New concepts in C. difficile management

BackgroundClostridium difficile infection is transmitted via spores, and the disease is mediated via secreted toxins. It represents a significant healthcare problem, and clinical presentation can range from asymptomatic carriage to life-threatening pseudomembranous colitis.Sources of datapublications in the field, with a focus on recent developments and concepts.Areas of agreementinfection control measures, antibiotic stewardship and current management of the initial episode of C. difficile infection.Areas of controversyselection and sequence of interventions for the management of recurrent C. difficile infection; management of persistent carriers of toxigenic C. difficile in patients at high risk of subsequent C. difficile infection.Growing pointsuse of faecal microbiota transplantation for recurrent C. difficile infection.Areas timely for developing researchrole of specific microbiota-mediated interventions and vaccination in the treatment and prevention of C. difficile infection

Indoor navigation for the visually impaired : enhancements through utilisation of the Internet of Things and deep learning

Wayfinding and navigation are essential aspects of independent living that heavily rely on the sense of vision. Walking in a complex building requires knowing exact location to find a suitable path to the desired destination, avoiding obstacles and monitoring orientation and movement along the route. People who do not have access to sight-dependent information, such as that provided by signage, maps and environmental cues, can encounter challenges in achieving these tasks independently. They can rely on assistance from others or maintain their independence by using assistive technologies and the resources provided by smart environments. Several solutions have adapted technological innovations to combat navigation in an indoor environment over the last few years. However, there remains a significant lack of a complete solution to aid the navigation requirements of visually impaired (VI) people. The use of a single technology cannot provide a solution to fulfil all the navigation difficulties faced. A hybrid solution using Internet of Things (IoT) devices and deep learning techniques to discern the patterns of an indoor environment may help VI people gain confidence to travel independently. This thesis aims to improve the independence and enhance the journey of VI people in an indoor setting with the proposed framework, using a smartphone. The thesis proposes a novel framework, Indoor-Nav, to provide a VI-friendly path to avoid obstacles and predict the user s position. The components include Ortho-PATH, Blue Dot for VI People (BVIP), and a deep learning-based indoor positioning model. The work establishes a novel collision-free pathfinding algorithm, Orth-PATH, to generate a VI-friendly path via sensing a grid-based indoor space. Further, to ensure correct movement, with the use of beacons and a smartphone, BVIP monitors the movements and relative position of the moving user. In dark areas without external devices, the research tests the feasibility of using sensory information from a smartphone with a pre-trained regression-based deep learning model to predict the user s absolute position. The work accomplishes a diverse range of simulations and experiments to confirm the performance and effectiveness of the proposed framework and its components. The results show that Indoor-Nav is the first type of pathfinding algorithm to provide a novel path to reflect the needs of VI people. The approach designs a path alongside walls, avoiding obstacles, and this research benchmarks the approach with other popular pathfinding algorithms. Further, this research develops a smartphone-based application to test the trajectories of a moving user in an indoor environment

Design and Performance Evaluation of DL MAC Scheduling Model in LTE

In case of Long Term Evolution (LTE), the scheduler in the MAC layer of the eNodeB allocates the available radio resources among different UEs in a cell through proper handling of priority. The scheduling method used largely impacts the throughput of individual users as well as throughput of the cell. It is worthwhile to check on the throughput conditions for different scheduling scenarios before the actual deployment of LTE. This would help design the algorithm of the scheduler at the eNodeB appropriately. In this dissertation, the throughput conditions require to investigate for different scheduling methods in LTE

Genetic variation in Rhabdomys pumilio (Sparrman 1784) - an allozyme study

The striped-mouse, Rhabdomys pumilio, is widely distributed throughout southern Africa. It prefers grasslands but is also found in vlei areas and dry river beds and its attraction to cultivated land has resulted in extensive damage to plants. An allozyme study of R. pumilio populations in different regions of southern Africa was undertaken to evaluate the genetic structure within and between 23 populations and to draw conclusions about the taxonomic status of populations within this species. Fifteen of the 26 loci examined were polymorphic. The mean heterozygosity (0.073) was high for a mammal, although relatively low heterozygosities (0.036–0.054) were recorded for three localities from the peninsular region of the Western Cape. The high mean value for local genetic differentiation (Fst) of 0.459 and the low mean value for the effective number of migrants (Nm) of 0.179 indicated low levels of gene flow between the different localities of R. pumilio.The negative, near zero Fis value of -0.01 indicated a balance between heterozygotes and homozygotes. Rogers (1972) genetic similarity ranged between 0.796 and 0.988, and Nei's (1978) unbiased genetic distance varied between 0.000 and 0.189 between the samples of R. pumilio. The phenogram based on Nei's (1978) unbiased genetic distance showed some degree of geographical subgrouping. The Mantel test indicated a significant relationship between the Fst values and the geographical distances between sample pairs, supporting an isolation by distance model for R. pumilio. Although the genetic evidence for geographical divergence does suggest the possible existence of subspecies, this remains to be substantiated

CORRELATION OF Hba1c LEVELS WITH PUPILLARY RESPONSE TO APRACLONIDINE 0,5% EYE DROPS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Pupillary reflex abnormalities can result from disorders of the innervation or iris structure of the eye. In people with diabetes mellitus, the pupil size becomes smaller than normal due to neuropathy in innocent sympathetic innervation of the pupil. This neuropathy is associated as a manifestation of uncontrolled diabetes complications. Pupillary response is associated as a general indication of autonomic neuropathy disorders in diabetes mellitus patients. Apraclonidine as an ophthalmic sympathomimetic agent can cause mydriasis, which is likely to identify pupillary sympathetic denervation in type 2 diabetes mellitus patients. This study aimed to find out the correlation between HbA1c levels and pupillary response to 0.5% Apraclonidine eye drops in diabetes mellitus type 2 patients at Mohammad Hoesin Hospital Palembang. Observational research with a correlation test design to investigate the correlation of HbA1c levels with pupillary response to apraclonidine 0.5% eye drops in patients with type 2 diabetes mellitus has been conducted from March to May 2019. The study sample met the inclusion and exclusion criteria of 31 diabetics mellitus type 2 with HbA1c level> 6.5% in the Eye clinic at the Mohammad Hoesin Palembang hospital. In this study 31 patients with type 2 diabetes mellitus with HbA1c levels >6.5 mg% were obtained. The average HbA1c level was 9.5 ± 1.4 mg%, which ranged from 7.6 - 12.6 mg%. The glycemic status of the patients in this study were all (100.0%) in an uncontrolled condition (HbA1c> 7.5 mg%). The estimated duration of diabetes mellitus is 2.7 ± 1.8 years, with a minimum value of 1 year and the largest being 8 years. The average change in pupillary diameter before - after dropping 0.5% apraclonidine was 1.16 ± 1.06 mm, ranging from 0 - 4 mm. There were 9 (29.0%) eyes that did not show any changes. Significant enlargement of pupillary size after dropping 0.5% apraclonidine (p = 0,000). This change in pupil size correlated with the estimated duration of diabetes mellitus (r = 0.436, p = 0.014) and HbA1c levels (r = 0.492, p = 0.005). Pupil size after using 0.5% apraclonidine has a distribution value of 4 (3-6) mm can be interpreted that there are subjects who have no change, but there are patients who have pupils dilated to 6 mm

Population genetics of the striped-mouse, Rhabdomys Pumilio (Sparrman, 1784)

Thesis (Ph.D.)-University of Natal, Durban, 1999.The striped-mouse, Rhabdomys pumilio, is widely distributed throughout southern Africa within a variety of habitats and rainfall regimes. It is found at sea level in the Eastern and Western Cape regions and at altitudes above 2700 m in the Drakensberg mountains. The attraction of R.pumilio to cultivated land and crops has resulted in extensive damage to plants and cultivated crops. A study of the genetic variation between populations of R.pumilio from different regions of southern Africa was undertaken by protein electrophoresis and randomly amplified polymorphic DNA using the polymerase chain reaction (PCR-RAPD). A cytogenetic study was also undertaken. The mean heterozygosity (H=0.074) for R.pumilio was more than twice that estimated for mammals (H=0.036) while the mean percent polymorphism (P=16.1%) was only slightly higher than the mean percent polymorphism obtained for mammals (P=14.7%). The highest heterozygosities were recorded in the Potchefstroom (H=0 .145) and Zimbabwe (H=0 .118) samples and the lowest mean heterozygosity was recorded in the peninsular Western Cape (H=0. 032). A mean Fst value of 0.459 was obtained, suggesting a high degree of genetic differentiation between the samples of R.pumilio but the negative Fis (-0.01) value emphasized that R.pumilio retained an outbreeding population structure. The similarity coefficient between the samples of R.pumilio using PCR-RAPD's ranged between 0.471 and 0.853 and substantiated the argument for genetic divergence between the samples of R.pumilio. An isolation by distance model for the population genetic structure of R.pumilio was supported by the allozymes (r=0.58, p<0.00l) and PCR-RAPD's (0.75, p<0.00l). Temperature and rainfall also had an influence on the allelic frequency distribution of certain loci of R.pumilio. Rogers (1972) genetic similarity varied between 0.796 and 0.988 while the values for Nei's (1978) unbiased genetic distance varied between 0.000 and 0.189 for the different samples of R.pumilio. Subgrouping of the KwaZulu-Natal samples, the peninsular Western Cape and Eastern Cape samples of R.pumilio was evident with the allozymes. With the PCR-RAPD' s the Zimbabwe sample showed the least similarity to the other samples with a KwaZulu-Natal/Potchefstroom subgroup separating from the less well defined Eastern Cape and Western Cape subgroup. Cytogenetic studies of specimens of R.pumilio from some of the localities in southern Africa revealed a chromosomal number of 2n=48 , while the Potchefstroom and Zimbabwe specimens displayed a chromosomal number of 2n=46. Homology in G-and C-banding was recorded. The allozymes, PCR-RAPD's and chromosomal studies suggested subspecies status for the Zimbabwe population of R.pumilio. The Potchefstroom sample displayed a greater genetic similarity to the remaining South African samples of R.pumilio than the Zimbabwe samples and therefore could not be considered for subspecies status. Although the South African samples of R.pumilio displayed a certain degree of genetic divergence, it was insufficient to warrant subspecies status although evolution in this direction was suggested