Résection trans urétrale de la prostate : première expérience à Bukavu, RD Congo: Transurethral resection of the prostate: pilot experience in Bukavu, DR Congo

Context and objective. Despite its large use as alternative to open surgical adenomectomy, transurethral resection of the prostate (TURP) is still poorly performed in many African countries. The purpose of this study was to describe a pilotTURP experience in Bukavu. Methods.This retrospective study included 159 patients (average age: 68 ± 8.5 years) with benign prostatic hypertrophy (BPH), treated at three medical centres in Bukavu between February 2014 andFebruary 2017. Socio-demographic, clinical, and ultrasound data were recorded, and comorbidities and complications reported. Each patient was questionned about treatment received before surgery. Results. The average prostatic volume was 53.2 ± 22 grams. All patients were severelysymptomatic (mean International Prostate Symptoms Score (IPSS) 26.8 ± 5.8) and severely bored (mean quality of life score (QOL) 6.2 ± 0.8).Hypertension (42%) and type 2 diabetes (41%) were the most common comorbidities. The most frequent complications of BPH were urinary tractinfection (44%) and urinary retention (40%). Prior to hospital admission, 60% of patients used traditional medicine. Conclusion.This study has revealed a late reference of patients to the hospital, when the illness is already in advanced stage with complications. There is a need of implementing educational measures targeting early detection and reference of patients with BPH in this area. Résumé Contexte et objectif. Bien que la résection trans urétrale de la prostate (RTUP) se soit imposée comme alternative à l’adénomectomie chirurgicale classique à ciel ouvert, sa pratique reste exceptionnelle dans quelques contrées africaines. L’objectif de la présente étude était de décrire la première expérience de la RTUP à Bukavu. Méthodes. La présente étude documentaire a porté sur 159 patients avec hypertrophie bénigne de la prostate (HBP), opérés dans 3 centres médicaux de Bukavu entre février 2014 et février 2017. Les paramètres d’intérêts comprenaient les données sociodémographiques, cliniques, échographiques les comorbidités, les complications et l’attitude thérapeutique avant l’intervention. Résultats. Leur âge moyen était de 68±8,5 ans. Le volume prostatique moyen était de 53,2 ± 22 grammes. Tous les patients étaient sévèrement symptomatiques (score international des symptômes prostatiques (IPSS) moyen de 26,8 ± 5,8) et fortement ennuyés (score de la qualité de vie (QOL) moyen de 6,2 ± 0,8). L’hypertension artérielle (42%) et le diabète sucré de type 2 (41 %) étaient les comorbidités les plus fréquentes. Les complications de l’HBP les plus fréquentes étaient l’infection urinaire (44 %) et la rétention urinaire (40%). Avant l’admission à l’hôpital, 60% des patients ont eu recours à la médecine traditionnelle. Conclusion. L’avènement de la RTUP à Bukavu a permis de déceler que la majorité des patients avec HBP consultent très tardivement au stade de sevérité symptomatique et des complications. Une campagne d’éducation, information et communication de la population sur le dépistage précoce de l’HBP est à envisager

Temperature-dependent trade-offs in maternal investments: An experimental test with two closely related soil microarthropods

Organisms face trade-offs in their reproductive investment due to energetic constraints. Yet, little is known about how such investments may change at different temperatures, and particularly so in soil invertebrate organisms. Here, we studied two Collembola species (Folsomia candida and Proisotoma minuta) using a long term (several generations) temperature incubation experiment (separately at 15 and 20 ◦C) to investigate how egg size and egg numbers and the trade-off between the two are affected in two temperature regimes. Both species are known to grow at these temperatures, but the variation in their reproductive strategies are little known. Our results show that egg sizes of F. candida were larger in colder temperature whereas no such patterns were found in P. minuta. By contrast, we found no effect of the two temperatures on egg numbers (per clutch) in any of the species. Moreover, we observed a negative correlation (indication of a potential trade-off) between egg size and egg numbers (per clutch) at colder temperature in F. candida, which disappeared in warmer temperature in the same species. No such trade-offs were found in P. minuta. Our results highlight that temperature effects on maternal investments are both trait- and species-specific, particularly when Collembola species are within their optimal thermal niches

Sky-averaged 21-cm signal extraction using multiple antennas with an SVD framework: the REACH case

In a sky-averaged 21-cm signal experiment, the uncertainty on the extracted signal depends mainly on the covariance between the foreground and 21-cm signal models. In this paper, we construct these models using the modes of variation obtained from the Singular Value Decomposition of a set of simulated foreground and 21-cm signals. We present a strategy to reduce this overlap between the 21-cm and foreground modes by simultaneously fitting the spectra from multiple different antennas, which can be used in combination with the method of utilizing the time dependence of foregrounds while fitting multiple drift scan spectra. To demonstrate this idea, we consider two different foreground models (i) a simple foreground model, where we assume a constant spectral index over the sky, and (ii) a more realistic foreground model, with a spatial variation of the spectral index. For the simple foreground model, with just a single antenna design, we are able to extract the signal with good accuracy if we simultaneously fit the data from multiple time slices. The 21-cm signal extraction is further improved when we simultaneously fit the data from different antennas as well. This improvement becomes more pronounced while using the more realistic mock observations generated from the detailed foreground model. We find that even if we fit multiple time slices, the recovered signal is biased and inaccurate for a single antenna. However, simultaneously fitting the data from different antennas reduces the bias and the uncertainty by a factor of 2-3 on the extracted 21-cm signal.Comment: 12 pages, 13 figures. Accepted for publication in MNRAS. Accompanying code is available https://github.com/anchal-009/SAVED21c

Biological inflammatory markers mediate the effect of preoperative pain-related behaviours on postoperative analgesics requirements

Peer reviewedPublisher PD

Interconnectivity between volume transports through Arctic straits

Arctic heat and freshwater budgets are highly sensitive to volume transports through the Arctic‐Subarctic straits. Here we study the interconnectivity of volume transports through Arctic straits in three models; two coupled global climate models, one with a third‐degree horizontal ocean resolution (HiGEM1.1) and one with a twelfth‐degree horizontal ocean resolution (HadGEM3), and one ocean‐only model with an idealized polar basin (tenth‐degree horizontal resolution). The two global climate models indicate that there is a strong anti‐correlation between the Bering Strait throughflow and the transport through the Nordic Seas, a second strong anti‐correlation between the transport through the Canadian Artic Archipelago (CAA) and the Nordic Seas transport, and a third strong anti‐correlation is found between the Fram Strait and the Barents Sea throughflows. We find that part of the strait correlations is due to the strait transports being coincidentally driven by large‐scale atmospheric forcing patterns. However, there is also a role for fast wave adjustments of some straits flows to perturbations in other straits since atmospheric forcing of individual strait flows alone cannot lead to near mass balance fortuitously every year. Idealized experiments with an ocean model (NEMO3.6) that investigate such causal strait relations suggest that perturbations in the Bering Strait are compensated preferentially in the Fram Strait due to the narrowness of the western Arctic shelf and the deeper depth of the Fram Strait

An approach to melodic segmentation and classification based on filtering with the Haar wavelet

We present a novel method of classification and segmentation of melodies in symbolic representation. The method is based on filtering pitch as a signal over time with the Haar-wavelet, and we evaluate it on two tasks. The filtered signal corresponds to a single-scale signal ws from the continuous Haar wavelet transform. The melodies are first segmented using local maxima or zero-crossings of ws. The segments of ws are then classified using the k–nearest neighbour algorithm with Euclidian and city-block distances. The method proves more effective than using unfiltered pitch signals and Gestalt-based segmentation when used to recognize the parent works of segments from Bach’s Two-Part Inventions (BWV 772–786). When used to classify 360 Dutch folk tunes into 26 tune families, the performance of the method is comparable to the use of pitch signals, but not as good as that of string-matching methods based on multiple features

Self-Similarity in General Relativity \endtitle

The different kinds of self-similarity in general relativity are discussed, with special emphasis on similarity of the ``first'' kind, corresponding to spacetimes admitting a homothetic vector. We then survey the various classes of self-similar solutions to Einstein's field equations and the different mathematical approaches used in studying them. We focus mainly on spatially homogenous and spherically symmetric self-similar solutions, emphasizing their possible roles as asymptotic states for more general models. Perfect fluid spherically symmetric similarity solutions have recently been completely classified, and we discuss various astrophysical and cosmological applications of such solutions. Finally we consider more general types of self-similar models.Comment: TeX document, 53 page

Effects of highly active antiretroviral therapy with nelfinavir in vertically HIV-1 infected children: 3 years of follow-up. Long-term response to nelfinavir in children

BACKGROUND: Antiretroviral treatment (ART) in children has special features and consequently, results obtained from clinical trials with antiretroviral drugs in adults may not be representative of children. Nelfinavir (NFV) is an HIV-1 Protease Inhibitor (PI) which has become as one of the first choices of PI for ART in children. We studied during a 3-year follow-up period the effects of highly active antiretroviral therapy with nelfinavir in vertically HIV-1 infected children. METHODS: Forty-two vertically HIV-infected children on HAART with NFV were involved in a multicentre prospective study. The children were monitored at least every 3 months with physical examinations, and blood sample collection to measure viral load (VL) and CD4+ cell count. We performed a logistic regression analysis to determinate the odds ratio of baseline characteristics on therapeutic failure. RESULTS: Very important increase in CD4+ was observed and VL decreased quickly and it remained low during the follow-up study. Children with CD4+ <25% at baseline achieved CD4+ >25% at 9 months of follow-up. HIV-infected children who achieved undetectable viral load (uVL) were less than 40% in each visit during follow-up. Nevertheless, HIV-infected children with VL >5000 copies/ml were less than 50% during the follow-up study. Only baseline VL was an important factor to predict VL control during follow-up. Virological failure at defined end-point was confirmed in 30/42 patients. Along the whole of follow-up, 16/42 children stopped HAART with NFV. Baseline characteristics were not associated with therapeutic change. CONCLUSION: NFV is a safe drug with a good profile and able to achieve an adequate response in children