Clinico-Pathological discrepancies in the Diagnosis of Causes of Maternal Death in Sub-Saharan Africa: Retrospective Analysis

Background Maternal mortality is a major public-health problem in developing countries. Extreme differences in maternal mortality rates between developed and developing countries indicate that most of these deaths are preventable. Most information on the causes of maternal death in these areas is based on clinical records and verbal autopsies. Clinical diagnostic errors may play a significant role in this problem and might also have major implications for the evaluation of current estimations of causes of maternal death. Methods and Findings A retrospective analysis of clinico-pathologic correlation was carried out, using necropsy as the gold standard for diagnosis. All maternal autopsies (n ¼ 139) during the period from October 2002 to December 2004 at the Maputo Central Hospital, Mozambique were included and major diagnostic discrepancies were analyzed (i.e., those involving the cause of death). Major diagnostic errors were detected in 56 (40.3%) maternal deaths. A high rate of false negative diagnoses was observed for infectious diseases, which showed sensitivities under 50%: HIV/AIDS-related conditions (33.3%), pyogenic bronchopneumonia (35.3%), pyogenic meningitis (40.0%), and puerperal septicemia (50.0%). Eclampsia, was the main source of false positive diagnoses, showing a low predictive positive value (42.9%). Conclusions Clinico-pathological discrepancies may have a significant impact on maternal mortality in sub-Saharan Africa and question the validity of reports based on clinical data or verbal autopsies. Increasing clinical awareness of the impact of obstetric and nonobstetric infections with their inclusion in the differential diagnosis, together with a thorough evaluation of cases clinically thought to be eclampsia, could have a significant impact on the reduction of maternal mortality.

'Freakish Fat', 'Wretched Black': Female abject beings in contemporary Colombian media and culture

This paper explores the construction of female abject beings in Colombian contemporary media and culture comparing a character in the 2010 telenovela Chepe Fortuna named Venezuela, and the cultural representation of Piedad Córdoba. I argue that the construction of these two characters as abject beings is coherent with the dominant discourse of Alvaro Uribe's national project, which relied on a strong nationalist rhetoric based on binary oppositions of the type "we/other." In this context both Chepe Fortuna's Venezuela and Piedad Córdoba are constructed as "other." While Venezuela's abjection is partly effected on the basis of her being fat and black, Córdoba's is on the basis of her being a left-wing politician, and mediated through her being a black female. These two instances evidence an approach to femaleness that goes hand-in-hand with particular understandings of female subjectivity within current post-feminist paradigms.

Study of selenocompounds from selenium-enriched culture of edible sprouts

Selenium is recognised as an essential micronutrient for humans and animals. One of the main sources of selenocompounds in the human diet is vegetables. Therefore, this study deals with the Se species present in different edible sprouts grown in Se-enriched media. We grew alfalfa, lentil and soy in a hydroponic system amended with soluble salts, containing the same proportion of Se, in the form of Se(VI) and Se(IV). Total Se in the sprouts was determined by acidic digestion in a microwave system and by ICP/MS. Se speciation was carried out by enzymatic extraction (Protease XIV) and measured by LC-ICP/MS. The study shows that the Se content of plants depends on the content in the growth culture, and that part of the inorganic Se was biotransformed mainly into SeMet. These results contribute to our understanding of the uptake of inorganic Se and its biotransformation by edible plants.

Macroporous Scaffolds for Bone Engineering. Studies on Cell Culture and Ectopic Bone Formation

Bone engineering is a rapidly developing area of reconstructive medicine where bone inducing factors and/or cells are combined with a scaffold material to regenerate the structure and function of the original tissue. The aim of this study was to compare the suitability of different macroporous scaffold types for bone engineering applications. The two scaffold categories studied were a) the mechanically strong and stable titanium fiber meshes and b) the elastic and biodegradable porous polymers. Furthermore, bioactive modifications were applied to these basic scaffold types, and their effect on the osteogenic responses was evaluated in cell culture and ectopic bone formation studies. The osteogenic phenotype of cultured cell-scaffold constructs was heightened with a sol-gel derived titania coating, but not with a mixed titania-silica coating. The latter coating also resulted in delayed ectopic bone formation in bone marrow stromal cell seeded scaffolds. However, the better bone contact in early implantation times and more even bone tissue distribution at later times indicated enhanced osteoconductivity of both the coated scaffold types. Overall, the most promising bone engineering results were obtained with titania coated fiber meshes. Elastic and biodegradable poly(ε-caprolactone/D,L-lactide) based scaffolds were also developed in this study. The degradation rates of the scaffolds in vitro were governed by the hydrophilicity of the polymer matrix, and the porous architecture was controlled by the amount and type of porogen used. A continuous phase macroporosity was obtained using a novel CaCl2 • 6H2O porogen. Dynamic culture conditions increased cell invasion, but decreased cell numbers and osteogenicity, within the scaffolds. Osteogenic differentiation in static cultures and ectopic bone formation in cell seeded scaffolds were enhanced in composites, with 30 wt-% of bioactive glass filler.

Entre culture du consensus et critique sociale : les intellectuels de gauche dans la Suisse de l'après-guerre (1945-1968)

Cette thèse étudie l'engagement des intellectuels de gauche dans la vie politique suisse, de 1945 à 1968. D'une part, il s'agit de retracer l'évolution du statut des intellectuels, que ce soit dans ou hors des partis. D'autre part, il est question d'analyser les débats politiques au sein desquels ces intellectuels furent impliqués, et la manière dont ces débats suscitèrent des clivages entre eux. De ce point de vue, nous mettons en lumière les différents courants et groupes formés par les intellectuels progressistes, souvent structurés autour de revues ; il s'agit aussi bien d'étudier l'engagement de personnalités sociales-démocrates que des communistes prosoviétiques, sans oublier les chrétiens pacifistes ou les intellectuels proches de la gauche radicale antistalinienne. S'agissant de l'évolution du statut des acteurs étudiés, ce travail souligne le déclin de la figure de l'intellectuel de gauche organiquement lié à son parti, souvent issu du milieu ouvrier, au profit d'intellectuels critiques, généralement au bénéfice d'une formation académique et revendiquant une certaine autonomie par rapport aux organisations politiques. Du point de vue des débats politiques, l'engagement des intellectuels de gauche est envisagé à la lumière de trois périodes. Tout d'abord, nous étudions la phase de l'immédiat après-guerre (1945-1949), marquée par une poussée de la gauche, y compris prosoviétique, qui met en cause le conservatisme politique issu des années de Mobilisation. Nous étudions ensuite les années les plus tendues de la guerre froide, entre 1950 et 1962, durant lesquelles la vie politique et intellectuelle en Suisse est dominée par un fort anticommunisme, auquel se rallient les dirigeants du Parti socialiste. Pourtant, l'engagement de certains intellectuels progressistes, en particulier dans le mouvement pacifiste, met en cause le consensus politique de guerre froide. Enfin, dans une troisième partie, nous montrons comment la critique intellectuelle de gauche se renforce après 1962, à la faveur de la détente Est-Ouest sur le plan international, et avec l'essor, en Suisse même, du mouvement des « non- conformistes ». Ce mouvement est animé par des intellectuels qui dénoncent le conservatisme helvétique, les excès de l'anticommunisme ou qui affirment leur solidarité avec les travailleurs immigrés en Suisse, aussi bien qu'avec les mouvements sociaux dans les pays du tiers-monde. Nous montrons en particulier comment l'engagement de ces intellectuels progressistes contribue à préparer le terrain pour les mobilisations de la jeunesse qui surviendront dans les « années 1968 ». -- This thesis adresses the political commitment of left-wing intellectuals in Switzerland between 1945 and 1968. It aims, on the one hand, to examine how the status of intellectuals developed within and outside of political parties. On the other hand, it endeavours to understand the political debates that involved and sometimes split these intellectuals. In this intent, we examine the various political orientations and formations that brought left-wing intellectuals together - often around dedicated periodicals - such as the Social-democratic, the Communist, the Christian Progressist or the anti-Stalinist Marxist movements. Regarding the evolving status of left-wing opinion leaders, we observe the decline of the organic, party-affiliated intellectuals - often from a working class background. By contrast, critical academics - left-wing oriented but.not directly linked to a political formation - became prevailing figures. Concerning left-wing intellectuals' involvement in the political debate, we differentiate three historical periods. Firstly, the immediate postwar years (1945-1949) were characterised by the strengthening of a left-wing faction, including pro-Soviet forces, which criticized the conservative political consensus built up during the War. Secondly, during the most tense years of the Cold War (1950-1962), the Swiss political and intellectual life became widely dominated by a strong anticommunism, supported by the Social-Democratic leaders. Still, the commitment of certain progressist intellectuals, particularly in the pacifist movement, called into question the political consensus resulting from the Cold War. This questioning strengthened after 1962, in the context of the Détente, corresponding to the rise of the "non-conformist" movement. This movement stemmed from progressist intellectuals, who criticized the Swiss conservatism, and the excesses of official anticommunism, while declaring their solidarity with immigrant workers or with the social movements in the Third World. We show in particular how these intellectuals paved the way for the youth mobilization due to occur in the "1968 years".

Understanding academics' popular science publishing : institution culture and management style effects

Most universities and higher education systems have formally taken up a third mission, which involves various public outreach and engagement activities. Little is known regarding how higher education institutions' organisations interact with academic's level of public outreach. This article examines to which extent the perceptions academics have of their institutions' culture and management style, as well as some of their own individual and statutory characteristics interact with their level of public outreach. Using the Academic Profession in Europe comparative and quantitative research database, this article focuses on two countries on the extremities of the spectrum - Switzerland and the United Kingdom.

Wonderalp. Une science émerveillée. Les Alpes et la culture de la curiosité

WonderAlp est un cabinet de curiosités réalisé à partir d'une documentation provenant d'anciens ouvrages de voyages dans les Alpes. L'app présente des images de dragons, de fossiles, de cristaux, de plantes, d'animaux, de phénomènes naturels. Elle donne des clés pour retrouver et comprendre l'émerveillement devant la nature qui animait la science à l'époque de la curiosité (XVIe-XVIIIe siècles). WonderAlp is a cabinet of curiosities that transforms your iPad or Android into an Early Modern Wunderkammer. It displays objects discovered in the Alps during the early period of exploration. These are grouped under three titles : "Dragons of the Alps", "Fossils and Crystals", "Plants to Landscapes". It helps apprehend a natural world that is both rational and wonderful, scholarly and popular, unlike the compartmentalized thinking of modern life.

Las entidades sub-nacionales en Norteamérica y la lucha contra el cambio climático: desarrollo normativo y vinculación de sistemas de comercio de derechos de emisión

[spa] Mientras que en Europa la interdependencia y la dimensión transfronteriza de las cuestiones ligadas al cambio climático ha facilitado una cierta"continentalización" de la gestión de este fenómeno, favorecida por el carácter intergubernamental de las medidas que se adoptan en el marco de la Unión Europea, al otro lado del Atlántico la transversalidad de este mismo fenómeno explica la necesidad de que, ante las limitaciones del marco regional, se pongan en marcha mecanismos que faciliten la intervención no sólo estatal sino también de las entidades sub-nacionales. En este sentido, la ausencia de la acción federal tanto en Estados Unidos como en Canadá ha comportado un mayor desarrollo de la acción de las entidades sub-nacionales, que han tomado el liderazgo en la lucha contra el cambio climático. Son estas medidas las que se han visualizado en el escenario internacional. Ello ha favorecido el establecimiento de mecanismos de coordinación de la acción de estas entidades sub-nacionales en el seno de redes transnacionales, que han ido adquiriendo una mayor relevancia en la implementación del Convenio Marco sobre el Cambio Climático y del Protocolo de Kyoto, particularmente en relación a uno de sus instrumentos, el comercio de los derechos de emisión de gases de efecto invernadero. En este contexto, la futura vinculación de los sistemas de comercio de derechos de emisión de gases de efecto invernadero en Norteamérica con el sistema de la Unión Europea presenta diversos retos de carácter material y formal.

Anomalous sub aortic left brachiocephalic vein: a case report

The left brachiocephalic vein occasionally follows an aberrant course. It is usually associated with congenital cardiac anomaly. We present a case of anomalous left brachiocephalic vein which followed a sub aortic course, with no cardiac abnormality. Multi detector computed tomography is very useful in accurate diagnosis of this condition and prevents any further investigation in cases of isolated abnormalities.

Prevention of vascular dysfunction and arterial hypertension in mice generated by assisted reproductive technologies by addition of melatonin to culture media.

Assisted reproductive technologies (ART) induce vascular dysfunction in humans and mice. In mice, ART-induced vascular dysfunction is related to epigenetic alteration of the endothelial nitric oxide synthase (eNOS) gene, resulting in decreased vascular eNOS expression and nitrite/nitrate synthesis. Melatonin is involved in epigenetic regulation, and its administration to sterile women improves the success rate of ART. We hypothesized that addition of melatonin to culture media may prevent ART-induced epigenetic and cardiovascular alterations in mice. We, therefore, assessed mesenteric-artery responses to acetylcholine and arterial blood pressure, together with DNA methylation of the eNOS gene promoter in vascular tissue and nitric oxide plasma concentration in 12-wk-old ART mice generated with and without addition of melatonin to culture media and in control mice. As expected, acetylcholine-induced mesenteric-artery dilation was impaired (P = 0.008 vs. control) and mean arterial blood pressure increased (109.5 ± 3.8 vs. 104.0 ± 4.7 mmHg, P = 0.002, ART vs. control) in ART compared with control mice. These alterations were associated with altered DNA methylation of the eNOS gene promoter (P < 0.001 vs. control) and decreased plasma nitric oxide concentration (10.1 ± 11.1 vs. 29.5 ± 8.0 μM) (P < 0.001 ART vs. control). Addition of melatonin (10(-6) M) to culture media prevented eNOS dysmethylation (P = 0.005, vs. ART + vehicle), normalized nitric oxide plasma concentration (23.1 ± 14.6 μM, P = 0.002 vs. ART + vehicle) and mesentery-artery responsiveness to acetylcholine (P < 0.008 vs. ART + vehicle), and prevented arterial hypertension (104.6 ± 3.4 mmHg, P < 0.003 vs. ART + vehicle). These findings provide proof of principle that modification of culture media prevents ART-induced vascular dysfunction. We speculate that this approach will also allow preventing ART-induced premature atherosclerosis in humans.