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Petrographic and petrophysical characterizations of the pre-salt Chela formation of the Nsiamfumu and Liawenda fields in the onshore Coastal Basin of the D.R. Congo it was performed. These characterizations, as part of the static modelling of the reservoirs, involved reading log measurements, thin-slice observations of rock samples taken from this formation, calculations and interpretation of logs, CPI (Computer Processed Interpretation) and DST (Drill Stem Testing) from well tests. The following observations were obtained: • Wells Lw-1: the formation is characterized by dolomitic limestone and micaceous black shale with a thickness of 34 m having heavy oil indices and an average porosity of 17% and a salinity greater than 300 gr/L; • Well Lw-2: the formation is characterized by islands of sand, coarse sandstone and a few quartz pebbles with a thickness of 10m showing evidence of light oil, gas and an average porosity of 24%; • Shaft Lw-3: the formation is dominated by micaceous shale and dolomite interbeds with a thickness of 14m showing little evidence of hydrocarbons, only salt water and residual oils; • Puits Ns-1: the formation is characterized by beige to grey dolomite, grey shale and white sand with a thickness of 6m showing evidence of light oil and an average porosity of 20%.

Introduction Maternity units are supposed to be places that welcome new life, but sometimes things do not go as hoped. Many mistakenly believe that the death of a baby, known for only a few hours or days, has less impact than the death of an older child. However, the sense of loss experienced by parents is equally profound. Purpose The objective of this study was to assess the opinions of caregivers on supporting couples in perinatal bereavement at the Kintambo Maternity Hospital in Kinshasa, Democratic Republic of the Congo. Methods This descriptive study was conducted at the Kintambo Maternity Ward in Kinshasa, focusing on caregivers' opinions regarding the support of couples during perinatal bereavement. A survey was used to explore the issue and collect data, aiming to describe and understand the phenomenon from the perspective of those involved. Additionally, face-to-face interviews were employed as a data collection technique, allowing caregivers to express their views. Results The results show that 56% of the caregivers interviewed were men and 46% were women. However, 41% of caregivers expressed a favourable opinion regarding the support of couples during perinatal bereavement, while 59% expressed an unfavourable opinion. Furthermore, 25.4% of caregivers believed that emotional involvement is an obstacle to supporting couples, 20.3% lacked in-depth knowledge about perinatal bereavement support, 35.5% showed a lack of empathy, and 18.6% of caregivers displayed a lack of psychological stability. Conclusion Supporting a couple during perinatal bereavement is challenging and requires a range of personal skills and significant self-awareness. A caregiver, dealing with both their own emotions and those of the couple, can be a custodian of suffering. It is essential for caregivers to harness their emotions positively, using them as a strength rather than fearing them, in order to better understand and care for those in mourning.

Introduction Pregnancy and childbirth have historically been considered, both in collective imagination and cultural transmission, as situations that threaten maternal and fetal survival. Purpose This study aims to understand the experiences of women who underwent Caesarean sections at Isiro General Reference Hospital, in relation to their pregnancies and labour, in order to inform precautions for future cases. Methods This is a qualitative study with a phenomenological approach. The population consists of women who underwent Caesarean sections in the gynecology-obstetrics department of Isiro General Reference Hospital. Data were collected through individual, semi-structured face-to-face interviews. Results For most women in the town of Isiro, pregnancy and childbirth are perceived as difficult and painful experiences. They reported discomfort and embarrassment, describing a variety of symptoms that were often mild: various pains, eating and digestion disorders, headaches, shortness of breath, dizziness, etc. In addition, the expectant mothers often felt vulnerable. Conclusion The conception of a child triggers a significant emotional upheaval in women, with psychological and physiological changes, particularly hormonal. These should not obscure the psychological challenges involved. Pregnancy and childbirth represent a period of identity crisis and psychological maturation for the woman transitioning into motherhood.

Introduction The issue of resorting to self-medication is currently common and no geographical area is spared from it in the world. Millions of people prefer to treat minor ailments rather than follow formal treatment. Purpose This study aimed to determine the factors associated with self-medication in the Barumbu Health Zone. Methods This is a descriptive correlational and cross-sectional study carried out in the city of Kinshasa, and more precisely in the Barumbu Health Zone. The sample was 266 heads of households. The questionnaire survey method was used with the structured interview technique to collect the data. Results After analysis with SPSS version 20 software, we arrived at the results according to which self-medication is practiced by 76.6%. Level of education (secondary) (X2 8.084, p=0.044) and monthly income ≤ 100$ (2 20.445., p=0.000) are associated with the practice of self-medication. Insufficient knowledge about the consequences of self-medication (X2 8.872, p= 0. 003), insufficient membership of mutual health insurance companies (X2 16,677, p=0.000), and the high cost of care (X2 30,304, p=0.000), are factors associated with the practice of self-medication in the commune of Barumbu, Kinshasa. Conclusion The revision of health care fees in all health care structures to allow everyone to access health care, the mobilisation to join mutual health insurance companies, and the sensitisation to the consequences of self-medication will allow to reduce this practice significantly.

Introduction Pregnancy is a physiological phenomenon, but it carries increased health risks for both the woman and the unborn child, in terms of morbidity and mortality. The objectives of pregnancy monitoring are to promote normal pregnancies and to identify and prevent possible complications. Purpose This study aimes to identify the reasons for late attendance at Antenatal Care (ANC) by pregnant women at the Révélation Health Center, Commune of Kisenso, City of Kinshasa, Democratic Republic of the Congo. Methods This is a descriptive, cross-sectional, and analytical study conducted at the Révélation Health Center, located in the Commune of Kisenso, City of Kinshasa, Democratic Republic of the Congo. The sample size was 35 pregnant women selected according to inclusion criteria, who provided data through a questionnaire. Data were analyzed using SPSS version 22.0 software. Results Analysis revealed that late attendance at prenatal consultations was motivated by the absence of complications during pregnancy (51.4%), financial difficulties (45.7%), professional occupation (28.6%), negligence (25.7%), and lack of decision-making power due to cultural practices (37.1%). Conclusion Strengthening awareness among women and their husbands about the importance of early and regular ANC is crucial. Effective measures to increase attendance and reduce delays include community education and involvement.

Introduction The professional identity of midwives develops and consolidates through various personal and professional experiences in the practice of care. However, the autonomous practice of midwifery, within a multidisciplinary approach, remains a significant obstacle to this construction. Purpose This study aims to understand how midwives construct their professional identity and autonomy in their practice. Method This is a qualitative study using grounded theory. Data were collected from seven midwives at the N'Djili General Reference Hospital through semi-structured interviews. The questions addressed professional identity. The analysis was conducted using open, axial, and selective coding, allowing the discovery of themes, categories, and concepts using an analysis grid. Results The construction of professional identity is associated with initial training, the specific care practices of midwives (roles), the support from health structures, and the support of the midwifery association. This process occurs through the practices of identity care, the precision of the midwife's field of activities, the publication of professional guidelines, and the dissemination of regulations specifying the scope of action of midwives. Conclusion The midwifery profession has experienced significant evolution in its skills in recent years, an evolution perfectly integrated from academic training. It is, therefore, necessary to inform learners in training about ways to achieve professional autonomy in a clinical environment. Practicing midwives should strive to create autonomy within a professional group, practice and demand to perform autonomous acts, and provide independent care in maternity wards, birthing centers, medically assisted procreation centers, family planning centers, or in private practice when they are independent.

Introduction Antenatal care provides a platform for important health benefits, including health promotion, screening, diagnosis, and disease prevention. It is established that timely implementation of appropriate evidence-based practices in antenatal care can save lives. PurposeThis study aimed to identify factors associated with the continuity of prenatal care among pregnant women in the Kingasani Health Zone. Methods This descriptive correlational study used proportional stratified sampling to select participants and collect data from February 20, 2021, to April 5, 2021. A total of 165 subjects were included in the study. Results The analysis revealed that the continuity of prenatal care is statistically linked to the delay in initiation of ANC (RR: 2.108, 95% CI [1.334-3.332], χ2: 13.780, p < 0.0001), encouragement of women to follow ANC (χ2: 5.643, p = 0.007), and compliance with appointments by pregnant women (RR: 3.143, 95% CI [1.106-8.901], χ2: 8.189, p = 0.004). However, continuity of antenatal care is not linked to the distance between home and the antenatal care service (RR: 2.188, 95% CI [1.002-5.377], χ2: 5.866, p = 0.015). These findings partially confirm that the use of prenatal services in the Kingasani Health Zone is positively influenced by the personal characteristics of the subjects. Conclusion Prenatal care providers have a major task in explaining to pregnant women the number of ANC visits scheduled for a pregnancy, their frequency, the importance, and the principles of each ANC activity. Evaluating the quality of ANC and the frequency of ANC clients at referral health centers is crucial.

La présente étude a pour objectif l’évaluation des connaissances, attitudes et pratiques des travailleurs de la Carrigrès sur l’hygiène, santé et sécurité au travail en vue de prévenir les accidents de travail et les maladies professionnelles. Cette entreprise compte 120 travailleurs regroupés en agents du service administratif et du secteur de la production dans une étude descriptive transversale menée auprès de la société Carrigrès. Les résultats ont montré que les connaissances des travailleurs sur l’hygiène, santé et sécurité au travail ont été évaluées à 88,3%. Près de 40% des participants ont connu un accident de travail au cours de leur carrière et 50% d’entre eux étaient pris en charge par l’entreprise. De façon générale, les travailleurs avaient une bonne connaissance sur l’hygiène, la sécurité et la santé au travail ainsi que sur les risques professionnels liés au travail.

There is a global upsurge in the use of cemented paste backfill (CPB) for various mining functions. However, the cost of the Portland cement binder is prohibitive, thus warranting strategies to reduce cement usage without overly diminishing the CPB quality. Since carbon dioxide is used for patented sand moulding processes, this study is premised on that physicochemical ability of CO2 to enhance the curing of consolidated inorganic materials. It evaluated the impact of carbon dioxide on the uniaxial compressive strength UCS and preparation cost of CPB standard samples (ASTM C109). The preparation cost was delimited to the purchase cost of the Portland cement. The backfill material was silica sand tailings with 4.5 wt.% Portland cement binder and a water-cement ratio of 7.6. Distilled water of pH 5.4 was used for the control samples while variable amounts of carbon dioxide were dissolved in distilled water to generate carbonated mixing water with pH values of 3.8; 4 and 4.2. The lower the carbonated water pH, the higher is the CO2 concentration. UCS tests were conducted on the samples after curing for 3, 7, 28, and 90 days. There was an observable increase in the UCSs and reduction in curing time with increasing carbon dioxide. Samples prepared with carbonated water of pH 3.8 had almost double the strength of those prepared with pure distilled water of pH 5.4, implying that more dissolved CO2 corresponds to higher CPB strength. This is supported by the trendline equations for the graphical simulation of strength on curing time. Thus, CPB with much less binder can be expected to attain the requisite UCS if carbon dioxide is incorporated. The average reduction in Portland cement consumption was 0.61 %, which translates to a cost saving of the same percentage points. If calculated over the operational life of a mine, this is a massive saving of millions of dollars.

La présente étude soutient que le système de gestion de déchets ménagers solides mis en place dans la Commune de Masina se révèle être anti-écologique ; en raison notamment de : - l’absence d’une véritable politique d’aménagement écologique du territoire, d’une bonne gouvernance et d’une éducation relative à l’environnement ; - l’ignorance et de l’incompétence écologique des autorités municipales, de l’équipe chargée de la collecte et de la population ; - la pauvreté multiforme (morale, humaine et matérielle) ; - le recours aux modes et techniques de gestion non écologique de déchets solides.

Le présent article a pour objectif de démontrer comment la méthode de centre d’analyse ou de sections homogènes peut être utilisée dans des structures sanitaires pour l’analyse des charges en termes de dépenses, et dans le calcul du coût des soins. Les données proviennent du rapport annuel des services de finances de l’hôpital José Oudney, et la méthode des sections homogènes nous a permis de faire une répartition analytique des charges indirectes d’exploitation afin de les imputer aux coûts réels des soins et services médicaux reçus par 3.585 patients pour l’exercice 2020.

The contribution of the combined interpretation of geo-petroleum data in the oil exploration program of the central Cuvette basin “case of the Lokoro sub-basin” carried out as part of our scientific research for Diplome d'Etudes Approfondies studies (DEA). The objective of this research is to update knowledge on oil exploration in the Lokoro sub-basin. We combined and analyzed geological, geochemical and geophysical data to obtain the following results: - Static terrestrial gravity campaign in the western part in order to have information on the sedimentary cover of this zone and the geological structures; - The Kiri structure is a salt dome superimposed by fragments of granitic rock which give a signature of heavy gravity anomaly; - The highlighting of three prospective zones, Zone A, Zone B and Zone C, for which we have proposed seismic work adapted to geological realities; - The L59 seismic line of the Dekesse well was not drilled in the right place, the interpretation of this profile shows the deformation by salt tectonics, which generated geological structures of oil interest, the location of which we had proposed drilling.

This paper is about the mismatch between vocabulary (its nature and importance in language) and the techniques used for teaching it. It is obvious that vocabulary is not solely a given meaning of a word; it is actually the study of the words of a language. Teaching vocabulary is therefore teaching words with their various features that make lexical knowledge. This objective cannot be achieved when depth and breadth of vocabulary do not matter for instructors. Unfortunately, this study reveals that the techniques dominantly used for teaching vocabulary in Mbujimayi (DRC) are scarcely ever effective in helping teachers impart knowledge of all or the majority of a word’s aspects. Visuals, gestures, eliciting and translation that have been the used in teaching vocabulary hardly ever succeeded in helping teachers present information about polysemy, sense relations, collocations, style, idioms and word parts during the vocabulary lessons. To take visuals (as they are the techniques the most applied) as an example, teachers do teach only the words’ spelling, pronunciation and only one of its meanings when applying this technique. The rest of word information is ignored (as it is explained in the text). To solve this problem, I advise teachers to reconsider their choices of the vocabulary teaching techniques and their combination with others paying attention to those likely to achieve lexical competence. I find the use of the dictionary the best technique for teaching vocabulary as the dictionary contains all the elements of vocabulary listed in this paper. Decision makers and teachers should maximise teacher training in dictionary use (in class or out of it) for the good of the learners’ lexical instruction.

Introduction: Adolescence is a period of psychological and somatic growth and development. Pregnancy and childbirth during this period expose women to medical and cognitive risks. The aim of this study was to determine the prevalence, indications, evolution and factors associated with the risk of caesarean section among adolescent and adult women. Methods: This was a cross-sectional, analytical study conducted at Lubao General Referral Hospital. Data covered the period from 2018 to 2022. Epi Info 7.2.4 and Jamovi 2.3.21 software were used for data analysis. The p-value and Odd ratio were used to determine the association between the variables. Results: Caesarean sections accounted for 15.3% of deliveries (375 out of 2444). The prevalence of caesarean sections was 78.0% (64 out of 82 deliveries) among adolescent women and 13.2% (311 out of 2362 deliveries) among adult women. The risk of caesarean section was 23.44 times higher among adolescents (OR 23.44; [IC95% 13.71-40.09]; p-0.0000). Fetal macrosomia and acute fetal distress were the main indications in both groups. Bone dystocia was found only among adolescents. Occupation (OR 39.04 [CI95% 5.34-285.27]; p=0.0000), being single (OR 43.26 [CI95% 9.54-196.10]; p=0.0000), mechanical dystocia (OR 2.08 [CI95% 1.11-3.87]; p=0.0190) and parity ≤ three (p=0.0000) were associated with the indication for caesarean section among the adolescents studied. Maternal and early neonatal outcome were not associated with maternal age. Conclusion: Adolescents present a very high risk of caesarean section. Raising parents' awareness of the risks of early marriage, educating girls in favour of sex education in schools, churches and youth clubs, and combating sexual exploitation and abuse and even sexual violence are all solutions that should be considered.

Abstract Introduction There is growing interest in health, developmental and survival outcomes of children who are born HIV‐free to women living with HIV (children born HIV‐free). To date, the research agenda has been largely determined by researchers, funders and policy makers, with limited involvement of parents, who are key stakeholders. Researchers at UCL Great Ormond Street Institute of Child Health in partnership with community‐based organisation 4M Network of Mentor Mothers conducted two workshops with parents in March 2022 to establish research priorities for children born HIV‐free, and key considerations for methodological approaches both to research and engagement with the affected communities. Discussion When exploring research on children born HIV‐free, we consider the following: what aspects of current research are aligned with women and parents’ priorities, what is missing and what approaches would be preferred. A holistic approach to research on children born HIV‐free should be prioritised, focussing on a breadth of outcomes and how they intersect. Secondary use of existing data sources should be maximised to facilitate this, with a view of monitoring the long‐term effects of fetal antiretroviral drug exposure alongside other key health and developmental outcomes. Involving and engaging with parents, and children where possible, must be at the heart of research design to maximise relevance and impact of findings for the affected communities. Potential barriers to engaging with individuals who were children born HIV‐free include parental disclosure and individuals not identifying as a child born HIV‐free to a mother living with HIV. Stigma‐free language must be incorporated into the vocabulary of researchers and other stakeholders, avoiding reference to exposure; we propose the term “children born HIV‐free.” Conclusions Mothers and parents living with HIV should be involved in research about their children born HIV‐free and are key in identifying research priorities so that findings may translate into an impact on their children's health and wellbeing. Meaningful involvement of women living with HIV through trusted community partners is an effective mechanism by which to elicit views on research about their children.

Abstract The thyroid imaging reporting and data systems by the European Thyroid Association (EU-TIRADS) has been widely used in malignancy risk stratification of thyroid nodules. However, there is a paucity of data in developing countries, especially in Africa, to validate the use of this scoring system. The aim of the study was to assess the diagnostic value of the EU-TIRADS score in Congolese hospitals, using pathological examination after surgery as the gold standard in Congolese hospitals. This retrospective and analytical study examined clinical, ultrasound and pathological data of 549 patients aged 45 ± 14 years, including 468 females (85.2%), operated for thyroid nodule between January 2005 and January 2019. In the present study, only the highest graded nodule according to the EU-TIRADS score in each patient was taken into account for the statistical analyses. So 549 nodules were considered. Nodules classified EU-TIRADS 2 and 3 on the one hand, and, on the other hand, 4 and 5, were considered respectively at low and high risk of malignancy. The sensitivity and specificity of the EU-TIRADS score were calculated. The significance level was set at 5%. Of all patients, 21.7% had malignant nodules. They made 48.4% of the nodules in patients younger than and at 20 years old, and 31.1% in those aged 60 or over. Malignant nodules were more frequent in men than in women (30.9% vs. 20.1%; p = 0.024). Papillary carcinoma (67.2%) and follicular carcinoma (21.8%) were the main types. The malignancy rate was 39.7% and 1.5% among nodules rated EU-TIRADS 4 and 5, and those with EU-TIRADS score 2 and 3, respectively (p

Abstract Introduction The prevalence of gestational diabetes (GD) is increasing globally. While universal risk factors for GD are reasonably well understood, questions remain regarding risks for women living with HIV (WLWH). We aimed to describe GD prevalence, evaluate associated maternal risk factors and assess specific birth outcomes in WLWH in the UK and Ireland. Methods We analysed all pregnancies (≥24 weeks’ gestation) in women diagnosed with HIV before delivery, reported to the UK‐based Integrated Screening Outcomes Surveillance Service between 2010 and 2020. Every report of GD was considered as a case. A multivariable logistic regression model, adjusted for women with more than one pregnancy fitted with generalized estimating equations (GEE) assessed the effect of independent risk factors. Results There were 10,553 pregnancies in 7916 women, of which 460 (4.72%) pregnancies had reported GD. Overall, the median maternal age was 33 years (Q1:29–Q3:37), and 73% of pregnancies were in Black African women. WLWH with GD (WLWH‐GD) were older (61% vs. 41% aged ≥35 years, p < 0.001) and more likely to be on treatment at conception (74% vs. 64%, p < 0.001) than women without GD. WLWH‐GD were more likely to have a stillbirth (odds ratio [OR]: 5.38, 95% CI: 2.14–13.5), preterm delivery (OR: 2.54, 95% CI: 1.95–3.32) and fetal macrosomia (OR: 1.14, 95% CI: 1.04–1.24). Independent risk factors for GD included estimated year of delivery (GEE‐adjusted odds ratio [GEE‐aOR]: 1.14, 95% CI: 1.10–1.18), advanced maternal age (≥35 years) (GEE‐aOR: 2.87, 95% CI: 1.54–5.34), Asian (GEE‐aOR: 2.63, 95% CI: 1.40–4.63) and Black African (GEE‐aOR: 1.55, 95% CI: 1.13–2.12) ethnicity. Timing and type of antiretroviral therapy showed no evidence of a relationship with GD in multivariable analyses; however, women with a CD4 count ≤350 cells/μl were 27% less likely to have GD than women with CD4 counts >350 cells/μl (GEE‐aOR: 0.73, 95% CI: 0.50–0.96). Conclusions GD prevalence increased over time among WLWH but was not significantly different from the general population. Maternal age, ethnicity and CD4 count were risk factors based on available data. Stillbirth and preterm delivery were more common in WLWH‐GD than other WLWH over the study period. Further studies are required to build upon these results.

Abstract Background Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended by the World Health Organization for the prevention of malaria in pregnancy (MIP)-associated adverse outcomes in high burden areas. However, the efficacy of IPTp-SP has decreased in step with increasing parasite drug resistance. Suitable alternative strategies are needed. Methods This is a protocol for a phase IIIb open-label, two-armed randomized controlled superiority trial to assess the safety and efficacy of a hybrid approach to IPTp combining screening and treatment with dihydroartemisinin-piperaquine (DP) to the current IPTp-SP regimen at the first antenatal care clinic visit. Pregnant women without HIV infection and without signs or symptoms of malaria will be randomized to either standard IPTp-SP or hybrid IPTp-SP plus screening and treatment (IPTp-SP+). In the IPTp-SP+ arm, participants who screen positive by rapid diagnostic test for P. falciparum will be treated with DP at the first antenatal visit while those who screen negative will receive SP per current guidelines. All participants will be administered SP on days 35 and 63 and will be actively followed biweekly up to day 63 and then monthly until delivery. Infants will be followed until 1 year after delivery. The primary endpoint is incident PCR-confirmed MIP at day 42. Secondary endpoints include incident MIP at other time points, placental malaria, congenital malaria, hemoglobin trends, birth outcomes, and incidence of adverse events in infants up to the first birthday. Discussion A hybrid approach to IPTp that combines screening and treatment with an artemisinin-based combination therapy at the first visit with standard IPTp-SP is hypothesized to confer added benefit over IPTp-SP alone in a high malaria transmission area with prevalent SP resistant parasites. Trial registration Pan African Clinical Trials Registry 201905721140808 . Registered retrospectively on 11 May 2019

Background: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms of the gastrointestinal tract (GIT) that represent approximately 1 to 2 percent of primary gastrointestinal (GI) cancers. Owing to their rarity, very little is known about their overall epidemiology, and the prognostic factors of their pathology. The current study aimed to evaluate the independent determinants of mortality in patients diagnosed with GISTs over the past decade. Methods: Our study comprised 2374 patients diagnosed with GISTs from 2000 to 2017 from the Surveillance, Epidemiology, and End Results (SEER) database. We analyzed the baseline characteristics, and overall mortality (OM), as well as the cancer-specific mortality (CSM) of GISTs. Variables with a p value < 0.01 in the univariate Cox regression were incorporated into the multivariate Cox model, to determine the independent prognostic factors. Results: Multivariate Cox proportional hazard regression analyses of factors affecting the all-cause mortality and GIST-related mortality among US patients between 2010 and 2017 revealed a higher overall mortality in non-Hispanic Black patients (HR = 1.516, 95% CI 1.172–1.961, p = 0.002), patients aged 80+ (HR = 9.783, 95% CI 4.185–22.868, p = 0), followed by those aged 60–79 (HR = 3.408, 95% CI 1.488–7.807, p = 0.004); male patients (HR = 1.795, 95% CI 1.461–2.206, p < 0.001); patients with advanced disease with distant metastasis (HR = 3.865, 95% CI 2.977–5.019, p < 0.001), followed by cases with regional involvement via both direct extension and lymph node involvement (HR = 3.853, 95% CI 1.551–9.57, p = 0.004); and widowed patients (HR = 1.975, 95% CI 1.494–2.61, p < 0.001), followed by single patients (HR = 1.53, 95% CI 1.154–2.028, p = 0.003). The highest CSM was observed in the same groups, except widowed patients and patients aged 60–79. The highest CSM was also observed among patients that underwent chemotherapy (HR = 1.687, 95% CI 1.19–2.392, p = 0.003). Conclusion: In this updated study on the outcomes of patients with GISTs, we found that non-Hispanic Black patients, male patients, and patients older than 60 years have a higher mortality with GISTs. Furthermore, patients who have received chemotherapy have a higher GIST-specific mortality, and married patients have a lower mortality. However, we do not know to what extent these independent prognostic factors interact with each other to influence mortality. This study paves the way for future studies addressing these interactions. The results of this study may help treating clinicians to identify patient populations associated with a dismal prognosis, as those may require closer follow-up and more intensive therapy; furthermore, with married patients having a better survival rate, we hope to encourage clinicians to involve family members of the affected patients early in the disease course, as the social support might impact the prognosis.

Objective We are analysing linked public health surveillance data on pregnancies to women living with HIV in the UK and vital registration data on all their children born HIV-free, an under-researched group. We sought to engage women living with HIV to elicit their feedback on our work and set research priorities. Approach In partnership with 4M Net, a national peer-support network for mothers living with HIV, we co-designed and held two online workshops (one workshop a week over two weeks) in March 2022. We designed the workshops to be highly interactive, using a combination of online tools and created a safe space for open discussion. All participants received a preparatory booklet in advance, comprising questions, activities, and space for reflections during the workshops. We also prompted participants to discuss their research priorities with peers and/or family members if they felt comfortable with this. Results In total, 6 participants attended the two 2-hour long workshops. All participants were from Black ethnic backgrounds, aged 30 years or older and were mothers of children or young adults born HIV-free. Overall, participants were positive about the programme of research and identified pregnancy, birth, and long-term outcomes in children (especially regarding HIV medication in pregnancy) as being of key importance. They supported the use of linked mental health, hospital, general practice (GP), health visiting and education data to explore pregnancy, health and developmental outcomes among children born HIV-free. Linkage to GP data was identified as a priority by participants, and there was particular interest in addressing knowledge gaps on the mental health of children and young adults born HIV-free. Conclusion Women living with HIV are often involved in research around pregnancy, but rarely in research about their children. By working with trusted community partners, we can engage this often marginalised group of parents who understand the value of linked data research exploring the health and wellbeing of their children born HIV-free.

AimsThe social parameters of an individual impact the incidence of cardiovascular diseases. French Guiana, an overseas French territory with a lower standard of living than France, has a prevalence of diabetes mellitus that is twice that of mainland France. In this context we aimed to study the relation between precariousness, diabetes complications and glycemic control.MethodsA multicenter prospective cohort was initiated since May 2019. 1243 patients were included and their outcomes and history were compared between the precarious and non-precarious based on their EPICES score, a score that measures social isolation and precariousness.Results73.3% of the sample was considered precarious. Retinopathy was significantly more frequent among the deprived. There were no significant differences for other macro or microvascular complications.There was a significant difference in Glycated Haemoglobin between the precarious and non-precarious groups (8.3% (67 mmol/l) vs 8.8% (73mmol/l)). After adjusting for potential confounders, precariousness was no longer associated with poor glycemic control; the independent factors significantly associated with poor glycemic control were: not being fluent in French, having creole or portugese as mother language, and not having any insurance.ConclusionsPrecariousness is a risk factor for retinal complications in patients with diabetes mellitus in French Guiana. In this chronic disease, the universal healthcare system alleviates health inequalities for many, but not all, diabetic complications.Translation and cultural mediation may further reduce health inequalities in this multicultural territory where a substantial proportion of the population is not fluent in French.

Abstract Background Maternal mortality in sub-Saharan Africa remains high despite programmatic efforts to improve maternal health. In 2007, the Zambian Ministry of Health mandated facility-based maternal death review (MDR) programs in line with World Health Organization recommendations. We assessed the impact of an [MDR program] at a district-level hospital in rural Zambia. Methods We conducted a mixed methods convergent study using hospital data on maternal mortality and audit reports of 106 maternal deaths from 2007 to 2011. To evaluate the overall impact of MDR on maternal mortality, we compared baseline (2007) to late (2010–11) post-intervention inpatient maternal mortality indicators. MDR committee reports were coded and dominant themes were extracted in a qualitative analysis. We assessed potential risk factors for maternal mortality in a before-and-after design comparing the periods 2008–09 and 2010–11. Results In-hospital maternal mortality declined from 23 per thousand live births in 2007 to 8 per thousand in 2010–11 (P

Background: Primary malignant melanomas of the Gastrointestinal mucosa are uncommon. Most cases of gastrointestinal (GI) melanomas are secondary, arising from metastasis at distant sites. The purpose of this study is to assess to what extent the interaction between independent prognostic factors (age and tumor site) of primary GI melanoma influence survival. Furthermore, we also aimed to investigate the clinical characteristics, survival outcomes, and independent prognostic factors of patients with primary GI melanoma in the past decade. Methods: A total of 399 patients diagnosed with primary GI melanoma, between 2008 and 2017, were enrolled in our study by retrieving data from the Surveillance, Epidemiology, and End Results (SEER) database. We analyzed demographics, clinical characteristics, and overall mortality (OM) as well as cancer-specific mortality (CSM) of primary GI melanoma. Variables with a p value < 0.1 in the univariate Cox regression were incorporated into the multivariate Cox model (model 1) to determine the independent prognostic factors, with a hazard ratio (HR) of greater than 1 representing adverse prognostic factors. Furthermore, we analyzed the effect of the interaction between age and primary location on mortality (model 2). Results: Multivariate cox proportional hazard regression analyses revealed higher OM in age group 80+ (HR = 5.653, 95% CI 2.212–14.445, p = 0), stomach location of the tumor (HR = 2.821, 95% CI 1.265–6.292, p = 0.011), regional lymph node involvement only (HR = 1.664, 95% CI 1.051–2.635, p < 0.05), regional involvement by both direct extension and lymph node involvement (HR = 1.755, 95% CI 1.047–2.943, p < 0.05) and distant metastases (HR = 4.491, 95% CI 3.115–6.476, p = 0), whereas the lowest OM was observed in patients with small intestine melanoma (HR = 0.383, 95% CI 0.173–0.846, p < 0.05). Multivariate cox proportional hazard regression analyses of CSM also revealed higher mortality of the same groups and lower CSM in small intestine and colon melanoma excluding the rectum. For model 2, considering the interaction between age and primary site on mortality, higher OM was found in age group 80+, followed by age group 40–59 then age group 60–79, regional lymph node involvement only, regional involvement by both direct extension and lymph node involvement and distant metastases. The small intestine had a lower OM. The rectum as primary location and the age range 40–59 interacted to lower the OM (HR = 0.14, 95% CI 0.02–0.89, p = 0.038). Age and primary gastric location did not interact to affect the OM. For the CSM, taking into account the interaction between age and the primary location, higher mortality was found in the same groups and the colon location. The primary colon location also interacted with the age group 40–59 to increase the CSM (HR = 1.38 × 109, 95% CI 7.80 × 107–2.45 × 1010, p = 0). Conclusions: In this United States population-based retrospective cohort study using the SEER database, we found that only the age range 40–59 interacted with the rectum and colon to lower and increase mortality respectively. Primary gastric location, which was the single most important location to affect mortality, did not interact with any age range to influence mortality. With those results, we hope to shed some light on this rare pathology with a very dismal prognosis.

Petrographic and petrophysical characterizations of the pre-salt Chela formation of the Nsiamfumu and Liawenda fields in the onshore Coastal Basin of the D.R. Congo it was performed. These characterizations, as part of the static modelling of the reservoirs, involved reading log measurements, thin-slice observations of rock samples taken from this formation, calculations and interpretation of logs, CPI (Computer Processed Interpretation) and DST (Drill Stem Testing) from well tests. The following observations were obtained: • Wells Lw-1: the formation is characterized by dolomitic limestone and micaceous black shale with a thickness of 34 m having heavy oil indices and an average porosity of 17% and a salinity greater than 300 gr/L; • Well Lw-2: the formation is characterized by islands of sand, coarse sandstone and a few quartz pebbles with a thickness of 10m showing evidence of light oil, gas and an average porosity of 24%; • Shaft Lw-3: the formation is dominated by micaceous shale and dolomite interbeds with a thickness of 14m showing little evidence of hydrocarbons, only salt water and residual oils; • Puits Ns-1: the formation is characterized by beige to grey dolomite, grey shale and white sand with a thickness of 6m showing evidence of light oil and an average porosity of 20%. [ABSTRACT FROM AUTHOR]

Objective: Rare coexistence of disease or pathology Background: Diabetes mellitus is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body is unable to effectively use the insulin it produces. Uncontrolled diabetes mellitus is usually associated with neurological manifestations, such as hemichorea, focal epileptic seizures, peripheral neuropathy, and peripheral facial paralysis. This report describes a 59-year-old woman presenting with hyperglycemia and ketoacidosis due to newly diagnosed diabetes mellitus, as well as a temporary episode of central facial paralysis, which regressed within a few days after medical treatment and metabolic correction. Case Report: A 59-year-old patient with hypertension and a family history of diabetes mellitus presented with polyuro-polydipsic syndrome and signs of metabolic ketoacidosis, with an elevated anion gap, compatible with newly discovered type 1 diabetes mellitus. Six hours after admission, we noted the abrupt onset of left central facial paralysis, with no brain damage shown on magnetic resonance imaging. Initially, the diagnosis was transient ischemic attack. After a second, normal cerebral magnetic resonance image on the fourth day, and clinical improvement on the fifth day after metabolic correction by insulin therapy and rehydration, the diagnosis of a regressive central facial paralysis was retained. Conclusions: Central facial paralysis in diabetic ketoacidosis is a rare neuroendocrine entity. The pathophysiological mechanisms that can explain the occurrence of central facial paralysis are not yet described and require further investigation. This report highlights the importance of diagnosis, early management of hyperglycemia and diabetic ketoacidosis, and reversibility of central facial paralysis after treatment. [ABSTRACT FROM AUTHOR]

Abstract Background The World Health Organization (WHO) recommendation of treating uncomplicated malaria during the second and third trimester of pregnancy with an artemisinin-based combination therapy (ACT) has already been implemented by all sub-Saharan African countries. However, there is limited knowledge on the effect of ACT on pregnancy outcomes, and on newborn and infant’s health. Methods Pregnant women with malaria in four countries (Burkina Faso, Ghana, Malawi and Zambia) were treated with either artemether–lumefantrine (AL), amodiaquine–artesunate (ASAQ), mefloquine-artesunate (MQAS), or dihydroartemisinin–piperaquine (DHA–PQ); 3127 live new-borns (822 in the AL, 775 in the ASAQ, 765 in the MQAS and 765 in the DHAPQ arms) were followed-up until their first birthday. Results Prevalence of placental malaria and low birth weight were 28.0% (738/2646) and 16.0% (480/2999), respectively, with no significant differences between treatment arms. No differences in congenital malformations (p = 0.35), perinatal mortality (p = 0.77), neonatal mortality (p = 0.21), and infant mortality (p = 0.96) were found. Conclusions Outcome of pregnancy and infant survival were similar between treatment arms indicating that any of the four artemisinin-based combinations could be safely used during the second and third trimester of pregnancy without any adverse effect on the baby. Nevertheless, smaller safety differences between artemisinin-based combinations cannot be excluded; country-wide post-marketing surveillance would be very helpful to confirm such findings. Trial registration ClinicalTrials.gov, NCT00852423, Registered on 27 February 2009, https://clinicaltrials.gov/ct2/show/NCT00852423