MXenes for Bioinspired Soft Actuators:Advancements in Angle-Independent Structural Colors and Beyond

Soft actuators have garnered substantial attention in current years in view of their potential appliances in diverse domains like robotics,biomedical devices,and biomimetic systems.These actuators mimic the natural movements of living organisms,aiming to attain enhanced flexibility,adaptability,and versatility.On the other hand,angle-independent structural color has been achieved through innovative design strategies and engineering approaches.By carefully controlling the size,shape,and arrangement of nanostructures,researchers have been able to create materials exhibiting consistent colors regardless of the viewing angle.One promising class of materials that holds great potential for bioinspired soft actuators is MXenes in view of their exceptional mechanical,electrical,and optical properties.The integration of MXenes for bioinspired soft actuators with angle-independent structural color offers exciting possibilities.Overcoming material compatibility issues,improving color reproducibility,scalability,durability,power supply efficiency,and cost-effectiveness will play vital roles in advancing these technologies.This perspective appraises the development of bioinspired MXene-centered soft actuators with angleindependent structural color in soft robotics.

COVID-19 impact in Crohn’s disease patients submitted to autologous hematopoietic stem cell transplantation

BACKGROUND Severe acute respiratory syndrome coronavirus 2 is the virus responsible for coronavirus disease 2019(COVID-19),a disease that has been blamed for inducing or exacerbating symptoms in patients with autoimmune diseases.Crohn's disease(CD)is an inflammatory bowel disease that affects genetically susceptible patients who develop an abnormal mucosal immune response to the intestinal microbiota.Patients who underwent hematopoietic stem cell transplantation(HSCT)are considered at risk for COVID-19.AIM To describe for the first time the impact of COVID-19 in CD patients who had undergone autologous,non-myeloablative HSCT.METHODS In this descriptive study a series of 19 patients were diagnosed with positive COVID-19.For two patients there were reports of the occurrence of two infectious episodes.Parameters related to HSCT,such as time elapsed since the procedure,vaccination status,CD status before and after infection,and clinical manifestations resulting from COVID-19,were evaluated.RESULTS Among the patients with COVID-19,three,who underwent Auto HSCT less than six months ago,relapsed and one,in addition to the CD symptoms,started to present thyroid impairment with positive anti-TPO.Only one of the patients required hospitalization for five days to treat COVID-19 and remained in CD clinical remission.Nine patients reported late symptoms that may be related to COVID-19.There were no deaths,and a statistical evaluation of the series of COVID-19 patients compared to those who did not present any infectious episode did not identify significant differences regarding the analyzed parameters.CONCLUSION Despite the change in CD status in three patients and the presence of nine patients with late symptoms,we can conclude that there was no significant adverse impact concerning COVID-19 in the evaluated patients who underwent HSCT to treat CD.

In situ and operando infrared spectroscopy of battery systems:Progress and opportunities

In situ and operando infrared spectroscopies are powerful techniques to support the design of novel materials for batteries and the development of new battery systems.These techniques can support the study of batteries by identifying the formation of new species and monitoring electrochemical energy stability.However,few works have employed these techniques,which can be used to investigate various materials,including systems beyond lithium-ion technology,in the research of batteries.Therefore,this review presents a comprehensive overview focusing on the main contributions of in situ and operando infrared spectroscopy for lithium-ion batteries(LIBs)and other battery systems.These techniques can successfully identify the formation of species during the electrolyte reduction,electrode degradation,and the formation of the solid-electrolyte interphase(SEI)layer.From these outcomes,it is possible to conclude that this characterization approach should be employed as a protocol to overcome remaining issues in batteries,consequently supporting battery research.This review aims to be a guide on how infrared spectroscopy can contribute to monitoring battery systems and to lead researchers interested in applying this technique.

Endodontic irrigants from a comprehensive perspective

This review article explores the fundamental principles of modern endodontics with a focus on root canal cleaning and shaping.It reviews commonly used endodontic irrigant,namely sodium hypochlorite(NaOCl),herbal extracts,chlorhexidine(CHX),and chelating agents,highlighting their properties,applications,and potential drawbacks.NaOCl,a key antimicrobial agent,demonstrates effectiveness against various microorganisms but poses challenges such as high cytotoxicity.Herbal extracts,gaining recognition in endodontics,present an alternative with potential advantages in preserving dentin integrity.CHX,known for its broad-spectrum antimicrobial activity,is discussed in both liquid and gel formulations,emphasizing its role in reducing smear layer formation and preserving hybrid layer durability.Chelating agents,specifically ethylenediaminetetraacetic acid and citric acid,play a vital role in removing the smear layer,enhancing dentin permeability,and facilitating the penetration of antimicrobial agents.The review article underscores the importance of careful application and consideration of each irrigant's properties to ensure safe and effective endodontic procedures.It serves as a valuable guide for clinicians in selecting appropriate irrigants based on specific treatment requirements.

Molecular Identification of Mycobacterium Strains Responsible of Bovine Tuberculosis Cases in Bobo-Dioulasso Slaughterhouse, Burkina Faso

Bovine tuberculosis (bTB) is an endemic zoonosis significantly affects animal health in Burkina Faso. The primary causative agent is Mycobacterium tuberculosis (M. tuberculosis) complex, mainly M. bovis. Cattle are considered as natural reservoir of M. bovis. However, in Burkina Faso, the circulation of these strains remains poorly understood and documented. This study aimed to identify and characterize Mycobacterium strains from suspected carcasses during routine meat inspection at Bobo-Dioulasso refrigerated slaughterhouse. A prospective cross-sectional study was conducted from January 2021 to December 2022 on cases of seizures linked to suspected bovine tuberculosis. Microbiological and molecular analyzes were used for mycobacterial strain isolation and characterization. Out of 50 samples, 24% tested positive by microscopy and 12% by culture. Molecular analysis identified 6 strains of Mycobacteria, exclusively Mycobacterium bovis specifically the subspecies bovis (Mycobacterium bovis subsp bovis). In conclusion, M. bovis subsp bovis is the primary agent responsible for bovine tuberculosis in Bobo-Dioulasso. Continuous monitoring of mycobacterial strains is therefore necessary for the effective control of this pathology in the local cattle population.

Antimicrobial and synergistic effects of lemongrass and geranium essential oils against Streptococcus mutans,Staphylococcus aureus,and Candida spp.

BACKGROUND The oral cavity harbors more than 700 species of bacteria,which play crucial roles in the development of various oral diseases including caries,endodontic infection,periodontal infection,and diverse oral diseases.AIM To investigate the antimicrobial action of Cymbopogon Schoenanthus and Pelargonium graveolens essential oils against Streptococcus mutans,Staphylococcus aureus,Candida albicans,Ca.dubliniensis,and Ca.krusei.METHODS Minimum microbicidal concentration was determined following Clinical and Laboratory Standards Institute documents.The synergistic antimicrobial activity was evaluated using the Broth microdilution checkerboard method,and the antibiofilm activity was evaluated with the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay.Data were analyzed by one-way analysis of variance followed by the Tukey post-hoc test(P≤0.05).RESULTS C.schoenanthus and P.graveolens essential oils were as effective as 0.12%chlorhexidine against S.mutans and St.aureus monotypic biofilms after 24 h.After 24 h P.graveolens essential oil at 0.25%was more effective than the nystatin group,and C.schoenanthus essential oil at 0.25%was as effective as the nystatin group.CONCLUSION C.schoenanthus and P.graveolens essential oils are effective against S.mutans,St.aureus,Ca.albicans,Ca.dubliniensis,and Ca.krusei at different concentrations after 5 min and 24 h.

Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey

Objective:To scrutinize the definitions of minimal invasive surgical therapy(MIST)and to investigate urologists’knowledge,attitudes,and practices for benign prostatic obstruction surgeries.Methods:A 36-item survey was developed with a Delphi method.Questions on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were included.Urologists were invited globally to complete the online survey.Consensus was achieved when more than or equal to 70%responses were“agree or strongly agree”and less than or equal to 15%responses were“disagree or strongly disagree”(consensus agree),or when more than or equal to 70%responses were“disagree or strongly disagree”and less than or equal to 15%responses were“agree or strongly agree”(consensus disagree).Results:The top three qualities for defining MIST were minimal blood loss(n=466,80.3%),fast post-operative recovery(n=431,74.3%),and short hospital stay(n=425,73.3%).The top three surgeries that were regarded as MIST were Urolift®(n=361,62.2%),Rezum®(n=351,60.5%),and endoscopic enucleation of the prostate(EEP)(n=332,57.2%).Consensus in the knowledge section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,day surgery feasibility,and post-operative continence.Consensus in the attitudes section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,and day surgery feasibility.Consensus on both sections was achieved for EEP as the option with the better symptoms and flow improvement,lower retreatment rate,and better suitable for prostate more than 80 mL.Conclusion:Minimal blood loss,fast post-operative recovery,and short hospital stay were the most important qualities for defining MIST.Urolift®,Rezum®,and EEP were regarded as MIST by most urologists.

Plant growth and metabolism of exotic and native Crotalaria species for mine land rehabilitation in the Amazon

Despite its enormous benefits,mining is respon-sible for intense changes to vegetation and soil properties.Thus,after extraction,it is necessary to rehabilitate the mined areas,creating better conditions for the establishment of plant species which is challenging.This study evaluated mineral and organic fertilization on the growth,and carbon and nitrogen(N)metabolism of two Crotalaria species[Cro-talaria spectabilis(exotic species)and Crotalaria maypu-rensis(native species from Carajás Mineral Province(CMP)]established on a waste pile from an iron mine in CMP.A control(without fertilizer application)and six fertilization mixtures were tested(i=NPK;ii=NPK+micronutrients;iii=NPK+micronutrients+organic compost;iv=PK;v=PK+micronutrients;vi=PK+micronutrients+organic compost).Fertilization contributed to increased growth of both species,and treatments with NPK and micronutrients had the best results(up to 257%cf.controls),while organic fertilization did not show differences.Exotic Crotalaria had a greater number of nodules,higher nodule dry mass,chlorophyll a and b contents and showed free ammonium as the predominant N form,reflecting greater increments in biomass compared to native species.Although having lower growth,the use of this native species in the rehabilitation of mining areas should be considered,mainly because it has good development and meets current government legislation as an opportunity to restore local biodiversity.

Influence of quarantine during the coronavirus disease 2019(COVID-19)pandemic on physical and psychosocial aspects:perceptions of 214 Brazilian athletes

Background:Social distancing may affect athletes,training,causing negative effects on mental and physical health.Objective:This study therefore aimed to characterize the perception of Brazilian athletes about their physical and psychosocial aspects,sleep quality and coping strategies during the quarantine of the coronavirus disease 2019(COVID-19)pandemic.Methods:This was a cross-sectional study with online survey,performed with Brazilian athletes(amateur and professional)over 18 years.The main outcomes measures assessed were physical and psychosocial aspects,sleep quality and coping strategies.Results:A total of 214 athletes were included.The average weekly hours of training during the quarantine was 4.71±3.71 h,of which 64.5%athletes(138/214)were oriented by medical staff during training.For 52.8%(113/214)of athletes,training intensity during the quarantine was different/very different from the intensity before the quarantine.79.4%athletes(170/214)reported moderate to extreme difficulties in keeping the same level of training during the quarantine.77.1%athletes(165/214)had moderate to extreme anxiety and each of the athletes had concern about his or her athletic career future,including return to the sport.72.9%athletes(156/214)reported change in sleep schedule during the quarantine period.Conclusion:The quarantine period during COVID-19 pandemic negatively affected the athlete^perception about training routine,since athletes reported reduction in training hours and training intensity.Overall,the athletes reported that they were moderately to extremely anxious.They also had concerns about their career in the future,as well as concerns regarding return to sport.

Fecal microbiota transplantation in patients with metabolic syndrome and obesity:A randomized controlled trial

BACKGROUND Metabolic syndrome is a multifactorial disease,and the gut microbiota may play a role in its pathogenesis.Obesity,especially abdominal obesity,is associated with insulin resistance,often increasing the risk of type two diabetes mellitus,vascular endothelial dysfunction,an abnormal lipid profile,hypertension,and vascular inflammation,all of which promote the development of atherosclerotic cardiovascular disease.AIM To evaluate the outcomes of fecal microbiota transplantation(FMT)in patients with metabolic syndrome.METHODS This was a randomized,single-blind placebo-controlled trial comparing FMT and a sham procedure in patients with metabolic syndrome.We selected 32 female patients,who were divided into eight groups of four patients each.All of the patients were submitted to upper gastrointestinal endoscopy.In each group,two patients were randomly allocated to undergo FMT,and the other two patients received saline infusion.The patients were followed for one year after the procedures,during which time anthropometric,bioimpedance,and biochemical data were collected.The patients also had periodic consultations with a nutritionist and an endocrinologist.The primary end point was a change in the gut microbiota.RESULTS There was evidence of a postprocedural change in microbiota composition in the patients who underwent FMT in relation to that observed in those who underwent the sham procedure.However,we found no difference between the two groups in terms of the clinical parameters evaluated.CONCLUSION There were no significant differences in biochemical or anthropometric parameters,between the two groups evaluated.Nevertheless,there were significant postprocedural differences in the microbiota composition between the placebo group.To date,clinical outcomes related to FMT remain uncertain.

Antifungal activity against Fusarium oxysporum of quinolizidines isolated from three controlled-growth Genisteae plants:structure-activity relationship implications

The Genisteae tribe belongs to the Fabaceae family.The wide occurrence of secondary metabolites,explicitly high-lighting the quinolizidine alkaloids(QAs),characterizes this tribe.In the present study,twenty QAs(1-20),including lupanine(1-7),sparteine(8-10),lupanine(11),cytisine and tetrahydrocytisine(12-17),and matrine(18-20)-type QAs were extracted and isolated from leaves of three species(i.e.,Lupinus polyphyllus(’rusell’hybrid),Lupinus muta-bilis,and Genista monspessulana)belonging to the Genisteae tribe.These plant sources were propagated under greenhouse conditions.The isolated compounds were elucidated by analyzing their spectroscopical data(MS,NMR).The antifungal effect on the mycelial growth of Fusarium oxysporum(Fox)of each isolated QA was then evaluated through the amended medium assay.The best antifungal activity was found to be for compounds 8(IC_(50)=16.5μM),9(IC_(50)=7.2μM),12(IC_(50)=11.3μM),and 18(IC_(50)=12.3μM).The inhibitory data suggest that some QAs could effi-ciently inhibit Fox mycelium growth depending on particular structural requirements deduced from structure-activity relationship scrutinies.The identified quinolizidine-related moieties can be involved in lead structures to develop further antifungal bioactives against Fox.

Terpenes extracted from marine sponges with antioxidant activity:a systematic review

Marine biodiversity has emerged as a very promising resource of bioactive compounds and secondary metabolites from different sea organisms.The sponge’s secondary metabolites demonstrated various bioactivities and potential pharmacological properties.This systematic review of the literature focuses on the advances achieved in the antioxidant potential of marine sponges in vitro.The review was performed in accordance with PRISMA guidelines.The main inclusion criterion for analysis was articles with identification of compounds from terpene classes that demonstrate antioxidant activity in vitro.Searching in three different databases,two hundred articles were selected.After screening abstracts,titles and evaluating for eligibility of manuscripts 14 articles were included.The most performed analyzes to detect antioxidant activity were scavenging activity 2,2-diphenyl-1-picrylhydrazyl(DPPH)and measurement of intracellular reactive oxygen species(ROS).It was possible to identify 17 compounds of the terpene class with pronounced antioxidant activity in vitro.Scientific evidence of the studies included in this review was accessed by the GRADE analysis.Terpenes play an important ecological role,moreover these molecules have a pharmaceutical and industrial application.

Surgical Complications of Kidney Transplantation in a Resource Limited Country: Retrospective Study of the First Five Years

Background: Kidney transplantation is the most efficient treatment for renal failure but may be ruined by complications. Objective: To report the surgical complications of renal transplantation and the therapeutic means applied. Method: It was a retrospective study including 42 files of kidney transplantation in Côte d’Ivoire. We report 11 cases of surgical complications of the recipient’s intervention during the first five years. Results: The mean age was 42.64 years (±15.04). In 90.9% of the cases, there was a comorbidity factor. Lymphocele and stenosis of the uretero vesical anastomosis were the most frequent complications. One death was observed. Conclusion: Kidney transplantation is an effective way of managing chronic renal failure. Postoperative complications are polymorphic and unpredictable.

Spontaneous Rupture of Urinary Bladder (SRUB): An Exceptional Presentation

Background: Spontaneous rupture of urinary bladder (SRUB) without trauma is an extremely rare pathology. The incidence is estimated to about 1/126,000. It is difficult to diagnose. Aim: To present an exceptional case report and emphasize on the difficulty of diagnosis. Case Presentation: We report the case of a 63-year-old man. The initial diagnosis of SRUB was obscured by a urinary retention. The pelvic ultrasound finally led to the diagnosis. We will pay particular attention to the circumstances of the diagnosis and the therapeutic measures applied. Conclusion: SRUB is exceptional and misdiagnosis is usual. Management is most of the time surgical.

Machine learning inspired workflow to revise field development plan under uncertainty

We present an efficient and risk-informed closed-loop field development (CLFD) workflow for recurrently revising the field development plan (FDP) using the accrued information. To make the process practical, we integrated multiple concepts of machine learning, an intelligent selection process to discard the worst FDP options and a growing set of representative reservoir models. These concepts were combined and used with a cluster-based learning and evolution optimizer to efficiently explore the search space of decision variables. Unlike previous studies, we also added the execution time of the CLFD workflow and worked with more realistic timelines to confirm the utility of a CLFD workflow. To appreciate the importance of data assimilation and new well-logs in a CLFD workflow, we carried out researches at rigorous conditions without a reduction in uncertainty attributes. The proposed CLFD workflow was implemented on a benchmark analogous to a giant field with extensively time-consuming simulation models. The results underscore that an ensemble with as few as 100 scenarios was sufficient to gauge the geological uncertainty, despite working with a giant field with highly heterogeneous characteristics. It is demonstrated that the CLFD workflow can improve the efficiency by over 85% compared to the previously validated workflow. Finally, we present some acute insights and problems related to data assimilation for the practical application of a CLFD workflow.

Store of value or speculative investment?Market reaction to corporate announcements of cryptocurrency acquisition

In this study,we analyze the stock market reaction to 35 events associated with 32 publicly traded companies from six countries that have announced cryptocurrency acquisitions,selling,or acceptance as a means of payment.Our analysis focuses on traditional firms whose core business is unrelated to blockchain or cryptocurrency.We find that the aggregate market reaction around these events is slightly positive but statistically insignificant for most event windows.However,when we perform heterogeneity analyses,we observe significant differences in market reaction between events with high(larger CARs)and low cryptocurrency exposure(lower CARs).Multivariate regressions show that the level of exposure to cryptocurrency("skin in the game")is a critical factor underlying abnormal returns around the event.Further analyses reveal that economically meaningful acquisitions of BTC or ETH(relative to firm’s total assets)drive the observed effect.Our findings have important implications for managers,investors,and analysts as they shed light on the relationship between cryptocurrency adoption and firm value.

Impact of Fungicide Spray Timings on Foliar Diseases Control in Wheat Cultivars

Wheat (Triticum aestivum L.) is grown throughout the winter time in Southern Brazil and turns out to be the main agricultural crop at such a year season in the State of Paraná. However, throughout the crop growing season foliar diseases significantly compromise commercial yields in such a manner as to justify the application of fungicides at the right time to control foliar diseases in production fields. The aim of the current manuscript was to assess the impact of different timings for fungicide application (epoxiconazole + pyraclostrobin) on the control of leaf rust (Puccinia triticina E.) and yellow spot (Pyrenophora tritici-repentis) diseases in two wheat genotypes featured by distinct levels of susceptibility in Southern Brazil. A field trial was conducted in Ponta Grossa, State of Paraná, Brazil, in light of split plot statistical design at an experimental area belonging to CESCAGE. The following treatments were imposed in the current study: control (with no sprays);sprays at the first node, booting and heading;sprays at stem extension and flowering;sprays at booting and heading. Throughout the entire crop growing season, the control treatment was conducive to the highest severity levels for both diseases. The increasing of the area under the diseases progress curve assessed herein substantially impinged upon yield components of both wheat genotypes under scrutiny. In general, fungicide sprays at the first node did not culminate in economical advantages. The best timing for fungicide application was the one ascribed to booting and heading stages.

Characteristics of Deaths of Children in the Pediatrics Department of Hôpital Spécialisé Mère-Enfant Blanche Gomes (Republic of the Congo) from 2019 to 2021

Introduction: The United Nations Sustainable Development Goals (SDGs) aim to decrease the global maternal mortality ratio to below 70 per 100,000 live births and eliminate preventable deaths of newborns and children under the age of five in all countries by 2030. The pediatric department at Spécialisé Mère-Enfant Blanche Gomes Hospital (HSMEBG) is divided into two sectors, one catering to children aged one month to four years and the other dedicated to children aged five to 17 years. According to department records, over the past three years, there has been an average of 1050 hospitalizations per year, with an average duration of five days. Objectives: This study aims to describe the socio-demographic characteristics of children who died while in the pediatrics department of the HSMEBG and analyze the factors associated with their deaths. Methodology: A retrospective analytical cross-sectional study was conducted, collecting data over a three-year period, covering the years 2019, 2020 and 2021. Data were collected from medical records of deceased children using Excel software version 2016, and statistical calculations and logistic regression were performed using Epi info software version 7.2.5.0. Results: During the three years of operation, the pediatric department at HSMEBG recorded 3060 new admissions, of which 271 resulted in death, representing an overall frequency of 8.8%. December and January had the highest mortality rates, accounting for 15.5% and 12.5%, respectively. Out of the 271 recorded deaths, 143 (52.77%) occurred in children under the age of one, and 230 (84.87%) occurred in children under the age of five. The average age at death was 2.4 years, ranging from one month to 17 years. The sex ratio was 1. More than half of the deaths (51.66%) occurred during the night, and 165 (60.89%) sought medical help more than three days after the onset of symptoms. Weekend deaths accounted for nearly half (45.7%) of the cases. Upon admission, slightly over half of the children (55.72%) had impaired consciousness, 219 (80.81%) presented with respiratory distress, and 194 (71.59%) had a fever. The average time from admission to administering the first medication was 72 minutes. Respiratory infections were the leading cause of death, accounting for 83 (30.26%) cases, followed by severe forms of malaria (anemic and neurological) at 23.25%. Among the 271 recorded deaths, 33 (12.18%) received no treatment before their demise, and 136 (50.18%) died within the first 24 hours of hospitalization. The average duration of hospitalization for patients who spent less than 24 hours was 15 hours, while those who died after the 24th hour had an average hospital stay of five days, ranging from one to 41 days. Children under the age of five who were admitted with impaired consciousness had roughly double the risk of dying compared to those without this condition (p = 0.001). Conclusion: The overall mortality rate in the pediatric department at HSMEBG is 8.8%. Acute respiratory infections are the primary cause of death. Improving this rate necessitates reducing consultation and treatment durations.

Immediate nipple-areola-sparing mastectomy reconstruction: An update on oncological and reconstruction techniques

Nipple-sparing mastectomy(NSM) is a safe technique in patients who are candidates for conservation breast surgery. However, there is worry concerning its oncological safety and surgical outcome in terms of postoperative complications. The authors reviewed the literature to evaluate the oncological safety, patient selection, surgical techniques, and also to identify the factors influencing postoperative outcome and complication rates. Patient selection and safety related to NSM are based on oncological and anatomical parameters. Among the main criteria, the oncological aspects include the clinical stage of breast cancer, tumor characteristics and location including small, peripherally located tumors, without multicentricity, or for prophylactic mastectomy. Surgical success depends on coordinated planning with the oncological surgeon andcareful preoperative and intraoperative management. In general, the NSM reconstruction is related to autologous and alloplastic techniques and sometimes include contra-lateral breast surgery. Choice of reconstructive technique following NSM requires accurate consideration of various patient related factors, including: breast volume, degree of ptosis, areola size, clinical factors, and surgeon's experience. In addition, tumor related factors include dimension, location and proximity to the nipple-areola complex. Regardless of the fact that there is no unanimity concerning the appropriate technique, the criteria are determined by the surgeon's experience and the anatomical aspects of the breast. The positive aspects of the technique utilized should include low interference with the oncological treatment, reproducibility, and long-term results. Selected patients can have safe outcomes and therefore this may be a feasible option for early breast cancer management. However, available data demonstrates that NSM can be safely performed for breast cancer treatment in selected cases. Additional studies and longer follow-up are necessary to define consistent selection criteria for NSM.

Practice of Pediatric Neurosurgery at the “Hôpital SpécialiséMère-Enfant Blanche Gomes” in the Republic of the Congo

Introduction: Pediatric Neurosurgery is a growing specialty in its own right worldwide. Its practice in sub-Saharan Africa remains confronted with many challenges, notably the absence of a pediatric neurosurgeon, the lack of a dedicated service and the absence of multidisciplinary pediatric collaboration (neuroanesthesist, neurologist, oncologist and psychotherapist). The objective of this preliminary study is to describe the practice of pediatric neurosurgery at the HSMEBG and to present perspectives for its improvement. Methods: This is a retrospective, monocentric, descriptive study covering the period from March 2021 to March 2022 at the Pediatric Surgery Department of the HSMEBG. Résults: During the study period, 50 children were hospitalized for a neurosurgical condition. The sex ratio was 1.77. The average age was 6 years with extremes of 2 weeks and 16 years. Most children were from the emergency department (46%). Computed tomography (CT) was performed in 35 patients (70%), magnetic resonance imaging (MRI) in 4% and plain radiography in two patients (8%). Malformative, traumatic (cranial and spinal) and tumor pathology were the most frequent with 42%, 36% and 12% respectively. Twenty-six patients were operated (52%). We recorded one postoperative infection (2.5%). The overall mortality was 8% (N = 4). Conclusion: This preliminary study allowed us to identify the epidemiological and clinical profile of the patients treated in our context as well as the therapeutic approach. Malformative pathology remains the most frequent, followed by traumatic and tumor pathology. The development of the practice of this discipline remains a challenge in our working conditions and requires the training of pediatric neurosurgeons and dedicated paramedical staff.