15 research outputs found

    Multi-Sensorial Interface for 3D Teleoperation at Micro and Nanoscale

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    International audienceThis paper presents the design of a new tool for 3D manipulations at micro and nanoscale based on the coupling between a high performance haptic system (the ERGOS system) and two Atomic Force Microscope (AFM) probes mounted on quartz tuning fork resonators, acting as a nano tweezers. This unique combination provides new characteristics and possibilities for the localization and manipulation of (sub)micronic objects in 3 dimensions. The nano robot is controlled through a dual sensorial interface including 3D haptic and visual rendering, it is capable of performing a number of real-time tasks on different samples in order to analyse their dynamic effects when interacting with the AFM tips. The goal is then to be able to compare mechanical properties of different matters (stiffness of soft or hard matter) and to handle submicronic objects in 3 dimensions

    Awareness of rabies control and challenges to the intersectoral management of dog bites in Western Cameroon

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    Abstract Background: Rabies is a zoonotic and a typical One Health challenge. Intersectoral surveillance is a critical component of rabies control programmes. However, the under-reporting of animal bite cases and the lack of coordination between sectors involved in the surveillance may lead to failure in the control efforts of this public health concern. Methods: A cross-sectional study was conducted at the operational level. Two separate survey grids were used for simultaneous data collection in the study sites, including 385 dog bite victims within communities and 273 human health and animal health professionals responsible for rabies surveillance in health and veterinary facilities Results: There was no association (OR: 0,76; CI: 0,452-1,39 and p=0.38) between data loss and professional profile of the surveillance focal points; however, there was a significant association between the under-reporting of physical aggression cases of dog bites by victims and the level of education (OR: 1.75; IC:1.02-2.99 and P=0.0413), and with individuals younger than 20 years and those over 50 years of age (OR:0.39; CI:0.16-0.96 and p=0.0415). Indeed, there was a positively and statistically significant association (OR: 3.11; CI: 1.94-5.00 and p<0.0001) between knowledge of rabies with under-reporting of dog bites by community members; while negatively associated CI: 0.52-1.82 and p=0.9226) with the level of education. Interestingly, there was no significant difference in the under-performance in case reporting whether the surveillance focal points had received prior training on rabies surveillance (OR: 1.14; CI: 0.64-2.01 and p=0.66), had knowledge of operational case definition (OR: 0.93; CI: 0.54- 1.58 and p=0.7851) or /and knew the manifestation of rabies (OR: 0.88; CI: 0.51-1.51and p=0.6408). Conclusion: The under-reporting of rabies bites in the West region of Cameroon is as a consequence of negligence and lack of application of the one health approach on rabies surveillance by the surveillance focal points in District health sectors, leading to the no-exhaustive collection and patchy dissemination of dog bite data

    Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

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    Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

    Le sanctuaire de 'La Taille Marie' Ă  Aiseau-Presles: Campagne de fouilles 2014

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    Présentation de la campagne de fouilles menée à Aiseau-Presles (Ht, Belgique) durant l'été 2014

    Comment définir et diagnostiquer la dénutrition chez le sujet obèse ?

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    National audienceUndernutrition in the obese patient, like the non-obese patient, has numerous clinical consequences and leads to an increase in morbidity and mortality, but it is still underestimated. It is therefore imperative to prevent, detect and manage it as early as possible especially in patients at risk or weakened by a chronic disease. However, the definition and diagnostic criteria for undernutrition in non-obese adult subjects are flawed due to the clinical, morphological and biological characteristics associated with excessive adiposity. In an area where there is no consensus, the aim of this review is to highlight the difficulties in assessing undernutrition in this circumstance and to clarify the parameters of undernutrition assessment and their limits in the situation of obesity.La dénutrition chez le patient obèse, à l’instar du patient non obèse, expose à de nombreuses conséquences cliniques et aboutit à un accroissement de la morbi-mortalité mais reste fortement sous-estimée. Il est donc impératif de la prévenir, de la dépister et de la prendre en charge le plus tôt possible surtout chez les patients à risque ou fragilisés par une maladie chronique. Cependant, la définition et les critères de diagnostic de la dénutrition destinés aux sujets adultes non obèses sont mis en défaut en raison des particularités cliniques, morphologiques et biologiques liées à l’adiposité excessive. Dans un domaine où il n’existe pas de consensus, cette synthèse a pour objectif de souligner les difficultés d’appréciation de la dénutrition dans cette circonstance et d’apporter des éclaircissements sur les paramètres de l’évaluation de la dénutrition et leurs limites en situation d’obésité
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