The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Autonomous Overhead Crane System Using a Fuzzy Logic Controller

Abstract: This paper pertains to advanced automation of the load transfer process using overhead cranes. Overhead cranes are widely used in various areas of industry, including manufacturing, construction, shipping, etc. Load transfer operations using overhead cranes have to be performed fast and safely. As such, these operations are handled by expert operators � however, the demand for an automatic consistent and reliable crane operation is on the rise. The crane–load system is highly nonlinear and time-varying, hence, solutions considering model-base approaches may lead to a complicated controller structure. Such a controller may require accurate estimation of the crane system parameters. In this paper we present a new fuzzy logic controller for overhead crane operation. The fuzzy controller is designed based on knowledge of an expert crane operator, and does not require any parameter estimation. It mimics the operator behavior by using the same crane–load system states that are realized by the operator. These states are the trolley position error and the load sway angle. The fuzzy controller action, on the other hand, is the desired trolley speed. The proposed controller is implemented and tested on a small-scale overhead crane. Experimental results sho

Spontaneous rupture of the common hepatic duct associated with acute pancreatitis: a case report

Abstract Background Rupture of the common bile duct is a life-threatening condition, usually observed after a trauma or in association with choledocholithiasis or an obstructive tumor of the bile duct. However, a spontaneous rupture of the common bile duct is a rare entity. Case presentation We report a new observation of a spontaneous rupture of the common bile duct, associated with biliary peritonitis and pancreatitis, in a 15-year-old North African girl. Etiological aspects, specificities of clinical presentation, means of diagnosis, as well as surgical and perioperative management are discussed. Conclusions The diagnosis of spontaneous rupture of the common bile duct is a challenge for both radiologist and surgeon. Beyond the difficulty of diagnosis, which requires radiological exploration, management of the subsequent biliary peritonitis involves urgent surgery, life-supporting measures, and close monitoring

Le lymphangiome kystique rétropéritonéal: à propos de 5 cas et revue de la littérature

Le lymphangiome kystique est une tumeur bénigne malformative rare des vaisseaux lymphatiques à localisations diverses. La localisation rétropéritonéale est moins fréquente comparée à celle mésentérique. Sa présentation clinique est polymorphe. Le diagnostic est évoqué par l'imagerie mais il nécessite une confirmation histologique. Le traitement de choix est chirurgical. Notre objectif est d'étudier les manifestations cliniques, les complications, les aspects diagnostiques et thérapeutiques de cette tumeur. Nous rapportons une série de 5 cas de lymphangiomes kystiques rétropéritonéaux (4 femmes et un homme) opérés dans notre service entre les années 2004 et 2014. Leurs dossiers ont été examinés rétrospectivement. Le suivi était basé sur l'examen clinique et l'échographie abdominale. L´âge moyen était de 45 ans. Le suivi moyen était de 32,6 mois. La symptomatologie révélatrice la plus fréquente était les douleurs et/ou une masse abdominale. Le scanner abdominal était l'examen le plus utile au diagnostic. Une exérèse complète était réalisée d'emblée chez quatre patients et elle était différée après cinq ans de surveillance par une échographie annuelle chez un. Dans un cas, on a eu recours à une néphrectomie. Aucune récidive ni complication n´ont été notées chez les 5 patients. le lymphangiome kystique à localisation rétropéritonéale est une affection rare. Sa prise en charge thérapeutique repose sur une exérèse complète, de cas de lésions symptomatiques ou de complications, pour limiter le risque de récidive. Cette dernière peut être différée chez les patients asymptomatiques.The Pan African Medical Journal 2016;2