Africa’s response to the COVID-19 pandemic : A review of the nature of the virus, impacts and implications for preparedness

Background: COVID-19 continues to wreak havoc in different countries across the world, claiming thousands of lives, increasing morbidity and disrupting lifestyles. The global scientific community is in urgent need of relevant evidence, to understand the challenges and knowledge gaps, as well as the opportunities to contain the spread of the virus. Considering the unique socio-economic, demographic, political, ecological and climatic contexts in Africa, the responses which may prove to be successful in other regions may not be appropriate on the continent. This paper aims to provide insight for scientists, policy makers and international agencies to contain the virus and to mitigate its impact at all levels. Methods: The Affiliates of the African Academy of Sciences (AAS), came together to synthesize the current evidence, identify the challenges and opportunities to enhance the understanding of the disease. We assess the potential impact of this pandemic and the unique challenges of the disease on African nations. We examine the state of Africa’s preparedness and make recommendations for steps needed to win the war against this pandemic and combat potential resurgence. Results: We identified gaps and opportunities among cross-cutting issueswhich must be addressed or harnessed in this pandemic. Factors such as the nature of the virus and the opportunities for drug targeting, point of care diagnostics, health surveillance systems, food security, mental health, xenophobia and gender-based violence, shelter for the homeless, water and sanitation, telecommunications challenges, domestic regional coordination and financing. Conclusion: Based on our synthesis of the current evidence, while there are plans for preparedness in several African countries, there are significant limitations. A multi-sectoral efforts from the science, education, medical, technology, communication, business, and industry sectors, as well as local communities, must work collaboratively to assist countries in order to win this fight

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Major histocompatibility complex class II molecules induce the formation of endocytic MIIC-like structures

During biosynthesis, major histochompatibility complex class II molecules are transported to the cell surface through a late endocytic multilaminar structure with lysosomal characteristics. This structure did not resemble any of the previously described endosomal compartments and was termed MIIC. We show here that continuous protein synthesis is required for the maintenance of MIIC in B cells. Transfection of class II molecules in human embryonal kidney cells induces the formation of multilaminar endocytic structures that are morphologically analogous to MIIC in B cells. Two lysosomal proteins (CD63 and lamp-1), which are expressed in MIIC of B cells, are also present in the structures induced by expression of major histocompatibility complex class II molecules. Moreover, endocytosed HRP enters the induced structures defining them as endocytic compartments. Exchanging the transmembrane and cytoplasmic tail of the class II alpha and beta chains for that of HLA-B27 does not result in the induction of multilaminar structures, and the chimeric class II molecules are now located in multivesicular structures. This suggests that expression of class II molecules is sufficient to induce the formation of characteristic MIIC-like multilaminar structures

Body mass index is associated with hospital mortality in critically ill patients: an observational cohort study

Item does not contain fulltextOBJECTIVE: Obesity is associated with a variety of diseases, which results in a decreased overall life expectancy. Nevertheless, some studies suggest that being overweight may reduce hospital mortality of certain patient groups, referred to as obesity paradox. Conflicting results for critically ill patients are reported. Therefore, we wished to investigate the association of body mass index and hospital mortality in critically ill patients. DESIGN: Observational cohort study in Dutch critically ill patients. SETTING: A dataset from the Dutch National Intensive Care Evaluation registry that includes patients admitted to Dutch ICUs was used. PATIENTS: One hundred fifty-four thousand three hundred and eight ICU patients of teaching and nonteaching units in urban and nonurban hospitals. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We used logistic regression analysis, correcting for case mix (Simplified Acute Physiology Score II, age, gender, admission type, neoplasm, AIDS, hematologic malignancy, immunologic insufficiency, mechanical ventilation, and calendar year), to determine the relationship between body mass index and hospital mortality. Body mass index was included in the model as a continuous nonlinear covariate in a restricted regression spline transformation. To facilitate interpretation, adjusted odds ratios were calculated for the World Health Organization-based body mass index classes. Body mass index was found to be significantly associated with hospital mortality, with risks quickly increasing for underweight patients (body mass index < 18.5 kg/m). Obese and seriously obese patients, with a body mass index of 30-39.9 kg/m, had the lowest risk of death with an adjusted odds ratio of 0.86 (0.83-0.90). CONCLUSIONS: This large observational database shows an inverse association between obesity and hospital mortality in critically ill patients that could not be explained by a variety of known confounders

Opposing motor activities of dynein and kinesin determine retention and transport of MHC class II-containing compartments

MHC class II molecules exert their function at the cell surface by presenting to T cells antigenic fragments that are generated in the endosomal pathway. The class II molecules are targetted to early lysosomal structures, termed MIIC, where they interact with antigenic fragments and are subsequently transported to the cell surface. We previously visualised vesicular transport of MHC class II-containing early lysosomes from the microtubule organising centre (MTOC) region towards the cell surface in living cells. Here we show that the MIIC move bidirectionally in a 'stop-and-go' fashion. Overexpression of a motor head-deleted kinesin inhibited MIIC motility, showing that kinesin is the motor that drives its plus end transport towards the cell periphery. Cytoplasmic dynein mediates the return of vesicles to the MTOC area and effectively retains the vesicles at this location, as assessed by inactivation of dynein by overexpression of dynamitin. Our data suggest a retention mechanism that determines the perinuclear accumulation of MIIC, which is the result of dynein activity being superior over kinesin activity. The bidirectional nature of MIIC movement is the result of both kinesin and dynein acting reciprocally on the MIIC during its transport. The motors may be the ultimate targets of regulatory kinases since the protein kinase inhibitor staurosporine induces a massive release of lysosomal vesicles from the MTOC region that is morphologically similar to that observed after inactivation of the dynein moto

Ingleses - Brazil: Urban problems due to coastal morphology

MSc Project Hydraulic Engineering - Delft University of Technology, Faculty of Civil Engineering and Geosciences, Section Hydraulic Engineering and Universidade do Vale do Itajaí, Centro de Ciências Tecnológicas da Terra e do Mar. - The town of Ingleses on Santa Catarina Island, in the state of Santa Catarina, Brazil, is threatened by nature at two different fronts. At the northern side of the town lies Ingleses Beach which appears to be subject to ongoing erosion. This forms a threat to the houses near the shore and diminishes the recreational value of the area. On the southern side, the town is threatened by a migrating dunefield, which is encroaching onto the houses and infrastructure. According to locals, dozens of houses have already been buried under the sand. The aim of this report is to give full insight in the situation and to find a number of possible solutions to the problems. There are, in fact, two dunefields in the area around Ingleses. The second dunefield does not pose a direct threat to the town, but passes the town on its eastern side. This dunefield is nevertheless very important, as it supplies a significant amount of sediment to Ingleses Beach. Research has been done to investigate how both dunefields migrate. An important result of this research is that the first dunefield (that is overwhelming the houses on the south side of the town) has never reached all the way to the beach. It had been previously assumed that the erosion of the beach was, wholly or partially, caused by the fact that sediment from the first dunefield could no longer reach the beach due to the urbanization between the dunefield and the beach. This assumption however has proven to be false. Another important result is the determination of the sediment influx rate from the second dunefield into the breaker zone of Ingleses Beach. This is an important factor in modelling the evolution of the beach. To be able to make predictions about the evolution of Ingleses Beach it is necessary to have nearshore wave data. Such data is not readily available and must, therefore, be obtained in another way. The available data consists of one year worth of measured wave data at a location about 35 kilometres offshore of Santa Catarina Island. To be able to translate this wave data to the nearshore of Ingleses Beach a thorough investigation of the bathymetry between the point where the wave data was measured and the beach has been carried out with the aid of the software package ArcGIS. With this bathymetry the available wave data can be translated to the nearshore of Ingleses Beach using the wave modelling program SWAN. The evolution of the beach has been modelled for two different scenarios using the computer program UNIBEST CL+. The first scenario represents a continuation of the present day situation. Simulation of this scenario has resulted in a trend prediction for the evolution of the beach. This prediction shows that, if no countermeasures are taken, some areas along the beach are indeed subject to erosion and houses in those areas will be severely threatened by the water. The second scenario represents a situation where the influx of sediment from the easterly dunefield is cut off from the sea. This may be due to ongoing urbanization between the dunefield and the sea, or fixation of the dunes by vegetation. If such a situation should occur the simulation shows that the erosion to be expected will be considerably more severe than in the first scenario. More houses will be threatened and a highly undesirable situation for people living near the shoreline, as well as economical damage due to loss of recreational areas, is the result. From the results of the dune study and the beach model simulation it is clear that action needs to be taken at both fronts. Several possible solutions to the problems have been produced based on the qualitative, and if possible quantitative, results of the research. It has been concluded that an extensive monitoring program and continued research are needed in order to quantify most of the suggested solutions. The monitoring can be done parallel to the excavation of the dunefield, which will give immediate results. While calculations and research are done on a suitable nourishment program, the sand of the Moçambique dunefield can be used for a small-scale nourishment. This will give extensive information about the way this sediment input will influence the morphology of Ingleses beach.Civil Engineering and GeosciencesHydraulic Engineerin

Cardiopulmonary resuscitation training for high school students using an immersive 360-degree virtual reality environment

Cardiopulmonary resuscitation (CPR) is a lifesaving emergency procedure. To increase survival rates, it is recommended to increase the number of high school students who know how to perform CPR. We have developed an immersive “Virtual Reality (VR) Resuscitation Training” to train the theoretical knowledge of CPR in which trainees must save the life of the patient in a virtual environment. This paper presents a randomized controlled study with a pre-posttest design to explore whether a VR enhanced curriculum improves high school students’ theoretical CPR knowledge. Forty students without previous CPR experience in the past year were randomly assigned to either the VR group or the standard group. The VR group had a significant higher increase of correct answers in comparison with the Standard group. More importantly, the gain in score on taking the correct sequence of CPR steps was significant favouring the VR-enhanced protocol over the Standard protocol. Therefore, the use of a VR training for CPR training appears to be an effective learning method for non-medical students and may be of great value skilling high school students in becoming adequate CPR providers