Peripheral precocious puberty including congenital adrenal hyperplasia: causes, consequences, management and outcomes

Peripheral precocious puberty results from peripheral production of sex steroids independent of activation of the hypothalamic-pituitary gonadal axis. It is much less common than central precocious puberty. Causes are variable and can be congenital or acquired. In this review, we will discuss the diagnosis and management of the most common etiologies including congenital adrenal hyperplasia, McCune Albright syndrome, familial male-limited precocious puberty, and adrenal and gonadal tumors

Effect of propagation phenomena on MIMO capacity of wireless systems between 3 and 10GHz

International audience— Multiple Input Multiple Output (MIMO) Antenna systems promise high spectral efficiency [1] over multipath channels. But accurate wideband MIMO channels models are required to optimize these new radio access schemes. This paper focuses on the MIMO channel capacity versus different propagation channel parameters such as frequency or antenna type. This study is based on both experimental and simulated results in a residential environment. The simulations have been computed with a full 3D ray tracing tool while measurements have been performed with a UWB MIMO channel sounder

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Incidence de la technique d’irrigation sur la pénétration en profondeur de la solution d’irrigation dans les tubules dentinaires – Étude in vitro

The irrigation of the endodontic system depends on two factors : the irrigant and the method of irrigation. Sodium Hypochlorite remains the irrigant of choice of the endodotist. Its ultrasonic activation has proven to improve its cleaning ability on the walls. Its effect on bacteria inside dentinal tubules still needs to be investigated. To measure the degree of penetration inside the tubules, the use of a dye marker with static and dynamic methods is compared

Ellipses and Fragments: linguistic means of decolonization in Joyce’s Dubliners

This paper traces Joyce’s linguistic techniques of void and gaps as he went about when writing Dubliners, and reveals what is implied in some of the stories and most importantly shows how through ellipses and fragments, his characters’ attempt to achieve decolonization. The main issue of explicit communication in colonial societies is replaced by such linguistic aspects where postcolonial writers like James Joyce tend to express their ideas of decolonization through the implicitness of language to deliver political messages. Hence, and in order to solve the problem of the explicit limitations of language, this paper attempts to reveal the covert messages of the stories by studying ellipses and fragments. While void and gaps portray negative connotations, the methodology used here to fill in the blanks of ellipses and fragments focuses on the information investigated, explored and then implemented by the reader to complete the unfinished thoughts and solve Joyce’s mysteries. Filling out ellipses are investigated mainly in the stories of “The Sisters” and “A Little Cloud” where characters are helped by the reader, who fills out these ellipses, to escape their colonial ordeals into a more hopeful world. Similarly, fragments show the characters’ struggle to achieve linguistic decolonization by completing the unfinished thoughts and utterances especially in the stories of “Eveline” and “Clay”. By analysing the discourse that takes place between the characters in these stories, the reader may reveal what has been left implied and will show how by filling out ellipses and completing fragments, characters may achieve decolonization. Additionally, the role of annexes in this article gives a more concrete proof of the use of ellipses and fragments as decolonial tools by presenting statistics of their usage in the stories and thoroughly analysing their implicit interpretations. Ultimately, findings will prove that those who struggle with the explicitness of censoredl anguage in politically disturbed environments will find other means to express their thoughts of freedom through the analysis of what language implies and not what is overtly expressed. Thus, the readers are allowed to reconstruct ellipses and fragments to come up with more comprehensible ideas of what is linguistically required to achieve decolonization

A Scoping Review on the Characteristics of Human Exposome Studies

Embraced as a breaking through methodological framework, the exposome is accompanied by novel exposure assessment methods and data processing tools or models. However, systematic mapping of the landscape of exposome studies, including their characteristics, components, tools and language has not been done so far. We conducted a scoping review to answer the question: “Which main domains of the human exposome have been included in the literature and which metrics of exposure(s)/outcome(s) have been used?” We performed a comprehensive search of human studies containing the word “exposom*” and published up to March 8, 2019. We screened 1133 records and 82 studies were included in the analysis. Most studies took place in Europe. Data analysis showed the non-systematic use of the exposome term. Most studies had a longitudinal design (n = 30, 37%), were conducted on adults (n = 40, 51%), and had a clearly defined health outcome in methodology (n = 48, 61%). Omics tools, such as metabolomics were used in 38 studies (49%), while environment-wide association analysis was used in 9 studies (11%). Thirty-seven (48%) studies included all three exposome domains (general external, specific external and internal) while 33 (42%) studies included two. Despite the large number of environmental components that comprise each of the exposome domains, only a subset has been currently studied. An optimized consideration of the components from all exposome domains, as well as the standardization of the exposure and outcome assessment methods is warranted to advance the utility of the human exposome concept

Synchronisation des étapes cliniques et de laboratoire d’une réhabilitation totale maxillaire et mandibulaire par prothèse composite : cas clinique

The total prosthetic rehabilitation by associated prosthesis seeks to redefine aesthetic criteria, restore good occlusal stability, and optimize the functions of the masticatory apparatus.The development of a sequential treatment plan for such cases and the systematic synchronization of clinical and laboratory steps are essential to their success. In this article, we present a clinical case whose management and implementation of treatment required a fundamental synchronization of the clinical and laboratory stages: initial periodontal preparation, extraction of unfavorable teeth, fixed temporization, indirect post and core, cross mounting leading to maxillary fixed prostheses and a mandibular skeletal prosthesis combined to fixed prostheses. Later, the mandibular removable prosthesis was replaced by implants and fixed prostheses