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International audience The complex vertical distribution of aerosols over coastal southern West Africa (SWA) is investigated using airborne observations and numerical simulations. Observations were gathered on 2 July 2016 offshore of Ghana and Togo, during the field phase of the Dynamics-Aerosol-Chemistry-Cloud Interactions in West Africa project. This was the only flight conducted over the ocean during which a downward-looking lidar was operational. The aerosol loading in the lower troposphere includes emissions from coastal cities (Accra, Lomé, Cotonou, and Lagos) as well as biomass burning aerosol and dust associated with long-range transport from central Africa and the Sahara, respectively. Our results indicate that the aerosol distribution on this day is impacted by subsidence associated with zonal and meridional regional-scale overturning circulations associated with the land–sea surface temperature contrast and orography over Ghana and Togo, as typically observed on hot, cloud-free summer days such as 2 July 2016. Furthermore, we show that the zonal circulation evidenced on 2 July is a persistent feature over the Gulf of Guinea during July 2016. Numerical tracer release experiments highlight the dominance of aged emissions from Accra on the observed pollution plume loadings over the ocean, in the area of aircraft operation. The contribution of aged emission from Lomé and Cotonou is also evident above the marine boundary layer. Given the general direction of the monsoon flow, the tracer experiments indicate no contribution from Lagos emissions to the atmospheric composition of the area west of Cotonou, where our airborne observations were gathered. The tracer plume does not extend very far south over the ocean (i.e. less than 100km from Accra), mostly because emissions are transported northeastward near the surface over land and westward above the marine atmospheric boundary layer. The latter is possible due to interactions between the monsoon flow, complex terrain, and land–sea breeze systems, which support the vertical mixing of the urban pollution. This work sheds light on the complex – and to date undocumented – mechanisms by which coastal shallow circulations can distribute atmospheric pollutants over the densely populated SWA region.

Teratomas are the most common fetal neoplasms, and represent 16.6% of all fetal tumours. Mediastinal teratomas usually occur in the anterior mediastinum and their most important clinical consequenc...

117 women with severe pelvic organ prolapse (POP; stage > 2) were enrolled to elucidate a 24-month outcome of POP surgery, using conventional or mesh repair with 3 techniques. 59 patients underwent conventional repair and 58 underwent mesh repair. Two types of mesh were used: a trocar-guided transobturator polypropylene (Avaulta, Bard Inc.) and a porcine dermis mesh (Pelvisoft, Bard Inc.). Women with recurrences, who underwent previous unsuccessful conventional repair, were randomised. Primary outcome was the evaluation of anatomic failures (prolapse stage > 1) in treated and untreated compartments. Anatomic failure was observed in 11 of 58 patients (19%; CI 8.9-29) in the mesh group and in 16 of 59 patients (27.1%; p value = 0.3) in the conventional group. 9 of 11 failures in the mesh group (15.5%; CI 6.2-24.8) were observed in the untreated compartment (de novo recurrences), 14.3% in Pelvisoft and 16.7% in Avaulta arm, while only 1 recurrence in the untreated compartment (1.7%) was observed in the conventional group (odds ratio 10.6, p = 0.03).

Background Feasibility and outcome of robotic-assisted laparoscopy (RAL) for endometrial cancer was evaluated with a mean follow-up of 4 years. Methods Robotic hysterectomy (RH) and type B robotic radical hysterectomy (RRH), with or without pelvic lymphadenectomy (PLH), was performed on 51 consecutive patients. Records were reviewed for demographic data, medical/surgical history and comorbidities, perioperative findings and outcomes, as well as long-term complications and recurrences. Regarding stage, according to 2009 FIGO, 25% of cases were IA, while 20%, 53% and 2% of cases were, respectively, IB, II and IIIA stage. Results Twenty-eight patients underwent RRH + PLH (54.9%), four patients underwent RH with concurrent nodal sampling (NS) (7.8%); a total of 32 PLH were performed (62.6%).The median operative time for RRH + PLH was 255 min (range: 160–435). Pathology confirmed the adequacy of the surgical specimen. Conclusion Our data support the adoption of RAL staging in patients with endometrial cancer, including those with cervical involvement, and demonstrate good long-term outcomes. Copyright © 2015 John Wiley & Sons, Ltd.

The objective of this study is to perform an economic analysis and examine the influence of procedural volume of our hospital, evaluating the accounting systems of Robotic radical hysterectomy (RRH) vs Laparoscopic radical hysterectomy (TLRH) in patients with cervical carcinoma, due to the costs widely variable and lack in literature. Costs were collected prospectively, from March 2010 to March 2016. Direct costs were determined by examining the overall medical pathway for each type of intervention. 52 patients with cervical carcinoma, which were matched by age, body mass index, tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage, comorbidity, previous neoadjuvant chemotherapy, histology type, and tumor grade to obtain homogeneous samples. Surgical time was similar for both the groups. RRH was associated with a significantly less (EBL) estimated blood loss (P = 0.000). The overall median length of follow-up was of 59 months. The cost of the robot-specific supplies was €2705 per intervention. When considering overall medical surgical care, the patient treatment average cost of an RRH was €5650,31 with an hospital stay (HS) of 3.58 days (SD ± 1) vs €3750.86 for TRLH, with an HS of 4.27 days (SD ± 1.79). Our results are similar to Finnish data; the costs of robot-assisted hysterectomies were 1.5 times higher than TLRH. The main drivers of additional costs are robotic disposable instruments, which are not compensated by the hospital room costs and by an experienced team staff. Implementation of strategies to reduce the cost of robotic instrumentation is due. RRH resulted less expensive than robotic simple hysterectomy for benign conditions.

We report the efficacy of a minimally invasive approach of the multidose protocol with methotrexate (MTX) in the management of three cases of interstitial pregnancy (IP), with elevated serum β-hCG in two cases. New considerations and management strategies are discussed. Successful termination of IP and in one case, a subsequent successful pregnancy, was achieved. The process led to the development of an enhanced understanding of diagnostic modalities and their limitations, with regard to the particular entities under discussion. We also focused attention on pivotal points and anatomical features in the management of this dangerous occurrence. Long-term results with careful follow-up were analysed by instrumental procedure. This hazardous type of ectopic pregnancy can be managed with systemic administration of MTX, also in patients with elevated β-hCG values. The present report underlines that an integrated approach in early diagnosis, multidose treatment and close follow-up, are essential forms of medical management.

New Late Ordovician and Triassic palaeomagnetic data from Iran are presented. These data, in conjunction with data from the literature, provide insights on the drift history of Iran as part of Cimmeria during the Ordovician–Triassic. A robust agreement of palaeomagnetic poles of Iran and West Gondwana is observed for the Late Ordovician–earliest Carboniferous, indicating that Iran was part of Gondwana during that time. Data for the Late Permian–early Early Triassic indicate that Iran resided on subequatorial palaeolatitudes, clearly disengaged from the parental Gondwanan margin in the southern hemisphere. Since the late Early Triassic, Iran has been located in the northern hemisphere close to the Eurasian margin. This northward drift brought Iran to cover much of the Palaeotethys in approximately 35 Ma, at an average plate speed of c. 7–8 cm year21, and was in part coeval to the transformation of Pangaea from an Irvingian B to a Wegenerian A-type configuration.

We studied the stratigraphy, composition, and paleomagnetic properties of lateritic weathering profiles of Permian age from northern Iran and western Karakoram, Pakistan. A limited set of samples deemed representative yielded stable low-inclination paleomagnetic components carried essentially by hematite of chemical origin isolated in massive, fine-grained, and homogeneous ferricrete facies. These laterites originated at equatorial paleolatitudes characterized by intense weathering processes under warm and humid climatic conditions. Paleomagnetic estimates of paleolatitude from Iran, Karakoram, and north Tibet from this study and the literature, albeit sparse, provide testable constraints on the motion of the Cimmerian terranes as the result of the opening of the Neo-Tethys Ocean along the eastern margin of Gondwana during the Permian. We confirm and help refine previous suggestions that the Cimmerian terranes migrated from southern Gondwanan paleolatitudes in the Early Permian to subequatorial paleolatitudes by the Middle Permian – Early Triassic. As a novel conclusion, we find that timing, rates, and geometry of Cimmerian tectonics are broadly compatible with the transformation of Pangea from an Irvingian B to a Wegenerian A-type configuration with Neo-Tethyan opening taking place contemporaneously essentially in the Permian.

6 pages; International audience; À partir d’observations in situ et analysées, de réanalyses atmosphériques, d’expériences numériques forcées parles températures de la Méditerranée, et de sorties CMIP5 issues de seize modèles couplés ayant participé au dernier exercicedu GIEC, nous tentons une synthèse des travaux collaboratifs entrepris au CRC ces cinq dernières années et portant sur lesinteractions tropiques/extra-tropiques au long du fuseau africain et sur leurs liens avec la mousson africaine. Après avoirrappelé le rôle des téléconnexions avec les grands bassins océaniques, de la circulation sur le secteur euro-atlantique et dela mousson indienne via le mécanisme de Rodwell-Hoskins, nous insistons sur le renforcement du rôle de la Méditerranée etparticulièrement de son bassin est sur les saisons des pluies soudano-sahéliennes africaines, dans l’Actuel et le futur.

1st Africa Photovoltaic Solar Energy Conference and Exhibition Proceedings, AfricaPVSEC 2014

Optimal management of severe early fetal growth restriction presents one of the greatest challenges in obstetrics. At present, a combination of several different monitoring modalities is used, including arterial and venous Doppler ultrasonography plus assessment of short-term fetal heart rate variation, without consensus on which of these should trigger the decision to deliver. Pathological Doppler waveforms in the ductus venosus (DV) have been found to be associated with adverse out come. However it is not clear how long a fetus in utero can withstand changes in presence of altered flussimetry and which are , specifically, the effects related to them during extrauterine life. Optimal management of severe early fetal growth restriction presents one of the greatest challenges in obstetrics. At present, a combination of several different monitoring modalities is used, including arterial and venous Doppler ultrasonography plus assessment of short-term fetal heart rate variation, without consensus on which of these should trigger the decision to deliver.

In 153 consecutive patients with cirrhosis we assessed: (1) the prevalence of IgG to Helicobacter pylori and compared it with that found in 1010 blood donors resident in the same area; and (2) the relationships of IgG to Helicobacter pylori with clinical and endoscopic features and with the risk of peptic ulcer. The IgG to Helicobacter pylori prevalence of cirrhotics was significantly higher than in blood donors (76.5% vs 41.8%; P < 0.0005) and was not associated with sex, cirrhosis etiology, Child class, gammaglobulins and hypertensive gastropathy. In both groups, the prevalence of IgG to Helicobacter pylori was significantly higher in subjects over 40. Among patients with cirrhosis a significantly higher prevalence of Helicobacter pylori was found in patients with previous hospital admission (P = 0.02) and/or upper gastrointestinal endoscopy (P = 0.01) and patients with peptic ulcer (P = 0.0004). Multivariate analysis identified increasing age and male sex as risk factors for a positive Helicobacter pylori serology and no independent risk factors for peptic ulcer. The high prevalence of Helicobacter pylori-positive serology found in the present series is related to age and sex and might also be explained by previous hospital admissions and/or upper gastrointestinal endoscopy. Our results do not confirm the role of Helicobacter pylori as risk factor for peptic ulcer in patients with liver cirrhosis.

The Karakoram and East Hindu Kush-Wakhan blocks are parts of the Mega Lhasa composite terrane (Zanchi et al., 2000). The identity of their components and the timing of their juxtaposition are still poorly known due to access difficulties. Zanchi et al. (1997, 2000) first reported the existence of a NE-SW trending left-lateral strike-slip fault zone, the Tirich Mir Fault Zone separating the East Hindu Kush from the Karakoram. The fault system is characterized by a sandwich of mantle peridotites, deformed gabbros, amphibolites and gneisses named Tirich Mir Boundary Zone (TBZ). The presence of ultramatic bodies is a strong argument to interpret the TBZ as the northwestern boundary of the Karakoram terrane. In any case the timing of the accretion of the Karakoram to the East Hindu Kush and to the Pamir belts has never been directly constrained. The Tirich Mir pluton (TMP) is a little-deformed large NE-SW trending granodioritic to granitic body, preserving intrusive margins with the exception of its southern part which is strongly deformed or even mylonitic. The preservation is generally poor and alteration (hydrothermal and/or meteoric) almost ubiquitous. It had been visited by Desio et al. (1964), but its structural importance had been overlooked. Zanchi et al. (2000) observed that the TMP intrudes the TBZ, cutting the mantle ultramafics and clearly post-dating peak metamorphism and associated deformation. This implies that dating the TMP puts a stringent lower limit for the age of the East Hindu Kush-Karakoram accretion. Desio et al. (1964) attributed to the TMP a Rb-Sr age of 115 Ma. We analysed two TMP samples, ZP-61 (Tirich Gol), and ZP-22 (Dir Gol). Muscovite ZP-61 has a lower 87Sr/86Sr ratio than its whole rock. This points to a hydrothermal perturbation of the whole rock system and makes the sample unsuitable for dating of the magmatic event. That the whole-rock systems are perturbed is attested by an apparent Rb-Sr WR age of 15 ± 2 Ma. It is likely that Desio et al.'s (1964) interpretation is incorrect because the influence of hydrothermalism on isotope systematics was unknown at that time. In sample ZP-22, muscovite defines a two-point age of 141.7 ± 1.9 Ma (95% c.1.). Altered biotite, giving a two-point age of 103 ± 2 Ma, testifies that the granite was affected by younger tectonic events, resulting in chloritization and mylonitization of the southern boundary as also suggested by Hildebrand et al. (2000). The accretion between Karakoram and East Hindu Kush thus occurred before 140 Ma (Tithonian), pre-dating the intrusion of the TMP. Our work has further shown the East Hindu Kush plutonic belt was active in Late Jurassic, as also suggested by the K-Ar 144 Ma age of the Shushar pluton north-east of the TMP (Gaetani et al., 1996).