Recurrent pancreatitis after partial ileal bypass for hyperlipidaemia : a case report

CITATION: Du Toit, D. F., Knott-Craig, C. & Laker, L. 1985. Recurrent pancreatitis after partial ileal bypass for hyperlipidaemia : a case report. South African Medical Journal, 68:483-484.The original publication is available at http://www.samj.org.zaThe case of a 28-year-old man with alcohol-induced bouts of recurrent acute pancreatitis after a partial ileal bypass performed for hyperlipidaemia is presented. Serial computed tomography proved valuable for assessing the resolution of the pancreatic mass. Peripheral parenteral hyperalimentation for 6 weeks had a beneficial effect on the course of the pancreatitis and proved to be useful for nutritional support.Publisher’s versio

Coherent deflection pattern and associated temperature enhancements in the near-Sun solar wind

Measurements of transverse magnetic field and velocity components from Parker Solar Probe have revealed a coherent quasi-periodic pattern in the near-Sun solar wind. As well as being Alfv\'enic and arc-polarised, these deflections were characterised by a consistent orientation and an increased proton core temperature, which was greater parallel to the magnetic field. We show that switchbacks represent the largest deflections within this underlying structure, which is itself consistent with the expected outflow from interchange reconnection simulations. Additionally, the spatial scale of the deflections was estimated to be around $1$\,Mm on the Sun, comparable to the jetting activity observed at coronal bright points within the base of coronal plumes. Therefore, our results could represent the in situ signature of interchange reconnection from coronal bright points within plumes, complementing recent numerical and observational studies. We also found a consistent relationship between the proton core temperature and magnetic field angle across the Parker Solar Probe encounters and discussed how such a persistent signature could be more indicative of an in situ mechanism creating a local increase in temperature. In future, observations of minor ions, radio bursts and remote sensing images could help further establish the connection between reconnection events on the Sun and signatures in the solar wind

Molecular microscopy on graphene

The autonomous ordering and assembly of atoms and molecules on atomically well-defined surfaces combines ease of fabrication with exquisite control over the shape, composition and mesoscale organization of the surface structures formed. Once the mechanisms controlling the self-ordering phenomena are fully understood, the self-assembly and growth processes can be steered to create a wide range of nanostructures with exotic and desirable properties, synthesised from the bottom-up, on an industrial scale from metallic, semiconducting and molecular materials. The work of this thesis aims to address questions concerning molecular self-assembly on graphene. Firstly, techniques for fabricating graphene membranes for electron microscopy (EM) are outlined. The complete fabrication process is described, beginning with the growth of CVD graphene, followed by the transfer of graphene from chemical vapour deposition (CVD) foils to a transmission electron microscope (TEM) support, and finishing with the cleaning steps involved to produce pristene regions of graphene. Strategies to chemically functionalise graphene through covalent and non-covalent means are detailed, as well as methods to fabricate more specialised graphene TEM membranes consisting of stacked and sandwiched graphene layers. With the methods used to fabricate and modify graphene EM membranes described, attention is next focused on specific microscopy techniques developed in order to study organic materials that readily damage when exposed to the electron beam in an electron microscope. Strategies to mitigate the damage arising due to beam exposure are investigated for a range of different organic molecules, and the effects of using a range of detection devices are also studied. Next, the growth of two very similar overlayer systems on graphene are studied. Trimesic acid (TMA) and terephthalic acid (TPA) thin films are grown on both freestanding and CVD graphene substrates for a range of thicknesses, and the resulting structures are probed using a range of microscopy techniques. For TMA, van der Waals epitaxy results in two preferred orientations of the assembly structure that grows in a layer-by-layer Frank-van der Merwe fashion, up to a height of ≈ 20 nm. In stark contrast, TPA assembles into a 2D monolayer before rapidly transitioning to its bulk-like structure as further layers are deposited, following a layer-plus-island, or Stranski-Krastanov, growth mode. Continuing the investigations into the structure of self-assembling molecular films on graphene, a pair of porphyrin-based molecules of the octaethyl porphyrin (OEP) class are studied. A monolayer film of OEP molecules is deposited either side of a freestanding graphene membrane, and the resulting assembly structure is driven by a remote interaction across the graphene between the two OEP films. The remote interaction is shown to diminish on the length scale of two graphene layers. Finally, the structure and motion of individual metal nanoclusters (M-NCs) deposited on freestanding graphene is studied using high-resolution TEM. Computational routines involving cross-correlation techniques are developed in order to better study the dynamic behaviour of M-NCs in atomically-resolved time-series image sequences. The strategies developed provide a means for accurately studying more complex systems, structural changes, and chemical reactions at atomic-resolution and in real-time

Bright lights show the way

Evidence from education in England and around the world reveals that bigger is often better

Recovery of effective hiv-specific cd4+ t-cell activity following antiretroviral therapy in paediatric infection requires sustained suppression of viraemia

Background The success of increasing access to antiretroviral therapy (ART) in paediatric HIV infection prompts the question of the potential for eradication of HIV infection in this age group. ‘Shock-and-kill’ HIV cure approaches, currently in development, may depend upon an effective antiviral T-cell response to eradicate virus-infected cells. Method We here investigate the ability of HIV-infected children receiving ART from early childhood (median 24 months’ age) to generate effective HIV-specific CD4þ and CD8þ T-cell immune responses thatwould facilitate future immune-based cure therapies. Results Initial analysis of ART-naive HIV-infected children demonstrated that maintenance of normal-for-age absolute CD4þ T-cell counts was strongly linked to high IL-2 production and polyfunctional HIV-specific CD4þ T-cell responses (P<0.0001 in each case). Low viral load was, similarly, strongly associated with markedly low IFN-g and high IL-2 HIV-specific CD4þ T-cell responses (P<0.0001). In children receiving ART, establishment of this immune profile (high IL-2 and low IFN-g HIV-specific T-cell production) was strongly related to the duration of viraemic suppression. Failure to suppress viraemia on ART, and even the successful suppression of viraemia interrupted by the occurrence of transient viraemia of more than 1000 HIV copies/ml, was associated with an immune profile of high IFN-g and low IL-2 HIV-specific T-cell responses and low polyfunctionality. Conclusion These data are consistent with recovery of functional CD4þ T-cell responses in ART-treated children, in contrast to relative lack of CD4þ T-cell function recovery described in ART-treated adults. However, the challenges of achieving longterm suppression of viraemia in ART-treated children through adolescence remain daunting

Pragmatic randomized controlled trial of the Mind Management Skills for Life Programme as an intervention for occupational burnout in mental healthcare professionals

Background Occupational burnout is highly prevalent in the mental healthcare workforce and associated with poorer job satisfaction, performance and outcomes. Aims To evaluate the effects of the Mind Management Skills for Life Programme on burnout and wellbeing. Methods N = 173 mental health nurses were recruited from the English National Health Service during the acute phase of the COVID-19 crisis. Participants were allocated to an immediate intervention or a delayed intervention control group, using a stepped wedge randomized controlled trial design. Measures of burnout (OLBI) and wellbeing (WEMWBS) were completed at four time-points: [1] baseline; [2] after the first group finished the intervention; [3] after the second group finished the intervention; and [4] six-months follow-up. Results Between-group differences were compared at each time-point using ANCOVA adjusting for baseline severity. Statistically significant effects on burnout (d = 0.60) and wellbeing (d = −0.62) were found at time-point 2, favouring the intervention relative to waitlist control. No significant differences were found at subsequent time-points, indicating that both groups improved and maintained their gains after the intervention. Conclusions This intervention led to moderate improvements in burnout and wellbeing, despite the adverse circumstances of the COVID-19 pandemic at the time of the study