COVID-19/Tuberculosis Co-Infection at the Epidemic Treatment Center (ETC) of Saint-Louis (Senegal): About 9 Cases

Introduction: COVID-19 is a global public health emergency that can cause acute respiratory distress syndrome. In countries where tuberculosis (TB) is endemic, coinfection of COVID-19 and TB is often encountered, which increases the risk of developing severe forms of COVID-19. Objectives: The aim of this study was to determine the prevalence of COVID-19/TB coinfection at the Epidemic treatment center (ETC) in Saint-Louis (Senegal) and to describe the epidemiological, clinical, paraclinical, and outcome profile of co-infected patients. Patients and Methods: This is a retrospective, cross-sectional, descriptive cohort study based on the records of COVID-19/ TB co-infected patients who were hospitalized at the ETC in Saint-Louis (Senegal) over an 18-month period from March 2020 to September 2021. Results: Out of a total of 454 hospitalizations, we collected records of 9 patients co-infected with COVID-19/TB, resulting in a prevalence of 2%. The study included patients with a median age of 34 years (range: 10-86 years), with a male predominance (7 cases) and a sex ratio of 3.5. The majority of patients (88.9%) had severe forms of COVID-19. Dyspnea and cough were reported in all patients (100%). Pulmonary TB was the most frequent localization, with 9 cases. The diagnosis of COVID-19 was confirmed by nasopharyngeal PCR in all patients (100%). Bacilloscopy was positive in 3 out of 5 cases. One patient tested positive for GeneXpert? MTB/RIF without rifampicin resistance. All patients were prescribed the hydroxychloroquine-azithromycin combination and anti-tuberculosis treatment. Out of the nine patients, four recovered (44.4%) and five died (55.5%). Conclusion: COVID-19/TB coinfection had a low prevalence in our cohort, but was associated with a high mortality due to the frequent occurrence of severe forms of the disease.

Profile of SARS-CoV-2 Infected Patients Hospitalized at the Epidemic Treatment Center (ETC) in Saint-Louis, Senegal during the First Two Waves

Introduction: The SARS-CoV-2 infection is a major public health emergency. Several risk factors are involved in the occurrence of respiratory distress that can lead to death despite resuscitation measures. Objectives: The aim of this study was to describe the epidemiological, clinical, paraclinical, therapeutic, and evolution profile of patients infected with SARS-CoV-2 hospitalized at the CTE of Saint-Louis (Senegal) during the first two waves. Patients and Methods: We conducted a retrospective, cross-sectional, descriptive, and analytical study that included all patients hospitalized at the ETC of Saint-Louis (Senegal) with SARS-CoV-2 infection from March 2020 to April 2021. Results: A total of 358 cases were collected, 256 (71.5%) during the first wave and 102 (28.5%) during the second wave. The mean age was 49.5 years (19.5). There was a male predominance (58.4%), with a sex ratio of 1.4. Hypertension was the main comorbidity, with 87 cases (24.3%). The most common functional signs were cough in 194 cases (54.2%), dyspnea in 143 cases (40%) and ageusia in 134 cases (37.4%). Thoracic CT scans were performed on 20 patients (5.6%), with severe involvement (50% - 75%) observed in 50% of cases. Hydroxychloroquine-azithromycin was prescribed to 351 patients (98%). Overall, 338 (94.4%) recovered and 17 (4.7%) died. In multivariate analysis, factors associated with death were male sex [OR = 2.645;95% CI: 1.530 - 4.785;p = 0.011], age 60 years [OR = 1.039;95% CI: 0.564 - 1.914;p = 0.002], the presence of comorbidities [OR = 2.171;95% CI: 0.564 - 3.429;p = 0.033], SpO2 (ambient air) 95% [OR = 2.061;95% CI: 0.616 - 3.827;p = 0.03], acute respiratory distress syndrome (ARDS) [OR = 0.635;95% CI: 0.316 - 1.275;p = 0.001], severe form [OR = 1.664;95% CI: 0.298 - 2.478;p = 0.016], occurrence of complications [OR = 0.521;95% CI: 0.287 - 0.944;p = 0.032], high creatinine levels [OR = 2.061;95% CI: 1.616 - 3.827;p = 0.026], and lymphopenia [OR = 0.485;95% CI: 0.370 - 0.636;p = 0.001]. Conclusion: In our series, infection with SARS-CoV-2 was associated with low lethality. Several risk factors were identified that need to be considered for successful management of patients.

A Blind Spot in the Reframing of a Universe of Possibles: Towards a Suitable Model for Decision-Making Theory and A.I.

Bayesian inference model is an optimal processing of incomplete information that, more than other models, better captures the way in which any decision-maker learns and updates his degree of rational beliefs about possible states of nature, in order to make a better judgment while taking new evidence into account. Such a scientific model proposed for the general theory of decision-making, like all others in general, whether in statistics, economics, operations research, A.I., data science or applied mathematics, regardless of whether they are time-dependent, have in common a theoretical basis that is axiomatized by relying on related concepts of a universe of possibles, especially the so-called universe (or the world), the state of nature (or the state of the world), when formulated explicitly. The issue of where to stand as an observer or a decision-maker to reframe such a universe of possibles together with a partition structure of knowledge (i.e. semantic formalisms), including a copy of itself as it was initially while generalizing it, is not addressed. Memory being the substratum, whether human or artificial, wherein everything stands, to date, even the theoretical possibility of such an operation of self-inclusion is prohibited by pure mathematics. We make this blind spot come to light through a counter-example (namely Archimedes’ Eureka experiment) and explore novel theoretical foundations, fitting better with a quantum form than with fuzzy modeling, to deal with more than a reference universe of possibles. This could open up a new path of investigation for the general theory of decision-making, as well as for Artificial Intelligence, often considered as the science of the imitation of human abilities, while being also the science of knowledge representation and the science of concept formation and reasoning.

Numerical Simulation of Saint-Venant Equations with Thermal Energy Dependency: Applications on Global Warming

Since the Industrial Revolution, humanity has been intensifying the burning of fossil fuels and as a consequence, the average temperature on Earth has been increasing. The 20th century was the warmest and future prospects are not favorable, that is, even higher temperatures are expected. This demonstrates the importance of studies on the subject, mainly to predict possible environmental, social and economic consequences. The objective of this work was to identify the interference of the increase in ambient temperature in the dynamics of fluids, such as ocean waves advancing over the continent. For this, thermal energy was considered in the Saint-Venant equations and computational implementations were performed via Lax-Friedrichs and Adams-Moulton methods. The results indicated that, in fact, depending on the amount of thermal energy transferred to the fluid, the advance of water towards the continent can occur, even in places where such a phenomenon has never been observed.

线性阻尼Boussinesq方程解的Phragmén-Lindelof二择一性

研究一类含有双调和算子的双曲方程解的空间性态.利用能量方法,构造一个能量表达式,推导出该能量表达式所满足的二阶微分不等式,通过求解该不等式,得到解的Phragmén-Lindelof型的二择一结果.该结果表明,Saint-Venant原则对于线性阻尼Boussinesq方程同样适用.

Mathematical Modeling and Evaluation of Reliability Parameters Based on Survival Possibilities under Uncertain Environment

In this article,mathematical modeling for the evaluation of reliability is studied using two methods.One of the methods,is developed based on possibility theory.The performance of the reliability of the system is of prime concern.In view of this,the outcomes for the failure are required to evaluate with utmost care.In possibility theory,the reliability information data determined from decision-making experts are subjective.The samemethod is also related to the survival possibilities as against the survival probabilities.The other method is the one that is developed using the concept of approximation of closed interval including the piecewise quadratic fuzzy numbers.In this method,a decision-making expert is not sure of his/her estimates of the reliability parameters.Numerical experiments are performed to illustrate the efficiency of the suggested methods in this research.In the end,the paper is concluded with some future research directions to be explored for the proposed approach.

El Arte de Bregar(The Art of Dealing):An Existentialism

“La brega”unveils a multifaceted exploration of human existence,reflecting the intricate interplay of ambiguity and ethical engagement within Puerto Rican culture.This concept,with its roots in the aesthetic realm of ambiguity,beckons individuals to savor the pleasure of indefiniteness and resist the confines of historical anchorage.Drawing parallels to Kierkegaard’s musings on Don Juan,it reveals the allure of eternal longing,evading the consummation of desire and leading to existential despair.However,“la brega”is far from static;it undergoes an evolution toward an ethical phase.Here,individuals navigate the turbulent waters of reconciliation and conflict resolution,eschewing violence while embracing the boundaries of responsibility.This ethical iteration resonates with Kierkegaard’s ethical stage,where moral responsibility and courageous choices take center stage.Yet,it is vital to recognize that“la brega”transcends any simplistic notions of docility;it embodies a resilient and transformative force within Puerto Rican culture,capable of driving meaningful and impactful actions.In its nuanced exploration of ambiguity,ethics,and resilience,“la brega”offers profound insights into the intricate tapestry of human experience.

Comparative Study of the Efficacy of Misoprostol and Oxytocin Im in the Prevention of Post-Partum haemorrhage in a Low-Resource Setting

Background: In developing countries, postpartum hemorrhage is responsible for 30% of maternal deaths. Although the World Health Organization recommends the use of oxytocin for the prevention of postpartum hemorrhage, the use of misoprostol is increasingly common. The objective of this study was to determine the frequency of postpartum hemorrhage in parturients delivering at Saint-Vincent Hospital and to compare the effectiveness of misoprostol use versus oxytocin in preventing postpartum hemorrhage. Material and Methods: We conducted a comparative longitudinal study at the Saint Vincent Hospital comparing 10 units of intramuscular oxytocin with 600 micrograms of sublingual misoprostol. The study was conducted from 01 January 2017 to 31 December 2019, a period of 3 years. The study population consisted of 2161 consenting women. Of these, 1289 received 10 IU of intramuscular oxytocin and 872 received 600 micrograms of misoprostol. The collected data were entered using Microsoft Excel 2013 and analysed using SPSS version 21 software. Results: The frequency of administration of Misoprostol and oxytocin in parturients was 40.4% and 59.6% respectively in this study. One hundred and fourteen cases of postpartum hemorrhage (114/2161 or 5.3%) were noted among the parturients. The average age of parturients who received oxytocin was 24.36 ± 4.45 years vs 24.63 ± 5.11 years among parturients who received Misoprostol;(p = 0.190). The mean parity was 2.52 ± 1.46 vs 2.66 ± 1.44;(p = 0.020). We noted a high proportion (78.3%) of postpartum hemorrhage from the oxytocin group vs. 21.7% from the Misoprostol group (OR 2.5-fold), with a statistically significant difference (p 0.001). We noted high proportions of uterine atony (92.3%) from the oxytocin group vs 7.7% from the Misoprostol group (p = 0.004). Uterine atony was the actual factor associated with postpartum hemorrhage (OR = 10.0895% CI: 1.78 - 57.10;p = 0.009). Conclusion: Misoprostol 600 Microgram administered sublingually immediately after neonatal expulsion and before delivery was 2.5 times more effective than oxytocin 10 IU/IM. Misoprostol is therefore a good alternative to oxytocin and offers more advantages in management, use and outcome than oxytocin.

The Prevalence of Female Genital Bilharziasis (FGB) in the Northern Region of Senegal

Introduction: Female Genital Bilharzia (FGB) is a pathology secondary to infection by Schistosoma haematobium. It is one of the neglected tropical diseases, capable of causing infertility, difficulties in childbirth and even cervical cancer. It represents a real public health problem. We therefore conducted a study in the maternity ward of the Saint-Louis regional hospital, with the overall aim of determining the prevalence of FBG in patients undergoing colposcopy. The specific objectives were to define the patient profile, and to compare colposcopic images with the World Health Organization (WHO) atlas. Methodology: We conducted a descriptive, analytical cross-sectional study of all colposcopic images taken at the maternity ward of the Saint-Louis regional hospital from August 1, 2018, to September 30, 2020, i.e. 25 months. The images were compared with the BGF images described in the WHO atlas. Results: We collected 178 colposcopy images. FBG images numbered 50, or 28%. The mean age of the patients was 44.5 years ±11.4 at the extremes of 18 and 78 years. Mean gestational age was 4.69 ± 2.72. Among patients with a bilharzian lesion on the cervix, visual acid inspection (VIA) was negative in 60% of cases (p = 0.007, Odd Ratio = 3.6 (1.49 - 9.07)). Conclusion: the results of our study show that FBG is a reality in our daily practice. It occurs in adult, multigestating, non-occupational women whose examination reveals a negative visual inspection with acetic acid (VIA). Healthcare providers therefore need to be trained in the recognition of lesions associated with genital bilharziasis, and public awareness needs to be raised.

Impact of Urban Anthropogenic Pressures on the Mangrove Forest of Sainte Marie (East Madagascar)

This article demonstrates the urban anthropogenic threats and their impacts on Sainte Marie (Eastern Madagascar) mangrove ecosystem. In addition to conducting interview with 158 residents, floristic inventories were carried out in order to compare the mangrove structure between a control site and another one that was impacted by Belle Vue dyke (south of the District downtown) rehabilitation. From 2003 to 2014, the island of Sainte Marie lost 0.47% per year of its mangrove area. 87% of the harvested resources from this ecosystem are fish products and are related to human nutrition. The mangrove is used as a dumping ground for liquid and solid waste in the lots of Saint Joseph and La Pointe. Defecation in the open air is topical under the island’s mangrove forest. A very weak resilience of the mangrove impacted by the rehabilitation of Belle Vue dyke was noted. Indeed, regenerations of Bruguiera gymnorrhiza and Ceriops tagal have struggled to rebuild. The total height and diameter of impacted trees decreased by 37.2% and 44.3%, respectively. The development of an updated urban master plan, including mangroves in the related zoning process is an imperative measurement for the conservation and/or valuation of existing lots.

The Possibility of Semantic Features and Analysis of Figures of Speech —— Cognitive Figures and Expressive Figures

In this paper, linguistic methodology is suggested for approaching figures of speech formed due to shift of cognitive relations. First, requisite features, possible features and impossible features are proposed on the basis of semantic analysis and their interrelationships and expressions are discussed. Then it is further argued that all figures formed due to shift of cognitive relation are expressed to accept an impossible feature; and there are four semantic forms to accept it: “zero distance/distanced”, “implicit/explicit”, “direct/indirect”, “positive/negative”. Finally, starting from the two approaches to figures we comment on the traditional idea of separating decoration and substance and the new idea of “function as form”.

PROCEDURE FOR COMPUTING THE POSSIBILITY AND FUZZY PROBABILITY OF FAILURE OF STRUCTURES

Traditionally, the calculation of reliability of fuzzy random structures is based on the well-known formulation of probability of fuzzy events. But sometimes the results of this formulation will not indicating the real state of safety of fuzzy-random structures. Based on the possibility theory, a computational procedure for the reliability analysis of fuzzy failure problems and random-fuzzy failure problems of mechanical structures that contain fuzzy variables were presented. A procedure for the analysis of structural reliability of problems of fuzzy failure criterion was also proposed. The failure possibility of fuzzy structures and possibility distribution of the probability of failure of fuzzy-random structures can be given by the proposed methods. It is shown that for the hybrid probabilistic and fuzzy reliability problems, the probability of failure should be suitably taken as a fuzzy variable in order to indicate the real safety of system objectively. Two examples illustrate the validity and rationality of the proposed methods.

Iranian Medical Staff’s Perception of the <i>All Saints</i>TV S

The present study was an attempt to explore the Iranian medical staff’s perception of the All Saints TV series. 199 participants including doctors, nurses, interns, and paramedics took part in this survey study which was done in 2011. A 17-item Likert scale questionnaire was developed by the team of researchers to gather further evidence on the issues raised by the participants in the focus group which was formed in order to delve into their thoughts, attitudes, and feelings about the mentioned program. The supportive and non-blaming nature of the working relationship among the treatment team, their respect for the patients, their strong team work, the accuracy and precision of the presented medical information, and the discipline and sense of responsibility on the part of the medical staff were among the most frequent issues being mentioned and noticed by the participants. In addition, the majority of the participants considered the demonstrated model for providing healthcare services to be an efficient one;however, they believed that it was not possible to apply that model in the Iranian hospitals mainly due to the cultural differences between the two contexts and the current regulations in Iran. The participants were also observed to be only moderately satisfied with the system they were working in. It seems that healthcare systems in the developed countries can be used as models to identify the problems with the existing healthcare system in Iran. Authorities need to take appropriate measures to resolve such problems. The possible solutions and actions have been suggested in the present article.

Author Correction: Successful implementation of intestinal resection and anastomosis in non-human primates suggests the possibility of longitudinal intestinal research

After the publication of Wang et al.(2020),we realized that there were some inappropriate statements in the content.Hereby,we correct them and apologize for any confusion this may have caused.

Transcatheter Aortic Valve Implantation: Experience of Sainte Clotilde Hospital in Reunion Island

Introduction: Degenerative aortic stenosis is the most common valvulopathy in developed countries. The implantation of a percutaneous aortic valve (TAVI) has taken an important place in the management of this valvulopathy. The objective of this work is to report the results of patients treated by TAVI by the team of Sainte Clotilde Hospital (Reunion Island). Patients and?Methods: This was a descriptive retrospective study conducted from 01/10/2014?to 01/10/ 2017 in the Sainte Clotilde Hospital, Reunion Island. All patients who received TAVI for degenerative aortic stenosis were included in the study. Follow-up was completed until 31/08/19. Results: Forty-six (46) patients were included (sex ratio 0.53). The age was 82 (±7.5). Respectively,?56.5%, 21.7% and 6.5% of patients were diabetic [n = 26 (56.5%)], severe renal impairment [n = 10 (21.7%)] and hemodialysis [n = 3 (6.5%)]. All procedures were performed by femoral route under consious sedation. Edwards’ prostheses were used more often (93%), 100% Sapien 3, 6% of which were size 23. The primary success rate was 97.8% and the failure rate was 2% (deaths per procedure). The TAVI range of 0.66 ± 0.14 and 46.8 ± 15.5 against 1.48 ± 4.3 and 13.8 ± 5 in post TAVI. Severe pulmonary arterial?hypertension (>60 mmHg) was observed in 21.7% of pre-TAVI patients?compared to 4% in post TAVI patients. The overall rate of complications was 17% (n = 8). They were related to conductive disorders [6.5% (n = 3)], paraprosthetic leakage [2% (n = 1)], tamponade [2% (n = 1)], and hemorrhagic complications [6.5% (n = 3)]. Mean follow-up was 946 days (median = 1007.5 days), mean follow-up death rate was 30.4% (n = 14). The causes of death were non-cardiac in 57% (n = 8) of the cases. Conclusion: The TAVI results of the Sainte Clotilde Hospital Clinic are comparable to those observed in the literature.

Gloves and Ebola virus:a consideration of the penetration possibility based on nanostructure consideration

To the editor,Ebola virus infection is the new deadly viral infection that is presently problematic in many countries in Africa.The prevention of this disease seems to be difficult and the rapid distribution of disease becomes the important issue for further discussion.As noted by Muyembe-Tamfum et al.[1],one of the major disease control measures is the distribution of protective equipment to health care workers.Gloves are important protective

Latent Possibility for a Change of the Fertility Behaviors of Rural－Urban Migrants

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Trinity of Devil, Human and Saint in Eula——A Psychoanalysis of the Heorine in The Hamlet

William Faulkner worte a great number of works taking American south as the setting.The Hamlet is one of these works.The paper is aimed to analyze its major female character Eula Varner based upon the theory of personality structure.There is a corresponding relationship between the id,the ego and the superego and Eula s different aspects of being devil,human and saint.According to the theory,the three parts of personality structure are unified and coordinated mutually.Therefore,It could be concluded that Eula is the trinity of devil,human and saint.

Psychological Assessment Involving Spirituality With Members of the Church of Jesus Christ of Latter-Day Saints

Interest in including spiritual assessments in therapeutic settings has increased in recent years.Even though many psychologists view spirituality as very important to clients’well-being,many report that they do not discuss spirituality in their practice.An inclusion of spirituality may be particularly important when dealing with specific groups for which spirituality/religiosity is a large part of their worldview,such as members of the Church of Jesus Christ of Latter-day Saints.Therefore,this study examined a number of comprehensive spiritual assessment tools to consider when working with members of the Church of Jesus Christ.These tools were evaluated by 100 clinicians.In general,this set of tools was moderately to be mostly consistent with the culture of the Church,with each one having specific strengths and limitations.

THE SAINT-VENANT PROBLEM OF PLANE BAR UNDER AN AXIAL FORCE

In the paper, the solution of Saint-Venant problem is obtained through assumption of principal stress curves by means of the equilibrium equations which were deduced in paper [1]. The results show that the speed of shear approaching to zero is a(3)/y(3) and axial stress approaching to constant is a(2)/y(2).