Bronchoscopy for Removal of Aspirated Tracheobronchial Foreign Bodies at Kenyatta National Hospital, in Kenya

Background: This study was aimed at defining the presentation, morbidity and mortality following inhalation and subsequent removal of  tracheobronchial foreign body using a rigid bronchoscope.Methods: This was a retrospective, cross-sectional study undertaken in the Ear Nose and Throat-Head and Neck Surgery Unit of Kenyatta National Hospital. The study population consisted of patients with brochoscopically proven tracheobronchial foreign body. Case notes of 107 consecutive admissions with brochoscopically verified tracheobronchial foreign bodieswere analyzed for age, sex, time interval between inhalation and removal, duration of stay in hospital, complications and mortality.Results: The vast majority of patients were below 3 years of age and 63% of them presented within 3 days after onset of symptoms. The right bronchus was the most frequent destination of inhaled foreign bodies (50.5%) followed by the left bronchus (17.8%) and carina (14.2%) inthat order. The turnover of patients with inhaled foreign bodies was high with 86.9% being discharged within 6 days after surgery. The bronchoscopic procedure was uneventful in 76.6% of patients. Repeat bronchoscopy was performed in three patients with one undergoing eventual thoracotomy.Intraoperative cardiac arrest occurred in 5 cases (4.6%) with successful resuscitation in 2 and mortality in three (2.7%) % cases.Conclusion: Bronchoscopic removal of inhaled foreign bodies remains one of the riskiest otolaryngologic emergencies in Kenyatta National Hospital partly because of involvement of the life sustaining airway and partly because of lack of ideal equipment and adequate expertise. The need for hands on experience and close cooperation and familiarity between theanaesthesiologist and the bonchoscopist is emphasized

FINANCING STRATEGIES, MACROECONOMIC FACTORS, INSTITUTIONAL QUALITY AND THE ACHIEVEMENT OF SUSTAINABLE DEVELOPMENT GOALS: A CRITICAL LITERATURE REVIEW

Purpose of the Study - The world through United Nations leadership has defined the post-2015 development agenda comprising of 17 goals, 169 targets and 230 global indicators, cutting across social, economic and environmental pillars, which when attained by all nations by the year 2030, will create the future the world needs. The purpose of this study is to critically review the existing literature on the effects of financing strategies, macroeconomic factors and institutional quality on the achievement of the development goals. Findings - Africa has embraced the Sustainable Development Goals framework and relies on domestic finances, foreign direct investment, external debt, trade, official development assistance, financial and technical cooperation to fund various development programs. The implementation of the post-2015 sustainable development goals has shifted from global to national and local perspective. Most of the existing studies focused on the eight millennium development goals with a global perspective. As a consequence, the significance and effectiveness of the diverse and conflicting policy recommendations founded on Millennium Development Goals studies and their contribution to the achievement of the post-2015 SDGs remains doubtful. This paper concludes that Africa in particular, will require more than identification of appropriate financing strategies in order to achieve the target development goals. The success of the financing strategies on the achievement of development goals will depend on how African nations address macroeconomic factors and institutional quality factors in its quest to achieve the sustainable development goals by year 2030. Implications – Africa will need policy intervention to address institutional quality factors such as political stability, corruption levels, financial market developments and human capital development. These factors affect the direction and or strength of the relationship between the financing strategies and development goals. In additional Africa nations need to address the macroeconomic factors such as the employment levels, income levels, inflation rates and economic growth. The microeconomic factors emerge to explain the impact of the financing strategies on the achievement of the development goals. Value of the study - the study identifies and document existing knowledge gaps and proposes study approaches to address the gap thereby enriching existing body of knowledge. In addition, this study provide in-depth analysis that will inform the understanding of the direction and impact of the various financing strategies on the achievement of development goals, which can form the basis for the policy review.

Assessment of rural livelihoods, health and wellbeing in Vhembe District Municipality, South Africa and Narok County, Kenya: A water-energy-food nexus perspective

The Water-Energy-Food (WEF) nexus has become an integral component duly suited to enable sustainable development and an important tool to achieve and sustain various socioeconomic and environmental outcomes, including the 2030 Agenda for Sustainable Development Goals. The WEF nexus has become increasingly important in recent years as it can holistically address humankind's current triple challenges, including resource depletion, environmental degradation, and population growth. Socioeconomic factors such as increased population, economic development, and climate change patterns frequently induce unprecedented pressure on WEF resources. From the various climate change model simulations, the climate is likely to increase in the future, exacerbating the demand of the population to access the WEF resources and services. For effective resource planning and decision-making, the availability of WEF resources must be assessed under ongoing climate change. In this regard, this study assessed rural livelihoods, health, and wellbeing indicators within the WEF nexus framework in Vhembe District Municipality (VDM), South Africa, and Narok County, Kenya. The premise was to determine the drivers of livelihood changes by applying the analytic hierarchy process (AHP), a Multi-Criteria Decision-Making to understand the causal linkages between the WEF nexus resources and the sustainable livelihood indicators. Data collected from the literature review, questionnaire/group discussions, and field visit engagements were used to formulate and develop a matrix of indicators to assess livelihoods, health, and wellbeing. A correlation analysis based on the AHP was used to determine the linkages between WEF resources and sustainable livelihood indicators. The multivariate analysis used the correlation matrix to capture the pairwise degrees of relationship between WEF resources and sustainable livelihood indicators in the two study areas. The results show that the resources for sustainable livelihoods in VDM are more sustainable than those in Narok County. The Consistency Ratio values for Narok County and VDM were 0.046 and 0.067, respectively. The resulting composite index (0.143) classified both study sites under the lowly sustainable category. The results are important for informing policy formulation that guides timely interventions to balance socio-ecological systems

Enhanced Functional Recovery in MRL/MpJ Mice after Spinal Cord Dorsal Hemisection

Adult MRL/MpJ mice have been shown to possess unique regeneration capabilities. They are able to heal an ear-punched hole or an injured heart with normal tissue architecture and without scar formation. Here we present functional and histological evidence for enhanced recovery following spinal cord injury (SCI) in MRL/MpJ mice. A control group (C57BL/6 mice) and MRL/MpJ mice underwent a dorsal hemisection at T9 (thoracic vertebra 9). Our data show that MRL/MpJ mice recovered motor function significantly faster and more completely. We observed enhanced regeneration of the corticospinal tract (CST). Furthermore, we observed a reduced astrocytic response and fewer micro-cavities at the injury site, which appear to create a more growth-permissive environment for the injured axons. Our data suggest that the reduced astrocytic response is in part due to a lower lesion-induced increase of cell proliferation post-SCI, and a reduced astrocytic differentiation of the proliferating cells. Interestingly, we also found an increased number of proliferating microglia, which could be involved in the MRL/MpJ spinal cord repair mechanisms. Finally, to evaluate the molecular basis of faster spinal cord repair, we examined the difference in gene expression changes in MRL/MpJ and C57BL/6 mice after SCI. Our microarray data support our histological findings and reveal a transcriptional profile associated with a more efficient spinal cord repair in MRL/MpJ mice

A review of the water-energy-food nexus research in Africa

Notwithstanding the dispersed nature of the water, energy and food (WEF) nexus scholarship in the African continent, its strategic importance to the African agenda has gained widespread attention in research and planning circles. In this regard, the bibliometric science mapping and content analysis of the WEF nexus scientific publication trends, the conceptual, intellectual and social structures, as well as the inherent paradigmatic shifts in the WEF nexus body of knowledge in the African continent have been undertaken, using the nexus body of literature accessed from the Web of Science and Scopus core collection databases. The review results confirmed that, whilst the WEF nexus scholarship has expanded since 2013, there is also evidence of growth in the conceptual, intellectual and social structures of the WEF nexus in the African continent. These shifts have resulted in the emergence of hot topics (subfields) including modelling and optimization, climate variability and change, environmental ecosystem services sustainability, and sustainable development and livelihoods. The review further determined that these structures have evolved along two main perspectives of WEF nexus research development, i.e., the interdisciplinary and transdisciplinary domains. In support of the interpretation of the visual analytics of the intellectual structure and changing patterns of the WEF nexus research, the shifts in positivist, interpretivist and pragmatic paradigmatic perspectives (these are underpinned by the ontology, epistemology, and methodology and methods) are considered when explaining WEF nexus research shifts: (a) From the unconnected silo paradigms that focus on water, energy and food (security concerns) to interconnected (and sometimes interdependent or nested) linkages or systems incorporating environmental, social-economic and political drivers (also viewed as subfields) in a bid to holistically support the Sustainable Development Goals (SDGs) across the African continent; and (b) in the evaluation of the WEF nexus scholarship based on novel analytical approaches. We contend that whilst the theories of science change underpin this apparent expansion, the macro-economic theory will find use in explaining how the WEF nexus research agenda is negotiated and the Integrative Environmental Governance (IEG) is the duly suited governance theory to bridge the inherent disconnect between WEF nexus output and governance processes uncovered in the literature. Overall, operational challenges and opportunities of the WEF nexus abound, transitioning the WEF nexus research to practice in Africa, motivating the need to take advantage of the scholar–practitioner research underpinnings, as contemplated in the transdisciplinary research approach, which is characterised by the dual quest for new knowledge and considerations of use. Yet, there is need for more coordinated and collaborative research to achieve impact and transition from WEF nexus thinking to WEF nexus practice.The Water Research Commission of South Africa. The APC was funded by the University of KwaZulu-Natal’s Centre for Transformative Agricultural and Food Systems.https://www.mdpi.com/journal/sustainabilitydm2022Geography, Geoinformatics and MeteorologySchool of Health Systems and Public Health (SHSPH

Genomic surveillance reveals multiple introductions of SARS-CoV-2 into Northern California

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally, with >365,000 cases in California as of 17 July 2020. We investigated the genomic epidemiology of SARS-CoV-2 in Northern California from late January to mid-March 2020, using samples from 36 patients spanning nine counties and the Grand Princess cruise ship. Phylogenetic analyses revealed the cryptic introduction of at least seven different SARS-CoV-2 lineages into California, including epidemic WA1 strains associated with Washington state, with lack of a predominant lineage and limited transmission among communities. Lineages associated with outbreak clusters in two counties were defined by a single base substitution in the viral genome. These findings support contact tracing, social distancing, and travel restrictions to contain the spread of SARS-CoV-2 in California and other states

Ceropegia striata, a new species of Asclepiadaceae in central Madagascar

Volume: 8Start Page: 38End Page: 4

Predicting infectious diseases: a bibliometric review on Africa

Africa has a long history of novel and re-emerging infectious disease outbreaks. This reality has attracted the attention of researchers interested in the general research theme of predicting infectious diseases. However, a knowledge mapping analysis of literature to reveal the research trends, gaps, and hotspots in predicting Africa’s infectious diseases using bibliometric tools has not been conducted. A bibliometric analysis of 247 published papers on predicting infectious diseases in Africa, published in the Web of Science core collection databases, is presented in this study. The results indicate that the severe outbreaks of infectious diseases in Africa have increased scientific publications during the past decade. The results also reveal that African researchers are highly underrepresented in these publications and that the United States of America (USA) is the most productive and collaborative country. The relevant hotspots in this research field include malaria, models, classification, associations, COVID-19, and cost-effectiveness. Furthermore, weather-based prediction using meteorological factors is an emerging theme, and very few studies have used the fourth industrial revolution (4IR) technologies. Therefore, there is a need to explore 4IR predicting tools such as machine learning and consider integrated approaches that are pivotal to developing robust prediction systems for infectious diseases, especially in Africa. This review paper provides a useful resource for researchers, practitioners, and research funding agencies interested in the research theme—the prediction of infectious diseases in Africa—by capturing the current research hotspots and trends