Explore the vast range of titles available.

Psoriatic arthritis (PsA) is a debilitating immune-mediated inflammatory arthritis of unknown pathogenesis commonly affecting patients with skin psoriasis. Here we use complementary single-cell approaches to study leukocytes from PsA joints. Mass cytometry demonstrates a 3-fold expansion of memory CD8 T cells in the joints of PsA patients compared to peripheral blood. Meanwhile, droplet-based and plate-based single-cell RNA sequencing of paired T cell receptor alpha and beta chain sequences show pronounced CD8 T cell clonal expansions within the joints. Transcriptome analyses find these expanded synovial CD8 T cells to express cycling, activation, tissue-homing and tissue residency markers. T cell receptor sequence comparison between patients identifies clonal convergence. Finally, chemokine receptor CXCR3 is upregulated in the expanded synovial CD8 T cells, while two CXCR3 ligands, CXCL9 and CXCL10, are elevated in PsA synovial fluid. Our data thus provide a quantitative molecular insight into the cellular immune landscape of psoriatic arthritis. Psoriatic arthritis (PsA) commonly affects patients with skin psoriasis, but its pathogenesis is still unclear. Here the authors use two types of single-cells data, mass cytometry and RNA sequencing, to describe the expansion and diversity of synovial, but not peripheral blood, CD8 T cells from PsA patients to provide a molecular immune landscape for PsA.

The solid foundation laid by Prof Theophilus Oladapo Ogunlesi and other founding fathers of the National Postgraduate Medical College of Nigeria (NPMCN) has consistently achieved its mandate of producing specialist medical practitioners in Nigeria. The ever-changing world requires that we have in Nigeria a critical mass of subspecialists to tackle the various old and emerging ailments that afflict the citizenry. Subspecialist training is popular among Nigerian specialists. While those who are not yet subspecialists crave for the training. Nigerian-born sub-specialists in the diaspora are willing to assist in the training. It is now left to policy makers and captains of the training institutions to seize the chance and move us forward with a view to improving the current embarrassingly low number of subspecialists in Nigeria. The NPMCN is hereby beckoned to take the lead. In doing so, it should combine excellence with relevance.

Soft tofu was used to produce a cake to ascertain its suitability in producing egg-free cake (EFC) for vegans and individuals allergic to eggs. A conventional cake (CVC) served as control and the quality characteristics of the EFC and CVC were evaluated. Results showed the egg-free cake had physical properties which were significantly (p < 0.05) higher in weight (1611 g), density (0.81 kg/m3) and specific volume (1.23%) than Conventional cake (1516 g, 0.61 kg/m3 and 0.25%, respectively). CVC showed significantly p < 0.05 higher height (8.50 cm) and volume (2644.78 m3) which is desirable in the baked cake. EFC showed significantly p < 0.05 higher values in ash (3.13%), moisture (24.01%), fibre (2.40%) and carbohydrate (52.34%), while CVC had significant (p < 0.05) higher values in protein (7.38%) and fat (16.34%). The taste (0.55), colour (0.55), texture (0.55) and aroma (0.55) of EFC was more preferred than CVC (0.45, 0.40, 0.45 and 0.45, respectively). Soft tofu showed suitability and an acceptable replacement for egg in making Egg-free cakes for vegetarians and individuals allergic to egg.

ObjectivesTropomyosin receptor kinase A (TrkA) mediates nociceptor sensitisation by nerve growth factor (NGF), but it is unknown whether selective TrkA inhibition will be an effective strategy for treating osteoarthritis (OA) pain. We determined the effects of a TrkA inhibitor (AR786) on pain behaviour, synovitis and joint pathology in two rat OA models.MethodsKnee OA was induced in rats by intra-articular monosodium-iodoacetate (MIA) injection or meniscal transection (MNX) and compared with saline-injected or sham-operated controls. Pain behaviour was assessed as weight-bearing asymmetry and paw withdrawal threshold to punctate stimulation. Oral doses (30 mg/kg) of AR786 or vehicle were administered twice daily in either preventive (day −1 to –27) or treatment (day 14–28) protocols. Effect maintenance was evaluated for 2 weeks after treatment discontinuation. Alterations in knee structure (cartilage, subchondral bone and synovium) were examined by macroscopic visualisation of articular surfaces and histopathology.ResultsPreventive AR786 treatment inhibited pain behaviour development and therapeutic treatment attenuated established pain behaviour. Weight-bearing asymmetry increased 1 week after treatment discontinuation, but remained less than in vehicle-treated arthritic rats, whereas paw withdrawal thresholds returned to levels of untreated rats within 5 days of treatment discontinuation. AR786 treatment reduced MIA-induced synovitis and did not significantly affect osteochondral pathology in either model.ConclusionsBlocking NGF activity by inhibiting TrkA reduced pain behaviour in two rat models of OA. Analgesia was observed both using preventive and treatment protocols, and was sustained after treatment discontinuation. Selective inhibitors of TrkA therefore hold potential for OA pain relief.

Nasal hematoma/abscess is an uncommon entity, but capable of leading to serious consequences if not handled meticulously, and with urgency. To present the management, and outcome of nasal septal hematoma/abscess in a Nigerian tertiary institution. Consecutive patients diagnosed with nasal septal hematoma/abscess over a 10-year period, treated at the University of Nigeria Teaching Hospital, Enugu, Nigeria, were prospectively studied. The processes leading to diagnosis, treatment, and outcome were sequentially evaluated. Fifty-three patients (37 males and 16 females), age 5-65 years (with mean age of 23.10 years), were included. Surgical drainage of the hematoma/abscess, intranasal packing with insertion of drain was performed with total resolution of problem in all the cases. Incision and drainage, and intranasal packing with insertion of drain was effective in treating nasal septal hematoma/abscess.

Objective: To determine the pattern of eye diseases at the general outpatient department (GOPD) of a Nigerian tertiary hospital. Materials and Methods: Patients selected by systematic random sampling at the GOPD of a Nigerian tertiary hospital were studied. Information on sociodemographics and ocular complaints were obtained using interviewer-administered questionnaire. Ocular examination included visual acuity measurement and anterior and posterior segments examinations. Data analysis was with Statistical Package for the Social Sciences. Results: Three hundred and eighty-two patients, comprising 124 (32.5%) males and 258 (67.5%) females, aged between 18 and 86 years, mean 44.8 ± 15.4 years, were studied; 112 (29.3%) had eye diseases but only 88 (78.6%) patients complained of ocular disorder(s). Common complaints were poor vision 53 (60.4%), red eye and grittiness 15 (17.0%) each. Common eye diseases were lens 52 (13.6%) and conjunctiva 46 (12.0%) disorders. Attaining higher education was protective against eye diseases (P < 0.05). Conclusion: Nearly a third of patients at the GOPD have eye diseases. Therefore, primary eye care should be integrated into the GOPD service with provision of relevant manpower and facilities for care of the ophthalmic patients.

Objective Advances in information technology (IT) in the past decade present opportunities and challenges in undergraduate surgical education. There may be need to evaluate the knowledge base and the use of Internet tools among medical students in settings where traditional mode of education is preeminent. This may help to establish a conceptual framework for integrating e-learning into the traditional teaching to enhance learning experience. In this study, we evaluated the medical students’ knowledge and use of Internet tools, and their opinion on the application of these tools in surgical education. Methods We undertook a cross-sectional survey of 2013 and 2014 graduating medical class of College of Medicine University of Nigeria, Enugu using structured self-administered questionnaire. The survey assessed the knowledge, utility, and application of Internet tools in surgical education using 5-point Likert scale. Results Overall response rate was 78% (227/291) comprising 151 (66.5%) males and 76 (33.5%) females. The median age was 24 years (range 20–33 years). Although 106 (46.7%) had formal training on information technology, 223 (98.2%) can access Internet, and 162 (71.4%) use one or more of the Internet tools, 90.6% (96/106) of those trained on ICT use Internet for education/learning compared to 88.4% (107/121) of those without ICT training ( p  = 0.76). Google™ search tool had the highest rating in terms of familiarity and utility for education/learning (mean rating 4.3 on a scale of 5.0), while Skype™ had the least rating (mean 2.0). Overall, 89% of respondents (mean rating 4.5 on a scale of 5.0) indicated that Internet tools could be effectively applied in surgical education specifically in areas of lectures, assignments, real-time procedure demonstration, case discussion, and interaction with surgical experts. The key benefits are utility as a regular self-assessment tool (mean rating = 4.6) and offer of flexible learning schedule (mean rating = 4.0). Fifty-two percent (118/227) strongly agree that combination of the use of Internet tools with the traditional teaching may give better learning outcome (mean rating 4.44). The major challenges were cost of accessing Internet ( n  = 126; 55.5%), lack of facility with the technology ( n  = 115; 50.7%), and network availability ( n  = 96; 42.3%). Availability of affordable Internet ( n  = 205; 90.3%), improvement of training on ICT ( n  = 135; 59.5%), and encouragement of the use of these tools by faculty ( n  = 107; 47.1%) were the major suggestions to address the challenges. Conclusion In our setting, a substantial number of undergraduate medical students are familiar with and use Internet tools for learning and believe that the tools may have utility in surgical education. However, to further consolidate and enhance learning experience, it may be useful to integrate this learning modality with the traditional mode of teaching through a well thought out curriculum modification.

Heat transfer augmentation features for the improvement of heat transfer from the absorber-plate of a solar air heater to the working fluid are mostly fins however these features also increase pressure drop in the flow channel. The exergy optimization philosophy is adopted in the fin sizing for this air heating application; this optimization philosophy ensures that the maximum quantity of heat is transferred by the fins while generating the least entropy in the system thus conserving exergy. Results indicate that the higher the fin efficiency, the higher the heat conversion and delivery potential. Given an optimum fin length (efficiency) and superior coating absorptive vigour, useful energy losses in the heater can be minimized. Some important observations relevant in design are made.

BackgroundA growing proportion of patients experience ongoing symptoms for more than 12 weeks following an initial COVID-19 illness. Long COVID or post-COVID syndrome is an increasing burden to the NHS. NHS England has mandated the setup of regional long COVID clinics to manage this demand.1 There is very little understanding of the range of symptoms and the symptom burden to patients.AimsWe describe self-reported symptoms and compare breathlessness and fatigue scoring for patients referred to the Cheshire and Merseyside Long COVID assessment hub, which serves a population of >2.5 million, between February 2021 and April 2021.MethodsRetrospective review of case notes of patients assessed in our virtual Long COVID assessment hub. Data was analysed using paired t-tests. Fatigue was scored on a scale of 0 (no fatigue) to 10 (extreme fatigue). Breathlessness was assessed using Borg breathlessness scale and MRC dyspnoea score.Results332 patients were assessed, with the following symptoms described in table 1. We found a significant increase in self-reported Borg breathlessness (4.9 vs 0.2, p<0.0001), MRC dyspnoea (2.5 vs 1.1, p<0.0001) and fatigue (7.1 vs 0.7, p<0.0001) at time of assessment, when compared with reported pre-morbid state.Abstract P139 Table 1Percentage of patients reporting various symptoms of Long COVID Symptom Percentage of patients Fatigue 98% Worsening breathlessness 97% Cognitive symptoms 91% Myalgia 66% Chest pain 47% Ongoing cough 46% Anosmia 45% DiscussionPatients experience significant worsening breathlessness and fatigue. This significant symptom burden emphasises the need for dedicated Long COVID assessment hubs to support patients. Further research should investigate whether pulmonary rehabilitation and dedicated psychological input can improve patients’ symptoms.ReferenceNHS England and NHS Improvement (2021). Long COVID: the NHS plan for 2021/22.