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Gastric ruptures in blunt abdominal traumatism is extremely rare accounting for 0.02 to 1.7 % of cases of blunt abdominal injuries. They are frequently associated with other intra- and or extra-abdominal lesions, which generally influence morbidity and mortality. We report two cases of gastric rupture, one with splenic and maxillo-facial injury, the other with forearm fracture, with good outcome after surgical treatment.

We have clarified the microbiological characterization of Gambian traditional fermented milk (FM), "Kosam." Two samples of FM were collected at two regions in The Gambia in 2019. The microbiota of these samples was analyzed by culture-dependent methods and Illumina sequencing. The number of lactic acid bacteria (LAB) in FM from Central River Region (CRR) and Lower River Region (LRR) was 8.27 ± 0.08 log CFU/ml and 7.21 ± 0.09 log CFU/ml, respectively. While no coliforms and Escherichia coli were detected in CRR-FM, LRR-FM contained 5.73 ± 0.17 log CFU/ml of coliforms and 4.82 ± 0.13 log CFU/ml of E. coli. The dominant viable LAB in FM from CRR was Lactobacillus delbrueckii, followed by Streptococcus lutetiensis, while that from LRR was Lactococcus lactis. The metagenomic analysis also revealed that these species were dominant in these Gambian traditional FM. Furthermore, it also revealed the possibility of the presence of pathogens such as Klebsiella spp. This study enhanced the knowledge of Gambian FM and contributed to the elucidation of microbial communities.

To identify vitamin A supplementation (VAS) trends in South Sudan and provide insights to refocus VAS programming vis a vis polio eradication campaigns recently phased out while access to health care, land, food, and markets remain challenging.Review of data from survey and coverage reports; review of policy and program documents; key informant responses; general literature search.Vitamin A deficiency (VAD) is likely a severe public health problem among preschool-aged children in South Sudan based on a high under-5 mortality rate (96.2 deaths/1,000 live births) and high levels of undernutrition, infections, and food insecurity. Vitamin A capsules, with deworming tablets (VASD), have been delivered to preschool-aged children during national immunization days (NIDs) for the past decade. Although areas of South Sudan and certain populations continue to have low VAS coverage, when comparing national VAS coverage (reported in the last 6 months) between 2010 and August 2019, a large improvement is noted from 4% to 76%. In 2021, VAS coverage was more than 90% at the national level during 2 stand-alone distribution campaigns. Deworming coverage trends generally mimicked VAS coverage. VAS is provided to postpartum mothers who deliver at health facilities (approximately 12%-25%), but coverage data are not available.Twice-yearly VAS should remain a key lifesaving intervention to address VAD, but alternative delivery strategies will be needed. Conducting events, such as child health days, supported by promotional activities or community-based VASD distribution activities for the youngest children and those missed during campaigns, should be considered. For the long term, a hybrid approach targeting underserved areas with mass distribution events while integrating VASD into community-based programs such as quarterly screening for wasting should be tested further and gradually scaled up everywhere as this has the potential to sustainably reach all vulnerable children twice yearly.

Emerging evidence from studies of older adults hospitalised with COVID-19 suggests that there is a high prevalence of frailty in this patient group. We reflect on the measurement of frailty in older patients hospitalized as an emergency and the translation of frailty from a research to a clinical concept. We consider whether, despite the contemporary challenges in the care of older adults as a result of COVID-19, there are opportunities for care quality improvement during a pandemic.

Rift Valley fever (RVF) is endemic in northern Senegal, a Sahelian area characterized by a temporary pond network that drive both RVF mosquito population dynamics and nomadic herd movements. To investigate the mechanisms that explain RVF recurrent circulation, we modelled a realistic epidemiological system at the pond level integrating vector population dynamics, resident and nomadic ruminant herd population dynamics, and nomadic herd movements recorded in Younoufere area. To calibrate the model, serological surveys were performed in 2015–2016 on both resident and nomadic domestic herds in the same area. Mosquito population dynamics were obtained from a published model trained in the same region. Model comparison techniques were used to compare five different scenarios of virus introduction by nomadic herds associated or not with vertical transmission in Aedes vexans. Our serological results confirmed a long lasting RVF endemicity in resident herds (IgG seroprevalence rate of 15.3%, n = 222), and provided the first estimation of RVF IgG seroprevalence in nomadic herds in West Africa (12.4%, n = 660). Multivariate analysis of serological data suggested an amplification of the transmission cycle during the rainy season with a peak of circulation at the end of that season. The best scenario of virus introduction combined yearly introductions of RVFV from 2008 to 2015 (the study period) by nomadic herds, with a proportion of viraemic individuals predicted to be larger in animals arriving during the 2nd half of the rainy season (3.4%). This result is coherent with the IgM prevalence rate (4%) found in nomadic herds sampled during the 2nd half of the rainy season. Although the existence of a vertical transmission mechanism in Aedes cannot be ruled out, our model demonstrates that nomadic movements are sufficient to account for this endemic circulation in northern Senegal., Author summary Rift Valley fever (RVF) is one of the most important vector borne disease in Africa, seriously affecting the health of domestic ruminants and humans and leading to severe economic consequences. This disease is endemic in northern Senegal, a Sahelian area characterized by a temporary pond network that drive both RVF mosquito population dynamics and nomadic herd movements. Two non-exclusive mechanisms may support this endemicity: recurrent introductions of the virus by nomadic animals, and vertical transmission of the virus (i.e. from infected female mosquito to eggs) in local Aedes populations. The authors followed resident and nomadic domestic herds for 1 year. They used the data thus obtained to model a realistic epidemiological system at the pond level integrating vector population dynamics, resident and nomadic ruminant herd population dynamics. They found that the best scenario explaining RVF remanence combined yearly introductions of RVFV by nomadic herds, with a viraemic proportion predicted to be larger in animals arriving during the 2nd half of the rainy season, which is consistent with an amplification of virus circulation in the area during the rainy season. Although the existence of a vertical transmission mechanism in Aedes cannot be ruled out, their results demonstrates that nomadic movements are sufficient to account for this endemic circulation in northern Senegal.

Background Many zoonotic infectious diseases have emerged and re-emerged over the last two decades. There has been a significant increase in vector-borne diseases due to climate variations that lead to environmental changes favoring the development and adaptation of vectors. This study was carried out to improve knowledge of the ecology of mosquito vectors involved in the transmission of Rift Valley fever virus (RVFV) in Senegal. Methods An entomological survey was conducted in three Senegalese agro-systems, Senegal River Delta (SRD), Senegal River Valley (SRV) and Ferlo, during the rainy season (July to November) of 2014 and 2015. Mosquitoes were trapped using CDC light traps set at ten sites for two consecutive nights during each month of the rainy season, for a total of 200 night-traps. Ecological indices were calculated to characterize the different populations of RVFV mosquito vectors. Generalized linear models with mixed effects were used to assess the influence of climatic conditions on the abundance of RVFV mosquito vectors. Results A total of 355,408 mosquitoes belonging to 7 genera and 35 species were captured in 200 night-traps. RVFV vectors represented 89.02% of the total, broken down as follows: Ae. vexans arabiensis (31.29%), Cx. poicilipes (0.6%), Cx. tritaeniorhynchus (33.09%) and Ma. uniformis (24.04%). Comparison of meteorological indices (rainfall, temperature, relative humidity), abundances and species diversity indicated that there were no significant differences between SRD and SRV (P = 0.36) while Ferlo showed significant differences with both (P

Anorectal disorders include a diverse group of pathological disorders that generate significant patient discomfort and disability. Its prevalence in general population is much higher than seen in clinical practice. Since most patients with symptoms referred to anorectal disorders do not seek medical attention. Of these symptoms, most patients with anorectal disease present with bleeding PR, pain during defecation, protrusion or itching. Anorectal disorders include hemorrhoids, fissures in ano, fistulas in ano, perianal abscesses, pruritis ani and ano rectal growth. In this study, most common anorectal disorders seen, are hemorrhoids in 50% cases followed by fissure in ano 31.36%. Most cases seen in the age group of 21-40years (55.45%). The most common presenting symptom was bleeding per rectum seen in 122 (55.45%) cases followed by pain during defecation 96(43.63%). Constipation and poor hygiene were the most common predisposing factors seen in most anorectal disorders. Most of the patients were treated with the surgical management in 92% cases with minimal recurrence without any mortality. All patients were discharged within 3 - 5 post operative days.

This edited collection is an extremely welcome addition to a growing body of scholarship that makes explicit the social significance of sports. Using innovative ethnographic and cultural studies ap...

BACKGROUND: Electronic health records are being adopted due to numerous potential benefits. This requires the development of objective metrics to characterize morbidity, comparable to studies performed in centers without an electronic health record. We outline the development of an electronic version of the postoperative morbidity score for integration into our electronic health record. METHODS: Twohundred and three frail patients who underwent elective surgery were reviewed. We retrospectively defined postoperative morbidity score on postoperative day 3. We also recorded potential electronic surrogates for morbidities that could not be easily extracted in an objective format. We compared discriminative capability (area under the receiver operator curve) for patients having prolonged length of stay or complex discharge requirements. RESULTS: One hundred thirty-nine patients (68%) had morbidity in ≥1 postoperative morbidity score domain. Initial electronic surrogates were overly sensitive, identifying 173 patients (84%) as having morbidity. We refined our definitions using backward logistic regression against "gold-standard" postoperative morbidity score. The final electronic postoperative morbidity score differed from the initial version in its definition of cardiac and neurological morbidity. There was no significant difference in the discriminative capability between electronic postoperative morbidity score and postoperative morbidity score for either outcome (area under the receiver operator curve: 0.66 vs 0.66 for complex discharge requirement, area under the receiver operator curve: 0.66 vs 0.67 for a prolonged length of stay; P> .05 for both). Patients with postoperative morbidity score or electronic postoperative morbidity score-defined morbidity on day 3 had increased risk of prolonged length of stay (P < .001 for both). CONCLUSIONS: We present a variant of postoperative morbidity score based on objective electronic metrics. Discriminative performance appeared comparable to gold-standard definitions for discharge outcomes. Electronic postoperative morbidity score may allow characterization of morbidity within our electronic health record, but further study is required to assess external validity.

Antibody-mediated long-lasting protection from harmful pathogens depends on collaboration of immune cells within immunological niches. Stoler-Barak et al. introduce an approach that enables the visualization of all the germinal center niches and activated B cells within intact lymph nodes., Germinal centers (GCs) are sites wherein B cells proliferate and mutate their immunoglobulins in the dark zone (DZ), followed by affinity-based selection in the light zone (LZ). Here, we mapped the location of single B cells in the context of intact lymph nodes (LNs) throughout the GC response, and examined the role of BCR affinity in dictating their position. Imaging of entire GC structures and proximal single cells by light-sheet fluorescence microscopy revealed that individual B cells that previously expressed AID are located within the LN cortex, in an area close to the GC LZ. Using in situ photoactivation, we demonstrated that B cells migrate from the LZ toward the GC outskirts, while DZ B cells are confined to the GC. B cells expressing very-low-affinity BCRs formed GCs but were unable to efficiently disperse within the follicles. Our findings reveal that BCR affinity regulates B cell positioning during the GC response.

Introduction: The central, psychiatric and peripheral neurological manifestations of lupus are among the most severe visceral disorders and are grouped under the general term of “neuro-psychiatric systemic lupus erythematosus” (NPSLE). We conducted a cross-sectional observational study within our Department of Internal Medicine aimed at describing the clinical and evolutionary aspects of central neurological disorders of SLE, excluding lupus myelopathy. Patients and Methods: This was a retrospective and observational cross-sectional study carried out from 1 January 2015 to 31 October 2017, in the Department of Internal Medicine of Aristide le Dantec University Hospital in Dakar (Senegal). All patients hospitalized during this period who met the 1997 ACR classification criteria of SLE and who presented with a central neuropsychiatric syndrome attributable to SLE (as defined by ACR 1999) were included. Patients with isolated headache, acute myelitis or secondary neurological involvement attributable to a toxic, metabolic, infectious or tumour-related cause were excluded from our study. Results: During the study period, 10 patients with neuropsychiatric lupus involvement were treated at our institution, including 9 women and 1 man; the median age was 29 years (20 - 55 years). Neurological involvement occurred during the course of lupus evolution in 9/10 cases. The median time to SLE evolution was 18 months (0 - 60 months). Neuropsychiatric syndromes as defined by the 1999 ACR were commonly associated and more than half of our patients had multiple neuropsychiatric syndromes. There were 5 cases of confusion syndrome and coma, 4 cases of seizure, 3 cases of psychosis, 2 cases of acute cerebrovascular disease and 1 case of aseptic meningitis. Among the extra-neurological manifestations of SLE, haematological and dermatological involvements were common. Renal involvement affected half of the patients. The other manifestations were: polyarthritis in 3 patients, serositis in 2 patients, 5 cases of fever, 4 cases of deterioration of the general state, and one isolated case of ophthalmological involvement. Therapeutically, 8 patients received a bolus of methylprednisolone and 3 patients received a bolus of cyclophosphamide. Oral corticosteroids and hydroxychloroquine were administered to all patients, and azathioprine was administered in 2 patients. The evolution was favorable in 4 patients, other 2 patients maintained neurological sequelae and 2 patients were transferred to intensive care. Death was recorded in 4 patients. Conclusion: Neuropsychiatric manifestations of lupus are rare and sometimes severe, potentially life-threatening. In our patients, we have identified some of the most severe neurological syndromes according to the ACR nomenclature. The neurological involvement is exceptionally revealing, as these syndromes are often associated and integrated into a systemic context of lupus. The evolution is rapidly unfavorable and requires early diagnosis and optimal management.

International audience; Bluetongue (BT) is an infectious, arthropod-borne viral disease of domestic and wild ruminants. The disease causes animal mortality, production decrease and commercial limits for herds. Despite the active circulation of the disease in the world, few studies have been carried out in Senegal. The objective of this study was to assess the current prevalence of BT in small ruminants and the serotypes circulating in Senegal. A cross-sectional study was conducted in the fourteen regions of Senegal. After the sampling campaign, sera collected in sheep and goats herds were screened for the presence of Bluetongue virus (BTV) specific antibodies using c-Elisa. The whole blood of seropositive animals was further analyzed by RT-qPCR and positive samples were typed to identify BTV serotypes. Analysis of several risk factors such as age, sex and species of animals was performed using logistic regression. The overall seroprevalence of BTV in Senegal was 72.6% (95% CI: 70.3-74.9%) with 75.9% (95% CI: 72.2-79.5%) in goat and 70.6% (95% CI: 67.5-73.6%) in sheep. Female (prevalence=77.1%) and adult (prevalence=80%) animals showed the highest seropositivity to BTV compared respectively to male (55.7%, p=6.133e-09) and young (49.4%, p < 2.2e-16). The RT-qPCR results showed the presence of BT viral genome in 359 small ruminants. The results obtained from serological and genotyping studies showed an active spread of the Bluetongue virus in domestic ruminants and phylogenetic analysis showed that the BTV-2 is one of the circulating serotypes in Senegal. This study allows having baseline information for controlling Bluetongue in Senegal.

Solar tower power plant has become the most promising concentrated solar power technology for the production of thermal and electrical energy because of its advantages including high improvement rate, possibility of small scale, hybridization, cogeneration. However, the high cost and the low efficiency of the heliostats field constitute an obstacle of this technology development. In this paper, a simple heliostat with an azimuth and altitude mechanism is implemented. The mirror position is determined thanks to the astronomical equations and Snell Descartes Law's. On each axis, a hybrid stepper motor is placed for moving the mirror. To improve the accuracy of the tracking system, this paper proposes the field oriented control like a positioning control technique of heliostats stepper motors. Simulations of the tracking are done in Matlab/Simulink. The results obtained show that the positions are reached without overshooting and with response times of 0.269 and 0.285s respectively for altitude and azimuth axis. According to the results of simulations, the field oriented control is a good method for heliostat motors control.

The use of efficient mosquito sampling methods in vector surveillance programs is crucial to inform control actions and prevent outbreaks. amongst existing trapping methods, the BG sentinel trap is widely used for collecting mosquitoes from the subgenus Stegomyia. However, studies state that the BG-sentinel trap underestimates the relative abundance of mosquito vectors. In this study, we used mice to enhance the effectiveness of the BG-sentinel trap to collect Aedes aegypti (Linnaeus) and follow the species' daily abundance under local conditions. The Latin square method was used to compare different combinations in three different seasons. Of the 35,107 mosquitoes collected, Ae. aegypti (53.82%) and Culex quinquefasciatus (46.07%) were dominant. The combination of BG-Lure + 3 mice captured more Ae. aegypti individuals (apparent density per trap/day (ADT = 187.65 ± 133.53; p0.001) followed by the 3 mice-baited BG-sentinel trap (ADT = 163.47 ± 117.32), the BG-sentinel trap without attractant (ADT = 74.15 ± 117.07) and the BG-sentinel trap + BG-Lure (ADT = 47.1 ± 115.91). Aedes aegypti showed two peaks of activity in the day, one following the sunrise and one before the sunset, influenced by temperature and relative humidity. Our study suggests the use of mice to enhance the efficiency of the BG-Sentinel trap to catch Ae. aegypti. However, its application in large scale entomological monitoring programs should be difficult because of ethical and operational constraints.

International audience; Our understanding of the viral communities associated to animals has not yet reached the level attained on the bacteriome. This situation is due to, among others, technical challenges in adapting metagenomics using high-throughput sequencing to the study of RNA viromes in animals. Although important developments have been achieved in most steps of viral metagenomics, there is yet a key step that has received little attention: the library preparation. This situation differs from bacteriome studies in which developments in library preparation have largely contributed to the democratisation of metagenomics. Here, we present a library preparation optimized for metagenomics of RNA viruses from insect vectors of viral diseases. The library design allows a simple PCR-based preparation, such as those routinely used in bacterial metabarcoding, that is adapted to shotgun sequencing as required in viral metagenomics. We first optimized our library preparation using mock viral communities and then validated a full metagenomic approach incorporating our preparation in two pilot studies with field-caught insect vectors; one including a comparison with a published metagenomic protocol. Our approach provided a fold increase in virus-like sequences compared to other studies, and nearly-full genomes from new virus species. Moreover, our results suggested conserved trends in virome composition within a population of a mosquito species. Finally, the sensitivity of our approach was compared to a commercial diagnostic PCR for the detection of an arbovirus in field-caught insect vectors. Our approach could facilitate studies on viral communities from animals and the democratization of metagenomics in community ecology of viruses.

Long-lasting immunity depends on the generation of protective antibodies through the germinal center (GC) reaction. N6-methyladenosine (m6A) modification of mRNAs by METTL3 activity modulates transcript lifetime primarily through the function of m6A readers; however, the physiological role of this molecular machinery in the GC remains unknown. Here, we show that m6A modifications by METTL3 are required for GC maintenance through the differential functions of m6A readers. Mettl3-deficient GC B cells exhibited reduced cell-cycle progression and decreased expression of proliferation- and oxidative phosphorylation–related genes. The m6A binder, IGF2BP3, was required for stabilization of Myc mRNA and expression of its target genes, whereas the m6A reader, YTHDF2, indirectly regulated the expression of the oxidative phosphorylation gene program. Our findings demonstrate how two independent gene networks that support critical GC functions are modulated by m6A through distinct mRNA binders.

In this paper, the sizing and design of a standalone photovoltaic water pumping system in Ngoundiane, a village located in Senegal is investigated. An intuitive sizing method is firstly applied to get approximate information on the sizes of the various components. In this method, the capacity of various components is separately computed and any relationship between them are considered. To improve the results, a new sizing approach based on numerical methods is developed using the Average Loss of Power Supply Probability (ALPSP) criterion. Empirical simple models are used to model the components of PV system. From the energy generated by PV array, the different states of charge of the battery storage are estimated. A simple algorithm has been elaborated to determine the different PV and battery combinations for various ALPSP levels. The proposed model has been applied to the meteorological average data in Ngoundiane site and conducted using MATLAB software. The results showed that the numerical method proposed allows a 50% reduction of the storage capacity when compared to the intuitive method. However, we noticed that the values of ALPSP are particularly high with a smaller value of 0.3, probably due to the underestimation of input parameters and the nature of meteorological data used in the model. In order to show the importance of the developed approach, a comparison with literature has been performed.

Dans cet article, nous étudions la résistance de la femme noire face à l’esclavage. Partant des épreuves imposées par les maîtres blancs, Morrison réhabilite la femme à travers les personnages de Sethe et de Baby Suggs, qui ont résisté là où beaucoup d’hommes ont échoué. En plus d’avoir une progéniture à prendre en charge, toutes les deux sont appelées à travailler laborieusement aussi bien à la maison que dans les champs des maîtres. Ce qui, loin de les fragiliser, les rend plus fortes et plus déterminées pour protéger leurs familles et les gens qu’elles aiment même s’il faut mourir ou tuer pour cela. Morrison a utilisé ces personnages pour, non seulement, mettre en exergue la détermination et l’engagement de la femme noire, mais aussi sa réhabilitation face aux préjugés de la gente masculine qui se croit supérieure.

Consecutive exposures to different pathogens are highly prevalent and often alter the host immune response. However, it remains unknown how a secondary bacterial infection affects an ongoing adaptive immune response elicited against primary invading pathogens. We demonstrated that recruitment of Sca-1