Roots and Routes of Political Violence in Kenya’s Civil and Political Society: A Case Study of Marsabit County

Struggles to influence the balance of power and the distribution of economic resources in Kenya have a long history of violence: national and local, actual and threatened, physical and psychological. Somewhat controlled by sophisticated legal, administrative and political institutions and strongly tempered by a deep fund of intercommunity cooperation, violence has been kept in check, but remains persistent. The levels of violence vary from place to place and year to year, and seldom break out into full-scale clashes or war. Nonetheless, different forms of violence combine with politics to form a resilient chain that exerts powerful control over people’s lives and resists straightforward policy prescriptions or easy practical resolutions. This case study uses a definition of political settlements to frame the inquiry (Parks and Cole 2010). This approach defines political settlements as the informal agreements that govern the formal negotiation and distribution of goods, rights and responsibilities within the state. The study aims to show one manifestation of how the political settlement in Kenya is upheld by a variety of interlinked forms of ‘normal’ violence, themselves linked to economic dependencies. Today’s political settlement is founded in the new constitution of Kenya and structured by the new system of devolved government. We show how the informal rules of the political (un)settlement in operation at the most local level play a role in sustaining a violent political system.UK Department for International Developmen

Compensation in Verbal and Nonverbal Communication after Total Laryngectomy

Total laryngectomy is a major surgical procedure with life-changing consequences. As a result of the surgery, the upper and lower airways are disconnected, the natural voice is lost, and patients breathe through a tracheostoma in the neck. Tracheoesophageal speech is the most common speech rehabilitation technique. Due to the lack of air volume, and the amount of muscle tension in the esophagus, some patients may suffer from a hyper- or hypo-tonic voice, resulting in less intelligible speech. To communicate as intelligibly as possible, patients likely adapt their verbal and nonverbal communication to their physical disabilities. The current study aimed to explore the compensation techniques in verbal and nonverbal communication after total laryngectomy focusing on the complexity of grammar and the use of co-speech gestures. We analyzed previously obtained interviews of eight laryngectomized women on the syntactic complexity in speech and the use and type of co-speech gestures. Results were compared with analyses of productions by healthy controls. We found that laryngectomized women reduce the syntactic complexity of their speech, and use nonverbal gestures in their communication. Further research is needed with systematically obtained data and more suitable match-groups

The effect of leucovorin rescue therapy on methotrexate-induced oral mucositis in the treatment of paediatric ALL: A systematic review

Introduction: This study aimed to determine the efficacy of different Leucovorin regimens to reduce oral mucositis in children with acute lymphoblastic leukemia after high-dose Methotrexate (HD-MTX). Methods: Twelve articles were included in a systematic literature review. Articles were categorized into low/medium/high risk of bias. Results: As no randomized controlled trial assessing the effect of Leucovorin has been performed, the efficacy of Leucovorin to reduce oral mucositis remains unknown. Leucovorin was initiated at 24, 36 or 42 h after HD-MTX at a dose of 15 or 30 mg/m2. No meta-analysis could be performed as treatment regimens differed. When comparing studies with similar HD-MTX doses, we observed lower oral mucositis rates in regimens with higher cumulative doses of Leucovorin and early initiation of Leucovorin after MTX. Conclusion: Even though future studies are necessary, higher cumulative Leucovorin doses and early initiation of Leucovorin after start of MTX seem to reduce oral mucositis

U-SPECT-BioFluo: an integrated radionuclide, bioluminescence, and fluorescence imaging platform

Background: In vivo bioluminescence, fluorescence, and single-photon emission computed tomography (SPECT) imaging provide complementary information about biological processes. However, to date these signatures are evaluated separately on individual preclinical systems. In this paper, we introduce a fully integrated bioluminescence-fluorescence-SPECT platform. Next to an optimization in logistics and image fusion, this integration can help improve understanding of the optical imaging (OI) results. Methods: An OI module was developed for a preclinical SPECT system (U-SPECT, MILabs, Utrecht, the Netherlands). The applicability of the module for bioluminescence and fluorescence imaging was evaluated in both a phantom and in an in vivo setting using mice implanted with a 4 T1-luc + tumor. A combination of a fluorescent dye and radioactive moiety was used to directly relate the optical images of the module to the SPECT findings. Bioluminescence imaging (BLI) was compared to the localization of the fluorescence signal in the tumors. Results: Both the phantom and in vivo mouse studies showed that superficial fluorescence signals could be imaged accurately. The SPECT and bioluminescence images could be used to place the fluorescence findings in perspective, e.g. by showing tracer accumulation in non-target organs such as the liver and kidneys (SPECT) and giving a semi-quantitative read-out for tumor spread (bioluminescence). Conclusions: We developed a fully integrated multimodal platform that provides complementary registered imaging of bioluminescent, fluorescent, and SPECT signatures in a single scanning session with a single dose of anesthesia. In our view, integration of these modalities helps to improve data interpretation of optical findings in relation to radionuclide images

How molecular imaging will enable robotic precision surgery: the role of artificial intelligence, augmented reality, and navigation

Molecular imaging is one of the pillars of precision surgery. Its applications range from early diagnostics to therapy planning, execution, and the accurate assessment of outcomes. In particular, molecular imaging solutions are in high demand in minimally invasive surgical strategies, such as the substantially increasing field of robotic surgery. This review aims at connecting the molecular imaging and nuclear medicine community to the rapidly expanding armory of surgical medical devices. Such devices entail technologies ranging from artificial intelligence and computer-aided visualization technologies (software) to innovative molecular imaging modalities and surgical navigation (hardware). We discuss technologies based on their role at different steps of the surgical workflow, i.e., from surgical decision and planning, over to target localization and excision guidance, all the way to (back table) surgical verification. This provides a glimpse of how innovations from the technology fields can realize an exciting future for the molecular imaging and surgery communities.Imaging- and therapeutic targets in neoplastic and musculoskeletal inflammatory diseas

Simulating growth, development, and yield of tillering pearl millet. II. Simulation of canopy development

Tillering is an important adaptive feature of pearl millet (Pennisetum americanum [Pennisetum glaucum]) to the unpredictable growing conditions of dry areas of the semiarid tropics. Yet, this feature has largely been ignored in the development of simulation models for pearl millet. The objective of this paper is to parameterize and validate a leaf area module for pearl millet, which dynamically simulates crop leaf area from the leaf area of individual axes through simulating inter-axis competition for light. To derive parameters for the model, four cultivars (BJ 104, WRajPop, HHB 67 and RCB-IC 911), contrasting in phenology and tillering habit, were grown under well-watered and well-fertilized conditions across a range of plant densities in three experiments at two locations in India (Patancheru, Andhra Pradesh and Jodhpur, Rajasthan) during 1996 and 1997. For selected plants, observations on the number of primary basal tillers and on the number of visible, fully expanded, and senesced leaves on each axis were made twice a week throughout the growing season. Occurrence of panicle initiation (PI) was observed in two experiments only, but data were complemented by published and unpublished data, obtained for comparable cultivars. Parameters were obtained for the time from emergence to PI as a function of daylength, leaf initiation rate, ate of leaf and tiller appearance, and the leaf senescence rate. Parameters for leaf size were determined in a previous paper. Our parameter estimates compared well with published data and were, with the exception of time to PI and leaf size, mostly independent of cultivar, axis and density. Genotypic effects on productive tiller number could be attributed to differences in main shoot leaf size. Validation of the leaf are module showed that the module adequately reproduced the effects of density, photoperiod and genotype on the leaf area of individual axes and on productive tiller number. This was despite the fact that the reduction in leaf area of non-productive tillers was achieved in the module through a reduction in leaf size, whereas the crop reduced leaf area through a reduction in leaf number. Our results indicate that leaf area index (LAI) of a tillering crop can be simulated adequately by simulating LAI from individual leaf area and incorporating the effects of competition for ligh

Global methylation in relation to methotrexate-induced oral mucositis in children with acute lymphoblastic leukemia

Background Children with acute lymphoblastic leukemia (ALL) often suffer from toxicity of chemotherapeutic drugs such as Methotrexate (MTX). Previously, we reported that 20% of patients receiving high-dose MTX developed oral mucositis. MTX inhibits folate metabolism, which is essential for DNA methylation. We hypothesize that MTX inhibits DNA methylation, which results into adverse effects. We studied DNA methylation markers during high-dose methotrexate treatment in pediatric acute lymphoblastic leukemia (ALL) in relation to developing oral mucositis. Materials & methods S-Adenosyl-Methionine (SAM) and S-Adenosyl-Homocysteine (SAH) levels and LINE1 DNA methylation were measured prospectively before and after high-dose methotrexate (HD-MTX 4 x 5g/m2) therapy in 82 children with ALL. Methotrexate-induced oral mucositis was registered prospectively. Oral mucositis (grade 3 National Cancer Institute Criteria) was used as clinical endpoint. Results SAM levels decreased significantly during methotrexate therapy (-16.1 nmol/L (-144.0 – +46.0), p<0.001), while SAH levels and the SAM:SAH ratio did not change significantly. LINE1 DNA methylation (+1.4% (-1.1 –+6.5), p<0.001) increased during therapy. SAM and SAH levels were not correlated to LINE1 DNA methylation status. No association was found between DNA methylation markers and developing oral mucositis. Conclusions This was the first study that assessed DNA methylation in relation to MTX-induced oral mucositis in children with ALL. Although global methylation markers did change during methotrexate therapy, methylation status was not associated with developing oral mucositis