Spatially explicit urban green indicators for characterizing vegetation cover and public green space proximity: a case study on Brussels, Belgium

Cities often have a substantial green infrastructure,which provides local ecosystem services that improve the quality of life of urban residents.These services should be explicitly addressed in urban development policies,and areas with insufficient vegetation and limited access to public green spaces should be identified.This paper presents two spatially explicit urban green indicators that are derived using remote sensing imagery,freely available map data and spatial analysis tools from open source geospatial libraries and commercial software.The first indicator represents proportional green cover(public as well as private)in the vicinity of each building within a city.The second indicator quantifies the proximity of public green spaces as walking distances from buildings to actual park entrances.A dasymetric mapping approach was used to take spatial variations in population density into account.This allows representing the indicators from the perspective of citizens instead of buildings,which may be more meaningful for deriving statistics at city level or at the level of neighbourhoods or administrative zones.The potential use of these indicators in a planning context is discussed on a case study carried out for the city of Brussels,Belgium.

Complication rates after direct anterior vs posterior approach for hip hemiarthroplasty in elderly individuals with femoral neck fractures

BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality rates.Approaches to this surgery are still debated,with no consensus regarding the superiority of any single approach.AIM To compare early postoperative complications after implementing the direct anterior and posterior approaches(PL)for hip hemiarthroplasty after femoral neck fractures.METHODS This is a comparative,retrospective,single-center cohort study conducted at a university hospital.Between March 2008 and December 2018,273 patients(a total of 280 hips)underwent bipolar hemiarthroplasties(n=280)for displaced femoral neck fractures using either the PL(n=171)or the minimally invasive direct anterior approach(DAA)(n=109).The choice of approach was related to the surgeons’practices;the implant types were similar and unrelated to the approach.Dislocation rates and other complications were reviewed after a minimum followup of 6 mo.RESULTS Both treatment groups had similarly aged patients(mean age:82 years),sex ratios,patient body mass indexes,and patient comorbidities.Surgical data(surgery delay time,operative time,and blood loss volume)did not differ significantly between the groups.The 30 d mortality rate was higher in the PL group(9.9%)than in the DAA group(3.7%),but the difference was not statistically significant(P=0.052).Among the one-month survivors,a significantly higher rate of dislocation was observed in the PL group(14/154;9.1%)than in the DAA group(0/105;0%)(P=0.002).Of the 14 patients with dislocation,8 underwent revision surgery for recurrent instability(posterior group),and one of them had 2 additional procedures due to a deep infection.The rate of other complications(e.g.,perioperative and early postoperative periprosthetic fractures and infection-related complications)did not differ significantly between the groups.CONCLUSION These findings suggest that the DAA to bipolar hemiarthroplasty for patients with femoral neck fractures is associated with a lower dislocation rate(<1%)than the PL.

Single-atom catalysts for the electrochemical reduction of carbon dioxide into hydrocarbons and oxygenates

The electrochemical reduction of carbon dioxide offers a sound and economically viable technology for the electrification and decarbonization of the chemical and fuel industries.In this technology,an electrocatalytic material and renewable energy-generated electricity drive the conversion of carbon dioxide into high-value chemicals and carbon-neutral fuels.Over the past few years,single-atom catalysts have been intensively studied as they could provide near-unity atom utilization and unique catalytic performance.Single-atom catalysts have become one of the state-of-the-art catalyst materials for the electrochemical reduction of carbon dioxide into carbon monoxide.However,it remains a challenge for single-atom catalysts to facilitate the efficient conversion of carbon dioxide into products beyond carbon monoxide.In this review,we summarize and present important findings and critical insights from studies on the electrochemical carbon dioxide reduction reaction into hydrocarbons and oxygenates using single-atom catalysts.It is hoped that this review gives a thorough recapitulation and analysis of the science behind the catalysis of carbon dioxide into more reduced products through singleatom catalysts so that it can be a guide for future research and development on catalysts with industry-ready performance for the electrochemical reduction of carbon dioxide into high-value chemicals and carbon-neutral fuels.

Connecting neurodevelopment to neurodegeneration:a spotlight on the role of kinesin superfamily protein 2A(KIF2A)

Microtubules play a central role in cytoskeletal changes during neuronal development and maintenance.Microtubule dynamics is essential to polarity and shape transitions underlying neural cell division,differentiation,motility,and maturation.Kinesin superfamily protein 2A is a member of human kinesin 13 gene family of proteins that depolymerize and destabilize microtubules.In dividing cells,kinesin superfamily protein 2A is involved in mitotic progression,spindle assembly,and chromosome segregation.In postmitotic neurons,it is required for axon/dendrite specification and extension,neuronal migration,connectivity,and survival.Humans with kinesin superfamily protein 2A mutations suffer from a variety of malformations of cortical development,epilepsy,autism spectrum disorder,and neurodegeneration.In this review,we discuss how kinesin superfamily protein 2A regulates neuronal development and function,and how its deregulation causes neurodevelopmental and neurological disorders.

Magnetopause properties at the dusk magnetospheric flank from global magnetohydrodynamic simulations,the kinetic Vlasov equilibrium,and in situ observations--Potential implications for SMILE

We derived the properties of the terrestrial magnetopause(MP)from two modeling approaches,one global–fluid,the other local–kinetic,and compared the results with data collected in situ by the Magnetospheric Multiscale 2(MMS2)spacecraft.We used global magnetohydrodynamic(MHD)simulations of the Earth’s magnetosphere(publicly available from the NASA-CCMC[National Aeronautics and Space Administration–Community Coordinated Modeling Center])and local Vlasov equilibrium models(based on kinetic models for tangential discontinuities)to extract spatial profiles of the plasma and field variables at the Earth’s MP.The global MHD simulations used initial solar wind conditions extracted from the OMNI database at the time epoch when the MMS2 observes the MP.The kinetic Vlasov model used asymptotic boundary conditions derived from the same in situ MMS measurements upstream or downstream of the MP.The global MHD simulations provide a three-dimensional image of the magnetosphere at the time when the MMS2 crosses the MP.The Vlasov model provides a one-dimensional local view of the MP derived from first principles of kinetic theory.The MMS2 experimental data also serve as a reference for comparing and validating the numerical simulations and modeling.We found that the MP transition layer formed in global MHD simulations was generally localized closer to the Earth(roughly by one Earth radius)from the position of the real MP observed by the MMS.We also found that the global MHD simulations overestimated the thickness of the MP transition by one order of magnitude for three analyzed variables:magnetic field,density,and tangential speed.The MP thickness derived from the local Vlasov equilibrium was consistent with observations for all three of these variables.The overestimation of density in the Vlasov equilibrium was reduced compared with the global MHD solutions.We discuss our results in the context of future SMILE(Solar wind Magnetosphere Ionosphere Link Explorer)campaigns for observing the Earth’s MP.

Endoscopic treatment of biliopancreatic pathology in patients with Whipple's pancreaticoduodenectomy surgical variants: Lessons learned from single-balloon enteroscopy-assisted ERCP

Background: Endoscopic treatment of biliopancreatic pathology is challenging due to surgically altered anatomy after Whipple's pancreaticoduodenectomy. This study aimed to evaluate the feasibility and safety of single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography(SBE-ERCP) to treat biliopancreatic pathology in patients with Whipple's pancreaticoduodenectomy surgical variants. Methods: We retrospectively analyzed 106 SBE-ERCP procedures in 46 patients with Whipple's variants. Technical and clinical success rates and adverse events were evaluated. Results: Biliary SBE-ERCP was performed in 34 patients and pancreatic SBE-ERCP in 17, including 5 with both indications. From a total of 106 SBE-ERCP procedures, 76 were biliary indication with technical success rate of 68/76(90%) procedures and clinical success rate of 30/34(88%) patients. Mild adverse event rate was 8/76(11%), without serious adverse events. From a total of 106 SBE-ERCP procedures, 30 were pancreatic indication with technical success rate of 24/30(80%) procedures( P = 0.194 vs. biliary SBEERCP) and clinical success rate of 11/17(65%) patients( P = 0.016 vs. biliary SBE-ERCP). Mild adverse event rate was 6/30(20%)( P = 0.194 vs. biliary SBE-ERCP), without serious adverse events. After SBE-ERCP failure, endoscopic ultrasound-guided drainage, percutaneous drainage and redo surgery were alternative therapeutic options. Conclusions: Biliopancreatic pathology after Whipple's pancreaticoduodenectomy variants can be treated using SBE-ERCP without serious adverse events. Technical and clinical success rates are high for biliary indications, whereas clinical success rate of pancreatic indications is significantly lower. SBE-ERCP can be considered as first-line treatment option in this patient group with surgically altered anatomy.

Combining video and GPS-tracking to study the spatial foraging distribution of a single-prey loading seabird

Seabirds are valuable indicators of marine ecosystem processes and studying seabird diets can shed light on natural or human-induced variability in food-web composition.Specifically single-prey loading seabird species such as terns have the potential to act as visual sentinels of prey availability offshore.However,obtaining diet information from remote bird colonies is often challenging and time consuming.In this pilot study we present a novel approach to combine two established methods to study seabird foraging ecology,providing a powerful and cost-effective tool to study the distribution of prey items available to seabirds.We combined GPS tracking data of Sandwich Terns(Thalasseus sandvicensis)with prey-observations from a hide in 2012 and 2013,and from semicontinuously recorded camera footage in 2017.By doing so,we identified 115 approximate catch locations of prey(86 herring/sprat Clupeidae,29 sandeel Ammodytidae).Combining GPS-data and prey observations yielded detailed knowledge on the movements and chick diets of tracked birds as well as the spatial origin and lengths of captured prey items.Further catch distances of both Clupeidae and Ammodytidae resulted in deliveries of larger prey items and thus higher energy yield per trip,but also a higher energy expenditure per trip.We discuss the limitations and potential of our methodological approach to study foraging energetics during chick-provisioning of seabirds that carry prey items visible in their beaks.

Advancing immunosuppression in liver transplantation: A narrative review

Immunosuppression is essential to ensure recipient and graft survivals after liver transplantation(LT). However, our understanding and management of the immune system remain suboptimal. Current immunosuppressive therapy cannot selectively inhibit the graft-specific immune response and entails a significant risk of serious side effects, i.e., among others, de novo cancers, infections, cardiovascular events, renal failure, metabolic syndrome, and late graft fibrosis, with progressive loss of graft function. Pharmacological research, aimed to develop alternative immunosuppressive agents in LT, is behind other solidorgan transplantation subspecialties, and, therefore, the development of new compounds and strategies should get priority in LT. The research trajectories cover mechanisms to induce T-cell exhaustion, to inhibit co-stimulation, to mitigate non-antigen-specific inflammatory response, and, lastly, to minimize the development and action of donor-specific antibodies. Moreover, while cellular modulation techniques are complex, active research is underway to foster the action of T-regulatory cells, to induce tolerogenic dendritic cells, and to promote the function of B-regulatory cells. We herein discuss current lines of research in clinical immunosuppression, particularly focusing on possible applications in the LT setting.

Enabling low-cost decentralized power reserves adopting carbon dioxide for green methane exchange in stabilized clathrate adsorbent

1.Challenges circular methane energy systems In recent decades,methane-based energy systems have rapidly gained traction across the globe because of the increasing availability of low-cost methane production capacity.However,fossil methane production and combustion lead to large greenhouse gas emissions,contributing to climate change[1].

The First Global Map of Atmospheric Ammonia(NH_(3)) as Observed by the HIRAS/FY-3D Satellite

Atmospheric ammonia(NH_(3)) is a chemically active trace gas that plays an important role in the atmospheric environment and climate change. Satellite remote sensing is a powerful technique to monitor NH_(3) concentration based on the absorption lines of NH_(3) in the thermal infrared region. In this study, we establish a retrieval algorithm to derive the NH_(3)column from the Hyperspectral Infrared Atmospheric Sounder(HIRAS) onboard the Chinese Feng Yun(FY)-3D satellite and present the first atmospheric NH_(3) column global map observed by the HIRAS instrument. The HIRAS observations can well capture NH_(3) hotspots around the world, e.g., India, West Africa, and East China, where large NH_(3) emissions exist. The HIRAS NH_(3) columns are also compared to the space-based Infrared Atmospheric Sounding Interferometer(IASI)measurements, and we find that the two instruments observe a consistent NH_(3) global distribution, with correlation coefficient(R) values of 0.28–0.73. Finally, some remaining issues about the HIRAS NH_(3) retrieval are discussed.

Liver transplantation and liver resection as alternative treatments for primary hepatobiliary and secondary liver tumors: Competitors or allies?

Although Starzl designed in the 1960’s liver transplantation(LT)to treat unresectable primary and also secondary liver tumors,transplantation still occupies a(too)small place in the respective therapeutic algorithms[1].Due to the lack of(any)selection criteria,the concept of transplantation became rapidly challenged because of the prohibitively high incidence of tumor recurrence[1–3].

Erratum to:Deriving Temporal and Vertical Distributions of Methane in Xianghe Using Ground-based Fourier Transform Infrared and Gas-analyzer

“Diurnal variation of CH4 at the surface from spring to winter.The time units are in local time(+8 h UTC).The error bar is 1σfor all the observed hourly mean data within that season at that local time.”in the caption of Fig.8 on Page 604 should be“Diurnal variation of CH4 at the surface from spring to winter.The time units are in UTC.The error bar is 1σfor all the observed hourly mean data within that season at that local time.”

Molecular Characterization of Gastrointestinal Stromal Tumors (Gist) and Contribution of Immunohistochemistry in Congolese from Kinshasa

Introduction: The differentiation of digestive tumors very often requires the use of techniques currently not widely in use in the Democratic Republic of Congo (DRC), such as immunohistochemistry. This is perfectly verified for GISTs whose precise, or at least highly certain, diagnosis can only be made using immunohistochemical markers. This underuse of these techniques due to lack of equipment and human skills explains the limited epidemiological data available to date, thus leading to untargeted and too often late treatment of patients. Research question: What contribution can immunohistochemical markers make to the diagnosis of digestive tract tumours? Objective: Discuss the contribution of immunohistochemical markers in the diagnosis of GIST and provide basic data on the epidemiology of these nosological entities in Kinshasa. Methodology: This was a retrospective study carried out at the LEBOMA private anatomy and pathological cytology centre. The main inclusion criterion was any digestive tract block or slide whose diagnosis of GIST had been requalified after review by at least 2 pathologists. An immuhistochemical study was performed using an automated technique (with a Ventana XT machine) using a panel of antibodies: CD-117 and DOG-1 which are listed in the literature as strongly correlated with the occurrence of GIST, all slides were made at Hj Hospital using an OLYMPUS BX41 co-observation microscope. Results: Of 601 cases of digestive tumors recorded during the concerned period, 32 (5.32%) concerned GIST. This prevalence was confirmed by our immunohistochemical results where the expression of CD117 and that of DOG-1 were positive in 90.6% and 100% of cases which prevalence is high compared with the worldwide prevalence according to the literature, respectively. The distribution of the patients concerned was made with a sex ratio of 1.6 women/men with a median age of 53 years. Most cases (81%) had a gastric location and were fusiform GISTs. Conclusion: Gastrointestinal stromal tumours, although rare and underestimated, account for 5.32% of cases in the DRC. This is a considerable and high prevalence compared with the world average. To the best of our knowledge, no studies have been carried out on these aspects in the DRC, which explains the importance of this study. The results of this research demonstrated the contribution of these 2 markers as specific and effective biomarkers for optimal and differential diagnosis in GIST. In view of the above, it is therefore more than necessary to popularise the use of these biomarkers in order to contribute effectively to improving the overall management of gastrointestinal tumours by improving their identification.

Rational and Continuous Measurement of Emotional-Fingerprint, Emotional-Quotient and Categorical vs Proportional Recognition of Facial Emotions with M.A.R.I.E., Second Half

Context: The advent of Artificial Intelligence (AI) requires modeling prior to its implementation in algorithms for most human skills. This observation requires us to have a detailed and precise understanding of the interfaces of verbal and emotional communications. The progress of AI is significant on the verbal level but modest in terms of the recognition of facial emotions even if this functionality is one of the oldest in humans and is omnipresent in our daily lives. Dysfunction in the ability for facial emotional expressions is present in many brain pathologies encountered by psychiatrists, neurologists, psychotherapists, mental health professionals including social workers. It cannot be objectively verified and measured due to a lack of reliable tools that are valid and consistently sensitive. Indeed, the articles in the scientific literature dealing with Visual-Facial-Emotions-Recognition (ViFaEmRe), suffer from the absence of 1) consensual and rational tools for continuous quantified measurement, 2) operational concepts. We have invented a software that can use computer-morphing attempting to respond to these two obstacles. It is identified as the Method of Analysis and Research of the Integration of Emotions (M.A.R.I.E.). Our primary goal is to use M.A.R.I.E. to understand the physiology of ViFaEmRe in normal healthy subjects by standardizing the measurements. Then, it will allow us to focus on subjects manifesting abnormalities in this ability. Our second goal is to make our contribution to the progress of AI hoping to add the dimension of recognition of facial emotional expressions. Objective: To study: 1) categorical vs dimensional aspects of recognition of ViFaEmRe, 2) universality vs idiosyncrasy, 3) immediate vs ambivalent Emotional-Decision-Making, 4) the Emotional-Fingerprint of a face and 5) creation of population references data. Methods: M.A.R.I.E. enables the rational, quantified measurement of Emotional Visual Acuity (EVA) in an individual observer and a population aged 20 to 70 years. Meanwhile, it can measure the range and intensity of expressed emotions through three Face- Tests, quantify the performance of a sample of 204 observers with hypernormal measures of cognition, “thymia” (defined elsewhere), and low levels of anxiety, and perform analysis of the six primary emotions. Results: We have individualized the following continuous parameters: 1) “Emotional-Visual- Acuity”, 2) “Visual-Emotional-Feeling”, 3) “Emotional-Quotient”, 4) “Emotional-Decision-Making”, 5) “Emotional-Decision-Making Graph” or “Individual-Gun-Trigger”, 6) “Emotional-Fingerprint” or “Key-graph”, 7) “Emotional-Fingerprint-Graph”, 8) detecting “misunderstanding” and 9) detecting “error”. This allowed us a taxonomy with coding of the face-emotion pair. Each face has specific measurements and graphics. The EVA improves from ages of 20 to 55 years, then decreases. It does not depend on the sex of the observer, nor the face studied. In addition, 1% of people endowed with normal intelligence do not recognize emotions. The categorical dimension is a variable for everyone. The range and intensity of ViFaEmRe is idiosyncratic and not universally uniform. The recognition of emotions is purely categorical for a single individual. It is dimensional for a population sample. Conclusions: Firstly, M.A.R.I.E. has made possible to bring out new concepts and new continuous measurements variables. The comparison between healthy and abnormal individuals makes it possible to take into consideration the significance of this line of study. From now on, these new functional parameters will allow us to identify and name “emotional” disorders or illnesses which can give additional dimension to behavioral disorders in all pathologies that affect the brain. Secondly, the ViFaEmRe is idiosyncratic, categorical, and a function of the identity of the observer and of the observed face. These findings stack up against Artificial Intelligence, which cannot have a globalist or regionalist algorithm that can be programmed into a robot, nor can AI compete with human abilities and judgment in this domain. *Here “Emotional disorders” refers to disorders of emotional expressions and recognition.

Rational and Continuous Measurement of the Emotional Decision Making in Visual Recognition of Facial Emotional Expressions with M.A.R.I.E.: First Half

Context: The advent of Artificial Intelligence (AI) requires modeling prior to its implementation in algorithms for most human skills. This observation requires us to have a detailed and precise understanding of the interfaces of verbal and emotional communications. The progress of AI is significant on the verbal level but modest in terms of the recognition of facial emotions even if this functionality is one of the oldest in humans and is omnipresent in our daily lives. Dysfunction in the ability for facial emotional expressions is present in many brain pathologies encountered by psychiatrists, neurologists, psychotherapists, mental health professionals including social workers. It cannot be objectively verified and measured due to a lack of reliable tools that are valid and consistently sensitive. Indeed, the articles in the scientific literature dealing with Visual-Facial-Emotions-Recognition (ViFaEmRe), suffer from the absence of 1) consensual and rational tools for continuous quantified measurement, 2) operational concepts. We have invented a software that can use computer-morphing attempting to respond to these two obstacles. It is identified as the Method of Analysis and Research of the Integration of Emotions (M.A.R.I.E.). Our primary goal is to use M.A.R.I.E. to understand the physiology of ViFaEmRe in normal healthy subjects by standardizing the measurements. Then, it will allow us to focus on subjects manifesting abnormalities in this ability. Our second goal is to make our contribution to the progress of AI hoping to add the dimension of recognition of facial emotional expressions. Objective: To study: 1) categorical vs dimensional aspects of recognition of ViFaEmRe, 2) universality vs idiosyncrasy, 3) immediate vs ambivalent Emotional-Decision-Making, 4) the Emotional-Fingerprint of a face and 5) creation of population references data. Methods: With M.A.R.I.E. enable a rational quantified measurement of Emotional-Visual-Acuity (EVA) of 1) a) an individual observer, b) in a population aged 20 to 70 years old, 2) measure the range and intensity of expressed emotions by 3 Face-Tests, 3) quantify the performance of a sample of 204 observers with hyper normal measures of cognition, “thymia,” (ibid. defined elsewhere) and low levels of anxiety 4) analysis of the 6 primary emotions. Results: We have individualized the following continuous parameters: 1) “Emotional-Visual-Acuity”, 2) “Visual-Emotional-Feeling”, 3) “Emotional-Quotient”, 4) “Emotional-Deci-sion-Making”, 5) “Emotional-Decision-Making Graph” or “Individual-Gun-Trigger”6) “Emotional-Fingerprint” or “Key-graph”, 7) “Emotional-Finger-print-Graph”, 8) detecting “misunderstanding” and 9) detecting “error”. This allowed us a taxonomy with coding of the face-emotion pair. Each face has specific measurements and graphics. The EVA improves from ages of 20 to 55 years, then decreases. It does not depend on the sex of the observer, nor the face studied. In addition, 1% of people endowed with normal intelligence do not recognize emotions. The categorical dimension is a variable for everyone. The range and intensity of ViFaEmRe is idiosyncratic and not universally uniform. The recognition of emotions is purely categorical for a single individual. It is dimensional for a population sample. Conclusions: Firstly, M.A.R.I.E. has made possible to bring out new concepts and new continuous measurements variables. The comparison between healthy and abnormal individuals makes it possible to take into consideration the significance of this line of study. From now on, these new functional parameters will allow us to identify and name “emotional” disorders or illnesses which can give additional dimension to behavioral disorders in all pathologies that affect the brain. Secondly, the ViFaEmRe is idiosyncratic, categorical, and a function of the identity of the observer and of the observed face. These findings stack up against Artificial Intelligence, which cannot have a globalist or regionalist algorithm that can be programmed into a robot, nor can AI compete with human abilities and judgment in this domain. *Here “Emotional disorders” refers to disorders of emotional expressions and recognition.

Comparative Study of Transvesical and Retropubic Prostatic Adenomectomies in the Urology-Andrology Department of Ignace Deen University Hospital Center

Objective: To compare the results of transvesical and retropubic prostatic adenomectomies at the Urology-Andrology Department of Conakry University Hospital. Methodology: This was a prospective multi-operator analytical study lasting 6 months. It included 70 patients operated on for benign prostatic hypertrophy (BPH), divided into 2 groups of 35 according to the retropubic or transvesical technique. The data was collected using a questionnaire and entered into the Epi info application. The analysis was initially descriptive and then univariate. To identify confounding factors, a multivariate analysis was performed. The application conditions of each test were checked before their application. A p-value Results: Upper adenomectomies represented 53.6% of surgeries performed for BPH. The average age was 73.2 years. The mean prostate volume was 117 ± 51.6 cc and the mean total PSA was 9.2 ± 11.4 ng/ml. The majority of patients had an ASA1 (60%) and ASA2 (37.1%) score. Spinal anesthesia, a double-current silicone probe with hinged hinge 22, and drainage of the prevesical space were carried out in all patients, i.e. 100%. The average overall blood loss was 229 ± 98.2 ml. It was lower in the group of patients operated via the retropubic route (187 ± 60.4 ml). The same was true for the duration of intervention (49.1 ± 7.17 vs 55.4 ± 7.9 min), the catheter wearing time (5.14 ± 0.97 vs 9.29 ± 2 .9 days) and the length of hospitalization (=6.26 ± 1.15 vs 12.1 ± 5.74 days). Conclusion: The retropubic technique has advantages over the transvesical one. These advantages are translated by a gain in the duration of the intervention, blood loss, catheter wearing time and length of hospitalization.

Investigating Non-Compliance with COVID-19 Vaccination through Hesitancy, Refusal, and Access Limitation: A Community-Based Survey from the Democratic Republic of the Congo

Introduction: Vaccination plays a pivotal role in mitigating the repercussions of the COVID-19 pandemic. However, vaccination campaigns encounter obstacles, especially in developing countries like the Democratic Republic of the Congo (DRC). This study aimed at investigating the roles of vaccine hesitancy, refusal, and access barriers, while identifying individual-level factors associated with non-vaccination in Mbujimayi, DRC. Methods: A community-based cross-sectional survey was conducted in three health districts and included 1496 residents. Attitudes and behaviors related to seeking COVID-19 vaccination were assessed using a standardized questionnaire. Hierarchical logistic regression modeling was used to assess factors potentially affecting non-compliance with vaccination. Results: Among participants (median age = 33, IQR = 23.3, M/F sex ratio = 0.7), 60% displayed misconceptions about COVID-19 or its vaccine, while only 35.2% perceived COVID-19 as a significant health threat. Vaccination coverage was estimated at 49.1% (95% CI: 47.5;52.6), with 71.8% of vaccinated individuals having received one dose. Among the unvaccinated individuals, 50.9% expressed no intention to be vaccinated in the future, citing hesitation (30.4%) or refusal (39.6%) mainly due to side effects or distrust of vaccines. Conversely, 32.7% of the unvaccinated persons expressed access barriers despite willingness to be vaccinated. Misconceptions about COVID-19 and its vaccines were the main drivers of vaccination non-compliance. Conclusion: These findings demonstrate significant vaccine non-compliance driven by hesitancy, refusal, and access barriers. Strategies to enhance vaccination coverage and pandemic preparedness should address misconceptions, sociodemographic barriers, and geographic disparities.

Immunohistochemical Profile of Breast Cancer: A Retrospective Study in the Democratic Republic of Congo

Background: The management of breast cancer increasingly requires molecular classification based on immunohistochemistry. As breast cancer is a heterogeneous disease characterized by the accumulation of multiple molecular alterations that give each tumour its own phenotype and evolutionary potential, immunohistochemistry, as a complementary technique to morphological examination, determines the status of hormone receptors and on protein in tumour cells, which are predictive and prognostic markers of breast cancer. This technique is often little used in the Democratic Republic of Congo (DRC), as this study shows. The under-use of this technique due to a lack of equipment and/or human skills explains the paucity of epidemiological data available to date. Objective: Determine the immunohistochemical profile of breast cancer. Methodology: This is a retrospective study carried out in the Anapath Department of the NGANDA Hospital from January 1, 2020 to December 31, 2022, i.e. a 3-year period. Result: A total of 736 patients were registered in the hospitalization register of the Oncology Department of CH NGANDA for the period corresponding to the present study. Breast cancer was diagnosed in 110 patients, representing 14.9% of all cases. The mean age of the patients was 58.4 ± 8.2 years, with extremes ranging from 30 to 76 years. Breast nodules were the most common reason for diagnosis in 56.3% of cases, with Luminal A dominating in 17.3%. Conclusion: Breast cancer is a major public health problem. Worldwide, it is the most frequently diagnosed cancer in women and the leading cause of cancer-related death in women. In the Democratic Republic of Congo, because of the delay in consulting our patients and the weakness of systematic screening, patients are seen at an advanced stage of the disease. Treatment is multidisciplinary, involving surgery, radiotherapy, chemotherapy (including targeted therapies) and hormone therapy. Patient awareness and screening campaigns will contribute to a considerable reduction in the delay in diagnosis and the morbidity and mortality associated with breast cancer.

Building Stock and Emission Models for Jakarta

Understanding urban-scale building emissions is crucial for achieving net-zero targets.This study examined embodied and operational emissions in Jakarta from 2010 to 2022 using the bottom-up Building Stock Model(BSM)and analyzed building stocks across seven categories:apartments,offices,malls,hotels,education facilities,hospitals,and landed houses.Carbon factors for construction materials,fuels,electricity,and cooking gas,along with occupancy rates,were included in the emissions calculations.The findings reveal consistent growth in apartments,malls,and offices,with operational emissions significantly decreasing after the 2015 green building regulations.Despite a declining share in Jakarta’s building stock,landed houses still account for over 40%of embodied and nearly 75%of operational emissions.With around 80%of the population preferring to live in landed houses,their impact on emissions remains substantial.In 2010,Jakarta’s building floor stock was 167 km2.Projections using simple linear regression suggest it could reach 268 km2 by 2050.Emission forecasts using the Prophet Forecasting Model(PFM)suggest that by 2050,building emissions could return to 2010 levels if stricter regulations are consistently enforced.The study underscores the necessity for continuous regulatory advancements and carbon offset initiatives to achieve net-zero emissions.

Infant’s Sigh Breathing Matters—The Role of the Hering-Breuer Deflation Reflex in Bronchial Decongestion

Background: The prolonged slow expiratory (PSE) technique can induce sigh breaths related to the Hering-Breuer reflex in children.PSE is a specific chest physiotherapy technique often used in children to help with the clearance of secretions, reduce pulmonary obstruction and decrease ventilatory effort. Purpose: The main objective of this review was to synthesize and clarify the existing knowledge of the physiological mechanism behind the Hering-Breuer reflex and its utility in the PSE technique. The secondary objective was to provide an overview of PSE which is probably the main mechanical feature for mucus clearance in infants and to identify gaps and any further research required. Method: A comprehensive literature search was performed using PubMed/MEDLINE and Ovid EMBASE, from 1968 to January 2024, using search terms relating to “Interaction of Hering-Breuer reflex and chest physiotherapy therapy, sigh breath in infants and prolonged slow expiration technique” to create an overview of the advances and gaps in current knowledge of PSE. Result: The data obtained following treatment with PSE maneuvers in infants with histories of recurrent wheezing shows that the presence of sighs could be the main active principle of treatment. Conclusion: Changes in volume induced by PSE technique and, effects from crying may stimulate the Hering-Breuer deflation reflex and sighs in turn improving alveolar ventilation as well as lung volume in infants.