Search Results (74)

Africa’s rapid urbanization often exceeds the capacity of governments to provide essential services and infrastructure, exacerbating structural inequalities and exposing vulnerable populations to serious health risks. This paper examines the case of Douala, Cameroon, to demonstrate that health inequities in African cities are not simply the result of urban growth but are shaped by spatial inequities, historical legacies, and systemic exclusion. Disadvantaged neighborhoods are particularly impacted, becoming epicenters of health crises. Using a mixed-methods approach combining spatial analysis, household surveys and interviews, the study identifies three key findings: (1) Healthcare services in Douala are unevenly distributed and dominated by private providers, which limits access for low-income residents. (2) Inadequate infrastructure and environmental risks in informal settlements lead to a higher disease burden and an overflow of demand into better-equipped districts, which overwhelms public health centers across the city. (3) This structural mismatch fuels widespread reliance on informal and unregulated care practices. This study positions Douala as a microcosm of broader public health challenges in rapidly urbanizing African cities. It highlights the need for integrated urban planning and health system reforms that address spatial inequalities, strengthen public health infrastructure, and prioritize equity—key principles for achieving the third Sustainable Development Goal (ensuring good health and well-being for all residents) in sub-Saharan Africa. Full article

This study assessed the accuracy of a long-term AI-based projection of signs of facial aging and their acceptance by consumers. Standardized photographs of 25 Chinese and 25 French women were first taken at T0 and graded using ethnic-specific skin aging atlases. An AI-based algorithm then aged the photographs by 10 (T10) and 15 (T15) years. A total of 246 women from China, France, and Thailand compared these images in pairs (T0 vs. T0 + 10 or T0 + 15) and provided feedback on their overall impressions, realism, and psychological acceptance via a questionnaire. Besides lower face ptosis (p < 0.01), the simulated images revealed that regardless of ethnicity, there were no significant differences in grading. Irrespective of ethnic background, 62–78% of overall panelists found the projections realistic and liked them, while 85–96% of panelists (Chinese and French) were willing to test them. A total of 47% of Thai panelists were reluctant to try, while 4–14% found it scary. This indicated some degree of cultural influence. This study confirms women’s acceptance of future facial appearance with some degree of cultural divergence. It also highlights a valid methodology to explore skin aging for a more realistic and personalized cosmetic improvement and innovation. Full article

Given the highly contested nature of the debate over secularization in modern literature, this paper examines the ways in which four contemporary French novelists address questions of human and divine absence in their fiction, focusing on Joël Egloff’s J’enquête, Gaspard-Marie Janvier’s Le dernier dimanche, Jérôme Ferrari’s Le sermon sur la chute de Rome, and Sylvie Germain’s Tobie des marais. It argues that some of the most pressing questions of our secular age—including questions of intersubjectivity and human and divine absence—are addressed in these competing narratives of secularization. It then examines Jean-Louis Chrétien’s notion of cardiognosie, or knowledge of the heart, and his argument that profanation, rather than secularization as such, is of central importance in the modern novel’s construction of meaning before concluding with a close reading of Jérôme Ferrari’s Le sermon sur la chute de Rome and a consideration of the heart in Sylvie Germain’s Tobie des marais as a first step toward establishing the means by which profanation has been faced and overcome in recent fictional texts. Full article

With the increasingly complex space environment, the operational safety of spacecraft faces severe challenges, creating an urgent need to develop efficient and reliable space target detection and identification technologies. Traditional optical detection equipment faces significant challenges in space target detection and identification due to the low signal-to-noise ratio of space targets. To address the limited field of view (FOV) of traditional spectrometers, this paper proposes an improved wide-FOV infrared slitless spectrometer system based on the Dyson spectrometer. The system consists of three main components: a front telescope system, a spectral dispersion system, and a relay lens system. The front telescope system adopts a Ritchey–Chrétien structure and incorporates a correction lens group to enhance imaging quality. To overcome the practical challenges of conventional Dyson spectrometers—such as the high difficulty and cost in manufacturing and aligning concave gratings—an improved Dyson spectrometer based on a planar blazed grating is designed. A collimating lens group is incorporated to reduce spectral line curvature and chromatic aberration while ensuring a linear spectral dispersion relationship, achieving “spectrum-value unification” in the system. Additionally, a secondary imaging relay lens system is designed to ensure 100% cold stop matching efficiency, thereby minimizing stray light interference. Through optimization and ray tracing using optical design software, the final system achieves a field of view of 0.69° × 0.55°, a spectral resolution of 8.41 nm/pixel, spectral line curvature and chromatic aberration both below 10 µm, and a nearly linear spectral dispersion relationship, realizing spectrum-value unification to facilitate target identification. This infrared slitless spectrometer can stably acquire the spectral characteristics of space targets without requiring high-precision theodolites, providing a novel technical solution for the identification of dynamic space targets. It holds broad application prospects in space surveillance and related fields. Full article

In the simulation of partially coherent light propagation within optical systems utilizing the Wigner function, the constraints imposed by the Fourier transform necessitate that the dimensions of the input and output matrices remain congruent. Consequently, the extent of the image plane is dictated by the dimensions of the light source matrix and the propagation distance. For optical systems of greater complexity, such simulations are highly memory-intensive. This paper innovatively incorporates the displacement theorem of the chirp z-transform and integrates it with the Wigner function. This approach affords enhanced flexibility in the simulation of partially coherent light transmission, enabling the targeted simulation of regions of interest within the frequency domain of the optical system, thereby significantly improving simulation efficiency. The efficacy of this novel method is demonstrated through the simulation of a Wigner transmission algorithm based on the chirp z-transform, applied to an RC (Ritchey–Chrétien) telescope system. The RC telescope, known for its optical design that minimizes aberrations and provides high-quality imaging, serves as a critical foundation for the simulation. The resultant simulations exhibit a high degree of consistency with traditional methods while offering increased flexibility, thus corroborating the validity and effectiveness of the proposed approach. Full article

The Gambia’s coastline, known for its unique ecosystems and vital role in the country’s economy through fisheries, tourism, and agriculture, is becoming increasingly vulnerable as a result of the combined effects of climate change and human activity. This coastline sustains an important portion of the population by providing livelihoods and contributing to food security, as well as housing critical infrastructure including ports, urban areas, and tourism hubs. However, as climate change intensifies pre-existing vulnerabilities, such as increased sea-level rise, coastal erosion, and extreme weather events, these socio-economic assets are becoming more and more vulnerable. As a result, this study focused on investigating the physical vulnerability of the coastline in the context of climate change. The vulnerability assessment was conducted using the coastal vulnerability index approach, utilising a combination of oceanographic data, remote sensing, and field observations. The research outcomes supported the identification of key areas at risk and examined the contributing factors such as tidal ranges, storm surges, and human activities. The findings highlight the immediate and long-term threats to coastal communities, infrastructure, and natural habitats. Due to the vulnerability provided by geological and geomorphological factors, the average Coastal Vulnerability Index (CVI) score of 29 indicates a high level of exposure to coastal hazards from Buniadu Point to Barra. From Banjul to Cape Point, the average coastline dynamic rate is positive at 0.21 m/year, indicating some accretion. Despite this, the CVI score of 22 indicates significant vulnerability to coastal hazards from Bald Cape to Salifor Point. The study also explored potential mitigation and adaptation strategies to enhance coastal resilience to sea-level rise, coastal erosion, and flooding. Integrated and sustainable strategies were outlined to support policy-making and community-based initiatives towards safeguarding coastal regions of The Gambia against the backdrop of climate change. Full article

This encyclopedic entry explores the vast field of courtly love poetry, romance, and other related genres, tracing the development of this topic across medieval Europe and discussing some of the major contributors. The focus rests on the element of discourse because so many different poets have made their voices heard and debated from many different perspectives the meaning, impact, and consequence of courtly love on the individual in ethical, social, moral, religious, economic, and even political terms. Courtly love is to be understood as a literary discourse on the mostly esoteric pursuit of love as a way of life for members of the high medieval aristocracy, finding vivid expression in poetry, short verse narratives, and romances. Full article

Background: Osteogenesis imperfecta (OI) is a rare genetic disorder affecting mainly type I collagen, which leads to bone fragility and deformities. OI patients also present craniofacial abnormalities such as macrocephaly and malocclusion. Recently, craniofacial dysmorphism was highlighted in the osteogenesis imperfecta mouse (oim), a validated model of the most severe form of OI. This study explores the impact of zoledronic acid (ZA), commonly administered to OI patients to increase bone mass and mechanical strength, on oim craniofacial structure. Methods: Fifteen oim received a single intravenous ZA injection (100 µg/kg) at 5 weeks (ZA group), while fifteen remained untreated (control). Before euthanasia at 14 weeks, in vivo computed tomography provided craniometric data. Post-euthanasia, heads underwent peripheral Quantitative Computed Tomography (pQCT); coronal decalcified sections through temporomandibular joints were analyzed (n = 6/mouse) after Masson’s trichrome staining (3 sections) or under polarized light to study collagen birefringence (3 sections). Results: In vivo craniometry highlighted the positive effect on vertical growth in ZA oim models as compared to untreated ones, with significant increases in mandibular length and incisor height and without any change in transversal dimensions. The pQCT scans showed the significantly higher total mineral density and cortical mineral density of the mandibular ramus in the ZA than the untreated group. Via microscopic analysis, the cranial vault was thicker and the collagen birefringence was higher in the ZA group than in the untreated group, but differences were not significant. Conclusion: To conclude, ZA had some beneficial effects on craniofacial vertical height and ramus density and, to a lower extent, on vault thickness, while transversal dimensions did not seem to be influenced by ZA intake. These data emphasize the need to consider the whole skeleton when treating OI patients. Full article

Whereas Marion’s earlier articulation of givenness has received a wide-spread hermeneutical critic justifiable within the framework of his two major initial texts on the issue (“Reduction and Givenness” and “Being Given”), in recent works he has reacted in diverse writings in view of repositioning hermeneutics within his phenomenology of givenness. Following Gadamer and Heidegger, this reaction culminated in the outline of an enigmatic structure of givenness where understanding is situated within the dynamic of call and response (Levinas, Chrétien). Yet, despite the reciprocity of call and response in hermeneutical understanding, Marion still seems to have reinforced his previous position in which meaning is that of the sole givenness, thereby compromising the point of view of the witness (the hermeneutic gaze). We shall defend not only this “hermeneutic gaze”—which is rooted in the symbolic ground of the witness as what s/he brings to bear on what is received in a network of relationships that transforms him,—but also demonstrate how the reciprocity between givenness and the gifted dynamically plays out in call and response (St. Paul). In addition, the hermeneutic gaze is indispensable since only it can explain an illusion that cohabits with givenness, i.e., with the phenomena. In the context of religious experience, the hermeneutical gaze is capable of modulating the way the divine word (aesthetic) is given: either as an illusion (ecstatic), which reverts him back to himself, or as meaning, which inscribes him into a faith community (symbolic). Full article

Background and Clinical Significance: Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but may underlie diverse and potentially life-threatening immune-related adverse events (irAEs). They may cause various conditions leading to respiratory failure, including myasthenic syndromes and myositis. However, diaphragmatic paralysis (DP) has rarely been reported. To describe patients with diaphragmatic paralysis in a pharmacovigilance registry, we searched the prospective REISAMIC registry at the Gustave Roussy Cancer Center (Villejuif, France) for cases of diaphragmatic palsy (DP) occurring from September 2014 to December 2021. Case Presentation: We identified three patients, in whom DP was confirmed by diaphragmatic ultrasonography, pulmonary function tests, and/or diaphragmatic electroneuromyogram. Diaphragmatic palsy was life-threatening in all patients, as it caused respiratory failure requiring mechanical ventilation. In all cases, a pre-existing subclinical paraneoplastic syndrome was detected. Onconeural antibodies (anti-titin and anti-VGCC) were detected in these patients before and after the initiation of ICI therapy, suggesting a mixed paraneoplastic syndrome with features overlapping those of myasthenic syndrome (myasthenia gravis in one patient and Lambert–Eaton syndrome in another) and myositis. Conclusions: Diaphragmatic palsy is a severe irAE potentially resulting from different mechanisms, including myositis and neuromuscular junction involvement (myasthenia gravis, Lambert–Eaton). Antineuronal antibodies associated with such conditions were already present in our patients prior to immunotherapy initiation, suggesting ICIs could trigger flare-ups of pre-existing silent paraneoplastic autoimmune conditions. Full article

Introduction: Inguinal hernia repair (IHR) is one of the most common procedures in pediatric surgery. In children, the application of robotic surgery is limited, meaning safety and efficacy is still to be assessed. This report is the first one worldwide that describes inguinal hernia repair in children using the Senhance^® Surgical System (SSS^®). The aim of this matched cohort study is to assess safety and feasibility of robot-assisted IHR (RIHR) in children, compared to conventional laparoscopic IHR (LIHR). Patients and methods: This pilot study included 26 consecutive patients between 3 months and 8 years old who underwent RIHR (31 IH’s) with the SSS^® between 2020 and 2024. These cases were matched based on gender, age, and unilateral or bilateral IH, with 26 patients (32 IH’s) who underwent conventional LIHR. Results: There was a significant difference in total anesthesia time, which is most likely due to the extra time needed to dock the robot in the RIHR cases. No significant difference was seen in surgical time. One recurrence (3.2%) was diagnosed in both groups. One patient in the LIHR group was readmitted on the day of discharge due to a hemorrhage. No intervention was necessary, and the patient was discharged 1 day later. Discussion: In this pilot study, the use of the robotic system was safe and feasible. More experience, further improvement of the system for use in very small children, and investigation in a larger sample size with long-term follow-up is necessary to evaluate efficacy. Full article

Background: Robotic-assisted surgery (RAS) holds many theoretical advantages, especially in pediatric surgical procedures. However, most robotic systems are dedicated to adult surgery and are less suitable for smaller children. The Senhance^® Surgical System (SSS^®), providing 3 mm and 5 mm instruments, focuses on making RAS technically feasible for smaller children. This prospective observational study aims to assess whether RAS in pediatric patients using the SSS^® is safe and feasible. Methods and Results: A total of 42 children (aged 0–17 years, weight ≥ 10 kg) underwent a RAS procedure on the abdominal area using the SSS^® between 2020 and 2023. The study group consisted of 20 male and 22 female individuals. The mean age was 10.7 years (range 0.8 to 17.8 years), with a mean body weight of 40.7 kg (range 10.1 to 117.3 kg). The 3-mm-sized instruments of the SSS^® were used in 12 of the 42 children who underwent RAS. The RAS procedures were successfully completed in 90% of cases. The conversion rate to conventional laparoscopy was low (10%), and there were no conversions to open surgery. One of the 42 cases (2%) experienced intraoperative complications, whereas six children (14%) suffered from a postoperative complication. Overall, 86% of the patients had an uncomplicated postoperative course. Conclusions: The results of the current observational study demonstrate the safety and feasibility of utilizing the SSS^® for abdominal pediatric RAS procedures. The study provides new fundamental information supporting the implementation of the SSS^® in clinical practice in pediatric surgery. Full article

The optimization of the new generation of piezoelectric nanogenerators based on 1D nanostructures requires a fundamental understanding of the different physical mechanisms at play, especially those that become predominant at the nanoscale regime. One such phenomenon is the surface charge effect (SCE), which is very pronounced in GaN NWs with sub-100 nm diameters. With an advanced nano-characterization tool derived from AFM, the influence of SCE on the piezo generation capacity of GaN NWs is investigated by modifying their immediate environment. As-grown GaN NWs are analysed and compared to their post-treated counterparts featuring an Al₂O₃ shell. We establish that the output voltages systematically decrease by the Al₂O₃ shell. This phenomenon is directly related to the decrease of the surface trap density in the presence of Al₂O₃ and the corresponding reduction of the surface Fermi level pinning. This leads to a stronger screening of the piezoelectric charges by the free carriers. These experimental results demonstrate and confirm that the piezo-conversion capacity of GaN NWs is favoured by the presence of the surface charges. Full article

Background: The effect of pediatric inguinal hernia repair (IHR) on testicular vascularization remains unclear. Manipulating the spermatic cord during surgery may reduce blood flow due to edema and vasoconstriction. This can lead to testicular atrophy. The study aims to review current knowledge of testicular vascular impairment following IHR in children. Methods: A systematic literature search was conducted in PubMed/Medline, Embase, Cochrane Library, and Web of Science. Methodological quality was assessed using validated tools. Data were extracted, and a pooled data analysis was performed. Results: Ten studies were included in the systematic review. Six of these studies were eligible for meta-analysis. This revealed a significant decrease in testicular vascularization during the short-term follow-up (1 day–1 week) after IHR using the open surgical approach. This decrease was not present after laparoscopic intervention. There was no more increased resistance in the vessels at long-term follow-up (1 month–6 months), suggesting that the impaired vascularity is only temporary. Conclusions: There seems to be a short-term transient vascular impairment of the testis after open IHR in children. This might be of clinical relevance to prefer the laparoscopic approach for IHR in children, even though the open approach is the gold standard, in contrast to adult IHR. The impact on testicular function and sperm quality later in life remains unclear. Comparative studies of both techniques are needed to determine if there is a significant difference in testicular vascularity. Long-term studies are necessary to assess the impact of transiently reduced vascularity on sperm quality and fertility later in life. Full article

The present paper aims to enable the assessment of the fatigue damage of wind turbine blades over a long duration (e.g., several months/years) in conjunction with different operating regimes and based on two information sources: the 10-min SCADA data and an interpolation using response surfaces identified using the FAST aeroelastic numerical tool. To assess blade damage, prior studies highlighted the need for a high-frequency (>1 Hz) sampling rate. Because of data availability and computation resource limitations, such methods limit the duration of the analysis period, making the direct use of such an approach based on a 1 Hz wind speed signal in current wind farms impractical. The present work investigates the possibility of overcoming these issues by estimating the equivalent damage using a 1 Hz wind speed for each 10-min sample stored in the SCADA data. In the literature, the influence of operating regimes is not considered in fatigue damage estimation, and for the first time, the present project takes a pioneering approach by considering these operating regimes. Full article