Improved diagnosis of Trichomonas vaginalis infection by PCR using vaginal swabs and urine specimens compared to diagnosis by wet mount microscopy, culture, and fluorescent staining

Four vaginal cotton swab specimens were obtained from each of 804 women visiting the outpatient sexually transmitted disease clinic of the Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands, for validation of various forms of Trichomonas vaginalis diagnostic procedures. One swab specimen was immediately examined by wet mount microscopy, a second swab was placed in Kupferberg's Trichosel medium for cultivation, and two swabs were placed in phosphate-buffered saline (PBS), pH 7.2. The resulting PBS suspension was used for direct staining with acridine orange and fluorescence microscopy, inoculation of modified Diamond's culture medium, and a PCR specific for T. vaginalis. A total of 70 samples positive in one or more of the tests were identified: 31 (3.8%) infections were detected by wet mount microscopy, and 36 (4.4%) were

Efficiency of stress-adaptive traits chlorophyll fluorescence and membrane thermo- stability in wheat under high temperature

Despite developments in targeted gene sequencing and whole-genome analysis techniques, the robust detection of all genetic variation, including structural variants, in and around genes of interest and in an allele-specific manner remains a challenge. Here we present targeted locus amplification (TLA), a strategy to selectively amplify and sequence entire genes on the basis of the crosslinking of physically proximal sequences. We show that, unlike other targeted re-sequencing methods, TLA works without detailed prior locus information, as one or a few primer pairs are sufficient for sequencing tens to hundreds of kilobases of surrounding DNA. This enables robust detection of single nucleotide variants, structural variants and gene fusions in clinically relevant genes, including BRCA1 and BRCA2, and enables haplotyping. We show that TLA can also be used to uncover insertion sites and sequences of integrated transgenes and viruses. TLA therefore promises to be a useful method in genetic research and diagnostics when comprehensive or allele-specific genetic information is needed

Do we need to rethink our waterways? Values of ageing waterways in current and future society

In the past canals were developed, and some rivers were heavily altered, driven by the need for good transportation infrastructure. Major investments were made in navigation locks, weirs and artificial embankments, and many of these assets are now reaching the end of their technical lifetime. Since then the concept of integrated water resource management (IWRM) emerged as a concept to manage and develop water-bodies in general. Two pressing problems arise from these developments: (1) major reinvestment is needed in order to maintain the transportation function of these waterways, and (2), it is not clear how the implementation of the concept of IWRM can be brought into harmony with such reinvestment. This paper aims to illustrate the problems in capital-intensive parts of waterway systems, and argues for exploring value-driven solutions that rely on the inclusion of multiple values, thus solving both funding problems and stakeholder conflicts. The focus on value in cooperative strategies is key to defining viable implementation strategies for waterway projects

A novel haemocytometric covid-19 prognostic score developed and validated in an observational multicentre european hospital-based study

COVID-19 induces haemocytometric changes. Complete blood count changes, including new cell activation parameters, from 982 confirmed COVID-19 adult patients from 11 European hospitals were retrospectively analysed for distinctive patterns based on age, gender, clinical severity, symptom duration and hospital days. The observed haemocytometric patterns formed the basis to develop a multi-haemocytometric-parameter prognostic score to predict, during the first three days after presentation, which patients will recover without ventilation or deteriorate within a two-week timeframe, needing intensive care or with fatal outcome. The prognostic score, with ROC curve AUC at baseline of 0.753 (95% CI 0.723-0.781) increasing to 0.875 (95% CI 0.806-0.926) on day 3, was superior to any individual parameter at distinguishing between clinical severity. Findings were confirmed in a validation cohort. Aim is that the score and haemocytometry results are simultaneously provided by analyser software, enabling wide applicability of the score as haemocytometry is commonly requested in COVID-19 patients

Pathogen-Specific Circulating Plasmablasts in Patients with Pneumonia

Peer reviewe

Societal Innovation: between dream and reality lies complexity

Jan Rotmans (1961) is one of the founders of Integrated Assessment (IA), and has outstanding experience in IA modeling, scenario-building, uncertainty management and transition management. During the past twenty years he has led a diversity of innovative projects in the field of climate change, global change, sustainable development and transitions and system innovations. He is founder and director of the International Centre for Integrative Studies (ICIS) (1998) at Maastricht University. Since 2004 he is a full professor in Transitions and Transition Management at Erasmus University Rotterdam in the Netherlands, where he founded the DRIFT-institute: Dutch Research Institute For Transitions. He is vice-president of The Integrated Assessment Society (TIAS), and founder and director of the Dutch Knowledge Network on System Innovations and Transitions (KSI). Jan Rotmans is founder of two scientific journals, Environmental Modeling and Assessment and Integrated Assessment, and has published ten books and more than 150 peer-reviewed scientific articles in journals and books in the fields of environment, sustainability, governance, transitions and system innovations.There are no easy, off-the-shelf solutions for persistent societal problems, because these are caused by fundamental flaws in our societal systems. Such systemic errors demand radical changes in our thinking and actions, i.e. transitions and system innovations. Transitions require a long period (one to two generations), and take time, patience, money, confidence, but also courage, daring and perseverance to gain the upper hand over various types of resistance. Research into transitions is by definition multidisciplinary and interdisciplinary. For this we need knowledge and experience from systems analysis, social administration, history, innovation science, economics, business administration and technology. The nature of research into transitions is fundamental, explorative, creative and practical. A conceptual framework for research into transitions is presented that consists of four interlinked conceptual building blocks, which in turn provide an outline of a transition theory in its embryonic stages. These concepts are rooted in common notions from complexity theory, new forms of governance and social theory. Central here is the concept of transition management, for which a new management framework is developed. Transition management is an attempt to tackle persistent stubborn problems by steering them in a more sustainable direction, through a visionary, cyclical process of putting issues on the agenda, learning, orchestrating and experimenting. Not based on management and control but through clever, subtle changes and adjustments at several levels concurrently. Transition management is a very promising management concept that can initially be applied to a wide range of complex societal problems: from health care to energy provision, and from social security to mobility. Transition management can also be applied to complex processes of change in a business context.Voor hardnekkige maatschappelijke problemen bestaan geen pasklare oplossingen. Deze zijn het gevolg van weeffouten in onze maatschappelijke stelsels. Deze systeemfouten vergen radicale veranderingen in ons denken en handelen: transities en systeeminnovaties. Transities vergen een lange periode (1 à 2 generaties), en kosten tijd, geduld, geld, vertrouwen, maar ook moed, durf en doorzettingsvermogen om verschillende soorten weerstand te overwinnen. Onderzoek naar transities is per definitie multi-en interdisciplinair, waarbij kennis nodig is vanuit de systeemkunde, bestuurskunde, geschiedenis, innovatiewetenschappen, economie, bedrijfskunde en techniek. Transitieonderzoek is zowel fundamenteel, exploratief, ontwerpend en praktisch van aard. Een conceptueel kader voor transitieonderzoek wordt gepresenteerd, dat bestaat uit een viertal samenhangende conceptuele bouwstenen, die de contouren vormen van een transitietheorie in wording. Deze concepten zijn geworteld in gemeenschappelijke noties uit de complexiteitstheorie, nieuwe vormen van governance en de sociale theorie. Centraal hierin staat het concept van transitiemanagement, waarvoor een nieuw sturingsraamwerk is ontwikkeld. Transitiemanagement beoogt hardnekkige problemen bij te sturen in een meer duurzame richting, via een visionair, cyclisch proces van agenderen, leren, instrumenteren en experimenteren. Niet op basis van controle en beheersing, maar via slim, subtiel schakelen en bijsturen op meerdere niveaus. Transitiemanagement is een veelbelovend sturingsconcept wat in beginsel toepasbaar is op tal van complexe maatschappelijke problemen: van gezondheidszorg tot energievoorziening, en van sociale zekerheid tot mobiliteit. Ook in de bedrijfscontext kan transitiemanagement worden toegepast op complexe veranderingsprocessen