Equipes mobiles ou agents de santé : quelle stratégie contre la maladie du sommeil ?

Les auteurs s'interrogent sur l'avenir de la lutte contre la Trypanosomiase humaine en Afrique. Au moment où cette endémie est en pleine recrudescence, les structures de surveillance et de lutte ne sont plus opérationnelles et les difficultés rencontrées par les Etats sur le plan économique limitent les interventions sur le terrain. Il est donc proposé que soient montés des réseaux de surveillance basés sur l'utilisation des Agents de Santé communautaires. Bien motivés et surtout soigneusement encadrés ces agents peuvent participer au suivi sérologique des populations et permettre d'évaluer à moindre frais le niveau et l'évolution de l'endémie; l'intervention des services spécialisés sera alors plus efficiente puisque ciblée sur les zones à risques. En cas de nécessité, les services de ces mêmes agents seront utilisés avec profit pour toutes les opérations de lutte antivectorielle. (Résumé d'auteur

ADOLESCENT GIRLS’ PERCEPTIONS ABOUT HIV AND AIDS-RELATED RISKY BEHAVIOURS: ARE WE CLOSER TO COMBATING THE PANDEMIC AMONG SOUTH AFRICA’S YOUTH?

Published ArticleSouth Africa has reportedly the largest number of people living with HIV and AIDS in the world. Although adolescents as a group comprises the greatest portion of infected people, their behaviours and perceptions about the disease leave a lot to be desired. The purpose of this article is to explore some South African adolescent girls’ risky behaviours and perceptions about HIV and AIDS. A qualitative case study approach, using a school in Soweto, Johannesburg, was adopted. The paradigmatic position was interpretive. Twelve adolescent girls aged between 15 and 19 were purposively selected to participate in semi-structured interviews. Data were qualitatively processed to discern themes. Results showed that adolescent girls have comprehensive knowledge about HIV and AIDS, but they indulge in risky sexual behaviours because of ignorance, peer influence and a need to access government child support grants. The study concludes that unless there is a sharp turn-around in the youthful adolescent girls’ perspectives on HIV and AIDS, the country’s efforts to attain a Sustainable Development Goal of combatting HIV and AIDS, will remain elusive

Initial results of the relative humidity observations by MEDA instrument onboard the Mars 2020 Perseverance Rover

Peer reviewe

A Comprehensive Framework for the Security Risk Management of Cyber-Physical Systems

Cyber Physical Systems are facing huge and diverse set of security risks, especially cyber-attacks that can cause disruption to physical services or create a national disaster. Information and communication technology (ICT) has made a remarkable impact on the society. A Cyber Physical System (CPS) relies basically on information and communication technology, which puts the system\u2019s assets under certain risks especially cyber ones, and hence they must be kept under control by means of security countermeasures that generate confidence in the use of these assets. And so there is a critical need to give a great attention on the cybersecurity of these systems, which consequently leads to the safety of the physical world. This goal is achieved by adopting a solution that applies processes, plans and actions to prevent or reduce the effects of threats. Traditional IT risk assessment methods can do the job, however, and because of the characteristics of a CPS, it is more efficient to adopt a solution that is wider than a method, and addresses the type, functionalities and complexity of a CPS. This chapter proposes a framework that breaks the restriction to a traditional risk assessment method and encompasses wider set of procedures to achieve a high level strategy that could be adopted in the risk management process, in particular the cybersecurity of cyber-physical systems

Enhanced Secretion of Amylase from Exocrine Pancreas of Connexin32-deficient Mice

To determine whether junctional communication between pancreatic acinar cells contributes to their secretory function in vivo, we have compared wild-type mice, which express the gap junctional proteins connexin32 (Cx32) and connexin26, to mice deficient for the Cx32 gene. Pancreatic acinar cells from Cx32 (−/−) mice failed to express Cx32 as evidenced by reverse transcription–PCR and immunolabeling and showed a marked reduction (4.8- and 25-fold, respectively) in the number and size of gap junctions. Dye transfer studies showed that the extent of intercellular communication was inhibited in Cx32 (−/−) acini. However, electrical coupling was detected by dual patch clamp recording in Cx32 (−/−) acinar cell pairs. Although wild-type and Cx32 (−/−) acini were similarly stimulated to release amylase by carbamylcholine, Cx32 (−/−) acini showed a twofold increase of their basal secretion. This effect was caused by an increase in the proportion of secreting acini, as detected with a reverse hemolytic plaque assay. Blood measurements further revealed that Cx32 (−/−) mice had elevated basal levels of circulating amylase. The results, which demonstrate an inverse relationship between the extent of acinar cell coupling and basal amylase secretion in vivo, support the view that the physiological recruitment of secretory acinar cells is regulated by gap junction mediated intercellular communication

Knee Exoskeletons Design Approaches to Boost Strength Capability: A Review

Exoesqueleto para incrementar la fuerza en las rodillasThere are different devices to increase the strength capacity of people with walking problems. These devices can be classified into exoskeletons, orthotics, and braces. This review aims to identify the state of the art in the design of these medical devices, based on an analysis of patents and literature. However, there are some difficulties in processing the records due to the lack of filters and standardization in the names, generating discrepancies between the search engines, among others. Concerning the patents, 74 patents were analyzed using search engines such as Google Patents, Derwent, The Lens, Patentscope, and Espacenet over the past ten years. A bibliometric analysis was performed using 63 scientific reports from Web of Science and The Lens in the same period for scientific communications. The results show a trend to use the mechanical design of exoskeletons based on articulated rigid structures and elements that provide force to move the structure. These are generally two types: (a) elastic elements and (b) electromechanical elements. The United States accounts for 32% of the technological patents reviewed. The results suggest that the use of exoskeletons or orthoses customized to the users’ needs will continue to increase over the years due to the worldwide growth in disability, particularly related to mobility difficulties and technologies related to the combined use of springs and actuators

Analytical and clinical validation of a blood progranulin ELISA in frontotemporal dementias

Heterozygous mutations in the granulin (GRN) gene may result in haploinsufficiency of progranulin (PGRN), which might lead to frontotemporal dementia (FTD). In this study, we aimed to perform analytical and clinical validation of a commercial progranulin kit for clinical use. Analytical validation parameters including assay precision, selectivity, measurement range, dilution linearity, interferences and sample stability were tested according to previously described procedures. For clinical validation, PGRN levels were measured in plasma from 32 cognitively healthy individuals, 52 confirmed GRN mutation carriers, 25 C9orf72 mutation carriers and 216 patients with different neurodegenerative diseases of which 70 were confirmed as non-mutation carriers. Among the analytical validation parameters, assay precision and repeatability were very stable (coefficients of variation <7 %). Spike recovery was 96 %, the measurement range was 6.25-400 μg/L and dilution linearity ranged from 1:50-1:200. Hemolysis did not interfere with progranulin levels, and these were resistant to freeze/thaw cycles and storage at different temperatures. For the clinical validation, the assay was capable of distinguishing GRN mutation carriers from controls and non-GRN mutation carriers with very good sensitivity and specificity at a cut-off of 57 μg/L (97 %, 100 %, respectively). In this study, we demonstrate robust analytical and diagnostic performance of this commercial progranulin kit for implementation in clinical laboratory practice. This easy-to-use test allows identification of potential GRN mutation carriers, which may guide further evaluation of the patient. This assay might also be used to evaluate the effect of novel PGRN-targeting drugs and therapies

Distance to care, care seeking and child mortality in rural Burkina Faso: findings from a population-based cross-sectional survey.

OBJECTIVE: Although distance has been identified as an important barrier to care, evidence for an effect of distance to care on child mortality is inconsistent. We investigated the association of distance to care with self-reported care seeking behaviours, neonatal and post-neonatal under-five child mortality in rural areas of Burkina Faso. METHODS: We performed a cross-sectional survey in 14 rural areas from November 2014 to March 2015. About 100 000 women were interviewed on their pregnancy history and about 5000 mothers were interviewed on their care seeking behaviours. Euclidean distances to the closest facility were calculated. Mixed-effects logistic and Poisson regressions were used respectively to compute odds ratios for care seeking behaviours and rate ratios for child mortality during the 5 years prior to the survey. RESULTS: Thirty per cent of the children lived more than 7 km from a facility. After controlling for confounding factors, there was a strong evidence of a decreasing trend in care seeking with increasing distance to care (P ≤ 0.005). There was evidence for an increasing trend in early neonatal mortality with increasing distance to care (P = 0.028), but not for late neonatal mortality (P = 0.479) and post-neonatal under-five child mortality (P = 0.488). In their first week of life, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 1.00, 1.39; P = 0.056). In the late neonatal period, despite the lack of evidence for an association of mortality with distance, it is noteworthy that rate ratios were consistent with a trend and similar to or larger than estimates in early neonatal mortality. In this period, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 0.92, 1.52; P = 0.202). Thus, the lack of evidence may reflect lower power due to fewer deaths rather than a weaker association. CONCLUSION: While better geographic access to care is strongly associated with increased care seeking in rural Burkina Faso, the impact on child mortality appears to be marginal. This suggests that, in addition to improving access to services, attention needs to be paid to quality of those services