ICAN sensitivity analysis

A computer program called Integrated Composite Analyzer (ICAN) was used to predict the properties of high-temperature polymer matrix composites. ICAN is a collection of NASA Lewis Research Center-developed computer codes designed to carry out analysis of multilayered fiber composites. The material properties used as input to the program were those of the thermoset polyimide resin PMR-15 and the carbon fiber Celion 6000. The sensitivity of the predicted composite properties to variations in the resin and fiber properties was examined. In addition, the predicted results were compared with experimental data. In most cases, the effect of changes in resin and fiber properties on composite properties was reasonable. However, the variations in the composite strengths with the moisture content of the PMR-15 resin were inconsistent. The ICAN-predicted composite moduli agreed fairly well with experimental values, but the predicted composite strengths were generally lower than experimental values

Rifampicin and clarithromycin (extended release) versus rifampicin and streptomycin for limited Buruli ulcer lesions: a randomised, open-label, non-inferiority phase 3 trial.

BACKGROUND: Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans infection that damages the skin and subcutis. It is most prevalent in western and central Africa and Australia. Standard antimicrobial treatment with oral rifampicin 10 mg/kg plus intramuscular streptomycin 15 mg/kg once daily for 8 weeks (RS8) is highly effective, but streptomycin injections are painful and potentially harmful. We aimed to compare the efficacy and tolerability of fully oral rifampicin 10 mg/kg plus clarithromycin 15 mg/kg extended release once daily for 8 weeks (RC8) with that of RS8 for treatment of early Buruli ulcer lesions. METHODS: We did an open-label, non-inferiority, randomised (1:1 with blocks of six), multicentre, phase 3 clinical trial comparing fully oral RC8 with RS8 in patients with early, limited Buruli ulcer lesions. There were four trial sites in hospitals in Ghana (Agogo, Tepa, Nkawie, Dunkwa) and one in Benin (Pobè). Participants were included if they were aged 5 years or older and had typical Buruli ulcer with no more than one lesion (caterories I and II) no larger than 10 cm in diameter. The trial was open label, and neither the investigators who took measurements of the lesions nor the attending doctors were masked to treatment assignment. The primary clinical endpoint was lesion healing (ie, full epithelialisation or stable scar) without recurrence at 52 weeks after start of antimicrobial therapy. The primary endpoint and safety were assessed in the intention-to-treat population. A sample size of 332 participants was calculated to detect inferiority of RC8 by a margin of 12%. This study was registered with ClinicalTrials.gov, NCT01659437. FINDINGS: Between Jan 1, 2013, and Dec 31, 2017, participants were recruited to the trial. We stopped recruitment after 310 participants. Median age of participants was 14 years (IQR 10-29) and 153 (52%) were female. 297 patients had PCR-confirmed Buruli ulcer; 151 (51%) were assigned to RS8 treatment, and 146 (49%) received oral RC8 treatment. In the RS8 group, lesions healed in 144 (95%, 95% CI 91 to 98) of 151 patients, whereas lesions healed in 140 (96%, 91 to 99) of 146 patients in the RC8 group. The difference in proportion, -0·5% (-5·2 to 4·2), was not significantly greater than zero (p=0·59), showing that RC8 treatment is non-inferior to RS8 treatment for lesion healing at 52 weeks. Treatment-related adverse events were recorded in 20 (13%) patients receiving RS8 and in nine (7%) patients receiving RC8. Most adverse events were grade 1-2, but one (1%) patient receiving RS8 developed serious ototoxicity and ended treatment after 6 weeks. No patients needed surgical resection. Four patients (two in each study group) had skin grafts. INTERPRETATION: Fully oral RC8 regimen was non-inferior to RS8 for treatment of early, limited Buruli ulcer and was associated with fewer adverse events. Therefore, we propose that fully oral RC8 should be the preferred therapy for early, limited lesions of Buruli ulcer. FUNDING: WHO with additional support from MAP International, American Leprosy Missions, Fondation Raoul Follereau France, Buruli ulcer Groningen Foundation, Sanofi-Pasteur, and BuruliVac

Pattern and Outcome of Chest Injuries at Bugando Medical Centre in Northwestern Tanzania.

Chest injuries constitute a continuing challenge to the trauma or general surgeon practicing in developing countries. This study was conducted to outline the etiological spectrum, injury patterns and short term outcome of these injuries in our setting. This was a prospective study involving chest injury patients admitted to Bugando Medical Centre over a six-month period from November 2009 to April 2010 inclusive. A total of 150 chest injury patients were studied. Males outnumbered females by a ratio of 3.8:1. Their ages ranged from 1 to 80 years (mean = 32.17 years). The majority of patients (72.7%) sustained blunt injuries. Road traffic crush was the most common cause of injuries affecting 50.7% of patients. Chest wall wounds, hemothorax and rib fractures were the most common type of injuries accounting for 30.0%, 21.3% and 20.7% respectively. Associated injuries were noted in 56.0% of patients and head/neck (33.3%) and musculoskeletal regions (26.7%) were commonly affected. The majority of patients (55.3%) were treated successfully with non-operative approach. Underwater seal drainage was performed in 39 patients (19.3%). One patient (0.7%) underwent thoracotomy due to hemopericardium. Thirty nine patients (26.0%) had complications of which wound sepsis (14.7%) and complications of long bone fractures (12.0%) were the most common complications. The mean LOS was 13.17 days and mortality rate was 3.3%. Using multivariate logistic regression analysis, associated injuries, the type of injury, trauma scores (ISS, RTS and PTS) were found to be significant predictors of the LOS (P < 0.001), whereas mortality was significantly associated with pre-morbid illness, associated injuries, trauma scores (ISS, RTS and PTS), the need for ICU admission and the presence of complications (P < 0.001). Chest injuries resulting from RTCs remain a major public health problem in this part of Tanzania. Urgent preventive measures targeting at reducing the occurrence of RTCs is necessary to reduce the incidence of chest injuries in this region

Industry environment features influencing construction innovation in a developing country: A case study of four projects in Ghana

This paper adds to the literature on innovation studies in developing economies by exploring features of the industry environment that drive project-based innovation. Using a conceptual framework of five key innovation determinants and a multiple case study, the study draws on evidence from four construction projects in Ghana by means of interviews. Nine features identified include: active pre-existing relationships among project participants; multinational networks; project actors with the willingness and ability to override contract conditions; presence of innovation lobbyists; manufacturers not owning proprietary products; manufacturers' lack of production capacity; prescriptive-based regulations mandating foreign professionals to form joint ventures with local professionals; high labour turnover; and emergent social media platforms. The results advance knowledge on the operation of the key innovation determinants in developing countries. Some of the findings contrast some key observations in broader literature on the impacts of the general industry environment on innovation

Adoption of financial innovation in the Ghanaian banking industry

This century has been full of innovations: new technologies, new products, new services and a plethora of new industries have emerged. Yet the call for innovation in business, especially in financial services, has never been more intense. Although research on this topic exists, there is no empirical evidence regarding the critical factors influencing customer adoption of electronic banking innovation in Ghana’s banking industry. The aim of this article is therefore to investigate the factors influencing the adoption of financial innovation in Ghana’s banking industry. Surveys were conducted involving 405 clients of the six major banks in the country. Using logistical regression, the results amongst other things show that innovation attributes such as lack of complexity, compatibility and perceived usefulness provided by financial innovation, increase the likelihood of e-banking adoption. In light of these findings, the study recommends that banks should focus on designing both useful and easy-to-use e-banking products that will attract potential and existing customers.Keywords: e-banking, financial innovation, Ghana, technology, West Afric

South-South Irregular Migration: The Impacts of China’s Informal Gold Rush in Ghana

This article examines irregular South‐South migration from China to Ghana, and the role it played in transforming livelihoods and broader developmental landscapes. It looks at the entry of approximately 50,000 Chinese migrants into the informal small‐scale gold mining sector from 2008‐2013. These migrants mainly hailed from Shanglin County in Guangxi Province. In Ghana, they formed mutually beneficial relationships with local miners, both legal and illegal, introducing machinery that substantially increased gold production. However, the legal status of Chinese miners was particularly problematic as, by law, small‐scale mining is restricted to Ghanaian citizens. In mid‐2013, President Mahama established a military task force against illegal mining, resulting in the deportation of many Chinese miners. The article examines the experiences of both Chinese migrants and Ghanaian miners. Findings are that irregular migration into an informal sector had long‐lasting impacts and played a significant role in the transformation of economic, political, and physical landscapes in Ghana

Combined Inflammatory and Metabolic Defects Reflected by Reduced Serum Protein Levels in Patients with Buruli Ulcer Disease

Buruli ulcer is a skin disease caused by Mycobacterium ulcerans that is spreading in tropical countries, with major public health and economic implications in West Africa. Multi-analyte profiling of serum proteins in patients and endemic controls revealed that Buruli ulcer disease down-regulates the circulating levels of a large array of inflammatory mediators, without impacting on the leukocyte composition of peripheral blood. Notably, several proteins contributing to acute phase reaction, lipid metabolism, coagulation and tissue remodelling were also impacted. Their down-regulation was selective and persisted after the elimination of bacteria with antibiotic therapy. It involved proteins with various functions and origins, suggesting that M. ulcerans infection causes global and chronic defects in the host’s protein metabolism. Accordingly, patients had reduced levels of total serum proteins and blood urea, in the absence of signs of malnutrition, or functional failure of liver or kidney. Interestingly, slow healers had deeper metabolic and coagulation defects at the start of antibiotic therapy. In addition to providing novel insight into Buruli ulcer pathogenesis, our study therefore identifies a unique proteomic signature for this disease