Encephalitis diagnosis using metagenomics: application of next generation sequencing for undiagnosed cases

BACKGROUND: Current estimates suggest that even in the most resourced settings, the aetiology of encephalitis is identified in less than half of clinical cases. It is acknowledged that filling this gap needs a combination of rigorous sampling and improved diagnostic technologies. Next generation sequencing (NGS) methods are powerful tools with the potential for comprehensive and unbiased detection of pathogens in clinical samples. We reviewed the use of this new technology for the diagnosis of suspected infectious encephalitis, and discuss the feasibility for introduction of NGS methods as a frontline diagnostic test. METHODS: A systematic literature review was performed, using MESH and text word searches for variants of "sequencing" and "encephalitis" in Medline and EMbase, and searching bibliographies and citations using the Web of Science database. Two authors independently reviewed, extracted and summarised data. FINDINGS: The review identified 25 articles reporting 44 case reports of patients with suspected encephalitis for whom NGS was used as a diagnostic tool. We present the data and highlight themes arising from these cases. There are no randomly controlled trials to assess the utility of NGS as a diagnostic tool. INTERPRETATION: There is increasing evidence of a role for NGS in the work-up of undiagnosed encephalitis. Lower costs and increasing accessibility of these technologies will facilitate larger studies of these patients. We recommend NGS should be considered as a front-line diagnostic test in chronic and recurring presentations and, given current sample-to-result turn-around times, as second-line in acute cases of encephalitis

Memory and Musical Expectation for Tones in Cultural Context

WE EXPLORED HOW MUSICAL CULTURE SHAPES ONE\u27S listening experience.Western participants heard a series of tones drawn from either the Western major mode (culturally familiar) or the Indian thaat Bhairav (culturally unfamiliar) and then heard a test tone. They made a speeded judgment about whether the test tone was present in the prior series of tones. Interactions between mode (Western or Indian) and test tone type (congruous or incongruous) reflect the utilization of Western modal knowledge to make judgments about the test tones. False alarm rates were higher for test tones congruent with the major mode than for test tones congruent with Bhairav. In contrast, false alarm rates were lower for test tones incongruent with the major mode than for test tones incongruent with Bhairav. These findings suggest that one\u27s internalized cultural knowledge may drive musical expectancies when listening to music of an unfamiliar modal system

Herpesvirus Infections of the Central Nervous System

There are over 200 herpesvirus species, of which 10 affect humans. Each of these 10 herpesviruses has a unique clinical syndrome, but common to all is their ability to cause infection and pathology in the central nervous system. In this article, we discuss the epidemiology, clinical presentation, diagnostic modalities, treatment, sequelae, and availability of vaccination of each of the following herpesviruses: herpes simplex virus 1 and 2, varicella zoster virus, human cytomegalovirus, human herpesvirus 6A, 6B, and 7, Epstein-Barr virus, human herpesvirus 8, and simian herpesvirus B

The problem of nitrophily

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Stakeholder engagement in hydro-climatic services in India: report of pump priming project April 2019

The India-UK Water Centre (IUKWC) promotes cooperation and collaboration between the complementary priorities of NERC-MoES water security research. This report presents an overview of a research project funded as a pump priming activity by the India-UK Water Centre (IUKWC), carried out between July–October 2017. Project activities included: a webinar, a desk-based literature review, a series of expert interviews and a participatory workshop held at the Indian Institute of Tropical Meteorology, Pune, in September 2017. The research was led by Dr Zareen Pervez Bharucha (Anglia Ruskin University), who worked with a team of scholars from the UK and India. This report outlines the key activities undertaken during the project, gives an overview of our research methods, and outlines the main findings. It is intended for participants in the research process, members of the India-UK Water Centre, and other stakeholders who have an interest in developing hydro-climatic services in India or comparable contexts. It should be read in conjunction with a State of the Science brief available on the IUKWC website (www.iukwc.org)

Online Detection of Tonal Pop-Out in Modulating Contexts

We investigated the spontaneous detection of wrong notes in a melody that modulated continuously through all 24 major and minor keys. Three variations of the melody were composed, each of which had distributed within it 96 test tones of the same pitch, for example, A2. Thus, the test tones would blend into some keys and pop out in others. Participants were not asked to detect or judge specific test tones; rather, they were asked to make a response whenever they heard a note that they thought sounded wrong or out of place. This task enabled us to obtain subjective measures of key membership in a listening situation that approximated a natural musical context. The frequency of observed wrong-note responses across keys matched previous tonal hierarchy results obtained using judgments about discrete probes following short contexts. When the test tones were nondiatonic notes in the present context they elicited a response, whereas when the test tones occupied a prominent position in the tonal hierarchy they were not detected. Our findings could also be explained by the relative salience of the test pitch chroma in short-term memory, such that when the test tone belonged to a locally improbable pitch chroma it was more likely to elicit a response. Regardless of whether the local musical context is shaped primarily by bottom-up or topdown influences, our findings establish a method for estimating the relative salience of individual test events in a continuous melody