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Nowadays, many researchers are focused on finding a solution to the problem of global warming. Carbon dioxide is considered to be responsible for the “greenhouse” effect. The largest global emission of industrial CO[sub.2] comes from fossil fuel combustion, which makes power plants the perfect point source targets for immediate CO[sub.2] emission reductions. A state-of-the-art method for capturing carbon dioxide is chemical absorption using an aqueous solution of alkanolamines, most frequently a 30% wt. solution of monoethanolamine (MEA). Unfortunately, the usage of alkanolamines has a number of drawbacks, such as the corrosive nature of the reaction environment, the loss of the solvent due to its volatility, and a high energy demand at the regeneration step. These problems have driven the search for alternatives to that method, and deep eutectic solvents (DESs) might be a very good substitute. Many types of DESs have thus far been investigated for efficient CO[sub.2] capture, and various hydrogen bond donors and acceptors have been used. Deep eutectic solvents that are capable of absorbing carbon dioxide physically and chemically have been reported. Strategies for further CO[sub.2] absorption improvement, such as the addition of water, other co-solvents, or metal salts, have been proposed. Within this review, the physical properties of DESs are presented, and their effects on CO[sub.2] absorption capacity are discussed in conjunction with the types of HBAs and HBDs and their molar ratios. The practical issues of using DESs for CO[sub.2] separation are also described.

The decline in absorption flux across membrane modules is attributed to the increase in concentration polarization resistance in flat-plate membrane contactors for CO[sub.2] absorption using monoethanolamine (MEA) as the absorbent. Researchers have discovered that this effect can be mitigated by inserting turbulence promoters, which enhance turbulence intensity at the cost of increased power consumption, thereby improving CO[sub.2] absorption flux. The performance of flat-plate membrane contactors for CO[sub.2] absorption was further enhanced by reducing the hydraulic diameters of embedded 3D-printed turbulence promoters, considering the increased power consumption. The mass-balance modeling, incorporating chemical reactions, was developed theoretically and conducted experimentally on a flat-plate gas/liquid polytetrafluoroethylene/polypropylene (PTFE/PP) membrane module in the present study. A one-dimensional theoretical analysis, based on the resistance-in-series model and the plug-flow model, was conducted to predict absorption flux and concentration distributions. An economic analysis was also performed on modules with promoter-filled channels, considering different array configurations and geometric shapes of turbulence promoters, weighing both absorption flux improvement and power consumption increment. Device performances were evaluated and compared with those of modules using uniform promoter widths. Additionally, the Sherwood number for the CO[sub.2] membrane absorption module was generalized into a simplified expression to predict the mass transfer coefficient for modules with inserted 3D-printed turbulence promoters. Results showed that the ratio of absorption flux improvement to power consumption increment in descending hydraulic-diameter operations is higher than in uniform hydraulic-diameter operations.

Traditional alkanolamine absorption methods for CO[sub.2] capture suffer from significant absorbent loss and high regeneration energy consumption. To address this issue, novel blended alkanolamine formulations based on monoethanolamine (MEA), methyldiethanolamine (MDEA) and 2–amino–2–methyl–1–propanol (AMP) were investigated. Based on the optimization of CO[sub.2] absorption conditions, a low–temperature and high–efficiency microwave heating desorption method for CO[sub.2] was proposed, and the microwave heating desorption process of a CO[sub.2] alkanolamine absorption solution was optimized. The results show that when the mass ratio of monoethanolamine (MEA), methyldiethanolamine (MDEA) and 2–amino–2-methyl–1–propanol (AMP) was 4:5:1, the composite alkanolamine solution with a concentration of 20% had the best absorption effect at an absorption temperature of 30 °C. The desorption efficiency of this group of formulations at 95 °C reached 89% in 4 min. Compared with the traditional heating desorption method, the CO[sub.2] desorption rate of the microwave heating method at 95 °C increased by 62%, the desorption time was significantly shortened, and the energy consumption was significantly reduced. This study provides a new research direction for the efficient and low-energy desorption of CO[sub.2] by blended alkanolamine.

The CO[sub.2] absorption performance in aqueous blends of monoethanolamine (MEA)—1-dimethylamino-2-propanol (DMA2P) and piperazine (PZ)—DMA2P was investigated using a bench-scale tray column under atmospheric pressure. The removal efficiency of CO[sub.2] (η [sub.CO2]) and the overall volumetric mass transfer coefficient (K [sub.G] a [sub.v]) in DMA2P-MEA and DMA2P-PZ solutions were determined at 313.2 K. The simulated flue gas was composed of 15% (mole fraction) CO[sub.2] and 85% N[sub.2]. The effects of inlet gas flow rate (G), absorbent composition (w), inlet liquid flow rate (L), and plate number (N [sub.P]) on η [sub.CO2] and K [sub.G] a [sub.v] were demonstrated. Our results showed that the absorption of CO[sub.2] in DMA2P aqueous solution can be accelerated by the addition of MEA/PZ in a tray column, and both η [sub.CO2] and K [sub.G] a [sub.v] can be significantly improved.

Anti-malarial artemisinin-based combination therapies (ACTs) might be losing efficacy in east Africa, with the spread of artemisinin partial resistance and reduced partner drug activity. Our trial aimed to measure the efficacies of artemether–lumefantrine, artesunate–amodiaquine, dihydroartemisinin–piperaquine, and artesunate–pyronaridine in three sites in Uganda. This randomised, open-label, phase 4 clinical trial was carried out at three sites in the Agago, Arua, and Busia districts of Uganda. Children aged 6 months to 10 years with uncomplicated Plasmodium falciparum malaria were randomly assigned to receive either artemether–lumefantrine (20 mg artemether; 120 mg lumefantrine; twice a day for 3 days) in all sites or dihydroartemisinin–piperaquine (40 mg dihydroartemisinin and 320 mg piperaquine, once a day for 3 days) in Agago, artesunate–amodiaquine (25 mg artesunate and 67·5 mg amodiaquine for children <9 kg or 50 mg artesunate and 135 mg amodiaquine for children ≥9 kg, once a day for 3 days) in Busia; and artesunate–pyronaridine (60 mg artesunate and 180 mg pyronaridine for children >15 kg or 20 mg artesunate and 60 mg pyronaridine for children <15 kg, once a day for 3 days) in Arua, with follow-up to 42 days. Participants were not blinded to group assignments; however, investigators and those assessing outcome were masked. The primary outcome was parasitaemia, assessed by microscopy, either uncorrected or PCR-corrected to distinguish recrudescence from new infection. All participants who received the treatment per protocol and were not lost to follow-up were included in the primary outcome. All participants who were randomly allocated to treatment groups were included in the safety analyses. This study is registered with the Pan African Clinical Trials Registry, number PACTR202301796134887, and is complete. Between Nov 7, 2022, and March 24, 2023, 808 participants (437 [54%] female) were enrolled and assigned to treatment groups; 15 (2%) were lost to follow-up and 793 (98%) completed follow-up. The uncorrected adequate clinical and parasitological response for artemether–lumefantrine was 87 (51·8%; 95% CI 44·0–59·5) of 168 participants in Arua, 88 (51·8%; 44·0–59·4) of 170 and Busia, and 131 (79·4%; 72·3–85·1) of 165 in Agago. This response for artemether–lumefantrine was lower than that of the other ACTs at all sites: 97 (98·0%; 92·2–99·6) of 99 for dihydroartemisinin–piperaquine in Agago, 95 (99·0%; 93·5–99·9) of 96 for artesunate–amodiaquine in Busia, and 73 (73·7%; 63·8–81·8) of 99 for artesunate–pyronaridine in Arua. PCR-corrected 28-day efficacies were 88 (81·5%; 72·6–88·1) of 108 for artemether–lumefantrine and 95 (100%; 95·2–100·0) of 95 for artesunate–amodiaquine in Busia; 131 (97·0%; 92·1–99·0) of 135 for artemether–lumefantrine and 97 (100%; 95·3–100·0) of 97 for dihydroartemisinin–piperaquine in Agago; and 87 (82·1%; 73·2–88·6) of 106 for artemether–lumefantrine and 73 (92·4%; 83·6–96·9) of 79 for artesunate–pyronaridine in Arua. All regimens were well tolerated. The most common adverse events were upper respiratory tract infection, diarrhoea, and anaemia. None of the reported adverse events were attributed to the study drugs. There were two serious adverse events, both cases of severe malaria in Arua, one in each of the treatment groups. Parasite clearance half-lives were prolonged with parasites carrying the PfK13 Cys469Tyr (median 4·2 h; IQR 3·4–4·9) and Ala675Val (4·9 h; 3·4–5·7) mutations compared with wild-type parasites (2·8 h; 2·3–3·6; p<0·0001). Artemether–lumefantrine was associated with a higher risk of recurrent malaria than other antimalarial combinations tested, and K13 mutations were associated with delayed parasite clearance. Changes in first-line therapy for uncomplicated malaria must be considered in response to suboptimal efficacy of artemether–lumefantrine. US President's Malaria Initiative, US Agency for International Development, through the Uganda Malaria Reduction Activity and the National Institutes of Health (AI075045 and AI117001). For the Swahili translation of the abstract see Supplementary Materials section.

In human spermatozoa, the electrochemical potentials across the mitochondrial and plasma membranes are related to sperm functionality and fertility, but the exact role of each potential has yet to be clarified. Impairing sperm mitochondrial function has been considered as an approach to creating male or unisex contraceptives, but it has yet to be shown whether this approach would ultimately block the ability of sperm to reach or fertilize an egg. To investigate whether the mitochondrial and plasma membrane potentials are necessary for sperm fertility, human sperm were treated with two small-molecule mitochondrial uncouplers (niclosamide ethanolamine and BAM15) that depolarize membranes by inducing passive proton flow, and evaluated the effects on a variety of sperm physiological processes. BAM15 specifically uncoupled human sperm mitochondria while niclosamide ethanolamine induced proton current in the plasma membrane in addition to depolarizing the mitochondria. In addition, both compounds significantly decreased sperm progressive motility with niclosamide ethanolamine having a more robust effect. However, these uncouplers did not reduce sperm adenosine triphosphate (ATP) content or impair other physiological processes, suggesting that human sperm can rely on glycolysis for ATP production if mitochondria are impaired. Thus, systemically delivered contraceptives that target sperm mitochondria to reduce their ATP production would likely need to be paired with sperm-specific glycolysis inhibitors. However, since niclosamide ethanolamine impairs sperm motility through an ATP-independent mechanism, and niclosamide is FDA approved and not absorbed through mucosal membranes, it could be a useful ingredient in on-demand, vaginally applied contraceptives. Summary Statement: Here we find that human sperm can maintain their ATP levels without mitochondrial oxidative phosphorylation, and we improve the subcellular localization of Adenosine Nucleotide Translocator 4; these findings will help focus future development of sperm-targeted contraceptives.

Plasmodium falciparum sporozite (PfSPZ) Vaccine is a metabolically active, non-replicating, whole malaria sporozoite vaccine that has been reported to be safe and protective against P falciparum controlled human malaria infection in malaria-naive individuals. We aimed to assess the safety and protective efficacy of PfSPZ Vaccine against naturally acquired P falciparum in malaria-experienced adults in Mali. After an open-label dose-escalation study in a pilot safety cohort, we did a double-blind, randomised, placebo-controlled trial based in Donéguébougou and surrounding villages in Mali. We recruited 18–35-year-old healthy adults who were randomly assigned (1:1) in a double-blind manner, with stratification by village and block randomisation, to receive either five doses of 2·7 × 105 PfSPZ or normal saline at days 0, 28, 56, 84, and 140 during the dry season (January to July inclusive). Participants and investigators were masked to group assignments, which were unmasked at the final study visit, 6 months after receipt of the last vaccination. Participants received combined artemether and lumefantrine (four tablets, each containing 20 mg artemether and 120 mg lumefantrine, given twice per day over 3 days for a total of six doses) to eliminate P falciparum before the first and last vaccinations. We collected blood smears every 2 weeks and during any illness for 24 weeks after the fifth vaccination. The primary outcome was the safety and tolerability of the vaccine, assessed as local and systemic reactogenicity and adverse events. The sample size was calculated for the exploratory efficacy endpoint of time to first P falciparum infection beginning 28 days after the fifth vaccination. The safety analysis included all participants who received at least one dose of investigational product, whereas the efficacy analyses included only participants who received all five vaccinations. This trial is registered at ClinicalTrials.gov, number NCT01988636. Between Jan 18 and Feb 24, 2014, we enrolled 93 participants into the main study cohort with 46 participants assigned PfSPZ Vaccine and 47 assigned placebo, all of whom were evaluable for safety. We detected no significant differences in local or systemic adverse events or laboratory abnormalities between the PfSPZ Vaccine and placebo groups, and only grade 1 (mild) local or systemic adverse events occurred in both groups. The most common solicited systemic adverse event in the vaccine and placebo groups was headache (three [7%] people in the vaccine group vs four [9%] in the placebo group) followed by fatigue (one [2%] person in the placebo group), fever (one [2%] person in the placebo group), and myalgia (one [2%] person in each group). The exploratory efficacy analysis included 41 participants from the vaccine group and 40 from the placebo group. Of these participants, 37 (93%) from the placebo group and 27 (66%) from the vaccine group developed P falciparum infection. The hazard ratio for vaccine efficacy was 0·517 (95% CI 0·313–0·856) by time-to-infection analysis (log-rank p=0·01), and 0·712 (0·528–0·918) by proportional analysis (p=0·006). PfSPZ Vaccine was well tolerated and safe. PfSPZ Vaccine showed significant protection in African adults against P falciparum infection throughout an entire malaria season. US National Institutes of Health Intramural Research Program, Sanaria.

Emergence of drug resistance demands novel antimalarial drugs with new mechanisms of action. We aimed to identify effective and well tolerated doses of ganaplacide plus lumefantrine solid dispersion formulation (SDF) in patients with uncomplicated Plasmodium falciparum malaria. This open-label, multicentre, parallel-group, randomised, controlled, phase 2 trial was conducted at 13 research clinics and general hospitals in ten African and Asian countries. Patients had microscopically-confirmed uncomplicated P falciparum malaria (>1000 and <150 000 parasites per μL). Part A identified the optimal dose regimens in adults and adolescents (aged ≥12 years) and in part B, the selected doses were assessed in children (≥2 years and <12 years). In part A, patients were randomly assigned to one of seven groups (once a day ganaplacide 400 mg plus lumefantrine-SDF 960 mg for 1, 2, or 3 days; ganaplacide 800 mg plus lumefantrine-SDF 960 mg as a single dose; once a day ganaplacide 200 mg plus lumefantrine-SDF 480 mg for 3 days; once a day ganaplacide 400 mg plus lumefantrine-SDF 480 mg for 3 days; or twice a day artemether plus lumefantrine for 3 days [control]), with stratification by country (2:2:2:2:2:2:1) using randomisation blocks of 13. In part B, patients were randomly assigned to one of four groups (once a day ganaplacide 400 mg plus lumefantrine-SDF 960 mg for 1, 2, or 3 days, or twice a day artemether plus lumefantrine for 3 days) with stratification by country and age (2 to <6 years and 6 to <12 years; 2:2:2:1) using randomisation blocks of seven. The primary efficacy endpoint was PCR-corrected adequate clinical and parasitological response at day 29, analysed in the per protocol set. The null hypothesis was that the response was 80% or lower, rejected when the lower limit of two-sided 95% CI was higher than 80%. This study is registered with EudraCT (2020–003284–25) and ClinicalTrials.gov (NCT03167242). Between Aug 2, 2017, and May 17, 2021, 1220 patients were screened and of those, 12 were included in the run-in cohort, 337 in part A, and 175 in part B. In part A, 337 adult or adolescent patients were randomly assigned, 326 completed the study, and 305 were included in the per protocol set. The lower limit of the 95% CI for PCR-corrected adequate clinical and parasitological response on day 29 was more than 80% for all treatment regimens in part A (46 of 50 patients [92%, 95% CI 81–98] with 1 day, 47 of 48 [98%, 89–100] with 2 days, and 42 of 43 [98%, 88–100] with 3 days of ganaplacide 400 mg plus lumefantrine-SDF 960 mg; 45 of 48 [94%, 83–99] with ganaplacide 800 mg plus lumefantrine-SDF 960 mg for 1 day; 47 of 47 [100%, 93–100] with ganaplacide 200 mg plus lumefantrine-SDF 480 mg for 3 days; 44 of 44 [100%, 92–100] with ganaplacide 400 mg plus lumefantrine-SDF 480 mg for 3 days; and 25 of 25 [100%, 86–100] with artemether plus lumefantrine). In part B, 351 children were screened, 175 randomly assigned (ganaplacide 400 mg plus lumefantrine-SDF 960 mg once a day for 1, 2, or 3 days), and 171 completed the study. Only the 3-day regimen met the prespecified primary endpoint in paediatric patients (38 of 40 patients [95%, 95% CI 83–99] vs 21 of 22 [96%, 77–100] with artemether plus lumefantrine). The most common adverse events were headache (in seven [14%] of 51 to 15 [28%] of 54 in the ganaplacide plus lumefantrine-SDF groups and five [19%] of 27 in the artemether plus lumefantrine group) in part A, and malaria (in 12 [27%] of 45 to 23 [44%] of 52 in the ganaplacide plus lumefantrine-SDF groups and 12 [50%] of 24 in the artemether plus lumefantrine group) in part B. No patients died during the study. Ganaplacide plus lumefantrine-SDF was effective and well tolerated in patients, especially adults and adolescents, with uncomplicated P falciparum malaria. Ganaplacide 400 mg plus lumefantrine-SDF 960 mg once daily for 3 days was identified as the optimal treatment regimen for adults, adolescents, and children. This combination is being evaluated further in a phase 2 trial (NCT04546633). Novartis and Medicines for Malaria Venture.

Administration of artemisinin-based combination therapy (ACT) to infant and young children can be challenging. A formulation with accurate dose and ease of administration will improve adherence and compliance in children. The fixed-dose combination dispersible tablet of arterolane maleate (AM) 37.5 mg and piperaquine phosphate (PQP) 187.5 mg can make dosing convenient in children. This multicenter (India and Africa), comparative, parallel-group trial enrolled 859 patients aged 6 months to 12 years with Plasmodium falciparum malaria. Patients were randomized in a ratio of 2:1 to AM-PQP (571 patients) once daily and artemether-lumefantrine (AL) (288 patients) twice daily for 3 days and followed for 42 days. The cure rate (ie, polymerase chain reaction-corrected adequate clinical and parasitological response) in the per-protocol population at day 28 was 100.0% and 98.5% (difference, 1.48% [95% confidence interval {CI}, .04%-2.91%]) in the AM-PQP and AL arms, respectively, and 96.0% and 95.8% (difference, 0.14% [95% CI, -2.68% to 2.95%]) in the intention-to-treat (ITT) population. The cure rate was comparable at day 42 in the ITT population (AM-PQP, 94.4% vs AL, 93.1%). The median parasite clearance time was 24 hours in both the arms. The median fever clearance time was 6 hours in AM-PQP and 12 hours in the AL arm. Both the treatments were found to be safe and well tolerated. Overall, safety profile of both the treatments was similar. The efficacy and safety of fixed-dose combination of AM and PQP was comparable to AL for the treatment of uncomplicated P. falciparum malaria in pediatric patients. CTRI/2014/07/004764.

Background In mild asthma exercise-induced bronchoconstriction (EIB) is usually treated with inhaled short-acting β2 agonists (SABAs) on demand. Objective The hypothesis was that a combination of budesonide and formoterol on demand diminishes EIB equally to regular inhalation of budesonide and is more effective than terbutaline inhaled on demand. Methods Sixty-six patients with asthma (>12 years of age) with verified EIB were randomised to terbutaline (0.5 mg) on demand, regular budesonide (400 μg) and terbutaline (0.5 mg) on demand, or a combination of budesonide (200 μg)  + formoterol (6 μg) on demand in a 6-week, double-blind, parallel-group study (ClinicalTrials.gov identifier: NCT00989833). The patients were instructed to perform three to four working sessions per week. The main outcome was EIB 24 h after the last dosing of study medication. Results After 6 weeks of treatment with regular budesonide or budesonide+formoterol on demand the maximum post-exercise forced expiratory volume in 1 s fall, 24 h after the last medication, was 6.6% (mean; 95% CI −10.3 to −3.0) and 5.4% (−8.9 to −1.8) smaller, respectively. This effect was superior to inhalation of terbutaline on demand (+1.5%; −2.1 to +5.1). The total budesonide dose was approximately 2.5 times lower in the budesonide+formoterol group than in the regular budesonide group. The need for extra medication was similar in the three groups. Conclusions The combination of budesonide and formoterol on demand improves asthma control by reducing EIB in the same order of magnitude as regular budesonide treatment despite a substantially lower total steroid dose. Both these treatments were superior to terbutaline on demand, which did not alter the bronchial response to exercise. The results question the recommendation of prescribing SABAs as the only treatment for EIB in mild asthma.