Early infant HIV-1 diagnosis programs in resource-limited settings: opportunities for improved outcomes and more cost-effective interventions

Early infant diagnosis (EID) of HIV-1 infection confers substantial benefits to HIV-infected and HIV-uninfected infants, to their families, and to programs providing prevention of mother-to-child transmission (PMTCT) services, but has been challenging to implement in resource-limited settings. In order to correctly inform parents/caregivers of infant infection status and link HIV-infected infants to care and treatment, a 'cascade' of events must successfully occur. A frequently cited barrier to expansion of EID programs is the cost of the required laboratory assays. However, substantial implementation barriers, as well as personnel and infrastructure requirements, exist at each step in the cascade. In this update, we review challenges to uptake at each step in the EID cascade, highlighting that even with the highest reported levels of uptake, nearly half of HIV-infected infants may not complete the cascade successfully. We next synthesize the available literature about the costs and cost effectiveness of EID programs; identify areas for future research; and place these findings within the context of the benefits and challenges to EID implementation in resource-limited settings

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Drying technologies for edible insects and their derived ingredients

Edible insects and their ingredients are considered as a novel, sustainable and high-quality nutritional source for their potential use as food and feed. However, they are highly oxidizable and potentially unsafe. Dehydration of insects removes moisture and extends their shelf life. Moreover, it is considered as a prerequisite and/or pretreatment for some extraction technologies for ingredient production. Drying technologies (sun drying, smoke drying, roasting, freeze drying and oven drying) have been used to dry insects, both at a laboratory and industrial level. Different drying pretreatments (thermal blanching, microwave-assisted drying and pulsed electric field) have been explored to improve the final quality of the insect products, extending their shelf life and reducing total energy consumption. Therefore, this article aimed to review the current research available in edible insect drying processing technologies, addressing their effectiveness and their influence over different quality parameters such as protein/lipid extraction efficiency, sensory characteristics of the final products, microbiological safety, shelf life and their impact on bioactive compounds

Advances in biofuel production from oil palm and palm oil processing wastes: A review

Over the last decades, the palm oil industry has been growing rapidly due to increasing demands for food, cosmetic, and hygienic products. Aside from producing palm oil, the industry generates a huge quantity of residues (dry and wet) which can be processed to produce biofuel. Driven by the necessity to find an alternative and renewable energy/fuel resources, numerous technologies have been developed and more are being developed to process oil-palm and palm-oil wastes into biofuel. To further develop these technologies, it is essential to understand the current stage of the industry and technology developments. The objective of this paper is to provide an overview of the palm oil industry, review technologies available to process oil palm and palm oil residues into biofuel, and to summarise the challenges that should be overcome for further development. The paper also discusses the research and development needs, technoeconomics, and life cycle analysis of biofuel production from oil-palm and palm-oil wastes

MRF: a tool to overcome the barrier of inconsistent genome annotations and perform comparative genomics studies for the largest animal DNA virus

BackgroundThe genome of the largest known animal virus, the white spot syndrome virus (WSSV) responsible for huge economic losses and loss of employment in aquaculture, suffers from inconsistent annotation nomenclature. Novel genome sequence, circular genome and variable genome length led to nomenclature inconsistencies. Since vast knowledge has already accumulated in the past two decades with inconsistent nomenclature, the insights gained on a genome could not be easily extendable to other genomes. Therefore, the present study aims to perform comparative genomics studies in WSSV on uniform nomenclature.MethodsWe have combined the standard mummer tool with custom scripts to develop missing regions finder (MRF) that documents the missing genome regions and coding sequences in virus genomes in comparison to a reference genome and in its annotation nomenclature. The procedure was implemented as web tool and in command-line interface. Using MRF, we have documented the missing coding sequences in WSSV and explored their role in virulence through application of phylogenomics, machine learning models and homologous genes.ResultsWe have tabulated and depicted the missing genome regions, missing coding sequences and deletion hotspots in WSSV on a common annotation nomenclature and attempted to link them to virus virulence. It was observed that the ubiquitination, transcription regulation and nucleotide metabolism might be essentially required for WSSV pathogenesis; and the structural proteins, VP19, VP26 and VP28 are essential for virus assembly. Few minor structural proteins in WSSV would act as envelope glycoproteins. We have also demonstrated the advantage of MRF in providing detailed graphic/tabular output in less time and also in handling of low-complexity, repeat-rich and highly similar regions of the genomes using other virus cases.ConclusionsPathogenic virus research benefits from tools that could directly indicate the missing genomic regions and coding sequences between isolates/strains. In virus research, the analyses performed in this study provides an advancement to find the differences between genomes and to quickly identify the important coding sequences/genomes that require early attention from researchers. To conclude, the approach implemented in MRF complements similarity-based tools in comparative genomics involving large, highly-similar, length-varying and/or inconsistently annotated viral genomes

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Not AvailableAccumulation of nitrogenous metabolites is considered as one of the limiting factors in the intensification of shrimp aquaculture worldwide. The present study reports the development and evaluation of microbial consortium containing ammonia oxidising bacteria (AOB), nitrite oxidising bacteria (NOB) and denitrifying bacteria (DNB) to mitigate total ammonia nitrogen (TAN) in commercial Penaeus vannamei shrimp farms. Oxidation rates of NH3-N and NO2 due to with AOB and NOB enrichment in the spiked media was 1.57 ppm day−1 and 1.46 ppm day−1 respectively under experimental conditions. The nitrite reduction rate due to Marinobacter spp. in the DNB consortia was 3–4.5 ppm h−1. The AOB and NOB consortia carried out ammonia oxidation and nitrite oxidation at salinities between 2 and 35‰ while DNBs were active above 15‰ salinity. DGGE analysis of the consortium showed the presence of eight AOB and 11 NOB and two DNB groups and metagenome analysis revealed the presence of more than 3000 OTUs at 97% similarity index. Eubacteria dominated the enrichment (>95%) while Proteobacteria were the predominant phylum. Nitrosomonas and Nitrosococcus (AOB) and Nitrospira (NOB) and ammonia oxidising archaea like Nitrosopumilus and Nitrososphaera were detected in addition to several unclassified species. Significant reduction in the levels of TAN (p < 0.05) was observed following application (at 5 L ha−1 week-1) of the microbial consortia (formulation) in four commercial P. vannamei shrimp farming sites having the salinity between 15 and 62‰. Results of the study suggests that the AOB, NOB and DNB formulation developed microbial formulation developed in the study could efficiently mitigate the toxic ammonia species in commercial P. vannamei shrimp culture farms.Not AvailableICA