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Introduction: The aim of this study was to evaluate the anesthesiological management of emergency caesareans at the CHU Gabriel TOURE. Methodology: This was a prospective study that took place at the CHU Gabriel TOURE in the Anesthesia Resuscitation department and in the operating theater of the Gyneco-Obstetrics department from August 01 to October 31, 2021. It concerned all caesarean sections performed in the Gyneco-Obstetrics department of the CHU Gabriel TOURE during a period of three months. All patients who came urgently to the Gyneco-Obstetrics department during the study period with an indication for emergency caesarean section Patients operated for emergency caesarean in another center were not included: caesareans performed outside our study period, planned caesareans, ruptured GEU (ectopic pregnancy), haemostasis hysterectomy. The information obtained from the patients and in the prenatal consultation book is compiled on an individual data collection sheet on which the variables to be studied appear. Statistical analysis was performed using SPSS version 25 software. Microsoft Word software was used for word processing. Results: During the study period, we performed 168 emergency cesarean sections out of 389 cases of cesarean section, i.e. a frequency of 43.18%. Conclusion: The practice of emergency obstetric anesthesia poses organizational difficulties, linked to the absence of a post-operative monitoring room, information from the anesthesia team and availability of products. PRH was the most frequent surgical indication; for this reason, GA has been the most practiced technique. Many patients were transferred to intensive care, i.e. 38.69% of cases and we recorded 38.69% of complications.

Introduction: Our study aimed to evaluate the anesthetic management of women suffering from obstetric vesico-vaginal fistulas at the Point G University Hospital. Patients and Methods: A descriptive retrospective study from 02 January 2018 to 31 December 2018 in the anesthesia-intensive care unit of the University Hospital Center (CHU) of Point G. Results: During the study period, we collected 48 cases of obstetric fistula out of a total of 237 operated during the period, a frequency of 20.25% of all surgical activities. Housewives were the most represented with 72.91% of cases. The most affected age group was 21-30 years with 37.5% of cases. Anesthesia was performed in 87.5% of cases by a medical assistant. The technique used was spinal anesthesia, so all patients received bipuvacaine for their anesthesia. One case of low blood pressure and one case of bradycardia were intraoperative incidents or a total of 2.08% of cases. Conclusion: Resuscitation anesthesia plays an important role in the successful management of obstetric fistula. Regional anesthesia is the most widely used method.

Introduction: The aim of this study was to evaluate the incidents and accidents during anesthesia in surgery at the Gabriel TOURE hospital. Methodology: This was a descriptive prospective study of anesthetic incidents and accidents that took place in the anesthesia department of the Gabriel TOURE hospital on the operating sites of programs and surgical and gyneco-obstetric emergencies ranging from the 1st January to March 31, 2021. Our study focused on all patients who underwent emergency and scheduled anesthesia during the period. Included were all patients with at least one accident or incident, All patients who did not present accidents and incidents or who refused to participate in the study were not included. The data was collected on the survey sheets and analyzed using the EPI INFO 7 software. Data entry was made using Windows XP software. Results: Over a period of 03 months, we collected 741 patients operated on in the operating theaters of the Gabriel TOURE hospital, of which 100 patients presented accidents/incidents in scheduled and emergency surgery, i.e. a rate of 13.49%. Urgent surgery represents 15.23% of incidents or accidents. Conclusion: We were able to take stock of several elements related to our practice of anesthesia. One of the essential interests of this work was the comparison of a population of subjects having "been victims of an anesthesia accident to the whole population anesthetized in the same structures, by the same practitioners, over the same period of study”.

Autophagy promotes or inhibits cell death depending on the environment and cell type. Our previous findings suggested that Atg1 is genetically involved in the regulation of Pmk1 MAPK in fission yeast. Here, we showed that Δatg1 displays lower levels of Pmk1 MAPK phosphorylation than did the wild-type (WT) cells upon treatment with a 1,3-β-D-glucan synthase inhibitor micafungin or CaCl2, both of which activate Pmk1. Moreover, the overproduction of Atg1, but not that of the kinase inactivating Atg1D193A activates Pmk1 without any extracellular stimuli, suggesting that Atg1 may promote Pmk1 MAPK signaling activation. Notably, the overproduction of Atg1 induces a toxic effect on the growth of WT cells and the deletion of Pmk1 failed to suppress the cell death induced by Atg1, indicating that the Atg1-mediated cell death requires additional mechanism(s) other than Pmk1 activation. Moreover, atg1 gene deletion induces tolerance to micafungin and CaCl2, whereas pmk1 deletion induces severe sensitivities to these compounds. The Δatg1Δpmk1 double mutants display intermediate sensitivities to these compounds, showing that atg1 deletion partly suppressed growth inhibition induced by Δpmk1. Thus, Atg1 may act to promote cell death upon micafungin and CaCl2 stimuli regardless of Pmk1 MAPK activity. Since micafungin and CaCl2 are intracellular calcium inducers, our data reveal a novel role of the autophagy regulator Atg1 to induce cell death upon calcium overload independent of its role in Pmk1 MAPK activation.

In Burkina Faso, the first case of cutaneous Leishmaniasis (CL) dates from 1960 and a few cases were reported in the following years. The objective of this review was to collect and analyze available data on CLin Burkina Faso to improve case management and control of disease transmission. A review of the literature was carried out using the PubMed, Google Scholar and Hinari databases. Publications dealing with the epidemiological aspects of CL, the parasite species involved, vectors and potential reservoir hosts, as well as drugs used in the treatment of CLwere searched. From 1960 to 1961, Burkina Faso recorded 13 cases of CL. From 2000 to 2005, an average of more than 1500 CLcases were recorded in Ouagadougou. In 2016 authors reported the results of the investigation of a second epidemic focus in Larama, Bassins region. More recently, in 2021, an investigation was carried out in a focus in the Centre-Nord region, bringing the number of CL focus to three in Burkina Faso. Leishmania major is the main species identified. In the wild area in the Ouagadougou focus, rodents Mastomys, Cricetomys, etc. have been described as the potential reservoir hosts, while in the domestic area, the animal reservoir would be the dog. In the focus of Ouagadougou, Phlebotomus duboscqi has been suspected since the 1960s as the possible vector of CL. The diagnosis is essentially microscopic. The first-line treatment meglumine antimoniate (Glucantime) accounted for only 65.9% of prescriptions. According to studies, the relapse rate after the first treatment with pentavalent antimony is about 37%. Despite the neglected disease status given to CL, there is therefore a need to strengthen the fight against this parasitosis by improving access to diagnosis and treatment, vector control and investigations to discover possible new endemic foci.&nbsp

This article investigates the emergence of recursive DPs in child language. In certain languages, DP modification can be achieved via diverse structures and any number of different embedding markers (prepositions, particles, case-marker, etc.), each having to be learned; this diversity may impact the L1 development of recursive DP modification. Japanese, in contrast, relies on two uniform unrestricted strategies: the adnominal particle の (no) or a relative clause. We report the results of an elicited production study comparing the production of recursive DPs in Japanese-speaking children and adults. Our results show that Japanese children were much like adults in the types of semantic modificational relations that elicited the most target responses. Children were different from adults in that they were: a) much less successful overall, and b) they preferred no, independently of whether the condition was biased toward no. We review the implications of these findings for analyses of no.

The use of colloidal particles to prepare and stabilize emulsions, known as "Pickering emulsions “, has aroused growing interest in recent years. Pickering and Ramsden demonstrated at the beginning of the last century the feasibility of surfactant-free emulsions, in presence of these emulsions is called "Pickering Emulsions". This concept of emulsions stabilized by solid particles is experiencing renewed interest nowadays given the many advantages it offers good stability, environmental protection, user safety, and particle varieties. The first part is devoted to the synthesis of Eudragit RSPO and pol epsilon-caprolactone nanoparticles and their characterization. The characterization of the nanoparticles is performed by dynamic light scattering and geometry. The understanding of the interfacial behavior of these nanoparticles and their associated stabilization mechanisms for emulsions was carried out. The second part of the study investigated the formulation and stabilization of the emulsion using the washed suspension containing the nanoparticles as the only stabilizer. The objective of this part is to stabilize and characterize the formulated emulsions. Droplet size determination and microscopy were performed using a Zeiss optical microscope. The direction of the formulated emulsions was determined by conductimetry. In conclusion, Pickering emulsions stabilized solely by Eudragit RSPO and Poly-epsilon Caprolactone nanoparticles appear to be highly effective innovative drug carriers, opening new doors as potential drug delivery systems.

Aims: This study constitutes the first approach to a food program. It was carried out in order to make up a useful database for a nutritional intervention by evaluating the level and practices of consumption of cassava semolina (Attiéké) among school children in rural communities. Study Design: This study was conducted from May 14 to 21, 2021 in elementary school in six villages in an area of Côte d'Ivoire that previously had a high incidence of childhood anemia. Methods: A cross-sectional survey collected data from first- to sixth-grade school children and aged from five to fifteen years (n = 460). Children provided data on their cassava semolina consumption in response to individual structured interviews conducted in their elementary schools and in the presence of one of their parents. Results: The results suggest that cassava semolina is an accessible, familiar and acceptable vehicle for food fortification to overcome nutritional deficits in children in this area. Cassava semolina is available throughout the year in this area. Children consumed an average of 95.5 g/day of cassava semolina and over three quarters of them (88.5%) had consumed this food on at least one day during the week prior to the survey. Cassava semolina was most often eaten for the midday meal (77.2%) in combination with fish (86.3%) and/or vegetables (79.1%). Finally, although cassava can be grown in this area, most children’s families (75.9%) purchased processed cassava semolina. Conclusion: The fortification of semolina would have high penetration in the population. However, the survey also identified a major challenge to using cassava semolina as a vehicle for micronutrient fortification. This is the shelf life of fresh cassava semolina, which is only 3 to 4 days in the absence of refrigeration.

Hadronic $\gamma$-ray sources associated with supernova remnants (SNRs) can serve as stopwatches for the escape of cosmic rays from SNRs, which gradually develops from highest-energy particles to lowest-energy particles with time. In this work, we analyze the 13.7~yr \emph{Fermi}-LAT data to investigate the $\gamma$-ray feature in/around the SNR G298.6$-$0.0 region. With $\gamma$-ray spatial analyses, we detect three point-like components. Among them, Src-NE is at the eastern SNR shell, and Src-NW is adjacent to the western edge of this SNR. Src-NE and Src-NW demonstrate spectral breaks at energies around/below 1.8~GeV, suggesting an old SNR age of $>$10~kyr. We also look into the X-ray emission from the G298.6$-$0.0 region, with the Chandra-ACIS data. We detected an extended keV source having a centrally filled structure inside the radio shell. The X-ray spectra are well fit by a model which assumes a collisional ionisation equilibrium of the thermal plasma, further supporting an old SNR age. Based on our analyses of the NANTEN CO- and ATCA-Parkes HI-line data, we determined a kinematic distance of $\sim$10.1~kpc from us to G298.6$-$0.0. This distance entails a large physical radius of the SNR of $\sim$15.5~pc, which is an additional evidence for an old age of $>$10~kyr. Besides, the CO data cube enables us to three-dimensionally locate the molecular clouds (MCs) which are potentially interacting with SNR G298.6$-$0.0 and could account for the hadronic $\gamma$-rays detected at Src-NE or Src-NW. Furthermore, the multiwavelength observational properties unanimously imply that the SNR--MC interaction occurs mainly in the northeast direction., Comment: Accepted by Publications of the Astronomical Society of Japan (PASJ) on 16-Jan-2023

BackgroundFungal lung diseases are global in distribution and require specific tests for diagnosis. We report a survey of diagnostic service provision in Africa.MethodsA written questionnaire was followed by a video conference call with each respondent(s) and external validation. To disseminate the questionnaire, a snowball sample was used.ResultsData were successfully collected from 50 of 51 African countries with populations >1 million. The questionnaire was completed by respondents affiliated with 72 health facilities. Of these 72 respondents, 33 (45.8%) reported data for the whole country while others reported data for a specific region/province within their country. In the public sector, chest X-ray and computed tomography are performed often in 49 countries (98%) and occasionally in 37 countries (74%), and less often in the private sector. Bronchoscopy and spirometry were done often in 28 countries (56%) and occasionally in 18 countries (36%) in the tertiary health facilities of public sector. The most conducted laboratory diagnostic assay was fungal culture (often or occasionally) in 29 countries (58%). In collaboration with the Africa Centre for Disease Control and Prevention, regional webinars and individual country profiles provided further data validation.ConclusionThis survey has found a huge disparity of diagnostic test capability across the African continent. Some good examples of good diagnostic provision and very high-quality care were seen, but this was unusual. The unavailability of essential testing such as spirometry was noted, which has a high impact in the diagnosis of lung diseases. It is important for countries to implement tests based on the World Health Organization Essential Diagnostics List.

This study aimed to evaluate the ability of single nucleotide polymorphisms (SNPs) to refine hepatocellular carcinoma (HCC) risk stratification.Six SNPs in PNPLA3, TM6SF2, HSD17B13, APOE, and MBOAT7 affecting lipid turnover and one variant involved in the Wnt-β-catenin pathway (WNT3A-WNT9A rs708113) were assessed in patients with alcohol-related and/or HCV-cured cirrhosis included in HCC surveillance programs (prospective CirVir and CIRRAL cohorts). Their prognostic value for HCC occurrence was assessed using Fine-Gray models combined into a 7-SNP genetic risk score (GRS). Prediction ability of two clinical scores (a routine nongenetic model determined by multivariate analysis and the external aMAP score) without then with the addition of the GRS was evaluated by C-indices. The standardized net benefit was derived from decision curves.Among 1145 patients, 86 (7.5%) developed HCC after 43.7 months. PNPLA3 and WNT3A-WNT9A variants were independently associated with HCC occurrence. The GRS stratified the population into 3 groups with progressively increased 5-yr HCC incidence [Group 1 (n=627, 5.4%), Group 2 (n=276, 10.7%), and Group 3 (n=242, 15.3%); P0.001]. The multivariate model identified age, male sex, diabetes, platelet count, GGT levels, albuminemia and the GRS as independent risk factors. The clinical model performance for 5-yr HCC prediction was similar to that of the aMAP score (C-Index 0.769). The addition of the GRS to both scores modestly improved their performance (C-Index 0.786 and 0.783, respectively). This finding was confirmed by decision curve analyses showing only fair clinical net benefit.Patients with cirrhosis can be stratified into HCC risk classes by variants affecting lipid turnover and Wnt-β-catenin pathway. The incorporation of this genetic information modestly improves the performance of clinical scores.The identification of patients at higher probability of developing liver cancer is pivotal to improve the performance of surveillance. Risk assessment can be achieved by combining several clinical and biological parameters used in routine practice. The addition of patients' genetic characteristics can modestly improve this prediction and will ultimately pave the way for precision medicine in patients eligible for HCC surveillance, allowing physicians to trigger personalized screening strategies.

Background: Copper is a metal that is widely used in many fields such as industry and construction, etc. These different industrial sectors use acid solutions such as nitric acid and hydrochloric acid, etc. The use of acid solutions in the industrial environment causes degradation of materials. In recent decades, the use of corrosion inhibitors has become very essential. Objective: The objective of our study is to test the performance of meloxicam as a copper corrosion inhibitor in a nitric acid medium. Methods: The studies were conducted using the gravimetric method and density functional theory (DFT) at B3LYP/6-311G (d, p) level of theory. The inhibitory efficiency of the molecule increases with increasing concentration of Meloxicam, but decreases with increasing temperature. The adsorption of the molecule on the copper surface follows the Villamil model. Results: The thermodynamic quantities of adsorption and activation were determined and discussed. Quantum chemical calculations have allowed determining the molecular descriptors. Conclusion: There is a good agreement between the experimental and theoretical results. Electrochemical studies are envisaged.

Introduction: A child is defined as “any human being under the age of 18, unless majority is reached earlier due to the legislation applicable to them. In reality, initial care is also found in multipurpose or adult emergency departments. In France (Seine-Saint-Denis), out of 390 children rescued by the Emergency Medical Assistance Service (SAMU) in 2004, 77% of child deaths were medicalized by the Regional Emergency Medical Service (SMUR). all-rounders of the department. As a result, at the hospital in Mali, many children are referred to the emergency department, while there is no pediatrician in the SAU and the technical platform is not well suited to their care,hence the objective of this work.. Methods and Materials: We conducted a prospective, longitudinal study over a period of 12 months from January 1, 2019 to December 31, 2019 at the emergency department of the hospital in Mali. The study involved patients aged zero (0) to fifteen (15) years The parameters studied were socio- demographic and clinical variables Results: During the study period, we collected 458 children aged 0 to 15 out of 6517 visits to the service, i.e. a frequency of 8.12%. The age group of 10 to 15 years was the most representative with 39% of cases. The male sex represented 58% of cases with a sex ratio of 1.36. The patients were uneducated in 10% of the cases, the workers represented 28.8% among the fathers and 54.8% of the mothers were housewives. Children belonging to families with more than three children accounted for 50.9% of cases and 39.5% of patients lived outside Bamako, the capital. Our study shows that 53.9% of patients were admitted between 8 a.m. and 4 p.m., 54.8% of patients came to the service by taxi, vehicle or motorbike and admissions by referral/evacuation represented 60.3% of case. AVP accounted for 48.7% of cases After the initial examination on admission, 36% of patients were classified as category three according to the Clinical Classification of Emergency Patients (CCMU3). Conclusion: The grounds for recourse of children from 0 to 15 years old to the general-purpose SAU of the Hospital of Mali are multiple. Accidents remain the most frequent reason for recourse in the service.

Background Biologics are commonly used for the treatment of Crohn’s disase (CD); however, the proportion of biologics used and their initiation time from diagnosis differs widely between different regions. There is limited information about the patient characteristics and the treatment persistence of each initial biologics, and the treatment persistence of top-down and step-up therapy. iCREST-CD is a prospective, non-interventional, longitudinal, observational registry study conducted at 19 tertiary centres to understand the characteristics of CD treatments in actual clinical settings in Japan. We conducted an interim analysis (cutoff date: 30 June 2022) of iCREST-CD to mainly evaluate the indication and outcomes of initial biologic therapy. Methods Patients newly diagnosed with CD after June 2016 based on the diagnostic criteria of the Japanese Guidelines, aged ≥16 years at the time of informed consent with no prior exposure to biologics were enrolled. Patient demographics, clinical data, disease activity and medical treatment were recorded. Biologic use without prior steroid use was defined as top-down and biologic use with prior steroid use was defined as step-up. Results A total of 672 eligible patients (68.2% male) with mean age (±SD) of 29.4 (13.1) years were analysed. Cumulative proportion of patients prescribed 5-aminosalicylic acid, steroids, immunomodulators, and biologics at 6- and 12-months from diagnosis were 71.3%, 40.6%, 31.4%, and 47.5%; and 75.0%, 43.6%, 36.0%, and 59.7%, respectively (Figure 1). A total of 498 patients received biological therapy—infliximab (IFX; 121 [24.3%]), adalimumab (ADA; 244 [49.0%]), ustekinumab (UST; 107 [21.5%]), and vedolizumab (VDZ; 26 [5.2%]). The mean age (±SD) at the initiation of biologic treatment was IFX: 28.2 (11.3), ADA: 26.6 (10.8), UST: 30.4 (14.1), and VDZ: 36.2 (17.4), and the mean (±SD) levels of C-reactive protein (CRP) (mg/L) was IFX: 25.9 (26.8), ADA: 18.9 (26.0), UST: 13.5 (17.9), and VDZ: 9.5 (19.0) (Table.1). The initial biologic treatment persistence rates of IFX, ADA, UST and VDZ at 36-months were 77.5%, 75.8%, 79.8%, and 49.0%, respectively (Figure 2). Patients receiving top-down and step-up therapy were 284 (57.0%) and 214 (43.0%), respectively. The treatment persistence rate of initial biologics by top-down and step-up therapy at 36-months from diagnosis was 81.6% and 66.9%, respectively (P=0.001) (Figure 3). Conclusion This registry study that demonstrated the treatment persistence rate of initial biologic therapy was significantly higher in the top-down than the step-up approach.

A relatively rare congenital malformation, hematocolpos is the progressive accumulation of menstrual blood in the vaginal cavity at puberty. It is often the consequence of a hymen imperforation. It is clinically manifested by cyclic pelvic pain and primary amenorrhea and, more rarely, by a pelvic mass syndrome. The diagnosis is primarily clinical. Ultrasound and magnetic resonance imaging (MRI) are additional tests to confirm hematolcolpos and exclude other associated genitourinary malformations. Treatment consists of a hymenotomy to drain the hematocolpos. The age of discovery of hematocolpos varies from 13 to 14 years. We report a case of hematocolpos secondary to hymenal imperforation diagnosed in a 17-year-old girl with periodic pelvic pain, primary amenorrhea and a pelvic mass. A first ultrasound trap had evoked a large ovarian cyst but the repeat pelvic ultrasound in our hospital confirmed the diagnosis of hematocolpos.

The valorisation of agricultural residues into a high value-added product is necessary to respond to the global environmental concerns caused by the pollution of agricultural waste. The objective of this study was to shed light on a new value-added usage of cocoa pod husk (CPH) for the synthesis of cellulose triacetate (CTA). Alkaline treatment with sodium hydroxide (5 wt%) followed by bleaching process with (2 wt%) hydrogen peroxide was found effective for the extraction of cellulose from CPH. The percentage of cellulose obtained was 80.5% with a yield of 54%. The CTA was synthesised by a explore new way acetylation reaction in the presence of acetic acid, acetic anhydride, and sulphuric acid. The CTA obtained had a degree of substitution of 2.87 and a percentage of acetylated group of 43.8%, as determined by titration. The result of Fourier transform infrared spectroscopy showed the appearance of the stretching of the ester and the acetyl groups, indicating the formation of CTA. X-ray diffraction showed that the crystallinity index of CPH cellulose was 38.4%, while indicating the semi-crystalline nature of CTA produced. Scanning electron microscopy confirmed a change in the morphology of CTA after acetylation. X-ray energy dispersive analysis showed that the CTA was mainly composed of carbon and oxygen.

This study is on the optimisation of the interface of the p-silicin/indigo camine for electrochemical sensors applications. In this study carried out in cyclic voltammetry, the p-type silicon paste electrode is in contact with the indigo carmine solution at pH=10. The nature of the current in the silicon / aqueous alkaline solution of indigo carmine junction was determined. The cyclic voltammogram is correlated by an affine straight-line, which allows the determination of the capacitance of the junction at a frequency of 50 Hz. Curve C-2=f(E) obtained is not linear. It is of Gaussian form. This form reflects that the ionization of the deep levels of the semiconductor began before the depopulation of the valence band. This study allows to determine the surface potential (Vs=-0,4V) and the flat band potential (VBP=-1,50V). The fermi potential is equal to 1, 50 These results are indications that this interface could not be used as an electrochemical sensor under these conditions.

Salah satu periode status gizi yang paling menentukan adalah status gizi pada masa prakonsepsi. Permasalahan gizi di Indonesia dipengaruhi oleh beberapa faktor yaitu salah satunya sanitasi dasar, sehingga perlu memastikan sanitasi lingkungan untuk wanita prakonsepsi yang memiliki masalah gizi. Tujuan dari penelitian ini mengetahui pengaruh sanitasi dasar terhadap status gizi wanita prakonsepsi di wilayah kerja Puskesmas Kawatuna Kota Palu. Penelitian ini merupakan penelitian analitik observasional korelatif dengan pendekatan Cross Sectional dengan menggunakan kuisioner dan data antropometrik pemeriksaan panjang badan dan berat badan wanita prakonsepsi di Wilayah Kerja Puskesmas Kawatuna serta pengambilan sampel menggunakan metode purposive sampling. Jumlah sampel pada penelitian ini sebanyak 90 responden. Hasil analisis korelasi menunjukkan bahwa semua variabel sanitasi dasar memiliki hubungan signifikan terhadap status gizi wnita prakonsepsi, dengan nilai signifikansi p< 0,05 yang berarti bahwa terdapat korelasi signifikan antara variabel sanitasi dasar dengan status gizi. Peran sanitasi dasar menjadi hal krusial dalam status gizi Wanita prakonsepsi dalam mempersiapkan kehamilannya nanti.

Purpose This paper aims to assess the efficiency of public investment in West African Economic and Monetary Union (WAEMU) countries at both the global and sectoral level over the 2005–2015 period. Design/methodology/approach This paper estimates efficiency scores using stochastic frontier analysis (SFA) models. Efficiency is divided into managerial efficiency (related to inputs management) and technological efficiency (related to production technology). A Tobit model is then used to investigate the determinants of public investment efficiency. Findings The findings suggest that, at the global level, WAEMU countries are less efficient than sub-Saharan African and Asian reference countries. However, the breakdown of global efficiency into managerial and technological reveals that WAEMU countries are more efficient than sub-Saharan African countries in terms of technological efficiency. Moreover, these findings are robust to nonparametric estimation. The assessment of financing sources indicates that external debt has a more positive and significant effect on public investment efficiency than internal debt does. Originality/value This paper is unique in that it disentangles managerial efficiency from the technological efficiency of public investment in WEAMU countries and highlights how financing sources of investment affect its efficiency. In terms of policy implications, the underlying message of the results is that the rules and conditions of domestic or regional debt in the WAEMU countries must be strengthened to ensure better monitoring and then better efficiency of these resources.

Anastomotic leakage (AL) is a serious complication after esophagectomy for esophageal cancer. The objective of this study was to identify the risk factors for AL.Patients with esophageal cancer who underwent curative esophagectomy and cervical esophagogastric anastomosis between 2009 and 2019 (N = 346) and those between 2020 and 2022 (N = 17) were enrolled in the study to identify the risk factors for AL and the study to assess the association between the risk factors and blood flow in the gastric conduit evaluated by indocyanine green (ICG) fluorescence imaging, respectively.AL occurred in 17 out of 346 patients (4.9%). Peptic or endoscopic submucosal dissection (ESD) ulcer scars were independently associated with AL (OR 6.872, 95% CI 2.112-22.365) in addition to diabetes mellitus. The ulcer scars in the anterior/posterior gastric wall were more frequently observed in patients with AL than in those without AL (75.0% vs. 17.4%, P = 0.042). The median flow velocity of ICG fluorescence in the gastric conduits with the scars was significantly lower than in those without the scars (1.17 cm/s vs. 2.23 cm/s, P = 0.004).Peptic or ESD ulcer scarring is a risk factor for AL after esophagectomy in addition to diabetes mellitus. The scars in the anterior/posterior gastric wall are significantly associated with AL, impairing blood flow of the gastric conduit. Preventive interventions and careful postoperative management should be provided to minimize the risk and severity of AL in patients with these risk factors.

Initially provided as an alternative to evaluation of serum analytes and nuchal translucency for the assessment of pregnancies at high risk of trisomy 21, cell-free DNA screening for fetal aneuploidy, also referred to as noninvasive prenatal screening, can now also screen for fetal sex chromosome anomalies such as monosomy X as early as 9 to 10 weeks of gestation. Early identification of Turner syndrome, a sex chromosome anomaly resulting from the complete or partial absence of the second X chromosome, allows medical interventions such as optimizing obstetrical outcomes, hormone replacement therapy, fertility preservation and support, and improved neurocognitive outcomes. However, cell-free DNA screening for sex chromosome anomalies and monosomy X in particular is associated with high false-positive rates and low positive predictive value. A cell-free DNA result positive for monosomy X may represent fetal Turner syndrome, maternal Turner syndrome, or confined placental mosaicism. A positive screen for monosomy X with discordant results of diagnostic fetal karyotype presents unique interpretation and management challenges because of potential implications for previously unrecognized maternal Turner syndrome. The current international consensus clinical practice guidelines for the care of individuals with Turner syndrome throughout the lifespan do not specifically address management of individuals with a cell-free DNA screen positive for monosomy X. This study aimed to provide context and expert-driven recommendations for maternal and/or fetal evaluation and management when cell-free DNA screening is positive for monosomy X. We highlight unique challenges of cell-free DNA screening that is incidentally positive for monosomy X, present recommendations for determining if the result is a true-positive, and discuss when diagnosis of Turner syndrome is applicable to the fetus vs the mother. Whereas we defer the subsequent management of confirmed Turner syndrome to the clinical practice guidelines, we highlight unique considerations for individuals initially identified through cell-free DNA screening.

Summary: The pilar cyst or trichilemmal is a benign tumour of the skin appendages. This tumour develops on the isthmic part of the pilar follicle and is characterised histologically by trichilemmal keratinisation. We report a case of bilateral giant temporal trichilemmal cysts with a giant occipital lipoma. Observation: This is a 53-year-old patient who presented with multiple scalp lesions that had been present for three years. On clinical examination, there were two bilateral symmetrical temporal tumours with an occipital mass. Histology revealed a trichellemmal cyst for the temporal and a lipoma for the occipital.

The computer-aided engineering approach has made it possible to achieve virtual prototypes and to describe expected performances of new apparatuses. In this study, a direct production of syngas with biogas using the configuration of the cascade conversion cell in the supply feed direction of the system was exhibited. Momentum, heat, mass and charge balances were solved using COMSOL Multiphysics® commercial software. These simulations allowed calculation of distributions of partial pressures for all gas species within the anode (CH4, H2, CO, CO2, H2O, N2), as well as velocity field and temperature. The conversion process included methane reforming (steam and dry) associated with the water–gas shift reaction. The computing results showed that the configuration of three porous oxide solid cells based on a solid oxide fuel cell (SOFC) system conferred a larger active surface area and limited thermal stress in oxide materials. In addition, depending on the production process of the biogas, feeding composition strongly influences the conversion rate of CO2 and CH4. We observed that production of syngas was optimal for a CO2/CH4 ratio = 1.

One of the technical challenges in the field of metabolomics is the development of a single-run method to detect the full complement of polar metabolites in biological samples. However, an ideal method to meet this demand has not yet been developed. Herein, we proposed a simple methodology that enables the comprehensive and simultaneous analysis of polar metabolites using unified-hydrophilic-interaction/anion-exchange liquid chromatography mass spectrometry (unified-HILIC/AEX/MS) with a polymer-based mixed amines column composed of methacrylate-based polymer particles with primary, secondary, tertiary, and quaternary amines as functional groups. The optimized unified-HILIC/AEX/MS method is composed of two consecutive chromatographic separations, HILIC-dominant separation for cationic, uncharged, and zwitterionic polar metabolites [retention times (RTs) = 0-12.8 min] and AEX-dominant separation for polar anionic metabolites (RTs = 12.8-26.5 min), by varying the ratio of acetonitrile to 40 mM ammonium bicarbonate solution (pH 9.8). A total of 400 polar metabolites were analyzed simultaneously through a combination of highly efficient separation using unified-HILIC/AEX and remarkably sensitive detection using multiple reaction monitoring-based triple quadrupole mass spectrometry (unified-HILIC/AEX/MS/MS). A nontargeted metabolomic approach using unified-HILIC/AEX high-resolution mass spectrometry (unified-HILIC/AEX/HRMS) also provided more comprehensive information on polar metabolites (3242 metabolic features) in HeLa cell extracts than the conventional HILIC/HRMS method (2068 metabolic features). Our established unified-HILIC/AEX/MS/MS and unified-HILIC/AEX/HRMS methods have several advantages over conventional techniques, including polar metabolome coverage, throughput, and accurate quantitative performance, and represent potentially useful tools for in-depth studies on metabolism and biomarker discovery.

Balloon-assisted enteroscopy allows endoscopic treatments in the deeper segments of the small bowel. Endoscopic balloon dilation has become a popular minimally invasive alternative for the treatment of Crohn's disease-associated small intestinal strictures. As a supplement to the Clinical Practice Guidelines for Enteroscopy, the Japan Gastroenterological Endoscopy Society's Working Committee has developed the present "Guidelines for endoscopic balloon dilation in treating Crohn's disease-associated small intestinal strictures," based on new scientific techniques and evidence. The guidelines cover standard procedures for the insertion route of the balloon endoscope, bowel preparation, indications, procedure-related complications, efficacy, target diameter and duration, management of multiple strictures, and the current state of combined and alternative treatments. Unresolved future research questions are also listed in this guideline.