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BackgroundHuman African trypanosomiasis (HAT) is a neglected tropical disease that usually occurs in rural areas in sub-Saharan Africa. It caused devastating epidemics during the 20th century. Sustained, coordinated efforts by different stakeholders working with national sleeping sickness control programmes (NSSCPs) succeeded in controlling the disease and reducing the number of cases to historically low levels. In 2012, WHO targeted the elimination of the disease as a public health problem by 2020. This goal has been reached and a new ambitious target was stated in the WHO road map for NTDs 2021-2030 and endorsed by the 73rd World Health Assembly: the elimination of gambiense HAT transmission (i.e. reducing the number of reported cases to zero). The interruption of transmission was not considered as an achievable goal for rhodesiense HAT, as it would require vast veterinary interventions rather than actions at the public health level.Methodology/principal findingsData reported to WHO by NSSCPs were harmonized, verified, georeferenced and included in the atlas of HAT. A total of 802 cases were reported in 2021 and 837 in 2022. This is below the target for elimination as a public health problem at the global level (< 2000 HAT cases/year); 94% of the cases were caused by infection with T. b. gambiense. The areas reporting ≥ 1 HAT case/10 000 inhabitants/year in 2018-2022 cover a surface of 73 134 km2, with only 3013 km2 at very high or high risk. This represents a reduction of 90% from the baseline figure for 2000-2004, the target set for the elimination of HAT as a public health problem. For the surveillance of the disease, 4.5 million people were screened for gambiense HAT with serological tests in 2021-2022, 3.6 million through active screening and 0.9 million by passive screening. In 2021 and 2022 the elimination of HAT as a public health problem was validated in Benin, Uganda, Equatorial Guinea and Ghana for gambiense HAT and in Rwanda for rhodesiense HAT. To reach the next goal of elimination of transmission of gambiense HAT, countries have to report zero cases of human infection with T. b. gambiense for a period of at least 5 consecutive years. The criteria and procedures to verify elimination of transmission have been recently published by WHO.Conclusions/significanceHAT elimination as a public health problem has been reached at global level, with seven countries already validated as having reached this goal. This achievement was made possible by the work of NSSCPs, supported by different public and private partners, and coordinated by WHO. The new challenging goal now is to reach zero cases by 2030. To reach this goal is crucial to maintain the engagement and support of donors and stakeholders and to keep the involvement and coordination of all partners. Along with the focus on elimination of transmission of gambiense HAT, it is important not to neglect rhodesiense HAT, which is targeted for elimination as a public health problem in the WHO road map for NTDs 2021-2030.

Summary: Lymphatic vessels (LVs) are important in the regulation of tissue fluid homeostasis and the pathogenesis of tumor progression. We investigated the innervation of LVs and the response to agonists and antagonists of the autonomic nervous system in vivo. While skin-draining collecting LVs express muscarinic, α1- and β2-adrenergic receptors on lymphatic endothelial cells and smooth muscle cells, intestinal lacteals express only β-adrenergic receptors and muscarinic receptors on their smooth muscle cells. Quantitative in vivo near-infrared imaging of the exposed flank-collecting LV revealed that muscarinic and α1-adrenergic agonists increased LV contractility, whereas activation of β2-adrenergic receptors inhibited contractility and initiated nitric oxide (NO)-dependent vasodilation. Tumor-draining LVs were expanded and showed a higher innervation density and contractility that was reduced by treatment with atropine, phentolamine, and, most potently, isoproterenol. These findings likely have clinical implications given the impact of lymphatic fluid drainage on intratumoral fluid pressure and thus drug delivery. : Bachmann et al. use in vivo imaging to demonstrate that muscarinic and α1-adrenergic agonists increase lymphatic contractility, whereas activation of β2-adrenergic receptors inhibits contractility and mediates NO-dependent vasodilation. Tumor-draining lymphatics have a denser innervation and increased contractility, which can be diminished by β2-adrenergic agonists. Keywords: lymphatic vessels, contractility, autonomic nervous system, Ca2+ imaging, tumor-draining lymphatics

The lymphatic vascular system plays important roles in the control of tissue fluid homeostasis and immune responses. While VEGF-A-induced angiogenesis promotes hair follicle (HF) growth, the potential role of lymphatic vessels (LVs) in HF cycling has remained unknown. In this study, we found that LVs are localized in close proximity to the HF bulge area throughout the postnatal and depilation-induced hair cycle in mice and that a network of LVs directly connects the individual HFs. Increased LV density in the skin of K14-VEGF-C transgenic mice was associated with prolongation of anagen HF growth. Conversely, HF entry into the catagen phase was accelerated in K14-sVEGFR3 transgenic mice that lack cutaneous LVs. Importantly, repeated intradermal injections of VEGF-C promoted hair growth in mice. Conditioned media from lymphatic endothelial cells promoted human dermal papilla cell (DPC) growth and expression of IGF-1 and alkaline phosphatase, both activators of DPCs. Our results reveal an unexpected role of LVs in coordinating and promoting HF growth and identify potential new therapeutic strategies for hair loss-associated conditions.

BACKGROUND: The surgical treatment for perforated peptic ulcer is still a matter of discussion. The surgeons, for many years, made their options between acid-reducing procedures with some morbi-mortality and simpler procedures like closure of the perforation. But, in these cases, were faced with a high chance of ulcer relapse. Since the proved link between peptic ulcer and gastroduodenal infection caused by H. pylori, a recommendation for a change in their attitudes going back to simpler procedures with eradication of the bacteria was done. AIM: To analyse ulcer recurrence in patients treated with the same surgical procedure but belonging to two different groups: positive and negative to H. pilori. METHODS: A total of 144 patients were treated with simple closure of their perforated pre-pyloric, pyloric and duodenal ulcers. Thirty days after operation they were submitted to upper endoscopy and tested for the bacteria by urease and histopathological exams and divided into two groups according to the results of the tests: positive and negative. The positive ones were eradicated and, together with the negative group, were followed through six months interval endoscopies and detection tests looking for ulcer relapses and reinfection in the eradicated group. The positive group consisted of 25 patients, with two patients considered non eradicable according to the treatment protocol. They were followed for an average period of 38,21 months. RESULTS: Relapse was detected in four patients (17,39%), half of them (8,69%) were reinfected. The negative group consisted of 26 patients, with a median follow-up of 38,28 months and eight (30,76%) relapses were detected. There was no statistical significant difference due probably to the high dropout of patients. CONCLUSION: Simple suture with H. pilori eradication is the gold standard for the positive group, leaving the question of acid-reducing procedures open for the negative ones.RACIONAL: O tratamento cirúrgico da úlcera péptica perfurada é assunto discutível. Os cirurgiões, por muitos anos, fizeram suas opções entre procedimentos de redução ácida, somente fechamento da perfuração - porém com maior chance de recidiva ulcerosa. Desde a comprovada vinculação da úlcera péptica e suas complicações à infecção gastroduodenal causada pelo Helicobacter pylori, houve recomendação para mudança na atitude dos cirurgiões na volta à operação mais simples com erradicação da bactéria. OBJETIVO: Analisar a recidiva ulcerosa em pacientes com úlcera perfurada H. pylori positiva que foram submetidos à simples sutura da lesão e omentopexia com erradicação da bactéria e compará-la com H. pylori negativo submetido ao mesmo tratamento cirúrgico. MÉTODOS: Cento e quatorze pacientes com úlceras pré-pilóricas, pilóricas e duodenais perfuradas foram atendidos com fechamento simples. Trinta dias após a operação submeteram-se à endoscopia digestiva alta com biópsias para testes da urease e histopatológicos. Foram divididos em dois grupos de acordo com o resultado dos testes: positivo e negativo.Os positivos foram erradicados e, junto com o grupo negativo, foram seguidos com endoscopias semestrais e testes de detecção para H. pylori procurando por recidiva ulcerosa e reinfecção no grupo erradicado. RESULTADOS: O grupo positivo foi formado por 25 pacientes, dos quais dois foram considerados não erradicáveis segundo os critérios do protocolo. Os demais foram seguidos por período médio de 38,21 meses e detectadas recidivas em quatro pacientes (17,39%), metade deles (8,69%) foram reinfectados. O grupo negativo foi formado por 26 pacientes, seguido por período médio de 38,28 meses e oito (30,76%) apresentaram recidiva ulcerosa. Não foi evidenciada diferença estatisticamente significativa entre os grupos. CONCLUSÃO: Em relação à recidiva ulcerosa, o fechamento simples seguido de erradicação da bactéria é o procedimento padrão para o grupo positivo; deixa-se em aberto a questão dos procedimentos ácido-redutores para o grupo negativo.

Tumor lymphangiogenesis is accompanied by a higher incidence of sentinel lymph node metastasis and shorter overall survival in several types of cancer. We asked whether tumor lymphangiogenesis might also occur in distant organs with established metastases and whether it might promote further metastatic spread of those metastases to other organs. Using mouse metastasis models, we found that lymphangiogenesis occurred in distant lung metastases and that some metastatic tumor cells were located in lymphatic vessels and draining lymph nodes. In metastasis-bearing lungs of melanoma patients, a higher lymphatic density within and around metastases and lymphatic invasion correlated with poor outcome. Using a transgenic mouse model with inducible expression of vascular endothelial growth factor C (VEGF-C) in the lung, we found greater growth of lung metastases, with more abundant dissemination to other organs. Our findings reveal unexpected contributions of lymphatics in distant organs to the promotion of growth of metastases and their further spread to other organs, with potential clinical implications for adjuvant therapies in patients with metastatic cancer.

A survey of moth flies in mountainous and desert areas of Morocco revealed 20 species, five genera with 10 species which are recorded from the country for the first time, six of which (Atrichobrunettia (Mirousiella) graeca Ježek & Goutner, 1993, Lepiseodina rothschildi (Eaton, 1912), Mormia revisenda (Eaton, 1893), Pericoma (Pachypericoma) fallax Eaton, 1893, Pericoma (Pericoma) trifasciata (Meigen, 1804), and Psychoda (Chodopsycha) divaricata Duckhouse, 1968), alongside two genera, Atrichobrunettia Satchell, 1953 and Lepiseodina Enderlein, 1937), are new to North Africa. In addition, three species and one species are new to the Rif and the Beni Snassen mountains, respectively, seven species are cited for the first time in the Atlas region and one species is new to the Sahara region. Information on the habitats of the 20 species is provided. The survey increases the biodiversity of moth flies in Morocco to 37 species.

Personalized e-learning systems have transformed the delivery of educational content, aligning it more closely with individual learners’ needs. Among the various approaches to achieving this personalization, the Myers-Briggs Type Indicator (MBTI) personality prediction emerged as a valuable tool for adapting learning content to match individual preferences and learning styles. Despite these advancements, personalized e-learning systems quite struggle with handling large volumes of information, often facing difficulties in balancing prediction accuracy and learning efficiency. To ensure personalization, integrating advanced technologies such as machine learning and deep learning is crucial for creating more sustainable and effective learning environments. This paper proposes a novel framework that integrates MBTI personality prediction with a deep learning approach and a Learner Profile ontology (LPO) to enhance the personalization and recommendation process. The proposed method employs the BERT model, a Transformer-based architecture, for personality prediction, combined with an oversampling technique to handle data imbalance. The predicted personality type is incorporated into a Semantic Web Rule Language (SWRL)-based ontology enriched with WordNet, enabling better alignment of learning resources with individual learner traits. Experimental results validate the efficacy of this integrated approach, demonstrating significant improvements in learner satisfaction and educational outcomes.

Abstract Background Factors affecting the outcomes after Fontan palliation are still controversial. Thus, this study aimed to compare hospital and long-term outcomes after Fontan palliation in patients with left-dominant, right-dominant, and co-dominant ventricles. Moreover, the study sought to identify factors associated with long-term surgical reintervention, catheter-based interventions, and morality. This retrospective cohort study was conducted in a single tertiary referral center between 2010 and 2024 and included all patients who had Fontan palliation (n = 247). The patients were grouped according to the dominant ventricle into three groups: left-dominant (n = 105), right-dominant (n = 108), and codominant (n = 36). Results No significant differences were found in demographic variables among groups. Heterotaxy was more common in codominant patients who exhibited higher preoperative saturation levels. Early postoperative complications were more frequent in right-dominant patients, with low cardiac output significantly lower in left-dominant patients. Codominant patients experienced more arrhythmias and complete heart block, while operative mortality rates were similar across groups. During a median follow-up of 80 months, the freedom from surgical reintervention at 5, 10, and 15 years was highest in the left-dominant group (97%) compared to right dominance (93%, 78%) and codominance (97%, 87%). Mortality was significantly higher in the right-dominant and codominant groups, with survival rates at 5, 10, and 15 years being 97% for left dominance, 92% for right dominance, and 91% for codominance. Factors influencing long-term mortality were older age, right dominance, and elevated pulmonary artery pressure. Conclusions Patients with left dominance exhibited superior survival rates and fewer complications compared to those with right dominance and codominance. The findings emphasize the importance of anatomical considerations in risk stratification and clinical decision-making. Young age at the time of palliation could improve the outcomes of the Fontan procedure.

Introduction. The survival of patients with chronic kidney disease (CKD) depends on several factors, abnormal nutritional status such as obesity or protein-energy malnutrition are among these factors. Hence the importance of accurate assess-ment of nutritional status in order to preserve not only the renal function of these patients but also their quality of life on dialysis. Objectives. To establish the prevalence of obesity in patients with CKD, before starting extra-renal purification, based on two anthropometric methods: body mass index (BMI) and bioelectrical impedance. Material and methods. This was a descriptive observational study on 125 patients with CKD before the stage of dialysis, meeting the study eligibility criteria. The nutritional and anthropometric parameters (BMI, impedancemetry) were measured. Results. The mean age was 56.3±12.3 years, and the sex-ratio was 0.95. Regarding the nutritional evaluation of patients with CKD, more than 71% of patients had a BMI (kg/m2) greater than 25 (overweight and obesity), and33.6% greater than 30. The percentage of obese women according to BMI was higher than that of men (51.6 versus 48.3%). The highest rate of obesity according to BMI was found in patients with stage 3b CD (p=0.003). Obesity by percentage of body fat estimated by the bio-impedancemetry method was identified in 60% of patients. BMI was associated with a 26.4% under-identification of obesity. An increased level of visceral fat was found in 60% of patients. Over 45% of patients had low muscle mass. Negative correlations were found between BMI and muscle mass (r=-0.732; p=0.000), and between body fat mass and muscle mass (r=-0.999 ; p=0.000). Indeed, according to the bio-impedancemetry method, a sarcopenic obesity was found in 90% of obese patients. Conclusion. Traditional BMI measurement identifies significantly fewer CKD patients as obese, compared to nutritional endpoints based on estimating body fat percentage by impedance measurement. [Introduction. La survie des patients présentant une insuffisance rénale chroni-que (IRC), dépend de plusieurs facteurs, les anomalies de l’état nutritionnel, telles que l’obésité ou la malnutrition protéino-énergétique font partie de ces facteurs. D’où l’importance de l’appréciation exacte du statut nutritionnel afin de préserver, non seulement, la fonction rénale de ces patients mais aussi leur qualité de vie en dialyse. Objectifs. Etablir la prévalence de l’obésité chez des patients présentant une IRC, avant de débuter l’épuration extra-rénale, en fonction de deux méthodes anthropométri-ques : l’indice de masse corporelle (IMC) et l’impédance bioélectrique. Matériel et méthodes. C’est une étude observationnelle descriptive portant sur 125 patients ayant une IRC avant le stade de dialyse. Des paramètres nutritionnels anthropométriques (IMC, impédancemétrie) ont été mesurés. Résultats. L’âge moyen des patients était de 56,3±12,3 ans et le sex-ratio était de 0,95. L’évaluation nutritionnelle des patients en IRC a montré que plus de 71% avaient un IMC supérieur à 25 (obésité et surpoids) et 33,6% un IMC supérieur à 30. Le pourcentage de femmes obèses selon l’IMC était plus élevé que celui des hommes (51,6 contre 48,3%). Le taux le plus élevé d’obèses selon l’IMC était retrouvé chez les patients atteints d'IRC au stade 3b (p= 0,003). L’obésité par pourcentage de graisse corporelle, estimée par la méthode de bio-impédancemétrie, a été identifiée chez 60% des patients. L’IMC est associée à une sous-identification de l'obésité de 26,4%. Un niveau de graisse viscérale augmenté était retrouvé chez 60% des patients. Plus de 45% des patients présentaient une masse musculaire basse. Des corrélations négatives ont été notées entre l’IMC et la masse musculaire (r=-0,732 ; p=0,000) et entre la masse grasse corporelle et la masse musculaire (r=-0,999 ; p=0,000). En effet, selon la méthode de bio-impédancemétrie, une obésité sarcopénique a été observée chez 90% des patients obèses. Conclusion. La mesure traditionnelle de l'IMC identifie moins de patients atteints d'IRC comme obèses, comparée aux critères d’évaluation nutritionnels basés sur l'estimation du pourcentage de graisse corporelle par impédancemétrie.]

This paper introduces iTEVAC, an advanced model of the Trusted Evacuation System (TEVAC), designed to optimize emergency evacuation procedures within commercial centers. Building upon the principles of TEVAC, iTEVAC incorporates additional features such as isolation, firefighting, and rescue intervention strategies to enhance the system's performance and efficiency. iTEVAC leverages the power of Fog computing and Internet of Things (IoT) devices to provide real-time guidance for individuals during emergencies. The system operates by executing alerts for isolated nodes and those unable to find an exit route, providing detailed guidance for nodes that need to move within the commercial center's network. A key advantage of iTEVAC is its decision-making speed, which is less than 1 second, crucial in high-stakes, time-sensitive situations. The iTEVAC model also addresses the limitations of older buildings, traditional markets, and crowded areas that often lack efficient and integrated evacuation systems. It allows users to rely not only on smart navigation guide panel but also on their smartphones to find the safest direction using local Wi-Fi and broadband cellular networks, supported by Fog computing. The iTEVAC model represents a significant advancement in emergency response strategies, contributing to the development of more effective and intelligent evacuation strategies.

Congenital hernia of the diaphragmatic dome is defined as a congenital embryopathy where all or part of the diaphragmatic dome fails to form during embryonic development. The classification is based on the location of the defect in the diaphragm.In this report, we present a case of Morgani hernia in a 52-year-old man whose sole initial symptom was dyspnea, occurring within the context of a SARS-CoV-2 (COVID-19) infection.Morgagni hernia is a congenital diaphragmatic hernia. It is rare and comprises only about 2% of all diaphragmatic hernias. Most cases of congenital diaphragmatic hernia (CDH) manifest with respiratory distress during infancy. CDH is a rare condition that can occur in adults and can have various symptoms that are often misdiagnosed or not fully investigated. Morgagni's hernia is currently associated with other malformations or anomalies such as Trisomy 21. CT scan of the chest and abdomen remains the best imaging method to confirm the diagnosis. Surgical correction is the only treatment for Morgagni hernia.

Most multicystic dysplastic kidneys (MCDKs) are detected prenatally, yet there is no clear consensus on initial evaluation and follow-up. We report the case of a 4-year-old male diagnosed with right pyelocalyceal dilation in utero, confirmed postnatally as MCDK. Follow-up ultrasounds revealed rapid growth of three upper pole cysts, reaching 8 cm. A right upper pole nephrectomy was performed, and histopathology revealed a renal dermoid cyst within segmental multicystic renal dysplasia. This case highlights the critical role of postnatal imaging and follow-up in detecting atypical features, including rare entities like intrarenal teratomas, enabling timely surgical intervention and improved outcomes.

Introduction: Artificial intelligence has revolutionized nursing education with the emergence of ChatGPT, which has the potential to transform active teaching methods. Despite this potential, there is still insufficient literature on the use of ChatGPT in nursing education. The aim of this pilot study is to examine nurse educators' knowledge, attitudes, and perceptions of ChatGPT, as well as their experience of using ChatGPT in active teaching methods. Subjects and methods: We conducted a cross-sectional pilot study using a self-administered questionnaire with 104 participants. Results: Although 61.52% of participants have an average level of knowledge about ChatGPT, they are not very familiar with its use, as 59.6% do not use it. In fact, 70.52% expressed indifference or negativity towards the use of ChatGPT by their students. Furthermore, male educators are five times more likely to believe that ChatGPT facilitates students cheating (OR = 5.147 (1.641; 16.141)).Despite being aware of the challenges associated with ChatGPT, educators in our sample demonstrate limited awareness of its potential applications in active teaching methods. For instance, only 33.33% use ChatGPT in problem-based learning, while a mere 10% use ChatGPT in simulation-based learning. This reluctance extends to use ChatGPT in teaching activities such as preparing pedagogical content (8.69%) and the design of assessment tools (9.78%). Conclusion: Implementing institutional guidelines and providing nurse educators with training on the potential applications of ChatGPT are essential for promoting positive change in nursing education. This will enable educators to guide their students in the responsible and ethical use of ChatGPT. Resumen: Introducción: La inteligencia artificial ha revolucionado la educación en enfermería con la aparición de ChatGPT, que tiene el potencial de transformar los métodos de enseñanza activa. A pesar de este potencial, todavía existe una literatura insuficiente sobre el uso de ChatGPT en la educación en enfermería. El objetivo de este estudio piloto es examinar el conocimiento, las actitudes y las percepciones de los educadores de enfermería sobre ChatGPT, así como su experiencia en el uso de ChatGPT en métodos de enseñanza activa. Sujetos y métodos: Realizamos un estudio piloto transversal utilizando un cuestionario autoadministrado con 104 participantes. Resultados: Aunque el 61.52% de los participantes tiene un nivel promedio de conocimiento sobre ChatGPT, no están muy familiarizados con su uso, ya que el 59,6% no lo utiliza. De hecho, el 70.52% expresó indiferencia o negatividad hacia el uso de ChatGPT por parte de sus estudiantes. Además, los educadores masculinos tienen cinco veces más probabilidades de creer que ChatGPT facilita el plagio por parte de los estudiantes (OR = 5.147 (1.641; 16.141)). A pesar de ser conscientes de los desafíos asociados con ChatGPT, los educadores en nuestra muestra demuestran una conciencia limitada de sus posibles aplicaciones en los métodos de enseñanza activa. Por ejemplo, solo el 33.33% utiliza ChatGPT en el aprendizaje basado en problemas, mientras que solo un 10% lo utiliza en el aprendizaje basado en simulación. Esta reticencia se extiende a la integración de ChatGPT en actividades de enseñanza, como la preparación de contenido pedagógico (8.69%) y el diseño de herramientas de evaluación (9.78%). Conclusión: Implementar directrices institucionales y proporcionar formación a los educadores de enfermería sobre las aplicaciones potenciales de ChatGPT es de gran importancia para catalizar un cambio positivo en la educación en enfermería. De esta manera, los educadores podrán guiar a sus estudiantes en el uso responsable y ético de ChatGPT.

Recent advances in immunotherapy have significantly improved outcomes for cancer patients. However, therapies such as immune checkpoint inhibitors (ICIs) can lead to immune-related adverse events, including potentially fatal ICI-myocarditis. The diagnosis of ICI-myocarditis is complex, and cardiac MRI plays a crucial role in identifying this condition. This report presents a novel finding of elevated muscular T1 and T2 relaxation parameters using standard CMR sequences, correlating with the clinical progression of ICI-myotoxicity affecting not only the heart but also the skeletal thoracic muscles and the diaphragm. Identifying diaphragm involvement in these patients is particularly important, as it may result in respiratory failure. MRI has shown significant potential in assessing diaphragmatic function, as well as detecting tissue damage and edema, while also monitoring their evolution over time. This comprehensive, imaging-based approach could guide treatment decisions, including the use of corticosteroids and immunosuppressive therapies. Combining functional and non-invasive tissue assessments in a single MRI examination may enhance early diagnosis and improve the management of patients undergoing ICI therapy.

Introduction. The stiff-person syndrome (SPS) is a rare disease whose incidence is estimated at approximately 1 in a million individuals in the general population. Diagnosis relies on a combination of clinical, immunological, and electromyographic items. We present the case of a patient diagnosed with the idiopathic SPS, initially misdiagnosed as focal paravertebral myositis. Case presentation. A 36-year-old patient was referred to us for the investigation of subacute dorsal myalgias. The patient reported a severe torticollis seven months ago, which resolved spontaneously after one month, and some episodes of back stiffness. On examination, the patient was afebrile, had hyperlordosis with a paravertebral contracture and tenderness. Neurological and cognitive examinations were normal. C-reactive Protein was at 137 mg/l. The rest of laboratory investigations, including creatine phosphokinase (CPK), were within normal range. Spinal MRI revealed T2 hyperintensity in the semispinalis muscle, erector spinae muscle, trapezius muscle, as well as the intervertebral muscles. Therefore, focal paravertebral myositis was suspected. The electromyogram (EMG) revealed the presence of a continuous motor unit activity in agonist and antagonist muscles, suggestive of stiff-person syndrome. Antinuclear antibodies, anti-glutamic acid decarboxylase 65 and onconeuronal antibodies were negative. Analysis of the cerebrospinal fluid, including anti-glutamic acid decarboxylase 65 test, was normal. We noticed that the paravertebral contracture became less noticeable when the patient was commenced on diazepam. Diagnosis of SPS was established according to Dalakas criteria. Investigations for an underlying neoplasm, were normal. Associated autoimmune disorders have been ruled out. The MRI description was rather explained by the continuous contraction of the affected muscles. Treatment included diazepam, baclofen, intravenous immunoglobulin and corticosteroids. The patient showed important signs of improvement. Conclusion. SPS is a rare condition whose diagnosis can be delayed. Recognizing and managing SPS as early as possible is crucial. It is based on clinical reasoning, imaging, biological features and EMG.

Gayet-Wernicke encephalopathy (GWE) is a neuropsychiatric syndrome due to Vitamin B1 (thiamine) deficiency, fatal in 30% of cases and preventable if treatment is initiated early, characterized by the classic triad of encephalopathy, ocular involvement: ophthalmoplegia and/or nystagmus and ataxia. GWE is mainly observed in alcoholics, but can also appear in any state of malnutrition. In obstetrics, hyperemesis gravidarum can be complicated by GWE due to low thiamine stores and increased thiamine requirements. We report a case of Gayet-Wernicke encephalopathy complicating incoercible vomiting in a pregnant woman.

Abstract Toxoplasmosis, caused by Toxoplasma gondii, has the unsettling ability to infect nearly every warm-blooded vertebrate. When transmitted from mother to fetus during pregnancy, it can lead to congenital toxoplasmosis in newborns, which may have severe and even fatal outcomes. Moreover, this parasite is a significant cause of reproductive issues in cattle. The aim of this literature review was to compile and synthesize information on the epidemiology and clinical features of naturally occurring Toxoplasma gondii infections in both humans and animals, as well as to assess the occurrence of oocysts in the environmental matrices in Morocco. To achieve these objectives, data were sourced from four electronic databases: PubMed, Web of Science, Scopus, and Google Scholar. A total of 32 articles published between January 1, 2000, and January 31, 2024, met the inclusion criteria. The findings indicated that the seroprevalence of T. gondii among pregnant women varied by city and appeared to be lower in drier climates. The study identified several risk factors associated with T. gondii infection among women in Morocco, including direct contact with soil, failure to wash fruits and vegetables before eating, limited education, and reliance on well water for drinking. Moreover, there is a limited amount of serological data on T. gondii in animals. In Morocco, the prevalence of this parasite can reach up to 30% in sheep, while it stands at 8.5% in cattle and goats. Leafy greens are particularly prone to hosting pathogens and are associated with foodborne outbreaks. In Morocco, the prevalence of T. gondii in leafy vegetables is around 16%, although soil analyses have not found any oocysts. This review offers a thorough epidemiological overview of T. gondii infections in Morocco, serving as a valuable resource for researchers and aiding in the development of control and prevention programs.

A comparative assessment of water quality for drinking purposes was conducted in Ain Larbi area using the Weighted Arithmetic Water Quality Index (WA-WQI). The origin of minerals is assessed by a saturation index approach and the Gibbs diagram. Also, mineral correlation process and ion exchange mechanism are detected by the Principal Component Analysis (PCA). The PCA results indicate that the groundwater quality in the Ain Larbi study area primarily results from weathering and geochemical alteration of rock. The saturation index and Gibbs diagram support these findings. The WA-WQI was calculated for each station based on physicochemical parameters. During the wet season, three out of five classes of WQI were observed in the present study, including excellent (25%), good (70%), and poor (5%). In the dry season, the classes excellent (25%), good (30%), and poor (45%) were represented. The present situation demonstrates how hydrogeological regimes and water–rock interactions affect groundwater ion concentrations. Our results contribute to identifying drinking water requirements in the Ain Larbi region, promoting sustainable water management. HIGHLIGHTS Hydro-chemical facies for discerning the diverse nature of water.; The origin of water minerals and the geochemical processes.; Mineral correlation process and ion exchange mechanism.; Calculation for assessing the qualities of drinking water.; Water assessment in a semi-arid area.; Detecting a potential pollution.;

Objective-Screening for cardiovascular risk is crucial, particularly in overweight patients. The aim of this study was to measure the correlation between levels of conventional cardiac enzymatic (CPK) markers Creatine Phospho Kinase, LDH Lactate dehydrogenase, ASAT Aspartate Amino Transferase and ALAT Alanine Amino Transferase) and body mass index, and to study their association with the reference marker, ultra-sensitive CRP and Liporprotein a in a series of cases. Materials & Methods-Sixty-two subjects were included in a descriptive cross-sectional study, divided into two groups according to body mass index. The first group included volunteers of the same sex and age group (BMI ≥ 25 kg/m²) and the second group normo-weight volunteers (BMI≤18.5 kg/m²). An analysis of CPK, LDH, ASAT, ALAT and Liporprotein a ) was performed for the entire study population, whileultra-sensitive CRP,l ipid abnormality exploration and atherogenicity index were assessed only in the overweight population. Results-LDH and CPK levels were significantly higher in overweight subjects compared with normoweight subjects. Ultra-sensitive CRP showed a positive and significant correlation with ASAT (r = 0.356*, p = 0.046) and LDH (r = 0.370*, p = 0.037). Conclusion-The results suggest that LDH could be a promising lead in the measurement of cardiovascular risk in overweight subjects.

Abstract: When examining judicial discourse, we find that it encompasses a variety of forms, with one of the most prominent being the lawyers' statements known as "pleadings." In these, the lawyer presents the facts of the case, its circumstances, and the demands of their client through an oral presentation. This is aimed at stirring the emotions of the judge, the judicial panel, and the audience, earning it the term "judicial oration." However, pleading goes beyond mere emotional appeal; it relies on argument, evidence, and the rules of the legislative system. It is a standard practice in criminal court sessions, often referred to as the "Court of Persuasion," as the pleading and efforts of the lawyer are geared toward convincing the judge and the panel. As the core of judicial discourse and the intersection between legal and judicial discourse, the plea serves multiple functions to achieve its primary goal—persuasion. The purpose is to convince the judge, making them yield to what is presented. Additionally, it aims to fulfill the pragmatic function, which is the most important role of a plea and is realized through the integration of several other functions. Keywords : Pleading, judicial oration, judicial discourse, legal discourse.

Leishmania infantum is a protozoan parasite of the family Trypanosomatidae, transmitted by the bite of phlebotomine sand flies (Diptera: Psychodidae). It is responsible for human and canine leishmaniasis in countries bordering the Mediterranean basin. Here we describe a clinical case of human cutaneous leishmaniasis in a 76-year-old female patient living in Marseille. Upon interrogation, the patient had no history of recent travel or contact with animals. The study involved clinical, serological, and molecular investigation of the occurrence of Leishmania infection in 718 dogs from five departments within a 130 km radius perimeter around Marseille. Five dogs showed signs of moderate leishmaniasis. Additionally, the serological survey of dogs revealed a global seroprevalence of 5.1%, with a significantly different prevalence in the Vaucluse department. Molecular analysis and phylogenetic studies highlighted the close relatedness of Leishmania strains between human and canine hosts with 99.6% of identity, indicating local transmission. The findings underscore the importance of serological surveillance in dogs and human. In a One Health approach, it is necessary to continue investigating Leishmania infection in all potential reservoirs, especially for zoonotic L. infantum in wildlife (red foxes, leporids, rodents, etc.) but also in dogs, cats, and equids.

Polycystic ovary syndrome (PCOS) is a common condition. Its pathophysiology involves an interaction between genetic and environmental factors, resulting in different reproductive and metabolic subtypes. Genetic variation in the angiotensin converting enzyme (ACE) gene has been implicated in the pathophysiology of the syndrome. Our project aims to investigate the relationship between the ACE I/D (insertion/deletion) polymorphism and circulating levels of ACE activity, renin and aldosterone in PCOS. Patients and methods: PCOS and healthy donors were enrolled over 2 years. The Rotterdam criteria were used to segregate 4 phenotypes. Enrolled controls were matched to PCOS patients for body mass index. Clinical data were recorded and blood samples were taken for analysis of ACE I/D polymorphism and biochemical parameters. Hardy-Weinberg equilibrium evaluation, mean/median comparison and Spearman correlation were performed. Results: A total of 102 women with PCOS and 107 controls were involved in the study. The most common polymorphism was ID, both in the control and PCOS groups. Renin levels in PCOS patients were positively correlated with luteinizing hormone (LH) and anti-mullerian hormone (AMH) in the ID genotype and with testosterone, free androgen index and insulin in the DD genotype. Conclusion: The ACE I/D variation may influence the pathophysiology of PCOS subtypes, together with an indirect relationship with renin. Our findings may provide valuable therapeutic insights into the management of PCOS, particularly regarding the potential need for ACE inhibitors or renin inhibitors tailored to ACE gene I/D genotypes or specific subtypes.

The Pregnancy-Associated Glycoproteins (PAGs) belong to aspartic protease family and are synthesized by trophoblast cells of ruminant placenta and secreted into maternal blood and milk. These biomarkers very closely associated to pregnancy have demonstrated their efficiency and reliability in detection of vital embryos or pregnancy loss. In order to measure the concentration of PAGs in bovine serum, a direct radioimmunoassay (RIA) system was developed and validated. The radioiodinated bPAG tracer was prepared by chloramine-T direct method and the solid phase was used in RIA/PAGs as a separation system. The optimization tests allowed to set the assays procedure as working buffers, time and temperature of the assays incubation. Assay sensitivity was 0.63 ng/mL, the intra and inter-assay CVs were 7.7% and 5.3% respectively and the accuracy of the assays was expressed by a good parallelism and recovery tests. The serums bPAG values determinated by this developed system were consistent with the reproduction status and pregnancy stages of cows. The developed RIA/PAG system can provide the laboratory with an efficient method for the accurate detection of pregnancy, which could offer veterinarians and farmers an important tool for the reproductive management in dairy herds. Moreover, this diagnostic tool can also be developed for other livestock species.

The evolution of mega-ships and maritime alliances, in tandem with global changes, has intensified hub port competitiveness, increasing the need for innovation and adaptation, with a focus on sustainability. This study analyzed the competitiveness of the Mediterranean maritime hub port with Northern European ports. It provided a comprehensive analysis of the competitiveness of ten leading international hub ports in the Mediterranean and Northern Europe. Using the Hybrid F-AHP TOPSIS method, this research first identified and assigned weights to 10 criteria across five categories of port competitiveness from a shipping liner perspective in the Mediterranean and Northern Europe. It then ranked those ten leading ports based on the weighted criteria. The results showed that handling cost, operational efficiency, and infrastructure were the main factors for defining a competitive hub port, with growing emphasis on sustainability considerations. The results also highlight that Tangier Med, Algeciras, and Port Said were the leading ports in the region, excelling in technical efficiency and maritime costs compared to Northern European ports. The analysis further provided a holistic overview of competitiveness in the region, identifying the strengths and opportunities of each port based on 5 aspects with a special focus on the hub ports of the Southern Mediterranean. This research offers valuable insights for maritime shippers and port authorities in understanding hub port performance and competitiveness in a sustainable context.

In this research article, we handle a class of (2+1) dimensional wave equations under fractional-order derivatives using an iterative integral transform due to Laplace. The concerned derivative is taken in the Caputo’s sense. The proposed method is a purely algebraic manipulation approach to compute solutions without a priori knowledge of geometry and physical meaning related to the proposed problem. In fact, in this procedure, we combine two novel techniques, Laplace transforms (LT) and iterative procedures to form a hybrid technique for computation of the solution to the proposed problem. The method is rapidly convergent. Here, we give various examples for the validation of our proposed method. The superiority of the method over the existing numerical method is that it does not require any prior discretization or collocation of functions. Also, the method is independent of axillary parameters as needed in the homotopy methods, because such auxiliary parameters control the efficiency of the mentioned methods. The proposed procedure is simple and straightforward. In addition, some comparison between exact and approximate solutions is also given. The proposed method is compared with the homotopy perturbation method (HPM) which shows that the proposed technique is more efficient and easy to implement.

Summary: Background: Erdheim-Chester disease (ECD) is a rare histiocytosis that may overlap with Langerhans Cell Histiocytosis (LCH). This “mixed” entity is poorly characterized. We here investigated the clinical phenotype, outcome, and prognostic factors of a large cohort of patients with mixed ECD-LCH. Methods: This retrospective study was performed at two referral centers in France and Italy (Pitié-Salpêtrière Hospital, Paris; Meyer Children’s Hospital, Florence). We included children and adults with ECD diagnosed in 2000–2022 who had biopsy-proven LCH, available data on clinical presentation, treatment and outcome, and a minimum follow-up of one year. Outcomes included differences in clinical presentation and survival between mixed ECD-LCH and isolated ECD; we also investigated response to treatments and predictors of survival in the mixed cohort. Survival was analyzed using the Kaplan-Maier method and differences in survival with the long-rank test. Cox regression models were used to evaluate the potential impact of age and gender on survival and to identify predictors of non-response and survival. Findings: Out of a cohort of 502 ECD patients, 69 (14%) had mixed ECD-LCH. Compared to isolated ECD, mixed ECD-LCH occurred more frequently in females (51 vs. 26%, p

Despite their overlooked status, weeds are increasingly recognized for their therapeutic value, aligning with historical reliance on plants for medicine and nutrition. This study investigates the medicinal potential of native weed species in Bangladesh, specifically pigments, antioxidants, and free radical scavenging abilities. Twenty different medicinal weed species were collected from the vicinity of Khulna Agricultural University and processed in the Crop Botany Department Laboratory. Pigment levels were determined using spectrophotometer analysis, and phenolics, flavonoids, and DPPH were quantified accordingly. Chlorophyll levels in leaves ranged from 216.70 ± 9.41 to 371.14 ± 28.67 µg g−1 FW, and in stems from 51.98 ± 3.21 to 315.89 ± 17.19 µg g−1 FW. Flavonoid content also varied widely, from 1,624.62 ± 102.03 to 410.00 ± 115.58 mg CE 100 g−1 FW in leaves, and from 653.08 ± 32.42 to 80.00 ± 18.86 mg CE 100 g−1 FW in stems. In case of phenolics content Euphorbia hirta L. displaying the highest total phenolic content in leaves (1,722.33 ± 417.89 mg GAE 100 g−1 FW) and Ruellia tuberosa L. in stems (977.70 ± 145.58 mg GAE 100 g−1 FW). The lowest DPPH 2.505 ± 1.028 mg mL−1was found in Heliotropium indicum L. leaves. Hierarchical clustering links species with pigment, phenolic/flavonoid content, and antioxidant activity. PCA, involving 20 species and seven traits, explained 70.07% variability, with significant PC1 (14.82%) and PC2 (55.25%). Leaves were shown to be superior, and high-performing plants such as E. hirta and H. indicum stood out for their chemical composition and antioxidant activity. Thus, this research emphasizes the value of efficient selection while concentrating on the therapeutic potential of native weed species.

El gran volumen de datos falsos o engañosos que circulan por las redes sociales en el momento actual es susceptible de ser interpretado por determinados usuarios como información verdadera que es redifundida posteriormente, lo que contribuye a generar más desinformación. La percepción de la realidad de estos individuos se ve alterada por factores de distinto signo, como la orientación política, el nivel formativo, el género, la edad o la cultura mediática, que afectan no solo a la toma de decisiones personales, sino también a otras de carácter colectivo. Estos grupos de usuarios pueden convertirse en fuentes indeseadas de desinformación en distintos grados, que comprenden desde la simple redifusión inconsciente de información falsa hasta el activismo político y social. En este ensayo se dibuja una tipología operativa de las fuentes de desinformación más activas en la esfera virtual, compuesta por usuarios comunes de redes sociales, influencers y activistas. Asimismo, se describen las estrategias comunicativas empleadas por cada una de estas categorías y los efectos perniciosos que causan estos nuevos líderes de opinión, tanto en entornos online como offline.

Abstract Background Fusarium head blight (FHB) infection results in Fusarium damaged kernels (FDK) and deoxynivalenol (DON) contamination that are downgrading factors at the Canadian elevators. Durum wheat (Triticum turgidum L. var. durum Desf.) is particularly susceptible to FHB and most of the adapted Canadian durum wheat cultivars are susceptible to moderately susceptible to this disease. However, the durum line DT696 is less susceptible to FHB than commercially grown cultivars. Little is known about genetic variation for durum wheat ability to resist FDK infection and DON accumulation. This study was undertaken to map genetic loci conferring resistance to DON and FDK resistance using a SNP high-density genetic map of a DT707/DT696 DH population and to identify SNP markers useful in marker-assisted breeding. One hundred twenty lines were grown in corn spawn inoculated nurseries near Morden, MB in 2015, 2016 and 2017 and the harvested seeds were evaluated for DON. The genetic map of the population was used in quantitative trait locus analysis performed with MapQTL.6® software. Results Four DON accumulation resistance QTL detected in two of the three years were identified on chromosomes 1 A, 5 A (2 loci) and 7 A and two FDK resistance QTL were identified on chromosomes 5 and 7 A in single environments. Although not declared significant due to marginal LOD values, the QTL for FDK on the 5 and 7 A were showing in other years suggesting their effects were real. DT696 contributed the favourable alleles for low DON and FDK on all the chromosomes. Although no resistance loci contributed by DT707, transgressive segregant lines were identified resulting in greater resistance than DT696. Breeder-friendly KASP markers were developed for two of the DON and FDK QTL detected on chromosomes 5 and 7 A. Markers flanking each QTL were physically mapped against the durum wheat reference sequence and candidate genes which might be involved in FDK and DON resistance were identified within the QTL intervals. Conclusions The DH lines harboring the desired resistance QTL will serve as useful resources in breeding for FDK and DON resistance in durum wheat. Furthermore, breeder-friendly KASP markers developed during this study will be useful for the selection of durum wheat varieties with low FDK and DON levels in durum wheat breeding programs.