Gradual emergence followed by exponential spread of the SARS-CoV-2 Omicron variant in Africa.

The geographic and evolutionary origins of the SARS-CoV-2 Omicron variant (BA.1), which was first detected mid-November 2021 in Southern Africa, remain unknown. We tested 13,097 COVID-19 patients sampled between mid-2021 to early 2022 from 22 African countries for BA.1 by real-time RT-PCR. By November-December 2021, BA.1 had replaced the Delta variant in all African sub-regions following a South-North gradient, with a peak Rt of 4.1. Polymerase chain reaction and near-full genome sequencing data revealed genetically diverse Omicron ancestors already existed across Africa by August 2021. Mutations, altering viral tropism, replication and immune escape, gradually accumulated in the spike gene. Omicron ancestors were therefore present in several African countries months before Omicron dominated transmission. These data also indicate that travel bans are ineffective in the face of undetected and widespread infection

Retraction.

This is a retraction of 'Gradual emergence followed by exponential spread of the SARS-CoV-2 Omicron variant in Africa' 10.1126/science.add873

Reducing Decision to Incision Time Interval for Emergency Cesarean Sections: 24 Months’ Experience from Rural Sierra Leone

Background: This study aimed at describing the changes in the completeness of documentation and changes in decision to incision time interval of emergency cesarean sections after an audit and feedback project a rural hospital in Sierra Leone. Methods: We documented and monitored the decision and incision times for emergency cesarean sections over the course of two years. Year one focused on the introduction of the project and year two focused on the continuous monitoring of the project. We compared the completeness of decision to incision data and used the 30-min benchmark as target for the decision to incision time interval. Results: A total of 762 emergency cesarean sections were included. While the completion of decision time data (72%) did not change between the two reporting periods, documentation of incision time increased from 95% to 98% (p < 0.001). Complete documentation for both decision and incision time was available for 540 (70.9%) emergency cesarean sections. The decision to incision time interval decreased from 105 min to 42 min (p < 0.001). The proportion of cesarean sections started within 30 min increased from 8.5% to 37% (p < 0.001). Conclusion: Although not all cesarean sections were performed within the 30-min threshold, the decision to incision interval decreased significantly. Improvements in documentation and routine reporting of the decision to incision time interval is recommended

Sap flow and leaf gas exchange response to a drought and heatwave in urban green spaces in a Nordic city

Urban vegetation plays a role in offsetting urban CO2 emissions, mitigating heat through tree transpiration and shading, and acting as deposition surfaces for pollutants. The frequent occurrence of heatwaves and of concurrent drought conditions significantly disrupts the processes of urban trees, particularly their photosynthesis and transpiration rates. Despite the pivotal role of urban tree functioning in delivering essential ecosystem services, the precise nature of their response remains uncertain. We conducted sap flux density (Js) and leaf gas exchange measurements of four tree species (Tilia cordata, Tilia × europaea, Betula pendula, and Malus spp.) located in different urban green areas (Park, Street, Forest, and Orchard) in Helsinki, Finland. Measurements were made over two contrasting summers 2020 and 2021. Summer 2021 experienced a local heatwave and drought, whereas summer 2020 was more typical of Helsinki. In this study, we aimed to understand the responses of urban tree transpiration (measured with sap flux density) and leaf gas exchange to heatwave and drought conditions, and we examined the main environmental drivers controlling the tree transpiration rate during these periods. We observed varying responses of Js during the heatwave period at the four urban sites. When comparing the heatwave and no heatwave periods, a 35 %-67 % increase in Js was observed at the Park, Forest, and Orchard locations, whereas no significant change was seen at the Street site. Our results also showed that Js was higher (31 %-63 %) at all sites under drought conditions compared with non-dry periods. The higher Js values during the heatwave and dry periods were mainly driven by the high atmospheric demand for evapotranspiration, represented by the high vapor pressure deficit (VPD), suggesting that the trees were not experiencing severe enough heat or drought stress that stomatal control would have decreased transpiration. Accordingly, photosynthetic potential (Amax), stomatal conductance (gs), and transpiration (E) at the leaf level did not change during heatwave and drought periods, excluding the Park site where a significant reduction in gs was seen. VPD explained 55 %-69 % of the variation in the daily mean Js during heatwave and drought periods at all sites. At the Forest site, the increase in Js saturated after a certain VPD level, likely due to low soil water availability during these hot and dry periods. Overall, the heat and drought conditions were untypical of the region but not excessive enough to restrict stomatal control and transpiration, indicating that ecosystem services such as cooling were not at risk.Peer reviewe

Flowchart of recruitment of women who enrolled for the MMHW intervention between July 1 and September 30, 2019 in Analamanga, Madagascar.

CHW, community health worker; MMHW, Maternal Mobile Health Wallet.</p

Institutional, interpersonal, and individual level factors influencing the usability and acceptance of the Mobile Maternal Health Wallet among women, facility- (FBHWs) and- community-based (CHWs) health workers.

Institutional, interpersonal, and individual level factors influencing the usability and acceptance of the Mobile Maternal Health Wallet among women, facility- (FBHWs) and- community-based (CHWs) health workers.</p

Factors influencing the usability of the Mobile Maternal Health Wallet by user group.

Factors influencing the usability of the Mobile Maternal Health Wallet by user group.</p

Experiential and motivational characteristics to use the MMHW among women, facility- and community-based health workers.

Experiential and motivational characteristics to use the MMHW among women, facility- and community-based health workers.</p

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Characteristics of target group sensitization activities and their perception among women.

Characteristics of target group sensitization activities and their perception among women.</p