Identification and critique of the citizenship notion informing the Itorero training scheme for high school leavers in post-genocide Rwanda

There is a dearth of research on citizenship education in post-genocide countries. The present article investigates the citizenship concept informing Itorero, a non-formal citizenship education platform meant for High School Leavers (hereafter HSLs) in post-genocide Rwanda. To this end, the paper engages with classical notions of citizenship (civic republicanism, liberalism and communitarianism), and modern ones (cosmopolitanism and radical democracy) in a bid to identify the notion deemed preferable to competing notions. It is revealed that the Itorero training relies heavily on the civic republican/communitarian concepts of citizenship. The paper argues that while these concepts contain constructive elements, such as fostering courage, self-sacrifice, patriotism, connectedness, and common good concern, excessive pursuit of this citizenship model might not be helpful for post-genocide Rwanda. The civic republican/communitarian paradigm – as it is practiced in Itorerotraining – is likely to produce uncritical, docile, dependent, short-sighted and child-like citizens; it encourages fanaticism.

Mucormycosis

The zygomycoses are infections caused by fungi of the class zygomycetes, comprised of the orders Mucorales and Entomophthorales. Fungi ofthis order are causes of mucormycosis, an acute opportunistic infection occurring mostly in immunocompromised individuals, particularly in patients with diabetic ketoacidosis. The purpose of this paper is to present an academic perspective on the pathophysiology, presentation and management of mucormycosis. Possible management strategies are provided

Ocular manifestations of mitochondrial disease

Mitochondrial disease caused by mutations in mitochondrial DNA is recognized as one of the most common causes of inherited neurological disease. Neuro-ophthalmic manifestations are a common feature of mitochondrial disease.  Optic atrophy causing central visual loss is the dominant feature of mitochondrial DNA diseases. Nystagmus is also encountered in mitochondrial disease.Although optometrists are not involved with the management of mitochondrial disease, they are likely to see more patients with this disease. Oph-thalmic examination forms part of the clinical assessment of mitochondrial disease. Mitochondrial disease should be suspected in any patient with unexplained optic neuropathy, ophthalmoplegia, pigmentary retinopathy or retrochiasmal visual loss. Despite considerable advances in the under-standing of mitochondrial genetics and the patho-genesis of mtDNA diseases, no effective treatment options are currently available for patients withmitochondrial dysfunction. (S Afr Optom 201271(1) 46-50

A comparative study of autokeratometric and Scheimpflug keratometric measurements of the anterior corneal surface: results for a single subject

One purpose of the broader study was to determine whether keratometric measurements obtained with an autokeratometer (Nidek ARK-700) would be comparable with those measured using the Oculus Pentacam(model 70700). Ten healthy subjects without ocular abnormality, no previous or current contact lens wear or history of ocular surgery were recruited and at least 43 successive keratometric measurements were obtained for the right eye of each subject using both instruments, namely the autokeratometer and the Pentacam. This paper will concern itself with data from only one of the ten subjects involved, namely Subject 1. The corneal powers were analyzed using multivariate methods for analyzing dioptric power. Scatter plots and meridional profiles of skewness and kurtosis were used to compare the results for the two instruments. Mean dioptric powers in conventional and scientific notation were determined. The results for this subject indicated that there was a statistically significant difference between the autokeratometry and the Pentacam. Although the means  between the two instruments were found to be significantly different at a 95% level of confidence, there was minimal clinical difference between the means of the two instruments. That is, this preliminary investigation suggests that in normal eyes, clinically, keratometric results obtained by means of an autokeratometer and a Pentacam are reasonably similar and can be used interchangeably

Randomised trials of COVID-19 vaccines in Africa – charting the path forward.

Vaccines have played a critical role in controlling disease outbreaks, hence the proliferation of the development and testing of multiple vaccine candidates during the COVID-19 pandemic. Randomised trials are gold standards for evaluating the safety and efficacy of pharmaceutical interventions such as COVID-19 vaccines. However, contextual differences may attenuate effects of COVID-19 vaccines. Thus, the need to conduct COVID-19 vaccine trials in all settings, including in Africa. We conducted a crosssectional analysis of planned, ongoing, and completed COVID-19 vaccine trials in Africa. We searched the South African National Clinical Trials Register, Pan African Clinical Trials Registry, and International Clinical Trials Registry Platform (ICTRP) on 12 January and 30 April 2022; and complemented this with a search of ClinicalTrials.gov on 17 May 2022. We screened the search output and included randomised trials with at least one recruitment site in Africa. We identified only 108 eligible trials: 90 (83%) evaluating candidate COVID-19 vaccines, 11 (10%) assessing if existing vaccines could prevent SARS-CoV-2 infection, and 7 (7%) evaluating interventions for improving COVID-19 vaccination coverage. South Africa had the highest number of trials at 58 (54%). Beyond South Africa, countries with more than 10 trial sites include Kenya, Ghana, Egypt, Uganda, and Zimbabwe. Among the trials, 14 (13%) do not have principal investigators based in Africa, 39 (30%) are funded by industry, and 91 (84%) are funded by institutions based outside the host country. COVID-19 vaccine trials with recruitment sites in Africa represented only 7% of the 1453 COVID-19 vaccine trials in the ICTRP. The paucity of COVID-19 vaccine trials conducted on the African continent is a cause for concern. This has implications for the role that Africa may play in future pandemics.Significance:• There are generally very few vaccine trials conducted in Africa, relative to the rest of the world.• The limited vaccine trials in Africa could be attributed to limited expertise and resources, both human and material, as well as lack of perceived market.• It is reassuring that many COVID-19 vaccines are planned, being conducted, or have been conducted in multiple African countries; but there is a need for more African public sector funding for vaccine trials on the continent

Optical transferences and their application to ray tracing through the human cornea*

The purpose of this paper is two fold, firstly to describe aspects of the quantitative analysis of the linear optical character of the corneas of ten young and healthy subjects using the exp-mean-log-transference and secondly to illustrate how mean transference and ray vector fields or diagrams can be used to explain and understand the optical properties of corneas as thick optical systems.An Oculus Pentacam was used to obtain 43 successive measurements of the radii of curvature of the anterior and posterior corneal surfaces and the central corneal thicknesses of the right eyes of ten subjects. From these measurements 4×4 ray transferences were calculated. Mean transferences were obtained via multi-dimensional Hamiltonian space and these mean transferences were used to produce stereo-pairs of ray vector fields. The mean transferences are also important in understanding the behaviour of light through each of the corneas concerned. This paper provides the first order optical characters of corneas from the positions and inclinations of rays entering and leaving such systems. As anticipated, light rays through the cornea are deflected inwards when the refractive index of the cornea is greater than the index of the surrounding medium. The exp-mean-log transference for a specific cornea exists and is the optical transference of the averaged cornea of the sample of measurements for that cornea. Within the limitations of linear or paraxial optics, the corneas of the different eyes in this sample and their averages were found to be close to that of thin optical systems; but they were not truly thin and instead should be considered as being thick optical systems. (S Afr Optom 2011 70(4) 156-167

Ocular surface disorder among HIV and AIDS patients using antiretroviral drugs

Background: Ocular disorders occur in 50% – 80% of HIV and AIDS patients, and dry eye has been reported as one of the most common anterior segment manifestations in these patients. Aim: The aim of this study was to investigate ocular surface disorders (OSDs) or dry eye in people living with HIV and AIDS on antiretroviral (ARVs) in a controlled setting. Setting: Mankweng Hospital, ARV Clinic. Methods: This study included 130 HIV and AIDS participants attending an ART Clinic at Mankweng Hospital and 48 controls. Each participant had an anterior and posterior segment eye examination with a slit lamp and fundus camera, respectively. The dry eye or OSD was investigated with Schirmer’s test and invasive fluorescein tear breakup time (TBUT). Results: The means of the Schirmer’s test and TBUT were 6.7 mm ± 4.0 mm and 6.9 ± 4 seconds in HIV and AIDS participants, while the means in the control group were 13.5 mm ± 3 mm and 14.2 ± 3 s, respectively. The correlations between the severity of dry eye and the level of CD4 cell count were positive and significant. Conclusion: There was decreased tear production as measured by the Schirmer’s test and TBUT in our study participants. Statistically significant correlations were found between the severity of dry eye and the level of CD4 cell count. Although the entire pathogenesis of dry eye in HIV and AIDS patients remains unclear, it may be associated with lymphocytic infiltration and destruction of the lacrimal gland

Bioceramic hydroxyapatite coating fabricated on TI-6AL-4V using Nd:YAG laser

A method of synthesising a biocompatible HAP coating is presented. In the current study, Nd:YAG laser was used to directly melt pre-place HAP powder beds on Ti-6Al-4V. The processing parameters used were 750 W laser power, 5 mm/s scanning speed and 27° inclined beam plane. The coating was studied under white light and scanning electron microscope where it was possible to characterise the microstructures. The produced coating was characterised of mixed morphologies of HAP, short and elongated titanium needles at the surface while in the middle of the coating dendrite trunks without arms were observed. This observation is related to the heat inputs, dilution and melting of the substrate and powder during processing. The absence of the arms growing from the trunks indicated low heat inputs. In addition, the microstructure of the HAP after soaking in Hanks’ solution indicated octagonal and hexagonal crystals of HAP. The hardness values indicated good metallurgical bonding at the interface. In conclusion, this study was successful in fabricating a desirable coating of HAP on Ti-6Al-4V for biomedical applications. This work highlights that even though laser power and scanning speed are predominantly influential parameter settings, it is also necessary to consider the angle at which the laser beam is scanned across the material

Tuberculosis treatment intervention trials in Africa: A cross-sectional bibliographic study and spatial analysis

Background Mycobacterium Tuberculosis (TB) poses a substantial burden in sub-Saharan Africa and is the leading cause of death amongst infectious diseases. Randomised controlled trials (RCTs) are regarded as the gold standard for evaluating the effectiveness of interventions. We aimed to describe published TB treatment trials conducted in Africa. Methods This is a cross-sectional study of published TB trials conducted in at least one African country. In November 2019, we searched three databases using the validated Africa search filter and Cochrane’s sensitive trial string. Published RCTs conducted in at least one African country were included for analysis. Records were screened for eligibility. Co-reviewers assisted with duplicate data extraction. Extracted data included: the country where studies were conducted, publication dates, ethics statement, trial registration number, participant’s age range. We used Cochrane’s Risk of Bias criteria to assess methodological quality. Results We identified 10,495 records; 175 trials were eligible for inclusion. RCTs were published between 1952 and 2019. The median sample size was 206 participants (interquartile range: 73–657). Most trials were conducted in South Africa (n = 83) and were drug therapy trials (n = 130). First authors were from 30 countries globally. South Africa had the most first authors (n = 55); followed by the United States of America (USA) (n = 28) and Great Britain (n = 14) with fewer other African countries contributing to the first author tally. Children under 13 years of age eligible to participate in the trials made up 17/175 trials (9.71%). International governments (n = 29) were the most prevalent funders. Ninety-four trials provided CONSORT flow diagrams. Methodological quality such as allocation concealment and blinding were poorly reported or unclear in most trials. Conclusions By mapping African TB trials, we were able to identify potential research gaps. Many of the global north’s researchers were found to be the lead authors in these African trials. Few trials tested behavioural interventions compared to drugs, and far fewer tested interventions on children compared to adults to improve TB outcomes. Lastly, funders and researchers should ensure better methodological quality reporting of trials