Concurrent Acquisition of a Single Nucleotide Polymorphism in Diverse Influenza H5N1 Clade 2.2 Sub-clades

Highly pathogenic Influenza A H5N1 was first identified in Guangdong Province in 1996, followed by human cases in Hong Kong in 1997. The number of confirmed human cases now exceeds 300, and the associated Case Fatality Rate exceeds 60%. The genetic diversity of the serotype continues to increase. Four distinct clades or sub-clades have been linked to human cases. The gradual genetic changes identified in the sub-clades have been attributed to copy errors by viral encoded polymerases that lack an editing function, thereby resulting in antigenic drift. We report here the concurrent acquisition of the same polymorphism by multiple, genetically distinct, clade 2.2 sub-clades in Egypt, Russia, and Ghana. These changes are not easily explained by the current theory of “random mutation” through copy error, and are more easily explained by recombination with a common source. This conclusion is supported by additional polymorphisms shared by clade 2.2 isolates in Egypt and Germany

Aggregation of Single Nucleotide Polymorphisms in a Human H5N1 Clade 2.2 Hemagglutinin

The evolution of H5N1 has attracted significant interest 1-4 due to linkages with avian 5,6 and human infections 7,8. The basic tenets of influenza genetics 9 attribute genetic drift to replication errors caused by a polymerase complex that lacks a proof reading function. However, recent analysis 10 of swine influenza genes identifies regions copied with absolute fidelity for more than 25 years. In addition, polymorphism tracing of clade 2.2 H5N1 single nucleotide polymorphisms identify concurrent acquisition 11 of the same polymorphism onto multiple genetic backgrounds in widely dispersed geographical locations. Here we show the aggregation of regional clade 2.2 polymorphisms from Germany, Egypt, and sub-Sahara Africa onto a human Nigerian H5N1 hemagglutinin (HA), implicating recombination in the dispersal and aggregation of single nucleotide polymorphisms from closely related genomes

Aggregation of Single Nucleotide Polymorphisms in a Human H5N1 Clade 2.2 Hemagglutinin

The rapid evolution of the H5N1 serotype of avian influenza has been explained by a mechanism involving the selection of single nucleotide polymorphisms generated by copy errors. The recent emergence of H5N1 Clade 2.2 in fifty countries, offered a unique opportunity to view the acquisition of new polymorphism in these evolving genomes. We analyzed the H5N1 hemagglutinin gene from a fatal human case from Nigeria in 2007. The newly emerged polymorphisms were present in diverse H5N1 isolates from the previous year. The aggregation of these polymorphisms from clade 2.2 sub-clades was not supported by recent random mutations, and was most easily explained by recombination between closely related sequences

Qatar welcomes the Extracorporeal Life Support Organisation South and West Asia Chapter 2017 Conference

Extracorporeal Life Support (ECLS) is saving an increasing number of lives worldwide, 1 so it is a great pleasure to welcome for the first time in Qatar the South and West Asia Chapter (SWAC) of the Extracorporeal Life Support Organisation (ELSO). The conference organizing and scientific committees have worked tirelessly under the leadership of Dr Ibrahim Fawzy Hassan (2017 Conference Chair) to make ELSO SWAC 2017 an enriching event that will help progress ECLS in the region. For this special occasion, the SWAC ELSO 2017 submission editorial team (AAH, AS, GA, CC, TM) is pleased to have been able to publish all accepted abstracts in this special issue of the Qatar Medical Journal (QMJ) as a legacy of everyone's efforts and commitment to contribute to saving lives. The vast majority of the abstracts are invited contributions from selected clinicians who are bringing specific knowledge and expertise to the conference and to the pre-conference workshops. The submissions received as part of the call for abstracts are presented at the end of this QMJ issue and been presented either as short oral or poster presentations during the conference. All submissions have been subjected to a rigorous peer review process involving a team of reviewers with a range of subject expertise and to whom we are grateful. Overall, this QMJ special issue represents the scientific contributions from over 150 authors from 17 countries

Outcome of Rhabdomyosarcoma in First Year of Life: Children’s Cancer Hospital 57357 Egypt

Background. Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma in children. Fifty percent of RMS cases occur in the first 10 years of life and less commonly in infants younger than one-year old. These infants require adapted multimodality treatment approaches. Patients and Methods. We analyzed patients' characteristics, treatment modalities, and the outcome for RMS infants treated at Children's Cancer Hospital Egypt (CCHE) between July 2007 and December 2010 and compared them to patients above one year treated on the same protocol. Results. Out of the 126 RMS treated during this period, 18 were below the age of one year. The male: female ratio was 1.25 : 1. The median age at diagnosis was 0.7 ± 0.2 years. Most of the cases (27.8%) were presented in head and neck regions. The estimated 4-years failure-free survival and overall survival for infants were 49 ± 12% and 70 ± 12%, respectively. These failure-free survival rate and overall survival rate did not differ from those for older patients (P = 0.2). Conclusion. Infants with RMS are a unique group of RMS who needs special concerns in tailoring treatment in addition to concerns regarding toxicity and morbidity in infants

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Shear Behavior and Design of High Strength Concrete Prestressed Bridge Girders

A simple semi-empirical set of equations was developed at the University of Houston (UH) to predict the shear strength of PC I-girders with normal-strength concrete. The UH-developed equation is a function of concrete strength, web area, shear span to effective depth ratio, and percentage of transverse steel. This research intends to validate or modify the UH-developed equation for (1) high-strength concrete and (2) different sizes of PC girders and studying the possibility of premature failure due to local failure in end zone. Ten modified Tx28 PC girders, derived by scaling down an existing TxDOT cross section, were tested in this study for the first objective. The girders were divided into three groups (Groups A, C and F) based on the concrete strength. Each group of the PC girders was tested with different shear span to effective depth ratio. The validity of the proposed UH-developed equations was ascertained using the experimental results. It was found able to predict accurately the ultimate shear strength of PC girders with concrete strength up to 117 MPa (17,000 psi) with enough ductility. Six PC girders of Tx-series with three different sizes were tested for the second objective. The girders were divided into three groups (Groups D, E and G) based on the girder depth. The experimental results ensured the validity of the UH-developed equations for PC girders with different sizes. Also, the experimental data showed that the PC girders of the new Tx-series can reach the maximum shear capacity without a shear-bond failure. The results of testing the 10 modified Tx-28 girders were used to validate a finite element program developed at UH, Simulation of Concrete Structures (SCS), for PC girders with different concrete strength. Analytical results presented in this dissertation proved the validity of SCS to predict the behavior of PC girders with different concrete strength up to 117 MPa (17,000 psi).Civil and Environmental Engineering, Department o