National Health Insurance interprofessional practice implementation in hand rehabilitation service delivery in South Africa

South Africa’s current healthcare system is unequal and inefficient, with 71% of the population accessing underfunded public healthcare facilities. The imminent National Health Insurance (NHI) aims to balance the inequality between private and public health services by providing universal healthcare. The high levels of road accidents, violence and injuries in South Africa, being one of the quadruple burdens of diseases frequently causing hand injuries with resultant devastating economic and functional implications without rehabilitation services, are concerning. The plea is that for specialised injuries, such as hand injuries, the NHI implementation requires innovative interprofessional health education and practice when managing individuals who sustained hand injuries optimally to return to preinjury functioning. When considering the devastating burden of mismanaged hand injuries on all levels of the International Classification of Functioning, Disability and Health (ICF) framework, all South Africans deserve rehabilitation by physiotherapists and occupational therapists based on each occupation’s unique strengths. Anecdotally, a lack of interprofessional undergraduate and postgraduate hand rehabilitation education and hand-injured patient management exists in South Africa, highlighting the need for urgent change towards future practice and NHI. This commentary aims to apply the ICF core sets to inform interprofessional hand rehabilitation delivery by physiotherapists and occupational therapists. Clinical implication: Interprofessional rehabilitation framed in the ICF Core Set, accompanied by inclusive interprofessional education opportunities according to the Health Professions Council of South Africa (HPCSAs) scope of practice, will benefit South Africans who sustained hand injuries to fully recover and maximise their functional performance considering the type of injuries sustained

Electronic device use and fine motor dexterity and handwriting in grade 2 elementary school children.

Master of Hand Rehabilitation. University of KwaZulu-Natal, Westville 2015.Aim: The study aimed to investigate whether a correlation exists in the electronic device usage and fine motor dexterity and handwriting in Grade 2 elementary male and female children. Methodology: A quantitative, correlation study design was utilized. Stratified sampling was employed to select n=34, grade 2 children together with their parents/primary caregivers. A parental self-administered questionnaire measured the electronic device type and frequency of use by the children. The children’s fine motor dexterity was measured with the Nine-Hole- Peg-Test and handwriting was measured with the Minnesota Handwriting Assessment. Data was analysed using SPSS version 22. Results and Discussion: Touch screen cellular phones and standard size tablet computers were most frequently used. The mean total time per week spent on electronic devices amounted to 9.3 hours and 5.5 hours per week across all mobile devices. Statistical significant correlations were measured for; total device use and total handwriting score (rho=0.110), total device use and non-dominant hand’s dexterity (rho=0.137), weak trunk stability and handwriting speed (p=0.007), male children’s handwriting speed was superior (p=0.015) and female children’s form of handwriting was superior (p=0.005), male children used handheld videogames more than female children (p=0.001). Conclusions: A weak positive correlation exists between the total time spent on electronic device usage in a week and non-dominant dexterity and handwriting. This implies that more frequent total electronic device usage per week has a higher handwriting total score but weaker non-dominant hand dexterity as a result. No correlation existed between total usage and dominant dexterity. Gender differentials revealed that males displayed faster and superior total scores in handwriting, females displayed superior scores for form, alignment and spacing and dominant/non-dominant hands’ dexterity

Effect of Y2O3 addition on the microstructure and mechanical properties of an Al1.8CoCrCu0.5FeNi BCC HEA

The present study investigated the influence of Y2O3 addition by mechanical alloying (MA) on the microstructure evolution of a BCC High Entropy Alloy (HEA). The characterisation and mechanical properties of the alloy were explored using X-ray diffraction, SEM, EBSD, and nano-indentation. The sintered Al1.8CoCrCu0.5FeNi HEA shows a microstructure formed by an ordered BCC phase (Al-rich) and a second disordered BCC (Cr-rich), while a minor FCC (Cu-rich) appears. These BCC phases show a wide morphology evolution from cuboidal and wave-like structures to irregular shapes. The minor FCC phase also adopts several morphologies as the MA is performed. The introduction of oxide reinforcements and microstructure refinement through mechanical alloying yields a change in phase quantification and grain structure. In accordance with the hardness and elastic modulus values from ordered/disordered BCC phases, the disordered BCC shows higher values than the ordered one. The grain size reduction as well as the solid solution strengthening from the microstructure evolution consequence of the MA are shown to be the main contributors to the increase in hardness and elastic modulus in the consolidated samples.This research was supported by the Regional Government of Madrid under the programme S2018/NMT-4381-MAT4.0-CM project. Funding from PID2019-109334RB-C32 awarded by the Spanish Ministry of Science, Innovation and Universities is also acknowledged. J. Cornide also acknowledges funding from the Spanish Ministry of Science and Innovation (IJCI-2017-31348) and TED2021-130831B-I00 funded by MCIN/AEI/10.13039/501100011033 and NextGenerationEU/PRTR. Funding for APC: Universidad Carlos III de Madrid (Read & Publish Agreement CRUE-CSIC 2023)

RNA and Toll-Like Receptor 7 License the Generation of Superior Secondary Plasma Cells at Multiple Levels in a B Cell Intrinsic Fashion

Secondary plasma cells (PCs) originate from memory B cells and produce increased levels of antibodies with higher affinity compared to PCs generated during primary responses. Here we demonstrate that virus-like particles (VLPs) only induce secondary PCs in the presence of toll-like receptor (TLR) 7 and if they are loaded with RNA. Furthermore, adoptive transfer experiments demonstrate that RNA and TLR7 signaling are required for secondary PC generation, both at the level of memory B cell as well as PC differentiation. TLR7-signaling occurred in a B cell intrinsic manner as TLR7-deficient B cells in an otherwise TLR7-competent environment failed to differentiate into secondary PCs. Therefore, RNA inside VLPs is essential for the generation of memory B cells, which are competent to differentiate to secondary PCs and for the differentiation of secondary PCs themselves. While we have not tested all other TLR or non-TLR adjuvants with our VLPs, these data have obvious implications for vaccine design, as RNA packaged into VLPs is a simple way to enhance induction of memory B cells capable of generating secondary PCs

The impact of episporic modification of Lichtheimia corymbifera on virulence and interaction with phagocytes

Fungal infections caused by the ancient lineage Mucorales are emerging and increasingly reported in humans. Comprehensive surveys on promising attributes from a multitude of possible virulence factors are limited and so far, focused on Mucor and Rhizopus. This study addresses a systematic approach to monitor phagocytosis after physical and enzymatic modification of the outer spore wall of Lichtheimia corymbifera, one of the major causative agents of mucormycosis. Episporic modifications were performed and their consequences on phagocytosis, intracellular survival and virulence by murine alveolar macrophages and in an invertebrate infection model were elucidated. While depletion of lipids did not affect the phagocytosis of both strains, delipidation led to attenuation of LCA strain but appears to be dispensable for infection with LCV strain in the settings used in this study. Combined glucano-proteolytic treatment was necessary to achieve a significant decrease of virulence of the LCV strain in Galleria mellonella during maintenance of the full potential for spore germination as shown by a novel automated germination assay. Proteolytic and glucanolytic treatments largely increased phagocytosis compared to alive resting and swollen spores. Whilst resting spores barely (1-2%) fuse to lysosomes after invagination in to phagosomes, spore trypsinization led to a 10-fold increase of phagolysosomal fusion as measured by intracellular acidification. This is the first report of a polyphasic measurement of the consequences of episporic modification of a mucormycotic pathogen in spore germination, spore surface ultrastructure, phagocytosis, stimulation of Toll-like receptors (TLRs), phagolysosomal fusion and intracellular acidification, apoptosis, generation of reactive oxygen species (ROS) and virulence

Mutations in GDP-mannose pyrophosphorylase b cause congenital and limb-girdle muscular dystrophies associated with hypoglycosylation of α-dystroglycan

Congenital muscular dystrophies with hypoglycosylation of α-dystroglycan (α-DG) are a heterogeneous group of disorders often associated with brain and eye defects in addition to muscular dystrophy. Causative variants in 14 genes thought to be involved in the glycosylation of α-DG have been identified thus far. Allelic mutations in these genes might also cause milder limb-girdle muscular dystrophy phenotypes. Using a combination of exome and Sanger sequencing in eight unrelated individuals, we present evidence that mutations in guanosine diphosphate mannose (GDP-mannose) pyrophosphorylase B (GMPPB) can result in muscular dystrophy variants with hypoglycosylated α-DG. GMPPB catalyzes the formation of GDP-mannose from GTP and mannose-1-phosphate. GDP-mannose is required for O-mannosylation of proteins, including α-DG, and it is the substrate of cytosolic mannosyltransferases. We found reduced α-DG glycosylation in the muscle biopsies of affected individuals and in available fibroblasts. Overexpression of wild-type GMPPB in fibroblasts from an affected individual partially restored glycosylation of α-DG. Whereas wild-type GMPPB localized to the cytoplasm, five of the identified missense mutations caused formation of aggregates in the cytoplasm or near membrane protrusions. Additionally, knockdown of the GMPPB ortholog in zebrafish caused structural muscle defects with decreased motility, eye abnormalities, and reduced glycosylation of α-DG. Together, these data indicate that GMPPB mutations are responsible for congenital and limb-girdle muscular dystrophies with hypoglycosylation of α-DG. © 2013 The American Society of Human Genetics.Funding for UK10K was provided by the Wellcome Trust under award WT091310

Sustainable healthy eating behaviour of young adults: towards a novel methodological approach

Background: Food, nutrition and health policy makers are poised with two pertinent issues more than any other: obesity and climate change. Consumer research has focused primarily on specific areas of sustainable food, such as organic food, local or traditional food, meat substitution and/or reduction. More holistic view of sustainable healthy eating behaviour has received less attention, albeit that more research is emerging in this area. Methods/design: This study protocol that aims to investigate young consumers’ attitudes and behaviour towards sustainable and healthy eating by applying a multidisciplinary approach, taking into account economical, marketing, public health and environmental related issues. In order to achieve this goal, consumers’ reactions on interactive tailored informational messages about sustainable from social, environmental and economical point of view, as well as healthy eating behaviour in a group of young adults will be investigated using randomized controlled trial. To undertake the objective, the empirical research is divided into three studies: 1) Qualitative longitudinal research to explore openness to adopting sustainable healthy eating behaviour; 2) Qualitative research with the objective to develop a sustainable healthy eating behaviour index; and 3) Randomised controlled trial to describe consumers’ reactions on interactive tailored messages about sustainable healthy eating in young consumers. Discussion: To our knowledge, this is the first randomised controlled trial to test the young adults reactions to interactive tailor made messages on sustainable healthy eating using mobile smartphone app. Mobile applications designed to deliver intervention offer new possibilities to influence young adults behaviour in relation to diet and sustainability. Therefore, the study will provide valuable insights into drivers of change towards more environmentally sustainable and healthy eating behaviours