New hybrid materials based on poly(ethyleneoxide)- grafted polysilazane by hydrosilylation and their anti-fouling activities

Abstract The objective of this work was to develop new coating materials based on poly(ethyleneoxide) (PEO), which was grafted onto polysilazane (PSZ) by hydrosilylation. Three types of PEO with different molecular weights (350, 750, 2000 g/mol) were studied. The kinetics and yields of this reaction have been surveyed by 1 H and 13 C NMR spectroscopy. The PEO grafting-density onto PSZ by hydrosilylation increases with a reduction of the S-H/allyl ratio and a decrease of the PEO chain-length. The PEO-graft-PSZ (PSZ-PEO) hybrid coatings, which can be used to prevent the adhesion of marine bacteria on surfaces, were applied by moisture curing at room temperature. The anti-adhesion performance, and thus the anti-fouling activity, of the coatings against three marine bacteria species, Clostridium sp. SR1, Neisseria sp. LC1 and Neisseria sp. SC1, was examined. The anti-fouling activity of the coatings depends on the grafting density and the chain length of PEO. The shortest PEO(350 g/mol)-graft-PSZ with the highest graft density was found to have the best anti-fouling activity. As the density of grafted PEO(750 g/mol) and PEO(2000 g/mol) chains onto the PSZ surface is approximately equal, the relative effectiveness of these two types of PEO is controlled by the length of the PEO chain. The PEO(2000 g/mol)-graft-PSZ coatings are more efficient than the PEO(750 g/mol)-graft-PSZ coatings for the bacterial anti-adhesion

Impact of Home-Based Management of malaria combined with other community-based interventions: what do we learn from Rwanda?

Introduction: This study aimed to evaluate the impact of home-based management of malaria (HBM) strategy on time to treatment and reported presumed malaria morbidity in children aged less than 5 years in Rwanda. Methods: The study was carried out in two malaria-endemic rural districts, one where HBM was applied and the other serving as control. In each district, a sample of mothers was surveyed by questionnaire before (2004) and after (2007) implementation of HBM. Results: After implementation, we observed: i) an increase (P<0.001) in the number of febrile children treated within 24 hours of symptom onset in the experimental district (53.7% in 2007 vs 5% in 2004) compared with the control district (28% vs 7.7%); ii) a decrease in the reported number of febrile children in the experimental district (28.7% vs 44.9%, P<0.01) compared with the control district (45.7% vs 56.5%, P<0.05). Conclusion: HBM contributed to decrease time to treatment and reported presumed malaria morbidity.Pan African Medical Journal 2013; 14:5

A TYPICAL EXTENSIVE GENITAL ULCER IN FULL BLOWN AIDS WITH SLIM DISEASE

Background: Atypical and exceptional clinical presentation of full blown AIDS may be observed in sub-Saharan Africa. We report herein the case of a Central African 37-year-old male patient presented with full blown AIDS, a typical picture of slim disease with marked cachexia and wasting faces. In addition, the patient was suffering from very extensive genital ulcer with complete loss of substance of the genitalia. Methods: Extensive histological and microbiological analysis of the genital lesion was carried out. Results: HIV-1 serology was positive, the HIV-1 RNA plasma viral load was 5.3 log copies/ml and CD4 T cell count was 1 per μL. Search for Mycobacterium tuberculosis in sputum and urine was negative by direct microscopic examination with Ziehl-Neelsen staining. Testing for syphilis serology was negative. Direct immunofluorescence detection on genital ulcer scraping was negative for Chlamydia trachomatis and Treponema pallidum. Furthermore, the infections with Haemophilus ducreyi and Chlamydia trachomatis were excluded by PCR on genital swabs.Genital PCR was positive for herpes simplex virus (HSV) type 2. Marked improvement was observed within 6 weeks after starting empirical therapy including first-line antiretroviral therapy, cotrimoxazole, doxycycline and valacyclovir, with progressive healing of genital ulcer and negativity of HSV PCR. Conclusion: Taken together, the extensive genital ulcer in this patient is likely the result of a multifactorial process, involving both profound cellular immune depression and complex genital infectious process in which herpetic infection may have participated as a chronic worsening co-factor

A biocodicological analysis of the medieval library and archive from Orval Abbey, Belgium.

Biocodicological analysis of parchments from manuscript books and archives offers unprecedented insight into the materiality of medieval literacy. Using ZooMS for animal species identification, we explored almost the entire library and all the preserved single leaf charters of a single medieval Cistercian monastery (Orval Abbey, Belgium). Systematic non-invasive sampling of parchment collagen was performed on every charter and on the first bifolium from every quire of the 118 codicological units composing the books (1490 samples in total). Within the genuine production of the Orval scriptorium (26 units), a balanced use of calfskin (47.1%) and sheepskin (48.5%) was observed, whereas calfskin was less frequent (24.3%) in externally produced units acquired by the monastery (92 units). Calfskin was preferably used for higher quality manuscripts while sheepskin tends to be the standard choice for 'ordinary' manuscript book production. This finding is consistent with thirteenth-century parchment accounts from Beaulieu Abbey (England) where calfskin supply was more limited and its price higher. Our study reveals that the making of archival documents does not follow the same pattern as the production of library books. Although the five earliest preserved charters are made of calfskin, from the 1230s onwards, all charters from Orval are written on sheepskin

African Linguistics in Central and Eastern Europe, and in the Nordic Countries

Non peer reviewe

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Interest of machine learning for the search for markers involved in cardiac remodelling and stroke heart syndrome

Dans le domaine de la santé, le volume, la diversité et la complexité croissante des données générées a nécessité une évolution des méthodes d’analyse. Les techniques d’analyse de données de type apprentissage machine (machine learning) répondent à ce défi en modélisant des relations complexes pour un grand nombre de variables. Nous avons testé l’apport de ces méthodes machine learning dans deux pathologies cardiovasculaires, l’infarctus du myocarde (IM) et l’accident vasculaire cérébral (AVC). Dans notre première étude nous avons cherché à améliorer la prédiction du risque d'apparition d'un remodelage ventriculaire gauche (RVG) à trois mois après IM avec sus-décalage du segment ST. Nous avons utilisé une approche issue du machine learning, dans une cohorte de 443 patients suivis au CHU d’Angers. 133 variables cliniques, biologiques et d'imagerie par résonance magnétique cardiaque (IRM) à la première semaine et 3 mois après l'IM ont été collectées. Un modèle de régression logistique de base utilisant des variables précédemment décrites dans la littérature a obtenu une AUC de 0,71 sur les données de test. En comparaison, notre meilleur modèle était un réseau de neurones utilisant sept variables sélectionnées par des algorithmes de sélection de variables qui a obtenu une AUC de 0,78 sur les données de test, atteignant un niveau de sensibilité plus élevé que les méthodes traditionnelles pour la prédiction d'un RVG à 3 mois après l'IM. Dans un second projet, nous avons utilisé le machine learning pour chercher des métabolites impliqués dans la physiopathologie du syndrome neuro-cardiaque. 630 métabolites issus d’une étude métabolipidomique ont été quantifiés dans le plasma et le cœur de 12 rats ayant subi un AVC et 28 rats contrôles. Nous avons identifié une signature métabolique dans le cœur des rats après l’AVC en lien avec le renouvellement du collagène, la production d’oxyde nitrique, et l’inflammation. En conclusion, ces résultats montrent l’intérêt de l'utilisation d'une approche machine learning pour améliorer le pronostic ou la compréhension des mécanismes physiopathologiques de pathologies cardiovasculaires.In the field of health, the increasing volume, diversity and complexity of the data generated has necessitated an evolution of the analysis methods and approaches. We describe the contribution of machine learning applied to the medical field, and more specifically to cardiology. We sought to improve the prediction of the risk of occurrence of left ventricular remodelling (LVR) at three months after ST-segment elevation myocardial infarction (MI), using a machine learning approach, in a cohort of 443 patients followed at the University Hospital of Angers. We retrieved 133 clinical, biological and cardiac magnetic resonance imaging (MRI) variables at the first week after MI, and the LVR was assessed by MRI at 3 months. A basic logistic regression model using variables previously described in the literature achieved an AUC of 0.71 on the test data. In comparison, our best model was a neural network using seven variables selected by variable selection algorithms that achieved an AUC of 0.78 on the test data, achieving a higher level of sensitivity than traditional methods for predicting LVR at 3 months after MI.In a second project, we used machine learning to analyse massive data from a metabolipidomic study assaying 630 metabolites in a rat stroke model to investigate metabolic changes affecting the heart within 1-3 days after stroke. We were able to analyse 12 rats that had suffered a stroke and 28 rats undergoing the sham procedure. We were able to identify a metabolic signature in the post-stroke rat heart that shows increased collagen turnover, increased arginase activity with decreased nitric oxide production, altered serine, asparagine, lysine and glycine metabolism. In conclusion, these results show the interest of using a machine learning approach to improve prognosis or the understanding of the physiopathological mechanisms of cardiovascular pathologie

La sécurité de proximité, un remède à la ségrégation territoriale ?

Partendo da un’analisi socio-giuridica, il presente articolo propone alcune risposte alle seguenti domande che vengono poste con una particolare cogenza nella società francese di oggi: la segregazione territoriale si ripercuote sull’ambito della sicurezza? E’ possibile trasformare la logica di prossimità in una risposta da implementare? Qual è l’impatto degli interventi di sicurezza di prossimità sulla lotta contro la segregazione territoriale, in particolare la partecipazione dei cittadini e la mediazione sociale? In altri termini, la sicurezza di prossimità rappresenta una risposta adatta ed efficace nei confronti della segregazione territoriale? A partir d’une analyse à la fois juridique et sociologique, cet article répond aux questions suivantes, qui se posent avec une acuité particulière dans la société française d’aujourd’hui : la ségrégation territoriale se manifeste-t-elle en matière de sécurité, et s’avère-t-il possible de développer en réponse une logique de proximité ? Quel est l’impact en matière de lutte contre la ségrégation territoriale des dispositifs de sécurité de proximité, en particulier de la participation citoyenne et de la médiation sociale ? En d’autres termes, la sécurité de proximité est-elle une réponse adaptée et efficace en matière de ségrégation territoriale ? From a legal and sociological perspective, this article aims to answer the following questions which are central to current French society: Does the territorial segregation reveal itself in regard to security and is it possible to develop in reply a response based on local security measures? What is the impact on the fight against territorial segregation of local security measures, in particular citizen participation and social medmediation? In other words, are local security measures an appropriate and efficient answer to territorial segregation