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Abstract Background Despite the progress made in recent years in the treatment of Acute Heart Failure (AHF), its prognosis remains poor in the developing country. The objective of this study is to analyze the survival and predictors of mortality of patients with acute heart failure in the cardiology department of the Basse Terre Hospital Center in Guadeloupe. Methods this was a historical cohort study carried out over a period from June 2021 to June 2022, targeting all acute heart failure patients undergoing cardiac monitoring in the cardiology department of the Basse Terre Hospital Center in Guadeloupe. Sociodemographic, clinical, biological characteristics and outcome (recovery or death) were studied. Survival was described using the Kaplan Meier method α = 5%. Results this study involved 242 acute heart failure patients whose median age was 75 years and the majority were male (sex ratio 2 M/1F). Among these patients, 14.9% died, the most common cause of death was cardiogenic shock (52.8%). After adjustment, tobacco consumption (aHR: 2.90; 95% CI: 1.36–8.09), Chronic Kidney Disease (aHR: 2.52; 95% CI: 1.22–5.20), infection (aHR: 2.14; 95CI %: 1.99–4.58), hyponatremia (aHR: 1.90; 95% CI: 1.10–2.86), mitral regurgitation (aHR: 3.04; 95% CI: 1.98–9.47) and N-terminal pro Brain Natriuretic Peptide > 10000ng/ml (aHR: 2.57; 95% CI: 1.21–5.49) were independently associated with the risk of death in heart failure patients. Conclusion Acute heart failure leads to high mortality, mainly due to cardiogenic shock and factors of multiple organ failure.

Abstract Background Although aging and being of African descent are well-known risk factors for masked uncontrolled hypertension (MUCH), data on MUCH among elderly black sub-Saharan Africans (BSSA) are limited. Furthermore, it is unclear whether the determinants of MUCH in younger individuals differ from those in the elderly. Objective This study aimed to determine the prevalence and risk factors associated with MUCH in both elderly and younger BSSA individuals. Methods In this study, 168 patients with treated hypertension were assessed for medical history, clinical examination, fundoscopy, echocardiography, and laboratory data. All patients underwent ambulatory blood pressure (BP) monitoring for 24 h. MUCH was diagnosed if the average 24-h mean BP ≥ 130/80 mmHg, the daytime mean BP ≥ 135/85 mmHg, and/or the nighttime mean BP ≥ 120/70 mmHg, despite controlled clinic BP (≤ 140/90 mmHg). Logistic regression analysis was performed to assess independent factors associated with MUCH, including elderly and younger adults separately. P-values

Résumé : Le sens étymologique du terme « séduire » comme étant un acte de détournement du droit chemin n’est qu’un indice d’une résiliation du sens des sémiotiques verbales ou non verbales. Cette extension indicielle n’est pourtant qu’un paradoxe, car le signe séduisant ne fait qu’oblitérer le sens lié à un but pour déclencher un parcours d’évocations libéré de toutes contraintes parce qu’autonymique. Dès lors, de ce point de vue, nous pouvons conclure que la séduction est une transgression d’interdit, un interdit qui assigne à tout signe une fonction utilitaire. Nous illustrerons cette hypothèse de diverses manières. Mots-clés : Poétique, séduction, autonymie, sens, interdit.

Abstract Background Child malnutrition is a major public health challenge, affecting millions of children worldwide, with alarming proportions of children under five in Benin. The complexity of managing this condition is increased by its potential association with opportunistic pathologies. An interesting approach arises from the use of medicinal plants, to address child malnutrition and its associated pathologies. This study aimed to document the knowledge and practices of Beninese mothers and traditional practitioners with regard to the use of medicinal plants to treat child malnutrition and associated diseases. Methods A total of 844 Beninese mothers and 201 traditional healers were surveyed between March 2022 and August 2023 in the communes of Karimama, Bopa and Za-Kpota in Benin. The respondents’ knowledge of child malnutrition and associated pathologies was explored. The ethnobotanical data collected from the subjects concerned the medicinal recipes used to treat child malnutrition, the medicinal plants that make them up and the methods of use. These data were analyzed using ethnobotanical indices such as the Informant Consensus Factor, the frequency of citation of medicinal recipes types and medicinal plants, and the contribution of plants to medicinal recipes. Results All respondents cited a total of 82 plant species used to treat child malnutrition and associated diseases. These plants were grouped into 37 botanical families, the most common of which were Fabaceae, Malvaceae and Annonaceae. The leaves were the most commonly used part of the plant species identified. The mothers shared 122 medicinal recipes, ranging from recipes based on a single plant to more complex compositions involving five plants. The most notable plants were Moringa oleifera Lam, Phyllanthus amarus Schumach & Thonn, Senna siamea (Lam.) H.S.Irwin & Barneby, Carica papaya L. and Ocimum gratissimum L. Traditional healers provided 52 plants in 71 recipes, with Moringa oleifera featuring prominently in both single-plant and multiplant formulations. Conclusion This study made it possible to constitute a rich base of medicinal recipes used against malnutrition and associated pathologies, with the preponderant involvement of certain plant species. It is therefore necessary to deepen research on these different identified species in order to scientifically assess their potential.

Introduction Glomerular hyperfiltration is highly frequent, theoretically dependent on cardiac output, low systemic vascular resistance and hemolysis markers. In sickle cell disease (SCD), hyperfiltration is an extremely common phenomenon and occurred in young and early adult patients. Despite the fact that the glomerular hyperfiltration is known as the early manifestations of sickle cell nephropathy, its burden among adult sickle cell disease in sub-Saharan is poor studied. This study aimed to determine the prevalence and associated factors of hyperfiltrationMethods This was an analytical multicentric cross-sectional study involving stable adult sickle cell patients in Kinshasa, recruited between March and October 2023. Parameters of interest encompasses demographic, clinical, biological, echocardiographic and pulse wave measurement data. Hyperfiltration was defined using the CDK-EPI equation based on cystatin C; eGFR >130 for women and >140 ml/min/1.73m2 for men. We used multivariate logistic regression analysis to search determinants of glomerular hyperfiltration.Results Two hundred and fourty six (246) patients with SCD were enrolled. The prevalence of hyperfiltration was 20.7%. In multiple logistic regression analysis, hyperfiltration status was independently associated with age (< 25 years) [3.57 (1.78-7.49); p = 0.027)], female sex [4.36 (2.55-5.62); p = 0.031), CRP (< 6 mg/l) [0.77 (0.61-0.97); p = 0.028)], central systolic pressure (< 100 mmHg) and central diastolic pressure (< 60 mmHg) [0.86(0.74-0.98), p = 0.028)], [(0.83 (0.71-0.98); p = 0.032)].Conclusion One out of five SS adults exhibits hyperfiltration, which is associated with young age and female sex, whereas low CRP and blood pressure were negative risk factors.

Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) infection is well established as a systemic disease including kidney damage. The entry point into the renal cell remains the angiotensin-converting enzyme 2 (ACE-2) receptor and the spectrum of renal lesions is broad, with a clear predominance of structural and functional tubular lesions. The most common form of glomerular injury is collapsing glomerulopathy (CG), which is strongly associated with apolipoprotein L1(APOL-1) risk variants. These acute lesions, which are secondary to the direct or indirect effects of SARS-CoV-2, can progress to chronicity and are specific to long COVID-19 in the absence of any other cause. Residual inflammation associated with SARS-CoV-2 infection, in addition to acute kidney injury (AKI) as a transitional state with or without severe histological lesions, may be responsible for greater kidney function decline in mild-to-moderate COVID-19. This review discusses the evidence for renal histological markers of chronicity in COVID-19 patients and triggers of low-grade inflammation that may explain the decline in kidney function in the post-COVID-19 period.

Summary: Background: Research in healthy young adults shows that characteristic patterns of brain activity define individual “brain-fingerprints” that are unique to each person. However, variability in these brain-fingerprints increases in individuals with neurological conditions, challenging the clinical relevance and potential impact of the approach. Our study shows that brain-fingerprints derived from neurophysiological brain activity are associated with pathophysiological and clinical traits of individual patients with Parkinson’s disease (PD). Methods: We created brain-fingerprints from task-free brain activity recorded through magnetoencephalography in 79 PD patients and compared them with those from two independent samples of age-matched healthy controls (N = 424 total). We decomposed brain activity into arrhythmic and rhythmic components, defining distinct brain-fingerprints for each type from recording durations of up to 4 min and as short as 30 s. Findings: The arrhythmic spectral components of cortical activity in patients with Parkinson’s disease are more variable over short periods, challenging the definition of a reliable brain-fingerprint. However, by isolating the rhythmic components of cortical activity, we derived brain-fingerprints that distinguished between patients and healthy controls with about 90% accuracy. The most prominent cortical features of the resulting Parkinson’s brain-fingerprint are mapped to polyrhythmic activity in unimodal sensorimotor regions. Leveraging these features, we also demonstrate that Parkinson’s symptom laterality can be decoded directly from cortical neurophysiological activity. Furthermore, our study reveals that the cortical topography of the Parkinson’s brain-fingerprint aligns with that of neurotransmitter systems affected by the disease’s pathophysiology. Interpretation: The increased moment-to-moment variability of arrhythmic brain-fingerprints challenges patient differentiation and explains previously published results. We outline patient-specific rhythmic brain signaling features that provide insights into both the neurophysiological signature and symptom laterality of Parkinson’s disease. Thus, the proposed definition of a rhythmic brain-fingerprint of Parkinson’s disease may contribute to novel, refined approaches to patient stratification. Symmetrically, we discuss how rhythmic brain-fingerprints may contribute to the improved identification and testing of therapeutic neurostimulation targets. Funding: Data collection and sharing for this project was provided by the Quebec Parkinson Network (QPN), the Pre-symptomatic Evaluation of Novel or Experimental Treatments for Alzheimer’s Disease (PREVENT-AD; release 6.0) program, the Cambridge Centre for Aging Neuroscience (Cam-CAN), and the Open MEG Archives (OMEGA). The QPN is funded by a grant from Fonds de Recherche du Québec - Santé (FRQS). PREVENT-AD was launched in 2011 as a $13.5 million, 7-year public-private partnership using funds provided by McGill University, the FRQS, an unrestricted research grant from Pfizer Canada, the Levesque Foundation, the Douglas Hospital Research Centre and Foundation, the Government of Canada, and the Canada Fund for Innovation. The Brainstorm project is supported by funding to SB from the NIH (R01-EB026299-05). Further funding to SB for this study included a Discovery grant from the Natural Sciences and Engineering Research Council of Canada of Canada (436355-13), and the CIHR Canada research Chair in Neural Dynamics of Brain Systems (CRC-2017-00311).

Abstract Traditional medicine (TM) is a significant resource for primary healthcare management all over the world, and principally in Africa. Quality improvement activities that promote evidence-based practices and the integration of traditional medicine into primary healthcare systems can help improve the quality of patient care. In the Republic of Benin (West Africa), traditional medicine practitioners (TMPs) provide different treatments and ways of use, depending on the ailments and the medicinal plants used. The present study aimed at documenting the knowledge, attitudes and practices of Beninese TMPs regarding the use of medicinal plants and the challenges associated with their activities. A focus group survey was conducted using semi-structured interviews with a sample of 91 TMPs in 8 departments of the Republic of Benin. The respondents had an average age of 50 years old and belonged to various categories of TMPs. Medicinal plants are harvested depending on the season and time of the day, and are dried in the shade before being used as decoctions or infusions. Nevertheless, the majority of TMPs do not conduct the necessary tests for quality control, efficacy or toxicity of the proposed remedies, which raises several scientific interrogations, particularly for the treatment of mental and brain-related disorders. Among ~ 110 plants used in the treatment of several pathologies, 66 were revealed as threatened species. The challenges faced by TMPs are mainly material, financial and technical difficulties. The present study reports the importance of intervention to modernize TM practices in Benin. Quality improvement could enhance healthcare delivery and provide support for evidence-based interventions aimed at addressing behavioral, social, and environmental determinants of health.

The main difference between an open-water (regular) flood and an ice jam flood is that it is normally the whole river length that is overtopped whereas an ice jam flood is localized to where the jam is located. Comparatively, the regular flood analysis can use the value of the extreme discharge as the main input parameter for a long river section, an ice jam flood needs to account for the probability of jams of various lengths and intensities occurring at specific locations under significantly variable discharges while having several mechanical ice parameters to be considered. Through the case study of the Chaudière River, the methodology presented in this paper demonstrates how to statistically characterize four significant inputs (jam location, jam length, jam properties and river discharge during jam event) into the widely used numerical river water model (HEC-RAS) and how Monte–Carlo simulations are generated to estimate probable ice jam floods along a whole river reach. The purpose of this article is to propose a robust methodology through a case study and asses the sensitivity that historical and mechanical parameters have as to why specific locations along the reach have higher 1:100 AEP ice-induced water levels as to 1:100 AEP open-water levels. HIGHLIGHTS Comparison of 1:100 AEP open-water flood and ice jam flood.; Historical distribution of input parameters.; Using stochastic modelling with HEC-RAS with external control via Python.; Strength of the Monte–Carlo method.;

This article introduces a novel multiple-cycle generation system for efficient heat recovery at high and low temperatures. The system is modeled and optimized using the M2EP analysis method (mass, energy, exergy, and performance) and the particle swarm optimization algorithm. The multigeneration system produces electricity, cold, domestic hot water, and biogas by utilizing Kalina cycles, diffusion–absorption refrigeration machines, and high-performance heat exchangers by harnessing waste heat from cement kiln exhaust gases. The Kalina cycle is employed for electricity generation, wherein the H2O+NH3 mixture, heated by hot water, circulates through heat exchangers. Downstream of the Kalina cycle, the refrigeration machine generates cold by evaporating the strong solution of the H2O+NH3 mixture. Hydrogen circulates in the diffusion–absorption refrigerator (DAR) circuit, facilitating the exchange between the evaporator and the absorber. The domestic hot water and biogas production systems operate at lower temperatures (around 45 °C). The simulation results for the Kalina cycle indicate an electrical energy production of 2565.03 kW, with a release of usable energy (residual gases) estimated at 7368.20 kW and a thermal efficiency of 22.15%. Exergy destruction is highest at heat exchanger 1, accounting for 26% of the total. A coefficient of performance of 0.268 and an evaporator temperature of 10.57 °C were obtained for the DAR cycle. The absorber contributes the most to energy exchanges, comprising 37% of the entire circuit. Summarizing the potential for valorizing waste heat from cement kilns, this article lays the foundation for future research.

Hepatic diseases represent a public health problem. Among the approaches to their management is the use of traditional treatments based on the use of medicinal plants. In Benin, several recipes based on Cochlospermum tinctorium are used in the treatment of hepatitis without a real scientific basis. This study aimed to evaluate the hepatoprotective effects and acute oral toxicity of 10 of these recipes. The variables studied were the variety of C. tinctorium (wild form vs. cultivated form), the species associated with C. tinctorium (Combretum micranthum vs. Chromolaena odorata), and the proportion of C. tinctorium in the recipe (1; 4/5; 1/2). The hepatoprotective effect of these extracts at doses of 100, 200, and 400 mg/kg/bw was evaluated in Wistar rats subjected to hepatotoxicity induction through the administration of 5 g/kg of paracetamol. Acute oral toxicity was assessed following the OECD 423 protocol. The results revealed an absence of acute oral toxicity for the 10 recipes. The hepatoprotective tests conducted indicated that the hepatoprotective effect of C. tinctorium is dose dependent. The wild variety of C. tinctorium had a better hepatoprotective effect than the cultivated one. The association with C. micranthum enhances the hepatoprotective effect of C. tinctorium, unlike that with C. odorata. This study emphasizes that the combination of C. tinctorium with C. micranthum in the treatment of hepatitis is scientifically justified and it exhibits a dose-dependent hepatoprotective effect.

Background and Objectives. The chest computed tomography (chest CT) has played an important role in the management of COVID-19. Few data on its use in sub-Saharan Africa (SSA) are reported. The objectives of this study conducted in Kinshasa, DR Congo, were to describe the lung lesions on day 1 of hospitalization in patients admitted for suspected COVID-19 and to identify those that were most associated with SARS-CoV-2 infection/RT-PCR and the determinants of chest CT associated with death. Methods. We included all patients with respiratory symptoms (dyspnea, fever, and cough) and/or respiratory failure admitted to the SOS Médecins de nuit SARL hospital, DR Congo, during the 2nd and 3rd waves of the COVID-19 pandemic. The diagnosis of COVID-19 was established based on RT-PCR anti-SARS-CoV-2 tests (G1 (RT-PCR positive) vs. G2 (RT-PCR negative)), and all patients had a chest CT on the day of admission. We retrieved the digital files of patients, precisely the clinical, biological, and chest CT parameters of the day of admission as well as the vital outcome (survival or death). Chest CT were read by a very high-definition console using Advantage Windows software and exported to the hospital network using the RadiAnt DICOM viewer. To determine the threshold for the percentage of lung lesions associated with all-cause mortality, we used ROC curves. Factors associated with death, including chest CT parameters, were investigated using logistic regression analysis. Results. The study included 200 patients (average age 56.2±15.2 years; 19% diabetics and 4.5% obese), and COVID-19 was confirmed among 56% of them (G1). Chest CT showed that ground glass (72.3 vs. 39.8%), crazy paving (69.6 vs. 17.0%), and consolidation (83.9 vs. 22.7%), with bilateral and peripheral locations (68.8 vs. 30.7%), were more frequent in G1 vs. G2 (p

Introduction. Zingiber officinalis est un alicament couramment utilisé seule ou en association avec d'autres plantes pour traiter diverses affections inflammatoires telle que les œdèmes. La présente vise à rechercher l’effet de synergie entre l’extrait aqueux des feuilles de Laurus nobilis et l'extrait aqueux des rhizomes de Z. officinalis dans une perspective de traitement efficient de l’œdème. Matériel et Méthodes. Trois types d'extraits aqueux (L. nobilus, Z. officinalis et L. nobilus + Z. officinalis) ont été testés aux concentrations de 250 mg/ml et 500 mg/ml en suivant des methodes standardisées. Le formol à 1 % a été utilisé comme agent phobogène. Résultats et Discussion. Les résultats montrent que l'extrait aqueux de L. nobilis prévient de façon significative l'œdème des pattes des rats à partir de la 120ème et 180ème minutes du test. Les pourcentages d'inhibition enregistré varient de 37,74 % à 53,57 % pour les concentrations testées. La même tendance d'augmentation du pourcentage d'inhibition est observée avec l'extrait de Z. officinalis qui varient respectivement de 37,74% à 47,61 % à la 120ème et 180ème minutes. Par ailleurs, la combinaison (L. nobilus + Z. officinalis) a montré des pourcentages d'inhibition plus élevé et varient de 52,97 % à 54,16 %. L'analyse des données montre que l'extrait de L. nobilis optimise l'activité anti-œdémateuse de l'extrait de Z. officinalis, ce qui confirme son application traditionnelle. Conclusion. Ces travaux montrent qu’un effet synergique se développe lors de l’utilisation combinée des extraits aqueux de L. nobilus + Z. officinalis. Toutefois des travaux plus approfondis méritent d’être effectué pour un meilleur traitement des affections inflammatoires

Introduction. Nauclea latifolia est une espèce médicinale largement utilisée dans la médecine traditionnelle béninoise pour traiter les gastrites. La présente étude vise à déterminer quelques paramètres toxicologiques d'un phytomédicament à base de décoction de racines de N. latifolia afin de mieux contrôler son dosage et sa posologie. Matériel et Méthodes. La toxicité orale aiguë a été évaluée chez des rats Sprague-Dawley à partir de 5 doses dont la première de 2500 mg/kg/vo a été déterminée par correspondance à la concentration à la limite de la solubilité de l’extrait croissantes du phytomédicament. Les 4 autres doses en ont été déduite (156,25 ; 31,25 ; 62,5 et 125 mg/kg/vo). La Dose Maximale Tolérée et la Dose Journalière Recommandée ont été déterminée au moyen des calculs de correspondance proposés par N’Guessan. Résultats et discussion. L'administration per os du phytomédicament à base de racines de N. latifolia n'a entraîné aucune mortalité ni aucun signe de toxicité chez les rats testés. La dose maximale tolérée qui équivaut à 2500 mg/kg/vo. Par ailleurs, les résultats indiquent que cette (2500 mg/kg/vo) enregistré est nettement supérieure à la Dose Journalière Recommandée (26,35 mg/kg/vo) par les praticiens de santé pour avoir l'effet thérapeutique attendu. Ainsi, ces données rassurent que dans les conditions traditionnelles de la préparation du phytomédicament car il est presque impossible d'atteindre la Dose Maximale Tolérée chez un homme de poids moyen de 60 kg. Toutefois, les résultats des tests biochimiques montrent que le phytomédicament entraîne quelques modifications des paramètres biochimiques. Conclusion. Au vu de ces données, le phytomédicament à base de décoction de N. latifolia dans les conditions traditionnelles d'utilisation thérapeutique ne semble pas toxique.

Introduction Acute kidney injury (AKI) is a complication of severe coronavirus disease 2019 (COVID-19). Kidney damage associated with COVID-19 could take specific features due to environmental and socio-cultural factors. This study evaluates the incidence of AKI, the associated factors, and mortality in COVID-19 patients in a Sub-Saharan African intensive care unit.Methods In a prospective cohort study conducted in the intensive care unit (ICU) of the Centre Médical de Kinshasa (CMK), consecutive patients admitted for COVID-19 were screened for the presence of AKI between 27 March, 2020 and 27 January 2022. AKI was defined according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines. The primary outcome was occurrence of AKI. The secondary outcome was 48 days’ mortality and recovery of the renal function at intensive care unit (ICU) discharge. Survival (time-to death) curves were built using the Kaplan Meier methods. Multivariate analyses were performed by logistic regression to identify factors associated with AKI and Cox regression to explore the association between AKI and in-hospital mortality. The significance level of the p-value was set at 0.05.Results The median(IQR) sequential organ failure assessment score (SOFA) score and mean age of patients (215) including in our cohort were respectively 3(2-4) and 58.9 ± 14.9 years. The incidence of AKI was 28.4% with stages 1, 2, or 3 AKI accounted for 39.3%, 11.5%, and 49.2%, respectively. Hemodialysis was required in 16 out 215 (7.4%) patients. Dyspnea (adjusted odds ratio (aOR):2.27 [1.1–-4.57] p = 0.021), SOFA ≥5 (aOR:3.11[1.29–7.53] p = 0.012), AST/ALT ratio (aOR: 1.53 [1.09–1.79] p = 0.015), N/L ratio (aOR:2.09 [1.09–3.20] p = 0.016), mechanical ventilation (aOR: 3.20 [1.66–10.51] p = 0.005) and Amikacin (aOR: 2.91 [1.37–6.18] p = 0.006) were the main factors associated with AKI. Patients with AKI had a mortality rate of 52.5% and 67.2% of the survivors did not recover kidney function at the end of hospitalization. Adjusted Cox regression analysis revealed that COVID-19-associated AKI was independently associated with in-hospital death (HR:2.96 [1.93–4.65] p = 0.013) compared to non-AKI patients.Conclusions AKI was present in three out of ten COVID-19 patients. The most significant factors associated with AKI were dyspnea, SOFA ≥ 5, AST/ALT and N/L ratio, mechanical ventilation and Amikacin. AKI has been associated with an almost threefold increase in overall mortality and seven out of ten survivors did not recover kidney function after AKI.

Summary Background One year after the coronavirus disease 2019 (COVID-19) pandemic, the focus of attention has shifted to the emergence and spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants of concern (VOCs). The aim of the study was to assess the frequency of VOCs in patients followed for COVID-19 at Kinshasa university hospital (KUH) during the 3rd and 4th waves of the pandemic in Kinshasa. Hospital mortality was compared to that of the first two waves. Method The present study included all patients in whom the diagnosis of SARS-CoV-2 infection was confirmed by the polymerase chain reaction (PCR). The laboratory team sequenced a subset of all SARS-CoV-2 positive samples with high viral loads define as Ct

Antimicrobial resistance (AMR) is a global public health threat. Quality data on AMR are needed to tackle the rise of multidrug-resistant clones. These data are rare in low-income countries, especially in sub-Saharan Africa. In this study, we investigated the rise of extended-spectrum β-lactamase–producing (ESBL) Enterobacteriaceae in Bangui, Central African Republic. We collected 278 fecal samples from 0–5-year-old children admitted to the Pediatric University Hospital Complex in Bangui from July to September 2021. Enterobacteriaceae were isolated and identified, and their susceptibility to 19 antibiotics was tested. We recovered one and two Enterobacteriaceae species from 208 and 29 samples, respectively. One clone of each species from each sample was further characterized, for a total of 266 isolates. Escherichia coli predominated, followed by Klebsiella. AMR was frequent, with 98.5% (262/266) of the isolates resistant to at least one antibiotic. Additionally, 89.5% (238/266) of the isolates were multidrug resistant, with resistance being frequent against all tested antibiotics except carbapenems and tigecycline, for which no resistance was found. Importantly, 71.2% (198/278) of the children carried at least one ESBL species, and 85.3% (227/266) of the isolates displayed this phenotype. This study confirms the rise of ESBL Enterobacteriaceae in Bangui and stresses the need for action to preserve the efficacy of antibiotics, as crucial for the treatment of bacterial infections.

L'intelligence artificielle (IA) est de plus en plus utilisée pour le diagnostic en ligne dans le domaine de la radiographie industrielle. Les avancées dans les algorithmes de classification et de segmentation sémantique ces dernières années constituent des outils qui permettent une détection plus précise des détails dans les images radiographiques, ce qui constitue une avancée majeure par rapports aux algorithmes traditionnels à base de traitements d’images « classiques » ou méthodes statistiques. Nous présentons ici 3 approches IA en radiographie industrielle, développées à des fins de diagnostic pour du contrôle sur ligne de production. ▪ La première approche, basée sur la classification, consiste à élaborer et entrainer un réseau de neurones de type CNN pour un établir un diagnostic qualité sur ligne de production sur image radiographique. Les images d’acquisition radiographique dont il est question ici sont des images acquises au moyen d’un capteur matriciel (projection conique). ▪ Les deux autres approches traitent du contrôle radiographique industriel sur ligne de production acquises au moyen d’un capteur linéaire (donc géométrie de projection semi-conique). ▪ La première de ces deux approches consiste à apprendre à un modèle de type Variational Autoencoder un pattern de « normalité », de la structure du matériau analysé, permettant ainsi de s’affranchir de l’apprentissage des défauts. ▪ La deuxième de ces deux approches consiste par des moyens de segmentation sémantique à détecter des défauts sur un produit à sur l’image. Le modèle ainsi conçu et entrainé, consiste en une segmentation sémantique à 5 sorties (4 classes de défauts et le background).

Antimicrobial resistance (AMR) is a global public health problem. In the alternatives being explored for developing new antimicrobials, medicinal plants occupy an important place, particularly in Africa, where they are widely used. This review aims to analyze the potential of medicinal plants from Benin, Togo, Ghana, Burkina-Faso, and Cape Verde in the fight against AMR. A bibliographic search was conducted to explore scientific databases such as PubMed and Google Scholar. During this search, particular attention was given to epidemiological data related to AMR in these countries, medicinal plants traditionally used to treat microbial infections and medicinal plants that have been shown to be active on multidrug-resistant microbial strains. In total, 94 manuscripts were investigated. Epidemiological data showed that the problem of AMR is worsening in each target country. In addition, several medicinal plants have been demonstrated to be effective against microbial strains resistant to conventional antibiotics. A total of 532 medicinal plants were identified according to their ethnomedical uses for the treatment of microbial infections. Scientific evidence was collected on the antimicrobial potential of 91 plants. This study showed the potential of medicinal plants in the fight against AMR. Their documented traditional use, coupled with the evidence of efficacy provided, make them interesting sources for developing new antimicrobials.

La surexploitation des nappes génère un coût économique et environnemental qui se traduit par la diminution de la disponibilité de l’eau et l’augmentation de son coût de pompage. Les études portant sur la distribution de ces coûts à travers les types d’exploitations et leur impact sur l’équité d’accès aux eaux souterraines demeurent limitées en Tunisie. À travers l’élaboration d’indicateurs par le modèle de programmation mathématique appliqué à des exploitations types, ce travail a montré que les coûts résultant de la surexploitation des nappes sont inégalement répartis. Les petites exploitations, disposant de moins de 3 ha, sont les plus affectées. Elles encourent des coûts de pompage de 1,25 à 1,5 fois plus élevés que les exploitations disposant d’une superficie beaucoup plus large. Le ratio bénéfice-coût de l’irrigation est également le plus faible dans cette catégorie, suggérant la non-rentabilité de l’irrigation dans un futur proche. Ce travail a révélé que l’accès économique à l’eau souterraine est désormais tributaire de la dotation de deux facteurs clés : le capital foncier et le capital financier. Les exploitations disposant de moyens fonciers et financiers vont continuer à profiter des eaux souterraines, tandis que les petites exploitations risquent d’en perdre rapidement l’accès, se trouvant ainsi exclues de leur part de cette ressource collective. Afin de préserver l’égalité d’accès pour toutes les catégories d’exploitations, et de prévenir une accentuation de la dégradation de la nappe, une politique robuste de gouvernance devrait être mise en place, avec une implication plus forte des usagers locaux et de l’administration agricole régionale.

Madurastatins are a group of pentapeptides containing an oxazoline moiety, and, in a few cases, an imidazolidinone ring as an additional structural feature. In our search for new potential antiparasitic metabolites from natural sources, we studied the acetone extracts from a culture of Actinomadura sp. CA-135719. The LC/HRMS analysis of this extract identified the presence of the known madurastatins C1 (1), D1 (4), and D2 (5) together with additional members of the family that were identified as the new madurastatins H2 (2) and 33-epi-D1 (3) after isolation and spectroscopic analysis. The planar structures of the new compounds were established by HRMS, ESI-qTOF-MS/MS, and 1D and 2D NMR data, and their absolute configuration was proposed using Marfey’s and bioinformatic analyses of the biosynthetic gene cluster (BGC). A revision of the absolute configuration of madurastatins D1 and D2 is proposed. Additionally, madurastatins containing imidazolidinone rings are proved to be artifacts originating during acetone extraction of the bacterial cultures.

The ability to predict the magnitude of an earthquake caused by deep fluid injections is an important factor for assessing the safety of the reservoir storage and the seismic hazard. Here, we propose a new approach to evaluate the seismic energy released during fluid injection by integrating injection parameters, induced aseismic deformation, and the distance of earthquake sources from injection. We use data from ten injection experiments performed at a decameter scale into fault zones in limestone and shale formations. We observe that the seismic energy and the hydraulic energy similarly depend on the injected fluid volume (V), as they both scale as V3/2. They show, however, a large discrepancy, partly related to a large aseismic deformation. Therefore, to accurately predict the released seismic energy, aseismic deformation should be considered in the budget through the residual deformation measured at the injection. Alternatively, the minimal hypocentral distance from injection points and the critical fluid pressure for fault reactivation can be used for a better prediction of the seismic moment in the total compilation of earthquakes observed during these experiments. Complementary to the prediction based only on the injected fluid volume, our approach opens the possibility of using alternative monitoring parameters to improve traffic-light protocols for induced earthquakes and the regulation of operational injection activities.

Article Highlights The study carried out made it possible to rule on the nature and quality of hospital effluents generated in the health structures in Benin. Physico-chemical parameters such as pH, temperature, electrical conductivity, total solids below, P-redox and suspended solids measured has been determined. The research of pathogenic bacteria as well as the research of heavy metals and antibiotic residues was done. Data were provided on the nature of the bacteria present in hospital effluents and their degree of pathogenicity. The types of heavy metals contained in the samples were reported and compared to the standards in force at the national and international level. The presence of antibiotic residues was evaluated and the most common ones were documented. The presence of residues of some specific antibiotics has confirmed their wide use in human therapeutics. The study raised awareness of the fact that untreated hospital effluent can enter the water table, end up in natural waterways and be the source of many environmental and health problems. The study highlighted the urgency of installing wastewater treatment plants for health facilities in Benin.

Résumé La Province du Bas-Uélé est entièrement agricole, les cultures pratiquées jadis étaient l’arachide, le coton et le caféier. Actuellement, les cultures vivrières pratiquées ne peuvent pas seules resoudre le problème de la pauvreté dont souffre la population. Il est donc le moment de penser à introduire les cultures de rente, en particulier le cacao à partir du Territoire de Bambesa. Cette étude qui a consistée à évaluer le comportement phenologique des cultivars de Yangambi a démontré que le cacaoyer peut être cultivé dans les conditions pedoclimatiques de Bambesa : Tous les trois hybrides introduits à Bambesa se sont bien comportés et peuvent être diffusés quant à leur comportement donc leur capacité d’adaptation. Abstract Bas-Uélé Province is entirely agricultural, crops grown in the past were peanuts, cotton and coffee. Currently, animal crops can not alone solve the problem of poverty that afflicts the population. It is therefore time to think about introducing cash crops, especially cocoa from the Bambesa Territory. This study, which evaluated the phenological behavior of Yangambi cultivars, showed that the cocoa tree can be cultivated under Bambesa pedoclimatic conditions: All three hybrids introduced at Bambesa have behaved well and can be disseminated as far as possible. their behavior and their ability to adapt.

La zone d’étude de ce travail fut encore hier, ignorée par les archéologues pour des raisons sanitaires, idéologiques et climatiques. La culture matérielle exhumée et étudiée montre que la zone a été anciennement occupée par des peuples chasseurs-cueilleurs comme illustre les outils employés par ces derniers, les stratégies développées et adaptées à cet écosystème. Les résultats archéologiques sont très intéressants, ils seraient semblables à ceux déjà reconnus dans la région de Yaoundé, la côte atlantique et le nord du Gabon. Les données issues des fouilles des abris sous roche permettent de proposer une esquisse des phases d’occupation de l’espace.

Abstract Background Africa has a rich and diverse flora that people use for their food and health needs. This study aims to explore the possibility of using aqueous and/or ethanolic extracts of Alchornea cordifolia leaves as an alternative in the fight against multi-resistant bacteria responsible for gastritis and urinary tract infections. Results The results show that 100% of the tested bacilli (E. coli, K. pneumoniae, P. aeruginosa) are resistant to the 10 antibiotic disks tested. This resistance is 66.66% for quinolones and fluoroquinolones. S. aureus was found to be resistant to glycopeptides and aminoglycosides. Three ESBL genes are identified in bacilli against only one type of ESBL gene in cocci. 100% of the bacilli carry the SHV genes, and S. aureus has the Mec A gene. The aqueous extract exerted a bactericidal effect on all the strains with MICs and BMCs varying, respectively, from 0.76 to 50 mg/ml and BMCs from 0.76 to 100 mg/ml. Only 40% of the chemical groups (tannin, flavonoids, mucilages and sterol-terpenes) sought were present in the aqueous extract. The ethanolic extract is not active. Conclusions Based on these data, the aqueous extract of A. cordifolia leaves is a good phytomedical candidate for the treatment of gastritis (stomach cramps, watery or bloody diarrhea) and urinary tract infections caused by multi-resistant Gram-negative and Gram-positive bacteria.

Abstract The Covid-19 pandemic has not only outlined the importance of using evidence in the healthcare policy making process but also the complexity that exists between policymakers and the scientific community. As a matter of fact, scientific data is just one of many other concurrent factors, including economic, social and cultural, that may provide the rationale for policy making. The pandemic has also raised citizens’ awareness and represented an unprecedented moment of willingness to access and understand the evidence underpinning health policies. This commentary provides policy recommendations to improve evidence-based policy making in health, through the lens of a young generation of public policy students and future policymakers, enrolled in a 24-hour course at Sciences Po Paris entitled “Evidence-based policy-making in health: theory and practice(s)”. Four out of 11 recommendations were prioritised and presented in this commentary which target both policymakers and the scientific community to make better use of evidence-based policy making in health. First, policy makers and scientists should build trusting partnerships with citizens and engage them, especially those facing our target health care issues or systems. Second, while artificial intelligence raises new opportunities in healthcare, its use in contexts of uncertainty should be addressed by policymakers in terms of liability and ethics. Third, conflicts of interest must be disclosed as much as possible and effectively managed to (re) build a trust relationship between policymakers, the scientific community and citizens, implying the need for risk management tools and cross border disclosure mechanisms. Last, well-designed and secure health information systems need to be implemented, following the FAIR (findable, accessible, interoperable and reusable) principles for health data. This will take us a step further from data to ‘policy wisdom’. Overall, these recommendations identified and formulated by students highlight some key issues that need to be rethought in the health policy cycle through elements like institutional incentives, cultural changes and dialogue between policy makers and the scientific community. This input from a younger generation of students highlights the importance of making the conversation on evidence-based policy making in health accessible to all generations and backgrounds.