089±14 to 2042±30 kg m−3 and E3=19.8 ±1.3 to 14.8±1.5 GPa), followed by a stabilization. Physico-chemical properties stabilized while microporosity increased slightly (from 3.3% to 4%) but not significantly (p>0.05). A multiple regression analysis showed that morphological and physico-chemical properties had significant effects on density regression model. Microporosity had a greater effect on Young’s modulus regression model than physico-chemical properties. This study showed that bone structure, mineralization and apatite maturation should be considered to improve the understanding of bone mechanical behaviour

Spinal Cord Stimulation in the 21st Century — Reviewing Innovation in Neuromodulation

INTRODUCTION Low back pain (LBP) is a pervasive problem impacting health systems across the world. In the United States, chronic LBP impacts up to 40% of Americans and results in excessive financial strain on the healthcare budget, estimated at up to $100 billion annually.1 Furthermore, treatment results are often disappointing, with the traditional pathway of conservative measures, narcotic pain medication, and surgical decompression and/or fusion leading to both patient and provider frustration, complications, and diminished patient productivity and quality of life. This has naturally led to questions from policymakers regarding the utility of healthcare dollars spent on back pain. In this milieu, a variety of neuromodulation techniques have found a niche in the management of this patient population, with indications commonly quoted including failed back surgery syndrome (FBSS), chronic neuropathic pain, and complex regional pain syndrome (CRPS), among others.1,2 From its inception on the basis of Melzak and Wall’s gate theory³, to its first human trial in the 1960s,⁴ and to the modern era, spinal cord stimulation has undergone a series of innovations that have expanded indications and improved patient outcomes. The goal of this study is to summarize the most important clinical trials involving both traditional SCS and newer stimulation paradigms to provide an overview of the current state of affairs of this rapidly-growing field

Influence of real-world characteristics on outcomes for patients with methicillin-resistant Staphylococcal skin and soft tissue infections:a multi-country medical chart review in Europe

BACKGROUND: Patient-related (demographic/disease) and treatment-related (drug/clinician/hospital) characteristics were evaluated as potential predictors of healthcare resource use and opportunities for early switch (ES) from intravenous (IV)-to-oral methicillin-resistant Staphylococcus aureus (MRSA)-active antibiotic therapy and early hospital discharge (ED). METHODS: This retrospective observational medical chart study analyzed patients (across 12 European countries) with microbiologically confirmed MRSA complicated skin and soft tissue infections (cSSTI), ≥3 days of IV anti-MRSA antibiotics during hospitalization (July 1, 2010-June 30, 2011), and discharged alive by July 31, 2011. Logistic/linear regression models evaluated characteristics potentially associated with actual resource use (length of IV therapy, length of hospital stay [LOS], IV-to-oral antibiotic switch), and ES and ED (using literature-based and expert-verified criteria) outcomes. RESULTS: 1542 patients (mean ± SD age 60.8 ± 16.5 years; 61.5% males) were assessed with 81.0% hospitalized for MRSA cSSTI as the primary reason. Several patient demographic, infection, complication, treatment, and hospital characteristics were predictive of length of IV therapy, LOS, IV-to-oral antibiotic switch, or ES and ED opportunities. Outcomes and ES and ED opportunities varied across countries. Length of IV therapy and LOS (r = 0.66, p < 0.0001) and eligibilities for ES and ED (r = 0.44, p < 0.0001) showed relatively strong correlations. IV-to-oral antibiotic switch patients had significantly shorter length of IV therapy (−5.19 days, p < 0.001) and non-significantly shorter LOS (−1.86 days, p > 0.05). Certain patient and treatment characteristics were associated with increased odds of ES (healthcare-associated/ hospital-acquired infection) and ED (patient living arrangements, healthcare-associated/ hospital-acquired infection, initiating MRSA-active treatment 1–2 days post cSSTI index date, existing ED protocol), while other factors decreased the odds of ES (no documented MRSA culture, ≥4 days from admission to cSSTI index date, IV-to-oral switch, IV line infection) and ED (dementia, no documented MRSA culture, initiating MRSA-active treatment ≥3 days post cSSTI index date, existing ES protocol). CONCLUSIONS: Practice patterns and opportunity for further ES and ED were affected by several infection, treatment, hospital, and geographical characteristics, which should be considered in identifying ES and ED opportunities and designing interventions for MRSA cSSTI to reduce IV days and LOS while maintaining the quality of care. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2334-14-476) contains supplementary material, which is available to authorized users

The structure of a resuscitation-promoting factor domain from Mycobacterium tuberculosis shows homology to lysozymes

Resuscitation-promoting factor (RPF) proteins reactivate stationary-phase cultures of (G+C)-rich Gram-positive bacteria including the causative agent of tuberculosis, Mycobacterium tuberculosis. We report the solution structure of the RPF domain from M. tuberculosis Rv1009 (RpfB) solved by heteronuclear multidimensional NMR. Structural homology with various glycoside hydrolases suggested that RpfB cleaved oligosaccharides. Biochemical studies indicate that a conserved active site glutamate is important for resuscitation activity. These data, as well as the presence of a clear binding pocket for a large molecule, indicate that oligosaccharide cleavage is probably the signal for revival from dormancy

Subcellular localization of MC4R with ADCY3 at neuronal primary cilia underlies a common pathway for genetic predisposition to obesity.

Most monogenic cases of obesity in humans have been linked to mutations in genes encoding members of the leptin-melanocortin pathway. Specifically, mutations in MC4R, the melanocortin-4 receptor gene, account for 3-5% of all severe obesity cases in humans1-3. Recently, ADCY3 (adenylyl cyclase 3) gene mutations have been implicated in obesity4,5. ADCY3 localizes to the primary cilia of neurons 6 , organelles that function as hubs for select signaling pathways. Mutations that disrupt the functions of primary cilia cause ciliopathies, rare recessive pleiotropic diseases in which obesity is a cardinal manifestation 7 . We demonstrate that MC4R colocalizes with ADCY3 at the primary cilia of a subset of hypothalamic neurons, that obesity-associated MC4R mutations impair ciliary localization and that inhibition of adenylyl cyclase signaling at the primary cilia of these neurons increases body weight. These data suggest that impaired signaling from the primary cilia of MC4R neurons is a common pathway underlying&nbsp;genetic causes of obesity in humans

Does training with amplitude modulated tones affect tone-vocoded speech perception?

Temporal-envelope cues are essential for successful speech perception. We asked here whether training on stimuli containing temporal-envelope cues without speech content can improve the perception of spectrally-degraded (vocoded) speech in which the temporal-envelope (but not the temporal fine structure) is mainly preserved. Two groups of listeners were trained on different amplitude-modulation (AM) based tasks, either AM detection or AM-rate discrimination (21 blocks of 60 trials during two days, 1260 trials; frequency range: 4Hz, 8Hz, and 16Hz), while an additional control group did not undertake any training. Consonant identification in vocoded vowel-consonant-vowel stimuli was tested before and after training on the AM tasks (or at an equivalent time interval for the control group). Following training, only the trained groups showed a significant improvement in the perception of vocoded speech, but the improvement did not significantly differ from that observed for controls. Thus, we do not find convincing evidence that this amount of training with temporal-envelope cues without speech content provide significant benefit for vocoded speech intelligibility. Alternative training regimens using vocoded speech along the linguistic hierarchy should be explored

Gauge-independent MS‾\overline{MS} renormalization in the 2HDM

We present a consistent renormalization scheme for the CP-conserving Two-Higgs-Doublet Model based on $\overline{MS}$ renormalization of the mixing angles and the soft-$Z_2$-symmetry-breaking scale $M_{sb}$ in the Higgs sector. This scheme requires to treat tadpoles fully consistently in all steps of the calculation in order to provide gauge-independent $S$-matrix elements. We show how bare physical parameters have to be defined and verify the gauge independence of physical quantities by explicit calculations in a general $R_{\xi}$-gauge. The procedure is straightforward and applicable to other models with extended Higgs sectors. In contrast to the proposed scheme, the $\overline{MS}$ renormalization of the mixing angles combined with popular on-shell renormalization schemes gives rise to gauge-dependent results already at the one-loop level. We present explicit results for electroweak NLO corrections to selected processes in the appropriately renormalized Two-Higgs-Doublet Model and in particular discuss their scale dependence.Comment: 52 pages, PDFLaTeX, PDF figures, JHEP version with Eq. (5.23) correcte