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International audience; Like much of the developing world, sub-Saharan Africa (SSA) is facing a major challenge. This challenge is due to noncommunicable diseases (NCDs) whose rates are rising dramatically in SSA. Two conditions that frequently coexist head the list of NCDs as either established disease entities or risk factors for NCDs. These are hypertension and diabetes. Hypertension is the foremost cardiovascular condition. The objective of this scoping review is to examine peer-reviewed publications for the period 2009–2019 related to the detection and management of hypertension in SSA. We seek to define the issues confronted in managing hypertension in SSA, what measures have been implemented and evaluated, and what barriers and facilitators have been found. By mapping the complex, heterogeneous literature, we aim to identify the key concepts that underpin a major public health issue in SSA. The central question that this review addresses is how to control hypertension in SSA.

In axial compressors, shrouded stator cavity flows are responsible for performance degradation due to their interaction with the power stream. The present paper aims at exploring the possibility of employing a single stage high pressure axial compressor as a test vehicle for cavity flows investigations. In a first step, the robustness of the adopted RANS approach is tested against experimental data on the closed-cavity baseline configuration (i.e. no downstream-to-upstream recirculation). In a second phase, the effect of different hub cavities layouts of different levels of realism is numerically investigated. The focus is set on the representativeness of a closed cavity configuration with injection. The cavity flow topology and impact on the overall performance are considered in the analysis. At its final extent, this paper provides numerical and experimental guidelines for the robust assessment of cavity flows topology and performance effects.

In axial compressors, shrouded stator cavity flows are responsible for performance degradation due to their interaction with the power stream. The present paper aims at exploring the possibility of employing a single stage high pressure axial compressor as a test vehicle for cavity flows investigations. In a first step, the robustness of the adopted RANS approach is tested against experimental data on the closed-cavity baseline configuration (i.e. no downstream-to-upstream recirculation). In a second phase, the effect of different hub cavities layouts of different levels of realism is numerically investigated. The focus is set on the representativeness of a closed cavity configuration with injection. The cavity flow topology and impact on the overall performance are considered in the analysis. At its final extent, this paper provides numerical and experimental guidelines for the robust assessment of cavity flows topology and performance effects.

International audience; Plus de cinquante millions de personnes vivent avec une épilepsie (PVE) dans le monde, dont 80 % résident dans les pays à revenu faible ou intermédiaire : cette prise de conscience a-t-elle permis une amélioration de la prise en charge de la maladie dans ces pays de la zone tropicale ? Les trois déterminants (socle minimum pour la prise en charge de l’épilepsie) sont bien connus et ont été étudiés : les connaissances sur la maladie et son traitement dans la population générale et chez les PVE, la formation des personnels de santé, et la disponibilité des traitements. Les premières initiatives visant l’amélioration de la prise en charge datent du début des années 1990, et se sont intensifiées durant la décennie 2000. Malgré cela, le déficit de traitement (proportion de PVE qui ne reçoit pas un traitement adéquat) restait élevé. Depuis 2010, l’organisation mondiale de la santé (OMS) et d’autres organismes non-gouvernementaux ont expérimenté des stratégies d’interventions (en agissant sur les 3 déterminants, avec parfois des actions innovantes supplémentaires). Au Mozambique, le taux de prise en charge de l’épilepsie est ainsi passé de 5 à 58 % en 3 ans. Au Myanmar, elle est passée de 2 à 40 % en 3 ans. Au Ghana, la proportion de la population cible en contact avec les services de santé est passée de 14,5 à 38,3 % en 5 ans. Au Vietnam, le déficit de traitement est passé de 58,6 à 39,2 % en 3 ans ; en Chine, de 62,6 % à 49,8 % en 2 ans ; et au Cambodge de 100 à 65,1 % en 1 an. Ces résultats, s’ils sont jugés satisfaisants, servent ensuite d’argumentaires à l’attention des autorités de santé publique pour les généraliser à l’échelle nationale. Cette revue des initiatives et stratégies d’intervention expérimentées récemment a permis une synthèse identifiant des modalités d’interventions efficaces pour ces pays où la démographie médicale, la disponibilité des médicaments antiépileptiques, et les contextes économique et socioculturel composent une équation difficile à résoudre pour la prise en charge de l’épilepsie.

This chapter deals with three diseases: traumatic brain injuries (TBIs), tumors, and multiple sclerosis (MS). TBIs are neurosurgical emergencies; they are a severity factor in polytraumas, frequently observed in road traffic accidents. They concern mainly young adults and are often severe with a very poor prognosis; the latter is related to the extent of brain damage, the quality of the management between the location of the accident and the hospital and the time to reach the equipped health structure. The epidemiological study of primary brain tumors in the tropics is limited by a lack of studies in the general population. In West Africa, incidence is estimated to be between 3.7/100,000 and 4.6/100,000 per year. The average age at diagnosis is between 36 and 42 years with a slight female predominance in the African series; in Asia, predominance is rather masculine. The prevalence of MS is very low in all tropical regions. If someone migrates after adolescence to a high-prevalence area, he/she retains the risk of the original region; more than the result of genetic factors, it appears to be the result of environmental factors. Ultraviolet B radiation through sun exposure could be one of the factors in tropical regions.

Background The History of African neurology is not well known. Objective Through this communication, our objective is to shed light on this barely History of African Neurology, which is very exciting, rich and rapidly evolving. Its rapid evolution, over the last fifty years is the result of the evolvement of its youth and its training schools. Patients and Methods / Material and Methods At the very beginning, it was confused with the History of Tropical Neurology, until the awareness, around 1950th, by the first neurologists, true pioneers, who worked in sub-Saharan Africa, that cultural and environmental factors conferred genuine specificity to African neurology. Results Since that time, African neurosciences has been structured and developed, contributing to the birth of Neurological Societies in some African countries, then the Pan African Association of Neurological Sciences (PAANS), continental structure, which was the first major cluster of neurologists and neurosurgeons on the continent. In August 2015, the African Academy of Neurology (AfAN) was set up in Dakar, with the aim of bringing together African Neurologists. This Academy, which was created thanks to the joint will of new pioneers and the World Federation of Neurology (WFN), allowed the recognition of neurology in the African continent, alongside other great regional Academies around the world. Conclusion African neurosciences have emerged from the shadows, allowing, in particular, a deepening of the knowledge in neuroepidemiology and the role of socio-economic, ethnographic and cultural factors.

This work focuses on the optical stimulation of dorsal root ganglion (DRG) neurons through infrared laser light stimulation. We show that a few millisecond laser pulse at 1875 nm induces a membrane depolarization, which was observed by the patch-clamp technique. This stimulation led to action potentials firing on a minority of neurons beyond an energy threshold. A depolarization without action potential was observed for the majority of DRG neurons, even beyond the action potential energy threshold. The use of ruthenium red, a thermal channel blocker, stops the action potential generation, but has no effects on membrane depolarization. Local temperature measurements reveal that the depolarization amplitude is sensitive to the amplitude of the temperature rise as well as to the time rate of change of temperature, but in a way which may not fully follow a photothermal capacitive mechanism, suggesting that more complex mechanisms are involved.

International audience