As SARS-CoV-2 continues to spread and evolve, detecting emerging variants early is critical for public health interventions. Inferring lineage prevalence by clinical testing is infeasible at scale, especially in areas with limited resources, participation, or testing and/or sequencing capacity, which can also introduce biases1–3. SARS-CoV-2 RNA concentration in wastewater successfully tracks regional infection dynamics and provides less biased abundance estimates than clinical testing4,5. Tracking virus genomic sequences in wastewater would improve community prevalence estimates and detect emerging variants. However, two factors limit wastewater-based genomic surveillance: low-quality sequence data and inability to estimate relative lineage abundance in mixed samples. Here we resolve these critical issues to perform a high-resolution, 295-day wastewater and clinical sequencing effort, in the controlled environment of a large university campus and the broader context of the surrounding county. We developed and deployed improved virus concentration protocols and deconvolution software that fully resolve multiple virus strains from wastewater. We detected emerging variants of concern up to 14 days earlier in wastewater samples, and identified multiple instances of virus spread not captured by clinical genomic surveillance. Our study provides a scalable solution for wastewater genomic surveillance that allows early detection of SARS-CoV-2 variants and identification of cryptic transmission.

Monoamniotic twin pregnancies and cord entanglement in such twins were diagnosed reliably by ultrasound. Abnormal tracings prompting cesarean delivery occurred in two of the five pregnancies with cord entanglement. Amniocentesis reflected pulmonary maturity of both twins in all pregnancies so assessed, and delivery after 32 weeks' gestation, with lung maturity, resulted in good perinatal outcomes. Statistical validity of these findings is limited by our small sample size.

As SARS-CoV-2 becomes an endemic pathogen, detecting emerging variants early is critical for public health interventions. Inferring lineage prevalence by clinical testing is infeasible at scale, especially in areas with limited resources, participation, or testing/sequencing capacity, which can also introduce biases. SARS-CoV-2 RNA concentration in wastewater successfully tracks regional infection dynamics and provides less biased abundance estimates than clinical testing. Tracking virus genomic sequences in wastewater would improve community prevalence estimates and detect emerging variants. However, two factors limit wastewater-based genomic surveillance: low-quality sequence data and inability to estimate relative lineage abundance in mixed samples. Here, we resolve these critical issues to perform a high-resolution, 295-day wastewater and clinical sequencing effort, in the controlled environment of a large university campus and the broader context of the surrounding county. We develop and deploy improved virus concentration protocols and deconvolution software that fully resolve multiple virus strains from wastewater. We detect emerging variants of concern up to 14 days earlier in wastewater samples, and identify multiple instances of virus spread not captured by clinical genomic surveillance. Our study provides a scalable solution for wastewater genomic surveillance that allows early detection of SARS-CoV-2 variants and identification of cryptic transmission.

The sinusoidal fetal heart rate pattern has been described in association with severe fetal anaemia, with fetal hypoxaemia, and with the administration of parenteral narcotics. Here, we report a case of decreased fetal movement in which a sinusoidal tracing was recorded. The sonographic diagnosis of a massive fetal intracranial haemorrhage was made. A non-interventive approach was taken and the fetus died soon after in utero. We review 28 previous cases in which the prenatal sonographic diagnosis of fetal intracranial haemorrhage was made, including the underlying maternal and fetal factors and neonatal outcomes. We propose that the sinusoidal tracing in this case was due to the intracranial bleed and suggest that fetal intracranial haemorrhage be considered in the sonographic evaluation of the fetus with a sinusoidal pattern.

An intrapericardial teratoma associated with a large pleural effusion and elevated aortic outflow velocity was diagnosed at 23.6 weeks' gestation. Less than 4 weeks earlier, an obstetric scan, including a four-chamber heart view, had been normal. In less than a week following diagnosis, fetal hydrops and bradycardia developed. 'Heroic' pericardiocentesis was declined by the patient, and the fetus died. This case demonstrates the potential for rapid growth in pericardial teratomas, and illustrates the possibility of anticipating fetal compromise from tumor mass effect, when intracardiac Doppler studies are abnormal. Implications for management of these rare tumors, and specifically for the hypothetical role of fetal surgery, are discussed.

We report a case of a patient who developed fulminant sepsis and respiratory distress caused by a gas-forming Escherichia coli intrauterine infection following premature rupture of the membranes and fetal death. Such gas-forming infections are rare, and, when they occur, they are usually caused by Clostridium welchii. This patient was treated with antibiotics, ventilator support, and hysterectomy, and at follow-up was in good health.

Rev. Sociedad&Equidad Nº 1, Enero de 2011. Resumen:El siguiente artículo caracteriza y busca describir al sector agrícola de temporada en el contexto de la globalización siguiendo el enfoque de género en Chile. Se realiza un recorrido histórico de las condiciones laborales del trabajo de temporada agrícola y cómo estas afectan la salud de las trabajadoras. Además en el texto se muestra cómo el trabajo asalariado agrícola de temporada profundiza la división sexual del trabajo marcada por las labores que realizan en el campo, produciendo una feminización del trabajo en este sector. La producción a gran escala de la fruta de exportación ha generado muchos cambios en la modernización del campo, se prioriza el monocultivo y un mercado más competitivo, lo cual se refleja en las ganancias de los empresarios agroexportadores. Sin embargo estas ganancias no se condicen con las precarias condiciones laborales que viven hombres y mujeres que trabajan en este sector productivo, donde sus problemas de salud se reflejan luego de 20 años de trabajo. Los problemas de salud mental que acarrea el ciclo de la fruta y la estacionalidad son algunos factores que inciden en la vida de mujeres asalariadas agrícolas. Palabras claves: Abstract:This article characterizes and seeks to describe the seasonal agricultural sector in context of globalization following a gender perspective in Chile. A historical overview of the working conditions of seasonal agricultural work and how the health workers is affected by that conditions is analyzed in the text. In addition the text shows how seasonal agricultural wage labor increase social division work producing a feminization of labor in this sector. The large-scale production of export fruit has produced a lot of changes in the modernization of the country, monoculture and competitive market are prioritized and this is reflected in the profits of the agro-export business men. But gains are not consistent with the precarious living working men and women in the

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