Recommendations for the use of endoscopic lung volume reduction in South Africa: Role in the treatment of emphysema

Emphysema is a very common cause of morbidity and mortality in South Africa (SA). Therapeutic options in severe emphysema are limited. Endoscopic lung volume reduction (ELVR) is increasingly being used internationally for the treatment of advanced emphysema in a subset of patients with advanced disease, aiming to obtain the same functional advantages as surgical lung volume reduction while reducing risks and costs. In addition to endobronchial valves, ELVR using endobronchial coils is now available in SA. The high cost of these interventions underscores the need for careful patient selection to best identify those who may or may not benefit from ELVR-related procedures. The Assembly on Interventional Pulmonology of the South African Thoracic Society appointed a committee comprising both local and international experts to extensively review all relevant evidence and provide advice on the use of ELVR in SA based on published evidence, expert opinion and local access to the various devices

Special Article: The South African Pilot Hospital Accreditation Progranune Part II. The developtnent of standards

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Wounds : an overlooked burden (Part 4) – Burn wounds : a searing situation

Burn injuries are a leading cause of deformities and death globally, and in developing countries, the recurrence of burn incidents increases the financial burden on health systems. Appropriate management of burn wounds with timeous referral of patients to burn wound experts must be prioritised to facilitate recovery and prevent complications. This article describes common characteristics of burn wounds based on their aetiology and severity to help the treating clinician determine the appropriate treatment protocol to be applied. Treatment strategies according to burn wound aetiology have been summarised into downloadable reference tables for use in everyday practice.http://www.sagp.co.zaam2022Pharmacolog

Recommendations for the use of endoscopic lung volume reduction in South Africa: Role in the treatment of emphysema

Emphysema is a very common cause of morbidity and mortality in South Africa (SA). Therapeutic options in severe emphysema are limited. Endoscopic lung volume reduction (ELVR) is increasingly being used internationally for the treatment of advanced emphysema in a subset of patients with advanced disease, aiming to obtain the same functional advantages as surgical lung volume reduction while reducing risks and costs. In addition to endobronchial valves, ELVR using endobronchial coils is now available in SA. The high cost of these interventions underscores the need for careful patient selection to best identify those who may or may not benefit from ELVR-related procedures. The Assembly on Interventional Pulmonology of the South African Thoracic Society appointed a committee comprising both local and international experts to extensively review all relevant evidence and provide advice on the use of ELVR in SA based on published evidence, expert opinion and local access to the various devices

Monovarietal extra-virgin olive oil classification: a fusion of human sensory attributes and an electronic tongue

Olive oil quality grading is traditionally assessed by human sensory evaluation of positive and negative attributes (olfactory, gustatory, and final olfactorygustatory sensations). However, it is not guaranteed that trained panelist can correctly classify monovarietal extra-virgin olive oils according to olive cultivar. In this work, the potential application of human (sensory panelists) and artificial (electronic tongue) sensory evaluation of olive oils was studied aiming to discriminate eight single-cultivar extra-virgin olive oils. Linear discriminant, partial least square discriminant, and sparse partial least square discriminant analyses were evaluated. The best predictive classification was obtained using linear discriminant analysis with simulated annealing selection algorithm. A low-level data fusion approach (18 electronic tongue signals and nine sensory attributes) enabled 100 % leave-one-out cross-validation correct classification, improving the discrimination capability of the individual use of sensor profiles or sensory attributes (70 and 57 % leave-one-out correct classifications, respectively). So, human sensory evaluation and electronic tongue analysis may be used as complementary tools allowing successful monovarietal olive oil discrimination.This work was co-financed by FCT/MEC and FEDER under Program PT2020 (Project UID/EQU/50020/2013); by Fundacao para a Ciencia e Tecnologia under the strategic funding of UID/BIO/04469/2013 unit; and by Project POCTEP through Project RED/AGROTEC-Experimentation network and transfer for development of agricultural and agro industrial sectors between Spain and Portugal

EPG5-related Vici syndrome: a paradigm of neurodevelopmental disorders with defective autophagy

Vici syndrome is a progressive neurodevelopmental multisystem disorder due to recessive mutations in the key autophagy gene EPG5. We report genetic, clinical, neuroradiological, and neuropathological features of 50 children from 30 families, as well as the neuronal phenotype of EPG5 knock-down in Drosophila melanogaster. We identified 39 different EPG5 mutations, most of them truncating and predicted to result in reduced EPG5 protein. Most mutations were private, but three recurrent mutations (p.Met2242Cysfs*5, p.Arg417*, and p.Gln336Arg) indicated possible founder effects. Presentation was mainly neonatal, with marked hypotonia and feeding difficulties. In addition to the five principal features (callosal agenesis, cataracts, hypopigmentation, cardiomyopathy, and immune dysfunction), we identified three equally consistent features (profound developmental delay, progressive microcephaly, and failure to thrive). The manifestation of all eight of these features has a specificity of 97%, and a sensitivity of 89% for the presence of an EPG5 mutation and will allow informed decisions about genetic testing. Clinical progression was relentless and many children died in infancy. Survival analysis demonstrated a median survival time of 24 months (95% confidence interval 0–49 months), with only a 10th of patients surviving to 5 years of age. Survival outcomes were significantly better in patients with compound heterozygous mutations (P = 0.046), as well as in patients with the recurrent p.Gln336Arg mutation. Acquired microcephaly and regression of skills in long-term survivors suggests a neurodegenerative component superimposed on the principal neurodevelopmental defect. Two-thirds of patients had a severe seizure disorder, placing EPG5 within the rapidly expanding group of genes associated with early-onset epileptic encephalopathies. Consistent neuroradiological features comprised structural abnormalities, in particular callosal agenesis and pontine hypoplasia, delayed myelination and, less frequently, thalamic signal intensity changes evolving over time. Typical muscle biopsy features included fibre size variability, central/internal nuclei, abnormal glycogen storage, presence of autophagic vacuoles and secondary mitochondrial abnormalities. Nerve biopsy performed in one case revealed subtotal absence of myelinated axons. Post-mortem examinations in three patients confirmed neurodevelopmental and neurodegenerative features and multisystem involvement. Finally, downregulation of epg5 (CG14299) in Drosophila resulted in autophagic abnormalities and progressive neurodegeneration. We conclude that EPG5-related Vici syndrome defines a novel group of neurodevelopmental disorders that should be considered in patients with suggestive features in whom mitochondrial, glycogen, or lysosomal storage disorders have been excluded. Neurological progression over time indicates an intriguing link between neurodevelopment and neurodegeneration, also supported by neurodegenerative features in epg5-deficient Drosophila, and recent implication of other autophagy regulators in late-onset neurodegenerative disease

Laparoscopic versus conventional appendectomy - a meta-analysis of randomized controlled trials

<p>Abstract</p> <p>Background</p> <p>Although laparoscopic surgery has been available for a long time and laparoscopic cholecystectomy has been performed universally, it is still not clear whether open appendectomy (OA) or laparoscopic appendectomy (LA) is the most appropriate surgical approach to acute appendicitis. The purpose of this work is to compare the therapeutic effects and safety of laparoscopic and conventional "open" appendectomy by means of a meta-analysis.</p> <p>Methods</p> <p>A meta-analysis was performed of all randomized controlled trials published in English that compared LA and OA in adults and children between 1990 and 2009. Calculations were made of the effect sizes of: operating time, postoperative length of hospital stay, postoperative pain, return to normal activity, resumption of diet, complications rates, and conversion to open surgery. The effect sizes were then pooled by a fixed or random-effects model.</p> <p>Results</p> <p>Forty-four randomized controlled trials with 5292 patients were included in the meta-analysis. Operating time was 12.35 min longer for LA (95% CI: 7.99 to 16.72, p < 0.00001). Hospital stay after LA was 0.60 days shorter (95% CI: -0.85 to -0.36, p < 0.00001). Patients returned to their normal activity 4.52 days earlier after LA (95% CI: -5.95 to -3.10, p < 0.00001), and resumed their diet 0.34 days earlier(95% CI: -0.46 to -0.21, p < 0.00001). Pain after LA on the first postoperative day was significantly less (p = 0.008). The overall conversion rate from LA to OA was 9.51%. With regard to the rate of complications, wound infection after LA was definitely reduced (OR = 0.45, 95% CI: 0.34 to 0.59, p < 0.00001), while postoperative ileus was not significantly reduced(OR = 0.91, 95% CI: 0.57 to 1.47, p = 0.71). However, intra-abdominal abscess (IAA), intraoperative bleeding and urinary tract infection (UIT) after LA, occurred slightly more frequently(OR = 1.56, 95% CI: 1.01 to 2.43, p = 0.05; OR = 1.56, 95% CI: 0.54 to 4.48, p = 0.41; OR = 1.76, 95% CI: 0.58 to 5.29, p = 0.32).</p> <p>Conclusion</p> <p>LA provides considerable benefits over OA, including a shorter length of hospital stay, less postoperative pain, earlier postoperative recovery, and a lower complication rate. Furthermore, over the study period it was obvious that there had been a trend toward fewer differences in operating time for the two procedures. Although LA was associated with a slight increase in the incidence of IAA, intraoperative bleeding and UIT, it is a safe procedure. It may be that the widespread use of LA is due to its better therapeutic effect.</p

Wanbegrippe ten opsigte van bewerkings met desimale breuke

Thesis (MEd)--University of Stellenbosch, 2005.ENGLISH ABSTRACT: Research shows that misconceptions about calculations develop in many classrooms without being noticed and these are not corrected by repeated routine exercises. The misconceptions formed are at times the result of inappropriate models used to solve problems. An even bigger concern is that these particular models sometimes provide the correct answers by accident. This may result in the learner's belief in the models being reinforced, as described by Swan (n.d.). The aim of this study is to identify the misconceptions related to the use of decimal fractions by Grade 8 and 9 learners and then, through the use of an intervention program, to address the learners' misconceptions and attempt to correct them. Two schools were involved in this study. The group of learners from school A served as a control group to determine the success of the intervention in learners from school B. The results of school A, the frequency and nature of errors were compared with the test results of school B as well as described by interviews with learners from school B. After the diagnostic tests and interview, the learners' answers were compared with those already described in literature. The learners from school B participated voluntarily in the intervention program. Learners from both schools wrote a post-test and the results were compared with those of a pre-test. The conclusion of this study is that there are misconceptions concerning calculations with decimal fractions at Grade 8 and 9 level. These misconceptions are formed during the intermediate phase and are not suitably corrected. The intervention program, for various reasons, had limited success. These reasons are discussed and recommendations are made for future intervention programs.AFRIKAANSE OPSOMMING: Navorsing toon dat wanbegrippe ten opsigte van berekeninge in baie klaskamers onopgemerk verbygaan en dat dit nie reggestel word deur herhaalde roetine oefeninge nie. Wanbegrippe wat kinders vorm is onder andere die gevolg van onvanpaste modelle wat gebruik word vir die oplos van probleme. 'n Groter gevaar is dat hierdie onvanpaste modelle toevallig die regte antwoord lewer. Dit kan dan veroorsaak dat die leerder se vertroue op die modelle net versterk word, soos Swan (s.j.) dit beskryf. Die doel van hierdie studie is om wanbegrippe ten opsigte van bewerkings met desimale breuke by Graad 8 en 9 leerders te identifiseer en dan deur middel van 'n intervensieprogram die leerders se wanbegrippe aan te spreek en te probeer regstel. Twee skole is by hierdie studie betrek. Die groep leerders van skool A sou dien as 'n kontrolegroep om die intervensie-sukses van die leerders van skool B te bepaal. Die skool A resultate en frekwensie van foute asook die aard daarvan is vergelyk met die toetse van skool B en beskryf op grond van onderhoude met die leerders van skool B. Ná die diagnostiese toets en onderhoud is die leerders se antwoorde vergelyk met dié wat reeds in die literatuur beskryf is. Die leerders van skool B is op vrywillige basis by 'n intervensieprogram betrek. Beide skole se leerders het daarna 'n natoets geskryf en die resultate is vergelyk met dié van die voortoets. Die gevolgtrekking wat uit hierdie studie gemaak word, is dat daar wanbegrippe ten opsigte van bewerkings met desimale breuke op graad 8 en 9 vlak aanwesig is. Hierdie wanbegrippe is in die intermediêre fase gevorm en nie reggestel nie. Die intervensieprogram het om verskeie redes slegs beperkte sukses gehad. Hierdie redes word bespreek en aanbevelings word gemaak vir toekomstige intervensieprogramme

Quantification of the natural variation in traffic flow on selected national roads in South Africa

Transport and traffic movement is complex and ever-changing. The movement of people and the means by which they travel are directly influenced by the transportation systems available to them. Engineers have the responsibility to provide safe, efficient and economical transportation services, and in order to do this, have to understand the variable nature of traffic. Numerous variations in traffic patterns exist due to the continuously changing movements of people. This study aims to quantify these variations to provide engineers with the tools to understand existing traffic conditions and to allow effective future planning and design. Various types of traffic variations exist, including: variation of traffic over a single day (hourly variation), a week (daily variation), between months of the year (monthly variation), and the annual growth of traffic (annual variation). These variations are analysed using data from 18 counting stations across South Africa. Modification Factors are introduced to quantify the traffic variations. Modification Factors are generated for each type of traffic pattern, providing a tool to understand the variable nature of traffic. This research was conducted at Stellenbosch University as the final year research dissertation of the main author towards the degree BEng (Civil).Papers presented at the 36th Southern African Transport Conference, CSIR International Convention Centre, Pretoria, South Africa on 10-13 July 2017.Transportation research board of the national academie