Bilateral Axillary Supernumerary Breasts: A Case Report and Review of the Literature

Supernumerary breasts or hypermastia are due to the non-regression of mammary buds during embryogenesis, with mammary glandular tissue persisting in the milky line running from the axillary line to the anterointernal surface of the thigh.Diagnosis is difficult in the absence of a nipple, which confuses them with a lipoma or axillary adenopathy.We report the case of bilateral supernumerary breasts discovered in a 34-year-old patient and managed surgically

Chronic Bladder Retention Due to Lip Coalescence: A Case Report

Coalescence of the labia minora is defined as partial or complete adhesion of the labia minora. Complete labial fusion is a rare condition in adults. Coalescence of the labia minora generally occurs in early childhood and in prepubertal girls. It is a rare entity in women of childbearing age, except in cases of hypo oestrogenism. In general, micturition dysfunction is a rare complication of labia minora coalescence. We report the case of an 18-year-old female with complete and severe labia minora coalescence complicated by bladder retention

German-Algerian university exchange from the perspective of students and teachers results of an intercultural survey

Academic exchange programs provide students and teachers with the opportunity to study or work temporarily at educational institutions abroad. For exchange programs to be successful in promoting intercultural education, they must be designed with their participants in mind. The present study constitutes an investigation of attitudes and expectations of students and teachers with respect to a German–Algerian university exchange program. Germany and Algeria belong to separate cultural spheres—the Western/European and the Arabic/Islamic—and almost no academic exchange has taken place between them to date. The survey’s four participant groups were German (n = 270) and Algerian students (n = 214), and German (n = 24) and Algerian teachers (n = 43). The study revealed large differences in the hopes and fears that German and Algerian university students and teachers attach to reciprocal academic exchange. The study’s ramifications for the future planning of a German–Algerian university exchange program are discussed

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

BACKGROUND: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. METHODS: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING: Bill & Melinda Gates Foundation

Facteurs socio-éducatifs et la puissance douce du langage- Le déluge de l’anglais en Pologne et au Portugal. By Anna Odrowąż-Coates, Lexington Books, 2019. 198 pp.

Book Review: Facteurs socio-éducatifs et la puissance douce du langage- Le déluge de l’anglais en Pologne et au Portugal. By Anna Odrowąż-Coates, Lexington Books, 2019. 198 pp. This review is in Frenc

EDUCATION FOR INTEGRAL PEACE – MEMORY, INTERCULTURALITY AND DECOLONIALITY

Review of the book written by Eduardo Andrés Sandoval Forero (2016). Education for Integral Peace – Memory, Interculturality and Decoloniality. Bogota: ARFO Editores e Impresores LTDA. 327 pp

Application of FSSIM in two test case regions to assess agro-environmental policies at farm and regional level. PD 6.3.2.2

SEAMLESS integrated project, EU 6th Framework Programme, contract no.010036-2.This deliverable presents the results of the first application of the bioeconomic farm model FSSIM for a set of farm types representing the arable farming systems in two Test Case regions of the SEAMLESS-IP project: Midi-Pyrénées (France) and Sikasso (Mali). This application is performed through the FSSIM standalone version (i.e. outside the SEAMLESS-IF system) and it has two aims: (i) to test the capacity of FSSIM to capture the diversity of conditions from the North to the South, regarding biophysical and socio-economic aspects; and (ii) to provide a first example of assessment at the field and farm levels of the economic and ecological impacts of specific agricultural and environmental policies and technological innovations. The impact assessment at the field level was done through the biophysical model CropSyst, used as a substitute for APES, which is not yet operational for an application. FSSIM is a comparative static mathematical programming model which seeks to capture resource, socio-economic and policy constraints and the major farmer’s objectives. It was designed to be sufficiently generic and flexible to be applied for all relevant farming systems, easily transferable between different geographic locations, reusable and with a rich usage comfort. The simulated scenario in the French region (Midi-Pyrénées) is focused on the adoption of the Nitrate Directive (91/676/EC). The Nitrate Directive is an environmental measure designed to reduce water pollution by nitrate from agricultural sources and to prevent such pollution occurring in the future. The CropSyst-FSSIM-Indicators modelling chain was used to compare a baseline scenario driven by the CAP reform, and a policy scenario combining the CAP reform with the application of the Nitrate Directive and the adoption of alternative crop management. This modelling chain was operated “manually”, i.e. using specific databases filed by one component for the next one, but in a manner consistent with the future applications done inside SEAMLESS-IF when the modelling chains will be operational. The tested scenario in the Malian region (Sikasso) is based on the adoption of new cropping techniques, more efficient and suited to a wide range of socioeconomic and biophysical conditions. These techniques are usually designed at the plot level within research stations and sometimes in farmers’ plots. FSSIM was used in this scenario as a tool to assist and establish a dialogue between agronomic research and farmers, in order to help the adoption or design processes of these new cropping techniques. After a brief description of the FSSIM framework, particularly model design, specification and components (farm activities, resource constraints, policies specification and objective function etc.), sections 3 and 4 present the results of the application for the two Test Case regions respectively. Each section exposes the context, the tested scenarios, the required input data, the procedure followed for running the model (i.e. specification of components, modules and calibration procedure used) and the results of the application. The conclusions, in relation to the comparison of the scenarios and the implications for future FSSIM development and integration into SEAMLESS-IF, are given in section