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

Enhancement of the Traffic Differentiation Architecture for WBAN based on IEEE 802.15.4

International audienceIn the healthcare domain, Wireless Body Area Network (WBAN) has emerged as a vital technology that is capable of providing better methods to diagnose various hazardous diseases. The CANet projet is a project that proposes alternative monitoring solutions. This paper studies the possibility of transmitting different types of information through an IEEE 802.15.4 MAC layer that not supports the transmission of heterogeneous information. We have proposed an extension to the MAC layer which makes possible the transmission of various information types. This solution designed by "diffrentiation layer" uses a purge function to ensure the use of CAP and CFP by the same node in the same superframe and allows the differentiation between several information. Our results show that our solution is reliable under worst-case

A fluid approach to large volume job shop scheduling

We consider large volume job shop scheduling problems, in which there is a fixed number of machines, a bounded number of activities per job, and a large number of jobs. In large volume job shops it makes sense to solve a fluid problem and to schedule the jobs in such a way as to track the fluid solution. There have been several papers which used this idea to propose approximate solutions which are asymptotically optimal as the volume increases. We survey some of these results here. In most of these papers it is assumed that the problem consists of many identical copies of a fixed set of jobs. Our contribution in this paper is to extend the results to the far more general situation in which the many jobs are all different. We propose a very simple heuristic which can schedule such problems. We discuss asymptotic optimality of this heuristic, under a wide range of previously unexplored situations. We provide a software package to explore the performance of our policy, and present extensive computational evidence for its effectiveness

Real-Time Capacity Management and Patient Flow Optimization in Hospitals Using AI Methods

Hospital systems are under constant pressure to provide quality care despite limited resources. However, traditional capacity management in hospitals is often not effective enough. One reason for this is the variability and uncertainty in the healthcare field that has to be managed. Another reason is the observation that hospitals are open loop systems, meaning they do not use feedback to determine if their output has achieved the desired goal of input. They do not observe the output of their processes controlled by them and use this information to take action. In hospital systems, there are few efficient planning systems or decision support systems to help administrators take decisions. This is different in other industries, where complex planning systems with the help of Artificial Intelligence, or AI as it is referred to, are often being used. This research chapter analyses the issues and possibilities for hospitals to incorporate AI into their capacity management and become intelligent systems in which operations and processes are regulated by feedback (closed loop system) and, more specifically, discusses the recent research of the authors on this topic, where Artificial Intelligent (Multi-Agent System) methods in combination with real-time coordination were described and implemented in the Aravind Eye Hospital (AEH) in India

Pregnancy-Related Complications in Patients With Fibromuscular Dysplasia: A Report From the European/International Fibromuscular Dysplasia Registry

Current literature suggests a higher risk of pregnancy-related complications in patients with renal fibromuscular dysplasia (FMD). The aim of our study was to assess the nature and prevalence of pregnancy-related complications in patients subsequently diagnosed with FMD. A call for participation was sent to centers contributing to the European/International FMD Registry. Patients with at least 1 pregnancy were included. Data on pregnancy were collected through medical files and FMD characteristics through the European/International FMD Registry. Data from 534 pregnancies were obtained in 237 patients. Despite the fact that, in 96% of cases, FMD was not diagnosed before pregnancy, 40% of women (n=93) experienced pregnancy-related complications, mostly gestational hypertension (25%) and preterm birth (20%), while preeclampsia was reported in only 7.5%. Only 1 patient experienced arterial dissection and another patient an aneurysm rupture. When compared with patients without pregnancy-related complications, patients with complicated pregnancies were younger at FMD diagnosis (43 versus 51 years old; P<0.001) and had a lower prevalence of cerebrovascular FMD (30% versus 52%; P=0.003) but underwent more often renal revascularization (63% versus 40%, P<0.001). In conclusion, the prevalence of pregnancy-related complications such as gestational hypertension and preterm birth was high in patients with FMD, probably related to the severity of renal FMD. However, the prevalence of preeclampsia and arterial complications was low/moderate. These findings emphasize the need to screen hypertensive women for FMD to ensure revascularization before pregnancy if indicated and appropriate follow-up during pregnancy, without discouraging patients with FMD from considering pregnancy.Current literature suggests a higher risk of pregnancy-related complications in patients with renal fibromuscular dysplasia (FMD). The aim of our study was to assess the nature and prevalence of pregnancy-related complications in patients subsequently diagnosed with FMD. A call for participation was sent to centers contributing to the European/International FMD Registry. Patients with at least 1 pregnancy were included. Data on pregnancy were collected through medical files and FMD characteristics through the European/International FMD Registry. Data from 534 pregnancies were obtained in 237 patients. Despite the fact that, in 96% of cases, FMD was not diagnosed before pregnancy, 40% of women (n=93) experienced pregnancy-related complications, mostly gestational hypertension (25%) and preterm birth (20%), while preeclampsia was reported in only 7.5%. Only 1 patient experienced arterial dissection and another patient an aneurysm rupture. When compared with patients without pregnancy-related complications, patients with complicated pregnancies were younger at FMD diagnosis (43 versus 51 years old; P<0.001) and had a lower prevalence of cerebrovascular FMD (30% versus 52%; P=0.003) but underwent more often renal revascularization (63% versus 40%, P<0.001). In conclusion, the prevalence of pregnancy-related complications such as gestational hypertension and preterm birth was high in patients with FMD, probably related to the severity of renal FMD. However, the prevalence of preeclampsia and arterial complications was low/moderate. These findings emphasize the need to screen hypertensive women for FMD to ensure revascularization before pregnancy if indicated and appropriate follow-up during pregnancy, without discouraging patients with FMD from considering pregnancy

The social psychology of "pseudoscience": A brief history.

The word 'pseudoscience' is a marker of changing worries about science and being a scientist. It played an important role in the philosophical debate on demarcating science from other activities, and was used in popular writings to distance science from cranky theories with scientific pretensions. These uses consolidated a comforting unity in science, a communal space from which pseudoscience is excluded, and the user's right to belong is asserted. The urgency of this process dwindled when attempts to find a formal demarcation petered out, and the growth of social constructionism denied science any special access to truth. The reaction to this led to the science wars, which ushered in a new anxiety in the use of 'pseudoscience', especially from the least secure branches. But recent writings on the disunity of science reveal how the sense of support drawn from it may be based on an illusion, creating a disunity of pseudoscience as well as of science