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BACKGROUND: Delay in seeking treatment at the hospital is a major challenge in current Buruli ulcer control; it is associated with severe sequelae and functional limitations. Choosing alternative treatment and psychological, social and practical factors appear to influence delay. Objectives were to determine potential predictors for pre-hospital delay with Leventhal's commonsense model of illness representations, and to explore whether the type of available dominant treatment modality influenced individuals' perceptions about BU, and therefore, influenced pre-hospital delay. METHODOLOGY: 130 healthy individuals aged >18 years, living in BU-endemic areas in Benin without any history of BU were included in this cross-sectional study. Sixty four participants from areas where surgery was the dominant treatment and sixty six participants from areas where antibiotic treatment was the dominant treatment modality were recruited. Using a semi-structured interview we measured illness perceptions (IPQ-R), knowledge about BU, background variables and estimated pre-hospital delay. PRINCIPAL FINDINGS: The individual characteristics 'effectiveness of treatment' and 'timeline acute-chronic' showed the strongest association with pre-hospital delay. No differences were found between regions where surgery was the dominant treatment and regions where antibiotics were the dominant treatment modality. CONCLUSIONS: Individual characteristics, not anticipated treatment modality appeared predictors of pre-hospital delay.

The aim of this paper is to apply all the existing pyranometric methods to estimate the sunshine duration from global solar irradiation in order to find the most suitable method for a tropical site in its original form. Then, in a second step, one of these methods will be optimized to effectively fit tropical sites. Five methods in the literature (Step algorithm, Carpentras Algorithm, Slob and Monna Algorithm, Slob and Monna 2 Algorithm, and linear algorithm) were applied with eleven years of global and diffuse solar radiation data. As a result, with regard to its original form, the step algorithm is in the first rank. But in the second step, after improving its main coefficients, the Carpentras Algorithm was found to be the best algorithm for tropical sites in the southern hemisphere.

This paper delves into the rapidly progressing 15-Minute City concept, an innovative urban planning model that envisions a city where residents can access essential services and amenities within a 15-min walk or bike ride from their homes. Endorsed by UN-Habitat as a critical strategy for sustainable urban regeneration, this concept has gained considerable worldwide recognition since its introduction in 2016. The 15-Minute City framework aims to enhance accessibility, sustainability, and social cohesion by emphasizing mixed-use development, compact urban design, and efficient transportation systems. Nevertheless, the swift expansion of this concept has surpassed the production of academic literature on the topic, leading to a knowledge gap that calls for alternative research methodologies. To address this gap, our paper adopts a mixed-method approach, systematically analyzing the scholarly literature, gray literature, media articles, and policy documents to offer a holistic understanding of the 15-Minute City concept, its real-world application, and the primary principles embraced by policymakers. By investigating the various manifestations of the 15-Minute City model and its potential advantages, challenges, and implications for urban planning and policy, this paper contributes to the ongoing conversation on sustainable urban development and planning. Through this study, we aim to inform policymakers, urban planners, and researchers about the current state of the 15-Minute City movement and its possible future trajectory.

Abstract Aims There is a growing body of literature on long‐term outcomes post‐transcatheter aortic valve replacement (TAVR), but to our knowledge, few research have focused on patients with advanced cardiac dysfunction. This challenging category of patients was excluded from the Partner 3 clinical trial. There are no data to guide the choice of valve type in patients with severely depressed ejection fraction. This study evaluates the safety, efficacy, and outcomes of TAVR in patients with severe aortic stenosis and left ventricular ejection fraction (LVEF) ≤ 35%. It compares post‐TAVR survival outcomes with self‐expanding (SEV) versus balloon‐expandable (BEV) valves in the context of cardiac dysfunction. Methods and results A retrospective cohort was conducted on 977 patients who underwent TAVR at Toulouse University Hospital between January 2016 and December 2020. The study population included two groups: LVEF ≤ 35% (N = 157) and LVEF ≥ 50% (N = 820). The group of LVEF ≤ 35% was divided into two subgroups according to the type of implanted device: self‐expanding (N = 66) versus balloon‐expandable (N = 91). The living status of each of study's participants was observed in December 2022. Patients with low ejection fraction were younger (82 vs. 84.6 years) and commonly males (71.3% vs. 45.6%). Procedural success was almost 98% in both study groups (97.5% vs. 97.9%). The prevalence of all in‐hospital post‐TAVR complications [acute kidney injury (3.8% vs. 2.2%), major bleeding events (2.5% vs. 3.2%), stroke (1.3% vs. 1.6%), pacemaker implantation (10.2% vs. 10.7%), major vascular complication (4.5% vs. 4.5%), new onset atrial fibrillation (3.2% vs. 3.4%), and in‐hospital death (3.2% vs. 2.8%)] were similar between groups (LVEF ≤ 35% vs. LVEF ≥ 50%). No difference in long‐term survival has been revealed over 3.4 years (P = 0.268). In patients with LVEF ≤ 35%, except for post‐TAVR mean aortic gradient (7.8 ± 4.2 vs. 10.2 ± 3.6), baseline and procedural characteristics were comparable between SEV versus BEV subgroups. An early improvement in LVEF (from 29.2 ± 5.5 to 37.4 ± 10.8) was observed. In patients with LVEF ≤ 35%, the all‐cause mortality rate was significantly higher in BEV than that in SEV subgroups, respectively (40.7% vs. 22.7%, P = 0.018). Kaplan–Meier curve showed better survival outcomes after SEV implantation (P = 0.032). A Cox regression identified BEV as independent predictor of mortality [HR = 3.276, 95% CI (1.520–7.060), P = 0.002]. Conclusions In the setting of low LVEF, TAVR remains a safe and effective procedure not associated with an increased risk of complications and mortality. SEV implantation may likely result in superior survival outcomes in patients with advanced cardiac dysfunction.

In this paper, we present and discuss the results of a survey of how corporate social responsibility (CSR) is being discussed and taught in engineering education in France. We shall first describe how those questions have been recently tackled in various programmes of higher education in France. We shall also analyse what faculty members have to say about their motivation or reluctance to enhance these new topics in their teaching. While this survey covered various fields of higher education, in this present, we mostly discuss the issues surrounding CSR teaching in engineering education. (Contains 1 table.)

Summary: Background: Mucormycosis is a deadly invasive fungal infection recently included in the WHO priority pathogen list. Here we sought to describe epidemiological trends of mucormycosis in France, and to evaluate factors associated with mortality. Methods: From 2012 to 2022, we implemented a nationwide prospective surveillance programme for mucormycosis in France, focusing on epidemiology, species, seasonal variations. Factors associated with 3-month mortality were studied by univariable and multivariable logistic regression. Findings: Among 550 cases of mucormycosis, the main underlying conditions were haematological malignancy (HM, 65.1%, 358/550), trauma (8%, 44/550), diabetes (7.5%, 41/550) and solid-organ transplants (6.5%, 36/550). Site of infection was pulmonary in 52.4% (288/550), rhinocerebral in 14.5% (80/550), and cutaneo-articular in 17.1% (94/550). Main species identified were Rhizopus arrhizus (21%, 67/316), Rhizopus microsporus (13.6%, 43/316), Lichtheimia corymbifera and Mucor circinelloides (13.3%, 42/316 each), Rhizomucor pusillus (12%, 38/316), and Lichtheimia ramosa (10.8%, 34/316). We found associations between underlying condition, site of infection, and infecting species, including a previously undescribed triad of trauma, cutaneo-articular localisations, and L. ramosa/M. circinelloides. Diagnostic contribution of Polymerase Chain Reaction (PCR) increased from 16% (4/25) in 2012 to 91% (61/67) in 2022, with more than 50% of diagnoses relying solely on PCR in 2022. We also found seasonal variations with relatively more cases in autumn. Ninety-day mortality was 55.8% (276/495). Independent prognostic factors were age, diagnosis in Intensive Care Unit (ICU), and HM while diagnosis after 2015 (i.e. large implementation of PCR) and surgery were associated with reduced mortality. Interpretation: This study reveals major mucormycosis epidemiological changes in France, with a large predominance of HM patients, and a parallel between PCR multicentre implementation and improved prognosis. We also evidence new associations between species, localisations and risk factors, as well as seasonal variations. Funding: Recurrent financial support from Santé Publique France and Institut Pasteur.

Why do men and women vote for the populist radical right? This question, which speaks to the phenomenon of the “radical right gender gap”, has been the topic of much scholarly interest. While previous studies refer to the role played by differences in political resources, attitudes, and socialization, this paper examines whether negative emotions towards the political system, and system-directed anger in particular, drive support for populist radical right parties differently for men and women. Drawing on the premise that populist radical right parties tend to appeal to angry voters, and given that acting upon anger is seen as an “agentic” trait, we expect that system-directed anger is more strongly associated with support for populist radical right parties among men compared to women. We test the hypothesis using original data from the RepResent voter survey organized in Belgium during the 2019 federal elections. In line with previous studies, we find that voters of the populist radical right party Vlaams Belang report high levels of system-directed anger. Men and women voters are similar in their display of this emotion, and contrary to our expectations, they are similar in how system-directed anger relates to vote choice as well. More than explaining gender differences in populist radical right voting, our findings confirm the idea that system-directed anger can incite women as well as men to cast a populist radical right vote.

Abstract Background Some research shows that advertising for high-fat, sugar, or salt (HFSS) products is contributing to a shift in consumer preferences toward products of poor nutritional quality, leading to unhealthy nutritional intakes that increase the risk of obesity and chronic diseases. A strategy of displaying simple and understandable nutritional information (like the front-of-pack nutrition label Nutri-Score) in food messages could be an aid to help guide consumers’ choice towards healthier products. Methods A randomized controlled experiment was conducted on 27,085 participants randomly assigned to two experimental conditions or a control condition. In both experimental conditions (independent variable: advertising messages with vs. without the Nutri-Score), participants were exposed to advertisements for diversified food products with contrasting nutritional quality and belonging to nine different food categories. Participants were then asked questions about their perception, affective evaluation, and intentions to purchase and consume the products. In the control condition, they were not exposed to the advertisements. Results Overall, interaction effects between the two variables (1) the messages with vs. without the Nutri-Score and (2) the nutritional quality of products, were significant for all dependent variables, with effect sizes between large and medium. Overall, the better the products’ nutritional quality, the more positive their perceptions, affective evaluations, and intentions to buy and consume them. When the Nutri-score was displayed in advertising messages (vs. when it was not), perceptions, affective evaluation, and behavioral intentions: (1) became more positive for products of good nutritional quality (Nutri-score A and B), (2) became more negative for products of poor nutritional quality (Nutri-score D and E), (3) changed little or not at all for products of intermediate nutritional quality (Nutri-Score C). Conclusions This research is the first in the literature to demonstrate that displaying the Nutri-Score in advertising messages assists consumers in directing their choices towards healthier foods. Regulations mandating the display of the Nutri-Score in food advertising could be an effective public health measure.

Abstract Background Several studies suggested that cavefish populations of Astyanax mexicanus settled during the Late Pleistocene. This implies that the cavefish’s most conspicuous phenotypic changes, blindness and depigmentation, and more cryptic characters important for cave life, evolved rapidly. Results Using the published genomes of 47 Astyanax cavefish from la Cueva de El Pachón, El Sótano de la Tinaja, La Cueva Chica and El Sótano de Molino, we searched for putative loss-of-function mutations in previously defined sets of genes, i.e., vision, circadian clock and pigmentation genes. Putative non-functional alleles for four vision genes were identified. Then, we searched genome-wide for putative non-functional alleles in these four cave populations. Among 512 genes with segregating putative non-functional alleles in cavefish that are absent in surface fish, we found an enrichment in visual perception genes. Among cavefish populations, different levels of shared putative non-functional alleles were found. Using a subset of 12 genes for which putative loss-of-function mutations were found, we extend the analysis of shared pseudogenes to 11 cave populations. Using a subset of six genes for which putative loss-of-function mutations were found in the El Sótano del Toro population, where extensive hybridization with surface fish occurs, we found a correlation between the level of eye regression and the amount of putative non-functional alleles. Conclusions We confirm that very few putative non-functional alleles are present in a large set of vision genes, in accordance with the recent origin of Astyanax mexicanus cavefish. Furthermore, the genome-wide analysis indicates an enrichment of putative loss-of-function alleles in genes with vision-related GO-terms, suggesting that visual perception may be the function chiefly impacted by gene losses related to the shift from a surface to a cave environment. The geographic distribution of putative loss-of-function alleles newly suggests that cave populations from Sierra de Guatemala and Sierra de El Abra share a common origin, albeit followed by independent evolution for a long period. It also supports that populations from the Micos area have an independent origin. In El Sótano del Toro, the troglomorphic phenotype is maintained despite massive introgression of the surface genome.

Abstract Chemoreception – the ability to smell and taste – is an essential sensory modality of most animals. The number and type of chemical stimuli that animals can perceive depends primarily on the diversity of chemoreceptors they possess and express. In vertebrates, six families of G protein-coupled receptors form the core of their chemosensory system, the olfactory/pheromone receptor gene families OR, TAAR, V1R and V2R, and the taste receptors T1R and T2R. Here, we study the vertebrate chemoreceptor gene repertoire and its evolutionary history. Through the examination of 1,527 vertebrate genomes, we uncover substantial differences in the number and composition of chemoreceptors across vertebrates. We show that the chemoreceptor gene families are co-evolving, highly dynamic, and characterized by lineage-specific expansions (for example, OR in tetrapods; TAAR, T1R in teleosts; V1R in mammals; V2R, T2R in amphibians) and losses. Overall, amphibians, followed by mammals, are the vertebrate clades with the largest chemoreceptor repertoires. While marine tetrapods feature a convergent reduction of chemoreceptor numbers, the number of OR genes correlates with habitat in mammals and birds and with migratory behavior in birds, and the taste receptor repertoire correlates with diet in mammals and with aquatic environment in fish.

Background For high bleeding-risk patients (HBR) undergoing percutaneous coronary intervention (PCI), the LEADERS FREE (LF) and LEADERS FREE II (LF II) trials established the safety and efficacy of a stainless steel polymer-free biolimus-coated stent (SS-BCS) with 30 days of dual antiplatelet treatment (DAPT). The LEADERS FREE III (LF III) trial investigated clinical outcomes after PCI with the next-generation cobalt-chromium thin-strut polymer-free biolimus-coated stent (CoCr-BCS) in HBR patients.Aims To report the final 3-year results of the LF III trial and compare them to LF II.Methods LF III was a prospective, multicentre, open-label single-arm study to evaluate the safety and efficacy of the CoCr-BCS stent. The primary safety endpoint was the composite of cardiac death (CD), myocardial infarction(MI) or definite/probable stent thrombosis (ST). The primary efficacy endpoint was clinically driven target lesion revascularisation (cd-TLR). We performed a propensity-matched comparison to the 3-year outcomes of LF II.Results After 3 years, CD/MI/ST had occurred in 57 patients (15%, 95% CI 11.8% to 19%) and cd-TLR in 23 (6.2%, 95% CI 4.1% to 9.2%) patients. In a propensity-matched comparison of patients treated with the CoCr-BCS versus the SS-BCS, there were similar rates of CD (6.6% vs 7.8%, p=0.50), MI (7.1% vs 8.3%, p=0.47) and definite/probable ST (1.1% vs 2%, HR 0.56, 95% CI 0.16 to 1.93, p=0.35). The rates of cd-TLR were 5.3% with CoCr-BCS versus 9.8% with SS-BCS (HR 0.54, 95% CI 0.31 to 0.96, p=0.03).Conclusion LF III confirms the long-term safety and efficacy of the CoCr-BCS in HBR patients treated with 1 month of DAPT.Trial registration number NCT02843633, NCT03118895.

Abstract Cooperative intelligent transport systems (C‐ITS) deployments for vehicle‐to‐infrastructure communication require substantial investments from European Member States in road‐side units (RSUs) and in central traffic management systems. The promise of numerous societal benefits should justify these public investments. However, C‐ITS uptake in passenger cars, and thus the subsequent societal benefits, are highly uncertain. Therefore, here, a case study of Flanders is presented in which real option analysis) is used to help road authorities assess the RSU investment opportunity. The framework combines a detailed cost and benefit model and includes managerial options for the road authority. This technique aims to incorporate the value of the flexibility that is available during the deployment to reduce risk exposure, and as such more accurately appraise the investment. C‐ITS uptake in passenger cars was modelled as the major source of uncertainty, as it is the primary driver of societal benefits. While a static RSU investment analysis for Flanders, Belgium, was found to be negative, embedding the option to defer the investment decision to further study C‐ITS uptake results in a positive average net present value. The results are useful for any road authority aspiring to roll out C‐ITS road‐side infrastructure.

The rapid development of equitably accessible vaccines is paramount in addressing emerging global health challenges. The safety and efficacy of vaccines hinge significantly on their ability to remain stable from manufacturing throughout the supply chain and up to administration. Furthermore, the release of vaccines requires sufficient understanding of the stability profile to allow for expiration dating. In the event of a public health crisis, the time to generate the necessary stability data and the need for rapid product release are in direct opposition. Developing manufacturing platforms with thermostable product formulations for rapid response is therefore key to meeting CEPI’s 100 Days Mission goal. This Review aims to highlight the need for stability preparedness through developing thermostable vaccine platforms and exploring innovative stability monitoring strategies that leverage advanced technologies, predictive modelling, and adaptive methodologies. By doing so, we seek to enhance the efficiency and effectiveness of stability assessments, supporting rapid development, regulatory approval, and widespread, equal distribution of vaccines—especially in an outbreak scenario. Finally, enhanced thermostability will allow for simplification across the supply chain, which will reduce the financial burden of vaccination programmes and enhance equitable access.

Abstract Background Gravity models are often hard to apply in practice due to their data-hungry nature. Standard implementations of gravity models require that data on each variable is available for each supply node. Since these model types are often applied in a competitive context, data availability of specific variables is commonly limited to a subset of supply nodes. Methods This paper introduces a methodology that accommodates the use of variables for which data availability is incomplete, developed for a health care context, but more broadly applicable. The study uses simulated data to evaluate the performance of the proposed methodology in comparison with a conventional approach of dropping variables from the model. Results It is shown that the proposed methodology is able to improve overall model accuracy compared to dropping variables from the model, and that model accuracy is considerably improved within the subset of supply nodes for which data is available, even when that availability is sparse. Conclusion The proposed methodology is a viable approach to improve the performance of gravity models in a competitive health care context, where data availability is limited, and especially where a the supply nodes with complete data are most relevant for the practitioner.

Abstract Human Respiratory Syncytial Virus (HRSV) is a prevalent cause of severe respiratory infections in children and the elderly. The helical HRSV nucleocapsid is a template for the viral RNA synthesis and a scaffold for the virion assembly. This cryo-electron microscopy analysis reveals the non-canonical arrangement of the HRSV nucleocapsid helix, composed of 16 nucleoproteins per asymmetric unit, and the resulting systematic variations in the RNA accessibility. We demonstrate that this unique helical symmetry originates from longitudinal interactions by the C-terminal arm of the HRSV nucleoprotein. We explore the polymorphism of the nucleocapsid-like assemblies, report five structures of the full-length particles and two alternative arrangements formed by a C-terminally truncated nucleoprotein mutant, and demonstrate the functional importance of the identified longitudinal interfaces. We put all these findings in the context of the HRSV RNA synthesis machinery and delineate the structural basis for its further investigation.

Abstract The earliest European carvings, made of mammoth ivory, depict animals, humans, and anthropomorphs. They are found at Early Aurignacian sites of the Swabian Jura in Germany. Despite the wide geographical spread of the Aurignacian across Europe, these carvings have no contemporaneous counterparts. Here, we document a small, intriguing object, that sheds light on this uniqueness. Found at the Grotte des Gorges (Jura, France), in a layer sandwiched between Aurignacian contexts and dated to c. 36.2 ka, the object bears traces of anthropogenic modifications indicating intentional carving. Microtomographic, microscopic, three-dimensional roughness and residues analyses reveal the carving is a fragment of a large ammonite, which was modified to represent a caniformia head decorated with notches and probably transported for long time in a container stained with ochre. While achieving Swabian Jura-like miniaturization, the Grotte des Gorges specimen displays original features, indicating the craftsman emulated ivory carvings while introducing significant technical, thematic, and stylistic innovations. This finding suggests a low degree of cultural connectivity between Early Aurignacian hunter-gatherer groups in the production of their symbolic material culture. The pattern conforms to the existence of cultural boundaries limiting the transmission of symbolic practices while leaving space for the emergence of original regional expressions.

Abstract Aims Coronary artery disease (CAD) is a common cause of heart failure (HF). It remains unclear who, when and why to direct towards coronary revascularization. The outcomes of coronary revascularization in HF patients are still a matter of debate nowadays. This study aims to evaluate the effect of revascularization strategy on all‐cause of death in the context of ischaemic HF. Methods and results An observational cohort was conducted on 692 consecutive patients who underwent coronary angiography at the University Hospital of Toulouse between January 2018 and December 2021 for either a recent diagnosis of HF or a decompensated chronic HF, and in whom coronary angiograms showed at least 50% obstructive coronary lesion. The study population was divided into two groups according to the performance or not of a coronary revascularization procedure. The living status (alive or dead) of each of the study's participants was observed by April 2022. Seventy‐three per cent of the study population underwent coronary revascularization either by percutaneous coronary intervention (66.6%) or coronary artery bypass grafting (6.2%). Baseline characteristics including age, sex and cardiovascular risk factors did not differ between the invasive and conservative groups, respectively. Death occurred in 162 study participants resulting in an all‐cause mortality rate of 23.5%; 26.7% of observed deaths have occurred in the conservative group versus 22.2% in the invasive group (P = 0.208). No difference in survival outcomes has been observed over a mean follow‐up period of 2.5 years (P = 0.140) even after stratification by HF categories (P = 0.132) or revascularization modalities (P = 0.366). Conclusions Findings from the present study showed comparable all‐cause mortality rates between groups. Coronary revascularization does not modify short‐term survival outcomes in HF patients compared with optimal medical therapy alone outside the setting of acute coronary syndrome.