An endometrial histomorphometric study of CD56+ natural killer cells in women with unexplained infertility

BACKGROUND. The number of peripheral blood and endometrial natural killer cells varies greatly during implantation and the first trimester of pregnancy and is thought to play a role in the maintenance of a healthy pregnancy. However, the role of endometrial CD56+ natural killer (NK) cells as an immunological mechanism in unexplained infertility is yet unknown. OBJECTIVES. The study aimed to enumerate the concentrations of CD56+ NK cells in endometrial samples, and to statistically compare these numbers between fertile and infertile women. METHODS. A histomorphometric analysis was conducted using haematoxylin and eosin staining and an immunohistochemical approach was used for quantifying cell numbers. RESULTS. Fifty samples were collected in equal parts between a study group of infertile female subjects (mean (standard deviation) age 35 (4), range 26 - 42 years) and a control group of multiparous fertile individuals (mean (SD) age 43.4 (6.3), range 30 - 55). The mean number of CD56+ NK cells present at different depths for both the study and control groups did not differ significantly. Age and group (study or control) were not significantly related to the mean number of CD56+ NK cells. However, for the late secretory phase the mean number of CD56+ NK cells was significantly higher than for the early phase. CONCLUSION. Our findings could not identify a statistically significant correlation between the number of CD56+ NK cells and infertility.Discovery Foundation Research Awardshttp://sajog.org.za/index.php/SAJOGhttp://www.journals.co.za/content/journalam2017Anatomical PathologyAnatomyHaematologyImmunologyStatistic

An evaluation of the state of wellness amongst medical aid company employees in South Africa

Huidige navorsing op die gebied van welstand in die werkplek is gefragmenteer en vereis ’n holistiese, geïntegreerde en stelselmatige begrip van werknemerwelstand sodat gesondheiden welstandsorg doeltreffend bestuur kan word. Die toenemende las van nie-oordraagbare toestande in Suid-Afrika beklemtoon die noodsaaklikheid van voorkomingstrategieë soos welstandprogramme. Die werkomgewing bied ’n ideale plek, aangesien ’n groot deel van die bevolking geteiken word, insluitende diegene wie se lewenstyl verbeter moet word. Hierdie studie is dus daarop gemik om verskeie gesondheid- en welstandkomponente onder werknemers van ’n mediesefondsmaatskappy te evalueer in ’n poging om risikogebiede te identifiseer wat verdere ingryping vereis. Die deelnemers het bestaan uit 140 werknemers van ’n mediesefondsmaatskappy wat ten minste 40 h per week werk. Hulle is onderwerp aan ’n welstandassesseringsbattery bestaande uit antropometrieke, gesondheidverwante en fisieke kapasiteitmetings. Die resultate toon dat ingryping nodig is betreffende alkohol- en dwelmgebruik, dieetgewoontes, hartgesondheid, liggaamsamestelling, spieruithouvermoë, kardiorespiratoriese uithouvermoë en individuele persepsies van die maatskappy. Dié studie het resultate opgelewer wat die bevindings van baie vorige navorsing op hierdie gebied staaf. Die trefwydte van welstandprogramme op die Suid-Afrikaanse bevolking is egter beperk. Die sukses van welstandprogramme wat fisieke aktiwiteit beklemtoon, is goed gedokumenteer in hoë-inkomstelande, met bewys van die ekonomiese voordele en opbrengs op belegging. Gevolglik word daar aangevoer dat die toepassing van welstandprogramme ’n positiewe uitwerking op die Suid-Afrikaanse werkmag sal hê.Current research in the area of wellness in the workplace is fragmented and requires a holistic, integrated and systemic understanding of employee wellness in order for health and wellness care to be effectively managed. The growing burden of noncommunicable conditions in South Africa highlights the necessity for prevention strategies such as wellness programmes to be implemented. The workplace provides an ideal setting as a large proportion of the population will be targeted, including those who require lifestyle improvement. Therefore this study sought to evaluate various health and wellness components among employees of a medical aid company in an attempt to identify risk areas which require further intervention. Participants were 140 employees of a medical aid company who work a minimum of 40 h per week and who were subjected to a wellness assessment battery, consisting of anthropometrical, health-related and physical capacity measurements. The results indicate that intervention is required in terms of alcohol and drug usage, dietary habits, heart health, body composition, muscular endurance, cardiorespiratory endurance, and individual perceptions towards the company. This study produced results which corroborate the findings of a great deal of previous research in this field. However, the scope for applying wellness programmes to the South African population is limited. The success of wellness programmes which emphasise physical activity has been well documented in high-income countries, with evidence of economic benefits and return on investment. And so it is proposed that implementation of wellness programmes will have a positive effect on the South African workforce.http://www.satnt.ac.zaam201

Influence of two sports vision training techniques on visual skills performance of university students

Vision is an essential sense and crucial throughout a student’s academic career. Reading and writing during formal studies require a basic level of visual skills. Training of visual skills to students may improve the way visual stimuli are processed, and subsequently lead to visual skill-, motor- and cognitive performance enhancement. The visual system processes information by way of ‘hardware’- skills (physical, mechanical properties) and the more trainable ‘software’-skills (perceptual, cognitive abilities). Sports vision skills training in athletes indicated faster response to visual information and ultimately improved performance, particularly in fast-ball sports. The efficiency of two sports vision training programmes were tested and compared in undergraduate physiology students of various ethnicities (aged 18-25 years), during a 6-week training period. Three groups were used. One control group and two experimental groups were used. Two programmes were used for the experimental groups (a vision laboratory executed battery of repeated visual skills vs. ‘Eyedrills’ an available webbased training programme). Both comprised ‘hardware’ and ‘software’ skills, and include: visual acuity, focusing, tracking, vergence, sequencing, eye-hand coordination and visualisation. For pretest/ post-test evaluations of all students the repeated laboratory training programme was executed. The control group was only exposed to the pre- and post-test. Individuals trained in the laboratory indicated the highest improvement in all visual skills, except vergence. The ‘Eyedrills’ group displayed significant improvements in focusing, tracking and eye-hand coordination, with the control group indicating the least improvement in visual skills - ruling out the notion of improvement occurring only due to test familiarity. Visual training was verified an essential method of improving visual skills, and fundamental in the expansion of basic visual abilities of university students for enhanced performance.http://www.journals.co.za/content/journal/ajpherd1am2017Biokinetics, Sport and Leisure SciencesPhysiologyPsychologySports MedicineStatistic

Influence of intense training program on cardio stress index

Rekrute in die gewapende magte word met talle stressors gekonfronteer, onder meer ’n strawwe opleidingsprogram wat ’n impak op hul fisiologiese funksionering kan hê. Die kardiostresindeks (KSI) is ’n nie-indringende merker van die stres wat die hart ervaar. Die berekening van die KSI is gebaseer op die duur van vaskulêre eksitasie (duur van QRS), hartkloptempo, hartritme en die standaardafwyking van die tyd wat verloop tussen elke opeenvolgende kardiale siklus (RRinterval). Die doel van die huidige studie was om die fisiologiese impak van 20 weke van strawwe opleiding op rekrute te toets, met behulp van KSI as ’n nie-indringende biomerker van kardiostres. Proefnemings is by drie geleenthede tydens die basiese militêre opleiding van rekrute, tussen die ouderdomme van 18 en 24 jaar, in die gewapende magte onderneem (week 1, week 12 en week 20) (n = 202, manlik = 115, vroulik = 87). Veranderlikes wat gemeet is, het die volgende ingesluit: rustende KSI, hartkloptempo (HKT) en bloeddruk. Data-analise is uitgevoer deur middel van gepaarde t-toetse ten einde die volgende pare te vergelyk: week 1 (basislyn) met week 12; week 12 met week 20; en week 1 met week 20. Wat die manlike rekrute betref, was die gemiddelde KSI en harttempo by al drie toetse binne normale perke. Die basislynwaardes vir vroulike rekrute was in betekenisvolle mate hoër in die eerste week. Daar was ’n algehele afname van die KSI oor die hele tydperk van 20 weke. Uit hierdie studie wil dit voorkom asof die meting van die KSI ’n nieindringende metode is om die uitwerking van afrigting op die hart te bepaal.Armed service recruits are faced with many stressors, including a strenuous training regimen that may have an impact on their physiological functioning. The Cardio Stress Index (CSI) is a noninvasive marker of the stress that the heart is experiencing. The aim of the study was to test the physiological impact of 20 weeks of intense training of armed service recruits, using CSI as a noninvasive biomarker of cardiac stress. Armed service recruits are faced with many stressors, including a strenuous training regimen that may have an impact on their physiological functioning. The CSI is a noninvasive marker of the stress that the heart is experiencing. The calculation of the CSI is based on the duration of vascular excitation (QRS duration), heart rate, heart rhythm and standard deviation of the duration of time between each successive cardiac cycle (RR-interval). The aim of the present study was to test the physiological impact of 20 weeks of strenuous training of armed service recruits, using CSI as a noninvasive biomarker of cardiac stress. Experiments were conducted at three points in time (weeks 1, 12, 20) during the basic military training of armed service recruits (n = 202, males = 115, females = 87), aged between 18 and 24 years. Variables measured include: Resting CSI, heart rate and blood pressure. Data analysis was performed, using paired t-tests for pairwise comparisons of week 1 (baseline) with week 12; week 12 with week 20; and week 1 with week 20. The average CSI and heart rate remained within normal values for male participants on all three testing occasions. However, baseline readings for females were significantly higher during week 1. There was an overall decrease in the CSI in the 20 week time frame. From this study it seems as if the CSI measurement is a noninvasive method to establish the effects of training on the health of the heart.http://www.satnt.ac.zaam201

The utility of high-flow nasal oxygen for severe COVID-19 pneumonia in a resource-constrained setting: A multi-centre prospective observational study.

BACKGROUND: The utility of heated and humidified high-flow nasal oxygen (HFNO) for severe COVID-19-related hypoxaemic respiratory failure (HRF), particularly in settings with limited access to intensive care unit (ICU) resources, remains unclear, and predictors of outcome have been poorly studied. METHODS: We included consecutive patients with COVID-19-related HRF treated with HFNO at two tertiary hospitals in Cape Town, South Africa. The primary outcome was the proportion of patients who were successfully weaned from HFNO, whilst failure comprised intubation or death on HFNO. FINDINGS: The median (IQR) arterial oxygen partial pressure to fraction inspired oxygen ratio (PaO2/FiO2) was 68 (54-92) in 293 enroled patients. Of these, 137/293 (47%) of patients [PaO2/FiO2 76 (63-93)] were successfully weaned from HFNO. The median duration of HFNO was 6 (3-9) in those successfully treated versus 2 (1-5) days in those who failed (p<0.001). A higher ratio of oxygen saturation/FiO2 to respiratory rate within 6 h (ROX-6 score) after HFNO commencement was associated with HFNO success (ROX-6; AHR 0.43, 0.31-0.60), as was use of steroids (AHR 0.35, 95%CI 0.19-0.64). A ROX-6 score of ≥3.7 was 80% predictive of successful weaning whilst ROX-6 ≤ 2.2 was 74% predictive of failure. In total, 139 patents (52%) survived to hospital discharge, whilst mortality amongst HFNO failures with outcomes was 129/140 (92%). INTERPRETATION: In a resource-constrained setting, HFNO for severe COVID-19 HRF is feasible and more almost half of those who receive it can be successfully weaned without the need for mechanical ventilation

Risk factors for Coronavirus disease 2019 (Covid-19) death in a population cohort study from the Western Cape province, South Africa

Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown. We conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector “active patients” (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates.Among 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70–2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81–4.04] and 1.51 [95% CI, 1.18–1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96–2.86); population attributable fraction 8.5% (95% CI, 6.1–11.1)

Deep image and video compression

Thesis (MEng)--Stellenbosch University, 2020.ENGLISH ABSTRACT: Forecasts indicate that video will make up 82% of all Internet traffic by 2022. Advancing video compression efficiency will play a crucial role in curbing high bitrates and mitigating excessive bandwidth consumption. To this end, recent deep learning models are emerging as likely successors to hand-tuned standard video codecs. Our goal is to further refine the compression quality of existing video codecs by improving their ability to predict video content. We subdivide video compression into two focus areas: 1. Still image compression of video frames, for which we propose the Binary Inpainting Network (BINet). 2. Motion compression in video, for which we learn binary motion codes (P-FrameNet and B-FrameNet). With BINet we learn to inpaint an image patch from the binary codes of its nearest neighbours to better compress a still image or single video frame (intra-frame compression). We adapt BINet to perform inter-frame prediction with P-FrameNet and B-FrameNet by learning binary motion codes that compensate for the relative displacement undergone by objects in a video sequence across time. Within the context of video compression our prediction methods are, to the best of our knowledge, the first fully parallelisable means of video intra-frame and inter-frame prediction. We show how inclusion of the BINet framework improves the intra-frame compression of a competitive deep image codec across a range of bitrates such that it outperforms the standard image codec JPEG. Experiments also highlight that its full-context patch inpaitings are of a higher quality than those sequentially predicted by the standard image codec WebP. In terms of inter-frame video prediction, we show that our learned binary motion codes describe more complex motion than the block-based optical flow algorithms employed by the standard video codecs: H.264 and H.265. This indicates that the BINet and our learned binary motion codes could be valuable extensions to existing video codecs, specifically in improving their intra-frame and inter-frame compression capabilities.AFRIKAANSE OPSOMMING: Voorspellings dui daarop dat video teen 2022, 82% van alle internetverkeer sal uitmaak. Die bevordering van videokompressie doeltreffenheid sal ’n belangrike rol speel in die bekamping van hoë bitrates en die vermindering van buitensporige bandwydte verbruik. Met die oog hierop verskyn die onlangse diepleermodelle as waarskynlike opvolgers vir die standaard handgestemde videokodekse. Ons doel is om die kompressiekwaliteit van bestaande videokodekse verder te verfyn deur hul vermoë om video-inhoud te voorspel, te verbeter. Ons verdeel videokompressie in twee fokusareas: 1. Stilbeeldkompressie van videorame, waarvoor ons die ‘Binary Inpainting Network’ (BINet) voorstel. 2. Bewegingskompressie in video, waarvoor ons binêre bewegingskodes leer (P-FrameNet and B-FrameNet). Deur die gebruik van BINet, leer ons om ’n beeldpatroon uit die binêre kodes van sy naaste bure te ‘inpaint’ om ’n enkele videoraam (kompressie binne raam) beter saam te druk. Ons pas BINet aan om interraamvoorspellings uit te voer met P-FrameNet en B-FrameNet deur binêre bewegings kodes te leer wat kompenseer vir die relatiewe verplasing wat deur voorwerpe in ’n videosekwensie oor tyd heen ondergaan word. BINet is binne die konteks van videokompressie, na die beste van ons wete, die eerste volledige parallelle middle van voorspelling van videorame. Ons bewys hoe die insluiting van die BINet-raamwerk die kompressie binne die raam van ’n mededingende diepbeeldkodek oor ’n reeks bitrates verbeter sodat dit die standaard-beeldkodek JPEG oortref. Eksperimente beklemtoon ook dat die volledige konteks van kol ‘inpaintings’ van hoër gehalte is as dié wat opeenvolgend voorspel word deur die standaard-beeldkodek WebP. In terme van voorspelling tussen raamwerke, toon ons aan dat ons aangeleerde binêre bewegingskodes meer ingewikkelde beweging beskryf as die blokgebaseerde optiese vloeialgoritmes wat gebruik word deur die standaard-videokodekse: H.264 en H.265. Dit dui daarop dat die BINet en ons aangeleerde binêre bewegingskodes waardevolle uitbreidings vir bestaande videokodekse kan wees, veral om hul binne-raam en interraam kompressievermoe te verbeter.Master

Radiological spectrum of metastasis to the oral and maxillofacial region

OBJECTIVE : Oral and maxillofacial metastasis may be the first indication of an undiscovered malignancy in a significant number of cases. Therefore, the rationale of this article is to highlight the clinical and radiological presentation of metastatic lesions involving the oral and maxillofacial region. This will serve as a reference for clinicians, who may first encounter patients with possible metastatic lesions in this region. METHODS : Histologically confirmed cases of oral and maxillofacial metastasis were retrospectively reviewed over a 30-year period. Twenty-three patients were included in the study. The following clinical information was reviewed: age at diagnosis, gender, medical history, main complaint, site of metastatic tumour, radiological features, preliminary clinical diagnosis and final histological diagnosis. RESULTS : Females were twice as commonly affected, with metastatic lesions three times more likely to occur in the mandible. Common clinical presentations included swelling, pain and paraesthesia, with non-specific dental-related symptoms occurring in a few cases. Fifteen cases presented radiologically with an osteolytic lesion with poorly demarcated margins. Four cases presented with well demarcated lesions with additional signs of destruction. Additionally, four cases showed an osteogenic radiological appearance. In the current population sample, metastasis to the oral and maxillofacial region most commonly originated from the breast. CONCLUSION : Lesions with poorly demarcated margins with cortical destruction, accompanied by clinical signs of swelling, pain and paraesthesia in the absence of any inflammatory process, should raise suspicion for metastasis. Considering the poor prognosis of these metastatic lesions, the responsibility lies with the clinician to identify these lesions and make appropriate referrals.http://link.springer.com/journal/11282hj2022Oral Pathology and Oral Biolog

The utility of high-flow nasal cannula oxygen therapy in the management of respiratory failure secondary to COVID-19 pneumonia

CITATION: Lalla, U. et al. 2020. The utility of high-flow nasal cannula oxygen therapy in the management of respiratory failure secondary to COVID-19 pneumonia. South African Medical Journal, 110(6):3, doi:10.7196/SAMJ.2020.v110i6.14882.The original publication is available at http://www.samj.org.zaCOVID-19 is a potentially fatal infection caused by SARS-CoV-2.[1] As of 4 May 2020, more than 6 000 cases had been confirmed in South Africa (SA) with numbers rising steadily, a situation that will place a major strain on the country’s health resources, including its ability to provide intensive care and ventilatory support to patients with severe disease.http://www.samj.org.za/index.php/samj/article/view/12941Publisher's versio

Clinical characteristics associated with mortality of COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa.

BackgroundOver 130 million people have been diagnosed with Coronavirus disease 2019 (COVID-19), and more than one million fatalities have been reported worldwide. South Africa is unique in having a quadruple disease burden of type 2 diabetes, hypertension, human immunodeficiency virus (HIV) and tuberculosis, making COVID-19-related mortality of particular interest in the country. The aim of this study was to investigate the clinical characteristics and associated mortality of COVID-19 patients admitted to an intensive care unit (ICU) in a South African setting.Methods and findingsWe performed a prospective observational study of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection admitted to the ICU of a South African tertiary hospital in Cape Town. The mortality and discharge rates were the primary outcomes. Demographic, clinical and laboratory data were analysed, and multivariable robust Poisson regression model was used to identify risk factors for mortality. Furthermore, Cox proportional hazards regression model was performed to assess the association between time to death and the predictor variables. Factors associated with death (time to death) at p-value ConclusionsIn this study, the mortality rate in COVID-19 patients admitted to the ICU was high. Older age, the need for invasive mechanical ventilation, HIV status, and metabolic acidosis were found to be significant predictors of mortality in patients admitted to the ICU