Evaluation of the SD BIOLINE HIV/syphilis Duo assay at a rural health center in Southwestern Uganda

Background: Point-of-care tests have the capacity to improve healthcare delivery by reducing costs and delay associated with care. A novel point-of-care immunochromatographic test for dual diagnosis of both HIV and syphilis by detecting IgG, IgM and IgA antibodies to HIV, and specific and recombinant Treponema pallidum antigens has recently been developed, but has not been evaluated in rural field settings. We evaluated the performance of the SD Bioline Syphilis/HIV Duo (Duo) assay at a healthcare center in rural Uganda. Methods: A convenience sample of pregnant women attending Kinoni Health Centre IV from March to May, 2013 was enrolled. Venous blood was collected and centrifuged for plasma isolation. Samples were tested with the Duo assay and compared with the Treponema pallidum hemaglutination assay and paired HIV rapid antibody tests as the reference standards. The ease of use and time required for the Duo assay were also assessed by laboratory technicians. Results: Two hundred twenty women were enrolled with a mean age of 25.00 years (SD 5.41). The sensitivity and specificity of the Duo assay were 100% (95% CI 79.0 – 100%) and 100% (95% CI 97.6 – 100.0) respectively, for syphilis, and, 100% (75.9 – 100%) and 99.5% (96.8 – 99.9%) respectively, for HIV. The duo kit was found to be faster and easier to use than the current HIV and syphilis testing techniques. Conclusion: The sensitivity and specificity of the SD Bioline HIV/Syphilis Duo test were excellent in a field setting in Uganda. The Duo assay should be further evaluated in alternate populations and with point-of-care specimens (e.g. whole blood from finger stick specimens), but shows promise as a tool for improved HIV and syphilis surveillance, diagnosis, and treatment in field settings

Development and evaluation of a free-field voice test for potential use as a community screening tool for hearing impairment in children

Early identification of hearing impairment in children is essential to avoid potentially disabling effects of hearing loss or deafness. This necessitates effective screening measures appropriate to the community in question. Current methods used in South Africa, especially for pre-school and school going children have resulted in poor coverage as they are designed for the more developed countries. There is thus a need to devise a screening method that is appropriate to our local conditions. In this study, a free-field live voice test was developed based on three levels: whisper, conversational and loud. This was evaluated against pure tone audiometry for sensitivity, specificity, cost and ease of application in two studies: hospital and school- based. A total of 394 children were tested; 189 in hospital-based study and 205 in school based study. 378 of the total were eligible for analysis. In the hospital-based study, the results of 177 children were analysed. The age range was 3 - 12 years with a mean of 5.8 years. The sensitivity (ability of the test to detect hearing impairment) was 80.0%; and the specificity (ability to identify children with normal hearing) was 95.0%. In the school-based study, done after modification and standardisation of the test set, the sensitivity and specificity were 83.3% and 97.8% respectively. Age range was 3 - 8 years with 79% being 4- 6 years. In both studies, the voice test was simpler to perform, easily understood and acceptable to the children and the testers; and considerably cheaper as the only equipment required was picture/toy set. The main limitation was non-standardisation of the test set. This was rectified in the school-based study. The drawbacks noted were the inability of the voice test to detect unilateral hearing loss/deafness and high frequency hearing loss. The voice test generally correlated well with pure tone audiometry and could be used as alternative for screening for hearing impairment in the community especially for pre-school and school going children. However, it is recommended to repeat the study in actual community settings using Community Health Care Workers as the testers. This would also determine the reliability of the voice test, as this cannot be reliably established at this stage

Fibre Reinforced Polymer Composite Deck Elements for Highway Bridges in Developing Countries

Fibre Reinforced Polymer (FRP) composite bridge decks are increasingly being accepted by bridge owners and designers as a suitable alternative to traditional construction materials such as reinforced concrete, steel and masonry. This is because FRP as a material has several advantages such as high strength to weight ratio and high durability due to inherent corrosion resistance properties. Additionally, the material lends itself to a large degree of prefabrication which saves construction time thus minimising traffic disruptions. This paper explores the possible application of FRP to bridge construction in developing countries and its implications on project management and delivery

An update on chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is a chronic condition which affects the respiratory system and worsens over time. Cigarette smoking and advancing age are the two major risks associated with this disease. It is concerning that the global incidence of this chronic illness is on the rise. Current projections indicate that it will become the third leading cause of death by the year 2020. Inflammatory changes underlie the pathophysiology of COPD. Irreversible damage and progressive narrowing of the air passages follow. COPD is characterised by the progressive loss of lung function. In addition, the Global Initiative for Chronic Obstructive Lung Disease released the latest update on its global strategy for the diagnosis, management, and prevention of COPD in 2015. This article provides an overview of the causative risk factors, underlying disease process, pathophysiological changes, and the classification and management of COPD, including the latest perspectives on this highly prevalent condition.Keywords: chronic bronchitis, chronic obstructive pulmonary disease, COPD, emphysema, LABA, SABA, SAMA, LAMA, methylxanthine

Effect of behavioural factors on the investment risk profile of investment schemes members in Nairobi County

Full- text thesisStudies conducted in behavioral finance science provide diverging and inconclusive results with respect to how behavioral biases blur investment decision making. Additionally, behavioral science studies have provided differing results compared to arguments of traditional finance theories, which suggest that investors are rational and make investment decisions after keen analysis of all available information. Behavioral finance suggests that investment decisions are greatly affected by irrational, emotional and psychological factors. It is against this background that the current study was premised to examine the effect of psychological biases and heuristics on the investment risk profile of members of investment schemes in Kenya. The study sought to respond to the following objectives: to assess the effect of heuristics on the investment risk profile of investment group (chama) members in Nairobi County and to examine the effect of psychological biases on the investment risk profile of investment group (chama) members in Nairobi County. The study was guided by behavioral finance theory and employed an explanatory research design. The study targeted all the 121 registered Chamas in Nairobi (Kenya Association of Investment Groups (KAIG) database). The study targeted three employees drawn from each of the chamas. The data analysis phase applied both descriptive and ordinal regression analysis. The survey was able to obtain an 81% response rate with only 19% of the considered sample respondents not able to present their questionnaires within the provided timeframe. Findings pointed out that most of the groups 48% had 11-30 members, 29% had 31-60 members with 18% having less than 10 members. The correlation results revealed that there was a weak positive and significant association between psychological biases, demographic factors and the investment risk profile of investment groups in Nairobi County. The correlation tests also revealed a strong positive and significant association between heuristic biases and the investment risk profile of investment groups in Nairobi County. Based on the study’s first objective, the study concluded that psychological biases and heuristic biases have a positive and significant effect on investment risk profile of investment groups in Nairobi County. Finally, the study concluded that demographic factors had an insignificant control effect on the investment risk profile of investment groups. The study recommended for oversight and supervision of investment groups to ensure that they comply with relevant laws and regulations. This can help to protect investors and promote a fair and transparent investment environment. Further individual groups should also establish a rigorous investment appraisal process that incorporates multiple perspectives and considers all relevant factors. The study also recommends that Chamas adopt a diversified investment strategy across different asset classes and industries to mitigate the risk of loss associated with concentration risk. This can help to minimize the impact of any single investment's performance on their overall portfolio

Review of Concrete Resistance to Abrasion by Waterborne Solids

In the last four decades, numerous investigations have been undertaken on abrasion-erosion of concrete using various test methods. These have suggested existence of different abrasion mechanisms, limitations of existing test methods and inconsistencies on the importance of compressive strength to abrasion resistance of concrete. The objective of this review is to: understand the mechanisms of concrete abrasion-erosion, assess the suitability of existing test methods to simulate field conditions and investigate the relationship between abrasion resistance and compressive strength. It is found that concrete abrasion mechanisms are dependent on both transport modes of abrasive charge and the ratio of coarse aggregate to matrix hardness. The ASTM C1138 (underwater) test method appears to simulate all the critical modes of sediment induced abrasion expected in field conditions and specific energy can be used as a framework to correlate ASTM C1138 test results with field measurements. With the exception of concrete with rubber aggregates, abrasion loss is found to fit a simple power function of its compressive strength, and no significant improvements in abrasion resistance can be gained by using concretes with compressive strengths exceeding 60 MPa (8.70 ksi). Also, the influence of cementitious additives and coarse aggregate properties is only significant at compressive strengths below the optimal value of 60MPa (8.70 ksi)

Influence of Coarse Aggregate Parameters and Mechanical Properties on the Abrasion Resistance of Concrete in Hydraulic Structures

The objective of this experimental investigation is to use the ASTM C1138 (underwater) test method to investigate the influence of the quantity and type of coarse aggregates on the hydrodynamic abrasion resistance of concrete. Thereafter, relationships between the abrasion resistance of concrete with its principal mechanical properties are comparatively examined. It is found that the use of natural coarse aggregates to replace fine aggregates by up to 25% does not significantly affect concrete abrasion performance, but the use of recycled tire rubber aggregates with aspect ratios of 4 to replace 25% of natural coarse aggregates increases the abrasion resistance by up to 64% depending on the test duration. Further, concretes produced with natural rounded coarse aggregates of 10 mm significantly outperformed those with angular 20 mm maximum particle size at all test durations by up to 57%. Finally, for the concrete mixtures tested, results indicate that tensile splitting strength is a superior parameter to compressive strength for predicting the concrete abrasion resistance in the ASTM C1138 test and the relations developed for the concretes tested predicted percentage abrasion loss within the margin of ±0.5%.</p

New heteroleptic tertiary phosphane-based Ni(ii) 3,4-dimethoxyphenylacetonitriledithiolates:bifunctional electrocatalysts for homogeneous HER and heterogeneous OER

Construction of highly efficient non-platinum complexes as catalysts for electrochemical water splitting is the need of time. Herein, three new Ni(II)-based dithiolates, with formulas of [(dpdt)Ni(dppe)] (Ni-dpe), [(dpdt)Ni(dppf)] (Ni-dpf) and [(dpdt)Ni(PPh3)2] (Ni-pph) (dpdt = 3,4-dimethoxyphenylacetonitriledithiolate, dppe = 1,2-bis(diphenylphosphino)ethane, dppf = 1,1′-bis(diphenylphosphino)ferrocene and PPh3 = triphenylphosphane), were synthesized and characterized. Single-crystal X-ray diffraction analysis of Ni-dpe revealed a distorted square planar coordination environment around nickel(II) fulfilled by two S and two P of the dpdt2− and dppe ligands, respectively. Various non-covalent interactions, such as C–H⋯C, C–H⋯S and C–H⋯O, stabilized the lattice of Ni-dpe, and their nature was investigated using Hirshfeld surface analysis. Furthermore, the activities of these complexes as homogeneous electrocatalysts for HERs using trifluoroacetic acid (TFA) as a proton source and heterogeneous electrocatalysts for OERs in an aqueous KOH solution were evaluated. For homogeneous electrocatalysis, turnover frequencies (TOFs) of 402, 655 and 1761 s−1 for Ni-dpe, Ni-dpf and Ni-pph were observed, respectively, at 100 mM TFA. The better electrocatalytic activity of Ni-pph was ascribed to the spatial flexibility of the PPh3 ligands, which facilitated attainment of a more stable transition state than those of other complexes. For heterogeneous OERs, the results suggested that Ni-dpf displayed the lowest Tafel slope of 64 mV dec−1 and the highest current density of 53.47 mA cm−2, thereby exhibiting the best electrocatalytic activity