Elucidating the Biological Role of Autologous Derived Platelet-Rich Plasma Gel in the Treatment of Chronic Diabetic Foot Ulcers.

MD (Res)The molecular basis for the use of synthetic growth factors (GFs) in tissue reparation has been poorly investigated. More recently, autologous derived platelet rich growth factor has gained popularity in the field of regenerative/ reparative medicine, mostly because it fits the description of an ideal naturally existing constellation of GFs. However, its efficacy remains controversial. Hence, this study is designed to further elucidate the physiological role of PRP in treating chronic diabetic foot ulcers. Platelet -rich plasma (PRP) and Platelet -poor plasma (PPP) were prepared from blood samples taken from healthy donors and diabetic patients through the use of platelet collecting and concentrating system. The GFs released were measured through immunoassay technique. The effects of the varying concentrations of PRP/PPP in culture media was assessed through tissue culture assay (proliferation, cell migration and angiogenesis assay) on human epithelia keratinocyte, dermal fibroblast and umbilical vein endothelia cell. Furthermore, immuno-histochemistry technique was used to evaluate the differentiation, proliferation, migration and extracellular matrix alterations occurring along wound margins of patients with chronic diabetic ulcers following PRP treatment. A significant difference was observed when the expression of platelet derived growth factor-AA, epidermal growth factor, vascular endothelia growth factor, transforming growth factor and thrombospodin-I released from PRP/PPP were compared between the two groups. There was a significant proliferative, migratory and angiogenic effect of PRP over PPP in the tissue culture assay; however this effect was most prominent with 5% PRP. Overall, hyperproliferative keratin, CD44 and β1-integrin were upregulated in diabetic ulcer keratinocytes as compared with normal foot skin. The clinical study showed that 3 of the 7 diabetic foot ulcer patients treated with PRP achieved complete wound re-epithelisation. We have been able to demonstrate through in vitro studies that PRP has a positive biological effect which mimics normal physiological tissue reparation process.Barts and the London Charity Fun

DERIVATIVES AND ANALYTIC SIGNALS: Improved Techniques for Lithostructural Classification.

In this study, derivatives and Analytic Signal (AS) techniques were employed to reveal the nature of rocks and lithostructural relationships that exist within the basement complexes around Ekiti and Ondo States. The derivatives techniques were used to enhance theReduction to Equator Total Magnetic Intensity (RTE_TMI) data. In order to make the results from derivatives techniques worthwhile and robust, Analytic Signal (AS) technique was then applied. The results of the derivatives and analytic signals revealed seven different lithological suites, namely: migmatite (M), migmatite-gneiss (MGn), gneiss and granite (Gn/G), schist and quartzite schist (S/Qs), granitegneiss and charnockite (Gn/Ch), charnockite and granite (Ch/G), and granite (G). Five different major lineaments/faults, folds and lithological contacts were also identified. The lineaments/faults were classified as F1, F2, F3, F4 and F5 with NW-SE, NNE-SSW, NE-SW, E-W and NNW-SSE trends respectively. Folds were classified into S1, S2, S3, S4 and S5 as symmetrical, asymmetrical, recumbent, ptygmatic and drag folds respectively. While lithological contacts were classified into C1, C2, C3, C4 and C5 as sharp contact of migmatite and granite, migmatite and granite-gneiss/charnockite/granite, migmatite and gneiss/granite, migmatite and schist/quartzite schist, and migmatite and gneiss respectively. It is evident from the study that migmatites and gneisses which form the basement in the area have been highly deformed and evince many intrusives. A detailed geological map for the study area is proposed as deduced from results analyses

IMPROVED MAGNETIC DATA ANALYSES AND ENHANCEMENT TECHNIQUES FOR LITHOLOGICAL AND STRUCTURAL MAPPING AROUND AKURE, SOUTHWESTERN NIGERIA

This study employs improved magnetic data analyses and enhancement techniques to map and interpret the lithological and structural features around Akure and its environs. Several forms of filtering processes were performed to improve and enhance the Total Magnetic Intensity (TMI) data and other reduced data that were later produced. The analysed results of the upward continuation to 500 m and 1 km revealed the attitudes of deepseated basement rocks and anomalous structures with regional trend of NW-SE direction, as well as depth of structures that ranged beyond 1 km. On the other hand, derivatives images revealed lineaments/faults: F1-F’1, F2- F’2, F3-F’3 (minors) and F4-F’4 trending NNE-SSW, N-S, NE-SW, minor (ENE-WSW and E-W) and NW-SE respectively. Based on magnetisation contrast, four amplitude zones were revealed on the Analytic Signal (AS) image, which include very high zone as migmatite complexes; intermediate zone as migmatite/gneiss and charnockite complexes; fairly low zone as granite-gneiss and granite complexes, and low zone as quartzite ridge/ complex. The large causative bodies delineated from the pseudo-gravity revealed density of about 0.133 g/cc in susceptibility. The total depth estimate to top of magnetic sources ranged from 53 m to 1.98 km for shallower and deeper sources respectively. This study, therefore, suggests different rock types of varying mineralogical compositions, tectonic framework and structural deformations that led to change in intensity of rocks in the study area

LITHOSTRUCTURAL RELATIONSHIPS AND PETROGENETIC AFFINITIES OF THE BASEMENT COMPLEX ROCKS AROUND OKPELLA, NIGERIA

Okpella area is the eastern extension of the Igarra Schist Belt, Southwestern Nigerian Basement Complex. The area comprises granite gneiss, metasedimentary rocks and Pan-African intrusives. Metasedimentary rocks occurring in the area include garnet-biotite schist, marble and calc-silicate gneiss, quartzite and Banded Iron Formation (BIF). The Pan-African intrusives include granite, charnockite, hybrid rocks, pegmatite, aplite and basic dykes. Structural data of rocks in the area suggest the presence of two contrasting structural trends. The older one which appears restrictedto thegranite gneiss, calc-silicate gneissandgarnet-biotite schisttrendsENE-WSWtoEW with moderate dips to the south. The latter NW-SE to NS trend is pervasive and occurs in all the metasediments and granite gneiss. These two trends are related to two deformational episodes and probably two orogenic periods. All the metasediments show affinity for sedimentary parentage, the granite gneiss is probably of igneous origin while the intrusives are magmatic. The charnockite-granite hybrid rock probably represents a zone of magma mixing between two contrasting magmas that were emplaced contemporaneously. The occurrence of metacarbonates in association with deformed metapelites as well as the complete absence of metavolcanics in the area suggests deposition of their protoliths in a continental environment along which crustal distention occurred. A sequence of nine geological events is suggested for the evolution of the area as deduced from field observation

BLACKFACE SURVEILLANCE CAMERA DATABASE FOR EVALUATING FACE RECOGNITION IN LOW QUALITY SCENARIOS

Many face recognition algorithms perform poorly in real life surveillance scenarios because they were tested with datasets that are already biased with high quality images and certain ethnic or racial types. In this paper a black face surveillance camera (BFSC) database was described, which was collected from four low quality cameras and a professional camera. There were fifty (50) random volunteers and 2,850 images were collected for the frontal mugshot, surveillance (visible light), surveillance (IR night vision), and pose variations datasets, respectively. Images were taken at distance 3.4, 2.4, and 1.4 metres from the camera, while the pose variation images were taken at nine distinct pose angles with an increment of 22.5 degrees to the left and right of the subject. Three Face Recognition Algorithms (FRA), a commercially available Luxand SDK, Principal Component Analysis (PCA) and Linear Discriminant Analysis (LDA) were evaluated for performance comparison in low quality scenarios. Results obtained show that camera quality (resolution), face-to-camera distance, average recognition time, lighting conditions and pose variations all affect the performance of FRAs. Luxand SDK, PCA and LDA returned an overall accuracy of 97.5%, 93.8% and 92.9% after categorizing the BFSC images into excellent, good and acceptable quality scales.

Medical doctors’ awareness of radiation exposure in diagnostic radiology investigations in a South African academic institution

Background: Diagnostic investigations using radiation have become a critical feature of medical practice in recent times. However, the possibility of doctors’ underestimation of risks of over-exposure of patients to diagnostic radiation still warrants further evaluation. Objectives: To investigate doctors’ awareness of diagnostic radiation exposure at Dr George Mukhari Academic Hospital, South Africa. Methods: This was a cross-sectional, analytical investigation of the awareness of doctors about radiation exposure in diagnostic radiology investigations. A cluster sampling technique was employed to recruit 217 participants. Consent and approval of the participants were sought and obtained before questionnaire administration during departmental meetings between October 2017 and March 2018. Results: Of the participants, 80% had no formal training on radiation exposure and 33.8% of them correctly estimated natural background radiation. Correct estimates of the effective dose from a single-view abdominal X-ray (AXR) were expressed by 7.5%, quantity of radiation of a single-phase computed tomography (CT) abdomen by 30.3% and dosage from a two-view unilateral mammogram by 29.1% of the participants. More than 75% of participants agreed that children are more sensitive to radiation, but only 10.5% suggested medical termination of pregnancy for a woman who had CT abdomen and pelvis with contrast. Dosage and risk of inducing fatal cancer from common but more complex imaging procedures were poorly understood. Only the doctors of the radiology department showed a statistically significant (p < 0.0001) association with regards to their radiation awareness. Conclusion: Because of the high rate of poor awareness of radiation risks observed in this study, it is important to initiate, early in the medical curriculum for medical students, the need for a rotation in the Department of Radiology, similar to such rotations in other medical specialties

Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire

Introduction The introduction of biological and synthetic meshes has revolutionised the practice of implant-based breast reconstruction (IBBR) but evidence for effectiveness is lacking. The iBRA (implant Breast Reconstruction evAluation) study is a national trainee-led project that aims to explore the practice and outcomes of IBBR to inform the design of a future trial. We report the results of the iBRA National Practice Questionnaire (NPQ) which aimed to comprehensively describe the provision and practice of IBBR across the UK. Methods A questionnaire investigating local practice and service provision of IBBR developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Summary data for each survey item were calculated and variation between centres and overall provision of care examined. Results 81 units within 79 NHS-hospitals completed the questionnaire. Units offered a range of reconstructive techniques, with IBBR accounting for 70% (IQR:50–80%) of participating units' immediate procedures. Units on average were staffed by 2.5 breast surgeons (IQR:2.0–3.0) and 2.0 plastic surgeons (IQR:1.0–3.0) performing 35 IBBR cases per year (IQR:20-50). Variation was demonstrated in the provision of novel different techniques for IBBR especially the use of biological (n = 62) and synthetic (n = 25) meshes and in patient selection for these procedures. Conclusions The iBRA-NPQ has demonstrated marked variation in the provision and practice of IBBR in the UK. The prospective audit phase of the iBRA study will determine the safety and effectiveness of different approaches to IBBR and allow evidence-based best practice to be explored

Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19

Importance: Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality. // Objective: To evaluate whether systemic anticancer treatments (SACTs), tumor subtypes, patient demographic characteristics (age and sex), and comorbidities are associated with COVID-19 mortality. // Design, Setting, and Participants: The UK Coronavirus Cancer Monitoring Project (UKCCMP) is a prospective cohort study conducted at 69 UK cancer hospitals among adult patients (≥18 years) with an active cancer and a clinical diagnosis of COVID-19. Patients registered from March 18 to August 1, 2020, were included in this analysis. // Exposures: SACT, tumor subtype, patient demographic characteristics (eg, age, sex, body mass index, race and ethnicity, smoking history), and comorbidities were investigated. // Main Outcomes and Measures: The primary end point was all-cause mortality within the primary hospitalization. // Results: Overall, 2515 of 2786 patients registered during the study period were included; 1464 (58%) were men; and the median (IQR) age was 72 (62-80) years. The mortality rate was 38% (966 patients). The data suggest an association between higher mortality in patients with hematological malignant neoplasms irrespective of recent SACT, particularly in those with acute leukemias or myelodysplastic syndrome (OR, 2.16; 95% CI, 1.30-3.60) and myeloma or plasmacytoma (OR, 1.53; 95% CI, 1.04-2.26). Lung cancer was also significantly associated with higher COVID-19–related mortality (OR, 1.58; 95% CI, 1.11-2.25). No association between higher mortality and receiving chemotherapy in the 4 weeks before COVID-19 diagnosis was observed after correcting for the crucial confounders of age, sex, and comorbidities. An association between lower mortality and receiving immunotherapy in the 4 weeks before COVID-19 diagnosis was observed (immunotherapy vs no cancer therapy: OR, 0.52; 95% CI, 0.31-0.86). // Conclusions and Relevance: The findings of this study of patients with active cancer suggest that recent SACT is not associated with inferior outcomes from COVID-19 infection. This has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers. Important differences in outcomes among patients with hematological and lung cancers were observed

Chapter 4: Skin-Influencing Factors in Daily Life

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