Global phylogeny of Treponema pallidum lineages reveals recent expansion and spread of contemporary syphilis

Syphilis, which is caused by the sexually transmitted bacterium Treponema pallidum subsp. pallidum, has an estimated 6.3 million cases worldwide per annum. In the past ten years, the incidence of syphilis has increased by more than 150% in some high-income countries, but the evolution and epidemiology of the epidemic are poorly understood. To characterize the global population structure of T. pallidum, we assembled a geographically and temporally diverse collection of 726 genomes from 626 clinical and 100 laboratory samples collected in 23 countries. We applied phylogenetic analyses and clustering, and found that the global syphilis population comprises just two deeply branching lineages, Nichols and SS14. Both lineages are currently circulating in 12 of the 23 countries sampled. We subdivided T. p.pallidum into 17 distinct sublineages to provide further phylodynamic resolution. Importantly, two Nichols sublineages have expanded clonally across 9 countries contemporaneously with SS14. Moreover, pairwise genome analyses revealed examples of isolates collected within the last 20 years from 14 different countries that had genetically identical core genomes, which might indicate frequent exchange through international transmission. It is striking that most samples collected before 1983 are phylogenetically distinct from more recently isolated sublineages. Using Bayesian temporal analysis, we detected a population bottleneck occurring during the late 1990s, followed by rapid population expansion in the 2000s that was driven by the dominant T. pallidum sublineages circulating today. This expansion may be linked to changing epidemiology, immune evasion or fitness under antimicrobial selection pressure, since many of the contemporary syphilis lineages we have characterized are resistant to macrolides.

Comparative study of renal drainage with different ureteral stents subject to extrinsic ureteral obstruction using an in vitro ureter-stent model

Background To compare the efficacy of different ureteral stents subject to extrinsic ureteral obstruction (EUO), in a controlled in vitro stented ureter experiment. Methods We employ an in vitro ureter-stent experimental set-up, with latex tubing simulating flexible ureters attached to vessels simulating renal units and bladders. The flow behavior of five ureteral stents—polymeric 8F, tandem 6F, tandem 7F, endopyelotomy and metal—was tested under a ureteral deformation configuration of 40°, with 2000 g external force over a 3.5 cm length of the ureter. A constant fluid flow was applied through the ureter-stent configurations, and pressure fluctuations in the renal unit were monitored. We considered a renal unit pressure of 10 cmH2O or flow discontinuation in the bladder as stent failure. Urine containing debris was mimicked by use of a colloidal solution. Results Of all assessed ureteral stents, under EUO conditions, only the single 8F stents remained patent throughout the length of the experiment. All other stents—tandem 6F and 7F, single 7F, metal and endopyelotomy—displayed limitations. Conclusions Tandem and metal stents show no superiority over large luminal polymeric stents for EUO treatment in this in vitro model. Larger luminal stents offer excellent resistance to external pressure and allow adequate colloidal flow. The need for frequent exchange and bladder irritation should also be considered in the choice of stent configuration for treatment of kidney drainage under EUO.

New intergeneric orchid hybrid found in Romania × Pseudorhiza nieschalkii (Senghas) P.F.Hunt nothosubsp. siculorum H.Kertész & N.Anghelescu, 2020

We describe the first reported intergeneric, which naturally occurs between two subspecies belonging to different genera, Dactylorhiza fuchsii subsp. sooana (genus Dactylorhiza) and Pseudorchis albida subsp. tricuspis (genus Pseudorchis), as × Pseudorhiza nieschalkii (Senghas) P.F.Hunt nothosubsp. siculorum H.Kertész & N.Anghelescu, 2020. The hybrid was found and digitally photographed for the first time by Hajnalka Kertész in June, 2020, within Terra Siculorum, in one of the Natura 2000 protected areas, known as Harghita Mădăraș, ROSCI00090. Following detailed morphometric analysis using 67 characters and molecular karyological analyses, we identified this unique specimen as an intergeneric hybrid, new to science. The hybrid, an F1 generation plant, most likely representing a single intergeneric pollination event, is phenotypically intermediate between its parental species in most of the characters scored, but it significantly closely resembles Pseudorchis albida subsp. tricuspis parent. Since several individuals of the parental species occurred in near proximity, within 1–10 meters distance, we suggest that the production of this hybrid required a minimum travel distance of ca 1–10 meters, by the pollinators and frequent exchange of pollen between the parental species was very likely. The parental species and the hybrid, which display a considerable synchronicity in their flowering time, overlap in the pollinator community, sharing various species of Hymenopterans and Dipterans, very abundant in the heathland. This Terra Siculorum hybrid is thus best described as a rarely occurring intergeneric hybrid that shows strong Pseudorchis albida subsp. tricuspis parental dominance in inheritance patterns.

Contemporary syphilis is characterised by rapid global spread of pandemic Treponema pallidum lineages

Syphilis is an important sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. The last two decades have seen syphilis incidence rise in many high-income countries, yet the evolutionary and epidemiological relationships that underpin this are poorly understood, as is the global T. pallidum population structure. We assembled a geographically and temporally diverse collection of clinical and laboratory samples comprising 726 T. pallidum genomes. We used detailed phylogenetic analysis and clustering to show that syphilis globally can be described by only two deeply branching lineages, Nichols and SS14. We show that both of these lineages can be found circulating concurrently in 12 of the 23 countries sampled. To provide further phylodynamic resolution we subdivided Treponema pallidum subspecies pallidum into 17 distinct sublineages. Importantly, like SS14, we provide evidence that two Nichols sublineages have expanded clonally across 9 countries contemporaneously with SS14. Moreover, pairwise genome analysis showed that recent isolates circulating in 14 different countries were genetically identical in their core genome to those from other countries, suggesting frequent exchange through international transmission pathways. This contrasts with the majority of samples collected prior to 1983, which are phylogenetically distinct from these more recently isolated sublineages. Bayesian temporal analysis provided evidence of a population bottleneck and decline occurring during the late 1990s, followed by a rapid population expansion a decade later. This was driven by the dominant T. pallidum sublineages circulating today, many of which are resistant to macrolides. Combined we show that the population of contemporary syphilis in high-income countries has undergone a recent and rapid global expansion.

Additional carbon stabilization in temperate subsoils impeded by biogeochemical and hydraulic constraints

<p>Formation of mineral-associated organic matter (MAOM) is a decisive process in the stabilization of OM against rapid microbial decomposition and thus in the soils’ role as global carbon (C) sink. Sorption experiments of dissolved OM (DOM) repeatedly showed that particularly mineral subsoils have a large sorption capacity to retain more C. However, there is also an increasing body of literature, revealing an increasing output of dissolved organic C (DOC) from soils. Here, we investigated into this paradox in forest soil under beech by a combination of a field labelling experiment with <sup>13</sup>C-enriched litter with a unique DO<sup>13</sup>C and <sup>13</sup>CO<sub>2</sub> monitoring, an in-situ C exchange experiment with <sup>13</sup>C-coated minerals, and batch sorption experiments.</p><p>Within two years of <sup>13</sup>C monitoring, only 0.5% of litter-derived DO<sup>13</sup>C entered the subsoil, where it was only short-term stabilized by formation of MAOM but prone to fast microbial mineralization. The <sup>13</sup>C monitoring, sorption/desorption experiments in the laboratory, and also the in-situ C exchange on buried soil minerals revealed that there is a frequent exchange of DOM with native OM and a preferential desorption of recently retained OM. Hence, there appeared to be a steady-state equilibrium between C input and output, facilitated by exchange and microbial mineralization of an adopted microbial community. The remobilized OM was also richer in less sorptive carbohydrates. Along with transport of most of DOM along preferential paths, this further increased the discrepancy between laboratory-measured sorption capacities of subsoil and the actual C loading of minerals. Finally, the <sup>13</sup>C labeling experiments revealed that input of fresh litter-derived OM into subsoil may even mobilize old-soil derived OM. Hence, in the field different biogeochemical constraints are acting that prevent that the laboratory-based C sink can be reached in the field.  We conclude, that forest subsoils can hardly be considered as additional C sink, even at management options that increase DOC input to subsoil.</p>

Contrasting Hydrodynamic Responses to Atmospheric Systems with Different Scales: Impact of Cold Fronts vs. That of a Hurricane

In this paper, subtidal responses of Barataria Bay to an atmospheric cold front in 2014 and Hurricane Barry of 2019 are studied. The cold fronts had shorter influencing periods (1 to 3 days), while Hurricane Barry had a much longer influencing period (about 1 week). Wind direction usually changes from southern quadrants to northern quadrants before and after a cold front’s passage. For a hurricane making its landfall at the norther Gulf of Mexico coast, wind variation is dependent on the location relative to the location of landfall. Consequently, water level usually reaches a trough after the maximum cold front wind usually; while after the maximum wind during a hurricane, water level mostly has a surge, especially on the right-hand side of the hurricane. Water level variation induced by Hurricane Barry is about 3 times of that induced by a cold front event. Water volume flux also shows differences under these two weather types: the volume transport during Hurricane Barry was 4 times of that during a cold front. On the other hand, cold front events are much more frequent (30–40 times a year), and they lead to more frequent exchange between Barataria Bay and the coastal ocean.

× Pseudorhiza nieschalkii (Senghas) P.F.Hunt nothosubsp. siculorum H.Kertész & N.Anghelescu, 2020 A Intergeneric Orchid Hybrid New to Science

We describe the first reported intergeneric hybrid to naturally occur between two subspecies belonging to different genera, Dactylorhiza fuchsii subsp. sooana (genus Dactylorhiza) and Pseudorchis albida subsp. tricuspis (genus Pseudorchis), as × Pseudorhiza nieschalkii (Senghas) P.F.Hunt nothosubsp. siculorum H.Kertész & N.Anghelescu, 2020. The hybrid was found and digitally photographed for the first time by Hajnalka Kertész in June, 2020, within Terra Siculorum, in one of the Natura 2000 protected areas, known as Harghita Mădăraș, ROSCI00090. Following detailed morphometric analysis using 67 characters and molecular karyological analyses, we identified this unique specimen as an intergeneric hybrid, new to science. The hybrid, an F1 generation plant, most likely representing a single intergeneric pollination event, is phenotypically intermediate between its parental species in most of the characters scored, but it significantly closely resembles Pseudorchis albida subsp. tricuspis parent. Since the parental species occurred in near proximity (1-10 meters distance), we suggest that the production of this hybrid required a minimum travel distance of ca 1-10 meters, by the pollinators and frequent exchange of pollen between the parental species was very likely.

× Pseudorhiza nieschalkii (Senghas) P.F.Hunt nothosubsp. siculorum H.Kertész & N.Anghelescu, 2020 AN INTERGENERIC ORCHID HYBRID NEW TO SCIENCE FOUND IN TERRA SICULORUM, ROMANIA

We describe the first reported intergeneric hybrid to naturally occur between two subspecies belonging to different genera, Dactylorhiza fuchsii subsp. sooana (genus Dactylorhiza) and Pseudorchis albida subsp. tricuspis (genus Pseudorchis), as × Pseudorhiza nieschalkii (Senghas) P.F.Hunt nothosubsp. siculorum H.Kertész & N.Anghelescu, 2020. The hybrid was found and digitally photographed for the first time by Hajnalka Kertész in June, 2020, within Terra Siculorum, in one of the Natura 2000 protected areas, known as Harghita Mădăraş, ROSCI00090. Following detailed morphometric analysis using 67 characters and molecular karyological analyses, we identified this unique specimen as an intergeneric hybrid, new to science. The hybrid, an F1 generation plant, most likely representing a single intergeneric pollination event, is phenotypically intermediate between its parental species in most of the characters scored, but it significantly closely resembles Pseudorchis albida subsp. tricuspis parent. Since the parental species occurred in near proximity (1-10 meters distance), we suggest that the production of this hybrid required a minimum travel distance of ca 1-10 meters, by the pollinators and frequent exchange of pollen between the parental species was very likely. The parental species and the hybrid, which display a considerable synchronicity in their flowering time, overlap in pollinator community, sharing various species of Hymenopterans and Dipterans, very abundant in the heathland. This Terra Siculorum hybrid is thus best described as a rarely occurring intergeneric hybrid that shows strong Pseudorchis albida subsp. tricuspis parental dominance in inheritance patterns.

Chamada para a inclusão da educação para a diversidade por meio das culturas-línguas no Ensino Fundamental I da escola pública

Este artigo apresenta os conceitos básicos que sustentam uma educação para a diversidade no ensino Fundamental I no Brasil por meio da descoberta da diversidade das culturas-línguas como campo de saber transdisciplinar. As descobertas sonoras e visuais de várias culturas-línguas nacionais e não nacionais introduzem naturalmente a diversidade pela escuta de um outro ser diferente. A variedade das culturas-línguas se torna então um catalisador didático da diversidade global do mundo, compondo assim o eixo didático transdisciplinar que visa, coletivamente, à alteridade como supra objetivo educativo. Desta maneira, cada campo de saber escolar pode expressar a diversidade intrínseca da origem dos saberes humanos que o constituem. Nesta abordagem educativa, a alteridade, necessária para a paz social, ultrapassa as fronteiras nacionais para alcançar os outros locutores diferentes no mundo destacando, de forma precoce e simultânea, a identidade humana comum e a riqueza das diferenças. De forma concreta, o artigo sugere alguns conteúdos didáticos de uma abordagem da diversidade do 1º ao 5º ano do Ensino Fundamental elaborados de maneira a incluir gradativamente a complexidade do mundo (do próximo para o distante) e as interligações constantes com os outros saberes escolares (matemática, história, biologia, geografia, etc.). A mutação societal para um convívio mais harmonioso e equitativo passa por uma metamorfose da escola que vem a considerar a alteridade como aprendizagem humanista primordial, presidindo as abordagens dos outros componentes escolares. Esta mutação depende também de uma parceria estreita entre escola e família na qual se valorizaria a troca frequente de competências e experiências de cada sujeito.Palavras-chave: Diversidade. Culturas. Línguas.Call for inclusion of education for diversity through cultures language in elementary education of public schoolABSTRACTThis article presents the basic concepts that support an education for diversity in Elementary Education in Brazil through the discovery of cultures-languages diversity as a transdisciplinary field of knowledge. The sound and visual discoveries of various national and non-national cultures languages naturally introduce diversity through another different human being. The variety of cultures-languages then becomes a didactic catalyst of the world diversity, thus composing the transdisciplinary didactic axis that collectively aims at alterity as a supra educational goal. Therefore, each field of knowledge at school can express the intrinsic diversity of the origin of the human knowledge that constitutes it. In this educational approach, alterity, which is necessary for social peace, goes beyond national boundaries to reach the other different speakers in the world, highlighting, at an early stage, the common human identity and the richness of differences. Specifically, the article suggests didactic contents of an approach of diversity from 1st to 5th year of Elementary School, elaborated in a way that gradually includes the complexity of the world (from a near to distant perspective) and the constant interconnections with the other school knowledge (Mathematics, History, Biology, Geography, etc.). The societal transformation to a more harmonious and equitable conviviality depends on a metamorphosis of the school that begins to consider alterity as primordial humanistic learning, presiding over the approaches of other school subjects. This mutation also depends on a close partnership between school and family in which the frequent exchange of skills and experiences of each subject is valued.Keywords: Diversity. Cultures. Languages.Llamada para la inclusión de la educación a la diversidad a través de las culturas-lenguas en la Escuela PrimariaRESUMENEse artículo presenta a los conceptos básicos que apoyan une educación para la diversidad en la Escuela Primaria en Brasil através del descubrimiento de la diversidad de las culturas-lenguas como área de conocimiento transdisciplinaria. Las descubiertas sonoras y visuales de varias culturas-lenguas nacionales y no nacionales introducen naturalmente a la diversidad a través de otro ser diferente. La variedad de las culturas-lenguas se vuelve por lo tanto en catalizador didáctico de la diversidad global del mondo así componiendo el eje didáctico transdisciplanario que suele lograr colectivamente a la alteridad como supra meta educativa. De este modo, cada área de conocimiento académico puede expresar la diversidad intrínseca del origen des les conocimientos humanos que la constituyen. Con ese enfoque académico, la alteridad, necesaria para la paz social, excede las fronteras nacionales para alcanzar a otros interlocutores diferentes del mondo subrayando, de modo precoz y simultaneo, la identidad humana común y la riqueza de las diferencias. De forma concreta, el articulo sugiere algunos contenidos didácticos de un planteamiento de la diversidad del 1º hasta el 5º año de la Escuela Primaria elaborado de modo a incluir gradualmente la complejidad del mondo (de su alrededor hasta más lejos) y las interconexiones constantes con los otros conocimientos académicos (matemáticas, historia, biología, geografía, etc.). La conversión societal hacia una convivencia más harmoniosa y ecuánime sucede a una metamorfosis de la escuela que empieza a considerar a la alteridad como enseñanza humanista primordial presidiendo los enfoques de los otros componentes académicos. Esa mutación depende también de una asociación estrecha entre escuela y familia en la cual se valora el intercambio frecuente de competencias y experiencias de cada sujeto.Palabras clave: Diversidad. Culturas. Lenguas.

Bilio-pancreatic endoscopy during COVID-19 pandemic

On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown etiology detected in Wuhan (Hubei Province of China). In January 2020, a new coronavirus named SARS-CoV2 was isolated and, since that time, SARS-CoV2 related disease (COVID-19) rapidly spread all over the world becoming pandemic in March 2020. The COVID-19 outbreak dramatically affected the public-health and the health-care facilities organization. Bilio-pancreatic endoscopy is considered a high-risk procedure for cross-contamination and, even though it is not directly involved in COVID-19 diagnosis and management, its reorganization is crucial to guarantee high standards of care minimizing the risk of SARS-CoV2 transmission among patients and health-care providers. Bilio-pancreatic endoscopic procedures often require a short physical distance between the endoscopist and the patient for a long period of time, a frequent exchange of devices, the involvement of a large number of personnel, the use of complex endoscopes difficult to reprocess. On this basis, endoscopic units should take precautions with adjusted management of bilio-pancreatic endoscopy. The aim of this article is to discuss the approach to bilio-pancreatic endoscopy in the COVID-19 era with focus on diagnostic algorithms, indications, management of the endoscopic room, proper use of Personal Protective Equipment and correct reprocessing of instrumentation.