Ocular toxoplasmosis: a review of the current diagnostic and therapeutic approaches.

PURPOSE: This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up and therapeutic approach of ocular toxoplasmosis focusing mainly on the postnatally acquired form of the disease. METHODS: A meticulous literature search was performed in the PubMed database. A supplementary search was made in Google Scholar to complete the collected items. RESULTS: Ocular toxoplasmosis is one of the most frequent infectious etiologies of posterior uveitis. It typically presents with retinochoroiditis. Setting an accurate diagnosis depends to a considerable degree on detecting characteristic clinical characteristics. In addition to the evaluation of clinical features, the diagnosis of toxoplasmosis relies at a large degree on serologic testing. The detection of the parasite DNA in the aqueous or vitreous humor can provide evidence for a definitive diagnosis. The current mainstay for the treatment, if necessary, is the use of oral antibiotic with systemic corticosteroids. Recent evidence suggests other therapeutic approaches, such as intravitreal antibiotics can be used. CONCLUSION: Recent developments in the diagnostic and therapeutic approach have contributed to preventing or limiting vision loss of patients suffering from ocular toxoplasmosis. Further studies are required to provide a better understanding of epidemiology, pathogenesis, diagnosis, and treatment with a significant impact on the management of this challenging clinical entity.

Early detection of dengue virus by use of reverse transcription-recombinase polymerase amplification.

A method for the rapid diagnosis of early dengue virus (DENV) infection is highly needed. Here, a prototype reverse transcription-recombinase polymerase amplification (RT-RPA) assay was developed. The assay detected DENV RNA in <20 min without the need for thermocycling amplification. The assay enabled the detection of as few as 10 copies of DENV RNA. The designed RT-RPA primers and exo probe detected the DENV genome of at least 12 genotypes of DENV circulating globally without cross-reacting with other arboviruses. We assessed the diagnostic performance of the RT-RPA assay for the detection of DENV RNA in 203 serum samples of patients with clinically suspected dengue. The sera were simultaneously tested for DENV using a reverse transcription-loop-mediated isothermal amplification (RT-LAMP) assay, quantitative RT-PCR (qRT-PCR), and IgM- and IgG-capture enzyme-linked immunosorbent assays (ELISA). Acute DENV infection was confirmed in 130 samples and 61 of the samples (46.9%) were classified as viremic with qRT-PCR. The RT-RPA assay showed good concordance (κ of ≥0.723) with the RT-LAMP and qRT-PCR assays in detecting the dengue viremic samples. When used in combination with ELISA, both the RT-RPA and RT-LAMP assays increased the detection of acute DENV infection to ≥95.7% (≥45/47) in samples obtained within 5 days of illness. The results from the study suggest that the RT-RPA assay is the most rapid molecular diagnostic tool available for the detection of DENV. Hence, it is possible to use the RT-RPA assay in a laboratory to complement routine serology testing for dengue.

Study of factors affecting the magnetic sensing capability of shape memory alloys for non-destructive evaluation of cracks in concrete: Using response surface methodology (RSM) and artificial neural network (ANN) approaches.

Currently, the field of structural health monitoring (SHM) is focused on investigating non-destructive evaluation techniques for the identification of damages in concrete structures. Magnetic sensing has particularly gained attention among the innovative non-destructive evaluation techniques. Recently, the embedded magnetic shape memory alloy (MSMA) wire has been introduced for the evaluation of cracks in concrete components through magnetic sensing techniques while providing reinforcement as well. However, the available research in this regard is very scarce. This study has focused on the analyses of parameters affecting the magnetic sensing capability of embedded MSMA wire for crack detection in concrete beams. The response surface methodology (RSM) and artificial neural network (ANN) models have been used to analyse the magnetic sensing parameters for the first time. The models were trained using the experimental data obtained through literature. The models aimed to predict the alteration in magnetic flux created by a concrete beam that has a 1 mm wide embedded MSMA wire after experiencing a fracture or crack. The results showed that the change in magnetic flux was affected by the position of the wire and the position of the crack with respect to the position of the magnet in the concrete beam. RSM optimisation results showed that maximum change in magnetic flux was obtained when the wire was placed at a depth of 17.5 mm from the top surface of the concrete beam, and a crack was present at an axial distance of 8.50 mm from the permanent magnet. The change in magnetic flux was 9.50 % considering the aforementioned parameters. However, the ANN prediction results showed that the optimal wire and crack position were 10 mm and 1.1 mm, respectively. The results suggested that a larger beam requires a larger diameter of MSMA wire or multiple sensors and magnets for crack detection in concrete beams.

Closing the antimicrobial stewardship gap - a call for LMICs to embrace the global antimicrobial stewardship accreditation scheme.

The escalating challenge of antimicrobial resistance (AMR) poses a considerable concern for global health, particularly impacting low- and middle-income countries (LMICs). This article highlights the critical importance of tackling AMR in LMICs by adopting the Global Antimicrobial Stewardship Accreditation Scheme (GAMSAS). GAMSAS is portrayed as a holistic and sustainable strategy for antimicrobial stewardship, extending beyond accreditation to include educational programs, capacity enhancement, improved surveillance, and support for AMS policy research. While acknowledging the global uptake of the scheme, the article highlights its preliminary phase of adoption in LMICs, particularly in high-AMR burden regions like Sub-Saharan Africa. The piece stresses the imperative for LMICs to integrate GAMSAS, underscoring its significance in optimizing antimicrobial usage and patient health outcomes. It advocates for an all-encompassing approach that leverages international cooperation and sustained financial backing, crucial for the effective deployment and enduring success of antimicrobial stewardship efforts in these key areas.

Novel anthraquinone amide derivatives as potential glyoxalase-I inhibitors.

This study aimed to identify novel Glyoxalase-I (Glo-I) inhibitors with potential anticancer properties, focusing on anthraquinone amide-based derivatives. We synthesized a series of these derivatives and conducted in silico docking studies to predict their binding interactions with Glo-I. In vitro assessments were performed to evaluate the anti-Glo-I activity of the synthesized compounds. A comprehensive structure-activity relationship (SAR) analysis identified key features responsible for specific binding affinities of anthraquinone amide-based derivatives to Glo-I. Additionally, a 100 ns molecular dynamics simulation assessed the stability of the most potent compound compared to a co-crystallized ligand. Compound MQ3 demonstrated a remarkable inhibitory effect against Glo-I, with an IC50 concentration of 1.45 µM. The inhibitory potency of MQ3 may be attributed to the catechol ring, amide functional group, and anthraquinone moiety, collectively contributing to a strong binding affinity with Glo-I. Anthraquinone amide-based derivatives exhibit substantial potential as Glo-I inhibitors with prospective anticancer activity. The exceptional inhibitory efficacy of compound MQ3 indicates its potential as an effective anticancer agent. These findings underscore the significance of anthraquinone amide-based derivatives as a novel class of compounds for cancer therapy, supporting further research and advancements in targeting the Glo-I enzyme to combat cancer.

Vaccine hesitancy under the lens: Nigeria's struggle against the worst diphtheria outbreak in decades.

The resurgence of diphtheria in Nigeria, culminating in an outbreak surpassing previous records, has spotlighted the critical imperative for robust immunization policies amidst a milieu of vaccine hesitancy. This commentary delineates the multifaceted dimensions of the current diphtheria outbreak, which started in May 2022, juxtaposed against historical outbreaks, with a focal examination of the pervasive vaccine hesitancy and its underpinning sociocultural and systemic determinants. The discourse extends to a meticulous evaluation of Nigeria's public health response, underlined by the synergy with international organizations, reflecting a global collaborative ethos in combating the diphtheria menace. A critical appraisal of the prevailing immunization policies unveils a necessity for strategic amendments to invigorate vaccination uptake, essential for curbing the diphtheria outbreak and enhancing public health resilience. The reflections herein advocate for a comprehensive, culturally resonant, and sustainable public health paradigm, encompassing a synergistic approach of policy fortification, community engagement, and international collaboration to navigate the challenges posed by vaccine-preventable diseases epitomized by the ongoing diphtheria outbreak. Through a synthesis of historical lessons, contemporary challenges, and global solidarity, this piece contributes to the broader discourse on enhancing immunization coverage and infectious disease control in Nigeria.

Fighting diphtheria in Nigeria: the challenge of getting everyone vaccinated Recently, Nigeria has faced its worst diphtheria outbreak in years, showing how important it is to get people vaccinated. This article looks closely at the current outbreak, compares it to past ones, and explores why some people are hesitant to get vaccinated. We discuss the reasons behind this hesitation, including cultural and social factors. We also review how Nigeria is responding to the outbreak with help from international groups. We point out that Nigeria's vaccination policies need to be updated to encourage more people to get vaccinated, which is crucial to stop the outbreak and strengthen overall health defenses. The article calls for a well-rounded and lasting approach to public health that includes better policies, working closely with communities, and international cooperation.

Dengue virus type 1 clade replacement in recurring homotypic outbreaks.

BACKGROUND: Recurring dengue outbreaks occur in cyclical pattern in most endemic countries. The recurrences of dengue virus (DENV) infection predispose the population to increased risk of contracting the severe forms of dengue. Understanding the DENV evolutionary mechanism underlying the recurring dengue outbreaks has important implications for epidemic prediction and disease control. RESULTS: We used a set of viral envelope (E) gene to reconstruct the phylogeny of DENV-1 isolated between the periods of 1987-2011 in Malaysia. Phylogenetic analysis of DENV-1 E gene revealed that genotype I virus clade replacements were associated with the cyclical pattern of major DENV-1 outbreaks in Malaysia. A total of 9 non-conservative amino acid substitutions in the DENV-1 E gene consensus were identified; 4 in domain I, 3 in domain II and 2 in domain III. Selection pressure analyses did not reveal any positively selected codon site within the full length E gene sequences (1485 nt, 495 codons). A total of 183 (mean dN/dS = 0.0413) negatively selected sites were found within the Malaysian isolates; neither positive nor negative selection was noted for the remaining 312 codons. All the viruses were cross-neutralized by the respective patient sera suggesting no strong support for immunological advantage of any of the amino acid substitutions. CONCLUSION: DENV-1 clade replacement is associated with recurrences of major DENV-1 outbreaks in Malaysia. Our findings are consistent with those of other studies that the DENV-1 clade replacement is a stochastic event independent of positive selection.

Detection of dengue viruses using reverse transcription-loop-mediated isothermal amplification.

BACKGROUND: Early and rapid detection of dengue virus (DENV) infection during the febrile period is crucial for proper patient management and prevention of disease spread. An easy to perform and highly sensitive method is needed for routine implementation especially in the resource-limited rural healthcare settings where dengue is endemic. METHODS: A single-tube reverse transcription-loop-mediated isothermal amplification (RT-LAMP) assay with a set of nine primers was developed for the detection of all four DENV serotypes and their different genotypes. The sensitivity and specificity of the RT-LAMP were evaluated. The clinical applicability of RT-LAMP assay for detection of DENV RNA was assessed in a total of 305 sera of clinically-suspected dengue patients. The test results of RT-LAMP were statistically compared to those of quantitative reverse transcription-polymerase chain reaction (qRT-PCR), IgM- and IgG-capture enzyme-linked immunosorbent assays (ELISA). RESULTS: Acute DENV infection was confirmed in 171 samples (n = 305); 43.3% (74/171) and 46.8% (80/171) of the samples were positive for DENV using RT-LAMP and qRT-PCR, respectively. The combination of RT-LAMP with the dengue IgM and IgG ELISA increased detection of acute DENV infection to 97.7% (167/171), in comparison to only 70.8% (121/171) when dengue IgM and IgG ELISA alone were used. The RT-LAMP assays showed high concordance (κ = 0.939) with the qRT-PCR. The RT-LAMP assay detected up to 10 copies of virus RNA within an hour but 100% reproducibility (12/12) was achieved with 100 copies. There was no cross reactivity of RT-LAMP with other closely related arboviruses. CONCLUSION: The RT-LAMP assay developed in this study is sensitive, specific and simple to perform. The assay improved the detection of dengue when used in combination with serological methods.

Extract of Scutellaria baicalensis inhibits dengue virus replication.

BACKGROUND: Scutellaria baicalensis (S. baicalensis) is one of the traditional Chinese medicinal herbs that have been shown to possess many health benefits. In the present study, we evaluated the in vitro antiviral activity of aqueous extract of the roots of S. baicalensis against all the four dengue virus (DENV) serotypes. METHODS: Aqueous extract of S. baicalensis was prepared by microwave energy steam evaporation method (MEGHE™), and the anti-dengue virus replication activity was evaluated using the foci forming unit reduction assay (FFURA) in Vero cells. Quantitative real-time polymerase chain reaction (qRT-PCR) assay was used to determine the actual dengue virus RNA copy number. The presence of baicalein, a flavonoid known to inhibit dengue virus replication was determined by mass spectrometry. RESULTS: The IC(50) values for the S. baicalensis extract on Vero cells following DENV adsorption ranged from 86.59 to 95.19 µg/mL for the different DENV serotypes. The IC(50) values decreased to 56.02 to 77.41 µg/mL when cells were treated with the extract at the time of virus adsorption for the different DENV serotypes. The extract showed potent direct virucidal activity against extracellular infectious virus particles with IC(50) that ranged from 74.33 to 95.83 µg/mL for all DENV serotypes. Weak prophylactic effects with IC(50) values that ranged from 269.9 to 369.8 µg/mL were noticed when the cells were pre-treated 2 hours prior to virus inoculation. The concentration of baicalein in the S. baicalensis extract was ~1% (1.03 µg/gm dried extract). CONCLUSIONS: Our study demonstrates the in vitro anti-dengue virus replication property of S. baicalensis against all the four DENV serotypes investigated. The extract reduced DENV infectivity and replication in Vero cells. The extract was rich in baicalein, and could be considered for potential development of anti-DENV therapeutics.

Clinical efficacy and safety of intravitreal fluocinolone acetonide implant for the treatment of chronic diabetic macular oedema: five-year real-world results.

BACKGROUND/AIM: To report 5-year real-world efficacy and safety data following the treatment of chronic diabetic macular oedema (DMO) with the intravitreal 0.19 mg fluocinolone acetonide implant(ILUVIEN). METHODS: Retrospective cohort study of 31 eyes treated with ILUVIEN for chronic DMO at a tertiary centre in Birmingham (UK). Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were recorded at baseline, and then at 1-,2-,3-, and 5-years. Safety was assessed based on intraocular pressure (IOP) -lowering medication, surgery, and other complications. RESULTS: BCVA significantly improved 1-year post-ILUVIEN (+4.2 letters, p < 0.05) and gradually reverted to baseline levels over the 5-year period of follow-up (+0.2 letters at year-5). A significant and sustained CRT reduction was observed throughout the 5-years. The proportion of eyes on IOP-lowering medication increased from 16% at baseline, to 70% at 5-years (p < 0.001) with eyes on a mean of 1.3 medications. Laser trabeculoplasty (n = 2), cyclodiode laser (n = 1), and trabeculoplasty and trabeculotomy (n = 1, in the same eye; 3.2%) were required for uncontrolled IOP. Other complications included endophthalmitis (n = 1) and vitreous haemorrhage (n = 1). 58% of eyes required additional intravitreal injections, with a mean 29.2 months to first injection. We observed a 69% reduction in treatment burden following treatment with ILUVIEN implant. CONCLUSIONS: Our real-world results confirm the efficacy of the ILUVIEN implant over 5 years, with two-thirds of eyes having improved or stable visual acuity 5 years after ILUVIEN, and an overall sustained improvement in anatomical outcome. Although the rate of IOP-lowering medications use was higher than previously reported, the rate of incisional IOP-lowering surgery and other complications remained low and in keeping with rates reported in larger studies.

Clinical Outcomes of Observed and Treated Acute Posterior Multifocal Placoid Pigment Epitheliopathy and Relentless Placoid Chorioretinitis.

PURPOSE: To assess the efficacy of treatment on acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and relentless placoid chorioretinopathy (RPC). METHODS: Cases were identified from three UK uveitis centers. Retrospective analysis of visual acuity recovery; OCT structural outcomes; and retinal lesion quantification in observed and treated cases of APMPPE/RPC. RESULTS: There were nine APMPPE and three RPC cases. Out of 12 patients, six were female. Median age: 26.5 years (range, 20-57 years). Four cases (six eyes) were observed, and eight cases (15 eyes) received corticosteroids ± immunosuppression. 4/4 observed and 6/10 treated foveal involving eyes regained 0.00 LogMAR vision. Observed lesions achieved more favorable anatomical outcomes. New lesions post-presentation developed in 1/6 (16%) observed eye versus 10/15 (66%) treated eyes. In three cases, a delayed, rebound lesion occurrence was observed post-high-dose corticosteroids. CONCLUSIONS: While subject to potential treatment bias, in this small case series, natural history alone appears non-inferior to corticosteroid treatment.

Effect of Crumb Rubber, Fly Ash, and Nanosilica on the Properties of Self-Compacting Concrete Using Response Surface Methodology.

Producing high-strength self-compacting concrete (SCC) requires a low water-cement ratio (W/C). Hence, using a superplasticizer is necessary to attain the desired self-compacting properties at a fresh state. The use of low W/C results in very brittle concrete with a low deformation capacity. This research aims to investigate the influence of crumb rubber (CR), fly ash (FA), and nanosilica (NS) on SCC's workability and mechanical properties. Using response surface methodology (RSM), 20 mixes were developed containing different levels and proportions of FA (10-40% replacement of cement), CR (5-15% replacement of fine aggregate), and NS (0-4% addition) as the input variables. The workability was assessed through the slump flow, T500, L-box, and V-funnel tests following the guidelines of EFNARC 2005. The compressive, flexural, and tensile strengths were determined at 28 days and considered as the responses for the response surface methodology (RSM) analyses. The results revealed that the workability properties were increased with an increase in FA but decreased with CR replacement and the addition of NS. The pore-refining effect and pozzolanic reactivity of the FA and NS increased the strengths of the composite. Conversely, the strength is negatively affected by an increase in CR, however ductility and deformation capacity were significantly enhanced. Response surface models of the mechanical strengths were developed and validated using ANOVA and have high R2 values of 86-99%. The optimization result produced 36.38%, 4.08%, and 1.0% for the optimum FA, CR, and NS replacement levels at a desirability value of 60%.

Effects of Graphene Oxide and Crumb Rubber on the Fresh Properties of Self-Compacting Engineered Cementitious Composite Using Response Surface Methodology.

Graphene oxide-modified rubberized engineered cementitious composite (GO-RECC) is attracting the attention of researchers because of the reported benefits of the GO and crumb rubber (CR) on the strength and deformation properties of the composite. While it is well established that GO negatively affects the workability of cementitious composites, its influence on the attainment of the desired self-compacting (SC) properties of ECC has not yet been thoroughly investigated, especially when combined with crumb rubber (CR). In addition, to simplify the number of trial mixes involved in designing SC-GO-RECC, there is a need to develop and optimize the process using Design of Experiment (DOE) methods. Hence, this research aims to investigate and model using response surface methodology (RSM), the combined effects of the GO and CR on the SC properties of ECC through the determination of T500, slump flow, V-funnel, and L-box ratio of the SC-GORECC as the responses, following the European Federation of National Associations Representing for Concrete (EFNARC) 2005 specifications. The input factors considered were the GO by wt.% of cement (0.02, 0.04, 0.06, and 0.08) and CR as a replacement of fine aggregate by volume (5, 10, and 15%). The results showed that increasing the percentages of GO and CR affected the fresh properties of the SC-GORECC adversely. However, all mixes have T500 of 2.4 to 5.2 s, slump flow of 645 to 800 mm, V-funnel time of 7.1 to 12.3 s, and L-box ratio (H2/H1) of 0.8 to 0.98, which are all within acceptable limits specified by EFNARC 2005. The developed response prediction models were well fitted with R2 values ranging from 91 to 99%. Through the optimization process, optimal values of GO and CR were found to be 0.067% and 6.8%, respectively, at a desirability value of 1.0.

Mechanical, Microstructural and Drying Shrinkage Properties of NaOH-Pretreated Crumb Rubber Concrete: RSM-Based Modeling and Optimization.

One of the primary causes of the low mechanical properties of rubberized concrete is the weak bond between crumb rubber (CR) and hardened cement paste. Many CR pretreatment techniques have been researched in an attempt to mitigate this problem. The NaOH pretreatment method is one of the most widely used, although the reported results are inconsistent due to the absence of standardized NaOH pretreatment concentrations and CR replacement levels. This study aims to develop models for predicting the mechanical and shrinkage properties of NaOH-pretreated CR concrete (NaOH-CRC) and conduct multi-objective optimization using response surface methodology (RSM). The RSM generated experimental runs using three levels (0, 5, and 10%) of both NaOH pretreatment concentration and the CR replacement level of fine aggregate by volume as the input factors. At 28 days, the concrete's compressive, flexural, and tensile strengths (CS, FS, and TS), as well as its drying shrinkage (S), were evaluated as the responses. The results revealed that higher CR replacements led to lower mechanical strengths and higher shrinkage. However, the strength loss and the shrinkage significantly reduced by 22%, 44%, 43%, and 60% for CS, FS, TS, and S, respectively, after the pretreatment. Using field-emission scanning electron microscopy (FESEM), the microstructural investigation indicated a significantly reduced interfacial transition zone (ITZ) with increasing NaOH pretreatment. The developed RSM models were evaluated using ANOVA and found to have high R2 values ranging from 78.7% to 98%. The optimization produced NaOH and CR levels of 10% and 2%, respectively, with high desirability of 71.4%.

Pathophysiological Aspects of Ocular Toxoplasmosis: Host-parasite Interactions.

PURPOSE: This review aims to present the state of the art to understand the pathophysiology of ocular toxoplasmosis (OT), providing further foundations that would help to improve the future treatment and prognosis of this potentially blinding disease. METHODS: A thorough literature search was performed in PubMed database. An additional search was made in Google Scholar to complete the collected items. RESULTS: Toxoplasma gondii ocular infection is one of the most frequent causes of posterior uveitis. Despite the ocular barriers, the parasite reaches the eye through different mechanisms. Once inside, it remains encysted livelong within the retina, and recurrences cannot be completely avoided. The complexity of host-parasite interactions, leading to the success of this parasite, encompasses host factors such as genetic predisposition, immune status, and age; and parasite factors such as strain diversity, virulence, phylogenetic origin, and geographical distribution. These factors influence the clinical presentation, course, and progression of the disease. Additional elements, such as pregnancy, eating behavior, and environmental, social, and cultural factors may also contribute to this complex balance. CONCLUSIONS: The host-parasite interaction in OT is a complex and multifactorial relationship, with the parasite always on the driving edge of the game. There are still multiple incompletely understood fields to be investigated. Future research would permit further insight into the immune-biology of the parasite and recognition of the host-parasite interplay to improve the diagnostic and management performance.

Tuberculosis treatment outcomes among pulmonary TB patients attending public hospitals in Kebbi State, Northern Nigeria: a four-year retrospective study.

Background: In Nigeria, effective case management and evaluation of pulmonary tuberculosis treatment outcomes are an integral part of controlling the spread of infectious diseases. The study reviewed the treatment outcomes of pulmonary tuberculosis and the factors associated with rates of successful and unsuccessful treatment outcomes in the 21 referral hospitals in Kebbi State, Nigeria. Methods: Documented records of pulmonary tuberculosis patients from January 2018 to December 2021 in 21 Local Area Councils in Kebbi State, Northern Nigeria were reviewed. A structured questionnaire collated the socio-demographic and clinical data from the documented records. Descriptive statistics were used to compute and analyse the outcomes of successful and unsuccessful treatment. Logistic regression models were used to determine the association of socio-demographic and clinical data with the unsuccessful treatment outcomes. Results: The study reviewed data from 6114 records of TB patients. 1161 (18.9%) started treatment, 963 (82.9%) were males and 198 (17.1%) were females. Of the 1161 patients, 985 (18.2%) had documented treatment outcomes. 932 of 985 (95.1%) had a pulmonary infection. 64 (5.8%) patients with documented treatment outcomes were HIV seropositive. 903 (91.7%) were successfully treated, and 82 (8.3%) failed. Of the patients with failed treatment outcomes, 15 (1.5%) were lost to follow-up, 43 (4.4%) defaulted and 24 (2.4%) died. In the logistic analysis, the odds of unsuccessful treatment outcomes were higher among elderly patients (AOR = 2.00, 95% CI 1.37-2.92), patients with extrapulmonary infections (AOR = 2.40, 95% CI 1.12-5.39), and with old cases of pulmonary TB (AOR = 3.03, 95% CI 1.47-7.19) when compared to their groups. Conclusions: The study reported a treatment success rate of 91.7% among TB patients attending public hospitals in Kebbi State. The outcome was higher than the projected success rate of 85% set by the WHO. However, one-fourth of the total patients reviewed were not documented for treatment. Therefore, the need to design an appropriate recruitment strategy to identify and enrol those patients for an effective and successful TB control program in Nigeria.

Properties of Rubberized Engineered Cementitious Composites Containing Nano-Silica.

To avoid explosive spalling during elevated temperature, crumb rubber (CR) is being added to the manufacturing of engineered cementitious composites (ECC). However, the addition of CR particles adversely affects the mechanical properties of ECC. Therefore, to overcome this issue, nano-silica (NS) is added into rubberized ECC mixture as cementitious material additives. Response surface methodology (RSM) has been utilized to optimize the mixtures of the rubberized ECC with variables: CR (0, 2.5, and 5 vol.%), polyvinyl alcohol (PVA) fiber (0, 1, and 2 vol.%), NS (0, 1, and 2 vol.%), and fly ash (0, 25, and 50 vol.%). The experimentally measured responses are flexural strength, direct tensile strength, elastic modulus, Poisson's ratio, creep, and drying shrinkage. Mathematical models to predict the targeted responses have been developed using RSM. As a result, a high correlation between the factors and responses has been exhibited by the developed models and the accuracy of fit, where less than 9.38% of the variation was found between the predicted and validated results. The experimental results revealed that the rubberized ECC with the incorporation of nano-silica exhibited a higher compressive strength, direct tensile strength, flexural strength, elastic modulus, Poisson's ratio, and lower drying shrinkage.

Utilization of Crumb Rubber and High-Volume Fly Ash in Concrete for Environmental Sustainability: RSM-Based Modeling and Optimization.

Waste tire and fly ash (FA) are two waste materials whose disposal and rapid rate of accumulation are among the pressing sources of concern and threat to the environment. Although much research exists on the use of these materials in cementitious composites, very little literature is available on the effectiveness of combining them in high volumes for concrete production. This work aimed to utilize crumb rubber (CR) from waste tires as a partial replacement of fine aggregate at 15%, 22.25%, and 30% by volume, and high-volume fly ash (HVFA) replacement of cement at 50%, 60%, and 70% (by weight of cementitious materials) to produce high-volume fly ash-crumb rubber concrete (HVFA-CRC). Using the central composite design (CCD) option of the response surface methodology (RSM), 13 mixes were produced with different combinations and levels of the CR and FA (the input factors) on which the responses of interest (compressive, flexural, and tensile strengths) were experimentally investigated. Furthermore, the composite influence of CR and HVFA on the workability of the concrete was assessed using the slump test. The results showed a decline in the mechanical properties with increasing replacement levels of the CR and HVFA. However, up to 22.25% and 60% of CR and HVFA replacements, respectively, produced a structural HVFA-CRC with a compressive strength of more than 20 MPa at 28 days. Response predictive models were developed and validated using ANOVA at a 95% confidence level. The models had high R2 values ranging from 95.26 to 97.74%. Multi-objective optimization was performed and validated with less than 5% error between the predicted and experimental responses.

Bond Relationship of Carbon Fiber-Reinforced Polymer (CFRP) Strengthened Steel Plates Exposed to Service Temperature.

Emerging as a new technology, carbon fiber-reinforced polymer (CFRP) has been introduced to rehabilitate and strengthen steel structures using an adhesive agent. However, the outdoor service temperature is potentially degrading to the mechanical strength of the adhesive, as well as affecting the bonding of the strengthened steel structure. Therefore, this paper aims to investigate the bond relationship of CFRP-strengthened steel plates exposed to service temperatures. Two types of experiments were conducted to determine the tensile and flexural performance of CFRP-strengthened steel plates. The experiments were designed using a Box-Behnken design (BBD) and response surface methodology (RSM) by considering three parameters: service temperature (25 °C, 45 °C and 70 °C), number of CFRP layers (one, three and five layers) and bond length (40, 80 and 120 mm). The findings show the dominant failure mode transformed from adhesion failure between steel and adhesive interfaces to adhesion failure between CFRP and adhesive interfaces as the service temperature increased. The tensile strength improved by 25.62% when the service temperature increased. Field emission scanning electron microscope (FESEM) analysis proved that the strength enhancement is due to the densification and reduction of the adhesive particle microstructure gaps through the softening effect at service temperature. However, service temperature is found to have less impact on flexural strength. Incorporating the experimental results in RSM, two quadratic equations were developed to estimate the tensile and flexural strength of CFRP-strengthened steel plates. The high coefficient of determination, R2, yields at 0.9936 and 0.9846 indicate the high reliability of the models. Hence, it can be used as an estimation tool in the design stage.

Mechanical Properties of Crumb Rubber Mortar Containing Nano-Silica Using Response Surface Methodology.

Crumb rubber (CR) from scrap tires is used as a partial replacement of fine aggregates in cement paste. This promotes the sustainable development of the environment, economy, and society, as waste tires are non-biodegradable and flammable. They occupy large landfill areas and are breeding grounds for mosquitoes and rodents. Inclusion of CR in mortar leads to several improvements on the mixture properties such as ductility, toughness, and impact resistance. However, it exhibits lower strengths and Modulus of Elasticity (ME). Therefore, to promote the use of mortar containing CR, it is vital to improve its mechanical strength. Past studies proved that nano-silica (NS) improves the strength of concrete due to the physico-chemical effects of NS. This study aims to examine the mechanical properties of crumb rubber mortar containing nano-silica (NS-CRM) and to develop models to predict these properties using Response Surface Methodology (RSM). Two variables were considered, CR as partial replacement to sand by volume (0%, 7.5%, 15%), and NS as partial replacement to cement by weight (0%, 2.5%, 5%). The results demonstrated a significant improvement in the mechanical properties of CRM when incorporating NS, and the models developed using RSM were acceptable with a 2% to 3% variation.