Caractérisation physico-chimique et microbiologique du mulet jaune (Mugil cephalus) séché-pilé « Lekhlia » d’origine Imraguen, Mauritanie

Lekhlia est un produit d’origine Imraguen en Mauritanie, fabriqué à base de poisson (mulet jaune séchépilé). Un totale de 163 échantillons de Lekhlia ont été prélevés à partir de 7 villages imraguen et évalués pour leurs qualités physico-chimiques et microbiologiques. Les résultats obtenus ont montré des teneurs moyennes de 65,33% en protéines, de 12,33% en matière grasse, de 9,21% en cendres, de 9,63% en taux d’humidité et de 1,02 mg/100g en histamine. La valeur moyenne en FMAT est de 17,30 104 ufc/g. Les charges moyennes des germes témoins de la contamination fécale sont de 0,74 102 et 3,66 ufc/g respectivement pour les coliformes totaux et fécaux. La flore fongique est de 1,70 103 ufc/g. Cependant, aucun germe pathogène n’a été détecté dans les produits analysés.Mots-clés : Imraguen, mulet jaune, Lekhlia, qualité, Mauritanie

Implementation of a novel continuous fetal Doppler (Moyo) improves quality of intrapartum fetal heart rate monitoring in a resource-limited tertiary hospital in Tanzania: An observational study

Background Intrapartum Fetal Heart Rate (FHR) monitoring is crucial for the early detection of abnormal FHR, facilitating timely obstetric interventions and thus the potential reduction of adverse perinatal outcomes. We explored midwifery practices of intrapartum FHR monitoring pre and post implementation of a novel continuous automatic Doppler device (the Moyo). Methodology A pre/post observational study among low-risk pregnancies at a tertiary hospital was conducted from March to December 2016. In the pre-implementation period, intermittent monitoring was conducted with a Pinard stethoscope (March to June 2016, n = 1640 women). In the post-implementation period, Moyo was used for continuous FHR monitoring (July-December 2016, n = 2442 women). The primary outcome was detection of abnormal FHR defined as absent, FHR160bpm. The secondary outcomes were rates of assessment/documentation of FHR, obstetric time intervals and intrauterine resuscitations. Chi-square test, Fishers exact test, t-test and Mann-Whitney U test were used in bivariate analysis whereas binary and multinomial logistic regression were used for multivariate. Results Moyo use was associated with greater detection of abnormal FHR (8.0%) compared with Pinard (1.6%) (p Conclusion Implementation of the Moyo device, which continuously measures FHR, was associated with improved quality in FHR monitoring practices and the detection of abnormal FHR. These improvements led to more frequent and timely obstetric responses. Follow-up studies in a high-risk population focused on a more targeted description of the FHR abnormalities and the impact of intrauterine resuscitation is a critical next step in determining the effect on reducing perinatal mortality

Ogden Material Calibration via Magnetic Resonance Cartography, Parameter Sensitivity, and Variational System Identification

Contemporary techniques in the mechanical calibration of materials that leverage full three-dimensional deformation fields and the weak form of the equilibrium equations face challenges in the numerical solving procedure of the inverse characterization problem. As material models and descriptions differ, so too must the approaches for identifying their system mechanics. The widely-used Ogden material model, comprised of an unknown number of terms of the same mathematical form, presents challenges in interpretability, stability, and parsimony. In turn, we intend to use our estimates to assess and improve our experimental design. Using fully 3D displacement fields acquired in silicone elastomers using our recently-developed magnetic resonance cartography (MR-u) technique on the order of $>20,000$ points per sample, we leverage PDE-constrained optimization as the basis of variational system identification of our material parameters. We incorporate the statistical F-test to maintain parsimony of representation. Using a new decomposition of the deformation field locally into mixtures of biaxial and uniaxial tensile states, we evaluate experiments based on an analytical sensitivity metric, and discuss the implications for future experimental design.Comment: 16 pages, 7 figure

Recommendations to improve young and novice driver safety in the State of Qatar

Introduction: Young driver behavior and safety are key concerns in Qatar, where they are disproportionately represented amongst road victims and fatalities. This paper summarizes the proceedings of a workshop, entitled “Enhancing the Safety of Young and Novice Drivers in Qatar”, held as a pre-conference workshop of the 24th World Congress of the International Traffic Medicine Association (ITMA) in Doha, Qatar. Methods: A guided discussion was conducted amongst a selected multi-sectoral group of 50 stakeholders, representing Law Enforcement, Health, Society and Education, Transport, and Road Safety. Each group discussed the best evidence and local realities of young driver safety in the State of Qatar. Using a modified Delphi approach, key areas were identified and prioritized; consensus recommendations were obtained and summarized. Results: Based on the stakeholders’ discussions a list of twelve key recommendations has been developed and its elements have been classified in order of priority. These recommendations are supported by relevant published evidence as well as expert opinion and have been shared with the relevant authorities to inform future policies. Conclusions: This article summarizes the workshop presentations and the twelve key recommendations that arose from the discussions and put them forward to the concerned authorities. It should be emphasized that the concerned authorities concerned need to take action on at least the top three recommendations (GDL, improved police enforcement, and improved licensing and training), but also to prioritize all other recommendations that can be easily addressed such as improved roads and auditing and risk-based insurance

Pathogenetic mechanisms of sepsis and their therapeutics implications

Este artigo apresenta uma revisão recente e objetiva dos principais mecanismos fisiopatológicos envolvidos na sepse, destacando o papel do endotélio vascular e a produção das diversas citocinas. Define a síndrome da resposta inflamatória sistêmica (SIRS) e a sepse, nos seus diversos graus de acometimento sistêmico. Mostra as disfunções produzidas pela sepse, nos diversos sistemas orgânicos, correlacionando-as com sua manifestação clínica, laboratorial e aos dados de monitorização hemodinâmica invasiva. Ao mesmo tempo, fornece as linhas gerais para o diagnóstico, avaliação da gravidade, monitorização e implicações terapêuticas, bem como as tendências terapêuticas atuais.This article presents a recent and objetive review of the pathogenetic mechanisms involved in sepsis, particularly the endothelial and mediators (citokines) role. It presents definitions for systemic inflammatory response syndrome and sepsis with its continuum of clinical and pathophysiologic severity. The organics dysfunctions were showed with its clinical, laboratorial and hemodynamics manifestations. The basic principles of management were discussed as well as new therapeutic approaches

The recent development of protection coordination schemes based on inverse of AC microgrid: A review

Integration of distributed generation systems and diversity of microgrid operations led to a change in the structure of the power system. Due to this conversion, new challenges have arisen when employing traditional overcurrent protection schemes. As a consequence, non‐classical protection schemes have attracted significant attention in the last few years. Engineers and scholars have proposed different non‐standard methods to increase the power protection system and ensure the highly selectivity performance. Although the non‐standard characteristics and their requirements, in general, have been outlined and analyzed in the available literature, protection coordination based on voltage current–time inverse, as a branch of non‐standard optimization methods, has not yet been thoroughly discussed, compared, or debated in detail. To close this gap, this review introduces a broad overview of recent research and developments of the voltage current–time inverse based protection coordination. Focuses on assessing the potential advantages and disadvantages of related studies and provide a classification and analysis of these studies. The future trends and some recommendations have been included in this review for improving fault detection sensitivity and coordination reliability

Novel Textbook Outcomes following emergency laparotomy: Delphi exercise

Background: Textbook outcomes are composite outcome measures that reflect the ideal overall experience for patients. There are many of these in the elective surgery literature but no textbook outcomes have been proposed for patients following emergency laparotomy. The aim was to achieve international consensus amongst experts and patients for the best Textbook Outcomes for non-trauma and trauma emergency laparotomy. Methods: A modified Delphi exercise was undertaken with three planned rounds to achieve consensus regarding the best Textbook Outcomes based on the category, number and importance (Likert scale of 1–5) of individual outcome measures. There were separate questions for non-trauma and trauma. A patient engagement exercise was undertaken after round 2 to inform the final round. Results: A total of 337 participants from 53 countries participated in all three rounds of the exercise. The final Textbook Outcomes were divided into ‘early’ and ‘longer-term’. For non-trauma patients the proposed early Textbook Outcome was ‘Discharged from hospital without serious postoperative complications (Clavien–Dindo ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation or death). For trauma patients it was ‘Discharged from hospital without unexpected transfusion after haemostasis, and no serious postoperative complications (adapted Clavien–Dindo for trauma ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation on or death)’. The longer-term Textbook Outcome for both non-trauma and trauma was ‘Achieved the early Textbook Outcome, and restoration of baseline quality of life at 1 year’. Conclusion: Early and longer-term Textbook Outcomes have been agreed by an international consensus of experts for non-trauma and trauma emergency laparotomy. These now require clinical validation with patient data

A new approach to assessing the health benefit from obesity interventions in children and adolescents: the assessing cost-effectiveness in obesity project

OBJECTIVE: To report on a new modelling approach developed for the assessing cost-effectiveness in obesity (ACE-Obesity) project and the likely population health benefit and strength of evidence for 13 potential obesity prevention interventions in children and adolescents in Australia. METHODS: We used the best available evidence, including evidence from non-traditional epidemiological study designs, to determine the health benefits as body mass index (BMI) units saved and disability-adjusted life years (DALYs) saved. We developed new methods to model the impact of behaviours on BMI post-intervention where this was not measured and the impacts on DALYs over the child\u27s lifetime (on the assumption that changes in BMI were maintained into adulthood). A working group of stakeholders provided input into decisions on the selection of interventions, the assumptions for modelling and the strength of the evidence. RESULTS: The likely health benefit varied considerably, as did the strength of the evidence from which that health benefit was calculated. The greatest health benefit is likely to be achieved by the \u27Reduction of TV advertising of high fat and/or high sugar foods and drinks to children\u27, \u27Laparoscopic adjustable gastric banding\u27 and the \u27multi-faceted school-based programme with an active physical education component\u27 interventions. CONCLUSIONS: The use of consistent methods and common health outcome measures enables valid comparison of the potential impact of interventions, but comparisons must take into account the strength of the evidence used. Other considerations, including cost-effectiveness and acceptability to stakeholders, will be presented in future ACE-Obesity papers. Information gaps identified include the need for new and more effective initiatives for the prevention of overweight and obesity and for better evaluations of public health interventions