Pore-scale numerical investigation of pressure drop behaviour across open-cell metal foams

The development and validation of a grid-based pore-scale numerical modelling methodology applied to five different commercial metal foam samples is described. The 3-D digital representation of the foam geometry was obtained by the use of X-ray microcomputer tomography scans, and macroscopic properties such as porosity, specific surface and pore size distribution are directly calculated from tomographic data. Pressure drop measurements were performed on all the samples under a wide range of flow velocities, with focus on the turbulent flow regime. Airflow pore-scale simulations were carried out solving the continuity and Navier–Stokes equations using a commercial finite volume code. The feasibility of using Reynolds-averaged Navier–Stokes models to account for the turbulence within the pore space was evaluated. Macroscopic transport quantities are calculated from the pore-scale simulations by averaging. Permeability and Forchheimer coefficient values are obtained from the pressure gradient data for both experiments and simulations and used for validation. Results have shown that viscous losses are practically negligible under the conditions investigated and pressure losses are dominated by inertial effects. Simulations performed on samples with varying thickness in the flow direction showed the pressure gradient to be affected by the sample thickness. However, as the thickness increased, the pressure gradient tended towards an asymptotic value

Predictive Models for the Diagnostic of Human Visceral Leishmaniasis in Brazil

Visceral leishmaniasis (VL) is a neglected tropical disease endemic to 65 countries, including Brazil, where the disease frequently occurs in remote locations and treatment is often performed on the basis of clinical suspicion. Predictive models based on scoring systems could be a helpful tool for the clinical management of VL. Based on clinical signs and symptoms, and five different serological tests of 213 patients with parasitologically confirmed (cases) and 119 with clinical suspicion of VL but with another confirmed etiology (non-cases), twelve prediction models using logistic regression and classification and regression trees (CART) for VL diagnosis were developed. The model composed of the clinical-laboratory variables and the rk39 rapid test showed the best performance in both logistic regression and CART (Sensitivity of 90.1% and specificity ranging from 97.2–97.4%). The scoring system is simple and based on the clinical-laboratory findings that are easily available in most clinical settings. The results suggest that those models might be useful in locations where access to available diagnostic methods is difficult, contributing to more efficient and more rational allocation of healthcare resources

Design, Development and Evaluation of rK28-Based Point-of-Care Tests for Improving Rapid Diagnosis of Visceral Leishmaniasis

Visceral Leishmaniasis caused by Leishmania donovani is endemic in several parts of South Asia, East Africa, South and Central America. It is a vector-borne disease transmitted by bites of infected sand flies and often fatal in the absence of chemotherapy. Timely diagnosis is an essential first step in providing proper patient care and in controlling transmission. VL diagnosis in East Africa and Latin America are currently based on microscopic confirmation of parasites in tissue aspirates. The Kalazar Detect rapid test is widely used as a confirmatory test in India with very high accuracy, but sensitivity issues have severely limited its usefulness in the African sub-continent. Direct Agglutination Test is another confirmatory test used widely in East Africa and offers high sensitivity but is not field-friendly. We report on the design of a novel synthetic fusion protein capable of sequestering antibodies against three different Leishmania donovani antigens and the development of point-of-care tests for improving VL diagnosis. We believe the ease of use of these rapid tests and their high accuracy in detecting VL cases could make them useful as a first-line test, thereby eliminating the need for painful biopsies and ensuring better patient care

Comparative Study of rK39 Leishmania Antigen for Serodiagnosis of Visceral Leishmaniasis: Systematic Review with Meta-Analysis

Visceral Leishmaniasis (VL) is a neglected tropical disease for which serodiagnostic tests are available, but not yet widely implemented in rural areas. The rK39 recombinant protein is derived from a kinesin-like protein of parasites belonging to the Leishmania donovani complex, and has been used in the last two decades for the serodiagnosis of VL. We present here a systematic review and meta-analysis of studies evaluating serologic assays (rK39 strip-test, rK39 ELISA, Direct Agglutination Test [DAT], Indirect Immunofluorescence test [IFAT] and ELISA with a promastigote antigen preparation [p-ELISA]) to diagnose VL to determine the accuracy of rK39 antigen in comparison to the use of other antigen preparations. Fourteen papers fulfilled the inclusion and exclusion selection criteria. The summarized sensitivity for the rK39-ELISA was 92% followed by IFAT 88% and p-ELISA 87%. The summarized specificity for the three diagnostic tests was 81%, 90%, and 77%. Studies comparing the rK39 strip test with DAT found a similar sensitivity (94%) and specificity (89%). However, the rK39 strip test was more specific than the IFAT and p-ELISA. In conclusion, we found the rK39 protein used either in a strip test or in an ELISA is a good choice for the serodiagnosis of VL

Control of Visceral Leishmaniasis in Latin America—A Systematic Review

Visceral leishmaniasis is a vector-borne disease characterized by fever, spleen and liver enlargement, and low blood cell counts. In the Americas VL is zoonotic, with domestic dogs as main animal reservoirs, and is caused by the intracellular parasite Leishmania infantum (syn. Leishmania chagasi). Humans acquire the infection through the bite of an infected sand fly. The disease is potentially lethal if untreated. VL is reported from Mexico to Argentina, with recent trends showing a rapid spread in Brazil. Control measures directed against the canine reservoir and insect vectors have been unsuccessful, and early detection and treatment of human cases remains as the most important strategy to reduce case fatality. Well-designed studies evaluating diagnosis, treatment, and prevention/control interventions are scarce. The available scientific evidence reasonably supports the use of rapid diagnostic tests for the diagnosis of human disease. Properly designed randomized controlled trials following good clinical practices are needed to inform drug policy. Routine control strategies against the canine reservoirs and insect vectors are based on weak and conflicting evidence, and vector control strategies and vaccine development should constitute research priorities