The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Modeling and validation of a parabolic solar collector with a heat pipe absorber

Cylindrical parabolic solar concentrators of small concentration ratio are attractive options for working temperatures around 120 degrees C. The heat gained can be utilized in many applications such as air conditioning, space heating, heating water and many others. These collectors can be easily manufactured and do not need to track the sun continuously. Using a heat pipe as a solar absorber makes the system more compact and easy to install. This study is devoted to modeling a system of cylindrical parabolic solar concentrators of small concentration ratio (around 5) fitted with a heat pipe absorber with a porous wick. The heat pipe is surrounded by evacuated glass tube to reduce thermal losses from the heat pipe. The liquid and vapor flow equations, energy equation, the internal and external boundary conditions were taken into consideration. The system of equations was solved and the numerical results were validated against available experimental and numerical results. The validated heat pipe model was inserted in an evacuated transparent glass tube as the absorber of the cylindrical parabolic collector. A calculation procedure was developed for the system, a computer program was developed and tested and numerical simulations were realized for the whole system. An experimental solar collector of small concentration, fitted with evacuated tube heat pipe absorber was constructed and instrumented. Experiments were realized with the concentrator axis along the E-W direction. Results of the instantaneous efficiency and heat gain were compared with numerical simulations realized under the same conditions and reasonably good agreement was found44299323CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESsem informaçã

Ventilated double glass window with reflective film : modeling and assessment of performance

In the present study, the thermal behavior of a ventilated double glass window with a solar reflective film is numerically investigated and validated against results available in the literature. The objectives of the study are to develop a validated robust thermal model for the ventilated double glass window, make it versatile so that it can incorporate different inserts (such as reflective and absorptive films, etc.), different glass sheets and different fluids and can be integrated with other available design tools. The proposed ventilated double window is composed of two glass sheets separated by a gap forming a channel having a solar reflective film on the internal surface of outer glass sheet. The model is based on the equations of mass, momentum and the energy conservation equations in steady state. Boussinesq approximation is used to evaluate buoyancy term. The discretization of conservative equations is done using the finite volume method. A numerical code is developed and validated against available experimental and numerical results. Thermal performance of the ventilated double glass window is assessed under different conditions and the results show that in order to reduce the heat gain in the internal ambient, the optimum spacing between the glass sheets should be at least 2.5 cm. The solar reflective film in a ventilated double glass window can reduce the penetrating solar energy by about 64.7% in comparison with a traditional double glass window1857288CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQnão te

Enhancement of ice formation around vertical finned tubes for cold storage applications

This paper reports the results of an experimental investigation on the solidification of phase change material (PCM) around a vertical finned tube. The objective is to assess the enhancing effects of the geometrical and operational parameters on the phase change process. The number of fins, fin width, tube wall temperature and mass flow rate of the working fluid were varied and their effects on the phase change parameters were discussed. It is found that the decrease of the tube wall temperature, the increase of the number of fins and width of fins increase the interface position, velocity, solidified mass and reduce the time for complete solidification. The variation of the mass flow rate of the working fluid showed relatively small effects. The study highlights the relative merits of the finned tubes and points out as new contributions the optimum number of fins and the optimum fin width99251263CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA E AO DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO DO MARANHÃO - FAPEMA304372/2016-1não te

Experimental correlations for the solidification and fusion times of PCM encapsulated in spherical shells

This paper reports the results of a study to investigate and develop correlations for the parameters affecting the time for complete solidification and fusion in spherical shells. For this study, four spherical shells of 35, 76, 106 and 131 mm diameter were used, the charging temperature was varied from -20 degrees C to -5 degrees C while the melting temperature varied from 10 degrees C to 25 degrees C. Water and mixtures of water and polyethylene glycol in percentages ranging from 7.5% to 50% were tested. The developed correlation for the time for complete solidification showed an agreement with experiments with maximum difference of about 5.91%. Validation of the correlation of the time for complete fusion showed maximum difference of 7.2% and minimum difference of 0.88% when compared with experimental resultsCONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ304372/2016-