An In-Depth Investigation of Micropillar Array Columns for the Separation of Finite-Sized Particles by Hydrodynamic Chromatography.

The exact moment approach (EMA) is adopted to predict, without any fitting parameters, the plate height curves for polystyrene microparticles of different sizes in micropillar array columns performed by hydrodynamic chromatography. The EMA allows us to decouple the contribution of horizontal and vertical dispersion terms and thus investigate the influence of pillar height and interpillar distance on separation performance. In the convection-controlled regime, we found that axial dispersion is mainly controlled by the vertical dispersion term, the latter being due to the flow-arresting top and bottom walls. This vertical contribution can be estimated from the axial dispersion in rectangular, open tubular channels formed between the pillars. Henceforth, plate height curves can be accurately predicted by simply adding the estimated vertical term to the horizontal dispersion term evaluated from 2D simulations. This finding allowed us to understand that, to improve separation performance, it is advisible to decrease the interpillar distance (expected result) and decrease the pillar height (counterintuitive result).

Color matching of bicomponent (PET/PTT) filaments with high performances using genetic algorithm.

In recent years, a great interest has focused on the use of bicomponent filaments in several high-performance textile articles such as swimwear, sportswear and even high-quality denim. To dye fabrics containing these filaments, it is necessary to establish appropriate dye recipes allowing to obtain desired shades. In this article, we developed a genetic algorithm to optimize the color matching step of these bicomponent filaments, especially (PET/PTT) filaments. Three disperse dyes with different molecular weights were used for dyeing. The objective is to reproduce the reference color by choosing the appropriate disperse dyes among the available dyestuffs and their corresponding quantities to use on the mixture. For modeling, two sets of parameters (lied to the color formulation problem and the genetic algorithm), the objective function as well as the different stages of the algorithm were defined and described. In addition, different techniques of selection and mutation were applied and evaluated. The optimization criterion is to reduce the CMC color difference between the desired reference colors and the colors proposed by the algorithm. The developed algorithm showed good performances with very small color differences. The results indicate that the roulette wheel selection technique outperforms both rank and uniform selection methods. Moreover, employing a simple mutation strategy yields favorable outcomes with CMC color differences all lower than 1.

Toward the elimination of hepatitis B: networking to promote the prevention of vertical transmission of hepatitis B virus through population-based interventions and multidisciplinary groups in Africa.

The WHO African Region had 81 million people with chronic hepatitis B in 2019, which remains a silent killer. Hepatitis B virus (HBV), hepatitis delta virus (HDV), and HIV can be transmitted from the mother to child. If the HBV infection is acquired at infancy, it may lead to chronic hepatitis B in 90% of the cases. WHO reports that 6.4 million children under 5 years live with chronic hepatitis B infection worldwide. The prevention of mother-to-child transmission (PMTCT) of HBV is therefore critical in the global elimination strategy of viral hepatitis as we take lessons from PMTCT of HIV programs in Africa. We sought to create a network of multidisciplinary professional and civil society volunteers with the vision to promote cost-effective, country-driven initiatives to prevent the MTCT of HBV in Africa. In 2018, the Mother-Infant Cohort Hepatitis B Network (MICHep B Network) with members from Cameroon, Zimbabwe, and the United Kingdom and later from Chad, Gabon, and Central African Republic was created. The long-term objectives of the network are to organize capacity-building and networking workshops, create awareness among pregnant women, their partners, and the community, promote the operational research on MTCT of HBV, and extend the network activities to other African countries. The Network organized in Cameroon, two "Knowledge, Attitude and Practice" (KAP) surveys, one in-depth interview of 45 health care workers which revealed a high acceptability of the hepatitis B vaccine by families, two in-person workshops in 2018 and 2019, and one virtual in 2021 with over 190 participants, as well as two workshops on grant writing, bioethics, and biostatistics of 30 postgraduate students. Two HBV seroprevalence studies in pregnant women were conducted in Cameroon and Zimbabwe, in which a prevalence of 5.8% and 2.7%, respectively, was reported. The results and recommendations from the MICHep B Network activities could be implemented in countries of the MICHep B Network and beyond, with the goal of providing free birth dose vaccine against hepatitis B in Africa.

Prevalence of hepatitis B virus infection and its associated factors among students in N'Djamena, Chad.

INTRODUCTION: Infection by hepatitis B virus (HBV) is a major issue in public health. The prevalence of HBV in Chad is 12.4%, all age groups considered. Here, we aimed to determine the prevalence of HBV and its associated factors among university students in N'Djamena, the country's capital. METHODS: A cross-sectional survey of students at either the University of N'djamena or Emi Koussi University was conducted from 3 to 23 July 2021. All participating students provided signed, informed consent and were included in the study consecutively. Blood samples were collected, and serum tested for hepatitis B surface antigen (HBsAg) using the Determine HBsAg rapid test kit, with confirmation of positive tests on an Abbott Architect i1000SR analyzer. Descriptive analysis and logistic regression were used to determine associations between the outcome variable and independent/covariate variables. RESULTS: A total of 457 students with a median age of 24 years were included across different faculties. The prevalence of HBV infection was 14.87% (68/457). Most students (75%) were aged 25 years or less. Unprotected sex was reported by 64.9% of the students and multiple sexual partners by 53.6%. Furthermore, 45.7% of them reported having no knowledge of hepatitis B. Having an HBsAg-positive mother (AOR: 2.11), having a history of transcutaneous medical procedures (AOR: 2.97) and living with a family (AOR: 4.63) were significantly associated with HBV status. Age ≥26 years appeared as a protective factor (AOR = 0.41). CONCLUSION: Our study detected a high, 14.87% prevalence of HBV infection among students in N'djamena, Chad, and shed light on its associated factors. HBV prevention strategies should include raising awareness among students, making full hepatitis vaccination mandatory before children begin school, promoting mass screening to identify and treat chronic HBV carriers and reduce transmission, and reducing the cost of vaccination.

On the contribution of the top and bottom walls in micro-pillar array columns and related high-aspect ratio chromatography systems.

We report on a steady-state based, and hence highly accurate numerical modelling study of the effect of the top and bottom wall in the current generation of micro-pillar array columns. These have a mesoporous retention layer that not only covers the pillar walls but also the bottom wall. Our results show that the performance of these columns can in general not be improved by also covering the top wall with the same layer, despite the increased column symmetry this approach would offer. The reason for this is that the local species retardation caused by a retentive layer is much stronger than the pure flow arresting effect of an uncovered wall. At least, this has a crucial impact in high aspect-ratio systems such as micro-pillar array columns because these require a small inter-pillar distance to promote mass transfer together with a large channel depth to enable a sufficiently high flow rate. On the other hand, a notable improvement could be made if micro-pillar array would be produced without having a retentive layer at the bottom. At Péclet number Pe = 50 and aspect ratio AR = 5 for flow-channels, this gain amounts up to about 4.5 h-units at a zone retention factor k'' = 2 and 1.75 h-units at k'' = 16 (gain scales almost linearly with Pe). To verify these results, we also considered another high aspect-ratio system with a simplified geometry: the open-tubular channel with a flat-rectangular cross-section. This led to very similar observations, thus confirming the findings for the micro-pillar array. The results produced in the present study also allow us to conclude that the classic modelling paradigm adopted in chromatography, which is based on the independency and hence additivity of the hCm- and hCs-contributions, can lead to large modelling errors in chromatographic systems with a high aspect-ratio, even when their geometry is so simple as that of a straight open-tubular channel with constant cross-section. Indeed, when both zones are treated independently, the analysis misses how the vertical diffusion through the retentive layer helps suppressing the vertical gradients in the mobile zone. The diffusion through this layer occurs in a ratio of k''Ds/Dm (Dm being the diffusion coefficient in mobile phase zone and Ds being the diffusion coefficient in stationary phase zone), such that at high retention factors this diffusion contribution even becomes the dominant one.

Dyeing of advanced denim fabrics (blend of cotton/bicomponent polyester filaments) using different processes and artificial intelligence method.

Denim clothes are the must-have items of clothing around the world. This kind of fabrics is evolving with the increasing consumer demand in order to keep its place as a versatile article. In this context, this paper contributes to the development and dyeing of a new blend fabric made of cotton fibers and bicomponent polyester filaments (PET/PTT). A comparative study between the mechanical and thermal properties of this fabric and conventional fabrics has confirmed the great interest to use bicomponent (PET/PTT) filaments in the manufacture of denim fabrics; these bicomponent filaments allow to give to wearer the desired elasticity and comfort. For dyeing (cotton/bicomponent polyester filaments) blend fabric, three different processes, using reactive and disperse dyes, were tested and analyzed. These dyeing processes are: two-baths/two-phases, one-bath/two-phases, and one-bath/one-phase processes. In addition, in order to obtain uniform shades between cotton fibers dyed with reactive dyes and bicomponent polyester filaments dyed with disperse dyes, an ant colony algorithm was elaborated to predict the optimal dye recipes. By observing obtained results, the developed algorithm is very effective; it allows to find the combination of reactive dyes necessary to achieve the same shade obtained by the disperse dyes with very small color differences between the two components and without having to make corrections mainly for the one-bath/two-phases process. Indeed, dyeing using the two processes (two baths/two phases and one bath/two phases) presents the best values of color yield (K/S) with almost similar results (ΔECMC(2:1) < < 1). For the one-bath/one-phase process, it presents less significant results; We can observe ΔECMC(2:1) greater than 1 in certain shades. This is due to the strongly pH value (basic pH of 11) of reactive dyeing.

Presence of neutralizing SARS-CoV-2 antibodies in asymptomatic population of N'Djamena, Chad.

INTRODUCTION: Neutralizing antibodies (NAbs) are an important specific defence against viral infections, as these antibodies bind to specific receptor(s) and block the viral entry. NAbs assessments are therefore useful in determining individual or herd immunity to SARS-CoV-2. This study aims to deepen the investigation by assessing the positivity rate of neutralizing anti-spike antibodies to understand the real protection of the studied population against SARS-CoV-2. METHODS: This study involved 260 plasma samples from a larger cohort of 2,700 asymptomatic volunteer donors, enrolled between August and October 2021 in health facilities of N'Djamena. In this study four different kits and techniques including the pseudotype assay have been used and compared with detect the SARS-CoV-2 antibodies. Pseudotyped vesicular stomatitis virus (VSV), was used both the identify and measure the NAbs that to evaluate the performance of two cheaper and easy to use commercial kits, specific for the detection of receptor-binding domain antibodies (anti-RBD) against the SARS-CoV-2 spike protein. RESULTS: The VSV spike neutralization assay showed that 59.0% (n = 59) samples were positive for NAbs with titers ranging from 1:10 to 1:4800. While 23 out the 41 negative NAbs samples were detected positive using anti-RBD (Abbott) test. Furthermore, a direct and significant strong correlation was found between NAbs and anti-RBD, specifically with Abbott kit. Taken together, the Roche and Abbott methods indicated agreement at the high concentrations of antibodies with the VSV-pseudovirus method. Abbott and Roche indicated a good sensitivity, but the Abbott system test appeared to have better specificity than the Roche test. CONCLUSION: Our findings indicated a high presence of NAbs against SARS-CoV-2 spike protein among asymptomatic individuals in N'Djamena. This could be one of the reasons for the low severity of Covid-19 observed in this area, given the key role of NAbs in blocking SARS-CoV-2 infection.

Performance characteristics of Allele-Specific PCR (ASPCR) in detecting drug resistance mutations among non-B HIV-1 Variants.

Allele-Specific Polymerase Chain Reaction (ASPCR) is an affordable point-mutation assay whose validation could improve the detection of HIV-1 drug resistance mutations (DRMs) in resource-limited settings (RLS). We assessed the performance of ASPCR onforty-four non-B HIV-1 plasma samples from patients who were ARV treated in failure in N'Djamena-Chad. Viral RNA was reverse-transcribed and amplified using LightCycler® FastStart DNA MasterPLUS SYBR Green I. Detection of six major DRMs (K70R, K103N, Y181C, M184V, T215F, T215Y) was evaluated on Roche LightCycler®480 automated system (with dilutions 0.01-100%). ASPCR-results were compared to Sanger-sequencing (gold-standard). Correlations of mutation curves were excellent (R2 >0.97); all DRMs were detected with desirable mutant/wild-type threshold differences (ΔCt≥9) except K70R(ΔCtK70R=6; ΔCtK103N=13; ΔCtM184V=9; ΔCtT215F=12; ΔCtT215Y=12; ΔCtY181C=9) and positive controls were below required thresholds. Also, ASPCR reproducibility on DRMs was assessed by using dilutions of intra-assay and inter-assay coefficient of variations respectively with a threshold of less than 50(i.e.<0.50 variation) which are;: K70R (0.02-0.28 vs. 0.12-0.37), K103N (0.08-0.42 vs. 0.12-0.37), Y181C (0.12-0.39 vs. 0.31-0.37), M184V (0.13-0.39 vs. 0.23-0.42), T215F (0.05-0.43 vs. 0.04-0.45) and T215Y (0.13-0.41 vs. 0.19-0.41). DRM detection-rate by ASPCR vs Sanger was respectively: M184V (63.6% vs. 38.6%); T215F (18.1% vs. 9.1%); T215Y (6.8% vs. 2.3%); K70R (4.5% vs. 2.3%). K103N (22.7% vs. 13.6%); Y181C (13.6% vs. 11.4%). Correlations of mutation curves were excellent (R2 >0.97); all DRMs were detected with desirable mutant/wild-type threshold differences (ΔCt≥9) except K70R(ΔCtK70R=6; ΔCtK103N=13; ΔCtM184V=9; ΔCtT215F=12; ΔCtT215Y=12; ΔCtY181C=9) and positive controls were below required thresholds. Also, ASPCR reproducibility on DRMs was assessed by using dilutions of intra-assay and inter-assay coefficient of variations respectively with a threshold of less than 50(i.e.<0.50 variation) which are;: K70R (0.02-0.28 vs. 0.12-0.37), K103N (0.08-0.42 vs. 0.12-0.37), Y181C (0.12-0.39 vs. 0.31-0.37), M184V (0.13-0.39 vs. 0.23-0.42), T215F (0.05-0.43 vs. 0.04-0.45) and T215Y (0.13-0.41 vs. 0.19-0.41). DRM detection-rate by ASPCR vs Sanger was respectively: M184V (63.6% vs. 38.6%); T215F (18.1% vs. 9.1%); T215Y (6.8% vs. 2.3%); K70R (4.5% vs. 2.3%). K103N (22.7% vs. 13.6%); Y181C (13.6% vs. 11.4%). ASPCR appears more efficient for detecting DRMs on diverse HIV-1 non-B circulating in RLS like Chad.

Theoretical computation of the band broadening in micro-pillar array columns.

We have investigated the possibility to establish a theoretical plate height expression for the band broadening in the most widely used micro-pillar array column format, i.e., a cylindrical pillar array wherein the pillar walls and the channel bottom are coated with a thin layer of meso­porous material. Assuming isotropic diffusion in the shell-layer, it was found that the vertical diffusive transport along the porous shell-layer covering the pillar walls significantly suppresses the band broadening originating from the vertical migration velocity gradients. As the vertical transport in the shell-layer increases linearly with the retention equilibrium constant K, this leads to an anomalous dependency on the retention factor. Indeed, instead of increasing with k'' and following the classic (1+ak''+bk''2)/(1 + k'')2-dependency governing a classic Taylor-Aris system, the variation of the mobile zone mass transfer resistance term hCm in a 3D pillar array with bottom-wall retention goes through a maximum (resp. factor 1.5 (k''=4) and 2 (k''=16) difference between observed and classic Taylor-Aris behaviour). This effect increases with increasing pillar heights and increasing reduced velocities. Because of this complex k''-dependency, it proves very cumbersome to establish a general plate height equation covering all conditions. Instead, a plate height expression was established that is limited up to k''=4, but remains accurate for higher k''-values for cases where the ratio of pillar height over inter-pillar distance remains below 5. It can however be anticipated the proposed analytical model is only valid in a rather limited range around the presently considered external porosity of ε=0.5.

Computational Fluid Dynamics Study of the Dispersion Caused by Capillary Misconnection in Nano-Flow Liquid Chromatography.

It is well known that high-speed/high-efficiency separations in nano-flow liquid chromatography (LC) are very sensitive to the quality of the connections between the column and the rest of the instrument. In the present study, two types of connection errors (capillary misalignment and the occurrence of an inter-capillary gap) have been investigated using computational fluid dynamics. Interestingly, it has been found that large degrees of capillary misalignment (assuming an otherwise perfect contact between the capillary end-faces) can be afforded without introducing any significant dispersion over the entire range of investigated relative misalignment errors (0 ≤ ε/dcap ≤ 75%), even at the largest flow rates considered in nano-LC. On the other hand, when an inter-capillary gap is present, the dispersion very rapidly increases with the radial width Dc of this gap (extra variance ∼Dcn with n even reaching values above 4). The dependency on the gap length Lc is however much smaller. Results show that, when Dc ≤ 30 µm and Lc ≤ 200 µm, dispersion losses can be limited to the order of 1 nL2 at a flow of 1.5 µL/min, which is generally very small compared to the dispersion in the capillaries (20 µm i.d.) themselves. This result also reconfirms that zero-dead volume connectors with a sufficiently narrow bore can in theory be used without compromising peak dispersion in nano-LC, at least when the capillaries can be matched perfectly to the connector in- and outlet faces. The results are also indicative of the extra dispersion occurring inside microfluidic chips or in the connections between a microfluidic chip and the outer world.

Fundamental investigation of the dispersion caused by a change in diameter in nano liquid chromatography capillary tubing.

We report on a Computational Fluid Dynamics (CFD) study of the extra dispersion caused by the change in diameter when coupling two pieces of capillary tubing with different diameter. In this first investigation into the problem, the focus is on the typical flow rates (0.25≤F≤2µL/min) and diameters (d≤40µm) used in nano-LC, considering both the case of either a doubling or halving of the diameter. The CFD simulations allow to study the problem from a fundamental point of view, i.e., under otherwise perfect conditions (perfect alignment, zero dead-volume). Flow rates, capillary diameters, diffusion coefficients and liquid viscosities have been varied over a range relevant for nano-LC (Reynolds-numbers Re ≤ 1), with also an excursion made towards high-temperature nano-LC conditions (Re ≥ 10 and more). The extra dispersion caused by the change in diameter has been quantified via a volumetric variance σ2conn, defined in such a way that the overall dispersion across the entire capillary system can be easily reconstructed from the known analytical solutions in the individual segments. When the two capillaries are longer than their diffusion entry length, covering most of the practical cases, σ2conn converges to a limiting value σ2conn,∞ which varies to a close approximation with the square of flow rate. Under the investigated nano-LC conditions, the σ2conn,∞-values are surprisingly small (e.g., on the order of 0.01 to 0.15 nL2 in a 20 to 40µm connection) compared to the dispersion occurring in the remainder of the capillaries.

Detailed computational fluid dynamics study of the parameters contributing to the viscous heating band broadening in liquid chromatography at pressures up to 2500 bar in 2.1 mm columns.

Over the past years viscous heating band broadening occurring in high pressure liquid chromatography has been studied extensively. In the present numerical study, we investigate the fine details of this band broadening contribution under extreme high-pressure conditions (2500 bar). To analyze the results, we first show that viscous heating leads to two clearly distinguishable band broadening effects, one originating from the radial differences in the species migration velocity and the other from the axial variations. It was found that the radial contribution is independent of the intrinsic band broadening of the bed (i.e. band broadening in absence of viscous heating) while it strongly depends on the radial dispersion coefficient and the retention enthalpy of the analytes. On the other hand, the axial contribution is strongly dependent on the bed intrinsic band broadening and it is found to be 4 to 5 times lower than the radial contribution. We also show the strong effect of the endfittings on the temperature gradients inside the column thus on the resulting viscous heating band broadening.

Modelling of analyte profiles and band broadening generated by interface loops used in multi-dimensional liquid chromatography.

Currently, the shape and variance of the analyte band entering the second dimension column when injected from an open loop interface in two-dimensional liquid chromatography is not fully understood. This is however important as it is connected to several other variables encountered when developing 2D-LC methods, including the first dimension flow rate, the sampling (modulation) time and the loop volume. Both numerical simulation methods and experimental measurements were used to understand and quantify the dispersion occurring in open tubular interface loops. Variables included are the analyte diffusion coefficient (Dmol), loop filling and emptying rates (Ffill & Fempty), loop inner diameter or radius (Rloop) and loop volume (Vloop). For a straight loop capillary, we find that the concentration profile (as measured at the loop outlet) depends only on a single dimensionless parameter tempty*=VloopFempty·DmolRloop2 and the ratio of the filling and emptying flow rates Fempty/Ffill. A model depending only on these two parameters was developed to predict of the peak variance resulting from the filling and emptying of a straight capillary operated in the first-in-last-out (FILO) modulation mode. Comparison of the concentration profiles and the corresponding variances obtained by either numerical simulation or experiments with straight capillaries shows the results generally agree very well. When the straight capillary is replaced by a tightly coiled loop, significantly smaller (20-40%) peak variances are observed compared to straight capillaries. The magnitude of these decreases is not predicted as well by simulations, however the simulation results are still useful in this case, because they represent an upper boundary (i.e., worst-case scenario) on the predicted variance.

Implementations of temperature gradients in temperature-responsive liquid chromatography.

Temperature Responsive Liquid Chromatography (TRLC) offers an alternative and environmentally friendly way to perform reversed-phase like separations. Its use of temperature responsive polymers to control retention based on column temperature, instead of the fraction of organic modifier in the mobile phase mobile, eliminates the need for solvent composition gradients and allows, for example, for purely aqueous separations. In principle this temperature induced retention should allow for gradient elutions to be performed using downward temperature gradients to control retention and refocus the analyte peaks. Yet, the unavailability of dedicated commercial temperature controlling systems allowing suitable temperature control in TRLC limits implementations thereof often to isothermal or step gradient applications. In this work we study the potential of 1) a simple yet programmable water bath and of 2) a modified HPLC system allowing column temperature programming through controlled mixing of a warm and cold mobile phase streams. The performance of both systems was evaluated under both isocratic and gradient applications, resulting in a more thorough understanding of the influence of temperature gradients in TRLC. This knowledge is then applied to a sample of phenolic solutes, illustrating that, although both systems have some flaws, both are able to impose temperature gradients in TRLC resulting in significantly reduced retention and enhanced refocusing of the analyte peak.

Computational fluid dynamics study of potential solutions to alleviate viscous heating band broadening in 2.1 millimeter liquid chromatography columns.

We report on a numerical simulation study of a number of potential column technology solutions to minimize the plate height contribution (Hvh) originating from the use of ultra-high pressures and their concomitant viscous heating effect. Looking as far as possible into the future of UHPLC, all main results are obtained for the case of a 2500 bar pressure gradient. However, to generalize the result, a correlation is given that can be used to interpolate the results to lower pressures with some 10% accuracy. For the considered case of a 2.1mm column, a liquid flow rate of 0.45 ml/min, an analyte with retention factor k(25°C)=3 and a retention enthalpy chosen such that ΔHR/R= -1000 K, it is found that, in order to keep the global plate height as measured at the column outlet (Hvh,glob,out) below 1 µm, the bed conductivity would need to be raised to λbed=2.4 W/m•K, i.e., 4 times higher than a typical packed bed of fully-porous or core-shell silica particles. An equivalent effect on the band broadening could be obtained if it would be possible to replace the steel column wall with a low conductivity material. In this case, a wall conductivity of 0.25 W/m•K, i.e., 64 times smaller than the conductivity of steel, would be needed to keep Hvh,glob,out below 1 µm. Results are also interpreted based on contour plots of the axial and radial velocity variation of a retained analyte.

[Recrudescence of yellow fever in Chad: case report of the last confirmed case in the health district of Lai-Chad]. / Recrudescence de la fièvre jaune au Tchad: à propos du dernier cas confirmé dans le district sanitaire de Lai-Tchad.

Yellow fever (YF) is a viral haemorrhagic fever caused by yellow fever virus transmitted by Aedes mosquitoes. Since 2013, in Chad, four cases of yellow fever have been detected and confirmed as part of the national fever surveillance program. We here report the last clinical case confirmed in the health district of Lai. The patient was a 57-year-old man with no significant medical and surgical history and unknown immunisation status. He consulted on April 21st, 2020 for fever, moderate to low abundance jaundice and epistaxis (nosebleed) and painful hepatomegaly. Paraclinical examinations, such as RT-PCR, objectified yellow fever virus in post-mortem tissue sample. Thus, confirmed yellow fever cases in this district, the low level of vaccination coverage, the circulation of the virus and the presence of vector in the country should warn of a real threat of reemergence of yellow fever in Chad.

Impact of the first wave of the COVID-19 pandemic on emergency surgical activities at the National Reference University Hospital of N'Djamena.

AIM OF THE WORK: An evaluation of Covid-19 pandemic impact on emergency surgical activities at the CHU-RN in N'Djamena, Chad. METHOD: A retrospective study of patients admitted to the surgical emergency room during the first wave of the pandemic (April-June 2020). The data were compared to those of patients admitted during the same period in 2019 (control group).  Results: A total of 3248 patients were received: 2366 in 2019 and 882 in 2020. Respective reduction of 50% of admissions and 31% of emergency operations were observed. The average age (30 years) and male predominance remained unchanged. The average admission time went from 72 hours in 2019 to 7 days in 2020. We also noticed that digestive emergencies, such as acute generalized peritonitis (6.6% vs 14.4%, p < 0.1) and strangulated hernias (6.6% vs 15.2% p: 0.07) were more severe in 2020. CONCLUSION: COVID-19 had reduced admissions and urgent surgical interventions.

Comparison of the Outcomes of Early Versus Late Tracheostomy in the Treatment of Critically Ill Patients: A Retrospective Multicenter Measurement Study Done in Two Hospital Centers in Lebanon.

Background  Benefits of early tracheostomy (ET) versus late tracheostomy (LT) while treating critically ill patients have been a matter of big debate in the last few years. Several meta-analyses tried to prove the benefits of ET in decreasing the duration of mechanical ventilation (MV), the length of intensive care unit (ICU) stay, and the mortality rates. However, no clear guidelines are available yet. This study will focus on comparing the outcomes of early tracheostomy versus late one. Methods This is a retrospective study done in two medical and surgical ICUs at "Sacre-Coeur Hospital" and "Rafik Hariri University Hospital" at Beirut, where we reviewed various files of patients who underwent elective tracheostomy for prolonged MV from January 2015 to June 2016. ET and LT were assumed to be procedures performed respectively before and after 10 days of MV. These two groups were subdivided based on the Acute Physiology and Chronic Health Evaluation II (APACHE II) score calculated in the first 24 hours of ICU admission. Data about short- and long-term mortality, the duration of MV, and the length of ICU stay were collected and compared. Results From a total of 45 patients, only 25 patients met the inclusion and exclusion criteria of whom 12 (48%) underwent ET and 13 (52%) patients underwent LT. In patients with APACHE II <25 (6 ET and 6 LT), ET was associated with 50% long-term mortality, 9.6 days mean duration of MV and 23 days mean length of ICU stay compared to 57% (P-value=0.05), 78 days (P-value=0.04) and 79 days (P-value=0.012) of respective parameters in LT groups. In patients with APACHE II >25 (6 ET and 7 LT), ET was associated with 50% long-term mortality, 8.6 days mean duration of MV and 24 days mean length of ICU stay compared to 84%, 105 days, 84 days of respective parameter in LT groups. Conclusions Our results are suggestive of the superiority of ET because it was associated with a reduced duration of MV, a decrease in the length of ICU stay, and, most importantly, a lower long-term mortality rate.

Numerical and experimental investigation of analyte breakthrough from sampling loops used for multi-dimensional liquid chromatography.

Two-dimensional liquid chromatography is increasingly being used to address challenging separations in fields ranging from pharmaceutical analysis to the food industry. A significant impediment to development of more methods is the lack of a complete theoretical foundation upon which sound development decisions can be made. One parameter that is currently not fully understood is the extent of filling of sampling loops in the case where effluent from the first dimension separation is transferred to the second dimension separation through this type of open loop interface. This is a highly important parameter because it is connected to several other variables in a 2D-LC system, including the first dimension flow rate, the sampling (modulation) time, and the loop volume. In this study we have used both numerical simulation methods and experimental measurements to understand the extent to which sampling loops can be filled before a significant fraction of the analyte is lost from the end of the loop. Variables included in the study are the analyte diffusion coefficient (Dmol), loop filling rate (Ffill), loop inner diameter or radius (Rloop) and loop volume (Vloop). For a straight loop capillary we find that analyte breakthrough curves (as measured at the loop outlet) depend only on a single the dimensionless parameter t*=VloopFfill·DmolRloop2 . As a function of this parameter, the fraction of analyte lost from the loop outlet for different extents of loop filling could be calculated, allowing to develop guidelines for the maximum permissible extent of filling before a specified level of analyte loss is reached. Breakthrough measurements using a coiled loop capillary show that less breakthrough is observed compared to the straight capillary at high filling flow rates, presumably due to secondary flows that increase radial dispersion. These measurements enabled the calculation of apparent radial diffusion coefficients for use with coiled capillaries such that the same relation for t* can be used to predict analyte loss due to breakthrough. These results should be very useful to practitioners of 2D-LC, enabling them to make rational decisions about the extent of loop filling on the basis of experimental conditions and analyte type.