Pathological and physiological studies on the brown rot fungus Monilinia fructicola (Winter) Honey

Call number: LD2668 .T4 1965 E52Master of Scienc

Proximate Composition, Mineral Content and Secondary Metabolites of Three Medicinal Wild Fagonia Species

Proximate composition of the aerial parts of three Fagonia species (Fagonia arabica L., F. mollis Delile and F. cretica L.) collected from different habitats were analyzed. Macro- and micro-elements as well as some secondary metabolites were estimated. The obtained results revealed that F. creticus contains appreciable levels of nutritive components considering that its nutritional value (351.06 kcal/100g dry wt.) was remarkably higher than that of F. arabica and F. mollis (327.99 and 293.07 kcal/100g dry wt., respectively). The concentration of Na was relatively the highest among the other estimated macroelements in the studied species followed by K, Ca and Mg, respectively while Fe was the highest microelement followed by Cu, Mn and Zn, respectively. The phytochemical composition revealed that methanolic extract of F. creticus was the richest in total alkaloids and flavonoids, while F. arabica found to be the richest in total phenolics and tannins

Bioremoval capacity of phenol by some selected endophytic fungi isolated from Hibiscus sabdariffa and batch biodegradation of phenol in paper and pulp effluents

Background and Objectives: The use of endophytic fungi for management of phenol residue in paper and pulp industries has been shown as cost-effective and eco-friendly approach. In this study, isolation of endophytic fungi from roots, stems, and leaves of Hibiscus sabdariffa was conducted. Additionally, the isolated fungi were examined for their ability to degrade phenol and its derivatives in paper and pulp industrial samples, using different growth conditions. Materials and Methods: Out of 35 isolated endophyitc fungi, 31 were examined for their phenol biodegradation capacity using Czapek Dox broth medium containing Catechol and Resorcinol as a sole carbon source at final concentrations of 0.4, 0.6 and 0.8%. Results: A total of 35 fungal species belonging to 18 fungal genera were isolated and identified from different parts of H. sabdariffa plants. All strains have the capability for degrading phenol and their derivatives with variable extents. The optimum condition of degrading phenol in paper and pulp effluent samples by Fusarium poae11r7 were at pH 3-5, temperature at 28-35°C, good agitation speed at no agitation and 100 rpm. Conclusion: All endophytic fungal species can utilize phenol and its derivatives as a carbon source and be the potential to degrade phenol in industrial contaminants

Ultrasound to identify systemic lupus erythematosus patients with musculoskeletal symptoms who respond best to therapy: the US Evaluation For mUsculoskeletal Lupus longitudinal multicentre study

Abstract Objective To determine whether SLE patients with inflammatory joint symptoms and ultrasound-synovitis/tenosyovitis achieve better clinical responses to glucocorticoid compared with patients with normal scans. Secondary objectives included identification of clinical features predicting ultrasound-synovitis/tenosynovitis. Methods In a longitudinal muticentre study, SLE patients with physician-diagnosed inflammatory joint pain received intramuscular methylprednisolone 120 mg once. Clinical assessments, patient-reported outcomes, and bilateral hands/wrist ultrasound were collected at 0-, 2- and 6-weeks. The primary outcome (determined via internal pilot) was early morning stiffness visual analogue scale (EMS-VAS) at 2-weeks, adjusted for baseline, comparing patients with positive (Grey-scale ≥2 and/or Power-Doppler ≥1) and negative ultrasound. Post-hoc analyses excluded fibromyalgia. Results Of 133 patients, 78 had positive ultrasound. Only 53/78 (68%) of these had ≥1 swollen joint. Of 66/133 patients with ≥1 swollen joint, 20% had negative ultrasound. Positive ultrasound was associated with joint swelling, symmetrical small joint distribution and serology. The primary end point was not met: in the full analysis set (n = 133) there was no difference in baseline-adjusted EMS-VAS at week-2 (-7.7 mm 95% CI -19.0 mm, 3.5 mm, p= 0.178). After excluding 32 patients with fibromyalgia, response was significantly better in patients with positive ultrasound at baseline (baseline-adjusted EMS-VAS at 2-weeks -12.1 mm, 95% CI -22.2 mm, -0.1 mm, p= 0.049). This difference was greater when adjusted for treatment (-12.8 mm (95% CI -22mm, -3mm), p= 0.007). BILAG and SLEDAI responses were higher in ultrasound-positive patients. Conclusions In SLE patients without fibromyalgia, those with positive ultrasound had better clinical response to therapy. Imaging-detected synovitis/tenosynovitis may be considered to decide on therapy and enrich clinical trials

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Stratification of biological therapies by pathobiology in biologic-naive patients with rheumatoid arthritis (STRAP and STRAP-EU): two parallel, open-label, biopsy-driven, randomised trials

Background Despite highly effective targeted therapies for rheumatoid arthritis, about 40% of patients respond poorly, and predictive biomarkers for treatment choices are lacking. We did a biopsy-driven trial to compare the response to rituximab, etanercept, and tocilizumab in biologic-naive patients with rheumatoid arthritis stratified for synovial B cell status. Methods STRAP and STRAP-EU were two parallel, open-label, biopsy-driven, stratified, randomised, phase 3 trials done across 26 university centres in the UK and Europe. Biologic-naive patients aged 18 years or older with rheumatoid arthritis based on American College of Rheumatology (ACR)–European League Against Rheumatism classification criteria and an inadequate response to conventional synthetic disease-modifying antirheumatic drugs (DMARDs) were included. Following ultrasound-guided synovial biopsy, patients were classified as B cell poor or B cell rich according to synovial B cell signatures and randomly assigned (1:1:1) to intravenous rituximab (1000 mg at week 0 and week 2), subcutaneous tocilizumab (162 mg per week), or subcutaneous etanercept (50 mg per week). The primary outcome was the 16-week ACR20 response in the B cell-poor, intention-to-treat population (defined as all randomly assigned patients), with data pooled from the two trials, comparing etanercept and tocilizumab (grouped) versus rituximab. Safety was assessed in all patients who received at least one dose of study drug. These trials are registered with the EU Clinical Trials Register, 2014-003529-16 (STRAP) and 2017-004079-30 (STRAP-EU). Findings Between June 8, 2015, and July 4, 2019, 226 patients were randomly assigned to etanercept (n=73), tocilizumab (n=74), and rituximab (n=79). Three patients (one in each group) were excluded after randomisation because they received parenteral steroids in the 4 weeks before recruitment. 168 (75%) of 223 patients in the intention-to-treat population were women and 170 (76%) were White. In the B cell-poor population, ACR20 response at 16 weeks (primary endpoint) showed no significant differences between etanercept and tocilizumab grouped together and rituximab (46 [60%] of 77 patients vs 26 [59%] of 44; odds ratio 1·02 [95% CI 0·47–2·17], p=0·97). No differences were observed for adverse events, including serious adverse events, which occurred in six (6%) of 102 patients in the rituximab group, nine (6%) of 108 patients in the etanercept group, and three (4%) of 73 patients in the tocilizumab group (p=0·53). Interpretation In this biologic-naive population of patients with rheumatoid arthrtitis, the dichotomic classification into synovial B cell poor versus rich did not predict treatment response to B cell depletion with rituximab compared with alternative treatment strategies. However, the lack of response to rituximab in patients with a pauci-immune pathotype and the higher risk of structural damage progression in B cell-rich patients treated with rituximab warrant further investigations into the ability of synovial tissue analyses to inform disease pathogenesis and treatment response

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Diversion detection and localization in small HDPE pipes using guided-wave ultrasound and deep learning techniques

This thesis presents a comprehensive study on the use of advanced techniques for detecting and accurately locating diversions in small-diameter High Density Polyethylene (HDPE) pipes. The integrity of pipelines is critical for the safe and efficient transportation of fluids and gas, and the early detection of defects and unauthorized diversions is crucial for preventing environmental damage and economic losses. A novel technique is proposed in this thesis, which is based on the transmission of a specifically designed signal through the pipe using a custom-designed array of ultrasonic piezoelectric transmitters and receivers. The goal of this technique is to generate an estimate of the pipe channel characteristics, which can then be used for defect detection and localization. The proposed technique combines ultrasonic guided waves, channel estimation, and deep learning to detect and localize defects in HDPE pipes. The first stage uses a supervised learning technique, a CNN-LSTM based architecture, for diversion detection. The second stage extends the first work by proposing an semi-supervised learning technique that incorporates a transformer-based autoencoder as an anomaly detection algorithm, which is utilized to detect diversions as anomalies. Finally, we propose a transformerbased encoder for diversion localization, which allows us to accurately locate the diversions with high accuracy and low mean absolute error. The results of our simulations and experiments demonstrate the superiority of the proposed method over the state-of-the-art techniques and its ability to detect diverisions and localize them with high accuracy. The proposed technique is cost-effective and reliable and has the potential to be applied to real-world systems.Applied Science, Faculty ofEngineering, School of (Okanagan)Graduat

Potential use of Brain Natriuretic Peptide in patients with asymptomatic significant mitral stenosis

Objective: To evaluate the ability of BNP to identify a subset of patients with asymptomatic significant rheumatic MS, who get symptoms on stress exercise testing. Methods: Seventy asymptomatic patients with significant rheumatic MS (MVA ⩽1.5 cm2) were included in the study. All patients underwent resting echo-Doppler study, exercise echocardiography and BNP level assessment pre- and one week post-balloon dilatation (for group I patients who had PMC). Patients were divided into two groups. Group I included 33 patients who became symptomatic on exercise and had low exercise capacity. Group II included 37 patients who were asymptomatic on exercise and had reasonable exercise capacity. Results: BNP level in group I was 92 ± 12 compared to 40 ± 10 pg/ml in group II, P < 0.001. Post PMC, BNP in group I significantly decreased (92 ± 12, compared to 31 ± 9 pg/dl, P < 0.001). LA dimension was significantly different between both groups (50 ± 2.9 in group I compared to 46 ± 3.1 mm in group II, P < 0.001). Post-exercise SPAP was 72 ± 12 in group I compared to 46 ± 13 mmHg in group II, P < 0.001. Post-exercise MV gradient was 28 ± 9 compared to 20 ± 12 mmHg, P = 0.002. BNP significantly correlated with post-exercise SPAP (r = 0.635; P < 0.001). Area under the ROC curve for BNP as a predictor of low exercise capacity and development of symptoms on exercise was 0.98 [CI 95% 0.96–1.0]. When using a cutoff value of 55 pg/mL for BNP, sensitivity was 93.9% and specificity was 91.9%. Conclusion: BNP may be used to approach asymptomatic patients with significant MS. BNP may identify a subset of patients with exercise-induced clinical and echo-Doppler criteria that meet the contemporary guidelines for intervention

Confounding factors in musculoskeletal ultrasound

Musculoskeletal ultrasound (US) is an imaging modality with the potential to revolutionise the way we practise rheumatology. Ultrasound has been shown to be more sensitive and valid when compared to conventional imaging methods and clinical examination in the assessment of inflammatory arthropathies (lA). However, major limitations to its widespread use have been its perceived poor reliability and unknown diagnostic discriminative ability. Image acquisition is a key point for improving reliability. A systematic literature review was performed and a survey of experts was obtained in order to understand the important confounding factors in image acquisition. The effect of two of these factors on synovitis detection was then examined. Non-steroidal anti-inflammatory drugs (NSAIDs) usage was found to significantly mask both grey scale (GS) and power Doppler (PD) signal and resultedinlower assessment of disease activity. Change in the joint position during scanning was found to significantly alter US findings in patients with lA. Scanning the hands in a flat position and the knees in a 30° position provided the highest GS and PD scores suggesting that they may be the optimal scanning positions. The ability of US to discriminate rheumatoid arthritis (RA) from other diseases by detecting bone erosions was explored by examining the specificity of US detected bone erosion. The overall presence of US detected erosions was not a specific fmding for RA. However, erosions in certain anatomical sites were specific for RA. In conclusion, this thesis has demonstrated that certain factors. including concurrent NSAID intake and joint position can affect US image acquisition. Ultrasound does / IV have the ability to discriminate RA from other diseases by specifically detecting bone erosions in target joints. Standardisation of the US confounding factors and better understanding of the specificity of common US findings may enhance the role of US in the assessment of IA.EThOS - Electronic Theses Online ServiceGBUnited Kingdo