THE THERAPEUTIC USE OF ADULT AUTOLOGOUS BONE MARROW DERIVED CELLS IN ISCHAEMIC CARDIOMYOPATHY

The effect of combined cytokine and cell therapy in ischaemic cardiomyopathy is unclear. Meta-analyses suggest improved cardiac function with cell therapy. The optimal cell delivery route remains unclear. The mechanism of effect on cardiac function with cell therapy remains to be elucidated. This thesis aims to address these unanswered questions. Chapter 1 introduces cell therapy in ischaemic cardiomyopathy. Chapter 2 details the methods. This thesis can be divided into three projects. The first project investigates whether granulocyte-colony stimulating factor (G-CSF) alone or in combination with intracoronary (IC) or intramyocardial (IM) injection of autologous bone marrow-derived cells (BMC) improves cardiac function as well as functional and biochemical parameters in patients with ischaemic cardiomyopathy. Chapter 3 details the results of the study which suggests an improvement in cardiac function, patient functional characteristics and biochemical parameters in patients who received IM BMC therapy along with G-CSF. The second and third projects assess the mechanisms by which improvements in cardiac function and/or symptoms may have occurred. The second study looked at the association between various pro- and anti-inflammatory cytokines as well as pro-angiogenic cytokines with G-CSF/cell therapy. Chapter 4 details the results of the cytokine sub-study. Important signals were observed including a reduction in certain pro-inflammatory cytokines (e.g. MCP-1, IL-8 and IL-1b) and an increase in the pro-angiogenic cytokine VEGF in the group with a significant improvement in cardiac function at 1 year i.e. the IM BMC group. The third project (chapter 5) looked at myocardial scar, diastolic function and cell characteristics in relation to G-CSF/cell therapy and cardiac function. The results highlighted important correlations including a significant association between colony-forming unit granulocyte-macrophage counts and improvement in cardiac function in the IM BMC group. Lastly, in chapter 6, I discuss the findings and the implications of the research in everyday practice

Insider risk profile matrix to quantify risk value of insider threat prediction framework

An insider threat refers to the threat arising from an individual inside an organization that maliciously leverages his or her system privileges, and closeness and proximity in a computerized environment to compromise valuable information and inflict harm. This scenario is an example of system violation that decreases the degree of system trustworthiness. Most cases of system trustworthiness use a peer judgment formulation, which may involve bias sentiments towards document sensitivity values. Moreover, audit trails of risky document navigation paths are important as an alarm to indicate any violation. Therefore, this study presents a combination of the trust criteria and document sensitivity level of an insider to obtain a risk value, which will be used to predict the occurrence of an insider threat. This study begins by investigating the prominent attributes of insiders with a focus on their degree of experience and skill in line with system trust. Subsequently, these prominent attributes are used to construct an insider Trust Profile Matrix (TPM). From the TPM, the trust value is calculated and combined with the sensitivity value of each document to produce a Risk Matrix (RM). As a result, (i) risk value and (ii) prediction rate and risky path are then calculated and analyzed using an Insider Threat Prediction Framework as an alarm for violation occurrence

Insider risk profile matrix to quantify risk value of insider threat prediction framework

An insider threat refers to the threat arising from an individual inside an organization that maliciously leverages his or her system privileges, and closeness and proximity in a computerized environment to compromise valuable information and inflict harm. This scenario is an example of system violation that decreases the degree of system trustworthiness. Most cases of system trustworthiness use a peer judgment formulation, which may involve bias sentiments towards document sensitivity values. Moreover, audit trails of risky document navigation paths are important as an alarm to indicate any violation. Therefore, this study presents a combination of the trust criteria and document sensitivity level of an insider to obtain a risk value, which will be used to predict the occurrence of an insider threat. This study begins by investigating the prominent attributes of insiders with a focus on their degree of experience and skill in line with system trust. Subsequently, these prominent attributes are used to construct an insider Trust Profile Matrix (TPM). From the TPM, the trust value is calculated and combined with the sensitivity value of each document to produce a Risk Matrix (RM). As a result, (i) risk value and (ii) prediction rate and risky path are then calculated and analyzed using an Insider Threat Prediction Framework as an alarm for violation occurrence

Systematic analysis of disease-specific immunological signatures in patients with febrile illness from Saudi Arabia

10.1002/cti2.1163Clinical and Translational Immunology98e116

Thiazolidinone Steroids Impregnated Polyurethane Foams as a Solid Phase Extractant for the Extraction and Preconcentration of Cadmium(II) from Industrial Wastewater

Abstract: Two new thiazolidinone steroids namely sulfadiazino-imino-steroid (I) and 3-sulfonamoyl-phenyl-spiro[4-oxo-thiazolidin-2, 2`steroid] (II) were prepared and characterized from their molecular weight determination and spectroscopic measurements. Compound II were physically immobilized onto polyurethane foams (PUFs) for the preconcentration of cadmium(II) from acidic aqueous media containing iodide ions. The kinetics of the retention step of cadmium(II) from aqueous solutions by compound II treated PUFs was studied. Particle diffusion was the most probable operating mechanism and did not control the kinetics of cadmium(II) retention by compound II immobilized PUFs. A preconcentration / separation procedure is presented for the solid phase extraction of trace cadmium(II) from aqueous media as its ternary complex ion associate with compound II in industrial wastewater samples onto compound II treated PUFs prior to determination by flame atomic absorption spectrometry (FAAS). Compound II treated PUFs sorbent was successfully packed in glass column for complete extraction and / or determination of trace concentrations of cadmium(II) in wastewater samples with satisfactory recovery (95 ±2.6). The cyclic voltammetry of compound II showed two well defined irreversible redox couples and suggested its possible use as complexing agent in stripping voltammetric determination of trace concentrations of toxic metal ions in wastewater

Global burden of human brucellosis : a systematic review of disease frequency

BACKGROUND: This report presents a systematic review of scientific literature published between 1990-2010 relating to the frequency of human brucellosis, commissioned by WHO. The objectives were to identify high quality disease incidence data to complement existing knowledge of the global disease burden and, ultimately, to contribute towards the calculation of a Disability-Adjusted Life Years (DALY) estimate for brucellosis.METHODS/PRINCIPAL FINDINGS: Thirty three databases were searched, identifying 2,385 articles relating to human brucellosis. Based on strict screening criteria, 60 studies were selected for quality assessment, of which only 29 were of sufficient quality for data analysis. Data were only available from 15 countries in the regions of Northern Africa and Middle East, Western Europe, Central and South America, Sub-Saharan Africa, and Central Asia. Half of the studies presented incidence data, six of which were longitudinal prospective studies, and half presented seroprevalence data which were converted to incidence rates. Brucellosis incidence varied widely between, and within, countries. Although study biases cannot be ruled out, demographic, occupational, and socioeconomic factors likely play a role. Aggregated data at national or regional levels do not capture these complexities of disease dynamics and, consequently, at-risk populations or areas may be overlooked. In many brucellosis-endemic countries, health systems are weak and passively-acquired official data underestimate the true disease burden.CONCLUSIONS: High quality research is essential for an accurate assessment of disease burden, particularly in Eastern Europe, the Asia-Pacific, Central and South America and Africa where data are lacking. Providing formal epidemiological and statistical training to researchers is essential for improving study quality. An integrated approach to disease surveillance involving both human health and veterinary services would allow a better understand of disease dynamics at the animal-human interface, as well as a more cost-effective utilisation of resources

A Case Series of Severe Hospitalized COVID-19 Patients Treated with Tocilizumab and Glucocorticoids: A Report from Saudi Arabian Hospital

Background: The clinical spectrum of COVID-19 is variable and ranges from asymptomatic, mildly symptomatic, moderately severe and severe disease. A small proportion might develop severe disease and may have cytokine storm. One of the therapeutic options to treat such cases is Tocilizumab (TCZ). In this study, we present cases of severe COVID-19 treated with TCZ and glucocorticoids and discuss the treatment responses. Methods: This is a retrospective observational study of severe COVID-19 cases treated with TCZ and glucocorticoids. The case series examined the characteristics and outcome of those patients. Results: This study included 40 Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) confirmed patients who received TCZ and glucocorticoids. The mean age of the included patients was 57.55 (±Standard deviation 12.86) years. There were 34 (85%) males, 19 (47.5%) were obese (BMI >30), 13 (32.5%) over weight, and five (12.5%) normal weight. The mean days from positive SARS-CoV-2 polymerase chain reaction (PCR) test to admission was 1.641 (±3.2) days. Of the patients, 18 (45%) had diabetes mellitus, 14 (35%) had hypertension. The mean days from hospital admission to ICU was 1.8 (±2.6), 20 (50%) required mechanical ventilation, 39 (97.5%) had received prone position, seven (17.5%) had renal replacement therapy, 13 (32.5%) required inotropes, four (10%) had plasmapheresis, one (2.5%) had intravenous immunoglobulin, all patients received steroid therapy, and the majority 31 (77.5%) did not receive any anti-viral therapy. Of all the patients, six (15%) died, 28 (70%) were discharged and six (15%) were still in hospital. Conclusion: The overall mortality rate was lower than those cited in meta-analysis. As our understanding of the COVID-19 continues, the approach and therapeutics are also evolving

Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations

Abstract Health care-associated infections (HAI) are a major public health problem with a significant impact on morbidity, mortality and quality of life. They represent also an important economic burden to health systems worldwide. However, a large proportion of HAI are preventable through effective infection prevention and control (IPC) measures. Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage. Given the limited availability of IPC evidence-based guidance and standards, the World Health Organization (WHO) decided to prioritize the development of global recommendations on the core components of effective IPC programmes both at the national and acute health care facility level, based on systematic literature reviews and expert consensus. The aim of the guideline development process was to identify the evidence and evaluate its quality, consider patient values and preferences, resource implications, and the feasibility and acceptability of the recommendations. As a result, 11 recommendations and three good practice statements are presented here, including a summary of the supporting evidence, and form the substance of a new WHO IPC guideline

Tuberculosis Trends in Saudis and Non-Saudis in the Kingdom of Saudi Arabia – A 10 Year Retrospective Study (2000–2009)

Tuberculosis (TB) remains a public health problem in the Kingdom of Saudi Arabia (KSA), which has a very large labour force from high TB endemic countries. Understanding the epidemiological and clinical features of the TB problem, and the TB burden in the immigrant workforce, is necessary for improved planning and implementation of TB services and prevention measures