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The influence of n-octylammonium iodide (OAI, passive layer) on the types of phases formed in a (MACl)0.33FA0.99MA0.01Pb(I0.99Br0.01)3 perovskite film was studied using X-ray diffraction. Using UV spectrophotometric techniques, it was determined how varied OAI additive layer ratios affected the linear and nonlinear optical characteristics of glass substrates/FTO/compact TiO2/mesoporous TiO2/(MACl)0.33FA0.99MA0.01Pb(I0.99Br0.01)3 films. All films’ direct optical bandgap energies were determined to be 1.54 eV. The effects of OAI addition on the films’ photoluminescence intensity and emitted colors were also investigated. For the fabricated perovskite solar cells (PSCs) without an OAI passivation layer, the corresponding power conversion efficiency (PCE), open-circuit voltage (VOC), short-circuit current density (JSC), and fill factor (FF) values were 18.8%, 1.02 V, 24.6 mAcm−2, and 75%, respectively. When the concentration of OAI reached 2 mg, the maximum obtained values of PCE, VOC, JSC, and FF were 20.2%, 1.06 V, 24.2 mAcm−2, and 79%, respectively. The decreased trap density and increased recombination resistance were responsible for the improvement in solar cell performance.

Existing TB diagnostic tests rely on sputum samples, which can be difficult to collect from all patients. This study examines plasma Mycobacterium tuberculosis cell-free DNA (Mtb cfDNA) based quantitative PCR (qPCR) assay for the diagnosis of pulmonary TB (PTB).The qPCR assay targeted insertion sequence (IS 6110 ), cyp141, and dev R genes on plasma samples from 106 PTB patients and 60 controls. Sensitivity was calculated using the Xpert ® MTB/RIF test, culture, and clinical diagnosis for the PTB group, while specificity was determined based on results from controls.Among PTB cases, 92 (86.8%) were bacteriologically confirmed, with the remaining 14 (13.2%) diagnosed clinically. The sensitivity of the plasma Mtb cfDNA assay, considering all three genes, was 71.7% (95% CI 62.6-71.7) for all PTB cases, with higher sensitivity in bacteriologically confirmed cases (78.3%) than in clinically diagnosed cases (28.6%). The combined specificity was 91.7%. The combination of IS 6110 and cyp141 targeted qPCR demonstrated a sensitivity of 70.8%, and IS 6110 and dev R showed a sensitivity of 69.8%. However, dev R and cyp141 resulted in a lower sensitivity of 63.2%. IS 6110 and cyp141 had sensitivities of respectively 59.4% and 60.4%, while dev R had 53.8%.Targeting multiple genes for plasma Mtb cfDNA-based TB diagnosis improves sensitivity and could be an important addition to current sputum-based diagnostic approaches..

In this study, the microstructure and elemental analysis of aluminum-copper alloy type-2024, Al-2024, and aluminum-manganese alloy type-3003, Al-3003, have been investigated by using a scanning electron microscope (SEM) equipped with Energy dispersive spectroscopy (EDS) detector. Experimental and theoretical radiation shielding studies were performed to assess the radiation shielding capabilities of the studied alloys. Considering the radiation shielding theoretical assessment, some reliable software tools were used, such as Phy-X/PSD, MCNP5, NXCom, and MRCsC. The microstructural observations and results have shown the presence of second phases rich with the main alloying elements in both alloys. Considering Al-2024 alloy, coarse second-phase particles, having a size range of 8-15 μm, were found aligning in lines parallel to the rolling direction, whereas smaller ones, having a size range of 2-8 μm, were found decorated the grain boundaries. Also, dark holes represent the pull-out large particles separated during preparation indicated poor adhesion with the main matrix that could be a result of losing particle coherency with the matrix where the misorientation in-between the atomic planes increase. However, better adhesion of the second-phase particles with the matrix, which were found possessing smaller particle size, have been observed in the Al-3003 alloy indicating good coherency and better manufacturing process for the non-heat-treatable alloy. The second-phase particles in case of Al-2024 alloy were found containing significant content of high-Z elements like Cu with greater volume fraction equals 7.5%. On the other side, Al-3003 alloy has possessed second-phase particles which lack of high-Z elements with only volume fraction equals 3.5%. All the former besides the higher density and content of high-Z elements like copper in Al-2024 alloy in compare to Al-3003 alloy and pure aluminum, led to relatively better radiation shielding capabilities against energetic photons, the highest in the low energy band and decreases with the increase of the photon energy, and slight superiority in the case of fast neutrons with only 3%inc. over pure aluminum. For instance, the radiation protection efficiency (RPE) values dropped from about; 23.2, 21.6, and 20.8% at 0.100 MeV to only 5.7, 5.9, and 5.6% at E γ = 2 MeV, for; Al-2024, Al-3003, and Al-Pure, respectively."Please check and confirm that the authors and their respective affiliations have been correctly identified and amend if necessary.""confirmed"., (© 2024. The Author(s).)

Introduction: The aim of this study was to evaluate a group of infants born to women with tuberculosis (TB) during pregnancy to determine the neonatal morbidities and its outcomes associated with tuberculosis in pregnancy., Materials and Methods: Data from January 2007 to December 2021 was collected for analysis as part of a retrospective cohort study. This study was conducted in a tertiary public hospital in Malaysia, Hospital Sultan Idris Shah (HSIS). Cases were identified from the hospital's bacille Calmette-Guerin (BCG) vaccination notification forms and merged with records from the neonatal intensive care unit's census. Controls were infants born to mothers unaffected by TB within the same hospital and year as the index case (1:4 ratio). Descriptive statistics and logistic regression were used to analyse the data. The main outcome measures were the risk of congenital tuberculosis, premature birth, low birth weight, small for gestational age and low APGAR score., Results: Data from January 2007 to December 2021 was collected for analysis as part of a retrospective cohort study. This study was conducted in a tertiary public hospital in Malaysia, Hospital Sultan Idris Shah (HSIS). Cases were identified from the hospital's bacille Calmette-Guerin (BCG) vaccination notification forms and merged with records from the neonatal intensive care unit's census. Controls were infants born to mothers unaffected by TB within the same hospital and year as the index case (1:4 ratio). Descriptive statistics and logistic regression were used to analyse the data. The main outcome measures were the risk of congenital tuberculosis, premature birth, low birth weight, small for gestational age and low APGAR score.

Aim: To identify the optimal size metric and threshold for Prostate Imaging Reporting and Data System (PIRADS) 5 upgrade, calculate its positive predictive value (PPV) for clinically-significant prostate cancer (csPCA), and determine if it is indicative of a "very high" likelihood of csPCA., Materials and Methods: One hundred and forty-three PIRADS 4 or 5 lesions were evaluated. Lesion diameters were used to calculate lesion volume (LV). Pearson correlation between maximum lesion diameter (MLD) and LV was calculated. Area under the curve (AUC) for discriminating csPCA (Gleason grade ≥ 3 + 4) was calculated using MLD and LV. Optimal size thresholds (using Youden index) and highly predictive size thresholds were identified for the whole prostate (WP), peripheral zone (PZ), and transitional zone (TZ)., Results: There was high correlation between MLD and LV (r=0.77-0.81), with comparable AUCs for MLD and LV in the identification of csPCA in the WP (0.73, 0.72), PZ (0.73, 0.73), and TZ (0.79, 0.75). Optimal MLD thresholds were 1.4, 1.4, and 1.6 cm in the WP, PZ, and TZ respectively, with PPVs of 76%, 81%, and 69%, respectively. An MLD threshold of 2.7 cm would be needed in the WP to achieve a PPV approaching 90%, with sensitivity decreasing to 10%., Conclusions: There is high correlation between MLD and LV with comparable discrimination of csPCA using each. PIRADSv2's 1.5 cm MLD threshold is near the optimal threshold for PIRADS 5 upgrade but has moderate PPV. A much higher threshold would be needed to increase its PPV, with significant sacrifice in sensitivity., (Copyright © 2023. Published by Elsevier Ltd.)

Background: Brazil, India and South Africa are among the top 30 high TB burden countries globally and experienced high rates of SARS-CoV-2 infection and mortality. The COVID-19 response in each country was unprecedented and complex, informed by distinct political, economic, social and health systems contexts. While COVID-19 responses have set back TB control efforts, they also hold lessons to inform future TB programming and services., Methods: This was a qualitative exploratory study involving interviews with TB stakeholders ( n = 76) in Brazil, India and South Africa 2 years into the COVID-19 pandemic. Interview transcripts were analysed using an inductive coding strategy., Results: Political will - whether national or subnational - enabled implementation of widespread prevention measures during the COVID-19 response in each country and stimulated mobile and telehealth service delivery innovations. Participants in all three countries emphasised the importance of mobilising and engaging communities in public health responses and noted limited health education and information as barriers to implementing TB control efforts at the community level., Conclusions: Building political will and social mobilisation must become more central to TB programming. COVID-19 has shown this is possible. A similar level of investment and collaborative effort, if not greater, as that seen during the COVID-19 pandemic is needed for TB through multi-sectoral partnerships., Competing Interests: Conflicts of interest: none declared., (© 2023 The Union.)

Background: The global COVID-19 pandemic has reversed many of the hard-won gains made in TB programmes and the associated reduction in the number of TB deaths, case notifications and incidence over the last three decades. Modelling estimates show that the impact will be lasting. There are global calls to recover the shortfalls along the TB care cascade that have resulted from COVID-19, with the recognition that the COVID-19 response holds lessons to inform more robust and comprehensive TB programmes and services., Objective: To explore lessons from response measures to the COVID-19 pandemic in two high TB burden South African provinces., Design: This was an exploratory qualitative study. We conducted interviews with TB programme stakeholders (managers and facility-level staff: n = 35) between February and June 2022., Results: We identified eight facilitators of the COVID-19 response, including political will, rapid policy development, multi-sectoral collaboration, patient-centred models of care delivery, community engagement, mHealth and telehealth technologies, rigorous contact tracing and widespread mask wearing. Political will was singled out as a critical driver of the response., Conclusion: Leveraging COVID-19 inspired collaborations, technologies and avenues for health service delivery is an opportunity to maximise benefits for the TB programme. Reinvestment in national TB programmes and political prioritisation of TB are critical., (© 2023 The Union.)

BACKGROUND: TB preventive therapy (TPT) is critical for ending TB, yet implementation remains poor. With new global guidelines expanding TPT eligibility and regimens, we aimed to understand TPT preferences among children, adolescents and caregivers. METHODS: We undertook a discrete choice experiment among 131 children, 170 adolescents and 173 caregivers, and conducted 17 in-depth interviews in 25 clinics in Cape Town, South Africa. The design included attributes for location, waiting time, treatment duration, dosing frequency, formulation/size, side effects, packaging and taste. Mixed-effects logistic regression models were used for analysis. RESULTS: Among children and caregivers, the number and size of pills, taste and side effects were important drivers of preferences. Among adolescents and caregivers, clinic waiting times and side effects were significant drivers of preferences. Adolescents expressed concerns about being stigmatised, and preferred services from local clinics to services delivered in the community. Dosing frequency and treatment duration were only significant drivers of choice among adolescents, and only if linked to fewer clinic visits. CONCLUSIONS: Introducing shorter TPT regimens in isolation without consideration of preferences and health services may not have the desired effect on uptake and completion. Developing TPT delivery models and formulations that align with preferences must be prioritised.

Background: South Africa has one the highest TB and HIV burdens globally. TB preventive therapy (TPT) reduces the risk of TB disease and TB-related mortality in adults and children living with HIV and is indicated for use in TB-exposed HIV-negative individuals and children. TPT implementation in South Africa remains suboptimal., Methods: We conducted a pragmatic review of TPT implementation using multiple data sources, including informant interviews ( n = 134), semi-structured observations ( n = 93) and TB patient folder reviews in 31 health facilities purposively selected across three high TB burden provinces. We used case descriptive analysis and thematic coding to identify barriers and facilitators to TPT implementation., Results: TPT programme implementation was suboptimal, with inadequate monitoring even in health districts with well-functioning TB services. Health workers reported scepticism about TPT effectiveness, deprioritised TPT in practice and expressed divergent opinions about the cadres of staff responsible for implementation. Service- and facility-level barriers included ineffective contact tracing, resource shortages, lack of standardised reporting mechanisms and insufficient patient education on TPT. Patient-level barriers included socio-economic factors., Conclusions: Improving TPT implementation will require radically simplified and more feasible systems and training for all cadres of health workers. Partnership with communities to stimulate demand driven service uptake can potentially facilitate implementation., Competing Interests: Conflicts of interest: none declared., (© 2022 The Union.)

Background: In South Africa, failure to link individuals diagnosed with TB to care remains an important gap in the TB care cascade. Compared to people diagnosed at primary healthcare (PHC) facilities, people diagnosed in hospitals are more likely to require additional support to be linked with PHC TB treatment services. We describe a patient interaction process to support linkage to TB care., Methods: We implemented a step-by-step early patient interaction process with 84 adults newly diagnosed with TB in one district hospital in Khayelitsha, Cape Town, South Africa (August 2020-March 2021). We confirmed patient contact details, provided TB and health information, shared information on accessing care at PHC facilities and answered patients' questions in their home language., Results: Most patients (54/84, 64%) provided updated telephone numbers, and 19/84 (23%) reported changes in their physical address. Patients welcomed practical and health information in their home language. The majority (74/84, 88%) were linked to care after hospital discharge., Conclusions: A simple early patient interaction process implemented as part of routine care is a feasible strategy to facilitate early TB treatment initiation and registration., Competing Interests: Conflicts of interest: none declared.

Background: Worldwide, diabetic kidney disease (DKD) remains the leading cause of chronic kidney disease (CKD) and its successor, the end stage renal disease, both of which constitute major morbidity and mortality concerns., Content: The residual risk of disease progression remains despite the advert of newer therapeutic modalities and current biomarkers. Meanwhile, microRNAs (miRNAs) are small non-coding RNAs, which regulate gene expression post-translationally by binding to specific mRNAs. Circulating miRNAs are increasingly recognised as novel biomarker or therapeutic targets, owing to their unique characteristics, such as their resilience to degradation by endogenous RNases, multiple downstream targets, involvement in biological processes, some degree of tissue specificity, relatively easy access and quantification. Unlike proteins, there are far less miRNAs and mature miRNAs are highly stable, structurally less complex without post-translational modification with high degree of conservation across species. Aberrant expression of miRNAs has been established in both in vitro and in vivo models of DKD. An up-to-date compilation of previous studies involving selected circulating miRNAs in blood and urine samples of DKD patients is discussed herein., Summary: This review highlights the unmet clinical challenges and dysregulation of miRNAs in the pathogenesis of DKD.

Together, SARS-CoV-2 and M. tuberculosis have killed approximately 5.7 million people worldwide over the past 2 years. The COVID-19 pandemic, and the non-pharmaceutical interventions to mitigate COVID-19 transmission (including social distancing regulations, partial lockdowns and quarantines), have disrupted healthcare services and led to a reallocation of resources to COVID-19 care. There has also been a tragic loss of healthcare workers who succumbed to the disease. This has had consequences for TB services, and the fear of contracting COVID-19 may also have contributed to reduced access to TB services. Altogether, this is projected to have resulted in a 5-year setback in terms of mortality from TB and a 9-year setback in terms of TB detection. In addition, past and present TB disease has been reported to increase both COVID-19 fatality and incidence. Similarly, COVID-19 may adversely affect TB outcomes. From a more positive perspective, the pandemic has also created opportunities to improve TB care. In this review, we highlight similarities and differences between these two infectious diseases, describe gaps in our knowledge and discuss solutions and priorities for future research.

Introduction: Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cancer in Malaysia. Despite advanced therapies, many cases of recurrence and resistance have been reported. Aberrant DNA methylation of HER3 has been implicated in carcinogenesis of CRC mainly through the regulation of gene expression. Hence, the objective of this study was to determine the status of HER3 DNA methylation and its effects on gene expression in CRC., Materials and Methods: Fifty-nine of archival formalin-fixed, paraffin-embedded CRC cases with the adjacent normal colon tissues were retrieved. Manual micro-dissection was performed prior to RNA and DNA extraction. HER3 gene expression and DNA methylation status was evaluated by qPCR and methylation-specific PCR (MSP) techniques respectively., Results: Upregulation of HER3 mRNA was found in CRC tissue compared to its adjacent normal colon tissue (8.04-fold). Of 59 CRC samples, 8.5% were methylated and 91.5% were unmethylated (hypomethylation). In the adjacent normal colon tissues, methylated and unmethylated tissue were observed in 6.8%and 93.2% respectively. DNA methylation of HER3 showed a significant association with tumour differentiation and tumour location., Conclusion: This study showed upregulation and hypomethylation of the HER3 gene in CRC cases. Epigenetic alterations were also found in the adjacent normal colon tissues. Thus, upregulation and hypomethylation of HER3 may play a key role in carcinogenesis of CRC. Hypomethylation of CpG islands might be associated with early steps during carcinogenesis. The findings of this biomarker serve a powerful approach to improve the current diagnostic and therapeutic measures.

Laparoscopic cholecystectomy is the standard of care for the surgical management of symptomatic gallstone disease. Gallstone spillage at laparoscopic cholecystectomy is common, with a reported incidence of 0.2-20%. In the majority of cases there are no complications associated with this spillage, but a series of studies report patients with complications of free peritoneal gallstones. We present a case of migration of gallstone to the lung resulting in an inflammatory mass in the right middle lobe as a complication of spillage at laparoscopic cholecystectomy.

Introduction: More than one million breast augmentation procedures using silicone breast implants (SBI) have been performed worldwide. Adverse events of SBI include local complications such as pain, swelling, redness, infections, capsular contracture, implant rupture, and gel-bleed. Furthermore, patients experience systemic symptoms such as chronic fatigue, arthralgias, myalgias, pyrexia, sicca, and cognitive dysfunction. These symptoms received different names such as autoimmune/autoinflammatory syndrome induced by adjuvants (ASIA) due to silicone incompatibility syndrome and breast implant illness (BII). Because of chronic immune activation, BII/ASIA, allergies, autoimmune diseases, immune deficiencies, and finally lymphomas may develop in SBI patients., Areas Covered: Causality for SBI-related BII/ASIA is reviewed. To address the role of silicone implants in promoting causality, we utilized the Bradford Hill criteria, with results highlighted in this article., Expert Opinion: We conclude that there is a causal association between SBIs and BII/ASIA. Using data derived from patients with BII/ASIA and from other medically implanted devices, there appears to be clear pathogenic relationship between SBI and BII/ASIA. Breast implants cause characteristic systemic reactions in certain women, leading to symptoms of sufficient severity to warrant device removal. The morbidity suffered is variable. SBI removal resolves the symptoms in most women, and removal is the most effective treatment.

OBJECTIVE: To investigate the uptake and usage of a WhatsApp-based interactive communication strategy to avert pre-diagnosis loss to follow-up (LTFU) from TB care in a high-incidence setting. METHODS: We enrolled adults (≥18 years) who underwent routine sputum TB testing in two primary healthcare clinics in Khayelitsha, Cape Town, South Africa. The intervention consisted of structured WhatsApp-based reminders (prompts) sent prior to a routine clinic appointment scheduled 2-3 days after the diagnostic visit. Pre-diagnosis LTFU was defined as failure to return for the scheduled appointment and within 10 days. RESULTS: We approached 332 adults with presumptive TB, of whom 103 (31%) were successfully enrolled; 213 (64%) did not own a WhatsApp-compatible phone. Of 103 participants, 74 (72%) actively responded to WhatsApp prompts; 69 (67%) opted to include a close contact in group communication to co-receive reminders. Pre-diagnosis LTFU was low overall ( n = 7, 6.8%) and was not associated with failure to respond to WhatsApp prompts. CONCLUSION: In this high-incidence setting, enrolment in a WhatsApp-based communication intervention among adults with presumptive TB was low, mainly due to low availability of WhatsApp-compatible phones. Among participants, we observed high message response rates and low LTFU, suggesting potential for interactive messaging services to support pre-diagnosis TB care.