Dysfunctional endometres in Libreville: 20 years retrospective study

Background: The objectives of this work were to inventory the different morphological entities, to alert the medical class to the need for multidisciplinary care; to sensitize the health authorities on this pathology having a considerable influence on the fertility of the woman and a possible evolution towards cancerous disease.Methods: A retrospective study was carried out over 20 years from January 1983 to December 2002 at the laboratory of anatomy pathology of the faculty of health sciences in Libreville. The revealing clinical signs were the couple's bleeding and infertility. Curettage, endometrial biopsy, and subtotal or total hysterectomy were fixed with 10% buffered formalin or Bouin's fluid. After staining, histological study was carried out by the pathologist.Results: The histological images of the endometrial polyps were the most representative (73 cases or 17.68%), followed by prolonged proliferative endometers (70 cases, or 16.95%), glandulo-cystic hyperplasia (66 cases, or 15.98%) and persistent proliferative endometers (58 cases, or 14.04%). More than half of the numbers concerned women under 35 (225/413 cases); in those over 45 years of age, the predominantly endometrial carcinoma was found. The most affected province was Woleu-Ntem (24%), followed by Haut-Ogooué (18%).Conclusions: The different dysfunctional endometers are also described in the different regions of the continent. The management of these aims to be multidisciplinary and urgently requires a frank collaboration between clinician and morphologist, especially for country where a birth policy is clearly expressed by governing bodies.

Circular bioeconomy potential and challenges within an African context: From theory to practice

A circular bioeconomy has the potential to minimize the environmental impacts of biowaste while simultaneously generating value-added bioproducts and bioenergy. Currently, most countries of the African Union lack well-defined policies, requisite infrastructure, and expertise for biowaste valorisation, thus limiting the potential development of the region. Against this background, it is necessary to deploy circular bioeconomy principles based on the awareness of the biocapacity of territories through the nexus of biowaste management and life cycle thinking. In the present study, a preliminary assessment of waste management practices in a tourist hotel in Victoria Falls in Zimbabwe is explored. The hotel produces about 3.26 tons per month of biowaste, which is often improperly disposed in non-engineered waste dumps. Furthermore, the disposal options for 1 tonne of biowaste are explored using City of Harare (CoH) as a case study. The preliminary results show composting as the most environmentally favourable option (9.6 kg CO2 eq), followed by anaerobic digestion (56.4 kg CO2 eq), and finally, biowaste incineration (140 kg CO2 eq). Anaerobic digestion and composting remain the most viable biowaste disposal alternatives in Africa, due to limited expenses and expertise for construction, operation, and maintenance. However, both technologies remain under-utilized, hence, a significant portion of the source-separated biowaste is still disposed of in waste dumps and this reflects the lack of supportive institutional, regulatory and policy frameworks. Overall, these early results point to the potential to develop a circular bioeconomy in Africa, while calling for shared responsibilities among the state, market, and civil society actors to develop and adopt appropriate institutional, regulatory, policy and funding models

Second T = 3/2 state in 9^9B and the isobaric multiplet mass equation

Recent high-precision mass measurements and shell model calculations~[Phys. Rev. Lett. {\bf 108}, 212501 (2012)] have challenged a longstanding explanation for the requirement of a cubic isobaric multiplet mass equation for the lowest $A = 9$ isospin quartet. The conclusions relied upon the choice of the excitation energy for the second $T = 3/2$ state in $^9$B, which had two conflicting measurements prior to this work. We remeasured the energy of the state using the $^9{\rm Be}(^3{\rm He},t)$ reaction and significantly disagree with the most recent measurement. Our result supports the contention that continuum coupling in the most proton-rich member of the quartet is not the predominant reason for the large cubic term required for $A = 9$ nuclei

Fine structure of the isoscalar giant monopole resonance in 58^{58}Ni, 90^{90}Zr, 120^{120}Sn and 208^{208}Pb

Over the past two decades high energy-resolution inelastic proton scattering studies were used to gain an understanding of the origin of fine structure observed in the isoscalar giant quadrupole resonance (ISGQR) and the isovector giant dipole resonance (IVGDR). Recently, the isoscalar giant monopole resonance (ISGMR) in $^{58}$Ni, $^{90}$Zr, $^{120}$Sn and $^{208}$Pb was studied at the iThemba Laboratory for Accelerator Based Sciences (iThemba LABS) by means of inelastic $\alpha$-particle scattering at very forward scattering angles (including $0\circ$). The good energy resolution of the measurement revealed significant fine structure of the ISGMR.~To extract scales by means of wavelet analysis characterizing the observed fine structure of the ISGMR in order to investigate the role of different mechanisms contributing to its decay width. Characteristic energy scales are extracted from the fine structure using continuous wavelet transforms. The experimental energy scales are compared to different theoretical approaches performed in the framework of quasiparticle random phase approximation (QRPA) and beyond-QRPA including complex configurations using both non-relativistic and relativistic density functional theory. All models highlight the role of Landau fragmentation for the damping of the ISGMR especially in the medium-mass region. Models which include the coupling between one particle-one hole (1p-1h) and two particle-two hole (2p-2h) configurations modify the strength distributions and wavelet scales indicating the importance of the spreading width. The effect becomes more pronounced with increasing mass number. Wavelet scales remain a sensitive measure of the interplay between Landau fragmentation and the spreading width in the description of the fine structure of giant resonances.Comment: 13 pages,7 figures, regular articl

Isoscalar giant monopole strength in 58^{58}Ni, 90^{90}Zr, 120^{120}Sn and 208^{208}Pb

Inelastic $\alpha$-particle scattering at energies of a few hundred MeV and very-forward scattering angles including $0^\circ$ has been established as a tool for the study of the isoscalar giant monopole (IS0) strength distributions in nuclei. An independent investigation of the IS0 strength in nuclei across a wide mass range was performed using the $0^\circ$ facility at iThemba Laboratory for Accelerator Based Sciences (iThemba LABS), South Africa, to understand differences observed between IS0 strength distributions in previous experiments performed at the Texas A\&M University (TAMU) Cyclotron Institute, USA and the Research Center for Nuclear Physics (RCNP), Japan. The isoscalar giant monopole resonance (ISGMR) was excited in $^{58}$Ni, $^{90}$Zr, $^{120}$Sn and $^{208}$Pb using $\alpha$-particle inelastic scattering with $196$ MeV $\alpha$ beam and scattering angles $\theta_{\text{Lab}} = 0^\circ$ and $4^\circ$. The K$600$ magnetic spectrometer at iThemba LABS was used to detect and momentum analyze the inelastically scattered $\alpha$ particles. The IS0 strength distributions in the nuclei studied were deduced with the difference-of-spectra (DoS) technique including a correction factor for the $4^\circ$ data based on the decomposition of $L > 0$ cross sections in previous experiments. IS0 strength distributions for $^{58}$Ni, $^{90}$Zr, $^{120}$Sn and $^{208}$Pb are extracted in the excitation-energy region $E_{\rm x} = 9 - 25$ MeV.Using correction factors extracted from the RCNP experiments, there is a fair agreement with their published IS0 results. Good agreement for IS0 strength in $^{58}$Ni is also obtained with correction factors deduced from the TAMU results, while marked differences are found for $^{90}$Zr and $^{208}$Pb.Comment: 12 pages, 10 figures, regular article submitted to PR

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49\ub74% (95% uncertainty interval [UI] 46\ub74–52\ub70). The TFR decreased from 4\ub77 livebirths (4\ub75–4\ub79) to 2\ub74 livebirths (2\ub72–2\ub75), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83\ub78 million people per year since 1985. The global population increased by 197\ub72% (193\ub73–200\ub78) since 1950, from 2\ub76 billion (2\ub75–2\ub76) to 7\ub76 billion (7\ub74–7\ub79) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2\ub70%; this rate then remained nearly constant until 1970 and then decreased to 1\ub71% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2\ub75% in 1963 to 0\ub77% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2\ub77%. The global average age increased from 26\ub76 years in 1950 to 32\ub71 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59\ub79% to 65\ub73%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1\ub70 livebirths (95% UI 0\ub79–1\ub72) in Cyprus to a high of 7\ub71 livebirths (6\ub78–7\ub74) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0\ub708 livebirths (0\ub707–0\ub709) in South Korea to 2\ub74 livebirths (2\ub72–2\ub76) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0\ub73 livebirths (0\ub73–0\ub74) in Puerto Rico to a high of 3\ub71 livebirths (3\ub70–3\ub72) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2\ub70% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury