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14 December 2022 | Story André Damons | Photo André Damons
Dr Michael Pienaar, Senior Lecturer and specialist in the UFS Department of Paediatrics and Child Health being presented to the acting Chancellor by his supervisor Prof Stephen Brown.

A lecturer from the University of the Free State (UFS) says the need to improve the care of seriously ill children is a vital part of reducing preventable deaths and diseases, and this led him to investigate the use of artificial neural networks to develop models for the prediction of patient outcomes in children with severe illness. The study was done for his PhD thesis. 

This forms the basis for the PhD thesis of Dr Michael Pienaar, Senior Lecturer and specialist in the UFS Department of Paediatrics and Child Health, called, The Development and Validation of Predictive Models for Paediatric Critical Illness in Children in Central South Africa using Artificial Neural Networks. His thesis reports the development and testing of several machine learning models designed to help healthcare workers identify seriously ill children early in a range of resource-limited settings. Combining a systematic literature search and Delphi technique with clinical data from 1 032 participants, this research led to significant progress towards implementable models for community health workers in clinical practice.

Care for critically ill children is a mission and calling 

Dr Pienaar graduated with a PhD specialising in Paediatrics on Monday (12 December) during the Faculty of Health Sciences’ December graduation ceremony. It took him three years to complete this degree. His supervisor was Prof Stephen Brown, Principal Specialist and Head of the Division of Paediatric Cardiology in the Department of Paediatrics and Child Health in the Faculty of Health Sciences at the UFS. Prof Nicolaas Luwes and Dr EC George were his co-supervisors. 

“I have been working in paediatric critical care since 2019 and see the care of critically ill children as my mission and calling in life. At the outset of the project, I was interested in approaches to complex phenomena and wanted to investigate new methods for tackling these in healthcare. 

“I have been interested in technology since childhood and in collaborating with other disciplines since I joined the university in 2019. Machine learning seemed like a great fit that could incorporate these interests and yield meaningful clinical results,” explains Dr Pienaar the reason why he chose this topic for his thesis.

He hopes that, in time, this work will lead to the implementation of integrated machine learning models to improve care and clinical outcomes for children in South Africa. From a scholarship perspective, he continues, his hope is that this work draws interest to this field in clinical research and encourages a move towards incorporating these new methods, as well as skills in areas such as coding and design in the armamentarium of a new generation of clinicians.

Medicine chooses you

According to Dr Pienaar, he always had broad interests, of which medicine is one. “I am very grateful to have found my way in medicine and am humbled and privileged to be allowed to walk with children and their families on a difficult and important journey. I believe this profession will choose you and put you where you are needed if you give it time and are prepared to listen.”

He describes graduating as a complicated ending to this period of his life and the beginning of a next chapter. He was humbled by the graduation ceremony. 

“It was wonderful to graduate with undergraduates and postgraduates in my profession – I felt great pride and solidarity joining these new colleagues and specialists in taking the oath. I am certainly relieved, proud, excited, and happy. I am also very grateful to the university, my promotors, colleagues, friends, and family for supporting me through this process. I must confess, it is also slightly bittersweet, I loved working on this and do miss it, but look forward to the next exciting project. 

“I would like to thank my Head of Department, Dr (Nomakhuwa) Tabane, my supervisors, my family and friends once again. I would also like to acknowledge and thank the National Research Foundation (NRF) as well as the University of the Free State for their assistance with funding this research.”

News Archive

Research eradicates bacteria from avocado facility
2017-01-17

 Description: Listeria monocytogenes Tags: Listeria monocytogenes

Listeria monocytogenes as seen under an electron
microscope. The photo was taken with a transmission
electron microscope at the microscopy unit of the UFS.
Bacteriophages (lollipop-like structures) can be seen
next to the bacterial cells.
Photo: Supplied

“The aim of my project was to identify and characterise the contamination problem in an avocado-processing facility and then to find a solution,” said Dr Amy Strydom, postdoctoral fellow in the Department of Microbial Biochemical and Food Biotechnology at the University of the Free State (UFS).

Her PhD, “Control of Listeria monocytogenes in an Avocado-processing Facility”, aimed to identify and characterise the contamination problem in a facility where avocados were processed into guacamole. Dr Strydom completed her MSc in food science in 2009 at Stellenbosch University and this was the catalyst for her starting her PhD in microbiology in 2012 at the UFS. The research was conducted over a period of four years and she graduated in 2016. The research project was funded by the National Research Foundation.

The opportunity to work closely with the food industry further motivated Dr Strydom to conduct her research. The research has made a significant contribution to a food producer (avocado facility) that will sell products that are not contaminated with any pathogens. The public will then buy food that is safe for human consumption.


What is Listeria monocytogenes?

Listeria monocytogenes is a food-borne pathogenic bacterium. When a food product is contaminated with L. monocytogenes, it will not be altered in ways that are obvious to the consumer, such as taste and smell. When ingested, however, it can cause a wide range of illnesses in people with impaired immune systems. “Risk groups include newborn babies, the elderly, and people suffering from diseases that weaken their immune systems,” Dr Strydom said. The processing adjustments based on her findings resulted in decreased numbers of Listeria in the facility.

The bacteria can also survive and grow at refrigeration temperatures, making them dangerous food pathogens, organisms which can cause illnesses [in humans]. Dr Strydom worked closely with the facility and developed an in-house monitoring system by means of which the facility could test their products and the processing environment. She also evaluated bacteriophages as a biological control agent in the processing facility. Bacteriophages are viruses that can only infect specific strains of bacteria. Despite bacteriophage products specifically intended for the use of controlling L. monocytogenes being commercially available in the food industry, Dr Strydom found that only 26% of the L. monocytogenes population in the facility was destroyed by the ListexP100TM product. “I concluded that the genetic diversity of the bacteria in the facility was too high and that the bacteriophages could not be used as a control measure. However, there is much we do not understand about bacteriophages, and with a few adjustments, we might be able to use them in the food industry.”

Microbiological and molecular characterisation of L. monocytogenes

The bacteria were isolated and purified using basic microbiological culturing. Characterisation was done based on specific genes present in the bacterial genome. “I amplified these genes with polymerase chain reaction (PCR), using various primers targeting these specific genes,” Dr Strydom said. Some amplification results were analysed with a subsequent restriction digestion where the genes were cut in specific areas with enzymes to create fragments. The lengths of these fragments can be used to differentiate between strains. “I also compared the whole genomes of some of the bacterial strains.” The bacteriophages were then isolated from waste water samples at the facility using the isolated bacterial strains. “However, I was not able to isolate a bacteriophage that could infect the bacteria in the facility.

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