Clinical Validation of the Xpert MTB/RIF test for Identification of the MTB Complex in AFB Smear-Positive MGIT broth cultures

The identification of the M. tuberculosis complex (MTBC) from smear positive broth cultures can be achieved using several methods including both lab-developed and commercially available molecular assays. In the United States, a commercially available probe-based assay has been used for over a decade by many laboratories for identification of MTBC directly from AFB smear positive broth cultures, including those recovered from the MGIT 960 system. However, recent difficulties in obtaining probe kits for identification resulted in mycobacteriology laboratories looking for alternative platforms to provide for rapid identification of MTBC and detection of rifampicin resistance. The Xpert® MTB/RIF test (Cepheid, Sunnyvale, Ca) has shown high sensitivity for the diagnosis of MTBC from pulmonary specimens but is not often used for identification directly from smear positive, MGIT 960 broth cultures (Becton Dickinson, Sparks, Md). We sought to validate the Xpert MTB/RIF test for use with AFB smear positive MGIT 960 cultures in a clinical hospital setting. Overall, the assay showed a categorical agreement of 100% for identification of MTBC and detection of rifampin resistance. No false positive results or cross-reactivity were noted. Findings indicate that the Xpert MTB/RIF test may be suitable as a rapid replacement for identification of MTBC and detection of rifampicin resistance from AFB smear positive MGIT 960 broth cultures.

Rapid replacement of the Beta variant by the Delta variant in South Africa

The Beta variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in South Africa in late 2020 and rapidly became the dominant variant, causing over 95% of infections in the country during and after the second epidemic wave. Here we show rapid replacement of the Beta variant by the Delta variant, a highly transmissible variant of concern (VOC) that emerged in India and subsequently spread around the world. The Delta variant was imported to South Africa primarily from India, spread rapidly in large monophyletic clusters to all provinces, and became dominant within three months of introduction. This was associated with a resurgence in community transmission, leading to a third wave which was associated with a high number of deaths. We estimated a growth advantage for the Delta variant in South Africa of 0.089 (95% confidence interval [CI] 0.084-0.093) per day which corresponds to a transmission advantage of 46% (95% CI 44-48) compared to the Beta variant. These data provide additional support for the increased transmissibility of the Delta variant relative to other VOC and highlight how dynamic shifts in the distribution of variants contribute to the ongoing public health threat.

Life-On-Hold: Lanthanoids Rapidly Induce a Reversible Ametabolic State in Mammalian Cells

Until now, the ability to reversibly halt cellular processes has been limited to cryopreservation and several forms of anabiosis observed in living organisms. In this paper we show that incubation of living cells with a solution containing ~50 mM neodymium induces a rapid shutdown of intracellular organelle movement and all other evidence of active metabolism. We have named this state REEbernation (derived from the terms REE (rare earth elements) and hibernation) and found that the process involves a rapid replacement of calcium with neodymium in membranes and organelles of a cell, allowing it to maintain its shape and membrane integrity under extreme conditions, such as low pressure. Furthermore, phosphate exchange is blocked as a result of non-dissolvable neodymium salts formation, which “discharged” the cell. We further showed that REEbernation is characterized by an immediate cessation of transcriptional activity in observed cells, providing an intriguing opportunity to study a snapshot of gene expression at a given time point. Finally, we found that the REEbernation state is reversible, and we could restore the metabolism and proliferation capacity of the cells. The REEbernation, in addition to being an attractive model to further investigate the basic mechanisms of cell metabolism control, also provides a new method to reversibly place a cell into “on-hold” mode, opening opportunities to develop protocols for biological samples fixation with a minimum effect on the omics profile for biomedical needs.

REACT-1 round 12 report: resurgence of SARS-CoV-2 infections in England associated with increased frequency of the Delta variant

Background England entered a third national lockdown from 6 January 2021 due to the COVID-19 pandemic. Despite a successful vaccine rollout during the first half of 2021, cases and hospitalisations have started to increase since the end of May as the SARS-CoV-2 Delta (B.1.617.2) variant increases in frequency. The final step of relaxation of COVID-19 restrictions in England has been delayed from 21 June to 19 July 2021. Methods The REal-time Assessment of Community Transmision-1 (REACT-1) study measures the prevalence of swab-positivity among random samples of the population of England. Round 12 of REACT-1 obtained self-administered swab collections from participants from 20 May 2021 to 7 June 2021; results are compared with those for round 11, in which swabs were collected from 15 April to 3 May 2021. Results Between rounds 11 and 12, national prevalence increased from 0.10% (0.08%, 0.13%) to 0.15% (0.12%, 0.18%). During round 12, we detected exponential growth with a doubling time of 11 (7.1, 23) days and an R number of 1.44 (1.20, 1.73). The highest prevalence was found in the North West at 0.26% (0.16%, 0.41%) compared to 0.05% (0.02%, 0.12%) in the South West. In the North West, the locations of positive samples suggested a cluster in Greater Manchester and the east Lancashire area. Prevalence in those aged 5-49 was 2.5 times higher at 0.20% (0.16%, 0.26%) compared with those aged 50 years and above at 0.08% (0.06%, 0.11%). At the beginning of February 2021, the link between infection rates and hospitalisations and deaths started to weaken, although in late April 2021, infection rates and hospital admissions started to reconverge. When split by age, the weakened link between infection rates and hospitalisations at ages 65 years and above was maintained, while the trends converged below the age of 65 years. The majority of the infections in the younger group occurred in the unvaccinated population or those without a stated vaccine history. We observed the rapid replacement of the Alpha (B.1.1.7) variant of SARS-CoV-2 with the Delta variant during the period covered by rounds 11 and 12 of the study. Discussion The extent to which exponential growth continues, or slows down as a consequence of the continued rapid roll-out of the vaccination programme, including to young adults, requires close monitoring. Data on community prevalence are vital to track the course of the epidemic and inform ongoing decisions about the timing of further lifting of restrictions in England.

Increased transmissibility and global spread of SARS-CoV-2 variants of concern as at June 2021

We present a global analysis of the spread of recently emerged SARS-CoV-2 variants and estimate changes in effective reproduction numbers at country-specific level using sequence data from GISAID. Nearly all investigated countries demonstrated rapid replacement of previously circulating lineages by the World Health Organization-designated variants of concern, with estimated transmissibility increases of 29% (95% CI: 24–33), 25% (95% CI: 20–30), 38% (95% CI: 29–48) and 97% (95% CI: 76–117), respectively, for B.1.1.7, B.1.351, P.1 and B.1.617.2.

The risk of venipuncture in newborn with severe hemophilia: Case report of a large elbow hemorrhage and literature review of compartment syndrome

Hemophilias are hemorrhagic congenital rare diseases. The gold standard of therapy in hemophilics is the intravenously replacement therapy. We can infuse intravenously plasma derived factors (FVIII for Hemophilia A and FIX for Hemophilia B) or recombinant products (i.e. clotting factor synthetically produced). Venipuncture is not a safe procedure in subjects with hemorrhagic diseases. It is considered an invasive technique with potential massive bleeding and it requires standardized procedures to prevent complications. Local pressure after the procedure (with eventually ice rest) must be always done. In case of bleeding a rapid replacement therapy must be conducted. A severe complication in hemophilia is compartment syndrome. We report a case of massive bleeding in a hemophilic newborn after venipuncture and a literature review of compartment syndrome in hemophiliacs. The aim of this paper is to help physicians in the clinical management to prevent the evolution of a massive bleeding in compartment syndrome.

CẢM THỨC CỦA NGUYỄN DU VỀ TRUNG QUỐC THANH TRIỀU TRONG BẮC HÀNH TẠP LỤC

Nguyen Du (1765-1820), with courtesy name To Nhu, poetic name Thanh Hien, and other pseudonym Hong Son Liep Ho, was born into the noble Nguyen clan of Tien Dien village in central Vietnam. Many of his family members served in high positions in the imperial mandarin system of the Le-Trinh dynasty. Inheriting honors from his father, Nguyen Du was bestowed the titles: Hoang Tin Great Man, Guard Commandant of Origin, and Thu Nhac Count. Therefore, deep within his conscience, Nguyen Du always felt indebted to the Le dynasty. However, the rapid replacement of the Le-Trinh by the Tay Son and then by the Nguyen dynasty during the chaotic years of the eighteen century seriously challenged his beliefs and emotions, pushing him into a reclusive lifestyle during his reluctant service to the Nguyen dynasty. In the 12th year of Gia Long (1813), Nguyen Du was appointed the mission leader on a yearly tribute trip to China, during which he wrote a collection of poetry titled “Bac hanh tap luc” (Trivial Notes on the Northward Trip). His “trivial notes” revealed his complicated thinking and feelings about the Chinese landscape, people and culture under the rule of the Jiaqing emperor. This article analyzes Nguyen Du’s rational and emotional perceptions of China, especially Chinese culture as implied in “Bac hanh tap luc”, to better understand a case of direct interaction of a Vietnamese Confucian scholar with imperial China.

Structural Transformation of Jobs from Manufacturing to Services: Will It Work for India?

India has struggled with the question of what to make in India—manufacturing or services. The Economic Survey 2014–2015 articulated that this was a false choice. Instead, India faced a choice between two disparate types of sectors, unskilled-intensive and skilled-intensive, in both of which India possessed a comparative advantage. Two years down the line, the Economic Survey 2016–2017 suggested that labour-intensive sectors may be more effective in addressing India’s job challenge. The World Economic Outlook Report 2018 has suggested that a rapid replacement in the share of manufacturing jobs by services is likely to have a welfare-enhancing effect on developed and developing economies alike. As the Economic Survey 2014–2015 suggested that this is both a positive and a policy question. This article re-examines this question of manufacturing versus services in the Indian context to contribute to this debate. Specifically, we use the KLEMS India dataset to examine the dynamics of labour productivity associated with (a) a steady shift in the composition of the workforce towards the services sector and (b) investment in human capital proxied by changes in the labour quality index. Contrary to the WEO’s policy prescription, our findings suggest that an increasing prevalence of informal job contracts in services could potentially weaken the positive relationship between labour quality and labour productivity. Additionally, we observe that India’s labour force seems to be rapidly shifting towards services sub-sectors with lower productivity. This mechanism is likely to obstruct any potential gains in productivity, associated with an optimal relocation of factors of production. JEL codes: J21, J24, O14, C31, C33

Research on maintenance tools of wire clamps for live working on Ultra High Voltage transmission lines

Aiming at the problem that the suspension clamp is difficult to be quickly replaced due to the heavy load of the suspension clamp when replacing the transmission line wire suspension clamp in the UHV live operation, this paper develops an auxiliary device for realizing the rapid replacement of the conductor suspension clamp. Through the design of fixtures suitable for the installation of UHV wires and connecting plates, the load transfer of the suspension clamp can be quickly realized, and the suspension clamp can be separated and replaced under the condition of no force. The device is flexible and light, and effectively improves the live working personnel work efficiency.