40 research outputs found

    Classification Terminology and Definitions in Reporting of MRI in Axial Spondyloarthritis

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    Spondyloarthritis (SpA) is a group of chronic inflammatory conditions which severely impact quality of life. Several criteria have been developed in the past to aid the diagnosis of SpA based on symptoms and radiographic changes during the course of the disease. However, it takes several years before structural changes manifest on conventional radiographs, leading to a diagnostic delay of 6 to 10 years. The use of MRI and its incorporation into the Assessment of Spondyloarthritis (ASAS) criteria, has radically changed the diagnosis of SpA in the last decade by allowing visualisation of both active and chronic inflammatory changes and enabling clinicians to recognise SpA during it’s early stage and initiate treatment. An understanding of the various terminology used in the divisions of disease presentations and their relevant imaging findings are key, along with the use of clear definitions of structural and inflammatory changes on MRI, in ensuring accurate diagnosis and classification of SpA

    Rheumatology training experience across Europe : Analysis of core competences

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    Publisher Copyright: © 2016 The Author(s). Copyright: Copyright 2019 Elsevier B.V., All rights reserved.Background: The aim of this project was to analyze and compare the educational experience in rheumatology specialty training programs across European countries, with a focus on self-reported ability. Method: An electronic survey was designed to assess the training experience in terms of self-reported ability, existence of formal education, number of patients managed and assessments performed during rheumatology training in 21 core competences including managing specific diseases, generic competences and procedures. The target population consisted of rheumatology trainees and recently certified rheumatologists across Europe. The relationship between the country of training and the self-reported ability or training methods for each competence was analyzed through linear or logistic regression, as appropriate. Results: In total 1079 questionnaires from 41 countries were gathered. Self-reported ability was high for most competences, range 7.5-9.4 (0-10 scale) for clinical competences, 5.8-9.0 for technical procedures and 7.8-8.9 for generic competences. Competences with lower self-reported ability included managing patients with vasculitis, identifying crystals and performing an ultrasound. Between 53 and 91 % of the trainees received formal education and between 7 and 61 % of the trainees reported limited practical experience (managing ≤10 patients) in each competence. Evaluation of each competence was reported by 29-60 % of the respondents. In adjusted multivariable analysis, the country of training was associated with significant differences in self-reported ability for all individual competences. Conclusion: Even though self-reported ability is generally high, there are significant differences amongst European countries, including differences in the learning structure and assessment of competences. This suggests that educational outcomes may also differ. Efforts to promote European harmonization in rheumatology training should be encouraged and supported.publishersversionPeer reviewe

    Ethnic differences in cellular and humoral immune responses to SARS-CoV-2 vaccination in UK healthcare workers: a cross-sectional analysis

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    Background: Few studies have compared SARS-CoV-2 vaccine immunogenicity by ethnic group. We sought to establish whether cellular and humoral immune responses to SARS-CoV-2 vaccination differ according to ethnicity in UK Healthcare workers (HCWs). Methods: In this cross-sectional analysis, we used baseline data from two immunological cohort studies conducted in HCWs in Leicester, UK. Blood samples were collected between March 3, and September 16, 2021. We excluded HCW who had not received two doses of SARS-CoV-2 vaccine at the time of sampling and those who had serological evidence of previous SARS-CoV-2 infection. Outcome measures were SARS-CoV-2 spike-specific total antibody titre, neutralising antibody titre and ELISpot count. We compared our outcome measures by ethnic group using univariable (t tests and rank-sum tests depending on distribution) and multivariable (linear regression for antibody titres and negative binomial regression for ELISpot counts) tests. Multivariable analyses were adjusted for age, sex, vaccine type, length of interval between vaccine doses and time between vaccine administration and sample collection and expressed as adjusted geometric mean ratios (aGMRs) or adjusted incidence rate ratios (aIRRs). To assess differences in the early immune response to vaccination we also conducted analyses in a subcohort who provided samples between 14 and 50 days after their second dose of vaccine. Findings: The total number of HCWs in each analysis were 401 for anti-spike antibody titres, 345 for neutralising antibody titres and 191 for ELISpot. Overall, 25.4% (19.7% South Asian and 5.7% Black/Mixed/Other) were from ethnic minority groups. In analyses including the whole cohort, neutralising antibody titres were higher in South Asian HCWs than White HCWs (aGMR 1.47, 95% CI [1.06–2.06], P = 0.02) as were T cell responses to SARS-CoV-2 S1 peptides (aIRR 1.75, 95% CI [1.05–2.89], P = 0.03). In a subcohort sampled between 14 and 50 days after second vaccine dose, SARS-CoV-2 spike-specific antibody and neutralising antibody geometric mean titre (GMT) was higher in South Asian HCWs compared to White HCWs (9616 binding antibody units (BAU)/ml, 95% CI [7178–12,852] vs 5888 BAU/ml [5023–6902], P = 0.008 and 2851 95% CI [1811–4487] vs 1199 [984–1462], P < 0.001 respectively), increments which persisted after adjustment (aGMR 1.26, 95% CI [1.01–1.58], P = 0.04 and aGMR 2.01, 95% CI [1.34–3.01], P = 0.001). SARS-CoV-2 ELISpot responses to S1 and whole spike peptides (S1 + S2 response) were higher in HCWs from South Asian ethnic groups than those from White groups (S1: aIRR 2.33, 95% CI [1.09–4.94], P = 0.03; spike: aIRR, 2.04, 95% CI [1.02–4.08]). Interpretation: This study provides evidence that, in an infection naïve cohort, humoral and cellular immune responses to SARS-CoV-2 vaccination are stronger in South Asian HCWs than White HCWs. These differences are most clearly seen in the early period following vaccination. Further research is required to understand the underlying mechanisms, whether differences persist with further exposure to vaccine or virus, and the potential impact on vaccine effectiveness. Funding: DIRECT and BELIEVE have received funding from UK Research and Innovation (UKRI) through the COVID-19 National Core Studies Immunity (NCSi) programme (MC_PC_20060)

    Batch Sedimentation Studies for Freshwater Green Alga Scenedesmus abundans Using Combination of Flocculants

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    Microalga is the only feedstock that has the theoretical potential to completely replace the energy requirements derived from fossil fuels. However, commercialization of this potential source for fuel applications is hampered due to many technical challenges with harvesting of biomass being the most energy intensive process among them. The fresh water microalgal species, Scenedesmus abundans, has been widely recognized as a potential feedstock for production of biodiesel (Mandotra et al., 2014). The present work deals with sedimentation of algal biomass using extracted chitosan and natural bentonite clay powder as flocculant. The effect of flocculant combination and different factors such as temperature, pH, and concentration of algal biomass on sedimentation rates has been analyzed. A high flocculation efficiency of 76.22 ± 7.81% was obtained at an algal biomass concentration of 1 ± 0.05 g/L for a settling time of 1 h at 50 ± 5°C with a settling velocity of 103.2 ± 0.6 cm/h and a maximum surface conductivity of 2,260 ± 2 μS/cm using an optimal design in response surface methodology (RSM). Biopolymer flocculant such as chitosan exhibited better adsorption property along with bentonite clay powder that reduced the settling time significantly

    Antimicrobial Properties of Polyaniline and Polypyrrole Decorated with Zinc-Doped Copper Oxide Microparticles

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    Polyaniline (PANI) and polypyrrole (PPY) were synthesized by carbon dots (CDs) under UV irradiation and then sonicated together with zinc acetate and copper acetate to form the PANI-Zn@CuO and PPY-Zn@Cu composites. The former consisted of agglomerated spherical particles with diameters of 1–5 µm, whereas the latter displayed irregular stick shapes with similar diameters. The bacterial potency of the composites against Escherichia coli and Staphylococcus aureus was enhanced remarkably with Zn doping in the CuO matrix, designated as Zn0.11Cu0.89O, at 0.144 mg/mL. The cell death was mainly attributed to the release of reactive oxygen species (ROS) that would severely damage DNA, proteins, and lipids. Bacteria could adhere to neutral surfaces of the composites by van der Waals attractive forces. The binding event disrupted the native surface charge of bacterial cells to induce cell lysis and result in eventual cell death

    Photocatalytic Degradation of Organic Dyes and Antimicrobial Activities by Polyaniline–Nitrogen-Doped Carbon Dot Nanocomposite

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    Nitrogen-doped carbon nanodots (N@CDs) were prepared by hydrothermal processing of bovine serum albumin (Mw: 69,324 with 607 amino acids). A polyaniline (PANI-N@CDs) nanocomposite was then synthesized by ultrasonication and used to degrade Congo red (CR), methylene blue (MB), Rhodamine B (RhB), and crystal violet (CV) four common organic dyes. The PANI-N@CD nanocomposite simultaneously adsorbed and concentrated the dye from the bulk solution and degraded the adsorbed dye, resulting in a high rate of dye degradation. The combination of holes (h+), hydroxyl (OH•), and O2•− was involved in the N@CD-mediated photocatalytic degradation of the dyes. Under visible light illumination at neutral pH, the PANI-N@CDs were proven as an efficient adsorbent and photocatalyst for the complete degradation of CR within 20 min. MB and RhB were also degraded but required longer treatment times. These findings supported the design of remediation processes for such dyes and predicted their fate in the environment. The nanocomposite also exhibited antimicrobial activities against Gram-negative bacterium E. coli and Gram-positive bacterium S. aureus
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