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In 2021, the Israel Ministry of Health began a national hepatitis C elimination program. Implementing a World Health Organization goal, Israel’s program involved targeted screening, barrier minimization, workup simplification, awareness campaigns, and a patient registry. We evaluated program costs for testing and treatment. By May 15, 2023, the program had identified 865,382 at-risk persons, of whom 555,083 (64.3%) were serologically screened for hepatitis C virus (HCV), which was detected in 24,361 (4.4%). Among 20,928 serologically positive patients, viremia was detected in 13,379 (63.9%), of whom 10,711 (80%) were treated, and 4,618 (96.5%) of 4,786 persons receiving posttreatment HCV RNA testing had sustained virologic response. We estimated costs of ₪14,426 (new Israel shekel; ≈$3,606 USD) per person whose HCV infection was diagnosed and successfully treated. The program yielded screening and treatment in almost two thirds of the identified at-risk population. Although not eliminated, HCV prevalence will likely decrease substantially by the 2030 target.

Abstract In the operation and control of power systems, load frequency control (LFC) plays a critical role in ensuring the stability and reliability of interconnected power systems. Modern power systems with significant penetration of highly variable and intermittent renewable sources present new challenges that make traditional control strategies ineffective. To address these new challenges, this paper proposes a novel LFC strategy that employs a cascaded fractional-order proportional integral-fractional-order proportional integral derivative with a derivative filter (FOPI-FOPIDN) as a controller. The parameters of the FOPI-FOPIDN are optimised using a variant of the particle swarm optimization (PSO) in the literature called ADIWACO. The effectiveness and scalability of the proposed strategy are validated by extensive simulations conducted on two- and three-area test systems and performance comparisons with recent LFC control strategies in the literature. The performance metrics used for the evaluation are ITAE values, deviations in the power flows in the tie-lines, and deviations in the frequencies of the control areas with the power systems subjected to diverse load and RES generation disturbances in several experimental scenarios. Governor dead band, communication time delay, and generation rate constraints are considered in one of the scenarios for more realistic evaluation. Again, the controller’s robustness to uncertain model parameters is validated by varying the parameters of the three-area test system by ± 50%. The simulation results obtained confirm the controller’s robustness and its superiority over the comparison LFC strategies in terms of the above performance metrics.

Abstract Background Lesotho’s government has shown consistent efforts to implement social protection programmes. However, while recent evidence established a positive causal relationship between some of these programmes and food security there is little evidence on the extent to which these initiatives are associated with better educational and sexual and reproductive health outcomes among vulnerable adolescents in Lesotho. Methods and Findings The study uses cross-sectional, nationally representative data from the 2018 Lesotho Violence Against Children and Youth Survey. Our research examined the association between social protection receipt and educational and sexual and reproductive health outcomes among adolescents and young people (13–24 years) living in poverty. We employed multivariate logistic regression controlling for age, orphanhood, HIV status and sex. Social protection receipt was defined as household receipt of financial support from a governmental, non-governmental, or community-based program that provides income. Additionally, we fitted a marginal effects model by sex. Among the 3,506 adolescent females and males living in the two lowest poverty quintiles, receipt of social protection was associated with improvements in multiple adolescent outcomes: higher odds of consistent condom use (aOR 1.64, 95% CI 1.17–2.29), educational attainment (aOR 1.79, 95% CI 1.36–2.36), and school enrolment (aOR 2.19, 95% CI 1.44–3.34). Stratified analyses by sex showed that social protection receipt was also associated with reduced likelihood of child marriage among females (aOR 0.59, 95% CI 0.42–0.83) and higher odds of educational attainment and school enrolment among males (aOR 2.53, 95% CI 1.59–4.03 and aOR 3.11, 95% CI 1.56–6.19, respectively). Conclusions Our study provides evidence that social protection programs are associated with improved educational, sexual and reproductive health and child marriage prevention outcomes among adolescents living in poverty. Implementing and expanding such social protection initiatives could prove instrumental in improving the well-being of vulnerable adolescents. Contributions Social protection programs have been increasing in sub-Saharan African countries, playing a pivotal role in poverty reduction, with Lesotho being no exception. Despite the optimistic outlook brought about by the implementation of the National Social Protection Strategy Lesotho I (2014-19) and II (2021–2031), the impact of these programs on some specific outcomes that concern the lives of the most vulnerable adolescents in Lesotho remains to some extent unexplored. Additionally, Lesotho grapples with high rates of HIV, adolescent pregnancy, child marriage and early school dropout, which can further contribute to poor long-term health and social outcomes among adolescents. In this study, we used data from the 2018 Lesotho Violence Against Children and Youth Survey (VACS) to examine the association between receiving social protection and multiple adolescent outcomes: educational, sexual and reproductive. The findings revealed that social protection programs, particularly the existing government-provided cash transfers, are significantly associated with multiple better outcomes among adolescents living in the poorest households in Lesotho. Such cash transfer schemes in Lesotho are associated with improved sexual and reproductive health outcomes for adolescent females, including reduced child marriage rates, and improved educational outcomes for males. These findings indicate that government-led social protection programmes are positively associated with favourable outcomes that can improve the quality of life for adolescents in resource-limited settings.

IntroductionMicroalgae provide a sustainable basis for protein-rich food production. However, human data concerning microalgae ingestion, subsequent postprandial amino acid (AA) availability and associated metabolic responses are minimal.ObjectivesWe investigated ingesting Arthrospira sp. (spirulina;SPR), and Chlorella sp. (chlorella; in ‘whole cell’ [WCC] and ‘split cell’ [SCC] forms, the latter proposed to improve digestibility), compared with a high-quality animal derived protein source (milk; MLK).Subjects/methodsTen participants (age; 21 ± 1y, BMI; 25 ± 1 kg·m−2) completed a randomised, crossover, double-blind study, partaking in 4 counterbalanced (for order) experimental visits. At each visit participants ingested SPR, WCC, SCC or MLK drinks containing 20 g protein and 75 g carbohydrate. Arterialised venous blood samples, indirect calorimetry and visual analogue scales were assessed postabsorptive, and throughout a 5 h postprandial period to measure AA, glucose, insulin and uric acid concentrations, whole-body energy expenditure and appetite scores, respectively.ResultsProtein ingestion increased plasma AA concentrations (p 0.05) were detected between conditions for postprandial glucose or insulin concentrations, whole-body energy expenditure or appetite scores, but serum uric acid concentrations increased (p < 0.05) following microalgae ingestion only.ConclusionOur data imply that microalgae can present a bioavailable source of protein for human nutrition, however, challenges remain, requiring species selection and/or biomass processing to overcome.

Background Leucaena leucocephala is a useful multipurpose tree species for agroforestry systems, but traditional seeded cultivars often become weedy and invasive. A seedless hybrid cultivar, ‘KX4-Hawaii’, offers a potential solution to this problem. However, relevant agronomic information and information on the performance of ‘KX4-Hawaii’ under varying growth conditions is required. The goal of this research was to evaluate ‘KX4-Hawaii’ as a source of agricultural biomass in Barbados, a small island developing state with limited arable land. Methods ‘KX4-Hawaii’ air layers were imported into Barbados to create stock trees. Air layering was used to create propagation material and a field study was established with a ‘KX4-Hawaii’ hedgerow planted as a field border. Three plant spacings (50, 75, and 100 cm) were evaluated and data on the growth and biomass yields of the trees were collected at 4-month intervals. Precipitation data were used to investigate climatic effects on ‘KX4-Hawaii’ productivity. Results ‘KX4-Hawaii’ was successfully propagated via air layers and could be planted directly in the field with irrigation. All recorded growth and biomass yields were correlated with precipitation. However, the woody (lignified stems and branches) biomass was more responsive to precipitation than the green (leaves and green tender stems) biomass and made up a large fraction of the total biomass produced. ‘KX4-Hawaii’ was productive even under drought conditions and biomass yields per meter of hedgerow increased with closer spacings. Of the tested spacing treatments, 75 cm was optimum for a 4-month pruning interval under the conditions seen in Barbados as it produced similar yields to the 50 cm spacing treatment but would require less propagation material.

Abstract Background Bed‐rest (BR) of only a few days duration reduces muscle protein synthesis and induces skeletal muscle atrophy and insulin resistance, but the scale and juxtaposition of these events have not been investigated concurrently in the same individuals. Moreover, the impact of short‐term exercise‐supplemented remobilization (ESR) on muscle volume, protein turnover and leg glucose uptake (LGU) in humans is unknown. Methods Ten healthy males (24 ± 1 years, body mass index 22.7 ± 0.6 kg/m2) underwent 3 days of BR, followed immediately by 3 days of ESR consisting of 5 × 30 maximal voluntary single‐leg isokinetic knee extensions at 90°/s each day. An isoenergetic diet was maintained throughout the study (30% fat, 15% protein and 55% carbohydrate). Resting LGU was calculated from arterialized‐venous versus venous difference across the leg and leg blood flow during the steady‐state of a 3‐h hyperinsulinaemic–euglycaemic clamp (60 mU/m2/min) measured before BR, after BR and after remobilization. Glycogen content was measured in vastus lateralis muscle biopsy samples obtained before and after each clamp. Leg muscle volume (LMV) was measured using magnetic resonance imaging before BR, after BR and after remobilization. Cumulative myofibrillar protein fractional synthetic rate (FSR) and whole‐body muscle protein breakdown (MPB) were measured over the course of BR and remobilization using deuterium oxide and 3‐methylhistidine stable isotope tracers that were administered orally. Results Compared with before BR, there was a 45% decline in insulin‐stimulated LGU (P

Abstract Introduction Lesotho has the second-highest prevalence of HIV. Despite progress in achieving HIV epidemic control targets, inequities persist among certain groups, particularly associations between disability, HIV, and violence. We assessed the prevalence of disability and examined associations between disability and HIV and violence using data from the 2018 Lesotho Violence Against Children and Youth Survey (VACS). Methods Lesotho VACS was a nationally representative survey of females and males ages 13–24. We assessed the associations between disability status and HIV, sexual risk behaviours, and violence using logistic regression, incorporating survey weights. Results Weighted functional disability prevalence was 14.1% for females (95% confidence interval [CI] 12.7–15.4) and 7.3% for males (5.3–9.2). Compared with females with no disabilities, females with disabilities had higher odds of being HIV positive (adjusted odds ratio [aOR] 1.92, 1.34–2.76), having transactional sex (aOR 1.79, 1.09–2.95), and experiencing any lifetime violence (aOR 2.20, 1.82–2.65), sexual violence (aOR 1.77, 1.36–2.31), emotional violence (2.02. 1.61–2.53), physical violence (aOR 1.85, 1.54–2.24), witnessing interparental violence (aOR 1.71, 1.46–2.01), and witnessing community violence (aOR 1.52, 1.26–1.84). Males with disabilities had higher odds of having transactional sex (aOR 4.30, 1.35–13.73), having recent multiple sex partners (aOR 2.31, 1.13–4.75), experiencing emotional violence (aOR 2.85, 1.39–5.82), and witnessing interparental violence (aOR 1.78, 1.12–2.84). HIV models for males did not converge due to low numbers. Conclusion Findings emphasize the importance of inclusion and accessibility for adolescents and young adults with disabilities in prevention and services for violence and HIV. Ending HIV in Lesotho depends on addressing the vulnerabilities that lead to potential infection including violence and ensuring equitable services for all.

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BackgroundThe COVID-19 pandemic led to several surges in the mass hospitalization rate. Extreme increases in hospital admissions without adequate medical resources may increase mortality. No study has addressed the impact of daily census of ventilated patients on mortality in the context of the pandemic in a nationwide setting. ObjectiveThis study aimed to determine whether daily census of ventilated patients affected COVID-19 mortality rates nationwide in Israel. MethodsWe conducted a cohort study using nationwide, public-domain, population-based COVID-19 data of hospitalized patients from an Israeli database from March 11, 2020, until February 11, 2021. We included all COVID-19 hospital admissions, classified as mild to severe per the Centers for Diseases Control and Prevention classification irrespective of whether they were mechanically ventilated. Outcome measures were daily death rates and death rates expressed as a percentage of ventilated patients. ResultsDuring the study period (338 days from March 11, 2020, to February 11, 2021), 715,743 patients contracted and were clinically confirmed as having COVID-19. Among them, 5577 (0.78%) patients died. In total, 3398 patients were ventilated because of severe COVID-19. Daily mortality correlated with daily census of ventilated patients (R2=0.828, P

The treatment of flue gases has become a crucial area of interest with the increasing air emissions into the atmosphere from industries involved in combustion of fossil fuels in their operations. In essence, there is a critical need for effective methods of treatment more than ever. Treatment and separation are now a demand for the overall industrial operations to control the rate of flue gas emissions. The major culprit in this wise is power generating industry. The major associated air pollutants are carbon dioxide, sulfur oxides, trace metals, volatile organic compounds, particulate matters, and nitrogen oxides. However, the choice of technologies to be utilized requires more than just knowledge of the separation process, but also a good understanding of the properties of the pollutants. This review explored and evaluated the various separation processes and technologies for the treatment of industrial flue gases for the control of the associated air pollutants. It also analyzed the performance with references to cost and efficiency, the advantages and disadvantages, principles for selection, research direction, and/or potential opportunities in existing separation processes and technologies.

In many developing nations, heavy reliance on petroleum products for power generation and transportation stems from limited access to sustainable energy sources and inadequate electricity supply. This research aims to experimentally develop predictive models for quantification of total volatile organic compounds (TVOCs) from the dispensing processes of the selected petroleum products: petrol, kerosene, and diesel. A lab-scale fueling station was fabricated with five selected siphon pumps of different flowrates. These with a view to investigating the effect of fuel flowrates on TVOCs emission released near the nozzle gun and the vehicle tanks/portable container openings with varying effective cross-sectional areas (CSAs). The results revealed that petrol emits the highest concentrations of TVOCs emissions among the fuels due to its high volatility. At the highest flowrate of 0.33 L/s and the smallest effective CSA (1.59 × 10−4 m2) of the receiving tank/container openings, the highest concentrations (89, 57, and 45 ppm) of petrol, kerosene, and diesel were released, respectively. When the fuel flowrate was reduced to 0.20 L/s with the same effective CSA, the TVOCs emissions decreased to 53, 37, and 29 ppm for each fuel respectively. Additionally, the lowest TVOCs emission concentration of 5 ppm was observed at the slowest diesel fill rate of 0.05 L/s with the largest effective CSA of the tank/container opening that would make the TVOCs emission concentrations above the standard 0.5 ppm recommended by TECAM. The results also showed that emission fluxes of TVOCs increase when the effective CSA of the tank/container opening is reduced. The highest TVOCs emission flux (5.6 ×105ppm/m2) was recorded from the receiving tank/container opening with the smallest effective CSA of 1.59 × 10−4m2. It was discovered in the study that at high flow rates and smaller effective cross-sectional areas of tank/container openings, there are increase in TVOCs emissions and fluxes. Predictive models. Equations (2)–(4), were developed from the results with the use of Minitab and MATLAB software for predicting, estimating emission inventory and controlling of TVOCs emissions at the points of sales of fueling stations by regulatory bodies.

In this research, the pyrolysis of wood sawdust to obtain bio-oil was investigated as a viable solution to the waste management of wood sawdust in southwestern Nigeria. This is also with a view to mitigating the erratic state of power supply. Bio-oil, a component that could be obtained from the pyrolysis of biomass, can serve as source of bio-chemicals and fuels to produce electricity. An Aspen plus simulation software, V11 of 2019 involving a four-stage process was developed: pyrolysis, cyclone separation of char, condensation of bio-oil and separation of bio-oil. The material and energy flow across the process were accounted for, all the key process equipment were sized and a detailed economics of the process was estimated. From the results of the simulation, a production rate of 0.124 tons of bio-oil was achieved per ton of wood sawdust. The estimated payback period posed as a major factor in determining the sales price of bio-oil and securing the attention of the would-be investors was determined. The price of the producible bio-oil varied widely between $9.90/kg and $4.65/kg for payback period between 2 and 6 years. This study revealed that proper harnessing of this process of pyrolyzing wood sawdust has the potential of generating $305,595.37 yearly in Southwest, Nigeria alone. Also, an electricity generation capacity of 131,233.75 kWh per year is possible.

Abstract Studies of extreme endurance have suggested that there is an alimentary limit to energy intake (EI) of ∼2.5 × resting metabolic rate (RMR). To gain further insight, this study aimed to simultaneously measure EI, total energy expenditure (TEE) body mass and muscle mass in a large cohort of males and females of varying ages during a transatlantic rowing race. Forty‐nine competitors (m = 32, f = 17; age 24–67 years; time at sea 46 ± 7 days) in the 2020 and 2021 Talisker Whisky Atlantic Challenge rowed 12–18 hday−1 for ∼3000 miles. TEE was assessed in the final week of the row using 2H218O doubly labelled water, and EI was analysed from daily ration packs over this period. Thickness of relatively active (vastus lateralis, intermedius, biceps brachaii and rectus abdominus) and inactive (gastrocnemius, soleus and triceps) muscles was measured pre (

Concerns over the negative impacts of climate change on ecosystems and human life have entered a new phase where many hypothetical views are fast becoming realities. Presently, the rampaging effect of climate change is, in theory, causing ecological catastrophes, and it is being felt at an alarming scale worldwide. As an important ecological niche, the soil ecosystem hosts a diversity of microbiomes and macrobiomes and affords a soil-plant-microbes ecological continuum. Also, it supports essential ecological processes meant to promote life-sustaining habits. However, changes in plant diversity due to increasing greenhouse effects, anthropogenic activities, and global warming have severely impacted the stability of soil microbial communities and interactions, particularly the soil-plant-microbe interaction. A good understanding of the mechanisms underpinning the plant-soil-microbial interactions, the complexity of the soil microbiome, ecosystem adaptability to climate change-induced stresses, and niche functionality of microbiota is necessary for the empirical impact assessment of climate change on soil microbial behaviors. Moreover, the soil system parameters and the various ecological services affected need to be further studied to identify opportunities that could assist the quest to mitigate the debilitating effects of climatic change in the soil ecosystem and sustainable food security initiatives.

The effects of dietary Bacillus protease on broiler performance were examined. Three hundred ‘Cobb 500’ day-old broilers were randomly assigned to five dietary groups with five replicates of 12 birds each. Treatments include: PROT0; without protease addition (0 g/kg; control), PROT10, PROT15, PROT20 and PROT25 diets supplemented with Bacillus protease at the level of 1, 1.5, 2 and 2.5 g/kg, respectively. Birds fed PROT25 had the highest (p

This study uses operational data from a 180 kWp grid-connected solar PV system to train and compare the performance of single and hybrid machine learning models in predicting solar PV production a day-ahead, a week-ahead, two weeks ahead and one month-ahead. The study also analyses the trend in solar PV production and the effect of temperature on solar PV production. The performance of the models is evaluated using R2 score, mean absolute error and root mean square error. The findings revealed the best-performing model for the day ahead forecast to be Artificial Neural Network. Random Forest gave the best performance for the two-week and a month-ahead forecast, while a hybrid model composed of XGBoost and Random Forest gave the best performance for the week-ahead prediction. The study also observed a downward trend in solar PV production, with an average monthly decline of 244.37 kWh. Further, it was observed that an increase in the module temperature and ambient temperature beyond 47 °C and 25 °C resulted in a decline in solar PV production. The study shows that machine learning models perform differently under different time horizons. Therefore, selecting suitable machine learning models for solar PV forecasts for varying time horizons is extremely necessary.

Abstract Background The decline in postabsorptive and postprandial muscle protein fractional synthesis rates (FSR) does not quantitatively account for muscle atrophy during uncomplicated, short‐term disuse, when atrophy rates are the highest. We sought to determine whether 2 days of unilateral knee immobilization affects mixed muscle protein fractional breakdown rates (FBR) during postabsorptive and simulated postprandial conditions. Methods Twenty‐three healthy, male participants (age: 22 ± 1 year; height: 179 ± 1 cm; body mass: 73.4 ± 1.5 kg; body mass index 22.8 ± 0.5 kg·m−2) took part in this randomized, controlled study. After 48 h of unilateral knee immobilization, primed continuous intravenous l‐[15N]‐phenylalanine and l‐[ring‐2H5]‐phenylalanine infusions were used for parallel determinations of FBR and FSR, respectively, in a postabsorptive (saline infusion; FAST) or simulated postprandial state (67.5 mg·kg body mass−1·h−1 amino acid infusion; FED). Bilateral m. vastus lateralis biopsies from the control (CON) and immobilized (IMM) legs, and arterialized‐venous blood samples, were collected throughout. Results Amino acid infusion rapidly increased plasma phenylalanine (59 ± 9%), leucine (76 ± 5%), isoleucine (109 ± 7%) and valine (42 ± 4%) concentrations in FED only (all P 0.05). However, immobilization decreased FSR (P

Abstract Background Knowledge of the diversity of invasion ligands in malaria parasites in endemic regions is essential to understand how natural selection influences genetic diversity of these ligands and their feasibility as possible targets for future vaccine development. In this study the diversity of four genes for merozoite invasion ligands was studied in Ecuadorian isolates of Plasmodium vivax. Methods Eighty-eight samples from P. vivax infected individuals from the Coast and Amazon region of Ecuador were obtained between 2012 and 2015. The merozoite invasion genes pvmsp-1-19, pvdbpII, pvrbp1a-2 and pvama1 were amplified, sequenced, and compared to the Sal-1 strain. Polymorphisms were mapped and genetic relationships between haplotypes were determined. Results Only one nonsynonymous polymorphism was detected in pvmsp-1-19, while 44 nonsynonymous polymorphisms were detected in pvdbpII, 56 in pvrbp1a-2 and 33 in pvama1. While haplotypes appeared to be more related within each area of study and there was less relationship between parasites of the coastal and Amazon regions of the country, diversification processes were observed in the two Amazon regions. The highest haplotypic diversity for most genes occurred in the East Amazon of the country. The high diversity observed in Ecuadorian samples is closer to Brazilian and Venezuelan isolates, but lower than reported in other endemic regions. In addition, departure from neutrality was observed in Ecuadorian pvama1. Polymorphisms for pvdbpII and pvama1 were associated to B-cell epitopes. Conclusions pvdbpII and pvama1 genetic diversity found in Ecuadorian P. vivax was very similar to that encountered in other malaria endemic countries with varying transmission levels and segregated by geographic region. The highest diversity of P. vivax invasion genes in Ecuador was found in the Amazonian region. Although selection appeared to have small effect on pvdbpII and pvrbp1a-2, pvama1 was influenced by significant balancing selection.

This study reviews the mass transfer with a focus on the challenges, benefits, processing and prospects in the pulp and paper industry with a scope limited to Kraft pulping which is the dominant pulping process worldwide. The mass transfer usually occurs in various processes that deal with reactions, separation, and heat transfer. All these aforementioned processes occur in the production of pulp and paper from their raw materials. The application of mass transfer to these processes is of great importance in setting target yields, and specifications and improving efficiency. The major processes where mass transfer principles are applied are drying, chemical washing, pulp digestion and pulp bleaching respectively. Understanding the requirements and targets of each of these processes in combination with the mass transfer principles helps in the development of models and design of equipment that operate based on the developed models in meeting the required targets. Studies have indicated that mass and energy balances cannot be done independently in meeting the required targets and equipment design. The drying and stripping of lignocellulosic components of the feed-in paper manufacture constitute a large part of the challenges faced by the industry. Drying techniques have been considered to be inefficient, and lignocellulosic by-products are known to contain toxic components. Green chemistry production processes and newer drying techniques were indicated as possible solutions. It is expected that researchers and investors would find this article useful.

ABSTRACTBrucellosis is a worldwide zoonosis that is endemic in Namibia. This study estimated seroprevalence of brucellosis, and determined the presence of Brucella infection in slaughtered cattle using the genus-specific 16-23S rRNA interspacer PCR (ITS-PCR), and the species-specific AMOS-PCR. Between December 2018 and May 2019, sera (n = 304), pooled lymph nodes (n = 304), and individual spleen (n = 304) were collected from slaughtered cattle from 52 farms. Sera were tested for anti-Brucella antibodies using the Rose Bengal test (RBT), and the complement fixation test (CFT). Seroprevalence was 2.3% (7/304) (RBT) and 1.6% (5/304) (CFT). Prevalence of positive herds was 9.6% (5/52). Lymph node (n = 200) and spleen (n = 200) samples from seronegative cattle tested negative for Brucella spp. DNA on ITS-PCR, but Brucella spp. DNA was detected in lymph nodes (85.7%, 6/7) and spleen (85.7%, 6/7) from RBT positive cattle. ITS-PCR confirmed isolates from lymph node (51.4%, 4/7) and spleen (85.7%, 6/7) as Brucella spp.; while AMOS-PCR and Brucella abortus species specific (BaSS) PCR confirmed the isolates as Brucella abortus, and field strains, respectively. Provision of adequate protective gear, and the promotion of brucellosis awareness among abattoir workers is recommended to prevent zoonotic infection.

Abstract Plasmodium vivax Duffy Binding Protein region II (PvDBPII) is a leading vaccine candidate against blood-stage vivax malaria. Anti-PvDBPII antibodies potentially block parasite invasion by inhibition of erythrocyte binding. However, knowledge of PvDBPII-specific T cell responses is limited. Here, to assess the responses of PvDBPII-specific CD4+T cells in natural P. vivax infection, three cross-sectional studies were conducted in recovered subjects. In silico analysis was used for potential T cell epitope prediction and selection. PBMCs from P. vivax subjects were stimulated with selected peptides and examined for cytokine production by ELISPOT or intracellular cytokine staining. Six dominant T cell epitopes were identified. Peptide-driven T cell responses showed effector memory CD4+T cell phenotype, secreting both IFN-γ and TNF-α cytokines. Single amino acid substitutions in three T cell epitopes altered levels of IFN-γ memory T cell responses. Seropositivity of anti-PvDBPII antibodies were detected during acute malaria (62%) and persisted up to 12 months (11%) following P. vivax infection. Further correlation analysis showed four out of eighteen subjects had positive antibody and CD4+T cell responses to PvDBPII. Altogether, PvDBPII-specific CD4+T cells were developed in natural P. vivax infections. Data on their antigenicity could facilitate development of an efficacious vivax malaria vaccine.

(1) Background: Vitamin D supplementation after type 1 diabetes mellitus (T1DM) onset has led to conflicting results on beta-cell preservation. Aim: This paper presents a systematic review to verify whether randomized prospective controlled trials (RCTs) demonstrate that improved vitamin D status confers protection on T1DM. (2) Methods: A systematic review was conducted up until 18 January 2024 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching MEDLINE, MEDLINE In-Process, Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, using keywords “vitamin D”, “type 1 diabetes”, and “children”. (3) Results: Following the above-mentioned search process, 408 articles in PubMed and 791 in Embase met inclusion criteria. After removing duplicates, 471 articles remained. After exclusion criteria, 11 RCTs remained. Because of major heterogeneity in design and outcomes, no meta-analyses were conducted, allowing only for qualitative analyses. There was no strong evidence that vitamin D supplementation has lasting effects on beta-cell preservation or glycemic control in new-onset T1DM. (4) Conclusions: More rigorous, larger studies are needed to demonstrate whether vitamin D improves beta-cell preservation or glycemic control in new-onset T1DM. Because T1DM may cause osteopenia, it is advisable that patients with new onset T1DM have adequate vitamin D stores.

Leishmaniasis is a group of parasitic diseases with the potential to infect more than 1 billion people; however, its treatment is still old and inadequate. In order to contribute to changing this view, this work consisted of the development of complexes derived from MI metal ions with thioureas, aiming to obtain potential leishmanicidal agents. The thiourea ligands (HLR) were obtained by reactions of p-toluenesulfohydrazide with R-isothiocyanates and were used in complexation reactions with AgI and AuI, leading to the formation of complexes of composition [M(HLR)2]X (M = Ag or Au; X = NO3− or Cl−). All compounds were characterized by FTIR, 1H NMR, UV-vis, emission spectroscopy and elemental analysis. Some representatives were additionally studied by ESI-MS and single-crystal XRD. Their properties were further analyzed by DFT calculations. Their cytotoxicity on Vero cells and the extracellular leishmanicidal activity on Leishmania infantum and Leishmania braziliensis cells were evaluated. Additionally, the interaction of the complexes with the Old Yellow enzyme of the L. braziliensis (LbOYE) was examined. The biological tests showed that some compounds present remarkable leishmanicidal activity, even higher than that of the standard drug Glucantime, with different selectivity for the two species of Leishmania. Finally, the interaction studies with LbOYE revealed that this enzyme could be one of their biological targets.

Abstract Repeated maximal breath‐holds have been demonstrated to induce bradycardia, increase haematocrit and haemoglobin and prolong subsequent breath‐hold duration by 20%. Freedivers use non‐maximal breath‐hold techniques (BHTs) to improve breath‐hold duration. The aim of this study was to investigate the cardiorespiratory and haematological responses to various BHTs. Ten healthy men (34.5 ± 1.9 years) attended five randomized experimental trials and performed a 40 min period of quiet rest or one of three BHTs followed by a maximal breath‐hold challenge during facial immersion in water at 30 or 10°C. Cardiovascular and respiratory parameters were measured continuously using finger plethysmography and breath‐by‐breath gas analysis, respectively, and venous blood samples were collected throughout. Facial immersion in cold water caused marked bradycardia (74.1 vs. 50.2 beats/min after 40 s) but did not increase breath‐hold duration compared with warm water control conditions. Facial immersion breath‐hold duration was 30.8–43.3% greater than the control duration when preceded by BHTs that involved repeated breath‐holds of constant duration (P = 0.021), increasing duration (P 0.05). In conclusion, the duration of apnoea can be extended by manipulating blood gases through repeated prior breath‐holds, but changes in cardiac output and red blood cell mass do not appear essential.

The increasing use of power electronic devices has resulted in harmonics that may cause in power systems overheating of equipment, poor power factor and voltage distortion. Shunt active power filter (SAPF) provides the most useful means for harmonics mitigation in power systems. In a certain number of SAPFs, the dc link capacitor voltage is regulated by means of a PI controller. This paper proposes a variant of a population based Jumping Spider Algorithm for optimal tuning of the PI controller to enhance the performance of the active filter. The SAPF considered in this paper uses the p-q theory to extract its reference current and the hysteresis current control to produce the triggering signals for the controlled switching devices of its inverter. The overall SAPF is developed and validated using MATLAB/Simulink tool under two different nonlinear loading conditions. The results obtained by simulation show that the SAPF with the proposed PI controller effectively controls the dc-link capacitor voltage and mitigates current harmonics.

Abstract Background Bed rest (BR) reduces whole‐body insulin‐stimulated glucose disposal (GD) and alters muscle fuel metabolism, but little is known about metabolic adaptation from acute to chronic BR nor the mechanisms involved, particularly when volunteers are maintained in energy balance. Methods Healthy males (n = 10, 24.0 ± 1.3 years), maintained in energy balance, underwent 3‐day BR (acute BR). A second cohort matched for sex and body mass index (n = 20, 34.2 ± 1.8 years) underwent 56‐day BR (chronic BR). A hyperinsulinaemic euglycaemic clamp (60 mU/m2/min) was performed to determine rates of whole‐body insulin‐stimulated GD before and after BR (normalized to lean body mass). Indirect calorimetry was performed before and during steady state of each clamp to calculate rates of whole‐body fuel oxidation. Muscle biopsies were taken to determine muscle glycogen, metabolite and intramyocellular lipid (IMCL) contents, and the expression of 191 mRNA targets before and after BR. Two‐way repeated measures analysis of variance was used to detect differences in endpoint measures. Results Acute BR reduced insulin‐mediated GD (Pre 11.5 ± 0.7 vs. Post 9.3 ± 0.6 mg/kg/min, P

The COVID-19 pandemic spread between neighboring countries through land, water, and air travel. Since May 2020, ministries of health for the Democratic Republic of the Congo, Tanzania, and Uganda have sought to clarify population movement patterns to improve their disease surveillance and pandemic response efforts. Ministry of Health–led teams completed focus group discussions with participatory mapping using country-adapted Population Connectivity Across Borders toolkits. They analyzed the qualitative and spatial data to prioritize locations for enhanced COVID-19 surveillance, community outreach, and cross-border collaboration. Each country employed varying toolkit strategies, but all countries applied the results to adapt their national and binational communicable disease response strategies during the pandemic, although the Democratic Republic of the Congo used only the raw data rather than generating datasets and digitized products. This 3-country comparison highlights how governments create preparedness and response strategies adapted to their unique sociocultural and cross-border dynamics to strengthen global health security.

Chemical kinetics and thermodynamics provide modes and mechanisms for the thermal death of microbial spores. In this study, the effect of thermal inactivation on Geobacillus stearothermophilus, a highly heat-resistant bacterial species, was studied over the temperature range of 95, 100, 105, and 110 °C and holding sterilization periods of 10, 15, 20, 25, 30, and 45 min by the application of mathematical analysis of kinetic and thermodynamic properties. Thermal death rate constant, k, for the best kinetic order of sterilization ranged between 0.0431 to 0.1581 min−1 with the energy of activation, Ea, estimated to be 115.96 kJ/mol. Two primary thermal death kinetic models were applied (log-linear first order and the nonlinear Weibull). Weibull's model provided more reliable kinetic parameters to predict the effect of thermal treatments. Concave curves (α >1) were predicted with the Weibull's model for 100, 105, and 110 °C (1.57, 1.26, and 1.22 respectively), indicating the susceptibility of spores to lethal treatment. The rate parameter, ɸ (first reduction time) decreased with increasing thermal heating (28.80 min (95 °C), 21.08 min (100 °C), 14.61 min (105 °C), and 9.65 min (110 °C)) following the paths of the D-values (about 7 min to attain 88% spores’ destruction after 110 °C heating) of the log-linear kinetic model. Thermal death time (TDT) for the complete destruction of spores was predicted to be after 40 min at 110 °C. The z-value was 23.31 °C, indicating the sterilization temperature that must be attained for one log destruction of spores. The heat of activation showed endothermic reactions for all temperatures (∆H ranged 112.90 – 112.78 kJ/mol), Gibb's free energy of activation, ∆G, ranged from 325 – 333.74 kJ/mol (indicating a non-spontaneous reaction), and the entropy of activation (∆S) showed reversibility of reaction (∆S < 1) for all the thermal temperatures.

Globally, the problem of pollution is considered to be one of the main cause of water scarcity, as it is common to waste dumped in streams and rivers. This problem has resulted in high levels of toxic chemicals such as pesticides, micro-pollutants and heavy metals being found in water bodies. The unwavering natural surroundings of worldwide rareness of water is the topographical and sequential discrepancy between the demands for clean fresh water and the obtainability of it.However, new and diverse technologies have been developed in order to achieve sustainable clean fresh water resources. The revolution in the development of novel technologies and materials such as nanomaterials is considered one of the most motivating and potential novel technologies for wastewater treatment. This review outlines the advancements of separation processes in treating polluted wastewater. Technologies such as phytoremediation, nanotechnologies and photo-catalysis were discussed.

Abstract Background Little is known about how normal variation in dietary patterns in humans affects the ageing process. To date, most analyses of the problem have used a unidimensional paradigm, being concerned with the effects of a single nutrient on a single outcome. Perhaps then, our ability to understand the problem has been complicated by the fact that both nutrition and the physiology of ageing are highly complex and multidimensional, involving a high number of functional interactions. Here we apply the multidimensional geometric framework for nutrition to data on biological ageing from 1560 older adults followed over four years to assess on a large-scale how nutrient intake associates with the ageing process. Results Ageing and age-related loss of homeostasis (physiological dysregulation) were quantified via the integration of blood biomarkers. The effects of diet were modelled using the geometric framework for nutrition, applied to macronutrients and 19 micronutrients/nutrient subclasses. We observed four broad patterns: (1) The optimal level of nutrient intake was dependent on the ageing metric used. Elevated protein intake improved/depressed some ageing parameters, whereas elevated carbohydrate levels improved/depressed others; (2) There were non-linearities where intermediate levels of nutrients performed well for many outcomes (i.e. arguing against a simple more/less is better perspective); (3) There is broad tolerance for nutrient intake patterns that don’t deviate too much from norms (‘homeostatic plateaus’). (4) Optimal levels of one nutrient often depend on levels of another (e.g. vitamin E and vitamin C). Simpler linear/univariate analytical approaches are insufficient to capture such associations. We present an interactive tool to explore the results in the high-dimensional nutritional space. Conclusion Using multidimensional modelling techniques to test the effects of nutrient intake on physiological dysregulation in an aged population, we identified key patterns of specific nutrients associated with minimal biological ageing. Our approach presents a roadmap for future studies to explore the full complexity of the nutrition-ageing landscape.

Abstract Background Dietary protein ingestion augments post (resistance) exercise muscle protein synthesis (MPS) rates. It is thought that the dose of leucine ingested within the protein (leucine threshold hypothesis) and the subsequent plasma leucine variables (leucine trigger hypothesis; peak magnitude, rate of rise, and total availability) determine the magnitude of the postprandial postexercise MPS response. Methods A quantitative systematic review was performed extracting data from studies that recruited healthy adults, applied a bout of resistance exercise, ingested a bolus of protein within an hour of exercise, and measured plasma leucine concentrations and MPS rates (delta change from basal). Results Ingested leucine dose was associated with the magnitude of the MPS response in older, but not younger, adults over acute (0–2 h, r2 = 0.64, p = 0.02) and the entire postprandial (>2 h, r2 = 0.18, p = 0.01) period. However, no single plasma leucine variable possessed substantial predictive capacity over the magnitude of MPS rates in younger or older adults. Conclusion Our data provide support that leucine dose provides predictive capacity over postprandial postexercise MPS responses in older adults. However, no threshold in older adults and no plasma leucine variable was correlated with the magnitude of the postexercise anabolic response.

Abattoir workers are liable to zoonotic infections from animals and animal products, primarily to diseases with asymptomatic and chronic clinical manifestations in animals, such as brucellosis. No published reports exist on the seroprevalence of brucellosis in abattoir workers in South Africa. Therefore, this cross-sectional study was conducted to estimate the occurrence and risk factors for Brucella exposure in abattoir workers in Gauteng Province. A total of 103 abattoir workers and managers from 6 abattoirs, where brucellosis-positive slaughtered cattle and sheep were previously detected, were interviewed and tested with serological assays using the Rose Bengal test (RBT), BrucellaCapt, and IgG-ELISA. A pre-tested questionnaire was administered to consenting respondents to obtain information on risk factors for brucellosis. Of the 103 respondents tested, the distribution of female and male workers was 16 (15.5%) and 87 (84.5%), respectively. The seroprevalence for exposure to brucellosis was 21/103 (20.4%, 95%CI: 13.1–29.5) using a combination of RBT, BrucellaCapt, or IgG-ELISA. For test-specific results, seroprevalences by RBT, BrucellaCapt, and IgG-ELISA were 13/103 (12.6%, 95%CI: 6.9–20.6), 9/103 (8.74%, 95%CI: 4.1–15.9), and 18/103 (17.5%, 95%CI: 10.7–26.2), respectively. Low-throughput abattoirs were identified as associated risks, as 29.3% of workers were seropositive compared with 12.7% of workers in high-throughput abattoirs, which highlights that direct contact at abattoirs poses higher risk to workers than indirect and direct contact outside abattoirs. This study confirms the occurrence of Brucella spp. antibodies among abattoir workers in South Africa, possibly due to occupational exposure to Brucella spp., and highlights the occupational hazard to workers. Furthermore, findings underscore that abattoir facilities can serve as points for active and passive surveillance for indicators of diseases of public health importance. We recommend periodic implementation of brucellosis testing of abattoir workers country-wide to establish baseline data for informing appropriate preventive practices and reducing the potential burden of infection rates among these high-risk workers.

Nigeria is a country blessed with vast oil and natural gas resources and due to inadequate management of resources most of the natural gas is flared. One of the most pressing challenges today is global warming. Gas flaring has been known to deliver carbon dioxide and other ozone depleting substances which causes unnatural weather change. This paper emphasizes on gas flaring; its definition, composition, types and classifications. It also highlights the policies that have been made in Nigeria concerning gas flaring and provides alternative solutions to gas flaring.

Rapid and accurate soybean yield prediction at an on-farm scale is important for ensuring sustainable yield increases and contributing to food security maintenance in Nigeria. We used multiple approaches to assess the benefits of rhizobium (Rh) inoculation and phosphorus (P) fertilization on soybean yield increase and profitability from large-scale conducted trials in the savanna areas of Nigeria [i.e., the Sudan Savanna (SS), Northern Guinea Savanna (NGS), and Southern Guinea Savanna (SGS)]. Soybean yield results from the established trials managed by farmers with four treatments (i.e., the control without inoculation and P fertilizer, Rh inoculation, P fertilizer, and Rh + P combination treatments) were predicted using mapped soil properties and weather variables in ensemble machine-learning techniques, specifically the conditional inference regression random forest (RF) model. Using the IMPACT model, scenario analyses were employed to simulate long-term adoption impacts on national soybean trade and currency. Our study found that yields of the Rh + P combination were consistently higher than the control in the three agroecological zones. Average yield increases were 128%, 111%, and 162% higher in the Rh + P combination compared to the control treatment in the SS, NGS, and SGS agroecological zones, respectively. The NGS agroecological zone showed a higher yield than SS and SGS. The highest training coefficient of determination (R2 = 0.75) for yield prediction was from the NGS dataset, and the lowest coefficient (R2 = 0.46) was from the SS samples. The results from the IMPACT model showed a reduction of 10% and 22% for the low (35% adoption scenario) and high (75% adoption scenario) soybean imports from 2029 in Nigeria, respectively. A significant reduction in soybean imports is feasible if the Rh + P inputs are large-scaled implemented at the on-farm field and massively adopted by farmers in Nigeria.

Vanessa Fontana,1,2 Richard Myles Turner,1,2 Ben Francis,3 Peng Yin,3 Benno Pütz,4 Timo P Hiltunen,5 Sanni Ruotsalainen,6 Kimmo K Kontula,5 Bertam Müller-Myhsok,1,4 Munir Pirmohamed1,2,7 1The Wolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK; 2MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK; 3Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, UK; 4Max Planck Institute of Psychiatry, Munich, Germany; 5Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland; 6Institute for Molecular Medicine Finland, Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, Finland; 7Royal Liverpool and Broadgreen University Hospitals NHS Trust, and Liverpool Health Partners, Liverpool, UKCorrespondence: Vanessa Fontana, MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, University of Liverpool, Block A: Waterhouse Buildings, 1-5 Brownlow Street, Liverpool, L69 3GL, UK, Fax +44 151 794 5059, Email V.Fontana@liverpool.ac.ukPurpose: Bisoprolol is a widely used beta-blocker in patients with cardiovascular diseases. As with other beta-blockers, there is variability in response to bisoprolol, but the underlying reasons for this have not been clearly elucidated. Our aim was to investigate genetic factors that affect bisoprolol pharmacokinetics (PK) and pharmacodynamics (PD), and potentially the clinical outcomes.Patients and Methods: Patients with non-ST elevation acute coronary syndrome were recruited prospectively on admission to hospital and followed up for up to 2 years. Patients from this cohort who were on treatment with bisoprolol, at any dose, had bisoprolol adherence data and a plasma sample, one month after discharge from index hospitalisation were included in the study. Individual bisoprolol clearance values were estimated using population pharmacokinetic modeling. Genome-wide association analysis after genotyping was undertaken using an Illumina HumanOmniExpressExome-8 v1.0 BeadChip array, while CYP2D6 copy number variations were determined by PCR techniques and phenotypes for CYP2D6 and CYP3A were inferred from the genotype. GWAS significant SNPs were analysed for heart rate response to bisoprolol in an independent cohort of hypertensive subjects.Results: Six hundred twenty-two patients on bisoprolol underwent both PK and genome wide analysis. The mean (IQR) of the estimated clearance in this population was 13.6 (10.0– 18.0) L/h. Bisoprolol clearance was associated with rs11029955 (p=7.17× 10− 9) mapped to the region of coiled-coil domain containing 34 region (CCDC34) on chromosome 11, and with rs116702638 (p=2.54× 10− 8). Each copy of the minor allele of rs11029955 was associated with 2.2 L/h increase in clearance. In an independent cohort of hypertensive subjects, rs11029955 was associated with 24-hour heart rate response to 4-week treatment with bisoprolol (p= 9.3× 10− 5), but not with rs116702638.Conclusion: A novel locus on the chromosomal region 11p14.1 was associated with bisoprolol clearance in a real-world cohort of patients and was validated in independent cohort with a pharmacodynamic association.Keywords: bisoprolol, pharmacokinetics, genome-wide association

Abstract Increasing skeletal muscle carnitine content can manipulate fuel metabolism and improve exercise performance. Intravenous insulin infusion during hypercarnitinemia increases plasma carnitine clearance and Na+‐dependent muscle carnitine accretion, likely via stimulating Na+/K+ ATPase pump activity. We hypothesized that the ingestion of high‐dose caffeine, also known to stimulate Na+/K+ ATPase activity, would stimulate plasma carnitine clearance during hypercarnitinemia in humans. In a randomized placebo‐controlled study, six healthy young adults (aged 24 ± 5 years, height 175 ± 8 cm, and weight 70 ± 13 kg) underwent three 5‐h laboratory visits involving the primed continuous intravenous infusion of l‐carnitine (CARN and CARN + CAFF) or saline (CAFF) in parallel with ingestion of caffeine (CARN + CAFF and CAFF) or placebo (CARN) at 0, 2, 3, and 4 h. Regular blood samples were collected to determine concentrations of blood Na+ and K+, and plasma carnitine and caffeine, concentrations. Caffeine ingestion (i.e., CAFF and CARN + CAFF conditions) and l‐carnitine infusion (i.e., CARN and CARN + CAFF) elevated steady‐state plasma caffeine (to ~7 μg·mL−1) and carnitine (to ~400 μmol·L−1) concentrations, respectively, throughout the 5 h infusions. Plasma carnitine concentration was ~15% lower in CARN + CAFF compared with CARN during the final 90 min of the infusion (at 210 min, 356 ± 96 vs. 412 ± 94 μmol·L−1; p = 0.0080: at 240 min, 350 ± 91 vs. 406 ± 102 μmol·L−1; p = 0.0079: and at 300 min, 357 ± 91 vs. 413 ± 110 μmol·L−1; p = 0.0073, respectively). Blood Na+ concentrations were greater in CAFF and CARN + CAFF compared with CARN. Ingestion of high‐dose caffeine stimulates plasma carnitine clearance during hypercarnitinemia, likely via increased Na+/K+ ATPase activity. Carnitine co‐ingestion with caffeine may represent a novel muscle carnitine loading strategy in humans, and therefore manipulate skeletal muscle fuel metabolism and improve exercise performance.

Abstract Background Development of an effective vaccine against blood-stage malaria requires the induction of long-term immune responses. Plasmodium vivax Reticulocyte Binding Protein 1a (PvRBP1a) is a blood-stage parasite antigen which is associated with invasion of red blood cells and induces antibody responses. Thus, PvRBP1a is considered as a target for design of a blood-stage vaccine against vivax malaria. Methods Both cross-sectional and cohort studies were used to explore the development and persistence of long-lived antibody and memory B cell responses to PvRBP1a in individuals who lived in an area of low malaria endemicity. Antibody titers and frequency of memory B cells specific to PvRBP1a were measured during infection and following recovery for up to 12 months. Results IgG antibody responses against PvRBP1a were prevalent during acute vivax malaria, predominantly IgG1 subclass responses. High responders to PvRBP1a had persistent antibody responses for at least 12-month post-infection. Further analysis of high responder found a direct relation between antibody titers and frequency of activated and atypical memory B cells. Furthermore, circulating antibody secreting cells and memory B cells specific to PvRBP1a were generated during infection. The PvRBP1a-specific memory B cells were maintained for up to 3-year post-infection, indicating the ability of PvRBP1a to induce long-term humoral immunity. Conclusion The study revealed an ability of PvRBP1a protein to induce the generation and maintenance of antibody and memory B cell responses. Therefore, PvRBP1a could be considered as a vaccine candidate against the blood-stage of P. vivax.

BackgroundQuality assessment in health care is a process of planned activities with the ultimate goal of achieving a continuous improvement of medical care through the evaluation of structure, process, and outcome measures. Physicians and health care specialists involved with quality issues are faced with an enormous and nearly always increasing amount of literature to read and integrate. Nevertheless, the novelty and quality of these articles (in terms of evidence-based medicine) has not been systematically assessed and described. ObjectiveThe objective of this study was to test the hypothesis that the number of high-evidence journal articles (according to the pyramid of evidence), such as randomized control trials, systematic reviews, and ultimately, practice guidelines, increases over time, relative to lower-evidence journal articles, such as editorials, reviews, and letters to the editors. MethodsWe used PubMed database to retrieve relevant articles published during the 31-year period between January 1, 1989, and December 31, 2021. The search was conducted in April 2022. We used the keywords “quality care,” “quality management,” “quality indicators,” and “quality improvement” and limited the search fields to title and abstract in order to limit our search results to articles nearly exclusively related to health care quality. ResultsDuring this 31-year evaluation period, there was a significant cubic increase in the total number of publications, reviews, clinical trials (peaking in 2017, with a sharp decline until 2021), controlled trials (peaking in 2016, with a sharp drop until 2021), randomized controlled trials (peaking in 2017, with a sharp drop until 2021), systematic reviews (nearly nonexistent in the 1980s through 1990s to a peak of 222 in 2021), and meta-analyses (from nearly none in the 1980s through 1990s to a peak of approximately 40 per year in 2020). There was a linear increase in practice guidelines from none during 1989-1991 to approximately 25 per year during 2019-2021, including a cubic increase in editorials, peaking in 2021 at 125 per year, and in letters to the editor, peaking at 50-78 per year in the last 4 years (ie, 2018-2021). ConclusionsOver the past 31 years, the field of quality in health care has seen a significant yearly increase of published original studies with a relative stagnation since 2015. We suggest that contributors to this dynamic field of research should focus on producing more evidence-based publications and guidelines.

BackgroundThe simultaneous infection of Plasmodium falciparum and Epstein-Barr virus (EBV) could promote the development of the aggressive endemic Burkitt's Lymphoma (eBL) in children living in P. falciparum holoendemic areas. While it is well-established that eBL is not related to other human malaria parasites, the impact of EBV infection on the generation of human malaria immunity remains largely unexplored. Considering that this highly prevalent herpesvirus establishes a lifelong persistent infection on B-cells with possible influence on malaria immunity, we hypothesized that EBV co-infection could have impact on the naturally acquired antibody responses to P. vivax, the most widespread human malaria parasite.Methodology/principal findingsThe study design involved three cross-sectional surveys at six-month intervals (baseline, 6 and 12 months) among long-term P. vivax exposed individuals living in the Amazon rainforest. The approach focused on a group of malaria-exposed individuals whose EBV-DNA (amplification of balf-5 gene) was persistently detected in the peripheral blood (PersVDNA, n = 27), and an age-matched malaria-exposed group whose EBV-DNA could never be detected during the follow-up (NegVDNA, n = 29). During the follow-up period, the serological detection of EBV antibodies to lytic/ latent viral antigens showed that IgG antibodies to viral capsid antigen (VCA-p18) were significantly different between groups (PersVDNA > NegVDNA). A panel of blood-stage P. vivax antigens covering a wide range of immunogenicity confirmed that in general PersVDNA group showed low levels of antibodies as compared with NegVDNA. Interestingly, more significant differences were observed to a novel DBPII immunogen, named DEKnull-2, which has been associated with long-term neutralizing antibody response. Differences between groups were less pronounced with blood-stage antigens (such as MSP1-19) whose levels can fluctuate according to malaria transmission.Conclusions/significanceIn a proof-of-concept study we provide evidence that a persistent detection of EBV-DNA in peripheral blood of adults in a P. vivax semi-immune population may impact the long-term immune response to major malaria vaccine candidates.

The occurrence and levels of polycyclic aromatic hydrocarbons (PAHs) in Nigeria's environment were reviewed in this study. A survey of the literature showed that a considerable number of reports exist on the presence of PAHs in Nigerian soil, water and sediments. Information on the presence of PAHs in the country's air- shed exists but in very limited number. The sources of PAHs are ubiquitous and their concentrations in the country's environment are above the permissible limit set for the pollutant by European Union, the United Kingdom, China and the World Health Organization in most instances. There is practically an absence of regulatory standards for PAHs in ambient air and soil in Nigeria. More studies on source apportionment are needed to be able to ascertain the sources of PAHs and their respective contributions to ambient air concentration. Considering the ubiquitous sources of PAHs, their reported elevated levels in the few publications available in the literature and their carcinogenic and mutagenic tendencies, there is the need for policy makers to drive research on PAHs in Nigeria with a view to setting regulatory standards for the individual carcinogenic PAHs as well as the total PAHs concentrations allowable in different media. Due to the low level of public awareness on the risks and hazards associated with an exposure to PAHs, there is a need to deepen advocacies on polycyclic aromatic hydrocarbons and their public health concerns.

Plasmodium vivax blood-stage invasion into reticulocyte is critical for parasite development. Thus, validation of novel parasite invasion ligands is essential for malaria vaccine development. Recently, we demonstrated that EBP2, a Duffy binding protein (DBP) paralog, is antigenically distinct from DBP and could not be functionally inhibited by anti-DBP antibodies. Here, we took advantage of a small outbreak of P.vivax malaria, located in a non-malarious area of Brazil, to investigate for the first time IgM/IgG antibodies against EBP2 and DEKnull-2 (an engineering DBPII vaccine) among individuals who had their first and brief exposure to P.vivax (16 cases and 22 non-cases). Our experimental approach included 4 cross sectional surveys at 3-month interval (12-month follow-up). The results demonstrated that while a brief initial P.vivax infection was not efficient to induce IgM/ IgG antibodies to either EBP2 or DEKnull-2, IgG antibodies against DEKnull-2 (but not EBP2) were boosted by recurrent blood-stage infections following treatment. Of interest, in most recurrent P. vivax infections (4 out of 6 patients) DEKnull-2 IgG antibodies were sustained for 6 to 12 months. Polymorphisms in the ebp2 gene does not seem to explain EBP2 low immunogenicity as the ebp2 allele associated with the P.vivax outbreak presented high identity to the original EBP2 isolate used as recombinant protein. Although EBP2 antibodies were barely detectable after a primary episode of P.vivax infection, EBP2 was highly recognized by serum IgG from long-term malaria-exposed Amazonians (range from 35 to 92% according to previous malaria episodes). Taken together, the results showed that individuals with a single and brief exposure to P.vivax infection develop very low anti-EBP2 antibodies, which tend to increase after long-term malaria exposure. Finally, the findings highlighted the potential of DEKnull-2 as a vaccine candidate, as in non-immune individuals anti-DEKnull-2 IgG antibodies were boosted even after a brief exposure to P.vivax blood stages.

The τ-phase Ba1.3Ca0.7-x-ySiO4:xDy3+/yTb3+ phosphors co-doped with Dy3+ (x = 0.03) and Tb3+ (y = 0.01–0.05) trivalent rare-earth ions were prepared by the gel-combustion method. The structure–property relation of the samples was examined by X-ray diffraction, scanning electron microscopy and spectrophotometer. Here, the effect of Tb3+'s concentration on the spectroscopic properties of Ba1.3Ca0.7-x-ySiO4:xDy3+/yTb3+ phosphors was explored by using the photoluminescence excitation, emission and decay curves. Importantly, the photonic energy transfer from (Dy3+:4F9/2 + Tb3+:7F6) to (Dy3+:6H15/2 + Tb3+:5D4) was observed, in which the Dy3+ ions act as a light-emitting donor whereas the Tb3+ ions as a light-absorbing acceptor, resulting in an enhanced emission from the co-doped Ba1.3Ca0.7-x-ySiO4:xDy3+/yTb3+ (x = 0.03 and y = 0.01–0.05) phosphors. Finally, the chromaticity coordinates were determined from the measured emission spectra, locating at the green and white light regions. This observation indicates that the characteristic emission colour could be tuned from white to green by varying Tb3+ concentrations under ultraviolet light.

Abstract In South Africa, brucellosis testing and record‐keeping are done by several laboratories, thus it is difficult to access any organized data to assess the status of the disease. This study evaluated the seropositivity for brucellosis using Rose Bengal test and complement fixation test in suspect cattle, sheep, goats and pigs sera submitted to Bacterial Serology Laboratory, Agricultural Research Council‐Onderstepoort Veterinary Research (ARC‐OVR) from nine provinces in the country during the period 2007–2015. This retrospective data analysis was conducted to estimate the occurrence of brucellosis in the country from the submitted samples, identify variables that affected seropositivity for brucellosis, investigate existing gaps in data recording and make recommendations on important variables to facilitate better data capture and inferences on brucellosis. Nine years of data were collated and analysed to detect association (seropositivity over time regarding animal species and location). Of the 764,276 animals tested, the distribution of samples was 90.50% (691,539/764,276), 5.19% (39,672/764,276), 3.92% (29,967/764,276) and 0.41% (3,098/764,276) for cattle, sheep, goats and pigs, respectively. The seropositivity for brucellosis by animal species was 6.31% (43,666/691,539, 95% CI: 6.26–6.37), 2.09% (828/39,672, 95% CI: 1.95–2.23), 0.63% (189/29,967, 95% CI: 0.55–0.73) and 0.13% (4/3,098, 95% CI: 0.05–0.33) in cattle, sheep, goats and pigs respectively. The data available did not capture information on the age, sex, breed and other host risk factors that would have been related to seropositivity for brucellosis. The data provide an understanding of the disease occurrence and confirm that brucellosis is enzootic in South Africa. Improved and standardized data collection can be used to pro‐actively drive, monitor, change or formulate policies to mitigate the challenges brought about by brucellosis in the livestock sector in South Africa.

Abstract Soil property and class maps for the continent of Africa were so far only available at very generalised scales, with many countries not mapped at all. Thanks to an increasing quantity and availability of soil samples collected at field point locations by various government and/or NGO funded projects, it is now possible to produce detailed pan-African maps of soil nutrients, including micro-nutrients at fine spatial resolutions. In this paper we describe production of a 30 m resolution Soil Information System of the African continent using, to date, the most comprehensive compilation of soil samples ( $$N \approx 150,000$$ N ≈ 150 , 000 ) and Earth Observation data. We produced predictions for soil pH, organic carbon (C) and total nitrogen (N), total carbon, effective Cation Exchange Capacity (eCEC), extractable—phosphorus (P), potassium (K), calcium (Ca), magnesium (Mg), sulfur (S), sodium (Na), iron (Fe), zinc (Zn)—silt, clay and sand, stone content, bulk density and depth to bedrock, at three depths (0, 20 and 50 cm) and using 2-scale 3D Ensemble Machine Learning framework implemented in the mlr (Machine Learning in R) package. As covariate layers we used 250 m resolution (MODIS, PROBA-V and SM2RAIN products), and 30 m resolution (Sentinel-2, Landsat and DTM derivatives) images. Our fivefold spatial Cross-Validation results showed varying accuracy levels ranging from the best performing soil pH (CCC = 0.900) to more poorly predictable extractable phosphorus (CCC = 0.654) and sulphur (CCC = 0.708) and depth to bedrock. Sentinel-2 bands SWIR (B11, B12), NIR (B09, B8A), Landsat SWIR bands, and vertical depth derived from 30 m resolution DTM, were the overall most important 30 m resolution covariates. Climatic data images—SM2RAIN, bioclimatic variables and MODIS Land Surface Temperature—however, remained as the overall most important variables for predicting soil chemical variables at continental scale. This publicly available 30-m Soil Information System of Africa aims at supporting numerous applications, including soil and fertilizer policies and investments, agronomic advice to close yield gaps, environmental programs, or targeting of nutrition interventions.

Honeybush (Cyclopia spp.) is a rich source of antioxidant properties and phenolic compounds. Water availability plays a crucial role in plant metabolic processes, and it contributes to overall quality. Thus, this study aimed to investigate changes in molecular functions, cellular components, and biological processes of Cyclopia subternata exposed to different water stress conditions, which include well-watered (as Control, T1), semi-water stressed (T2), and water-deprived (T3) potted plants. Samples were also collected from a well-watered commercial farm first cultivated in 2013 (T13) and then cultivated in 2017 (T17) and 2019 (T19). Differentially expressed proteins extracted from C. subternata leaves were identified using LC-MS/MS spectrometry. A total of 11 differentially expressed proteins (DEPs) were identified using Fisher’s exact test (p < 0.00100). Only α-glucan phosphorylase was found to be statistically common between T17 and T19 (p < 0.00100). Notably, α-glucan phosphorylase was upregulated in the older vegetation (T17) and downregulated in T19 by 1.41-fold. This result suggests that α-glucan phosphorylase was needed in T17 to support the metabolic pathway. In T19, five DEPs were upregulated, while the other six were downregulated. Based on gene ontology, the DEPs in the stressed plant were associated with cellular and metabolic processes, response to stimulus, binding, catalytic activity, and cellular anatomical entity. Differentially expressed proteins were clustered based on the Kyoto Encyclopedia of Genes and Genomes (KEGG), and sequences were linked to metabolic pathways via enzyme code and KEGG ortholog. Most proteins were involved in photosynthesis, phenylpropanoid biosynthesis, thiamine, and purine metabolism. This study revealed the presence of trans-cinnamate 4-monooxygenase, an intermediate for the biosynthesis of a large number of substances, such as phenylpropanoids and flavonoids.

Leptospira was investigated in kidneys (n = 305) from slaughtered livestock in the Gauteng Province abattoirs, South Africa, using a culture medium to isolate Leptospira, followed by the LipL32 qPCR to detect Leptospira DNA. The SecY gene region was amplified, sequenced, and analyzed for LipL32 qPCR-positive samples or Leptospira isolates. The overall frequency of isolation of Leptospira spp. was 3.9% (12/305), comprising 4.8% (9/186), 4.1% (3/74), and 0% (0/45) from cattle, pigs, and sheep, respectively (p > 0.05). However, with LipL32 qPCR, the overall frequency of Leptospira DNA was 27.5%, consisting of 26.9%, 20.3%, and 42.2% for cattle, pigs, and sheep, respectively (p = 0.03). Based on 22 SecY sequences, the phylogenetic tree identified the L. interrogans cluster with serovar Icterohaemorrhagiae and the L. borgpetersenii cluster with serovar Hardjo bovis strain Lely 607. This study is the first molecular characterization of Leptospira spp. from livestock in South Africa. The reference laboratory uses an eight-serovar microscopic agglutination test panel for leptospirosis diagnosis, of which L. borgpetersenii serovar Hardjo bovis is not part. Our data show that pathogenic L. interrogans and L. borgpetersenii are circulating in the livestock population. Diagnostic use of molecular methods will eliminate or reduce the under-reporting of leptospirosis in livestock, particularly sheep, in South Africa.

Ecological issues posed in the land, air and water compartments of the environment by waste PET packaging materials linger to be a significant problem nowadays, strictly linked to the rise in consumption of PET packaging materials by the populates in developing countries. However, little efforts are involved in these parts of the world, in managing sources and impacts of waste PET packaging materials. Although the main raw materials, PET polymers, are not considered lethal, the residual monomers in the raw materials have been proven hazardous to the environment. Also, many chemicals used in the production of PET packaging materials such as additives are dangerous to the environment, along with some degradation products that may be released during the PET packaging materials life cycle. In view of the potential impacts by waste PET packaging materials in the environment, this paper highlights the sources, impacts and management of waste PET packaging materials. The method adopted for the study involved extensive literature review on the subject matter (waste PET packaging materials). It was concluded that management of waste PET packaging materials by the sources generating them together with recycling, enlightenment, reduce re-usage, ban, product replacement, and improved collection of waste will mitigate the impacts on the environment.

Mosquito coils of various brands are frequently burnt in indoor environments to drive away mosquitoes—the vector for malaria parasite in regions where the disease is endemic. Emissions from the coils could be a source of indoor air pollution. In this study, various brands of mosquito coils obtained from retail shops in Lagos, Nigeria were burnt in an environmental test box with a view to characterizing carbon monoxide (CO), nitric oxide (NO), and nitrogen dioxide (NO 2 ) in the gaseous emissions as well as elemental concentrations of the ash. Emission characterization achieved with the RAS1700 bio-gas analyzer while AAS was adopted for elemental analysis of the mosquito coil ashes. The emission factor of CO, NO and NO 2 from the coil samples ranged between 0.00138 to 0.26277 μg/m 3 , 0.0002 to 0.00454 μg/m 3 , and 0.000074 to 0.00714 μg/m 3 , respectively. These values were found to be lower than permissible indoor levels recommended by NIOSH. The range of concentrations of Pb, Zn, Cd, Cr, Cu, As, Hg, Fe in the coil ashes from all the brands were 0.02 to 0.04 mg/g, 0.011 to 0.02 mg/g, 0.001 to 0.003 mg/g, 0.004 to 0.008 mg/g, 0.004 to 0.006 mg/g, 0.0001 to 0.0004 mg/g, 0.001 to 0.003 mg/g, and 0.124 to 0.14 mg/g, respectively. Although, the concentrations of the pollutants obtained in this study are within the recommended limits, prolong exposure could trigger chronic disease conditions. Adequate ventilation of indoor environments or utilization of mosquito nets in place of coils could be considered.

Background: Obesity is prevalent among patients undergoing total hip arthroplasty and has been associated with the risk of wound complications, particularly when an anterior approach is used. However, most studies have focused on obesity defined by the body mass index (BMI), without considering the metabolic effects of adiposity. Thus, in this study, we investigated the independent effects of the BMI and metabolic syndrome on wound complications after total hip arthroplasty. Methods: Among 804 consecutive patients undergoing total hip arthroplasty between October 2013 and July 2016, we evaluated the associations between obesity (BMI ≥30 mg/kg2), metabolic syndrome (defined by the National Cholesterol Education Program Adult Treatment Panel III guidelines), and wound complication (defined as documented wound dehiscence, drainage, erythema, hematoma, infection, or seroma) over a 1-year follow-up period. We used Cox proportional hazards models adjusting for demographics, smoking status, and hospital length of stay. Results: Patients’ mean age at time of surgery was 62.0 ± 11.9 years. Forty-seven percent were male, 27.9% were obese, and 11.6% met the definition for metabolic syndrome. Metabolic syndrome was associated with a 4-fold higher risk of wound complication (95% confidence interval: 1.4-11.1) after adjusting for all covariates including the BMI. In unadjusted analysis, obesity was associated with a higher risk of wound complication (hazard ratio: 2.8, 95% confidence interval: 1.3-6.2). However, obesity was not associated with the risk of wound complication after adjusting for the metabolic syndrome (P = .16). Conclusions: Metabolic syndrome, but not obesity, defined by a BMI ≥30, was associated with wound complications, suggesting that metabolic effects of adiposity may represent a distinct risk factor in the development of wound complications from a higher BMI alone.