ISOLATION AND CHARACTERISATION OF CELLULOLYTIC AND PECTOL YTIC MICROORGANISMS FROM NATURALLY DEGRADING SOLID WASTES

Cc llulolyuc microorganisms were isolated Irorn natural compos! heaps. using differentmedia such as Duboos cellulose. cellulose mineral salt. cellulose agar. cellulose dextrinagar which contain cellulose as the only carbon source. Using pectin agar medium. whichcontained pectin as the only carbon source. pcctolytic microorganisms were isolatCellulolytic fungal genera isolated were Hehninthosporium sp.. A.lpergi//lls sp ..Cc plu dosporinnr sp. and Gliocladiiun sp. There were only cellulolytic acunomycctcs(Sfc/Jfo/l/\"ces sp.) and one cellulolytic bacterium. Pcctolytic microorganisms isolated werespecies of Aspergillus. Penirilliu,n. Mucor. Yeast and a pcctolytic bacterium. Cellulolyticand pcciolytic enzyme activities of isolated microorganisms were determined using cottonwool, carboxymethyl cellulose (CMC) and pectin as substrates. Sugar produced bydegradation of substrates were determined by Somogyi-Ncfson micro method. Highestcotton wool degrading activity and CMCase activity were obtained from Gram negativeshort rod bacterium (X.X99x 10' units of enzyme/Sml and 1.2X92 units of enzyme/Smlrespectively). Highest pectinase activity was obtained from Penicillium sp. (ii ) «J.OI36 unitsof enzyme/Sml).All isolated cellulolytic microorganisms showed high growth rate at 30 and 3S()C while mostpcciolyric microorganisms showed high growth rate at 3S()C. Except for species ofGliocladiun: other cellulolytic microorganisms showed high growth rate at acidic pH range(pl-l 4.Sl. Among pcctolytic microorganisms Penicillium sp. (I) and Aspergillus nigershowed high growth rates at pH 5.5. But Penicillium sp. (ii ) and Aspergiltus sp . (ii) showedhigh growth rates at pH 6.5.It was clear that these microorganisms have the ability to degrade complex cellulose andpectin molecules to simple compounds but it may not he economical as they showedrelatively low capacity. However it would be possible to develop a microbial mixture. usingabove types of native microorganisms that may have a high potential for degradation ofsolid wastes

SOME STUDIES ON THE DIVERSITY AND DISTRIBUTION OF LICHENS ON RITIGALA MOUNTAIN

Studies on lichens at Ritigala Mountain revealed that a marked variation exists inthe distribution and diversity of lichens with change in elevation. Light andmoisture are two main environmental factors that changed the microclimate,which in turn determine the distribution of lichens at different elevations. Most ofthe lichens recorded on the barks of trees and rocks at lower elevation belonged togenera such as Dirinaria, Graphis, Parmelia, Psyxine, Pyremula and Parmotrentaand, Leptogium. At mid elevation (i.e. between 400 - 500m contour line)diversity and distribution found to be much different from those at lowerelevations. Crustoses such as species of Myreotrema, Thelotrema, Porina,Phyllospora, Ocellularia and several sterile ones were found on tree trunks androcks. However, the lichen diversity of the crowns of trees at mid elevation seemsto be somewhat similar to that at lower elevation although tree species aredifferent. At mid elevation, tree trunks get only diffused light while the canopygets more direct light. The difference in distribution and diversity observed onbarks could mainly be due light condition prevailing at mid elevations.At elevations above 600m, genera observed were very much different to thosefound at lower levations. Commonest genera recorded were Heterodeeermia,Pseudocyphellaria, Sticta, Collema, Leptogium and Parmelia. At higherelevations, it is cool but sunny during the day while nights are cooler and wet dueto mist. Thus. differences observed with respect to lichen diversity could be dueto the difference in microclimate that prevails at higher elevations.Air quality studies indicated that air pollution due S02 is minimal in this area.Thisresearch reveals that Mount Ritigala supports extremely interesting and diverselichen community which has not yet been explored fully yet. Similar to vascularplants, lichens show a marked zonation in the distribution of various species. Thiscould be mainly due to differences in the microclimate at different attitudes. Aslichens are sensitive to changes in the microclimate (specially with respect to airpollutants) it is important that the prevailing conditions are maintained. Anyactivities that lead to severe atmospheric pollution may cause significant changesin the existing lichen diversity.

ABPI against Colour Duplex Scan: A Screening Tool for Detection of Peripheral Arterial Disease in Low Resource Setting Approach to Validation

Background. In Sri Lanka the ABPI has not been used as a screening tool to detect peripheral arterial disease (PAD) in epidemiological studies. This study was conducted to determine the best cutoff value of ABPI to detect PAD in Sri Lankan population. Methods. The ABPI measured by arterial Doppler to detect PAD was validated against colour duplex scan as the criterion using 165 individuals referred to vascular laboratory, National Hospital Sri Lanka. In all selected individuals ABPI was measured and lower limb colour duplex scan was performed. Narrowing of luminal diameter of lower limb arteries 50% or more was considered as haemodynamically significant and having PAD. The discriminative performance of the ABPI was assessed using Receiver Operator Characteristic (ROC) curve and calculating the area under the curve (AUC). The sensitivity and specificity of different threshold levels of ABPI and the best cutoff value of ABPI to detect PAD were determined. Results. ABPI 0.89 was determined as the best cutoff value to identify individuals with PAD. At this level of ABPI high sensitivity (87%), specificity (99.1%), positive predictive value (98.9%), and negative predictive value (88.4%) were observed. Conclusion. ABPI ≤ 0.89 could be used as the best cut off value to detect PAD

A core outcome set for trials in miscarriage management and prevention: an international consensus development study.

OBJECTIVE: To develop core outcome sets (COS) for miscarriage management and prevention. DESIGN: Modified Delphi survey combined with a consensus development meeting. SETTING: International. POPULATION: Stakeholder groups included healthcare providers, international experts, researchers, charities and couples with lived experience of miscarriage from 15 countries: 129 stakeholders for miscarriage management and 437 for miscarriage prevention. METHODS: Modified Delphi method and modified nominal group technique. RESULTS: The final COS for miscarriage management comprises six outcomes: efficacy of treatment, heavy vaginal bleeding, pelvic infection, maternal death, treatment or procedure-related complications, and patient satisfaction. The final COS for miscarriage prevention comprises 12 outcomes: pregnancy loss <24 weeks' gestation, live birth, gestation at birth, pre-term birth, congenital abnormalities, fetal growth restriction, maternal (antenatal) complications, compliance with intervention, patient satisfaction, maternal hospitalisation, neonatal or infant hospitalisation, and neonatal or infant death. Other outcomes identified as important were mental health-related outcomes, future fertility and health economic outcomes. CONCLUSIONS: This study has developed two core outcome sets, through robust methodology, that should be implemented across future randomised trials and systematic reviews in miscarriage management and prevention. This work will help to standardise outcome selection, collection and reporting, and improve the quality and safety of future studies in miscarriage

Vascular endothelial growth factor-A165b is protective and restores endothelial glycocalyx in diabetic nephropathy

Diabetic nephropathy is the leading cause of ESRD in high-income countries and a growing problem across the world. Vascular endothelial growth factor-A (VEGF-A) is thought to be a critical mediator of vascular dysfunction in diabetic nephropathy, yet VEGF-A knockout and overexpression of angiogenic VEGF-A isoforms each worsen diabetic nephropathy. We examined the vasculoprotective effects of the VEGF-A isoform VEGF-A165b in diabetic nephropathy. Renal expression of VEGF-A165b mRNA was upregulated in diabetic individuals with well preserved kidney function, but not in those with progressive disease. Reproducing this VEGF-A165b upregulation in mouse podocytes in vivo prevented functional and histologic abnormalities in diabetic nephropathy. Biweekly systemic injections of recombinant human VEGF-A165b reduced features of diabetic nephropathy when initiated during early or advanced nephropathy in a model of type 1 diabetes and when initiated during early nephropathy in a model of type 2 diabetes. VEGF-A165b normalized glomerular permeability through phosphorylation of VEGF receptor 2 in glomerular endothelial cells, and reversed diabetes-induced damage to the glomerular endothelial glycocalyx. VEGF-A165b also improved the permeability function of isolated diabetic human glomeruli. These results show that VEGF-A165b acts via the endothelium to protect blood vessels and ameliorate diabetic nephropathy

Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome

Study QuestionWhat is the recommended assessment and management of women with polycystic ovary syndrome (PCOS), based on the best available evidence, clinical expertise, and consumer preference? Summary AnswerInternational evidence-based guidelines including 166 recommendations and practice points, addressed prioritized questions to promote consistent, evidence-based care and improve the experience and health outcomes of women with PCOS. What is Known AlreadyPrevious guidelines either lacked rigorous evidence-based processes, did not engage consumer and international multidisciplinary perspectives, or were outdated. Diagnosis of PCOS remains controversial and assessment and management are inconsistent. The needs of women with PCOS are not being adequately met and evidence practice gaps persist. Study Design, Size, DurationInternational evidence-based guideline development engaged professional societies and consumer organizations with multidisciplinary experts and women with PCOS directly involved at all stages. Appraisal of Guidelines for Research and Evaluation (AGREE) II-compliant processes were followed, with extensive evidence synthesis. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was applied across evidence quality, feasibility, acceptability, cost, implementation and ultimately recommendation strength. Participants/Materials, Setting, MethodsGovernance included a six continent international advisory and a project board, five guideline development groups (GDGs), and consumer and translation committees. Extensive health professional and consumer engagement informed guideline scope and priorities. Engaged international society-nominated panels included pediatrics, endocrinology, gynecology, primary care, reproductive endocrinology, obstetrics, psychiatry, psychology, dietetics, exercise physiology, public health and other experts, alongside consumers, project management, evidence synthesis, and translation experts. Thirty-seven societies and organizations covering 71 countries engaged in the process. Twenty face-to-face meetings over 15months addressed 60 prioritized clinical questions involving 40 systematic and 20 narrative reviews. Evidence-based recommendations were developed and approved via consensus voting within the five guideline panels, modified based on international feedback and peer review, with final recommendations approved across all panels. Main Results and the Role of ChanceThe evidence in the assessment and management of PCOS is generally of low to moderate quality. The guideline provides 31 evidence based recommendations, 59 clinical consensus recommendations and 76 clinical practice points all related to assessment and management of PCOS. Key changes in this guideline include: (a) considerable refinement of individual diagnostic criteria with a focus on improving accuracy of diagnosis; (b) reducing unnecessary testing; (c) increasing focus on education, lifestyle modification, emotional wellbeing and quality of life; and (d) emphasizing evidence based medical therapy and cheaper and safer fertility management. Limitations, Reasons for CautionOverall evidence is generally low to moderate quality, requiring significantly greater research in this neglected, yet common condition, especially around refining specific diagnostic features in PCOS. Regional health system variation is acknowledged and a process for guideline and translation resource adaptation is provided. Wider Implications of the FindingsThe international guideline for the assessment and management of PCOS provides clinicians with clear advice on best practice based on the best available evidence, expert multidisciplinary input and consumer preferences. Research recommendations have been generated and a comprehensive multifaceted dissemination and translation program supports the guideline with an integrated evaluation program.Peer reviewe

Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome

Study Question What is the recommended assessment and management of women with polycystic ovary syndrome (PCOS), based on the best available evidence, clinical expertise, and consumer preference? Summary Answer International evidence-based guidelines including 166 recommendations and practice points, addressed prioritized questions to promote consistent, evidence-based care and improve the experience and health outcomes of women with PCOS. What Is Known Already Previous guidelines either lacked rigorous evidence-based processes, did not engage consumer and international multidisciplinary perspectives, or were outdated. Diagnosis of PCOS remains controversial and assessment and management are inconsistent. The needs of women with PCOS are not being adequately met and evidence practice gaps persist. Study Design, Size, Duration International evidence-based guideline development engaged professional societies and consumer organizations with multidisciplinary experts and women with PCOS directly involved at all stages. Appraisal of Guidelines for Research and Evaluation (AGREE) II-compliant processes were followed, with extensive evidence synthesis. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was applied across evidence quality, feasibility, acceptability, cost, implementation and ultimately recommendation strength. Participants/Materials, Setting, Methods Governance included a six continent international advisory and a project board, five guideline development groups, and consumer and translation committees. Extensive health professional and consumer engagement informed guideline scope and priorities. Engaged international society-nominated panels included pediatrics, endocrinology, gynecology, primary care, reproductive endocrinology, obstetrics, psychiatry, psychology, dietetics, exercise physiology, public health and other experts, alongside consumers, project management, evidence synthesis, and translation experts. Thirty-seven societies and organizations covering 71 countries engaged in the process. Twenty face-to-face meetings over 15 months addressed 60 prioritized clinical questions involving 40 systematic and 20 narrative reviews. Evidence-based recommendations were developed and approved via consensus voting within the five guideline panels, modified based on international feedback and peer review, with final recommendations approved across all panels. Main Results and the Role of Chance The evidence in the assessment and management of PCOS is generally of low to moderate quality. The guideline provides 31 evidence based recommendations, 59 clinical consensus recommendations and 76 clinical practice points all related to assessment and management of PCOS. Key changes in this guideline include: i) considerable refinement of individual diagnostic criteria with a focus on improving accuracy of diagnosis; ii) reducing unnecessary testing; iii) increasing focus on education, lifestyle modification, emotional wellbeing and quality of life; and iv) emphasizing evidence based medical therapy and cheaper and safer fertility management. Limitations, Reasons for Caution Overall evidence is generally low to moderate quality, requiring significantly greater research in this neglected, yet common condition, especially around refining specific diagnostic features in PCOS. Regional health system variation is acknowledged and a process for guideline and translation resource adaptation is provided. Wider Implications of the Findings The international guideline for the assessment and management of PCOS provides clinicians with clear advice on best practice based on the best available evidence, expert multidisciplinary input and consumer preferences. Research recommendations have been generated and a comprehensive multifaceted dissemination and translation program supports the guideline with an integrated evaluation program. Study Funding/Competing Interest(S) The guideline was primarily funded by the Australian National Health and Medical Research Council of Australia (NHMRC) supported by a partnership with ESHRE and the American Society for Reproductive Medicine. Guideline development group members did not receive payment. Travel expenses were covered by the sponsoring organizations. Disclosures of conflicts of interest were declared at the outset and updated throughout the guideline process, aligned with NHMRC guideline processes. Full details of conflicts declared across the guideline development groups are available at https://www.monash.edu/medicine/sphpm/mchri/pcos/guideline in the Register of disclosures of interest. Of named authors, Dr Costello has declared shares in Virtus Health and past sponsorship from Merck Serono for conference presentations. Prof. Laven declared grants from Ferring, Euroscreen and personal fees from Ferring, Euroscreen, Danone and Titus Healthcare. Prof. Norman has declared a minor shareholder interest in an IVF unit. The remaining authors have no conflicts of interest to declare. The guideline was peer reviewed by special interest groups across our partner and collaborating societies and consumer organizations, was independently assessed against AGREEII criteria and underwent methodological review. This guideline was approved by all members of the guideline development groups and was submitted for final approval by the NHMRC

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Hot temperatures can force delayed mosquito outbreaks via sequential changes in Aedes aegypti demographic parameters in autocorrelated environments

Aedes aegypti L. (Diptera: Culicidae) is a common pantropical urban mosquito, vector of dengue, Yellow Fever and chikungunya viruses. Studies have shown Ae. aegypti abundance to be associated with environmental fluctuations, revealing patterns such as the occurrence of delayed mosquito outbreaks, i.e., sudden extraordinary increases in mosquito abundance following transient extreme high temperatures. Here, we use a two-stage (larvae and adults) matrix model to propose a mechanism for environmental signal canalization into demographic parameters of Ae. aegypti that could explain delayed high temperature induced mosquito outbreaks. We performed model simulations using parameters estimated from a weekly time series from Thailand, assuming either independent or autocorrelated environments. For autocorrelated environments, we found that long delays in the association between the onset of "hot" environments and mosquito outbreaks (10 weeks, as observed in Thailand) can be generated when "hot" environments sequentially trigger a larval survival decrease and over-compensatory fecundity increase, which lasts for the whole "hot" period, in conjunction with a larval survival increase followed by a fecundity decrease when the environment returns to "normal". This result was not observed for independent environments. Finally, we discuss our results implications for prospective entomological research and vector management under changing environments