text:
JBBS Vol.11 No.9 , September 2021
The Diagnostic Value of Metagenomic Next-Generation Sequencing in Angiostrongylus cantonensis Encephalitis/Meningitis
Xiaowei Fan1*, Qiang Wang1*, Peiqing Li1, Bin Ai2, Yongling Song1, Qiuyan Peng1, Hongli Wang3#
1 Pediatric Emergency Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
2 Pediatric Radiology Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
3 Pediatric Gastroenterology Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Abstract: Objective: Angiostrongylus cantonensis (A. cantonensis) is an important parasite, which causes neurological infection in children, and is generally difficult to diagnose. We analyzed the significance of metagenomic next-generation sequencing in diagnosing A. cantonensis encephalitis/meningitis in children to provide a reference for clinical diagnosis. Methods: The case collection of A. cantonensis encephalitis/meningitis was from July 2018 to August 2020. The patients' clinical characteristics and pathogen were described, and diagnostic sensitivity methods for A. cantonensis encephalitis/meningitis were compared and analyzed, including parasite antibody detection and metagenomic next-generation sequencing (mNGS) detection in different samples. Results: Eleven cases were diagnosed with A. cantonensis encephalitis/meningitis, including six males (54.5%) and five females (45.5%), and the age ranged from 1 to 13 years with a median of 21 months (IQR: 15.6, 96). All patients were undiagnosed upon admission, of which ten cases had neurological symptoms or signs, six cases (54.5%) had a history of definite or suspicious exposure to parasites, and eight cases (72.7%) had abnormal changes in cranial MRI. The results of A. cantonensis antibodies in the peripheral blood and cerebrospinal fluid (CSF) were compared with CSF's metagenomic next-generation sequencing (mNGS). The antibody-positive rate of peripheral blood was 54.5%, CSF antibody-positive rate was 27.2%, and mNGS-positive rate of CSF was 81.8%, and the positive diagnostic rate of the latter was significantly higher than the former two (p = 0.035 < 0.05 and p = 0.030 < 0.05, respectively). Conclusion: Metagenomic next-generation sequencing has a higher positive rate for diagnosing infection and plays an important role in clarifying diagnosis and reducing misdiagnosis.
Keywords: Angiostrongylus cantonensis Encephalitis, Meningitis, Diagnosis, Metagenomic Next-Generation Sequencing
Angiostrongylus cantonensis is parasites prevalent in Southeast Asia and the Pacific Ocean. Humans can be infected by ingesting uncooked intermediate hosts, such as snails, crabs, freshwater shrimp, frogs, and certain fishes, or through contact with soil or water sources contaminated by parasites [1]. It can develop into stage IV and stage V larvae in the human host but not into adults. Its larvae are neurotrophic and migrate to the nervous tissue after infecting the human body, which can cause acidophilic meningitis, but can also cause encephalitis, encephalomyelitis, and even eye involvement [2].
The diagnosis of A. cantonensis encephalitis/meningitis is mainly based on epidemiological history, clinical manifestations, cerebrospinal fluid acidophilia, and immune examination. The gold standard for diagnosis is the discovery of A. cantonensis in CSF. However, it is usually difficult. Although antibody detection of serum and CSF are the most commonly used clinical diagnostic methods, they both lack sensitivity [3]. Alternatively, the clinical metagenomic next-generation sequencing (mNGS) has developed rapidly in recent years and has played an important role in the accurate diagnosis of infectious diseases. The mNGs technique is advantageous because there is no need to preset, cultivate, and no preferences; results are obtained by extracting the sum of all microbial genetic material (DNA and RNA) from clinical specimens, constructing a library, and analyzing by high- throughput sequencing and suitable bio-informatics algorithms; and it is fast and has comprehensive identification of all types of microorganisms (bacteria, fungi, viruses, parasites, etc.) detection technology [4]. It is also extremely competitive in the pathogenic diagnosis of the most difficult-to-diagnose cases or immunocompromised patients [4].
Although the infection of A. cantonensis is uncommon, it can usually cause severe clinical manifestations and neurological sequelae. Due to the low positive rate of pathogenic diagnosis, the clinical treatment of the disease could be delayed or even missed, which increases the risk of deterioration and sequelae. Here, we study children with A. cantonensis encephalitis/meningitis in the past three years and compared the sensitivity and specificity of different diagnostic methods to provide a clinical diagnostic reference.
2. Patients and Methods
This is a retrospective study of patients diagnosed with A. cantonensis encephalitis/meningitis in Guangzhou Women and Children's Medical Center from July 2018 to August 2020, who were undiagnosed upon admission. The diagnosis meets the following criteria [5]: 1) a clear epidemiological history; 2) clear infection, mainly symptoms of CNS infection; 3) eosinophil elevation in cerebrospinal fluid by more than 10%; 4) pathogen examination: larvae, A. cantonensis antibody positive in serum or cerebrospinal fluid. Comprehensive assessment of the appeal of four criteria, while excluding infection from other causes. All patients were treated with albendazole combined with low-dose glucocorticoids [6].
The clinical data for all included cases were recorded, including demographic features, clinical manifestations, laboratory and imaging results, treatments, and outcomes. A. cantonensis antibodies in peripheral blood and CSF were tested by Guangzhou Golden Field Medical Laboratory Co., Ltd. Cerebrospinal fluid mNGS were tested by Shenzhen MGI Technology Co., Ltd.
Statistical analysis was conducted using SPSS v.26.0 (IBM, Armonk, NY, USA). Categorical variables are described as n (%). Continuous variables with normal distribution are expressed as mean ± standard deviation (SD). Continuous variables with non-normal distribution are expressed as the median (interquartile range, IQR). Use the c2 test to compare differences between groups. The bilateral p-value < 0.05 is considered statistically significant.
Characteristics of cases
A total of 11 patients were diagnosed with A. cantonensis encephalitis/me- ningitis in Guangzhou Women and Children's Medical Center from July 2018 to August 2020, whose clinical data were collected. All of them were undiagnosed upon admission, including six males (54.5%) and five females (45.5%), and the age ranged from 1 to 13 years with a median of 21 months (IQR: 15.6, 96). Among them, one case (9.1%) had a clear history of raw snail-eating, three cases (27.3%) had edible shrimp and oysters, two cases (18.2%) had contact with field water sources, and five cases (45.5%) had no obvious exposure history of the parasite. Among them, nine cases (81.8%) had fever and vomiting, five cases (45.5%) had a headache, one case (9.1%) had convulsions, and five cases (45.5%) had mental changes. The interval between onset and definite diagnosis was 5 - 102 d, with a median of 26 d (IQR: 20, 38). The total length of hospital stay was 17 - 92 d, with a median of 27 d (IQR: 18, 39) (see Table 1).
General laboratory results
After admission, the peripheral blood leukocytes were 11.5 ± 4.3 * 109/L, and eosinophils were 1.8 ± 1.3 * 109/L. Lumbar puncture showed that CSF pressure range was 250 to over 330 mmH2O, CSF leukocytes were 426 ± 194 * 106/L, the ratio of eosinophils to leukocytes was 0% - 50% (median 10%, IQR: 1%, 19%), CSF protein was 0.66 ± 0.26 g/L, and the glucose concentration was 2.32 ± 0.94 mmol/L (see Table 2). Thus, there were eight cases (72.7%) of eosinophilia in cerebrospinal fluid, which met the standard of eosinophilic meningitis (eosinophilic meningitis is defined by the presence of ten or more eosinophils/μL in the CSF or eosinophilia of at least 10% CSF leukocyte count [7] ).
Imaging and neurophysiology
A chest X-ray in all patients, found four cases (36.4%) were normal, 7 cases (63.6%) had a lung infection, and one (9.1%) had lung consolidation. All patients underwent head magnetic resonance imaging (MRI) examination, and eight positive
Table 1. Patients characteristics.
Table 2. General laboratory results.
Note: PB, peripheral blood; CSF, cerebrospinal fluid; mNGS, metagenomic next-generation sequencing; /, not available; +, positive; -, negative; SD, Standard Deviation.
cases (72.7%) were found, including meningitis changes and abnormal reinforcement of brain parenchymal (see Table 3, Figure 1, Figure 2). Except for seven cases (63.6%) with normal electroencephalogram (EEG), one case (9.1%) showed slow background activity and a large amount of 3.5 - 5 hz slow-wave burst in each lead, and three cases (27.3%) showed boundary EEG changes with increased slow background activity.
Diagnostic test
The results of A. cantonensis in peripheral blood and cerebrospinal fluid (CSF) were compared with the metagenomic next-generation sequencing (mNGS) of CSF. The antibody-positive rate of peripheral blood was 54.5% (6/11), CSF antibody-positive rate was 27.2% (3/11), and mNGS-positive rate of CSF was 81.8% (9/11), and the positive diagnostic rate of the latter was significantly higher than the former two (p = 0.035 < 0.05 and p = 0.030 < 0.05, respectively) (see Table 4), and after the treatment, it was found that the mNGS reads in the CSF decreased, indicating the anti-A. cantonensis treatment was effective (see Figure 3).
Treatment and prognosis
The patients were given empirical antibiotic treatment and completed pathogenic sampling and testing after admission. After the diagnosis was confirmed, albendazole (20 mg/kg∙d * 10 d, 2 courses) combined with low-dose methylprednisolone (0.2 mg/kg∙d * 5 - 10 d) treatment were conducted. Except for one
Figure 1. Case 2 MRI. A 1.4-year-old girl with fever and headache for three weeks. (a) Contrast-enhanced MRI T2WI-FLAIR sequence showed a linear abnormal signal focus on the surface of the cerebral gyrus; (b) After the treatment, the lesions disappeared
Figure 2. Case 4 MRI. An 11-year-old boy with vomiting and headache for two weeks. (a) MR enhanced T 2WI-FLAIR sequence showed multiple linear enhancement of the pia mater with meningitis; (b) It is difficult to distinguish the meningeal enhancement with enhanced T1WI sequence from the blood vessels on the brain surface, so it is difficult to show lesions in the T1WI sequence.
Figure 3. Next-generation sequencing (NGS) of Angiostrongylus cantonensis in Case 5's cerebrospinal fluid. (a) NGS showed 934 reads corresponding to the Angiostrongylus cantonensis, with coverage of 0.0374%; (b) The re-examination of NGS 5 d later showed 147 reads corresponding to the Angiostrongylus cantonensis, with coverage of 0.0059%.
Table 3. Imaging and neurophysiology results.
Note: MRI, magnetic resonance imaging; EEG, electroencephalogram; -, normal.
Table 4. Comparison of positive rate of diagnostic test methods.
Note: PB, peripheral blood; CSF, cerebrospinal fluid; mNGS, metagenomic next-generation sequencing; a, compared with PB Angiostrongylus-induced antibodies-positive rate and CSF mNGS; b, compared with CSF Angiostrongylus-induced antibodies positive rate and CSF mNGS; *p < 0.05.
case lost to follow-up, the remaining 10 cases were followed up for 3 months to half a year after discharge, and no sequelae were left.
A. cantonensis is a zoonotic pathogen. In the past 20 years, there have been local outbreaks or occasional cases [8] [9] [10]. The basis for the diagnosis of finding the larvae from the cerebrospinal fluid is difficult. Simultaneously, neither clinical manifestations nor cerebrospinal fluid with increased eosinophils are specific for diagnosis. Although advances in immunological technology have improved the diagnostic rate of parasitic infections, this technology is still insufficient for diagnosis A. cantonensis encephalitis [11]. It usually takes a long time to identify A. cantonensis infection, with a median of 26 d in our study. This not only aggravates illness, but also increases the family economic burden. Therefore, it is necessary to find a simple sampling detection method with high diagnostic specificity, and our research found that CSF mNGS is a good alternative.
Since children often like to play with water and soil, once contaminated by A. cantonensis, they can accidentally be infected. Among the study cases in this group, four cases had a history of eating snails, shrimp, or oysters, and two cases had water exposure in the wild, and the remaining five cases failed to trace a suspicious epidemiological contact history and could not provide help in diagnosis. A. cantonensis infection with neurological involvement is more common [2]. In this study, except for one case with fever of unknown origin, ten patients had different neurological symptoms or signs, the most common was headache (45.5%), complained by older children mainly, followed by muscle weakness (21%) and convulsions (9%). Although vomiting occurred in nine cases (81.8%), it might be a nonspecific neurological symptom. Because children cannot clearly describe personal feelings, such as headaches, and activity trajectories, the feasibility of assisting diagnosis through epidemiological history and neurological symptoms is reduced.
A. cantonensis is one of the important pathogen causing eosinophilic meningitis [12], and the increase in eosinophils in CSF is also an important clue for A. cantonensis encephalitis/meningitis. Previous studies have shown that 71% of patients have elevated eosinophils in the cerebrospinal fluid [13], while eight cases (72.7%) increased eosinophils in CSF in our study. However, it has also been reported that only 4% of cases had elevated eosinophils in CSF in the early course of the disease [13], which is not a unique indicator of A. cantonensis encephalitis/meningitis needing ruled out other causes such as other pathogens infections and brain tumors.
Head magnetic resonance imaging (MRI) can find abnormal signals, including multiple nodular enhancement lesions and linear enhancement of the pia mater, which are common in the brain [14] [15]. In our study, five cases (45.5%) showed multinodular enhancement of brain lesions, and three cases (27.3%) showed leptomeningeal enhancement. Although neuroangiostrongyliasis cannot be diagnosed by brain MRI, but may have suggestive, and contribute to other causes of eosinophilic meningitis excluded.
Finding pathogens in human tissues, secretions, and excrement is the basis for diagnosis parasitic infection. However, it is more challenging to detect A. cantonensis directly from the central nervous system (CNS) to confirm the CNS A. cantonensis infection. In contrast, immunological diagnosis methods are relatively feasible, which were used in our study and found that the positive rates of A. cantonensis antibodies in serum and CSF were 54.5% and 27.2%, respectively. In another aspect of the diagnostic technique, the CSF mNGS-positive rate exceeds 80% in our study, which is significantly higher than immunization methods. The patients have a good prognosis by targeted treatment. Metagenomic next-generation sequencing (mNGS) has greatly increased the pathogen detection rate of central nervous system infections [16-18]. Additionally, pathogens of mixed infections in CNS can be found more comprehensively by mNGS, especially in patients with a long course of the disease and low immunity, simultaneously, the therapeutic effect can be evaluated by monitoring the reads [18]. Miao et al. suggest that mNGS could yield higher sensitivity for early identification of fastidious and time-consuming microbes (e.g., Mycobacterium tuberculosis, virus, anaerobe, and fungus) [19]. Our study confirmed that mNGS also has a high sensitivity in the diagnosis of parasitic infection. Presently, the mNGS technology is not widely used in clinical practice due to its high cost of testing, however, a clear early diagnosis, followed by targeted treatment in exchange for lower hospital stay, costs and sequelae rate, and comprehensive cost performance might be more beneficial to patients.
Compared with epidemiological history, elevated eosinophils, antibody immune detection, and brain MRI examination, CSF mNGS technology can obtain a higher positive diagnosis rate in children with A. cantonensis encephalitis/me- ningitis, which not only helps find the CNS pathogens earlier and comprehensively, but also evaluate the efficacy of treatment, and its clinical value is worthy of promotion.
This study still has some limitations. First of all, this is a retrospective single- center study with a limited number of children. Additionally, due to the limitation of testing costs, it was impossible to conduct a re-examination of CSF mNGS in all patients. Its clinical promotion requires further technical improvement and reduction in testing costs.
This study was supported by the Innovative Project of Children's Research Institute, Guangzhou Women and Children's Medical Center, China (No. NKE- PRE-2019-015).
*These authors contributed equally to this work.
#Corresponding author.
Cite this paper: Fan, X. , Wang, Q. , Li, P. , Ai, B. , Song, Y. , Peng, Q. and Wang, H. (2021) The Diagnostic Value of Metagenomic Next-Generation Sequencing in Angiostrongylus cantonensis Encephalitis/Meningitis. Journal of Behavioral and Brain Science, 11, 216-226. doi: 10.4236/jbbs.2021.119017.
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https://doi.org/10.1093/cid/ciy693


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When His Eyes Opened By Simple Silence Chapter 81
Read When His Eyes Opened By Simple Silence Chapter 81
Tammy was frantically sending signals at Avery with her eyes, but all Avery could think about was the relationship between Elliot and Jun.
"Miss Tate, the reason why I never told you that I knew Elliot was because I did not want to make you feel troubled," Jun began to explain himself with a smile. "You didn't exactly get along well before this. I didn't mean to hide it from you… I really do want to buy your father's company."
Tammy moved her phone under the table and sent Avery a text.
Tammy: [Don't listen to him, Avery! Elliot Foster is the one who wants to buy Tate Industries! It's Elliot Foster!]
Avery glanced at her phone on the table and opened up the text.
She read it and gazed coldly at Jun. "Did you tell Elliot about your interest in buying my company?" she asked.
Jun's warm smile remained on his face as he said, "I did. I asked for his opinion and he told me it was worth a try. As I told you before, I've been looking for investment opportunities ever since I graduated college."
Avery received yet another text from Tammy: [He's lying! He's just Elliot Foster's pawn!]
Her heart tightened as she continued to interrogate Jun.
"Did you really get the money from your father? Does he have time to meet up tomorrow? I'd like to talk to him."
Jun turned pale as he responded, "I borrowed the money! I didn't tell you because I was embarrassed…"
"Who lent you the money?" Avery pried.
Elliot, who was sitting in silence throughout the entire conversation, finally spoke up.
"I did," he said.
Tammy sent Avery another text: [They're both lying! Elliot Foster is Mr. Z! Jun told me himself just now! You have to expose them right now!]
Avery had one hand clenched tightly around her phone and the other gripping her glass of water.
Her face was rid of color, and her lips were pale from her biting down on them.
Elliot was Mr. Z.
He wanted to use Jun's name to buy out Tate Industries.
No matter what his objectives were, Elliot's actions left a bad taste in her mouth.
Why did he not make the offer himself?
Was he looking down on Tate Industries?
Or was this his way of humiliating her?
The night of her first meeting with Mr. Z popped into Avery's mind.
Elliot was furious that she had gone out to meet a complete stranger and made her suffer through the entire night.
Did he think she was an idiot?
Was it exciting for him to have her wrapped around his finger?
If there were no other people around them, Avery would have slapped Elliot in the face.
Even if she did that, however, what would that change?
Avery left the cup on the table, stood up, and stormed off.
"Wait for me, Avery!" Tammy cried as she picked up her bag and trailed after Avery.
Jun's jaw dropped in mortification.
What the h**l?
Did they know each other?
"Elliot… I'm sorry… I had no idea that they were friends!"
His mind was in a frenzy of thoughts as his cheeks turned crimson.
He messed up!
Elliot's expression was cold as he curled his fingers to form a fist.
"I thought your girlfriend looked familiar when you sent me her photo yesterday. Then, I recalled seeing her when I was at the concert hall with Avery before. She told me that she had a friend there at the time."
"I see… So, you brought Avery along to meet me because you knew they were friends!" Jun said with an enlightened expression on his face.
"Why did you take the risk of Avery finding out about all of this and bring her here?"
"Did you tell your girlfriend anything?" Elliot asked.
Jun scratched his head and answered truthfully, "I said some things before you got here. It was just some information to make conversation easier with you… Why is Avery so upset about this? Isn't she overreacting even if you were the one who wanted to acquire her company? It's a lot of money that we're talking about here! Nobody else other than you would be willing to cough up that amount to buy out Tate Industries."
"She can't accept the fact that I'm Mr. Z," Elliot replied hoarsely.
The Divorced Billionaire Heiress by I Wanna Eat Meat Ch. 208

redpajama_set_name: RedPajamaCommonCrawl


Guatemala Fair Trade: These are the days of our lives.
19 Jun Guatemala Fair Trade: These are the days of our lives.
Last time we check in we had just finished our trek from Xela to Lago Atitlan with QuetzalTrekkers. It was magical adventure into misty mountains, mayan ceremonies, a reforestation project with Chico Mendes and finally breathtaking view over Lago Atitlan. Our team took a every step of the trek with stride and bright spirits even in the pouring rain. The final day the rainy season came down hard and TL's and QT staff decided to avoid a wet and utterly frozen team, hopped onto a nearby truck and made our way to our next families home to warm up by fire with marshmallows and card games; Yaneff! We woke up at 4am to the stars and hit the road for our final leg stretch to see the sunrise over Lago Atitlan. What a view! It was not long before our sleeping bags were out and snuggling commenced over cafecito and hot cocoa. A short siesta over the cliffs before our descendance into San Juan La Laguna.
After the hike we went to hang out at the OG hub in San Juan La Laguna on Lago Atitlan. We got to go fishing with a local cooperative, weaving with women and learning some of the quickest embroidering known to mankind! We even played host to a local family to share some of our very own 'local' cuisine. The great pancake and stuffed frech toast exchange, but here's the delicious catch: It was smothered in maple syrup that some of us grabbed at duty free!
From here the team headed west to Santa Anita La Union. One of the highlights and richest cultural experiences for the team was our home stays in this region! We were part of the construction of the coffee cooperative's (AMCASA) very first coffee drying patio. We worked hard pouring the concrete and framing the structure and spent our down time listening to incredible stories from families surrounding their ex-Guerrilla history and current revolutionary politics.
San Miguel Ixtahuacan was a short, but memorable stop for the Fair Trade team. Their stories hit home with us as we visited people in communities that are directly affected by open pit Marlin Mine gold mining operations. We visited with ADISMI who warmly welcomed us into the barracks for several days and gave us a glimpse into the complicated surrounding and disparate community opinions surrounding anti-mining politic. Our final morning was spent in a mayoral meeting with men who welcomed us into a discussion about future collaboration and project development in San Miguel Ixtauhaucan.
Our next stop was Tzibal, then Lanquin and El Estor! Lots of travel time, but we all feel Guatemalan transportation and truckin' is da bomb! Our team continues to trek by foot, crowd on chicken buses and squeeze onto microbuses, but the favorite amongst us all is the 4×4 pick up truck!
More updates to come soon! We leave you for now. Les dejamos por ahora!
Santa Anita la Union, Xela, Quetzaltrekkers, cafecito, San Miguel, The hub!


Environmental groups from Papua New Guinea issued a letter to China during the recent Asia-Pacific Economic Cooperation (APEC) Summit, highlighting the negative effects of rampant logging in the country's forest-dependent communities.
China's imports of timber from Papua New Guinea (PNG) are winnowing away the country's forests, according to a group of NGOs, researchers and landowners. Without action by Chinese leaders, they wrote in a letter to President Xi Jinping, the illegalities and corruption that plague PNG's forestry sector will only continue.
Amid the political posturing around the trade war between the United States and China at the Asia-Pacific Economic Cooperation (APEC) Summit in PNG's capital, Port Moresby, last week, the delivery of the letter to Xue Bing, China's ambassador to PNG, garnered little attention. But for the future of PNG's forests and the communities that depend on them, it's vital that China mandates that all the wood it imports be legally and sustainably harvested, the letter's authors said.
Xue did not respond to Mongabay's request for an interview.
"China's influence in PNG is strong and growing," Peter Bosip, executive director of the PNG-based Center for Environmental Law and Community Rights (CELCOR), said in a statement. CELCOR was one of the signatories to the letter.
Bosip said PNG had recently signed onto China's Belt and Road Initiative, leading to a tidal wave of potential new investments in PNG, as well as the roughly 60 other countries throughout Africa, Asia and Europe that are involved.
"But meanwhile, the forests that sustain our livelihoods and culture are being liquidated," Bosip said.
PNG's timber sector has struggled with illegality and corruption, including claims that communities have not given proper consent for the forests they manage to be cut down. In other cases, agricultural companies have improperly used "special agriculture and business leases," or SABLs, intended to promote food production, to instead harvest and export timber.
In fact, a report published in July 2018 by the watchdog NGO Global Witness found that, despite legal protections for PNG's forests and the communities that depend on them, much of the timber leaving the country's shores has a high risk of having been illegally harvested.
Lela Stanley, a policy adviser at Global Witness and author of the recent report on PNG's timber sector, agreed.
Stanley also said there was little question that PNG's forests were being logged and cleared at rates far beyond what could be considered sustainable. A 2015 analysis found that 7.5 per cent of the province of West New Britain had been logged or clear-cut between 2002 and 2014.
Since 2014, deforestation appears to have ramped up considerably in the province. Satellite data from the University of Maryland (UMD) show tree cover loss skyrocketed in 2015, more than quadrupling over 2014 levels. In that single year, the province lost 1.7 per cent of its forest cover.
[China has] effectively become the world's launderer of illegal timber.
Data from 2018 indicate deforestation may be advancing inland and encroaching into the island's last intact forest landscapes (IFLs), which are areas of native vegetation cover that are large and undisturbed enough to harbor their original levels of biodiversity. One such area is in the northwestern part of the province. Deforestation alerts from UMD's Global Land Analysis & Discovery lab show what appear to be logging roads cropping up around dense clusters of tree cover loss. According to the forest monitoring platform Global Forest Watch, these roads are infiltrating IFLs and areas with high levels of biodiversity.
According to UMD data, clearing in this area began in early September. By November 15, nearly 2,000 deforestation alerts had been recorded, with most occurring in an IFL that was intact in 2016.
Global Witness is joining the letter's authors in calling for China to extend its plans for an "ecological civilisation" beyond its borders.
However, even as China shores up its environmental practices at home, the harvest of resources that fuel its economy, including timber from PNG, are "driving environmental devastation" abroad, Juffa said.
"This needs to change now," he said.
China gets nearly 30 per cent of its tropical timber from PNG. PNG and its neighbor, the Solomon Islands, a country battling similar questions about sustainability and legality, collectively account for half of tropical wood imports to China.
China has "effectively become the world's launderer of illegal timber," Stanley said, as other markets in Europe, the United States and Australia have clamped down on the imports of illicitly harvested wood.
She said that China, with its sizable influence in the region, could instigate positive change in the way forests are managed in countries like PNG. The status quo comes with significant risks, especially to the communities represented by the organisations behind the letter to China's president.
"What happens to them when they're left behind after the forest has been cleared or heavily logged, and it's a forest that they've relied on for food and medicine and cultural sustenance?" Stanley said. "What do they do then?


Rhinos don't eat pancakes / written by Anna Kemp ; illustrated by Sara Ogilvie.
Kemp, Anna, (author.). Ogilvie, Sara, 1971- (illustrator.).
Publisher: [Place of publication not identified] : Simon & Schuster, 2015/05/05.
"Originally published in 2011 by Simon & Schuster UK Ltd."
Daisy's parents never listen to her, even when a purple rhinoceros moves in and starts eating all the pancakes in the house.
Subject: Parent and child > Fiction.


text:
Q: make UIAccessibilityTrait adjustable ignore double-tap (like a button) swift I have a custom control to increment and decrement values. Now that I've added support for voice over, I've stumbled upon a problem.
My customView has the accessibility trait .adjustable and I implemented the correct methods for increasing and decreasing the values.
However, the voice over user can also double tap on that view to activate it. The problem is, that this triggers a gesture which is irrelevant to voice over users.
Is there a way to prevent an adjustable accessibility view from being activated so that the element is only adjustable, not double-tappable like a button?

A: There are two important properties to know when a double-tap occurs:

*

*accessibilityActivate.

*accessibilityActivationPoint.

In your case, you could just return true by overriding accessibilityActivate and if it's not enough, provide as well a CGPoint coordinate that triggers nothing (depends of your custom control and its neighborhood).
Otherwise, use the accessibilityElementIsFocused instance method to know wether you can trigger actions as this complete example shows up.

A: I ended up using UIAccessibility.isVoiceOverRunning to stop any tasks which would be triggered by a doubletap on that specific element.

redpajama_set_name: RedPajamaStackExchange


Azure Data Lake Store (ADLS) is a fully managed, elastic, scalable, and secure file system that supports semantics of the Hadoop distributed file system (HDFS) and the Microsoft Cosmos file system. It is specifically designed and optimized for a broad spectrum of big data analytics that depend on an extremely high degree of parallel reads and writes, as well as colocation of compute and data for high-bandwidth and low-latency access. It brings together key components and features of Cosmos — long used internally at Microsoft as the warehouse for data and analytics — and HDFS. It also is a unified file storage solution for analytics on Azure. Internal and external workloads run on this unified platform. Distinguishing aspects of ADLS include its support for multiple storage tiers, exabyte scale, and comprehensive security and data sharing. Raghu Ramakrishnan will cover ADLS architecture, design points, the Cosmos experience, and performance.