The Impact of Treatment on the Serum Concentration of Interleukin-1 Beta in Pulmonary Tuberculosis.

Tuberculosis (TB) is a major public health problem in the world. Further elucidation of the pathogenesis and identification of suitable biomarkers of the disease have remained research priorities. Interleukin-1 beta (IL-1 ß) signaling is known to be high in active tuberculosis. In this study, we followed up a cohort of adult sputum-positive tuberculosis patients and investigated the impact of anti-tuberculosis treatment on the serum concentrations of IL-1 ß. The protocol was approved by the Ethics Committee of University of Nigeria Teaching Hospital Enugu. Each participant gave informed consent. Serum concentration of Interleukin-1 was measured before treatment, after 2 months of treatment, and after 6 months of treatment by Enzyme linked immunosorbent assay method. Forty-two tuberculosis patients and 31 healthy volunteers completed the study. The patients had good clinical response to treatment. The mean serum concentration of Interleukin-1 beta (IL-1 ß) for the patients before treatment was very high (30.20 ± 2.0 pg/mL) compared with those of healthy controls (13.30 ± 1.30). As treatment progressed there was remarkable, progressive and statistically significant (P < 0.05) reduction in the mean IL-1 ß serum concentration of the patients: 21.80 ± 1.1 pg/ml after 2 months and 16.96 ± 1.3 pg/mL after 6 months treatment. At the completion of treatment, the mean serum concentration of IL-1 ß of the patients was comparable but slightly higher than those of the healthy controls. Serum concentration of Interleukin-1 beta is thus considered a potential host biomarker for active tuberculosis in adult humans.

Integration of the athena vortex lattice aerodynamic analysis software into the multivariate design synthesis of a blended wing body aircraft.

This paper describes the process of integrating the Athena Vortex Lattice aerodynamics solver into a conceptual design environment for the multivariate design synthesis and optimisation of a Blended Wing Body (BWB) Aircraft. The work is derived from a PhD study, by one of the authors, which developed a design methodology for the conceptual design synthesis, analysis and optimisation of a BWB aircraft. This research was driven by the desire to utilise proven aerodynamic solvers, written in legacy codes, in modern computational design environments in order to improve the accuracy and fidelity in the design of novel aircraft configurations. The Athena Vortex Lattice code is a legacy code written in the FORTRAN programming language and developed at the Massachusetts Institute of Technology by Mark Drela while the multivariate conceptual design synthesis and optimisation was implemented in JAVA object oriented programming tool. The result from this study is the successful integration of the AVL software into the JAVA programming environment for the multivariate design synthesis optimisation of the BWB without loss of accuracy. The successful integration of these codes permit a more accurate design synthesis, analysis and optimisation of the novel aircraft configuration in the absence of a tailor-made and realistic empirical aerodynamic analysis model for the BWB Aircraft. Additionally, this research enables the automation of the design process and the accomplishment of the multivariate optimisation.

Evaluation of the Influence of Eggshell (ES) Concentration on the Degradation Behavior of Mg-2.5Zn Biodegradable Alloy in Simulated Body Fluid.

Currently, permanent vascular stents are fabricated using titanium and stainless steel implants that are nondegradable and offer high stability, but they have certain disadvantages. For example, the prolonged exposition of aggressive ions in the physiological media and the existence of defects in the oxide film create conditions for corrosion to occur, thus triggering unwanted biological events and compromising the mechanical integrity of the implants. Moreover, when the implant does not need to be permanent, there is the need to submit the patient for a second surgery for implant removal. As a solution for nonpermanent implants, biodegradable magnesium alloys have been deemed a promising substitute, for example, for cardiovascular-related applications and the construction of orthopedic devices. A biodegradable magnesium alloy (Mg-2.5Zn) reinforced by zinc and eggshell was employed in this study as an environment-conscious magnesium (eco) composite (Mg-2.5Zn-xES). Disintegrated melt deposition (DMD) was used to fabricate the composite. Experimental studies were conducted to investigate the biodegradation performance of Mg-Zn alloys containing 3 and 7 wt % eggshell (ES) in simulated body fluid (SBF) at 37 °C. Different corrosion techniques were used to study the corrosion behavior of the Mg-2.5Zn-xES composites, including weight loss measurements, hydrogen evolution, potentiodynamic polarization, electrochemical impedance spectroscopy (EIS), and scanning vibrating electrode technique (SVET). Scanning electron microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), and X-ray diffraction (XRD) were employed to scrutinize the corroded surfaces' morphology and composition. The outcomes indicated that Mg-2.5Zn-3ES possesses the lowest degradation activity.

Renewable energy as a source of electricity for Murzuq health clinic during COVID-19.

Abstract: A great number of populations of the world, primarily in developing countries, are living in rural areas and are commonly isolated from the grid connection. Unstable power supply and increasing energy prices have significant effects on developing countries, especially during this COVID-19 pandemic. Renewable energy sources can provide sustainable and efficient electricity supply. Murzuq is a rural community situated in the southern part of Libya and endowed with renewable energy resources. While there is high electricity consumption during the lockdown, health clinics also experienced higher energy consumption of longer operating hours and an increased number of electrical appliances. This study investigates the techno-economic assessment of three different hybrid energy systems for health clinics in Murzuq. HOMER (Hybrid optimization model for electric renewables) software tool was used to evaluate the feasibility of employing renewable energy, to provide sustainable energy supply to the clinic. The current unsteady energy supply comes from the national grid and the current energy supply is not sufficient for the clinic's operating hours and requires a sustainable and steady supply. Measured data collected from the health clinic and HOMER software were used to analyze and optimize the change in overall electricity demand for the health clinic before and during the COVID-19 pandemic. The results showed that the photovoltaic/battery hybrid energy system has a lower net present cost, compared to the Photovoltaic/Generator set/ battery hybrid energy system, but higher than the standalone generator set. However, the highest amount of carbon emission associated with the standalone generator set compared to the other two hybrid energy systems disqualifies it from being a suitable contender for the source of electricity for the health clinic. The photovoltaic/battery was deemed to be most economically beneficial in terms of emission reduction and energy price. The outcomes of this investigation will help stakeholders and designers to optimize hybrid energy systems that economically meet the health clinic energy demands, especially during this pandemic.

Multilayer Reflective Coatings for BEUV Lithography: A Review.

The development of microelectronics is always driven by reducing transistor size and increasing integration, from the initial micron-scale to the current few nanometers. The photolithography technique for manufacturing the transistor needs to reduce the wavelength of the optical wave, from ultraviolet to the extreme ultraviolet radiation. One approach toward decreasing the working wavelength is using lithography based on beyond extreme ultraviolet radiation (BEUV) with a wavelength around 7 nm. The BEUV lithography relies on advanced reflective optics such as periodic multilayer film X-ray mirrors (PMMs). PMMs are artificial Bragg crystals having alternate layers of "light" and "heavy" materials. The periodicity of such a structure is relatively half of the working wavelength. Because a BEUV lithographical system contains at least 10 mirrors, the optics' reflectivity becomes a crucial point. The increasing of a single mirror's reflectivity by 10% will increase the system's overall throughput six-fold. In this work, the properties and development status of PMMs, particularly for BEUV lithography, were reviewed to gain a better understanding of their advantages and limitations. Emphasis was given to materials, design concepts, structure, deposition method, and optical characteristics of these coatings.

Anticorrosion and dispersive adsorption studies of natural andrographolide on carbon steel in acid-chloride environments.

Andrographolide, a bioactive naturally occurring labdane diterpenoid with outstanding antioxidant effects in medicine, has been isolated and purified from Andrographis paniculata, and applied in acid-chloride environments for the corrosion protection of carbon steel. Upon isolation, the phytochemical was identified by NMR and FTIR, while its corrosion inhibition evaluation was achieved by combined electrochemical and gravimetric experiments. The adsorption of andrographolide on carbon steel was examined by SEM, FTIR, and 3D surface measurement, and computational studies were used to describe the adsorption characteristics and properties. The experimental measurements revealed that andrographolide is an effective mixed-type corrosion inhibitor whose efficiency was dependent on both its concentration and the temperature of the environment, with maximum inhibition efficiency of 92.4% recorded for 2.0 g/L andrographolide after 48 h at 318 K. The adsorption of andrographolide and its anticorrosion capacity on carbon steel surface was confirmed by the employed surface analytical techniques, while molecular electrostatic potential, conceptual density functional theory, and molecular dynamics simulation predicted the quantum chemical details and binding properties of the phytochemical on Fe (110) surface at different temperatures.

Enhancement of mechanical and corrosion resistance properties of electrodeposited Ni-P-TiC composite coatings.

In the present study, the effect of concentration of titanium carbide (TiC) particles on the structural, mechanical, and electrochemical properties of Ni-P composite coatings was investigated. Various amounts of TiC particles (0, 0.5, 1.0, 1.5, and 2.0 g L-1) were co-electrodeposited in the Ni-P matrix under optimized conditions and then characterized by employing various techniques. The structural analysis of prepared coatings indicates uniform, compact, and nodular structured coatings without any noticeable defects. Vickers microhardness and nanoindentation results demonstrate the increase in the hardness with an increasing amount of TiC particles attaining its terminal value (593HV100) at the concentration of 1.5 g L-1. Further increase in the concentration of TiC particles results in a decrease in hardness, which can be ascribed to their accumulation in the Ni-P matrix. The electrochemical results indicate the improvement in corrosion protection efficiency of coatings with an increasing amount of TiC particles reaching to ~ 92% at 2.0 g L-1, which can be ascribed to a reduction in the active area of the Ni-P matrix by the presence of inactive ceramic particles. The favorable structural, mechanical, and corrosion protection characteristics of Ni-P-TiC composite coatings suggest their potential applications in many industrial applications.

Quality of anti-malarial drugs provided by public and private healthcare providers in south-east Nigeria.

BACKGROUND: There is little existing knowledge about actual quality of drugs provided by different providers in Nigeria and in many sub-Saharan African countries. Such information is important for improving malaria treatment that will help in the development and implementation of actions designed to improve the quality of treatment. The objective of the study was to determine the quality of drugs used for the treatment of malaria in a broad spectrum of public and private healthcare providers. METHODS: The study was undertaken in six towns (three urban and three rural) in Anambra state, south-east Nigeria. Anti-malarials (225 samples), which included artesunate, dihydroartemisinin, sulphadoxine-pyrimethamine (SP), quinine, and chloroquine, were either purchased or collected from randomly selected providers. The quality of these drugs was assessed by laboratory analysis of the dissolution profile using published pharmacopoeial monograms and measuring the amount of active ingredient using high performance liquid chromatography (HPLC). FINDINGS: It was found that 60 (37%) of the anti-malarials tested did not meet the United States Pharmacopoeia (USP) specifications for the amount of active ingredients, with the suspect drugs either lacking the active ingredients or containing suboptimal quantities of the active ingredients. Quinine (46%) and SP formulations (39%) were among drugs that did not satisfy the tolerance limits published in USP monograms. A total of 78% of the suspect drugs were from private facilities, mostly low-level providers, such as patent medicine dealers (vendors). CONCLUSION: This study found that there was a high prevalence of poor quality drugs. The findings provide areas for public intervention to improve the quality of malaria treatment services. There should be enforced checks and regulation of drug supply management as well as stiffer penalties for people stocking substandard and counterfeit drugs.

Synthesis and Performance Evaluation of Pulse Electrodeposited Ni-AlN Nanocomposite Coatings.

This research work presents the microscopic analysis of pulse electrodeposited Ni-AlN nanocomposite coatings using SEM and AFM techniques and their performance evaluation (mechanical and electrochemical) by employing nanoindentation and electrochemical methods. The Ni-AlN nanocomposite coatings were developed by pulse electrodeposition. The nickel matrix was reinforced with various amounts of AlN nanoparticles (3, 6, and 9 g/L) to develop Ni-AlN nanocomposite coatings. The effect of reinforcement concentration on structure, surface morphology, and mechanical and anticorrosion properties was studied. SEM and AFM analyses indicate that Ni-AlN nanocomposite coatings have dense, homogenous, and well-defined pyramid structure containing uniformly distributed AlN particles. A decent improvement in the corrosion protection performance is also observed by the addition of AlN particles to the nickel matrix. Corrosion current was reduced from 2.15 to 1.29 µA cm-2 by increasing the AlN particles concentration from 3 to 9 g/L. It has been observed that the properties of Ni-AlN nanocomposite coating are sensitive to the concentration of AlN nanoparticles used as reinforcement.

Consumers stated and revealed preferences for community health workers and other strategies for the provision of timely and appropriate treatment of malaria in southeast Nigeria.

BACKGROUND: The African Heads of State meeting in Abuja, Nigeria on Roll Back Malaria adopted effective treatment of malaria nearer the home as one of the strategies for malaria control in Africa. A potentially effective strategy for bringing early, appropriate and low cost treatment of malaria closer to the home is through the use of community health workers (CHWs). There is paucity of information about people's actual preferences for CHWs and how stated preferences relates to revealed preferences for both the CHW strategy and other strategies for improving the timeliness of malaria treatment in not only Nigeria but in many malaria endemic countries. OBJECTIVES: To determine peoples' stated and actual preferences for different strategies for improving the timeliness and appropriateness of treatment of malaria before and after the implementation of a community health workers (CHW) strategy in their community. METHODS: A prospective study was undertaken in a rural malaria holo-endemic Nigerian community. A questionnaire was used to collect information on health-seeking from householders before (first survey) and after (second survey) implementation of a CHW malaria treatment strategy. RESULTS: The consumers mostly preferred the CHW strategy over self-treatment in the homes and other strategies of treatment. The use of community health workers (CHWs) increased from 0% to 26.1% (p < 0.05), while self-treatment in the homes decreased from 9.4% to 0% (p < 0.05) after the implementation of the CHW strategy. Use of patent medicine dealers also decreased from 44.8% to 17.9% (p < 0.05) after CHW strategy was implemented. CONCLUSION: Community health workers can be used to improve and ensure timely and appropriate treatment of malaria. The CHW strategy could also be sustained since it was preferred and used by consumers over self-treatment in the homes as well as other strategies for improving treatment. Hence, the CHW strategy is a feasible and promising method of improving home-management of uncomplicated malaria.

Effect of methylprednisolone injection on interleukin-4 and interferon-gamma expression following hepatitis B vaccination in mice.

BACKGROUND/AIM: The prevalence of hepatitis B infection is high worldwide with liver cirrhosis and hepatocellular carcinoma as important complications. Immunosuppression, especially from corticosteroids, is often cited as a cause of poor immune response and there is documented evidence of irrational administration of glucocorticoids to children and adults. Decreased expression of interleukin-4 and interferon-gamma is an indication of poor humoral and cellular immune responses, respectively. Therefore, we decided to find out if methylprednisolone injection decreases interleukin-4 and interferon-gamma expression following hepatitis B vaccination in mice. MATERIALS AND METHODS: Mice were randomly divided into 2 groups. Daily intramuscular injections of methylprednisolone (15 mg/kg) were given to the test group while water for injection (0.1 mL) was given to the control group for 30 days. On day 6 all mice were given 2 µg of hepatitis B vaccine and they received a booster dose on day 27. On day 34, blood samples were collected and analyzed for interleukin-4 and interferon-gamma titers. RESULTS: There was positive interleukin-4 and interferon-gamma response in all groups but the differences in titers were not statistically significant. CONCLUSION: At the dosages and length of exposure used in this study, methylprednisolone injection did not significantly inhibit interleukin-4 and interferon-gamma expression following immunization against hepatitis B virus in mice.

Exploring Consumer Perceptions and Economic Burden of Onchocerciasis on Households in Enugu State, South-East Nigeria.

INTRODUCTION: Onchocerciasis or river blindness constitutes a major burden to households especially in resource-poor settings, causing a significant reduction in household productivity. There has been renewed interest from policy makers to reduce the burden of Neglected Tropical Diseases (NTDs) such as onchocerciasis on individuals and households. This paper provides new information on the patient's perceptions of onchocerciasis and its economic burden on households in South-eastern Nigeria. The information will be useful to health providers and policy makers for evidence-informed resource allocation decisions. METHODS: Information was generated from a cross-sectional household survey conducted in Achi community, Oji River Local Government Area (LGA) of Enugu State, Southeast Nigeria. A pre-tested interviewer-administered questionnaire was used to collect data. A total of 747 households were visited randomly and data were collected using pre-tested interviewer administered questionnaire from 370 respondents. The respondents' knowledge of the cause of symptoms of the disease, costs incurred for seeking treatment and productivity losses were elicited. Data were analyzed using tabulations and inferential statistics. A socio-economic status (SES) index was used to disaggregate some key variables by SES quintiles for equity analysis. RESULTS: Many people had more than one type of manifestation of onchocerciasis. However, more than half of the respondents (57%) had no knowledge of the cause of their symptoms. Male respondents had significantly more knowledge of the cause of symptoms than females (P = 0.04) but knowledge did not differ across SES (P = 0.82). The average monthly treatment cost per respondent was US$ 14.0. Drug cost (US$10) made up about 72% of total treatment cost. The per capita productivity loss among patients was US$16 and it was higher in the poorest (Q1) (US$20) and the third SES quintiles (Q3) (US$21). The average monthly productivity loss among caregivers was US$3.5. CONCLUSION: Onchocerciasis still constitutes considerable economic burden on patients due to the high cost of treatment and productivity loss. Prioritizing domestic resource allocation for the treatment of onchocerciasis is important for significant and sustained reduction in the burden of the disease. In addition, focused health promotion interventions such as health education campaigns should be scaled up in onchocerciasis-endemic communities.

Is combination therapy for malaria based on user-fees worthwhile and equitable to consumers? Assessment of costs and willingness to pay in Southeast Nigeria.

OBJECTIVES: To examine the equity implications of the costs of an episode of malaria, the benefit/cost ratios of using two artemisinin-based combination therapy (CT) from the consumers' view and inequities in willingness to pay (WTP) for CT. METHODS: A cross-sectional survey was conducted in Southeast Nigeria, where there is a moderate to high level of malaria resistance to chloroquine and sulfadoxine-pyrimethamine formulations. WTP was elicited from respondents using the bidding game (BG) and the structured haggling technique (SH). A socio-economic status (SES) index was used to examine the level of inequity in the key variables. In the benefit/cost ratios, the average cost of CT in Nigeria and price of Coartem were, respectively, used as the cost inputs while the mean WTP was the measure of benefit. Multiple regression analyses were used to determine the validity of the WTP estimates. RESULTS: More than 90% of the respondents were willing to pay for CT. The mean WTP in the BG was 301.1 Naira while it was 438.0 Naira in the SH. People in the highest SES quartile (Q4) were more willing to pay for CT than the lowest SES quartile (Q1). In the regression models, the SES quartiles were significantly related to levels of WTP. The benefit/cost ratios were higher in the SH group, and the ratio was only more than 1 using Coartem in only the SH group. The Q1 groups had the least benefit cost-ratios but the trend of SES differentials in benefit/cost ratios were not statistically significant in the BG group but was in the SH group. CONCLUSION: CT based on user-fees may not be worthwhile and equitable because there are economic and equity constraints to its wide-scale use. Benefit/cost ratios depend on the type of questions that were used to elicit WTP. Governments and donors should be willing to commit funds to make CT affordable to the poor consumers for the intervention to be used to significantly reduce the burden of malaria.

Altruistic willingness to pay in community-based sales of insecticide-treated nets exists in Nigeria.

The objective of this study was to determine whether households who are willing to pay for insecticide-treated nets (ITNs) for themselves are prepared to contribute for the ITNs to be purchased for the indigent community members who cannot afford the nets. This was in the framework of community-based and directed sales for ITNs. The study was conducted in four malaria holoendemic communities in south-eastern Nigeria. Contingent valuation method was used to determine the altruistic willingness to pay (WTP) from randomly selected household heads or their representatives, which was elicited using an open-ended question. Theoretical validity was assessed using the Tobit model. Median altruistic WTP ranged from $0.11 to $0.21 across the four communities (95 Naira = $1). However, using a pooled data from the four communities, the mean was $0.34. In Tobit estimation, altruistic WTP varied significantly with two of the communities; the respondents were resident in, sex, marital status and the amount of savings of the respondent. It also varied significantly with the respondents' WTP for their own ITNs and average monthly household expenditures to treat malaria (p<0.05). Altruistic WTP will exist in community-based and directed sales of ITNs. Thus there can be intra-community subsidisation by the rich for the poor who may not be able to pay for the nets. Community mobilisation and sensitisation should be used to encourage able households to actually pay at least the amounts they have stated.

Community-directed treatment with ivermectin in two Nigerian communities: an analysis of first year start-up processes, costs and consequences.

OBJECTIVES: To determine the start-up processes, costs and consequences of community-directed treatment with ivermectin (CDTI) in two onchocerciasis endemic rural towns of Southeast Nigeria; namely Achi and Nike. The other objectives were to discover the community-financing mechanisms, local ivermectin distribution strategies and communities' organisational capacity to handle the programme. METHODS: Structured questionnaires, informal interviews, observations, discussions with community members at general village assemblies and community outreach lectures were used at different stages of the study. RESULT: The towns had the organisational capacity to implement the programme. Coverage with ivermectin was between 31-73% in Achi (mean = 58.6%), and 36.6-72% in Nike (mean = 61.95%). The unit financial costs were $0.17 in Nike and $0.13 in Achi, but the unit aggregate cost was $0.37 in Nike and $0.39 in Achi. When research costs were removed, the unit aggregate cost was $0.22 in Achi and $0.20 in Nike. Provider's financial costs and communities' non-financial costs were the biggest contributors to the aggregate cost. The cost would decrease in subsequent years since the research cost and parts of the mobilisation and training costs would not be incurred after the first year. CONCLUSION: Governments and sponsors of CDTI should find means of continuously strengthening the programme and providing technical support to the communities. As both CDTI and communities are dynamic entities, continuous health education campaigns are needed to keep reminding the people of the benefit of long-term ivermectin distribution, together with the need for community ownership of the programme.