The future is in our hands

A lot has been said and written about leadership theories and the effectiveness of the same. No other major contributor to organisational performance is focused on than leadership. But each individual is unique in her/his own ways. In the Kenyan context, the landscape has been turned upside down. From a male dominated sector where all vice chancellors of the public universities were men, now plethora of female vice chancellors can be counted from the public to the private universities almost in equal numbers. The performance of management of the various universities has ranged from mediocre to exceptional. Some management systems and leadership styles that could be replicated must be hidden somewhere. In this realm of knowledge, it therefore portends great danger if one was to prescribe a one-fits-all dose of the applicable leadership style in our higher education set up. But that is the very essence of science, to search and discover the discernible patterns that can be replicated across the line for posterity. Being the custodians of knowledge and disseminators of the same, the various complaints emanating from students, lecturers, staff and other stakeholders on how universities preach water and take gallons of wine in the field of management is a complaint that needs serious consideration. Further, having seen the problems that other learning institutions have had in management mostly traced to the fact that most administrators were plucked from class and given positions of leadership without orientation, then it behoves those in the scholarly world of management and leadership to synthesise some bitable bits that could assist those in positions of authority to appreciate the scientific approach to management. We conclude that time might have come when leadership in universities will not be reserved to academicians but to corporate executives capable of inspiring the whole institutions to great heights of performance excellence

Advances in nanophotonics: ultrafast & ultrasensitive

In this tutorial on NanoPhotonics recent advances are highlighted with focus on near field optical methods, ultra-fast probing of single molecules and ultra-sensitive detection of individual non-fluorescent nanoparticles

Complications in ankle arthroscopy

PURPOSE: To determine the complication rate for ankle arthroscopy. METHODS: A review of a consecutive series of patients undergoing ankle arthroscopy in our hospital between 1987 and 2006 was undertaken. Anterior ankle arthroscopy was performed by means of a 2-portal dorsiflexion method with intermittent soft tissue distraction. Posterior ankle arthroscopy was performed by means of a two-portal hindfoot approach. Complications were registered in a prospective national registration system. Apart from this complication registry, patient records, outpatient charts and operative reports were reviewed. Patients with a complication were asked to visit our hospital for clinical examination and assessment of permanent damage and persisting complaints. RESULTS: An overall complication rate of 3.5 % in 1,305 procedures was found. Neurological complications (1.9 %) were related to portal placement. Age was a significant risk factor for the occurrence of complications. Most complications were transient and resolved within 6 months. Complications did not lead to functional limitations. Residual complaints did not influence daily activities. CONCLUSIONS: Our complication rate is less than half of what has been reported in literature (3.5 vs 10.3 %). The use of the dorsiflexion method for anterior ankle arthroscopy can prevent a significant number of complications. Posterior ankle arthroscopy by means of a two-portal hindfoot approach is a safe procedure with a complication rate that compares favourably to that of anterior ankle arthroscopy. LEVEL OF EVIDENCE: Retrospective prognostic study, Level II

“Web impingement” of the ankle: a case report

This case report presents two patients with persisting anterior ankle impingement pain after an ankle distortion. A web-like intra-articular fibrous band was discovered and resected. The patients presented were, after a 1-year follow-up, pain fre

Weightbearing ovine osteochondral defects heal with inadequate subchondral bone plate restoration: implications regarding osteochondral autograft harvesting

PURPOSE: It is unknown what causes donor site morbidity following the osteochondral autograft transfer procedure or how donor sites heal. Contact pressure and edge loading at donor sites may play a role in the healing process. It was hypothesized that an artificially created osteochondral defect in a weightbearing area of an ovine femoral condyle will cause osseous bridging of the defect from the upper edges, resulting in incomplete and irregular repair of the subchondral bone plate. METHODS: To simulate edge loading, large osteochondral defects were created in the most unfavourable weightbearing area of 24 ovine femoral condyles. After killing at 3 and 6 months, osteochondral defects were histologically and histomorphometrically evaluated with specific attention to subchondral bone healing and subchondral bone plate restoration. RESULTS: Osteochondral defect healing showed progressive osseous defect bridging by sclerotic circumferential bone apposition. Unfilled area decreased significantly from 3 to 6 months (P = 0.004), whereas bone content increased (n.s.). Complete but irregular subchondral bone plate restoration occurred in ten animals. In fourteen animals, an incomplete subchondral bone plate was found. Further common findings included cavitary lesion formation, degenerative cartilage changes and cartilage and subchondral bone collapse. CONCLUSIONS: Osteochondral defect healing starts with subchondral bone plate restoration. However, after 6 months, incomplete or irregular subchondral bone plate restoration and subsequent failure of osteochondral defect closure is common. Graft harvesting in the osteochondral autograft transfer procedure must be viewed critically, as similar changes are also present in humans. LEVEL OF EVIDENCE: Prognostic study, Level III

Estimating infarct severity from the ECG using a realistic heart model

The early phase of myocardial infarction is accompanied by changes in the ST segment of the ECG. This makes the ST segment the clinical marker for the detection of acute myocardial infarction. The determination of the infarct severity, location and size of the myocardial tissue at risk will support clinical decision making. In this study we used an inverse procedure to estimate the location and size of the infarcted heart region. The method estimates the local transmembrane amplitude based on the ECG amplitude near the J-point of the standard 12 leads signals using a patient specific volume conductor model. For the 5 available patient cases the positions as well as the size of the estimated infarct region were in accordance with results based on MRI

Validation of infarct size and location from the ECG by inverse body surface mapping

This paper describes the incorporation of body surface mapping algorithms to detect the position and size of acute myocardial infarctions using standard 12 lead ECG recording. The results are compared with the results from cardiac MRI scan analysis. In case patient specific volume conductor models are used, the position of the infarction could be accurately determined. When generalized patient volume conductor models were examined, the estimation of the infarct position became significantly less accurate. The calculations of the size of the infarctions need further improvement

Measuring hindfoot alignment radiographically: the long axial view is more reliable than the hindfoot alignment view

BACKGROUND: Hindfoot malalignment is a recognized cause of foot and ankle disability. For preoperative planning and clinical follow-up, reliable radiographic assessment of hindfoot alignment is important. The long axial radiographic view and the hindfoot alignment view are commonly used for this purpose. However, their comparative reliabilities are unknown. As hindfoot varus or valgus malalignment is most pronounced during mid-stance of gait, a unilateral weight-bearing stance, in comparison with a bilateral stance, could increase measurement reliability. The purpose of this study was to compare the intra- and interobserver reliability of hindfoot alignment measurements of both radiographic views in bilateral and unilateral stance. MATERIALS AND METHODS: A hindfoot alignment view and a long axial view were acquired from 18 healthy volunteers in bilateral and unilateral weight-bearing stances. Hindfoot alignment was defined as the angular deviation between the tibial anatomical axis and the calcaneus longitudinal axis from the radiographs. Repeat measurements of hindfoot alignment were performed by nine orthopaedic examiners. RESULTS: Measurements from the hindfoot alignment view gave intra- and interclass correlation coefficients (CCs) of 0.72 and 0.58, respectively, for bilateral stance and 0.91 and 0.49, respectively, for unilateral stance. The long axial view showed, respectively, intra- and interclass CCs of 0.93 and 0.79 for bilateral stance and 0.91 and 0.58 for unilateral stance. CONCLUSION: The long axial view is more reliable than the hindfoot alignment view or the angular measurement of hindfoot alignment. Although intra-observer reliability is good/excellent for both methods, only the long axial view leads to good interobserver reliability. A unilateral weight-bearing stance does not lead to greater reliability of measuremen