Diabetes mellitus in The Gambia, west Africa

A register of diabetic patients attending the Royal Victoria Hospital, Banjul, The Gambia, was kept and data on hospital admissions recorded over a 1-year period. Two hundred and sixty-nine patients (110 men, 159 women) were registered of whom 66 (25%) were receiving insulin. Seventy-five patients (28%: 40 men, 35 women) were newly diagnosed. There were significant differences in age (p less than 0.001) and obesity (p less than 0.001) between men and women and between patients with different types of diabetes. There were 95 hospital admissions (5.2%) related to diabetes, as were a fifth of medical out-patient attendances. Ketoacidosis was the major cause of death while foot infections were more common (p less than 0.01) in women. Diabetes imposed a heavy burden on the health services of The Gambia, a small developing country in West Africa; more than 3.6% of the annual health budget was spent on the treatment of diabetic patients.

Structural Origins of Voltage Hysteresis in the Na-Ion Cathode P2-Na0.67[Mg0.28Mn0.72]O2: A Combined Spectroscopic and Density Functional Theory Study

P2-layered sodium-ion battery (NIB) cathodes are a promising class of Na-ion electrode materials with high Na+ mobility and relatively high capacities. In this work, we report the structural changes that take place in P2-Na0.67[Mg0.28Mn0.72]O2. Using ex situ X-ray diffraction, Mn K-edge extended X-ray absorption fine structure, and 23Na NMR spectroscopy, we identify the bulk phase changes along the first electrochemical charge-discharge cycle-including the formation of a high-voltage "Z phase", an intergrowth of the OP4 and O2 phases. Our ab initio transition state searches reveal that reversible Mg2+ migration in the Z phase is both kinetically and thermodynamically favorable at high voltages. We propose that Mg2+ migration is a significant contributor to the observed voltage hysteresis in Na0.67[Mg0.28Mn0.72]O2 and identify qualitative changes in the Na+ ion mobility.

Strengthening the Magnetic Interactions in Pseudobinary First-Row Transition Metal Thiocyanates, M(NCS)2

Understanding the effect of chemical composition on the strength of magnetic interactions is key to the design of magnets with high operating temperatures. The magnetic divalent first-row transition metal (TM) thiocyanates are a class of chemically simple layered molecular frameworks. Here, we report two new members of the family, manganese(II) thiocyanate, Mn(NCS)₂, and iron(II) thiocyanate, Fe(NCS)₂. Using magnetic susceptibility measurements on these materials and on cobalt(II) thiocyanate and nickel(II) thiocyanate, Co(NCS)₂ and Ni(NCS)₂, respectively, we identify significantly stronger net antiferromagnetic interactions between the earlier TM ions-a decrease in the Weiss constant, θ, from 29 K for Ni(NCS)₂ to -115 K for Mn(NCS)₂-a consequence of more diffuse 3d orbitals, increased orbital overlap, and increasing numbers of unpaired t_2g electrons. We elucidate the magnetic structures of these materials: Mn(NCS)₂, Fe(NCS)₂, and Co(NCS)₂ order into the same antiferromagnetic commensurate ground state, while Ni(NCS)₂ adopts a ground state structure consisting of ferromagnetically ordered layers stacked antiferromagnetically. We show that significantly stronger exchange interactions can be realized in these thiocyanate frameworks by using earlier TMs.

Graphite Anodes for Li-Ion Batteries: An Electron Paramagnetic Resonance Investigation

Graphite is the most commercially successful anode material for lithium (Li)-ion batteries: its low cost, low toxicity, and high abundance make it ideally suited for use in batteries for electronic devices, electrified transportation, and grid-based storage. The physical and electrochemical properties of graphite anodes have been thoroughly characterized. However, questions remain regarding their electronic structures and whether the electrons occupy localized states on Li, delocalized states on C, or an admixture of both. In this regard, electron paramagnetic resonance (EPR) spectroscopy is an invaluable tool for characterizing the electronic states generated during electrochemical cycling as it measures the properties of the unpaired electrons in lithiated graphites. In this work, ex situ variable-temperature (10-300 K), variable-frequency (9-441 GHz) EPR was carried out to extract the g tensors and line widths and understand the effect of metallicity on the observed EPR spectra of electrochemically lithiated graphites at four different states of lithiation. We show that the increased resolution offered by EPR at high frequencies (>300 GHz) enables up to three different electron environments of axial symmetry to be observed, revealing heterogeneity within the graphite particles and the presence of hyperfine coupling to Li nuclei. Importantly, our work demonstrates the power of EPR spectroscopy to investigate the local electronic structure of graphite at different lithiation stages, paving the way for this technique as a tool for screening and investigating novel materials for use in Li-ion batteries.

Effect of CD40 ligand on the course of murine histoplasmosis

CD40 ligand-CD40 ligation is important in the development of T-cell-mediated immune responses. The purpose of this study was to examine the role of CD40L in recovery from histoplasmosis using a murine model of intratracheally induced infection. B6C3F1 mice were infected intratracheally with Histoplasma capsulatum yeast and monitored for clearance of the organism from the lungs and spleen. CD40L treatment was begun on either day -2 or +2 post inoculation and continued until day 14 in CD4-depleted animals and from day -2 to day +4 in non-immunosuppressed animals. Amphotericin B treatment was begun four days following inoculation and given every other day for 10 days. CD40L reduced fungal burden by less than one log when started two days before infection but did not act synergistically with low-dosage amphotericin B (0.2 mg kg(-1) qod) in CD4 depleted mice. Low-dose amphotericin B, CD40L, and the combination of the two failed to lower the fungal burden in a second experiment using a more virulent isolate of the same strain of H. capsulatum in CD4-depleted mice. Furthermore, CD40L did not increase the concentrations of IFN-gamma, IL-12 or IL-10 in the lungs or spleens of infected animals. In summary, CD40L had minimal or no effect on the course of infection in this murine model of histoplasmosis.

Operando electron spin probes for the study of battery processes

Operando electron spin probes, namely magnetometry and electron paramagnetic resonance (EPR), provide real-time insights into the electrochemical processes occurring in battery materials and devices. In this work, we describe the design criteria and outline the development of operando magnetometry and EPR electrochemical cells. Notably, we show that a clamping mechanism, or springs, are needed to achieve sufficient compression of the battery stack and an electrochemical performance on par with that of a standard Swagelok-type cell. The tandem use of operando EPR and magnetometry allows us to identify five distinct and reversible redox processes taking place on charge and discharge of the intercalation-type LiNi0.5Mn0.5O2 Li-ion cathode. While redox processes in conversion-type electrodes are notoriously difficult to investigate using standard characterization methods (e.g. X-ray based) and/or post mortem analysis, due to the formation of poorly crystalline and metastable reaction intermediates and products during cycling, we show that operando magnetometry provides unique insight into the kinetics and reversibility of Fe nanoparticle formation in the Na3FeF6 electrode for Na-based batteries. Step increases in the cell magnetization upon extended cycling indicate the build-up of Fe nanoparticles in the system, hinting at only partially reversible charge-discharge processes. The broad applicability of the tools developed herein to a range of electrode chemistries and structures, from intercalation to conversion electrodes, and from crystalline to amorphous systems, makes them particularly promising for the development of electrochemical energy storage technologies and beyond.

Peripartum cardiac failure in The Gambia

Twenty-seven patients with peripartum cardiac failure were seen at the Royal Victoria Hospital, Banjul over a 2-year period while one further patient presented 6 months after delivery with a cerebral embolus secondary to a dilated cardiomyopathy. Five (18%, P less than 0.001) patients had twin pregnancies. Seventeen (63%) patients attended for follow-up, of whom eight had evidence of continuing cardiac dysfunction and required treatment with diuretics; two patients were known to have died. In five asymptomatic patients the electrocardiogram had reverted to normal and three patients had further pregnancies without relapse. The bipolar distribution of onset of symptoms in relation to pregnancy was suggestive of two different pathological processes. There was no evidence that cultural habits played any significant part in the aetiology of peripartum cardiac failure in The Gambia.

A comparative study of use of psychoactive substances amongst secondary school students in two local Government Areas of Akwa Ibom State, Nigeria

BACKGROUND

The use and abuse of psychoactive substances is very rampant, even in our secondary schools. In recent times, there has been a growing concern about negative effects of these substances on youths. The high incidence of school dropouts and other nefarious activities are the resultant impacts on the students.

OBJECTIVES

The objectives of the study were: (1) To determine the prevalence of substance use amongst secondary school students. (2) Compare the findings in two different local settings. (3) To determine the sociodemographic variables.

MATERIALS AND METHODS

Four hundred secondary school students from two Local Government Areas were assessed for use of psychoactive substances, during the second term of 2004/2005 school session, using a Youth Survey Questionnaire.

RESULTS

A total of 254 (63.5%) students, consisting of 119 from Uyo and 135 from Eket were analyzed. The mean age of the students in both schools was 17.1 + 2.0 and 16.6 + 1.7 years respectively. The difference in the mean was statistically significant (t = 1.14; df = 3, p > 0.05). More students from Uyo, 37 (31.1%) used kolanuts, 54 (45.4%) sedatives, while more students from Eket, 47 (34.8%) used tobacco/cigarettes, 76 (56.3%) alcohol, 21 (15.6%) Indian hemp, 5 (3.7%) cocaine and 1 (0.7%) heroin. Class level (P = 0.04), upbringing (P = 0.02) and parents' marital status (P = 0.01) was statistically significant in the use of tobacco/cigarettes. Also, class level (P = 0.02) parents' marital status (P = 0.00) was statistically significant in the use of alcohol, while family type (P = 0.00) and parents' marital status was significant in the use of sedatives. Similarly, parents' marital status (P = 0.05) was statistically significant in the use of Indian hemp, while family type (P = 0.00), upbringing (P = 0.03) was significant in cocaine.

CONCLUSION

The findings of this study confirm the presence and use of psychoactive substances in varying proportions among students. Therefore, there is need to strengthen the monitoring and preventive programmes aimed at reducing their spread in schools.

17O NMR Spectroscopy in Lithium-Ion Battery Cathode Materials: Challenges and Interpretation

Modern studies of lithium-ion battery (LIB) cathode materials employ a large range of experimental and theoretical techniques to understand the changes in bulk and local chemical and electronic structures during electrochemical cycling (charge and discharge). Despite its being rich in useful chemical information, few studies to date have used ¹⁷O NMR spectroscopy. Many LIB cathode materials contain paramagnetic ions, and their NMR spectra are dominated by hyperfine and quadrupolar interactions, giving rise to broad resonances with extensive spinning sideband manifolds. In principle, careful analysis of these spectra can reveal information about local structural distortions, magnetic exchange interactions, structural inhomogeneities (Li⁺ concentration gradients), and even the presence of redox-active O anions. In this Perspective, we examine the primary interactions governing ¹⁷O NMR spectroscopy of LIB cathodes and outline how ¹⁷O NMR may be used to elucidate the structure of pristine cathodes and their structural evolution on cycling, providing insight into the challenges in obtaining and interpreting the spectra. We also discuss the use of ¹⁷O NMR in the context of anionic redox and the role this technique may play in understanding the charge compensation mechanisms in high-capacity cathodes, and we provide suggestions for employing ¹⁷O NMR in future avenues of research.

Strong Magnetic Exchange Interactions and Delocalized Mn-O States Enable High-Voltage Capacity in the Na-Ion Cathode P2-Na0.67[Mg0.28Mn0.72]O2

The increased capacity offered by oxygen-redox active cathode materials for rechargeable lithium- and sodium-ion batteries (LIBs and NIBs, respectively) offers a pathway to the next generation of high-gravimetric-capacity cathodes for use in devices, transportation and on the grid. Many of these materials, however, are plagued with voltage fade, voltage hysteresis and O2 loss, the origins of which can be traced back to changes in their electronic and chemical structures on cycling. Developing a detailed understanding of these changes is critical to mitigating these cathodes' poor performance. In this work, we present an analysis of the redox mechanism of P2-Na0.67[Mg0.28Mn0.72]O2, a layered NIB cathode whose high capacity has previously been attributed to trapped O2 molecules. We examine a variety of charge compensation scenarios, calculate their corresponding densities of states and spectroscopic properties, and systematically compare the results to experimental data: 25Mg and 17O nuclear magnetic resonance (NMR) spectroscopy, operando X-band and ex situ high-frequency electron paramagnetic resonance (EPR), ex situ magnetometry, and O and Mn K-edge X-ray Absorption Spectroscopy (XAS) and X-ray Absorption Near Edge Spectroscopy (XANES). Via a process of elimination, we suggest that the mechanism for O redox in this material is dominated by a process that involves the formation of strongly antiferromagnetic, delocalized Mn-O states which form after Mg2+ migration at high voltages. Our results primarily rely on noninvasive techniques that are vital to understanding the electronic structure of metastable cycled cathode samples.

Probing Jahn-Teller Distortions and Antisite Defects in LiNiO2 with 7Li NMR Spectroscopy and Density Functional Theory

The long- and local-range structure and electronic properties of the high-voltage lithium-ion cathode material for Li-ion batteries, LiNiO2, remain widely debated, as are the degradation phenomena at high states of delithiation, limiting the more widespread use of this material. In particular, the local structural environment and the role of Jahn-Teller distortions are unclear, as are the interplay of distortions and point defects and their influence on cycling behavior. Here, we use ex situ7Li NMR measurements in combination with density functional theory (DFT) calculations to examine Jahn-Teller distortions and antisite defects in LiNiO2. We calculate the 7Li Fermi contact shifts for the Jahn-Teller distorted and undistorted structures, the experimental 7Li room-temperature spectrum being ascribed to an appropriately weighted time average of the rapidly fluctuating structure comprising collinear, zigzag, and undistorted domains. The 7Li NMR spectra are sensitive to the nature and distribution of antisite defects, and in combination with DFT calculations of different configurations, we show that the 7Li resonance at approximately -87 ppm is characteristic of a subset of Li-Ni antisite defects, and more specifically, a Li+ ion in the Ni layer that does not have an associated Ni ion in the Li layer in its 2nd cation coordination shell. Via ex situ7Li MAS NMR, X-ray diffraction, and electrochemical experiments, we identify the 7Li spectral signatures of the different crystallographic phases on delithiation. The results imply fast Li-ion dynamics in the monoclinic phase and indicate that the hexagonal H3 phase near the end of charge is largely devoid of Li.

Controlling Interlayer Disorder Toward Reversible Phase Transition in a Layered Sodium Manganese Oxide Cathode

Sodium manganese oxides are promising Na-ion battery cathodes but they suffer from irreversible phase transitions during electrochemical reactions. Most strategies to date have aimed to suppress the phase transitions by stabilizing their layered structures through limiting the content of extractable Na+. Here, we conversely increase atomic disorder in the Na-birnessite, a layered sodium manganese oxide, and thereby modulate its phase transition behavior toward improved electrochemical reversibility. Our study reveals that Mn vacancies and Mn migrated into the interlayer affect interlayer local environment of Na+ and water molecules consequently enhancing Na+ mobility. We observe better capacity retention for disordered "D-Na-birnessite", which undergoes a reversible phase transition from the birnessite-type structure to an O'3-type α-NaxMnO2-like structure through another intermediate metastable birnessite-type phase. This research highlights the positive effects of atomic disorder to regulate phase transition routes for achieving superior electrochemical reversibility, finally paving the way to overcoming the limits of layered oxide cathodes.

Hydrophobic response of Escherichia coli exposed to subminimal inhibitory concentrations of ampicillin and chloramphenicol

Hydrophobicity generally increased as the cells passed from lag to exponential phases of growth and declined in the stationary phase. All concentrations of ampicillin used increased hydrophobicity, although still subject to effect of phase of growth. Chloramphenicol caused decline in hydrophobicity. Combination of the two antibiotics gave a concentration dependent balance of the two forces observed. Protein synthesis inhibition may render cells resistant to phagocytic uptake by lowering surface hydrophobicity. This phenomenon is probably involved in cases of therapeutic failures, persistent of recurrent infections. This is a further indication of the undesirability of antibiotic abuse.

Challenges of Case Management of COVID-19 in University of Uyo Teaching Hospital: A One-Year Experience

BACKGROUND AND OBJECTIVES

Coronavirus disease 2019 (COVID-19) is a global pandemic. Older people and those with poorly controlled co-morbidities have higher risk of mortality. This study was conducted to highlight the clinical features, challenges of management and outcome for the patients we have seen in our centre over the past one year.

METHODS

This was a retrospective cross-sectional study involving all patients admitted in the COVID-19 Isolation unit of University of Uyo Teaching Hospital (UUTH) from June, 2020-May, 2021. Clinical and laboratory information were obtained from the patient case notes. Ethical clearance for the conduct of the study was obtained from the Ethics committee, UUTH, Uyo. Data was analysed with STATA version 13.

RESULTS

Thirty-three (37.9%) patients were COVID-19 PCR positive. The mean ± SD age of COVID-19 PCR positive patients was 57.3 ± 13.4 years with majority (69.7%) being above 50 years. There was a male preponderance (75%). Eleven (34.4%) patients died while 21(65.6%) were discharged. The highest co-morbidity associated with COVID-19 mortality was diabetes mellitus (7 out of 11; 63.6%). There was a poor uptake of supportive investigations for the management of COVID-19 patients. A raised body temperature (P=0.0006), a low SPO2 (0.00004), high respiratory rate (0.0009) on admission and shorter duration of admission (0.0002), were associated with mortality.

CONCLUSION

The presence of co-morbidities, fever, low SPO2 and high respiratory rates on admission are associated with increased mortality from COVID-19 disease. A paucity of supportive investigations was a major challenge to COVID-19 management. We therefore recommend the strengthening of our laboratory capacity.

Impact of Mg Substitution on the Structure, Stability, and Properties of the Na2Fe2F7 Weberite Cathode

Of the few weberite-type Na-ion cathodes explored to date, Na2Fe2F7 exhibits the best performance, with capacities up to 184 mAh/g and energy densities up to 550 Wh/kg reported for this material. However, the development of robust structure-property relationships for this material is complicated by its tendency to form as a mixture of metastable polymorphs, and transform to a lower-energy Na y FeF3 perovskite compound during electrochemical cycling. Our first-principles-guided exploration of Fe-based weberite solid solutions with redox-inactive Mg2+ and Al3+ predicts an enhanced thermodynamic stability of Na2Mg x Fe2-x F7 as the Mg content is increased, and the x = 0.125 composition is selected for further exploration. We demonstrate that the monoclinic polymorph (space group C2/c) of Na2Fe2F7 (Mg0) and of a new Mg-substituted weberite composition, Na2Mg0.125Fe1.875F7 (Mg0.125), can be isolated using an optimized synthesis protocol. The impact of Mg substitution on the stability of the weberite phase during electrochemical cycling, and on the extent and rate of Na (de)intercalation, is examined. Irrespective of the Mg content, we find that the weberite phase is retained when cycling over a narrow voltage window (2.8-4.0 V vs Na/Na+). Over a wider voltage range (1.9-4.0 V), Mg0 shows steady capacity fade due to its transformation to the Na y FeF3 perovskite phase, while Mg0.125 displays more reversible cycling and a reduced phase transformation. Yet, Mg incorporation also leads to kinetically limited Na extraction and a reduced overall capacity. These findings highlight the need for the continued compositional optimization of weberite cathodes to improve their structural stability while maximizing their energy density.

Superstructure and Correlated Na+ Hopping in a Layered Mg-Substituted Sodium Manganate Battery Cathode are Driven by Local Electroneutrality

In this work, we present a variable-temperature 23Na NMR and variable-temperature and variable-frequency electron paramagnetic resonance (EPR) analysis of the local structure of a layered P2 Na-ion battery cathode material, Na0.67[Mg0.28Mn0.72]O2 (NMMO). For the first time, we elucidate the superstructure in this material by using synchrotron X-ray diffraction and total neutron scattering and show that this superstructure is consistent with NMR and EPR spectra. To complement our experimental data, we carry out ab initio calculations of the quadrupolar and hyperfine 23Na NMR shifts, the Na+ ion hopping energy barriers, and the EPR g-tensors. We also describe an in-house simulation script for modeling the effects of ionic mobility on variable-temperature NMR spectra and use our simulations to interpret the experimental spectra, available upon request. We find long-zigzag-type Na ordering with two different types of Na sites, one with high mobility and the other with low mobility, and reconcile the tendency toward Na+/vacancy ordering to the preservation of local electroneutrality. The combined magnetic resonance methodology for studying local paramagnetic environments from the perspective of electron and nuclear spins will be useful for examining the local structures of materials for devices.

First-Principles Statistical Mechanics Study of Magnetic Fluctuations and Order-Disorder in the Spinel LiNi0.5Mn1.5O4 Cathode

While significant magnetic interactions exist in lithium transition metal oxides, commonly used as Li-ion cathodes, the interplay between magnetic couplings, disorder, and redox processes remains poorly understood. In this work, we focus on the high-voltage spinel LiNi0.5Mn1.5O4 (LNMO) cathode as a model system on which to apply a computational framework that uses first principles-based statistical mechanics methods to predict the finite temperature magnetic properties of materials and provide insights into the complex interplay between magnetic and chemical degrees of freedom. Density functional theory calculations on multiple distinct Ni-Mn orderings within the LNMO system, including the ordered ground-state structure (space group P4332), reveal a preference for a ferrimagnetic arrangement of the Ni and Mn sublattices due to strong antiferromagnetic superexchange interactions between neighboring Mn4+ and Ni2+ ions and ferromagnetic Mn-Mn and Ni-Ni couplings, as revealed by magnetic cluster expansions. These results are consistent with qualitative predictions using the Goodenough-Kanamori-Anderson rules. Simulations of the finite temperature magnetic properties of LNMO are conducted using Metropolis Monte Carlo. We find that a "semiclassical" Monte Carlo sampling method based on the Heisenberg Hamiltonian accurately predicts experimental magnetic transition temperatures observed in magnetometry measurements. This study highlights the importance of a robust computational toolkit that accurately captures the complex chemomagnetic interactions and predicts finite temperature magnetic behavior to help analyze experimental magnetic and magnetic resonance spectroscopy data acquired ex situ and operando.

Magnetic structure and properties of the honeycomb antiferromagnet [Na(OH2)3]Mn(NCS)3

We report the magnetic structure and properties of a thiocyanate-based honeycomb magnet [Na(OH2)3]Mn(NCS)3 which crystallises in the unusual low-symmetry trigonal space group P3̄. Magnetic measurements on powder samples show this material is an antiferromagnet (ordering temperature TN,mag = 18.1(6) K) and can be described by nearest neighbour antiferromagnetic interactions J = -11.07(4) K. A method for growing neutron-diffraction sized single crystals (>10 mm3) is demonstrated. Low temperature neutron single crystal diffraction shows that the compound adopts the collinear antiferromagnetic structure with TN,neut = 18.94(7) K, magnetic space group P3̄'. Low temperature second-harmonic generation (SHG) measurements provide no evidence of breaking of the centre of symmetry.

Structural Evolution in Disordered Rock Salt Cathodes

Li-excess Mn-based disordered rock salt oxides (DRX) are promising Li-ion cathode materials owing to their cost-effectiveness and high theoretical capacities. It has recently been shown that Mn-rich DRX Li1+xMnyM1-x-yO2 (y ≥ 0.5, M are hypervalent ions such as Ti4+ and Nb5+) exhibit a gradual capacity increase during the first few charge-discharge cycles, which coincides with the emergence of spinel-like domains within the long-range DRX structure coined as "δ phase". Here, we systematically study the structural evolution upon heating of Mn-based DRX at different levels of delithiation to gain insight into the structural rearrangements occurring during battery cycling and the mechanism behind δ phase formation. We find in all cases that the original DRX structure relaxes to a δ phase, which in turn leads to capacity enhancement. Synchrotron X-ray and neutron diffraction were employed to examine the structure of the δ phase, revealing that selective migration of Li and Mn/Ti cations to different crystallographic sites within the DRX structure leads to the observed structural rearrangements. Additionally, we show that both Mn-rich (y ≥ 0.5) and Mn-poor (y < 0.5) DRX can thermally relax into a δ phase after delithiation, but the relaxation processes in these distinct compositions lead to different domain structures. Thermochemical studies and in situ heating XRD experiments further indicate that the structural relaxation has a larger thermodynamic driving force and a lower activation energy for Mn-rich DRX, as compared to Mn-poor systems, which underpins why this structural evolution is only observed for Mn-rich systems during battery cycling.