The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridioides difficile infection and other potential indications: second edition of joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) guidelines.

The first British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS)-endorsed faecal microbiota transplant (FMT) guidelines were published in 2018. Over the past 5 years, there has been considerable growth in the evidence base (including publication of outcomes from large national FMT registries), necessitating an updated critical review of the literature and a second edition of the BSG/HIS FMT guidelines. These have been produced in accordance with National Institute for Health and Care Excellence-accredited methodology, thus have particular relevance for UK-based clinicians, but are intended to be of pertinence internationally. This second edition of the guidelines have been divided into recommendations, good practice points and recommendations against certain practices. With respect to FMT for Clostridioides difficile infection (CDI), key focus areas centred around timing of administration, increasing clinical experience of encapsulated FMT preparations and optimising donor screening. The latter topic is of particular relevance given the COVID-19 pandemic, and cases of patient morbidity and mortality resulting from FMT-related pathogen transmission. The guidelines also considered emergent literature on the use of FMT in non-CDI settings (including both gastrointestinal and non-gastrointestinal indications), reviewing relevant randomised controlled trials. Recommendations are provided regarding special areas (including compassionate FMT use), and considerations regarding the evolving landscape of FMT and microbiome therapeutics.

Anti HCV activity and expression inhibition of HCC markers by protein extract from Iberis gibraltarica / Atividade anti-HCV e inibição da expressão de marcadores HCC por extrato de proteína de Iberis gibraltarica

Hepatitis C virus infection (HCV) is the foremost reason of progressive hepatic fibrosis and cirrhosis, with an elevated risk of hepatocellular carcinoma (HCC) development. Medicinal plants have been used for human health benefits for several years, but their therapeutic potential needs to be explored. The main objective of this study was to figure out the in vitro antiviral and anticancer characteristics of total crude protein of Iberis gibraltarica against HCV and HCC. Total crude protein of Iberis gibraltarica was isolated and quantified. The level of cytotoxicity was measured against the HepG2 cell line and it shows no significant cytotoxicity at the concentration of 504µg/ml. The anti-HCV effect was determined by absolute quantification via real time RT-PCR method and viral titer was reduced up to 66% in a dose dependent manner against the total protein of Iberis gibraltarica. The anticancer potential of Iberis gibraltarica was also examined through mRNA expression studies of AFP and GPC3 genes against the total protein of Iberis gibraltarica-treated HepG2 cells. The results show up to 90% of the down-regulation expression of AFP and GPC3. The obtained results indicate the therapeutic potential of total protein of Iberis gibraltarica against HCV and hepatocellular carcinoma in vitro.

A infecção pelo vírus da hepatite C (HCV) é a principal causa de fibrose hepática progressiva e cirrose, com risco elevado de desenvolvimento de carcinoma hepatocelular (HCC). As plantas medicinais vêm sendo utilizadas para benefícios à saúde humana há vários anos, mas seu potencial terapêutico precisa ser explorado. O principal objetivo deste estudo foi descobrir as características antivirais e anticancerígenas in vitro da proteína bruta total de Iberis gibraltarica contra HCV e HCC. A proteína bruta total de Iberis gibraltarica foi isolada e quantificada. O nível de citotoxicidade foi medido contra a linha celular HepG2 e não apresenta citotoxicidade significativa na concentração de 504µg/ml. O efeito anti-HCV foi determinado por quantificação absoluta através do método RT-PCR em tempo real e o título viral foi reduzido em até 66% de forma dose-dependente contra a proteína total de Iberis gibraltarica. O potencial anticancerígeno de Iberis gibraltarica também foi examinado através de estudos de expressão de mRNA dos genes AFP e GPC3 contra a proteína total de células HepG2 tratadas com Iberis gibraltarica. Os resultados mostram até 90% da expressão de regulação negativa de AFP e GPC3. Os resultados obtidos indicam o potencial terapêutico da proteína total de Iberis gibraltarica contra HCV e carcinoma hepatocelular in vitro.

Thermal performance of dual flow slotted fin mini channel heat sink using Al2O3-H2O and TiO2-H2O: a numerical and experimental approach.

To overcome the extensive heat generation inside the microprocessors nanofluids have gained importance because of their better thermophysical properties as compared with air and water. This work proposes a two-pronged strategy for thermal performance enhancement of mini channel heat sinks. Firstly, a novel dual flow slotted fin mini channel heat sink flow configuration is proposed. Secondly, a detailed numerical investigation is performed to assess heat transfer enhancement property of Al2O3-H2O and TiO2-H2O nanofluids. Considering the first step, fin spacing, number of slots, slot thickness and slot angle are investigated in detail yielding to the selection of best structural parameters. Two slots per fin of 0.5 mm thickness at an angle of 45° is selected because it provides better thermal performance as compared with water. Further, numerical assessment of nano fluid behavior was carried out at volumetric concentrations of 0.005% and 0.01%. For the case of novel dual flow slotted fin mini channel heat sink, maximum numerical and experimental advantages in all targeted system properties is observed for Al2O3-H2O nano fluid at volumetric concentration of 0.01%, as compared with water. Al2O3-H2O nano fluid provides better thermal performance both numerically and experimentally as compared with TiO2-H2O nanofluids. Increment in the pressure drop is noted with increasing volumetric concentrations.

Assessment of essential minerals and physico-chemical analysis of floral origins fresh honey produced by Apis mellifera.

Honey is one of the best nutritious substances in the world, having different services in the body functions regulation. Ten elements (K, Na, Ca, Co, Cr, Mn, Mo, Ni, Pb, Se) from honey samples were analyzed from 80 different locations of Punjab and ten floras. The aim of the present study was to determine the quality and quantity of minerals and Physico-chemical analysis in honey. A flame photometer was used to measure the concentration of major minerals (K, Ca and Na). The concentration of micro minerals (Co, Cr, Mn, Mo, Ni, Pb and Se) was analyzed using Atomic Absorption Spectrometer. The concentration of macro-elements obtained was as follow (in ppm): K (166-1732), Na (107-418) and Ca (07-99), while the concentration of microelements (in ppm) Co (1-2), Cr (>1), Mn (<1), Mo (1.818), Ni (1.911), Pb (<1) and Se (1.968). The most abundant minerals were potassium, calcium and sodium, ranging between 396-810.5, 17.5-640.63 and 169.88-238.62 ppm, respectively. However, the trace mineral elements of honey were obtained in the order of decreasing Se > Co > Ni > Pb > Cr > Mo > Mn. The findings showed that all the heavy metals like Co, Cr, Ni and Pb were present in trace amounts and close to International Honey Quality Standard. The result of given honey samples represented highest value of moisture (31.23%), color (80 mm pfund), pH (8.23), acidity (72.02 meq/kg), electrical conductivity (0.85 ms/cm) and ash contents (0.83%).

Anti HCV activity and expression inhibition of HCC markers by protein extract from Iberis gibraltarica.

Hepatitis C virus infection (HCV) is the foremost reason of progressive hepatic fibrosis and cirrhosis, with an elevated risk of hepatocellular carcinoma (HCC) development. Medicinal plants have been used for human health benefits for several years, but their therapeutic potential needs to be explored. The main objective of this study was to figure out the in vitro antiviral and anticancer characteristics of total crude protein of Iberis gibraltarica against HCV and HCC. Total crude protein of Iberis gibraltarica was isolated and quantified. The level of cytotoxicity was measured against the HepG2 cell line and it shows no significant cytotoxicity at the concentration of 504µg/ml. The anti-HCV effect was determined by absolute quantification via real time RT-PCR method and viral titer was reduced up to 66% in a dose dependent manner against the total protein of Iberis gibraltarica. The anticancer potential of Iberis gibraltarica was also examined through mRNA expression studies of AFP and GPC3 genes against the total protein of Iberis gibraltarica-treated HepG2 cells. The results show up to 90% of the down-regulation expression of AFP and GPC3. The obtained results indicate the therapeutic potential of total protein of Iberis gibraltarica against HCV and hepatocellular carcinoma in vitro.

Results from the first English stool bank using faecal microbiota transplant as a medicinal product for the treatment of Clostridioides difficile infection.

BACKGROUND: Faecal Microbiota Transplant (FMT) has improved outcomes for the treatment of Clostridioides difficile infection (CDI) compared to antibiotic therapy. FMT is classified as a medicinal product in the United Kingdom, similar to the USA and Canada, limiting supply via stool banks without appropriate licencing. In the largest UK cohort to date, we describe the clinical outcomes for 124 patients receiving FMT for recurrent or refractory CDI and present a framework to produce FMT as a licenced medicinal product. METHODS: Anonymous unrelated healthy donors, screened via health assessment and microbiological testing donated stool. In aerobic conditions FMT aliquots were prepared for immediate use or frozen storage, following a production framework developed to comply with Good Manufacturing Practice. Outcome measures were clinical response to FMT defined as resolution of diarrhoea within seven days and clinical cure defined as response without diarrhoea recurrence at 90 days. FINDINGS: Clinical response was 83·9% (95% CI 76·0%-90·0%) after one treatment. Clinical cure was 78·2% (95% CI 67·4%-89·0%) across the cohort. Refractory cases appeared to have a lower initial clinical response rate compared to recurrent cases, however at day 90 there were no differences observed between these groups. INTERPRETATION: The methodology developed here enabled successful licencing of FMT by The Medicines and Healthcare products Regulatory Agency as a medicinal product. This has widened the availability of FMT in the National Health Service via a stool bank and can be applied in other centres across the world to improve access to safe and quality assured treatments.

Evaluation of the Applicability of 3d Models as Perceived by the Students of Health Sciences.

The methodology and style of teaching anatomy in the faculties of Health Sciences is evolving due to the changes being introduced as a result of the application of new technologies. This brings a more positive attitude in the students, enabling an active participation during the lessons. One of these new technologies is the creation of 3D models that reliably recreates the anatomical details of real bone pieces and allow access of anatomy students to bone pieces that are not damaged and possess easily identifiable anatomical details. In our work, we have presented previously created 3D models of skull and jaw to the students of anatomy in the Faculties of Health Sciences of the University of Salamanca, Spain. The faculties included were odontology, medicine, occupational therapy nursing, health sciences and physiotherapy. A survey was carried out to assess the usefulness of these 3D models in the practical study of anatomy. The total number of students included in the survey was 280.The analysis of the results presents a positive evaluation about the use of 3D models by the students studying anatomy in different Faculties of Health Sciences.

Quantification of particulate matter, tracking the origin and relationship between elements for the environmental monitoring of the Antarctic region.

The present work reports on the analysis of atmospheric aerosols in the Antarctic region, Deception Island, collected during austral summer 2016-2017 by field measurements carried from Gabriel de Castilla Spanish Research Station. A low-volume sampler was used to capture the aerosols depositing them onto the air filters. A chemical analysis of the samples using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) and Inductively Coupled Plasma-Atomic Emission Spectroscopy (ICP-AES) provided the total carbon (TC), organic carbon (OC), elemental Carbon (EC) and elements such as Al, Ca, Fe, K, Mg, Na, P, S, Cu, Pb, Sr, Ti, Zn and Cr. The average mass concentration of particulate matter (PM10) originated by natural and anthropogenic activities was calculated as 10 ±â€¯4 µg/m3, although values such as 28.2 µg/m3 were also obtained which is very high even when compared to other places in the coast of the Antarctic region. In addition, high enrichment factors have been found for elements such as Pb, Cr, Cu and Zn showing a remote anthropogenic contribution to particulate matter in this region. Correlations were found between Na, Mg, Ca, Al, Ti and S, where Na/Mg displayed the influence of marine environments, S correspond to volcanic activities, Ca to penguin colonies and influence of sea whereas Al/Ti indicated the crustal origin. Polar contour graphical maps were obtained from meteorological data using chemometrics methods, which allowed reproducing wind maps revealing the distribution of the aerosols and possible emission sources of different elements in the area. Given that this island has not been previously studied for atmospheric contamination, this work provides an interesting insight about the site-specific characteristics of particulate matter.

Efficacy of direct-acting anti-viral therapy on chronic, naïve hepatitis C virus patients of Punjab, Pakistan: a cross-sectional study.

The success of interferon-free regimens using new direct-acting antiviral (DAA) is a revolution and major breakthrough in the development of new therapeutic options against hepatitis C virus (HCV). Accumulating evidence suggest sustained virological response (SVR) with DAA in 95% of patients. To date, however, there are very few data related to efficacy of DAA in the Pakistani population. We aimed to investigate the efficacy of sofosbuvir-based regimen among Pakistani population. A total of 1,913 patients who attained SVR24 after being treated with sofosbuvir and ribavirin from August 2015 to March 2017 were enrolled in this study. We analyzed the demographic, clinical and virological data and screened all patients for HCV in March 2017 to evaluate the response rate. We found an overall response rate of 92.8%. In addition, we also observed lower response rates among older patients. It can be inferred that a large proportion of patients achieved SVR after treatment with sofosbuvir-based regimen.

Different Digitalization Techniques for 3D Printing of Anatomical Pieces.

The use of different technological devices that allow the creation of three-dimensional models is in constant evolution, allowing a greater application of these technologies in different fields of health sciences and medical training. The equipment for digitalization is becoming increasingly sophisticated allowing obtaining three-dimensional which are more defined and similar to real image and original object. In this work, different modalities of designing 3D anatomical models of bone pieces are presented, for use by students of different disciplines in Health Sciences. To do this we digitalized bone pieces, with different models of scanners, producing images that can be transformed for 3D printing, with a Colido X 3045 printer by digital treatment with different software.

ASSESSMENT OF RADIATION DOSE AND EXCESSIVE LIFE-TIME CANCER RISK FROM THE BUNAIR GRANITE, NORTHERN PAKISTAN.

Natural radioactivity was measured in Bunair Granite using high purity germanium gamma-ray spectrometer and compared to world's granites and building materials to access its suitability for the construction purpose. Average gamma-activities of 226Ra, 232Th and 40K were found to be 52.41, 58.41 and 1130.12 Bq kg-1, respectively. The Indoor and outdoor radiation indices including excessive life-time cancer risk (ELCR) were calculated. The average indoor ELCR was estimated as 3.49 × 10-3. The average outdoor ELCR was assessed as 0.46 × 10-3. As a basic building material Bunair Granite should be on low propriety. For flooring, facing the buildings and as Table tops, in kitchens and other utilities it is safe.

Hepatitis C virus induces oxidative stress and DNA damage by regulating DNAPKCs, ATM, ATR and PARP mediated signaling and guards cell from cancerous condition by upregulating RB, P53 and downregulating VEGF.

Hepatitis C virus is responsible for liver damage and various metabolic disorders. HCV infections promote oxidative stress and cause damage to macromolecules. The aim of our study was to design a preliminary study with establishment of HCV genotype 3a infectivity assay in order to determine DNA damage in Huh-7 cell line at 72 hours post inoculation. Quantitative expression levels of COX-2 and GSR (oxidants and antioxidants), DNAPKCs, ATM, ATR and PARP (DNA damage and repair genes), RB and P53 (tumor suppressor genes) and VEGF (angiogenesis marker) were observed via real time PCR. Our findings revealed 1.533 fold upregulated expression of COX-2. The expression level of GSR was increased by1.27 fold and VEGF expression decreased by 0.367 fold. Thus, preventing cells to enter cancerous phase.

Investigation of community carriage rates of Clostridium difficile and Hungatella hathewayi in healthy volunteers from four regions of England.

Faecal samples from 1365 healthy asymptomatic volunteers from four regions in England were screened for the presence of Clostridium difficile between December 2013 and July 2014. The carriage rate of C. difficile in healthy patients was 0.5%, which is lower than reported previously. This study demonstrates that the true community reservoir of C. difficile in the healthy UK population is very low and is, therefore, unlikely to be a reservoir for infections diagnosed in the hospital setting.

Quantitative evaluation of insulin resistance markers in Pakistani patients suffering from HCV-associated type 2 diabetes mellitus.

The current study was designed to determine the role of the host genes involved in the development of chronic hepatitis C-associated type 2 diabetes mellitus. This study was carried out in patients in four different stages of chronic hepatitis C virus (HCV) infection, including treatment-naïve HCV patients, HCV-positive patients with type 2 diabetes mellitus (T2DM), non-responders and responders. The mRNA expression level of host genes, such as glucose-6-phosphatase (G6Pase), tumor necrosis factor α (TNF-α) and different adipokines including adiponectin, leptin and resistin, was quantified and compared to healthy controls. HCV infection was found to be associated with insulin resistance, a step towards type 2 diabetes mellitus (T2DM). The results also suggest the potential role of adipokines in chronic HCV (CHC)-associated T2DM. The upregulation of gluconeogenic genes, such as G6Pase and resistin, and a decreased mRNA expression level of adiponectin suggest the potential role of selected markers in the CHC-associated T2DM in Pakistani population. Based on these results, it is concluded that upregulation of TNF-α, G6Pase and resistin in chronic HCV patients leads to gluconeogenesis, eventually favoring T2DM. Collectively, these findings suggest that CHC patients are more prone to T2DM.

Qualitative and quantitative analysis of milk for the detection of adulteration by Laser Induced Breakdown Spectroscopy (LIBS).

The present work focuses on the development of a fast and cost effective method based on Laser Induced Breakdown Spectroscopy (LIBS) to the quality control, traceability and detection of adulteration in milk. Two adulteration cases have been studied; a qualitative analysis for the discrimination between different milk blends and quantification of melamine in adulterated toddler milk powder. Principal Component Analysis (PCA) and neural networks (NN) have been used to analyze LIBS spectra obtaining a correct classification rate of 98% with a 100% of robustness. For the quantification of melamine, two methodologies have been developed; univariate analysis using CN emission band and multivariate calibration NN model obtaining correlation coefficient (R2) values of 0.982 and 0.999 respectively. The results of the use of LIBS technique coupled with chemometric analysis are discussed in terms of its potential use in the food industry to perform the quality control of this dairy product.

Evaluation of foot and mouth vaccination for yak (Bos grunniens) in Pakistan.

In northern Pakistan, many farming communities rely on domestic yak (Bos grunniens) as a principle source of income. A 2006 participatory disease surveillance report from this region indicated that foot-and-mouth disease (FMD) is the most prevalent annual disease of yak. Our objectives of this study were to determine exposure levels of yak to FMD virus; implement a vaccination program based on current, regional FMD virus serotypes and subtypes; and quantify immune responses following vaccination. Blood samples were used to determine pre-vaccination exposure of animals to FMD virus by antibody presence to non-structural proteins of FMD virus using a 3-ABC trapping indirect ELISA. Vaccine used consisted of FMD serotypes 'O' (PanAsia-2), 'A' (Iran-05), and 'Asia-1' (Shamir), but changed later during the study to match newly circulating viruses in the country ('O'-PanAsia-2; 'A'-Turk-06 and Asia-1-Sindh-08). Three hundred sixty-three blood samples were tested from selected villages to determine pre-vaccination FMD virus exposure in yak with an average of 37.7%. Immune responses from initial vaccination and booster dose 30 days later showed clear protective levels (as mean percent inhibition) of antibodies against structural proteins of serotypes 'O,' 'A,' and 'Asia-1.' These responses remained above threshold positive level even at day 210 following initial vaccination. Results of sero-surveillance and anecdotal information of repeated FMD outbreaks demonstrate the persistence of FMD virus of yak in northern Pakistan. Laboratory results and field observations clearly indicated that yak can be protected against FMD with a good quality vaccine with FMD serotype(s) matching current, regionally circulating FMD virus.

Heterosis and correlation in interspecific and intraspecific hybrids of cotton.

Interspecific and intraspecific hybrids show varying degrees of heterosis for yield and yield components. Yield-component traits have complex genetic relationships with each other. To determine the relationship of yield-component traits and fiber traits with seed cotton yield, six lines (Bt. CIM-599, CIM-573, MNH-786, CIM-554, BH-167, and GIZA-7) and three test lines (MNH-886, V4, and CIM-557) were crossed in a line x tester mating design. Heterosis was observed for seed cotton yield, fiber traits, and for other yield-component traits. Heterosis in interspecific hybrids for seed cotton yield was more prominent than in intraspecific hybrids. The interspecific hybrid Giza-7 x MNH-886 had the highest heterosis (114.77), while among intraspecific hybrids, CIM-554 x CIM-557 had the highest heterosis (61.29) for seed cotton yield. A major trait contributing to seed cotton yield was bolls/plant followed by boll weight. Correlation studies revealed that bolls/plant, boll weight, lint weight/boll, lint index, seed index, lint/seed, staple length, and staple strength were significantly and positively associated with seed cotton yield. Selection based on boll weight, boll number, lint weight/boll, and lint index will be helpful for improving cotton seed yield.

Identification and Discrimination of Brands of Fuels by Gas Chromatography and Neural Networks Algorithm in Forensic Research.

The detection of adulteration of fuels and its use in criminal scenes like arson has a high interest in forensic investigations. In this work, a method based on gas chromatography (GC) and neural networks (NN) has been developed and applied to the identification and discrimination of brands of fuels such as gasoline and diesel without the necessity to determine the composition of the samples. The study included five main brands of fuels from Spain, collected from fifteen different local petrol stations. The methodology allowed the identification of the gasoline and diesel brands with a high accuracy close to 100%, without any false positives or false negatives. A success rate of three blind samples was obtained as 73.3%, 80%, and 100%, respectively. The results obtained demonstrate the potential of this methodology to help in resolving criminal situations.

Laser induced breakdown spectroscopy for the discrimination of Candida strains.

The present study reports the evaluation of Laser Induced Breakdown Spectroscopy (LIBS) and Neural Networks (NN) for the discrimination of different strains of various species of Candida. This genus of yeast was selected due to its medical relevance as it is commonly found in cases of fungal infection in humans. Twenty one strains belonging to seven species of Candida were included in the study. Scanning Electron Microscopy with Energy-Dispersive X-ray Spectroscopy (SEM-EDS) was employed as a complementary technique to provide information about elemental composition of Candida cells. The use of LIBS spectra in combination with optimized NN models provided reliable discrimination among the distinct Candida strains with a high spectral correlation index for the samples analyzed, without any false positive or false negative. Therefore, this study indicates that LIBS-NN based methodology has the potential to be used as fast fungal identification or even diagnostic method.

Diallel cross analysis of plesiomorphic traits in Triticum aestivum L. genotypes.

We conducted a 5 x 5 complete diallel cross experiment in bread wheat (Triticum aestivum) with the genotypes 6309, Chkwal-50, Dhrabi, Bhkhar-02, and FS-08. Our objective was to evaluate the type of gene action and the general and specific combining abilities required for various morphological traits in wheat. The results of analysis of variance revealed highly significant differences among genotypes for all the investigated traits. The results of joint regression analysis showed that the data for all the investigated traits fitted a simple additive dominance model. Graphical representation of variance and covariance suggested that most of the investigated traits were controlled by overdominance gene action. However, the peduncle length and plant height were controlled by additive gene action. Variety 6309 carried the highest number of dominant genes for the number of spikelets per spike, number of tillers per plant, plant height, number of fertile tillers per plant, and grain yield per plant. Chakwal-50 carried the highest number of recessive genes for grain yield per plant, number of tillers per plant, number of grains per spike, number of fertile tillers per plant, and plant height. Chakwal-50 and 6309 were the best general combiners for number of spikelets per spike, number of grains per spike, grain yield per plant, 1000-grain weight, number of fertile tillers per plant, and number of tillers per plant. On other hand, 6309 performed well in specific crosses with Chakwal-50, FS-08, and Bhakhar-02 for spike length and number of tillers per plant.