University Ferhat Abbas of Setif

<h3>Importance</h3> Liver cancer is among the leading causes of cancer deaths globally. The most common causes for liver cancer include hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and alcohol use. <h3>Objective</h3> To report results of the Global Burden of Disease (GBD) 2015 study on primary liver cancer incidence, mortality, and disability-adjusted life-years (DALYs) for 195 countries or territories from 1990 to 2015, and present global, regional, and national estimates on the burden of liver cancer attributable to HBV, HCV, alcohol, and an “other” group that encompasses residual causes. <h3>Design, Settings, and Participants</h3> Mortality was estimated using vital registration and cancer registry data in an ensemble modeling approach. Single-cause mortality estimates were adjusted for all-cause mortality. Incidence was derived from mortality estimates and the mortality-to-incidence ratio. Through a systematic literature review, data on the proportions of liver cancer due to HBV, HCV, alcohol, and other causes were identified. Years of life lost were calculated by multiplying each death by a standard life expectancy. Prevalence was estimated using mortality-to-incidence ratio as surrogate for survival. Total prevalence was divided into 4 sequelae that were multiplied by disability weights to derive years lived with disability (YLDs). DALYs were the sum of years of life lost and YLDs. <h3>Main Outcomes and Measures</h3> Liver cancer mortality, incidence, YLDs, years of life lost, DALYs by etiology, age, sex, country, and year. <h3>Results</h3> There were 854 000 incident cases of liver cancer and 810 000 deaths globally in 2015, contributing to 20 578 000 DALYs. Cases of incident liver cancer increased by 75% between 1990 and 2015, of which 47% can be explained by changing population age structures, 35% by population growth, and −8% to changing age-specific incidence rates. The male-to-female ratio for age-standardized liver cancer mortality was 2.8. Globally, HBV accounted for 265 000 liver cancer deaths (33%), alcohol for 245 000 (30%), HCV for 167 000 (21%), and other causes for 133 000 (16%) deaths, with substantial variation between countries in the underlying etiologies. <h3>Conclusions and Relevance</h3> Liver cancer is among the leading causes of cancer deaths in many countries. Causes of liver cancer differ widely among populations. Our results show that most cases of liver cancer can be prevented through vaccination, antiviral treatment, safe blood transfusion and injection practices, as well as interventions to reduce excessive alcohol use. In line with the Sustainable Development Goals, the identification and elimination of risk factors for liver cancer will be required to achieve a sustained reduction in liver cancer burden. The GBD study can be used to guide these prevention efforts.

Humans express a wide array of ideal mate preferences. Around the world, people desire romantic partners who are intelligent, healthy, kind, physically attractive, wealthy, and more. In order for these ideal preferences to guide the choice of actual romantic partners, human mating psychology must possess a means to integrate information across these many preference dimensions into summaries of the overall mate value of their potential mates. Here we explore the computational design of this mate preference integration process using a large sample of n = 14,487 people from 45 countries around the world. We combine this large cross-cultural sample with agent-based models to compare eight hypothesized models of human mating markets. Across cultures, people higher in mate value appear to experience greater power of choice on the mating market in that they set higher ideal standards, better fulfill their preferences in choice, and pair with higher mate value partners. Furthermore, we find that this cross-culturally universal pattern of mate choice is most consistent with a Euclidean model of mate preference integration.

Several studies have invested in machine learning classifiers to protect plants from diseases by processing leaf images. Most of the proposed classifiers are trained and evaluated with small datasets, focusing on the extraction of hand-crafted features from image to classify the leaves. In this study, we have used a large dataset compared to the state-of-the art. Here, the dataset contains 14,828 images of tomato leaves infected with nine diseases. To train our classifier, we have introduced the Convolutional Neural Network (CNN) as a learning algorithm. One of the biggest advantages of CNN is the automatic extraction of features by processing directly the raw images. To analyze the proposed deep model, we have used visualization methods to understand symptoms and to localize disease regions in leaf. The obtained results are encouraging, reaching 99.18% of accuracy, which ourperforms dramatically shallow models, and they can be used as a practical tool for farmers to protect tomato against disease.

Natural dyes have been used from ancient times for multiple purposes, most importantly in the field of textile dying. The increasing demand and excessive costs of natural dye extraction engendered the discovery of synthetic dyes from petrochemical compounds. Nowadays, they are dominating the textile market, with nearly 8 × 105 tons produced per year due to their wide range of color pigments and consistent coloration. Textile industries consume huge amounts of water in the dyeing processes, making it hard to treat the enormous quantities of this hazardous wastewater. Thus, they have harmful impacts when discharged in non-treated or partially treated forms in the environment (air, soil, plants and water), causing several human diseases. In the present work we focused on synthetic dyes. We started by studying their classification which depended on the nature of the manufactured fiber (cellulose, protein and synthetic fiber dyes). Then, we mentioned the characteristics of synthetic dyes, however, we focused more on their negative impacts on the ecosystem (soil, plants, water and air) and on humans. Lastly, we discussed the applied physical, chemical and biological strategies solely or in combination for textile dye wastewater treatments. Additionally, we described the newly established nanotechnology which achieves complete discharge decontamination.

In this article, we assess the structural equivalence of the Zimbardo Time Perspective Inventory (ZTPI) across 26 samples from 24 countries ( N = 12,200). The ZTPI is proven to be a valid and reliable index of individual differences in time perspective across five temporal categories: Past Negative, Past Positive, Present Fatalistic, Present Hedonistic, and Future. We obtained evidence for invariance of 36 items (out of 56) and also the five-factor structure of ZTPI across 23 countries. The short ZTPI scales are reliable for country-level analysis, whereas we recommend the use of the full scales for individual-level analysis. The short version of ZTPI will further promote integration of research in the time perspective domain in relation to many different psycho-social processes.

BACKGROUND: For more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions. METHODS: The GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010-23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution. FINDINGS: Total numbers of global DALYs grew 6·1% (95% UI 4·0-8·1), from 2·64 billion (2·46-2·86) in 2010 to 2·80 billion (2·57-3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0-14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31-1·61) global DALYs in 2010, increasing to 1·80 billion (1·63-2·03) in 2023, alongside a concurrent 4·1% (1·9-6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176-209] DALYs), stroke (157 million [141-172]), and diabetes (90·2 million [75·2-107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0-107·5]), depressive disorders (26·3% [11·6-42·9]), and diabetes (14·9% [7·5-25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837-917) in 2010 to 681 million (642-736) in 2023, and a 25·8% (22·6-28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7-61·0) for diarrhoeal diseases, 42·9% (38·0-48·0) for HIV/AIDS, and 42·2% (23·6-56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6-22·0) and 24·8% (7·4-36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7-19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18-1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation-with high SBP accounting for 8·4% (6·9-10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories-behavioural, metabolic, and environmental and occupational-risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8-37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0-11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023-eg, declining by 54·4% (38·7-65·3) for unsafe sanitation, 50·5% (33·3-63·1) for unsafe water source, and 45·2% (25·6-72·0) for no access to handwashing facility, and by 44·9% (37·3-53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [-2·7 to 15·6]; non-significant). INTERPRETATION: Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors-eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG-including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic-the complex interaction of multiple health risks, social determinants, and systemic challenges-will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity. FUNDING: Gates Foundation and Bloomberg Philanthropies.

In this paper, we present a direct power control (DPC) of three-phase pulsewidth modulation rectifier with constant switching frequency using space-vector modulation (SVM). The developed DPC scheme is based on the predictive control strategy to achieve direct control of instantaneous active and reactive power of the converter. For this purpose, at the beginning of each switching period, the required rectifier average voltage vector allowing the cancellation of active and reactive power tracking errors, at the end of the switching period, is calculated by means of predictive control algorithm in the sense of deadbeat control. The main advantages of the proposed control, compared to the works published in this subject, are that no need to use predefined switching table and voltage vector or virtual flux position, PI-based active and reactive power control loops are not necessary and constant-switching frequency. The proposed predictive direct power control was tested both in simulations and experimentally and compared with DPC using switching table. Results have proved excellent performance, and verify the validity of the proposed DPC scheme, which is much better than conventional DPC using switching table.

This paper focuses on the study of the effect of chemical treatments of fibers by alkalization on the flexural properties of polyester matrix composite reinforced with natural fibers. The used reinforcement consists of Alfa fiber, extracted from the plant Stippa tenacissima from Hodna Region (Algeria). Alfa fibers are subjected to alkali treatments with NaOH at 1, 5 and 10% for a period of 0, 24, and 48 h to 28 °C. The composites reinforced with layers of Alfa random costituente a rate of 40% by weight. Influence of alkaline treatments on the flexural properties is studied to determine the optimum conditions of alkaline treatment. The experimental results show that the bending behavior of composites made from alkali treated fibers are better compared to the untreated fiber composite, For a fiber processing Alfa 10% NaOH in 24 h, the flexural strength and flexural modulus improved by 23 MPa to 57 MPa and from 1.16 to 3.04 GPa. However, the flexural properties of composites decreased after alkali treatment with 5% NaOH for 48 h. This is mainly due to the reduction of lignin that binds the cellulose fibrils together.

Considerable research has examined human mate preferences across cultures, finding universal sex differences in preferences for attractiveness and resources as well as sources of systematic cultural variation. Two competing perspectives—an evolutionary psychological perspective and a biosocial role perspective—offer alternative explanations for these findings. However, the original data on which each perspective relies are decades old, and the literature is fraught with conflicting methods, analyses, results, and conclusions. Using a new 45-country sample ( N = 14,399), we attempted to replicate classic studies and test both the evolutionary and biosocial role perspectives. Support for universal sex differences in preferences remains robust: Men, more than women, prefer attractive, young mates, and women, more than men, prefer older mates with financial prospects. Cross-culturally, both sexes have mates closer to their own ages as gender equality increases. Beyond age of partner, neither pathogen prevalence nor gender equality robustly predicted sex differences or preferences across countries.

BACKGROUND: Timely and comprehensive analyses of causes of death stratified by age, sex, and location are essential for shaping effective health policies aimed at reducing global mortality. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides cause-specific mortality estimates measured in counts, rates, and years of life lost (YLLs). GBD 2023 aimed to enhance our understanding of the relationship between age and cause of death by quantifying the probability of dying before age 70 years (70q0) and the mean age at death by cause and sex. This study enables comparisons of the impact of causes of death over time, offering a deeper understanding of how these causes affect global populations. METHODS: GBD 2023 produced estimates for 292 causes of death disaggregated by age-sex-location-year in 204 countries and territories and 660 subnational locations for each year from 1990 until 2023. We used a modelling tool developed for GBD, the Cause of Death Ensemble model (CODEm), to estimate cause-specific death rates for most causes. We computed YLLs as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. Probability of death was calculated as the chance of dying from a given cause in a specific age period, for a specific population. Mean age at death was calculated by first assigning the midpoint age of each age group for every death, followed by computing the mean of all midpoint ages across all deaths attributed to a given cause. We used GBD death estimates to calculate the observed mean age at death and to model the expected mean age across causes, sexes, years, and locations. The expected mean age reflects the expected mean age at death for individuals within a population, based on global mortality rates and the population's age structure. Comparatively, the observed mean age represents the actual mean age at death, influenced by all factors unique to a location-specific population, including its age structure. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 250-draw distribution for each metric. Findings are reported as counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2023 include a correction for the misclassification of deaths due to COVID-19, updates to the method used to estimate COVID-19, and updates to the CODEm modelling framework. This analysis used 55 761 data sources, including vital registration and verbal autopsy data as well as data from surveys, censuses, surveillance systems, and cancer registries, among others. For GBD 2023, there were 312 new country-years of vital registration cause-of-death data, 3 country-years of surveillance data, 51 country-years of verbal autopsy data, and 144 country-years of other data types that were added to those used in previous GBD rounds. FINDINGS: The initial years of the COVID-19 pandemic caused shifts in long-standing rankings of the leading causes of global deaths: it ranked as the number one age-standardised cause of death at Level 3 of the GBD cause classification hierarchy in 2021. By 2023, COVID-19 dropped to the 20th place among the leading global causes, returning the rankings of the leading two causes to those typical across the time series (ie, ischaemic heart disease and stroke). While ischaemic heart disease and stroke persist as leading causes of death, there has been progress in reducing their age-standardised mortality rates globally. Four other leading causes have also shown large declines in global age-standardised mortality rates across the study period: diarrhoeal diseases, tuberculosis, stomach cancer, and measles. Other causes of death showed disparate patterns between sexes, notably for deaths from conflict and terrorism in some locations. A large reduction in age-standardised rates of YLLs occurred for neonatal disorders. Despite this, neonatal disorders remained the leading cause of global YLLs over the period studied, except in 2021, when COVID-19 was temporarily the leading cause. Compared to 1990, there has been a considerable reduction in total YLLs in many vaccine-preventable diseases, most notably diphtheria, pertussis, tetanus, and measles. In addition, this study quantified the mean age at death for all-cause mortality and cause-specific mortality and found noticeable variation by sex and location. The global all-cause mean age at death increased from 46·8 years (95% UI 46·6-47·0) in 1990 to 63·4 years (63·1-63·7) in 2023. For males, mean age increased from 45·4 years (45·1-45·7) to 61·2 years (60·7-61·6), and for females it increased from 48·5 years (48·1-48·8) to 65·9 years (65·5-66·3), from 1990 to 2023. The highest all-cause mean age at death in 2023 was found in the high-income super-region, where the mean age for females reached 80·9 years (80·9-81·0) and for males 74·8 years (74·8-74·9). By comparison, the lowest all-cause mean age at death occurred in sub-Saharan Africa, where it was 38·0 years (37·5-38·4) for females and 35·6 years (35·2-35·9) for males in 2023. Lastly, our study found that all-cause 70q0 decreased across each GBD super-region and region from 2000 to 2023, although with large variability between them. For females, we found that 70q0 notably increased from drug use disorders and conflict and terrorism. Leading causes that increased 70q0 for males also included drug use disorders, as well as diabetes. In sub-Saharan Africa, there was an increase in 70q0 for many non-communicable diseases (NCDs). Additionally, the mean age at death from NCDs was lower than the expected mean age at death for this super-region. By comparison, there was an increase in 70q0 for drug use disorders in the high-income super-region, which also had an observed mean age at death lower than the expected value. INTERPRETATION: We examined global mortality patterns over the past three decades, highlighting-with enhanced estimation methods-the impacts of major events such as the COVID-19 pandemic, in addition to broader trends such as increasing NCDs in low-income regions that reflect ongoing shifts in the global epidemiological transition. This study also delves into premature mortality patterns, exploring the interplay between age and causes of death and deepening our understanding of where targeted resources could be applied to further reduce preventable sources of mortality. We provide essential insights into global and regional health disparities, identifying locations in need of targeted interventions to address both communicable and non-communicable diseases. There is an ever-present need for strengthened health-care systems that are resilient to future pandemics and the shifting burden of disease, particularly among ageing populations in regions with high mortality rates. Robust estimates of causes of death are increasingly essential to inform health priorities and guide efforts toward achieving global health equity. The need for global collaboration to reduce preventable mortality is more important than ever, as shifting burdens of disease are affecting all nations, albeit at different paces and scales. FUNDING: Gates Foundation.

Climate change is having short- and long-term impacts on surface and groundwater in the northern part of the African continent. This has led to a wide range of consequences that have added pressure on the groundwater systems in this part of the world. Among such pressures, we can cite the mal-distribution and the irregularity of precipitation and ice, flooding, evaporitic sediments input by the drainage net, water degradation, mud stagnation in dams, dead tranche, drought, decreasing of the natural recharge and increasing of the groundwater abstraction, conflict between trans-boundary waters, desertification, imbalance between the regions, migration, revolution, socio-economic imbalance, etc. Actually, water-monitoring networks indicate noticeable hydrogeologic variations and a rise of the groundwater salinity. It was confirmed by the geochemical analysis of water resources that showed scattered data between the northern part characterized by low mineralized groundwater (TDS ranging 0.4–3 g/l) and the southern area where the salinity ranges from 2.5 to 90 g/l. The obtained values are far above the permissible limits for both human consumption, agricultural and tourist activities. These effects, when compounded, are anticipated to worsen the situation and to constitute veritable threats for social and economic development in these regions of North Africa (Morocco, Algeria, Tunisia, Libya, Egypt, etc.). The potential solutions consist of taking urgent to utilize the intelligent technology (bio and nano-technology), policies relevant policies to manage water resources, and the engagement of private, civil, and international sectors if a major crisis is to be averted (collective effort).

In this work, we studied the aptitude to sintering green bodies using γ-Al2O3 transition alumina as raw powder. We focused on the influence of the heating rate on densification and microstructural evolution. Phase transformations from transition alumina γ → δ → θ → α-Al2O3 were studied by in situ X-rays diffraction from the ambient to 1200 °C. XRD patterns revealed coexistence of various phase transformations during the heating cycle. DTA and dilatometry results showed that low heating rate leads to a significant reduction of the temperature of the α-Al2O3 alumina formation. Around 1190, 1217 and 1240 °C were found when using 5, 10 and 20 °C/min of heating rate, respectively. The activation energy for θ-Al2O3 → α-Al2O3 transformation calculated by Kissinger and JMA equations using dilatometry method were 464.29 and 488.79 kJ/mol, respectively and by DTA method were 450.72 and 475.49 kJ/mol, respectively. In addition, the sintering of the green bodies with low heating rate promotes the rearrangement of the grains during θ-Al2O3 → α-Al2O3 transformation, enhancing the relative density to 95% and preventing the development of a vermicular structure. En este trabajo, se ha estudiado la capacidad de sinterización de muestras en verde a partir de γ-Al2O3 de transición en forma de polvo. El trabajo se ha focalizado en la influencia de la velocidad de calentamiento sobre la densificación y la evolución microestructural. Las transformaciones de fase de alúminas de transición γ→δ→θ→α-Al2O3 se han estudiado in situ mediante Difracción de Rayos X (DRX) desde temperatura ambiente hasta 1.200 °C. Los diagramas de XRD han revelado la coexistencia de diversas transformaciones de fase durante el ciclo de calentamiento. Los Análisis Térmicos Diferenciales (ATD) realizados y los datos de dilatometría han mostrado que velocidades de calentamiento bajas conducen a una reducción significativa de la temperatura de formación de α-Al2O3. Detectándose alrededor de 1.190, 1.217 y 1.240 °C cuando se utilizan 5, 10 y 20 °C/min como velocidad de calentamiento, respectivamente. La Energía de Activación para la transformación θ-Al2O3→α-Al2O3 calculada mediante las ecuaciones de Kissinger y JMA usando métodos dilatometricos han sido 464,29 y 488,79 kJ/mol, respectivamente, y mediante ATD 450,72 y 475,49 kJ/mol, respectivamente. Además, la sinterización con velocidad de calentamiento baja promueve la reorganización de los granos durante la transformación θ-Al2O3 → α-Al2O3, el aumento de la densidad relativa al 95% y la prevención del desarrollo de una estructura vermicular.

Primary diabetes care and diabetic retinopathy (DR) screening persist as major public health challenges due to a shortage of trained primary care physicians (PCPs), particularly in low-resource settings. Here, to bridge the gaps, we developed an integrated image-language system (DeepDR-LLM), combining a large language model (LLM module) and image-based deep learning (DeepDR-Transformer), to provide individualized diabetes management recommendations to PCPs. In a retrospective evaluation, the LLM module demonstrated comparable performance to PCPs and endocrinology residents when tested in English and outperformed PCPs and had comparable performance to endocrinology residents in Chinese. For identifying referable DR, the average PCP's accuracy was 81.0% unassisted and 92.3% assisted by DeepDR-Transformer. Furthermore, we performed a single-center real-world prospective study, deploying DeepDR-LLM. We compared diabetes management adherence of patients under the unassisted PCP arm (n = 397) with those under the PCP+DeepDR-LLM arm (n = 372). Patients with newly diagnosed diabetes in the PCP+DeepDR-LLM arm showed better self-management behaviors throughout follow-up (P < 0.05). For patients with referral DR, those in the PCP+DeepDR-LLM arm were more likely to adhere to DR referrals (P < 0.01). Additionally, DeepDR-LLM deployment improved the quality and empathy level of management recommendations. Given its multifaceted performance, DeepDR-LLM holds promise as a digital solution for enhancing primary diabetes care and DR screening.

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000-2018 geospatial estimates of anemia prevalence in women of reproductive age (15-49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization's Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.

International audience

In this paper an intelligent method of maximum power point tracking (MPPT) using fuzzy logic control for stand-alone photovoltaic (PV) system has been presented. The PV system is composed of PV solar array, buck DC-DC converter, and MPPT controller. Fuzzy logic controller (FLC) is easy to implement, and does not need knowledge of the exact model of the system. Simulation results compared with those obtained by the conventional perturbation and observation (P&O) technique show the effectiveness of the fuzzy logic controller during steady-state and varying weather conditions.

This paper proposes a novel and simple direct power control (DPC) scheme of a three-phase pulsewidth-modulated rectifier without the use of a predefined switching table. The converter switching state selection is based on fuzzy logic rules, using the instantaneous active and reactive power tracking errors as fuzzy logic variables. The basic idea of fuzzy rules synthesis is based on the knowledge of the instantaneous variation of active and reactive power. According to the input fuzzy variables and in a specific moment, the best switching state of the converter is chosen to restrict the instantaneous active and reactive power tracking errors simultaneously, for maintaining the DC-bus voltage close to the reference value and guarantying the unity-power-factor operation. The main advantages of the proposed DPC scheme, compared to the classical one, are that it is not necessary to use hysteresis comparators, and smooth control of active and reactive power is obtained during all sectors. Finally, the developed DPC was tested both in simulations and experimentally, and illustrative results are presented here. Results have proven excellent performance, and verify the validity of the proposed DPC scheme which is much better than the classical DPC.

Ant colony algorithm is an intelligent optimization algorithm that is widely used in path planning for mobile robot due to its advantages, such as good feedback information, strong robustness and better distributed computing. However, it has some problems such as the slow convergence and the prematurity. This article introduces an improved ant colony algorithm that uses a stimulating probability to help the ant in its selection of the next grid and employs new heuristic information based on the principle of unlimited step length to expand the vision field and to increase the visibility accuracy; and also the improved algorithm adopts new pheromone updating rule and dynamic adjustment of the evaporation rate to accelerate the convergence speed and to enlarge the search space. Simulation results prove that the proposed algorithm overcomes the shortcomings of the conventional algorithms.

Polylactic acid (PLA) is an attractive candidate for replacing petrochemical polymers because it is from renewable resources. In this study, a specific PLA 2002D was melt-mixed with two plasticizers: triethyl citrate (TEC) and acetyl tributyl citrate (ATBC). The plasticized PLA with various concentrations were analyzed by differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA), melt flow index (MFI), thermogravimetric analysis (TGA), X-ray diffraction (XRD), UV-Visible spectroscopy and plasticizer migration test. Differential scanning calorimetry demonstrated that the addition of TEC and ATBC resulted in a decrease in glass transition temperature (Tg), and the reduction was the largest with the plasticizer having the lowest molecular weight (TEC). Plasticizing effect was also shown by decrease in the dynamic storage modulus and viscosity of plasticized mixtures compared to the treated PLA. The TGA results indicated that ATBC and TEC promoted a decrease in thermal stability of the PLA. The X-ray diffraction showed that the PLA have not polymorphic crystalline transition. Analysis by UV-Visible spectroscopy showed that the two plasticizers: ATBC and TEC have no effect on the color change of the films. The weight loss plasticizer with heating time and at 100°C is lesser than at 135 °C. Migration of TEC and ATBC results in cracks and changed color of material. We have concluded that the higher molecular weight of citrate in the studied exhibited a greater plasticizing effect to the PLA.

Importance: Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning. Objective: To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates. Evidence Review: The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019. Findings: In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia. Conclusions and Relevance: In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts.