Tibialization of the fibula in a child with chronic osteomyelitis of the tibia: A case report

A case of a ten year old patient on treatment for chronic osteomyelitis of the right tibia is presented. After undergoing multiple sessions of debridement and sequestrectomy, first at a district hospital then at Kenyatta National Hospital, the patient ended up with a large bone defect of the tibia. After his infection was clinically cured, the options for surgical management of the tibial defect included: a through-knee disarticulation, segment transport with the help of a ring fixator and tibialization of the fibula. Amputation was deemed too radical a procedure in a young patient especially now that the infection was cured. Segment transport would have been difficult considering that the bone defect involved almost 70% of bone length. Additionally, we were doubtful how compliant the patient would have been with distraction of the callus by fixator once discharged. We therefore employed tibialization of the fibula to treat this patient. This case discusses tibialization of the fibula as a viable option for  management of large bone defects of the tibia

Production of Giant \u3cem\u3ePanicum\u3c/em\u3e in Contrasting Environments in Semi-Arid Kenya

Giant panicum (Panicum maximum Jacq.) is a tall, vigorous perennial grass that is native to tropical and sub-tropical Africa. It is drought tolerant due to its deep and dense fibrous roots system and grows in a wide range of soil types. It is an important livestock feed and has been extensively cultivated in Brazil (Santos et al. 2006). Despite its wide genetic diversity in East Africa, its potential for livestock feed has not been exploited there due to limited research. Our research was aimed at evaluating the production of several giant panicum ecotypes in contrasting environments in semi-arid areas of Kenya

Being Black (and) Immigrant Students: When Race, Ethnicity, and Nativity Collide

While Black immigrants share some of the racialized experiences of native-Black Americans, they also have distinctive experiences. U.S. education presents an important environment to investigate these experiences as immigrants have the fastest growing child population and these children are increasingly entering the education system. This paper engages a systematic review of the growing body of literature centering on Black immigrants across the U.S. P-20 pipeline (preschool through graduate school). Findings reveal that the presentation of Black immigrants is incomplete in terms of the frameworks and research designs used to examine their educational experiences, pointing to a larger issue of a single narrative concerning this group

A Qualitative Toolkit for Institutional Research

This chapter provides tools, resources, and examples for engaging qualitative inquiry as a part of institutional research and assessment. It supports the development of individual ability and organizational intelligence in qualitative inquiry

Defining childhood severe falciparum malaria for intervention studies.

Background Clinical trials of interventions designed to prevent severe falciparum malaria in children require a clear endpoint. The internationally accepted definition of severe malaria is sensitive, and appropriate for clinical purposes. However, this definition includes individuals with severe nonmalarial disease and coincident parasitaemia, so may lack specificity in vaccine trials. Although there is no “gold standard” individual test for severe malaria, malaria-attributable fractions (MAFs) can be estimated among groups of children using a logistic model, which we use to test the suitability of various case definitions as trial endpoints. Methods and Findings A total of 4,583 blood samples were taken from well children in cross-sectional surveys and from 1,361 children admitted to a Kenyan District hospital with severe disease. Among children under 2 y old with severe disease and over 2,500 parasites per microliter of blood, the MAFs were above 85% in moderate- and low-transmission areas, but only 61% in a high-transmission area. HIV and malnutrition were not associated with reduced MAFs, but gastroenteritis with severe dehydration (defined by reduced skin turgor), lower respiratory tract infection (clinician's final diagnosis), meningitis (on cerebrospinal fluid [CSF] examination), and bacteraemia were associated with reduced MAFs. The overall MAF was 85% (95% confidence interval [CI] 83.8%–86.1%) without excluding these conditions, 89% (95% CI 88.4%–90.2%) after exclusions, and 95% (95% CI 94.0%–95.5%) when a threshold of 2,500 parasites/μl was also applied. Applying a threshold and exclusion criteria reduced sensitivity to 80% (95% CI 77%–83%). Conclusions The specificity of a case definition for severe malaria is improved by applying a parasite density threshold and by excluding children with meningitis, lower respiratory tract infection (clinician's diagnosis), bacteraemia, and gastroenteritis with severe dehydration, but not by excluding children with HIV or malnutrition

Role of student affairs in international student transition and success

International student mobility has grown significantly in recent years, with over 4.1 million students in 2013 who studied abroad around the world (Institute of International Education [IIE], 2016). With the changes in student demographics and increased mobility, student affairs professionals are in a unique role to support international student transition and success. Unfortunately, current research and practice in higher education tends to place a high level of responsibility on the international student to successfully transition to a new campus environment or places the responsibility on the international student affairs/student services office to solely work with these students. Given the multi-faceted needs of international students, we argue that it is critical for student affairs professionals across functional areas to be prepared to support this diverse population

Tissue biochemical diversity of 20 gooseberry cultivars and the effect of ethylene supplementation on postharvest life

The European gooseberry (Ribes uva-crispa) is still an understudied crop with limited data available on its biochemical profile and postharvest life. A variety of polyphenols were detected in the skin and flesh of 20 gooseberry cvs, representing mainly flavonol glycosides, anthocyanins and flavan-3-ols. In contrast, gooseberry seeds were for the first time characterised by the presence of considerable amounts of hydroxycinnamic acid glycosides tentatively identified by UPLC-QToF/MS. All cvs examined represented a good source of vitamin C while being low in sugar. Furthermore, the postharvest stability of bioactives was explored by supplementation of exogenous ethylene in air at 5 °C. Results suggest a low sensitivity of gooseberries to ethylene. The overall quality of gooseberries remained stable over two weeks, showing potential for extended bioactive life