Wastewater to clinical case (WC) ratio of COVID-19 identifies insufficient clinical testing, onset of new variants of concern and population immunity in urban communities

Clinical testing has been the cornerstone of public health monitoring and infection control efforts in communities throughout the COVID-19 pandemic. With the extant and anticipated reduction of clinical testing as the disease moves into an endemic state, SARS-CoV-2 wastewater surveillance (WWS) is likely to have greater value as an important diagnostic tool to inform public health. As the widespread adoption of WWS is relatively new at the scale employed for COVID-19, interpretation of data, including the relationship to clinical cases, has yet to be standardized. An in-depth analysis of the metrics derived from WWS is required for public health units/agencies to interpret and utilize WWS-acquired data effectively and efficiently. In this study, the SARS-CoV-2 wastewater signal to clinical cases (WC) ratio was investigated across seven different cities in Canada over periods ranging from 8 to 21 months. Significant increases in the WC ratio occurred when clinical testing eligibility was modified to appointment-only testing, identifying a period of insufficient clinical testing in these communities. The WC ratio decreased significantly during the emergence of the Alpha variant of concern (VOC) in a relatively non-immunized community’s wastewater (40-60% allelic proportion), while a more muted decrease in the WC ratio signaled the emergence of the Delta VOC in a relatively well-immunized community’s wastewater (40-60% allelic proportion). Finally, a rapid and significant decrease in the WC ratio signaled the emergence of the Omicron VOC, likely because of the variant’s greater effectiveness at evading immunity, leading to a significant number of new reported clinical cases, even when vaccine-induced community immunity was high. The WC ratio, used as an additional monitoring metric, complements clinical case counts and wastewater signals as individual metrics in its ability to identify important epidemiological occurrences, adding value to WWS as a diagnostic technology during the COVID-19 pandemic and likely for future pandemics.Ontario's Ministry of Environment, Conservation and Parks||Alberta Healt

Emergence and Spread of the SARS-CoV-2 Omicron Variant in Alberta Communities Revealed by Wastewater Monitoring

Wastewater monitoring of SARS-CoV-2 allows for early detection and monitoring of COVID-19 burden in communities and can track specific variants of concern. Targeted assays enabled relative proportions of SARS-CoV-2 Omicron and Delta variants to be determined across 30 municipalities covering >75% of the province of Alberta (pop. 4.5M) in Canada, from November 2021 to January 2022. Larger cities like Calgary and Edmonton exhibited a more rapid emergence of Omicron relative to smaller and more remote municipalities. Notable exceptions were Banff, a small international resort town, and Fort McMurray, a more remote northern city with a large fly-in worker population. The integrated wastewater signal revealed that the Omicron variant represented close to 100% of SARS-CoV-2 burden prior to the observed increase in newly diagnosed clinical cases throughout Alberta, which peaked two weeks later. These findings demonstrate that wastewater monitoring offers early and reliable population-level results for establishing the extent and spread of emerging pathogens including SARS-CoV-2 variants.Alberta Healt

Impacto de las aplicaciones de un mineral bio-activo sobre parametros agronomicos y fitosanitaríos en plantas de banano del grupo cavendish variedad williams a nivel de laboratorio e invernadero

LA INVESTIGACIÓN REALIZADA BUSCA CONOCER CUAL ES EL IMPACTO DE LAS APLICACIONES DE UN MINERAL BIO-ACTIVO SOBRE PARÁMETROS AGRONÓMICOS Y FITOSANITARIOS EN PLANTAS DE BANANO DEL GRUPO CAVENDISH, VARIEDAD WILLIAMS A NIVEL DE LABORATORIO E INVERNADERO, DIRIGIDO A LA OBTENCIÓN DE NUEVAS ALTERNATIVAS EN LA FERTILIZACIÓN Y FITOPROTECCIÓN DEL CULTIVO DEL BANANO. LA INVESTIGACIÓN SE ENFOCA EN VALIDAR LA HIPÓTESIS DE QUE LAS APLICACIONES DE SILICIO, EN DIFERENTES CONCENTRACIONES, PUEDE PRESENTAR UN EFECTO DIRECTO O INDIRECTO SOBRE EL PATÓGENO MYCOSPHAERELLA FIJIENSIS, CAUSANTE DE LA SIGATOKA NEGRA. DENTRO DEL TEMA TAMBIÉN SE HA PLANTEADO EVALUAR LA RESPUESTA AGRONÓMICA Y FISIOLÓGICA DEL BANANO

Minimally invasive surgery with tubular retractor system for deep-seated or intraventricular brain tumors: Report of 13 cases and technique description

Background: Surgical treatment of tumors in those areas of the brain considered difficult to reach is becoming accessible thanks to minimally invasive surgery. Through the use of tubular retractor systems, a circular displacement and a symmetrical distribution of the brain are provided, reducing the complications of prolonged retraction, as well as the risk of edema and infarction. This has become an ideal method to reach areas such as deep parenchymal, subcortical and intraventricular regions. Methods: From January 2015 to November 2018, we selected thirteen cases of patients diagnosed with intraparenchymal or intraventricular tumors. Surgical resection was performed with the assistance of a microscope, neuroendoscope, and brain tubular retractors. The volumetric study and the depth of the tumor were obtained on the MRI using the neuronavigation system. Depth was measured from the entry point on the cortical surface to the area closest to the tumor. Results: Gross total resection was achieved in eight patients, subtotal resection in three, partial removal in one case and one biopsy was performed. One patient developed hydrocephalus and one a cerebrospinal fluid fistula as a post-surgical complication. Conclusions: Minimally invasive surgery for tumor excision could allow directly access deep brain lesions and decrease injury to the surrounding brain tissue, as well as prevent adhesions from it in tubular retractors. Simultaneously, the microsurgical and endoscopic technique could shorten the surgical time. The purpose is to reduce the morbidity associated with conventional surgical procedures and the days of hospitalization in the ICU, improving quality of life

Red de distribución de medicamentos en la ciudad de Guayaquil

Se considera que una red de distribución es una colección finita de nodos (cada uno de los cuales representa, una planta, un almacén o una tienda detallista); un arco indica la posibilidad de enviar bienes entre los dos nodos conectados por el arco. En otras palabras también se puede considerar que una red de distribución es la administración racionalizada del stock, gracias al amplio rango de servicios de distribución, lo cual sirve para: • Reducir costos de aprovisionamiento de productos; • Incrementar el capital circulante; y • Reducir los costos asociados con el almacenamiento, transporte y reposición de sus componentes. Toda red de distribución esta conformada por los siguientes elementos: Nodos, es un círculo de una red de distribución utilizada para representar una planta, almacén o tienda al menudeo. Nodo de suministro, nodo desde el cual los bienes se van a enviar. Nodo de demanda, nodo que va a recibir los bienes para cumplir con demandas conocidas. Nodo de trasbordo o intermedio, un nodo que recibe bienes desde otros nodos para su redistribución. VII Arcos, línea de una red de distribución que conecta un par de nodos; se lo utiliza para representar una ruta valida desde el nodo de origen hasta el nodo de distribución

Additional file 2: of A next generation sequencing-based method to study the intra-host genetic diversity of norovirus in patients with acute and chronic infection

Various supporting data. This file contains: 1) the data used to estimate the correlation between percentage of NoVreads and Ct values, 2) the commands used for NGS analysis, 3) a summary of the sequences filtered out by Prinseq-lite due to quality control and 4) a description of the primers designed for sequencing sample OU3 via Sanger's method. (DOCX 86 kb

Comparison of Detecting and Quantitating SARS-CoV-2 in Wastewater Using Moderate-Speed Centrifuged Solids versus an Ultrafiltration Method

Mounting evidence suggests that solids are a reliable matrix for SARS-CoV-2 detection in wastewater, yet studies comparing solids-based methods and common concentration methods using the liquid fraction remain limited. In this study, we developed and optimized a method for SARS-CoV-2 detection in wastewater using moderate-speed centrifuged solids and evaluated it against an ultrafiltration reference method. SARS-CoV-2 was quantified in samples from 12 wastewater treatment plants from Alberta, Canada, using RT-qPCR targeting the N2 and E genes. PCR inhibition was examined by spiking salmon DNA. The effects of using different amounts of solids, adjusting the sample pH to 9.6–10, and modifying the elution volume at the final step of RNA extraction were evaluated. SARS-CoV-2 detection rate in solids from 20 mL of wastewater showed no statistically significant difference compared to the ultrafiltration method (97/139 versus 90/139, p = 0.26, McNemar’s mid-p test). The optimized wastewater solids-based method had a significantly lower rate of samples with PCR inhibition versus ultrafiltration (3% versus 9.5%, p = 0.014, Chi-square test). Our optimized moderate-speed centrifuged solids-based method had similar sensitivity when compared to the ultrafiltration reference method but had the added advantages of lower costs, fewer processing steps, and a shorter turnaround time

Changes in norovirus genotype diversity in gastroenteritis outbreaks in Alberta, Canada: 2012–2018

Abstract Background The emergence of norovirus genotype GII.4 variants has been associated with gastroenteritis pandemics worldwide, prompting molecular surveillance for early detection of novel strains. In this study, we aimed to analyze the outbreak activity of norovirus and characterize the norovirus strains circulating in Alberta between July 2012 and February 2018. Methods Stool samples from gastroenteritis outbreaks in Alberta were tested for norovirus at the Provincial Laboratory for Public Health using a multiplex real time-RT PCR assay. The ORF1 and ORF2-genotypes of norovirus positive samples were assigned based on phylogenetic analyses of partial polymerase and capsid sequences, respectively. Results A total of 530 norovirus outbreaks were identified. During July 2012 and June 2017 there was a gradual decrease in the annual number of GII.4 outbreaks, however, outbreak numbers increased from June 2017–February 2018. Four novel strains emerged: GII.17 Kawasaki in July 2014–June 2015, GII.P16/GII.4 Sydney in July 2015–June 2016, GII.P16/GII.2 and GII.P4 New Orleans/GII.4 Sydney in July 2016–June 2017. GII.Pe/GII.4 Sydney was the single predominant strain responsible for the majority (over 50%) of all norovirus outbreaks up to June 2015. Between June 2017 and February 2018, GII.P16/GII.4 Sydney was the leading strain causing 63% of all norovirus outbreaks. Conclusions GII.4 stands as the predominant capsid genotype causing a large majority of the norovirus outbreaks in early 2018. An increase in genotype diversity was observed in the last years, characterized by a high circulation of non-GII.4 strains and GII.4 recombinants