0541: Management of heart failure: experiences in African patients

AimTo determine clinical characteristics and mode of treatment of patients with heart failure in Yaounde military hospital (YMH).MethodsData of patients with heart failure (HF) followed on a period of 6 months in YMH were used to determine clinical characteristics and mode of treatment.ResultsA total of 72 patients were consecutively studied comprising 45 men (62.5%) and 27 women (37.5%) aged 62.8±16.5 and 61.1±19.4 years, respectively. All the patients presented with NYHA functional class III or IV. Alcohol was the most common etiological factor of HF (66.7%) hypertension was the most common risk factor for HF (37.5%) while only 16.7% of the patients were smokers. Global heart failure was the common presentation (60.9%). Left bundle branch was present in 47% of electrocardiograms while 8.7% of the patients were in atrial fibrillation. Dilated cardiomyopathy was the common lesion (80%). Most patients presented with severe left ventricular (LV) systolic dysfunction (66.6%). Male subjects had worse LV systolic dys-function compare to women without significant difference (56.3% vs 43.8% p=0.8). Diabete was not associated with severe LV dysfunction (78.9% on non diabetic vs 6.3% of diabetic patients). Current recommended pharmacology therapies were used in most of the cases. Diuretics were used in 100% while ACE inhibitors were in 91.3% of cases. 52.4% of patients had beta blockers.ConclusionMost heart failure patients in Cameroon present in the sixth decade with severe heart failure. All the recommended therapies are not available in our country

Quality of nutritional status assessment and its relationship with the effect of rainfall on childhood stunting: a cross-sectional study in rural Burkina Faso

Objectives: In Burkina Faso, one in every four children under 5 years is stunted. Climate change will exacerbate childhood stunting. Strengthening the health system, particularly the quality of nutrition care at primary health facilities, can minimise the adverse climate effect on stunting. Thus, we examined the quality of nutritional status assessment (QoNA) during curative childcare services in primary health facilities in rural Burkina Faso and its relationship with rainfall-induced childhood stunting. Study design: We conducted a cross-sectional analysis using anthropometric, rainfall, and clinical observation data. Methods: Our dependent variable was the height-for-age z-score (HAZ) of children under 2 years. Our focal climatic measure was mean rainfall deviation (MRD), calculated as the mean of the difference between 30-year monthly household-level rainfall means and the corresponding months for each child from conception to data collection. QoNA was based on the weight, height, general paleness and oedema assessment. We used a mixed-effect multilevel model and analysed heterogeneity by sex and socio-economic status. Results: Among 5027 young (3–23 months) children (mean age 12 ± 6 months), 21% were stunted (HAZ ≤ −2). The mean MRD was 11 ± 4 mm, and the mean QoNA was 2.86 ± 0.99. The proportion of children in low, medium, and high QoNA areas was 10%, 54%, and 36%, respectively. HAZ showed a negative correlation with MRD. Higher QoNA lowered the negative effect of MRD on HAZ (β = 0.017, P = 0.003, confidence interval = [0.006, 0.029]). Males and children from poor households benefited less from the moderating effect of QoNA. Conclusion: Improving the quality of nutrition assessments can supplement existing efforts to reduce the adverse effects of climate change on children's nutritional well-being

Restricted Application of Insecticides: A Promising Tsetse Control Technique, but What Do the Farmers Think of It?

Restricted application of insecticides to cattle is a cheap and safe farmer-based method to control tsetse and the diseases they transmit, i.e. human and animal African trypanosomoses. The efficiency of this new control method has been demonstrated earlier but no data is available on its perception and adoption intensity by farmers. We studied these two features in Burkina Faso, where the method has diffused thanks to two development projects. The study allowed identifying three groups of farmers with various adoption intensities, of which one was modern and two traditional. The economic benefit and the farmers' knowledge of the epidemiological system appeared to have a low impact on the early adoption process whereas some modern practices, as well as social factors appeared critical. The quality of technical support provided to the farmers had also a great influence on the adoption rate. The study highlighted individual variations in risk perceptions and benefits, as well as the prominent role of the socio-technical network of cattle farmers. The results of the study are discussed to highlight the factors that should be taken into consideration, to move discoveries from bench to field for an improved control of trypanosomoses vectors

Marine climate change risks to biodiversity and society in the ROPME Sea Area

The subtropical ROPME Sea Area (RSA), comprising the Gulf, the Gulf of Oman and the northern Arabian Sea, is a heavily exploited sea region that experiences extreme environmental conditions, and for which climate change is expected to further impact marine ecosystems and coastal communities, sectors and industries. Climate change risk assessments provide a valuable tool to inform decision-making and adaptation planning through identifying and prioritising climate risks and/or opportunities. Using the first UK Climate Change Risk Assessment as an example, a marine climate change risk assessment was undertaken for the marine and coastal environment of the RSA for the first time. Through an extensive literature review and a workshop involving regional experts, marine and coastal climate change risks were identified, scored and prioritised. A total of 45 risks were identified, which spanned two key themes: ‘Risks to Biodiversity’ and ‘Risks to Economy and Society’. Of these, 13 were categorised as ‘severe’, including degradation of coral reefs and their associated ecological assemblages, shifts in the distribution of wild-capture fisheries resources, changes to phytoplankton primary productivity, impacts on coastal communities, threats to infrastructure and industries, and impacts on operations and safety in maritime transport. The diversity of risks identified and their transboundary nature highlight that climate change adaptation responses will require coordinated action and cooperation at multiple scales across the RSA. This risk assessment provides a crucial baseline for a largely overlooked geographic area, that can be used to underpin future decision-making and adaptation planning on climate change, and serve as a ‘blueprint’ for similar assessments for other regional shared seas

Inequities and their determinants in coverage of maternal health services in Burkina Faso

Background: Poor and marginalized segments of society often display the worst health status due to limited access to health enhancing interventions. It follows that in order to enhance the health status of entire populations, inequities in access to health care services need to be addressed as an inherent element of any effort targeting Universal Health Coverage. In line with this observation and the need to generate evidence on the equity status quo in sub-Saharan Africa, we assessed the magnitude of the inequities and their determinants in coverage of maternal health services in Burkina Faso. Methods: We assessed coverage for three basic maternal care services (at least four antenatal care visits, facility-based delivery, and at least one postnatal care visit) using data from a cross-sectional household survey including a total of 6655 mostly rural, poor women who had completed a pregnancy in the 24 months prior to the survey date. We assessed equity along the dimensions of household wealth, distance to the health facility, and literacy using both simple comparative measures and concentration indices. We also ran hierarchical random effects regression to confirm the presence or absence of inequities due to household wealth, distance, and literacy, while controlling for potential confounders. Results: Coverage of facility based delivery was high (89%), but suboptimal for at least four antenatal care visits (44%) and one postnatal care visit (53%). We detected inequities along the dimensions of household wealth, literacy and distance. Service coverage was higher among the least poor, those who were literate, and those living closer to a health facility. We detected a significant positive association between household wealth and all outcome variables, and a positive association between literacy and facility-based delivery. We detected a negative association between living farther away from the catchment facility and all outcome variables. Conclusion: Existing inequities in maternal health services in Burkina Faso are likely going to jeopardize the achievement of Universal Health Coverage. It is important that policy makers continue to strengthen and monitor the implementation of strategies that promote proportionate universalism and forge multi-sectoral approach in dealing with social determinants of inequities in maternal health services coverage

MedShapeNet -- A Large-Scale Dataset of 3D Medical Shapes for Computer Vision

Prior to the deep learning era, shape was commonly used to describe the objects. Nowadays, state-of-the-art (SOTA) algorithms in medical imaging are predominantly diverging from computer vision, where voxel grids, meshes, point clouds, and implicit surface models are used. This is seen from numerous shape-related publications in premier vision conferences as well as the growing popularity of ShapeNet (about 51,300 models) and Princeton ModelNet (127,915 models). For the medical domain, we present a large collection of anatomical shapes (e.g., bones, organs, vessels) and 3D models of surgical instrument, called MedShapeNet, created to facilitate the translation of data-driven vision algorithms to medical applications and to adapt SOTA vision algorithms to medical problems. As a unique feature, we directly model the majority of shapes on the imaging data of real patients. As of today, MedShapeNet includes 23 dataset with more than 100,000 shapes that are paired with annotations (ground truth). Our data is freely accessible via a web interface and a Python application programming interface (API) and can be used for discriminative, reconstructive, and variational benchmarks as well as various applications in virtual, augmented, or mixed reality, and 3D printing. Exemplary, we present use cases in the fields of classification of brain tumors, facial and skull reconstructions, multi-class anatomy completion, education, and 3D printing. In future, we will extend the data and improve the interfaces. The project pages are: https://medshapenet.ikim.nrw/ and https://github.com/Jianningli/medshapenet-feedbackComment: 16 page

Influence of oxidation time on semiconductive behaviour of thermally grown oxide films on AISI 304L

International audienceThe oxide films formed on AISI 304L stainless steel at 300 °C in the oxidation time range between 2 and 4 h have been studied by photoelectrochemistry. Photocurrents were investigated as a function of the wavelength of the incident light and the electrode potential. The investigation allowed the determination of the semiconductive properties of the oxides. The oxide films showed n-type behaviour. A duplex structure of the oxide films has been suggested on the basis of the photocurrent spectra, with an internal oxide layer having an optical gap (Eg2 = 2.16–2.3 eV) depending on the applied potential and oxidation time, higher to that of the external oxide layer (Eg1 ≈ 1.9 eV). Significant variations in the amplitude of the photocurrent were detected as a function of the applied potential and the oxidation time

Characterization of Thin Anodically Grown Oxide Films on AISI 304L Stainless Steel

International audienceThe passivity and protective nature of the passive films are essentially related to ionic and electronic transport processes, which are controlled by the optical and electronic properties of passive films. Corrosion properties of passive films anodically formed on 304L stainless steel in borate/boric acid solution have been examined using electrochemical impedance spectroscopy (EIS). An electrical equivalent circuit based on the impedance analysis, which describes the behavior of the passive film on stainless steel more satisfactorily than the proposed models, is presented. The semiconducting properties of the passive films were also investigated by photoelectrochemistry. Effects of film-formation potential, film-formation time, and applied potential on the electronic properties were studied. Depending on the operating conditions, the optical bandgap values were estimated to vary from 2.1 to 2.75 eV. Both film resistance and bandgap were found to decrease with applied potential. Therefore, correlation between the two significant parameters was determined