The Hydroclimate Variability of Central Africa: seasonal cycle, mechanisms, teleconnections and impacts on neighbouring regions

Central Africa is, climatologically speaking, a poorly studied region (Clivar, 2000; Dezfuli and Nicholson, 2012; Nicholson and Dezfuli, 2012; Todd and Washington, 2004). It is considered as a knowledge gap in the understanding of the tropical climate system (Todd and Washington, 2004). Drivers of Central Africa rainfall are not well documented and deserve more attention. The aims of thesis are to enhance our fundamental understanding of Central Africa rainfall and the mechanisms involved in its seasonal and interannual variability as well as to assess how an atmospheric general circulation model forced by observed sea surface temperature (SST), the ECHAM5.3 model, does represent the main features of Central Africa hydroclimate variability. The seasonal cycle of Central Africa rainfall is primarily driven by change in the atmospheric low-pressure system of Central Africa landmass, water vapor and latent heat release rather than change of local temperature. From October to April, over Central Africa and its neighbouring regions, we highlight the existence in the mid-lower troposphere, between 1000 and 500 hPa of a dominant cyclonic and quasipermanent circulation pattern that drives the atmospheric large-scale circulation and its associated water vapor transports, namely the Central Africa Low. The Central Africa Low, with its variation strongly modulated by El Niño Southern Oscillations (ENSO), is characterized by strong convective activity due to an unstable atmosphere over central Africa, leading to high rainfall with less variance. Nevertheless, when the Central Africa Low prevails, Central Africa is a sink of water vapor, with the Indian Ocean as the main supplier. The weakening of the Central Africa Low, in May to September, is associated with the reversal of the water vapor transport at the northern boundary channel, leading Central Africa to become a source of moisture. During this season, both surrounding oceans are suppliers of moisture, with some additional contribution from the Congo basin rainforest. Central Africa rainfall variability is controlled by large-scale circulation variation, rather than variation in tropospheric water vapor. Year-round, the large-scale circulation is characterized by dominant easterly jets at middle (African easterly jets, AEJs) and upper (tropical easterly jets, TEJ) levels, owed by the Central Africa Low. At low-levels, there is a shallow zonal overturning circulation thermally direct, namely the Congo Basin Cell, driven by near-surface land-ocean thermal contrast between the warm central Africa landmass and the relatively cold Atlantic Ocean. The Congo Basin Cell, characterizes by eastward flow, persists year-round, with a maximum strength (-196.92±32.89 Sv) and width (30o degree) in August/September and minimum strength (-24.80± 17.83 Sv) and width (~6o degree) in May. The Congo Basin Cell does not play any crucial role in modulating Central Africa rainfall but it does regulate the rainfall distribution, through the seasonal position of the ITCZ. At midlevel, the atmospheric convective instability over Central Africa is controlled by the southward import of high moist static energy from the warmer Sahel associated with the AEJ over Central Africa. The saturation of the rising moist air at midlevel determines the location of high rainfall over central Africa year-round. Nevertheless, the absence of significant trend (- 0.013 mm per decade) of the Central Africa rainfall is associated with the weakening of the Central Africa Low in recent decades (1979 to 2015), consistent with Lau and Wu (2006). Further investigations on physical mechanisms affecting the Central Africa hydroclimate reveals that the Central Africa Low and land-ocean thermal contrasts are the main drivers of Central Africa rainfall variability at seasonal and interannual time scale, through the control of AEJs and the Congo Basin Cell strength and width. The analysis of ECHAM5.3 experiments provide a support to these mechanisms. Finally, to unravel what are the physical mechanisms shaping the rainfall anomalies patterns associated with the interannual variability of Central Africa rainfall, we found out that the Central Africa does reflect the regional-scale response of the atmosphere to the variation of the interbasin SST anomalies gradient (ΔSST) between tropical Atlantic and Indian Oceans. Likely, the zonal contrast of central Africa rainfall is owed by the Central Africa Low, which separates central Africa in two distinct regions of opposite polarity by regulating the strength of the low-level westerly and mid-upper easterly jets and their associated water vapor transports. This east-west dipole-like pattern of Central Africa rainfall is similar to the second leading mode obtained by empirical orthogonal functions (EOF) analysis of rainfall anomalies during the long rainy season. Thus, during the positive phase of ΔSST, the Central Africa Low area change induces an anomalous clockwise zonal overturning cell over Central Africa, with ascending branch over Atlantic, indicative of deep convection leading to rainfall surplus, and sinking branch over Indian Ocean, indicative of subsistence, which suppress convection and lead to rainfall deficit, consistent with the mechanism proposed by Dezfuli et al. (2015). However, the impact of ΔSST on Central Africa rainfall variability is asymmetrical during positive and negative phases of ΔSST

3D radiation therapy boost improves the outcome of whole brain radiation therapy treated RPA II patients with one or two brain metastases

PURPOSE: to evaluate the role of whole brain radiotherapy (WBRT) and radiation boost (RB) for 208 patients recursive partitioning analysis (RPA) II with 1 or 2 brain metastases (BM) at a single institution. METHODS AND MATERIALS: the dose of WBRT was 30 Gy (10 fractions of 3 Gy). One hundred thirty-two patients (63.5%) benefited from RB of 9 Gy in 3 fractions of 3 Gy at the metastatic site. Patients had 1 or 2 BM in 122 (58.7%) and 86 cases (41.3%), respectively. RESULTS: patients with one or two metastases had similar survival (4.6 and 5.1 months, respectively) (p = 0.4). Median overall survival (OS) for patients treated with WBRT and RB, and with WBRT alone was 5.9 and 3.7 months, respectively (p = 0.03). The 6-, 12- and 24-month OS rates after WBRT and RB were 48.5%, 25% and 10.6%, respectively, while WBRT alone resulted in OS rates of 34%, 22.4% and 3.2%, respectively (p = 0.03). After WBRT and RB, the 6-, 12- and 24-month local control rates were 92%, 82% and 67%, respectively, while they were 81.2%, 75% and 37.5%, respectively, after WBRT alone (p = 0.03). The 6-, 12- and 24-month brain control rates after WBRT and RB were 88.7%, 75.8% and 62%, respectively, and after WBRT alone they were 78.5%, 59% and 37.7%, respectively (p = 0.03). CONCLUSION: additional boost delivered with 3D conformal radiotherapy improves local and brain control rates significantly as well as overall survival for RPA II patients with 1 or 2 unresectable BM

SIMPLIFIED METHOD OF ENCAPSULATING FRAGILE PV CELLS FOR COTTAGE INDUSTRY PRODUCTION OF PHOTOVOLTAIC MODULES

ABSTRACT More than two decades ago, Richar

Building a diverse workforce and thinkforce to reduce health disparities

The Research Centers in Minority Institutions (RCMI) Program was congressionally man-dated in 1985 to build research capacity at institutions that currently and historically recruit, train, and award doctorate degrees in the health professions and health-related sciences, primarily to individuals from underrepresented and minority populations. RCMI grantees share similar infrastructure needs and institutional goals. Of particular importance is the professional development of multidisciplinary teams of academic and community scholars (the “workforce”) and the harnessing of the heterogeneity of thought (the “thinkforce”) to reduce health disparities. The purpose of this report is to summarize the presentations and discussion at the RCMI Investigator Development Core (IDC) Workshop, held in conjunction with the RCMI Program National Conference in Bethesda, Maryland, in December 2019. The RCMI IDC Directors provided information about their professional development activities and Pilot Projects Programs and discussed barriers identified by new and early-stage investigators that limit effective career development, as well as potential solutions to overcome such obstacles. This report also proposes potential alignments of professional development activities, targeted goals and common metrics to track productivity and success

Periodontal treatment to improve glycaemic control in diabetic patients: study protocol of the randomized, controlled DIAPERIO trial

<p>Abstract</p> <p>Background</p> <p>Periodontitis is a common, chronic inflammatory disease caused by gram-negative bacteria leading to destruction of tissues supporting the teeth. Epidemiological studies have consistently shown increased frequency, extent and severity of periodontitis among diabetic adults. More recently, some controlled clinical trials have also suggested that periodontal treatment could improve glycaemic control in diabetic patients. However current evidence does not provide sufficient information on which to confidently base any clinical recommendations. The main objective of this clinical trial is to assess whether periodontal treatment could lead to a decrease in glycated haemoglobin levels in metabolically unbalanced diabetic patients suffering from chronic periodontitis.</p> <p>Methods</p> <p>The DIAPERIO trial is an open-label, 13-week follow-up, randomized, controlled trial. The total target sample size is planned at 150 participants, with a balanced (1:1) treatment allocation (immediate treatment vs delayed treatment). Periodontal treatment will include full mouth non-surgical scaling and root planing, systemic antibiotherapy, local antiseptics (chlorhexidine 0.12%) and oral health instructions. The primary outcome will be the difference in change of HbA1c between the two groups after the 13-weeks' follow-up. Secondary outcomes will be the difference in change of fructosamine levels and quality of life between the two groups.</p> <p>Discussion</p> <p>The DIAPERIO trial will provide insight into the question of whether periodontal treatment could lead to an improvement in glycaemic control in metabolically unbalanced diabetic patients suffering from periodontitis. The results of this trial will help to provide evidence-based recommendations for clinicians and a draft framework for designing national health policies.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN15334496</p

Impact Assessment of vB_KpnP_K1-ULIP33 Bacteriophage on the Human Gut Microbiota Using a Dynamic In Vitro Model

peer reviewedNew control methods are needed to counter antimicrobial resistances and the use of bacteriophages as an alternative treatment seems promising. To that end, the effect of the phage vB_KpnP_K1-ULIP33, whose host is the hypervirulent Klebsiella pneumoniae SA12 (ST23 and capsular type K1), was assessed on intestinal microbiota, using an in vitro model: the SHIME® system (Simulator of the Human Intestinal Microbial Ecosystem). After stabilization of the system, the phage was inoculated for 7 days and its persistence in the different colons was studied until its disappearance from the system. The concentration of short chain fatty acids in the colons showed good colonization of the bioreactors by the microbiota and no significant effect related to the phage treatment. Diversity (α and β), the relative abundance of bacteria, and qPCR analysis targeting different genera of interest showed no significant variation following phage administration. Even if further in vitro studies are needed to assess the efficacy of this phage against its bacterial host within the human intestinal ecosystem, the phage ULIP33 exerted no significant change on the global colonic microbiota

Clinically Translatable Transcrocetin Delivery Platform for Correction of Tumor Hypoxia and Enhancement of Radiation Therapy Effects

Improving the tumor reoxygenation to sensitize the tumor to radiation therapy is a cornerstone in radiation oncology. Here, the pre‐clinical development of a clinically transferable liposomal formulation encapsulating trans sodium crocetinate (NP TSC) is reported to improve oxygen diffusion through the tumor environment. Early pharmacokinetic analysis of the clinical trial of this molecule performed on 37 patients orient to define the optimal fixed dosage to use in a triple‐negative breast cancer model to validate the therapeutic combination of radiation therapy and NP TSC. Notably, it is reported that this formulation is non‐toxic in both humans and mice at the defined fixed concentration, provides a normalization of the tumor vasculature within 72 h window after systemic injection, leads to a transient increase (50% improvement) in the tumor oxygenation, and significantly improves the efficacy of both mono‐fractionated and fractionated radiation therapy treatment. Together, these findings support the introduction of a first‐in‐class therapeutic construct capable of tumor‐specific reoxygenation without associated toxicities

Determinants of Use of Intermittent Preventive Treatment of Malaria in Pregnancy: Jinja, Uganda

BACKGROUND: Maternal malaria is associated with serious adverse pregnancy outcomes. One recommended means of preventing malaria during pregnancy is intermittent preventive therapy (IPTp) with sulfadoxine/pyrimethamine (SP). We sought to identify determinants of preventive use of SP during pregnancy among recently pregnant women in Uganda. Additionally, we characterized the timing of and indications for the administration of SP at antenatal care (ANC) visits and missed opportunities for SP administration. METHODOLOGY/PRINCIPAL FINDINGS: Utilizing a population-based random sample, we interviewed 500 women living in Jinja, Uganda who had been pregnant in the past year. Thirty-eight percent (192/500) of women received SP for the treatment of malaria and were excluded from the analysis of IPTp-SP. Of the remaining women, 275 (89.3%) reported at least two ANC visits after the first trimester and had an opportunity to receive IPTp-SP according to the Ugandan guidelines, but only 86 (31.3%) of these women received a full two-dose course of IPTp. The remaining 189 (68.7%) women missed one or more doses of IPTp-SP. Among the 168 women that were offered IPTp, 164 (97.6%) of them took the dose of SP. CONCLUSIONS/SIGNIFICANCE: Use of IPTp in Uganda was found to be far below target levels. Our results suggest that women will take SP for IPTp if it is offered during an ANC visit. Missed opportunities to administer IPTp-SP during ANC were common in our study, suggesting provider-level improvements are needed

Resurgence of Ebola virus in 2021 in Guinea suggests a new paradigm for outbreaks

These authors contributed equally: Alpha K. Keita, Fara R. Koundouno, Martin Faye, Ariane Düx, Julia Hinzmann.International audienc