Identification of missed viruses by metagenomic sequencing of clinical respiratory samples from Kenya

Pneumonia remains a major cause of mortality and morbidity. Most molecular diagnoses of viruses rely on polymerase chain reaction (PCR) assays that however can fail due to primer mismatch. We investigated the performance of routine virus diagnostics in Kilifi, Kenya, using random-primed viral next generation sequencing (viral NGS) on respiratory samples which tested negative for the common viral respiratory pathogens by a local standard diagnostic panel. Among 95 hospitalised pneumonia patients and 95 household-cohort individuals, analysis of viral NGS identified at least one respiratory-associated virus in 35 (37%) and 23 (24%) samples, respectively. The majority (66%; 42/64) belonged to the Picornaviridae family. The NGS data analysis identified a number of viruses that were missed by the diagnostic panel (rhinovirus, human metapneumovirus, respiratory syncytial virus and parainfluenza virus), and these failures could be attributed to PCR primer/probe binding site mismatches. Unexpected viruses identified included parvovirus B19, enterovirus D68, coxsackievirus A16 and A24 and rubella virus. The regular application of such viral NGS could help evaluate assay performance, identify molecular causes of missed diagnoses and reveal gaps in the respiratory virus set used for local screening assays. The results can provide actionable information to improve the local pneumonia diagnostics and reveal locally important viral pathogens.

Cost-effectiveness analysis of implementing an integrated neonatal care kit to reduce neonatal infection in rural Pakistan

ObjectiveTo evaluate the cost-effectiveness of distribution of the integrated neonatal care kit (iNCK) by community health workers from the healthcare payer perspective in Rahimyar Khan, Pakistan.SettingRahimyar Khan, Pakistan.ParticipantsN/A.InterventionCost-utility analysis using a Markov model based on cluster randomised controlled trial (cRCT: NCT 02130856) data and a literature review. We compared distribution of the iNCK to pregnant mothers to local standard of care and followed infants over a lifetime horizon.Primary and secondary outcome measuresThe primary outcome was incremental net monetary benefit (INMB, at a cost-effectiveness threshold of US$15.50), discounted at 3%. Secondary outcomes were life years, disability-adjusted life years (DALYs) and costs.ResultsAt a cost-effectiveness threshold of US$15.50, distribution of the iNCK resulted in lower expected DALYs (28.7 vs 29.6 years) at lower expected cost (US$52.50 vs 55.20), translating to an INMB of US$10.22 per iNCK distributed. These results were sensitive to the baseline risk of infection, cost of the iNCK and the estimated effect of the iNCK on the relative risk of infection. At relative risks of infection below 0.79 and iNCK costs below US$25.90, the iNCK remained cost-effective compared with current local standard of care.ConclusionThe distribution of the iNCK dominated the current local standard of care (ie, the iNCK is less costly and more effective than current care standards). Most of the cost-effectiveness of the iNCK was attributable to a reduction in neonatal infection.

Caatinga Albedo Preserved and Replaced by Pasture in Northeast Brazil

The caatinga is considered South America’s largest seasonally dry tropical forest (SDTF) and one of the most vulnerable endemic biomes in relation to climate change. The surface albedo in caatinga is relevant to understanding the role of this biome in the climate of the Northeast region of Brazil. Thus, a comparative analysis was conducted between the albedos of preserved and anthropized caatinga (pasture). Data were collected using CNR4-type net radiometers during the dry and rainy seasons. The mean albedo values were higher in the Pasture both in the dry and rainy season, with values of 0.181 and 0.177, respectively. In the caatinga, the mean albedo values were 0.137 in the dry season and 0.146 in the rainy season. The hourly average values for albedo, taken between 6:30 a.m. and 4 p.m., with intervals of 30 min, were also higher in the pasture. For convenience, this study uses local standard time (LST), which is 3 h behind from coordinated universal time (UTC). The greatest dispersions in the frequencies of the mean hourly albedo values occurred in the early morning and late afternoon. Some of the consequences of this study is the confirmation that there is an increase in albedo in caatinga replaced by pasture and this causes a reduction in the net radiation and also the finding that a region where there is adequate pasture management also enables albedo management and from solar radiation. And that further studies can indicate the impacts on temperature and precipitation, especially in warmer periods during the dry season.

Phonological Variation and Change in European French

We discuss here the considerable amount of phonological variation and change in European French in the varieties spoken in France, Belgium, and Switzerland, the major francophone countries of Europe. The data discussed here derive from the perceptual and especially behavioral studies that have sought to extend the Labovian paradigm beyond Anglo-American variable linguistic phenomena to bear upon Romance. Regarding France, what emerges is a surprisingly high degree of uniformity in pronunciation, at least over the non-southern part of the country, and most Southern French varieties are also showing convergence to the Parisian norm. Pockets of resistance to this tendency are nevertheless observable. The Belgian and Swiss situations have in common the looming presence of a supralocal and indeed supranational norm playing a role often attested in other discussions of standard or legitimized languages, that of the variety representing what commonly corresponds to the nonlocal. Indeed, it may be that Belgium and Switzerland typify the local–standard relation most often reported, while the French situation, because of its relatively leveled character, is less easily described as one of standardization.

Hemoglobin A2 and Heterogeneous Diagnostic Relevance Observed in Eight New Variants of the Delta Globin Gene

Background: Hemoglobin A (Hb A) (α2β2) in the normal adult subject constitutes 96–98% of hemoglobin, and Hb F is normally less than 1%, while for hemoglobin A2 (Hb A2) (α2δ2), the normal reference values are between 2.0 and 3.3%. It is important to evaluate the presence of possible delta gene mutations in a population at high risk for globin gene defects in order to correctly diagnose the β-thalassemia carrier. Methods: The most used methods for the quantification of Hb A2 are based on automated high performance liquid chromatography (HPLC) or capillary electrophoresis (CE). In particular Hb analyses were performed by HPLC on three dedicated devices. DNA analyses were performed according to local standard protocols. Results: Here, we described eight new δ-globin gene variants discovered and characterized in some laboratories in Northern Italy in recent years. These new variants were added to the many already known Hb A2 variants that were found with an estimated frequency of about 1–2% during the screening tests in our laboratories. Conclusions: The knowledge recognition of the delta variant on Hb analysis and accurate molecular characterization is crucial to provide an accurate definitive thalassemia diagnosis, particularly in young subjects who would like to ask for a prenatal diagnosis or preimplantation genetic diagnosis.

Soft Power In the politics and reform process of China (1978-1992)

China is one of the rare world events that almost every country in the world has unforgettable. This may become the basis for the development of economic, political and ideological methods within a short and precise time frame. China has developed from a primitive agricultural country such as life cycle, medical care, education and local standard management to a country with strong economic, scientific and technological strength. Regional and international norms have transformed China from a ruined and despised country into a valuable international political force. While influencing the international and regional political equations, it also puts the world’s powerful countries first. This is the application of soft power in politics and international relations, enabling them to obtain basic materials for establishing and strengthening local politics and conducting social, scientific, military, and technological reforms while voluntarily joining the bondage. And closed the door on a regional and international scale. Establish standards and establish opaque diplomatic relations with different continents. Through these standards, they can ensure the market for their products and provide the necessary energy for the production process they initiate.

YIELD COMPONENTS EVALUATION IN CHICKPEA GERMPLASM COLLECTION, GROWN IN AKMOLA REGION, KAZAKHSTAN

Germplasm collection of chickpea (Cicer arietinum L.) originated from various countriies andecology was evaluated in field trial conditions of Akmola region. The analysis of yield components among germplasm accessionswas carried out according to local standard indicators of productivity. The following genotypes are recommended for yield breeding in Kazakhstan based on the current research: ICC-8515 (Greece); ICC-12947, ICC-1431, ICC-456, ICC-1205, and ICC-5337 (India); ICC-3776, ICC-1083, ICC-13283, ICC-13764, and ICC-13187 (Iran); ICC-15697 (Syria); and ICC-7272 (Algeria). The recommended germplasm accessions were identified asthe most adapted for cultivation in environment of Akmola region and, therefore, they can be used as ainitial genetic resourse for breeding of chickpea varieties with ‘Northern-ecotype’. Hybrid populations were produced in the crossings between International and domestic chickpea germplasms. The offspring segregations in chickpea hybrid populations represent perspective and important genetic resorses for selection of superious genotypes with high yield and tolerance to drought. Finally, the best selected breeding lines are expected to be introduced into domestic chickpea breeding programs in Kazakhstan.

CROP ADAPTATION TO CLIMATE CHANGE: High-Temperature Stress in Drought-Prone Areas

The papers presented in this special issue are focused on the development of mutant lines and new crop varieties of rice and common bean with improved adaptation to climate change. Also included are the development or adaptation of screening techniques that enable efficient selection of desired phenotypes in plant breeding programmes. The breeding methods used are based on mutation induction and mutation detection, where mutation induction is via physical mutagenesis using gamma and X-ray irradiation. Selection for improved mutant lines is achieved through screening for plant performance in the laboratory, green house and field under hight temperature and/or drought stress. The papers presented are the result of a 5-year coordinated research project (CRP) on Climate Proofing Crops: Genetic Improvement for Adaptation to High Temperatures in Drought Prone Areas and Beyond, funded by the IAEA. The CRP, initiated in 2011, focused on tolerance to increased temperatures in rice and common bean. All participating countries generated new mutant populations in rice and bean and identified heat-tolerant lines with better yields than local standard varieties

1359 Everyone Deserves to Smile: An Audit on The Success Rate of Dental Implants in Complex Maxillofacial Patients

Aim To determine the success rates of dental implants in complex patients treated in the Oral and Maxillofacial Surgery Department at Rotherham General Hospital (RGH). Method All patients who received dental implants in the period January 2010 – March 2017 at RGH were included in the audit. Standards 90% local standard Results 68 dental implants were placed in 22 patients: 15 patients head and neck reconstruction, 5 atrophic edentulous patients, 2 trauma. Conclusions Survival rates for dental implants in the literature is variable ranging from 91 -96% in native bone and mucosa and 46 - 98% in irradiated tissue.