Identifying the research, advocacy, policy and implementation needs for the prevention and management of respiratory syncytial virus lower respiratory tract infection in low- and middle-income countries

Introduction: The high burden of respiratory syncytial virus (RSV) infection in young children disproportionately occurs in low- and middle-income countries (LMICs). The PROUD (Preventing RespiratOry syncytial virUs in unDerdeveloped countries) Taskforce of 24 RSV worldwide experts assessed key needs for RSV prevention in LMICs, including vaccine and newer preventive measures. Methods: A global, survey-based study was undertaken in 2021. An online questionnaire was developed following three meetings of the Taskforce panellists wherein factors related to RSV infection, its prevention and management were identified using iterative questioning. Each factor was scored, by non-panellists interested in RSV, on a scale of zero (very-low-relevance) to 100 (very-high-relevance) within two scenarios: (1) Current and (2) Future expectations for RSV management. Results: Ninety questionnaires were completed: 70 by respondents (71.4% physicians; 27.1% researchers/scientists) from 16 LMICs and 20 from nine high-income (HI) countries (90.0% physicians; 5.0% researchers/scientists), as a reference group. Within LMICs, RSV awareness was perceived to be low, and management was not prioritised. Of the 100 factors scored, those related to improved diagnosis particularly access to affordable point-of-care diagnostics, disease burden data generation, clinical and general education, prompt access to new interventions, and engagement with policymakers/payers were identified of paramount importance. There was a strong need for clinical education and local data generation in the lowest economies, whereas upper-middle income countries were more closely aligned with HI countries in terms of current RSV service provision. Conclusion: Seven key actions for improving RSV prevention and management in LMICs are proposed

Recovery potential of rare earth elements (REEs) from the gem mining waste of Sri Lanka:A case study for mine waste management

Sri Lanka is one of the wealthiest countries in terms of gems. Therefore, gem mining is extensively carried out in many areas of Sri Lanka, including districts such as Ratnapura, Monaragala, Matale, and Kalutara. During the mining process, only valuable gemstones are collected, and the remaining gravel fraction with many heavy minerals is discarded. Therefore, the gem mining industry produces a large amount of waste that is mainly used only for backfilling. To sustainably manage this waste stream, gem mining waste collected from a gem pit at Wagawatta in the Kalutara district in Sri Lanka was investigated for value recovery, specifically for rare-earth elements (REEs). The gem-bearing alluvial layer contained 0.3% rare-earth oxide (REO) that could easily be upgraded up to 2.8% (LREEs = 94%) with wet sieving and subsequent density separation via a shaking table. Therefore, the concentrates of gem mine tailings with REE-bearing minerals have the potential to be a secondary source for LREEs. The organic-rich clay layer underlying the gem-bearing alluvial layer contained 0.6% REO with 49% HREEs, including Gd, Dy, Er, Yb, and especially Y enrichments. Detailed explorations are thus necessary to assess the REE potential in Sri Lanka’s gem mining waste, and value recovery flowsheets should be subsequently developed to economically extract REEs. In addition, the presence of high U concentrations (800 mg/kg) in the concentrated samples could be alarming when considering the health and safety of the people engaged in gem mining. This aspect also requires detailed research studies