Europe-Afrique : des acteurs en quête de scénarios

With the marginalization of Africa in international trade, previous models for operationalizing relations with Europe have become obsolete. There is increasingly a trend towards uncoupling between North Africa, the Republic of South Africa, and Black Africa. North Africa has broken away to the point of regarding itself as a hinterland of Europe. South Africa is likely to become both a crossroads and a transit point in trade between Europe, Africa, and the Pacific region. In Black Africa, the only current scenarios for reconnection with the rest of the world seem to amount to pointing out this subregion's capability to do harm if it were ever abandoned

Nigeria's "manifest destiny" in West Africa: dominance without power

"Ever since independence, messianic references to a natural Nigerian leadership in the affairs of the African continent have been ingrained in the conduct of Nigeria's foreign policy. Internationally, Nigeria's endowments of human and natural resources, deeply asymmetrical interactions with neighboring states and the active engagement of successive regimes in the affairs of the continent have called for the country's treatment as a regional power and a pivotal state for West Africa. However, Nigeria's 'manifest destiny' remains more about influence than power. The country's unsteady projection of structural or relational power starkly contrasts with the deep regional imprint left by trans-frontier networks that focus on Nigeria but operate independently of territorial affiliations. The related regionalization process exacerbates the fluidity and fragility of region-building as much as problems of statehood and governance within Nigeria." (author's abstract

Europe Within the World of Regionalisms

The surge of diversified forms of regionalism and regional integration within the past few decades has stimulated the reappraisal of the conceptual tools traditionally designed to bench-mark and monitor region-building processes across the world. More recently, the Brexit negotiations have become a reminder that the EU remains an unfolding experience. This article argues that the study of African regionalisms constitutes a timely invitation to revisit the experience of the EU and its contribution to the world of regionalisms. After a brief survey of the classic definition of the region, we will discuss the ongoing relevance of European integration and the implications of the analytical distinction between regionalism, regionalisation and regional integration, before drawing from the study of Africa five threads which set the basis for a comparative study of regions and regionalisms beyond the classic emphasis on the EU or the world of regions

The Deligne-Simpson problem for connections on Gm\mathbb{G}_m with a maximally ramified singularity

The classical additive Deligne-Simpson problem is the existence problem for Fuchsian connections with residues at the singular points in specified adjoint orbits. Crawley-Boevey found the solution in 2003 by reinterpreting the problem in terms of quiver varieties. A more general version of this problem, solved by Hiroe, allows additional unramified irregular singularities. We apply the theory of fundamental and regular strata due to Bremer and Sage to formulate a version of the Deligne-Simpson problem in which certain ramified singularities are allowed. These allowed singular points are called toral singularities; they are singularities whose leading term with respect to a lattice chain filtration is regular semisimple. We solve this problem in the important special case of connections on $\mathbb{G}_m$ with a maximally ramified singularity at $0$ and possibly an additional regular singular point at infinity. We also give a complete characterization of all such connections which are rigid, under the additional hypothesis of unipotent monodromy at infinity.Comment: 27 pages. Minor correction

The Number of Endothelial Progenitor Cell Colonies in the Blood Is Increased in Patients With Angiographically Significant Coronary Artery Disease

ObjectivesThe objective of this study was to determine whether the number of endothelial progenitor cells (EPCs) and circulating angiogenic cells (CACs) in peripheral blood was associated with the presence and severity of coronary artery disease (CAD) in patients undergoing coronary angiography.BackgroundPrevious studies have suggested an inverse relationship between levels of circulating EPCs/CACs and the presence of CAD or cardiovascular risk factors, whereas other studies have observed increased numbers of EPCs in the setting of acute ischemia. However, the criteria used to identify specific angiogenic cell subpopulations and methods of evaluating CAD varied in these studies. In the present study, we used rigorous criteria to identify EPCs and CACs in the blood of patients undergoing coronary angiography.MethodsThe number of EPCs and CACs were measured in the blood of 48 patients undergoing coronary angiography. Patients with acute coronary syndromes were excluded.ResultsCompared with patients without angiographically significant CAD, the number of EPCs was increased (1.11 ± 2.50 vs. 4.01 ± 3.70 colonies/well, p = 0.004) and the number of CACs trended higher (175 ± 137 vs. 250 ± 160 cells per mm2, p = 0.09) among patients with significant CAD. The highest levels of EPCs were isolated from patients subsequently selected for revascularization (5.03 ± 4.10 colonies/well).ConclusionsIn patients referred for coronary angiography, higher numbers of EPCs, and a trend toward higher numbers of CACs, were associated with the presence of significant CAD, and EPC number correlated with maximum angiographic stenosis severity. Endothelial progenitor cell levels were highest in patients with CAD selected for revascularization

Adverse effects of delayed antimicrobial treatment and surgical source control in adults with sepsis: results of a planned secondary analysis of a cluster-randomized controlled trial

BACKGROUND: Timely antimicrobial treatment and source control are strongly recommended by sepsis guidelines, however, their impact on clinical outcomes is uncertain. METHODS: We performed a planned secondary analysis of a cluster-randomized trial conducted from July 2011 to May 2015 including forty German hospitals. All adult patients with sepsis treated in the participating ICUs were included. Primary exposures were timing of antimicrobial therapy and delay of surgical source control during the first 48 h after sepsis onset. Primary endpoint was 28-day mortality. Mixed models were used to investigate the effects of timing while adjusting for confounders. The linearity of the effect was investigated by fractional polynomials and by categorizing of timing. RESULTS: Analyses were based on 4792 patients receiving antimicrobial treatment and 1595 patients undergoing surgical source control. Fractional polynomial analysis identified a linear effect of timing of antimicrobials on 28-day mortality, which increased by 0.42% per hour delay (OR with 95% CI 1.019 [1.01, 1.028], p ≤ 0.001). This effect was significant in patients with and without shock (OR = 1.018 [1.008, 1.029] and 1.026 [1.01, 1.043], respectively). Using a categorized timing variable, there were no significant differences comparing treatment within 1 h versus 1–3 h, or 1 h versus 3–6 h. Delays of more than 6 h significantly increased mortality (OR = 1.41 [1.17, 1.69]). Delay in antimicrobials also increased risk of progression from severe sepsis to septic shock (OR per hour: 1.051 [1.022, 1.081], p ≤ 0.001). Time to surgical source control was significantly associated with decreased odds of successful source control (OR = 0.982 [0.971, 0.994], p = 0.003) and increased odds of death (OR = 1.011 [1.001, 1.021]; p = 0.03) in unadjusted analysis, but not when adjusted for confounders (OR = 0.991 [0.978, 1.005] and OR = 1.008 [0.997, 1.02], respectively). Only, among patients with septic shock delay of source control was significantly related to risk-of death (adjusted OR = 1.013 [1.001, 1.026], p = 0.04). CONCLUSIONS: Our findings suggest that management of sepsis is time critical both for antimicrobial therapy and source control. Also patients, who are not yet in septic shock, profit from early anti-infective treatment since it can prevent further deterioration. Trial registration ClinicalTrials.gov (NCT01187134). Registered 23 August 2010, NCT01187134 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-03901-9