Miracle-dz/UniFAR-FTUs huggingface dataset:
Complex methods of inquiry: structuring uncertainty

Organizational problem spaces can be viewed as complex, uncertain and ambiguous. They can also be understood as open problem spaces. As such, any engagement with them, and any effort to intervene in order to pursue desirable change, cannot be assumed to be just a matter of ‘complicatedness’. The issue is not just a need to cope with dynamics of system. It is also the perceptual ‘boundedness’ of multitudes of assumptions about scope of whole and limitations of organization as system. Furthermore, explicit attention to complexities of feedback loops is an extremely important aspect of any systemic discussion. How can we help teams of competent professionals to engage purposefully with such uncertain and ambiguous problem domains? The author suggests that we can only address this effectively through pragmatic efforts to incorporate a multitude of boundary-setting assumptions, explored as part of active (self-) reflection and practical engagement. This must be undertaken without resorting to an overly simplistic application of convergent thinking in our efforts to support problem solving. Instead, we need to pursue divergent thinking and ‘complexification’ in our effort to support problem resolving. The main contribution of this thesis is to present a collection of principles that taken together, provide support for this engagement ntervention. A core feature of this result is the framework for Strategic Systemic Thinking, which includes examples of pragmatically useful methods and tools.
Granulomatous Pneumocystis carinii pneumonia in patients with malignancy

Background: A review was undertaken of the clinical features and results of diagnostic tests in non-HIV infected patients who developed granulomatous Pneumocystis carinii pneumonia (PCP). Methods: A retrospective review was performed of the charts and radiographs of patients with a granulomatous reaction to P carinii identified from computerised pathology records at Memorial Sloan Kettering Cancer Center, a university affiliated tertiary care hospital. Results: Three cases were identified; the incidence of granulomatous PCP was 3%. All patients had risk factors for PCP and had received high dose corticosteroids which had been stopped. Two patients had received chemotherapy. Presentation was insidious with only mild symptoms; only one patient had fever. Chest radiographs showed a reticulonodular pattern. Bronchoscopy was negative for PCP in all cases and open lung biopsy was necessary. Conclusion: A granulomatous pathological reaction to PCP occurs rarely in patients with malignancy. In these cases the clinical presentation may be atypical and bronchoscopy can be non-diagnostic.
Moments of Discounted Dividends for a Threshold Strategy in the Compound Poisson Risk Model

Abstract We consider a compound Poisson risk model in which part of the premium is paid to the shareholders as dividends when the surplus exceeds a specified threshold level. In this model we are interested in computing the moments of the total discounted dividends paid until ruin occurs. However, instead of employing the traditional argument, which involves conditioning on the time and amount of the first claim, we provide an alternative probabilistic approach that makes use of the (defective) joint probability density function of the time of ruin and the deficit at ruin in a classical model without a threshold. We arrive at a general formula that allows us to evaluate the moments of the total discounted dividends recursively in terms of the lower-order moments. Assuming the claim size distribution is exponential or, more generally, a finite shape and scale mixture of Erlangs, we are able to solve for all necessary components in the general recursive formula. In addition to determining the optimal threshold level to maximize the expected value of discounted dividends, we also consider finding the optimal threshold level that minimizes the coefficient of variation of discounted dividends. We present several numerical examples that illustrate the effects of the choice of optimality criterion on quantities such as the ruin probability.
Metabolic and behavioral effects of high-dose, exogenous testosterone in healthy men.

In addition to their use as replacement therapy for hypogonadal males, androgens, particularly testosterone (T), are being explored as potential hormonal male contraceptive agents, alone or in combination with other compounds. Androgens have regulatory effects on a variety of physiological systems in addition to gonadotropin secretion and spermatogenesis. Therefore, as hormonal contraceptive regiments that alter serum T levels are explored, it is important to evaluate their effects on these aspects of normal male physiology. The effects of exogenous T on suppression of spermatogenesis in 19 healthy men were recently compared, using a T dosage of 200 mg im/week for 20 weeks. Before treatment, the men were evaluated during a 3-month pretreatment period, and after treatment, they were followed for 4-6 months or until their sperm counts normalized. Because of the lack of information regarding the effects of exogenous T on nonreproductive physiology, we examined the effects of high-dose T on plasma lipids, calcium metabolism, and sexual behavior in our subjects. Mean serum T and estradiol levels increased significantly during the treatment period. Plasma high-density lipoprotein (HDL) cholesterol levels decreased significantly within the first month and remained suppressed during the duration of T administration. At the end of the treatment period, mean plasma HDL cholesterol had decreased by 13 +/- 2% (P < 0.05); plasma levels of HDL2, HDL3, and apoprotein AI also decreased significantly; mean levels of low density lipoprotein cholesterol and triglycerides were unchanged. After 1 month of the recovery period, plasma HDL levels had returned to the baseline range. Serum calcium levels decreased slightly during treatment; this decrease was statistically significant. Urinary calcium excretion did not change. Mean levels of serum intact PTH increased by 84 +/- 17% (P < 0.05) during T administration; in contrast, 25-hydroxyvitamin D levels decreased by 16 +/- 4% (P < 0.05), and 1,25-dihydroxyvitamin D levels did not change significantly. All markers of calcium metabolism returned to baseline during the posttreatment period. Little change was found in self-reported sexual and aggressive behaviors during the study. There was a trend toward increased arousal and spontaneous erections during T administration, but this did not reach statistical significance. Frequency of sexual intercourse, masturbation, and kissing and fondling did not change, nor was the subjects' satisfaction in their relationships affected by T administration. Mean body weight increased by 4.0 +/- 0.5 kg. Approximately half the men noted mild acne. Body weight and acne symptoms returned to baseline during the recovery period. (ABSTRACT TRUNCATED AT 400 WORDS)
Chemical and Bacteriological Analysis of Drinking Water from Alternative Sources in the Dschang Municipality, Cameroon

In the poor zones of sub-Saharan Africa, the conventional drinking water network is very weak. The populations use alternative groundwater sources which are wells and springs. However, because of urbanization, the groundwater sources are degrading gradually making pure, safe, healthy and odourless drinking water a matter of deep concern. There are many pollutants in groundwater due to seepage of organic and inorganic pollutants, heavy metals, etc. Seventeen alternative water points created in 2008, for drinking water in Dschang municipality were examined for their physicochemical and bacteriological characteristics. The results revealed that water from managed points in Dschang is of poor quality. Most of the water samples were below or out of safety limits (standards) provided by WHO. The water is characterized by high turbidity and presence of feacal coliforms. It can be used for drinking and cooking only after prior treatment. This situation shows that water point management was limited only to the drawing up comfort. These water points require installation of suitable surfaces of filtration and the development of a chlorination follow-up plan. Specific concerns of well water were raised and the management options to be taken proposed.
Identity transformation and a changed lifestyle following dramatic weight loss and body-contouring surgery: An exploratory study

This article reports on two major quality-of-life perception changes for patients who had undergone plastic surgery following dramatic weight loss. The exploratory, qualitative study was undertaken with 20 patients from one teaching hospital. In-depth interviews were conducted, and a thematic analysis of the data was undertaken. The results provide unique glimpses of surgical consumption empowering and facilitating ‘identity transformation’, embracing improved physical function and enhanced self-esteem, confidence and quality of life, and a ‘changed lifestyle’. For a minority, identity transformation was sometimes interrupted by ‘identity lag’, posing the need for additional health-care support throughout the adjustment process. The study provides additional insight into existing quantitative studies, adding to the body of knowledge in this area.
Humoral beta-cell autoimmunity in relation to HLA-defined disease susceptibility in preclinical and clinical type 1 diabetes.

We have studied the relationship between diabetes-associated autoantibodies and various HLA genotypes and alleles in patients with newly diagnosed type 1 diabetes, in non-diabetic siblings and in children representing the general population to test the hypothesis that specific HLA genes regulate the humoral immune response to various autoantigens. Among the newly diagnosed patients we observed that those carrying the DR4-DQB1*0302 haplotype had increased levels of insulin autoantibodies (IAA) and IA-2 antibodies (IA-2A), but low levels of GAD antibodies (GADA). In contrast, those with the DR3-DQB1*02 haplotype had increased GADA titers but low IAA and IA-2 levels. DQB1*02-homozygous patients had a conspicuously low frequency and low levels of IA-2A. Among the siblings there was an apparent association between genetic risk and the prevalence of islet cell antibodies (ICA), IAA, GADA, IA-2A and multiple autoantibodies, the latter being detectable at a frequency of 24.1% in high risk siblings and at a frequency of only 0.9% in those with genotypes conferring disease protection. Among 7-16-year-old Finnish schoolchildren there was an association between GADA and the DQB1*02/*0302 genotype and the DQB1*0302 allele. Among young children identified from the general population based on high (DQB1*02/0302 heterozygosity) or moderate (DQB1*0302/x; x not equal *02, *0301, *0602, *0603) genetic risk for type 1 diabetes the high risk children seroconverted more often to positivity for ICA, GADA and IA-2A over their first 2 years of life. Among older sibs of these children we observed an obvious relationship between the degree of genetic risk and the frequency of ICA, IAA, GADA, IA-2A, and multiple antibodies. Taken together these observations suggest that HLA genes have a strong impact on the appearance of diabetes-associated autoantibodies both in first-degree relatives of affected children and in the general population. In patients with newly diagnosed disease IA-2A may be a more specific marker of beta-cell damage, whereas GADA might reflect a propensity to autoimmunity in general.
Risk of dietary exposure to aflatoxins and fumonisins in infants less than 6 months of age in Rombo, Northern Tanzania.

Infants less than 6 months of age receiving foods other than breast milk are at a high risk of exposure to mycotoxins. We surveyed food intake and estimated the risk of exposures to aflatoxin and fumonisin mycotoxins for infants less than 6 months of age in Northern Tanzania. A total of 143 infants were progressively recruited and three follow-up visits were made at 1, 3 and 5 months of age. A 24-h dietary recall technique was used to estimate flour intake of infants who had been introduced to maize foods. Aflatoxins and fumonisins in the flours were analysed using high-performance liquid chromatography technique. Exposure to aflatoxins or fumonisins was estimated using the deterministic approach. By the age of 3 months, 98 infants had started taking food; 67 of them, maize flours at levels ranging from 0.57 to 37.50 g per infant per day (average 8 g per infant per day). Fifty-eight per cent of 67 maize flour samples contained detectable aflatoxins (range 0.33-69.47 μg kg(-1) ; median 6 μg kg(-1) ) and 31% contained detectable fumonisins (range 48-1224 μg kg(-1) ; median 124 μg kg(-1) ). For infants who consumed contaminated flours, aflatoxin exposure ranged from 0.14 to 120 ng kg(-1) body weight (BW) per day (all above the health concern level of 0.017 ng kg(-1) BW per day as recommended by the European Food Safety Agency) and fumonisin exposure ranged from 0.005 to 0.88 μg kg(-1) BW per day. Insignificant association was observed between exposure to fumonisins or aflatoxins and stunting or underweight. Reducing aflatoxin and fumonisin contamination of maize and dietary diversification can prevent infants and the public, in general, from exposure to the toxins.
The effect of CdTe growth temperature and ZnTe:Cu contacting conditions on CdTe device performance

CdTe device performance is strongly dependent on the quality of the back contact and the ability of the back contact to introduce a copper doping profile in the CdTe layer itself. Copper-doped ZnTe (ZnTe:Cu) is a nearly ideal contact material for CdTe solar cells due to its work function and ability to source copper to CdTe. Most of the ZnTe:Cu studies in the past used CdTe grown at relatively low deposition temperatures (550°C and below). Here we investigate the use of ZnTe:Cu as a back contact for CdTe grown at temperatures up to 620°C. We observe a strong interplay between the CdTe absorber deposition conditions and optimized ZnTe:Cu contacting conditions. Device JV characteristics suggest that CdTe solar cells with absorber layers deposited by close-space sublimation (CSS) at high temperature, 600-620°C, are more robust to the back contact Cu doping level and contacting temperature than CdTe grown at lower temperatures. The implication for industrial processes is a ~1% absolute increase in device efficiency for devices in which the CdTe is deposited on PV glass at high temperature. Perhaps more importantly, this increased performance is maintained for a larger window of temperature and doping level of the ZnTe:Cu back contact. For devices with CdTe absorbers deposited at 600°C, device efficiency in excess of 13.5% is maintained for back contacts containing 2-5 wt. % Cu, and for contacting temperatures ranging from 300-360°C. Red-light bias quantum efficiency (QE) and capacitance-voltage (CV) measurements are used to probe the effect of the introduced copper doping profiles and net acceptor density to better understand how ZnTe:Cu sources influences the resulting CdTe device.
Disease expression and class II HLA antigens in systemic lupus erythematosus

The aim of this investigation was to examine the relationship between Class II HLA antigens and disease expression in systemic lupus erythematosus (SLE). HLA-DR and DQ antigen frequency was studied serologically in 217 SLE patients followed prospectively and compared to 320 healthy controls. The relationship between HLA antigens and the presence of disease manifestations, as well as death was investigated in 117 SLE patients enrolled within the first year of their disease. A univariate analysis confirmed the association between HLA-DR3 and SLE. HLA antigen DR1, DR6, DR7, DQw1 and DQw3 were decreased in patient group compared to the controls. A logistic regression model showed a significantly negative association with HLA-DR1, DR6 and DR7, and a positive association with HLA-DR3. The reduced frequency of HLA-DQw1 and DQw3 was maintained using a logistic procedure. Cox Proportional Hazards models revealed no association between HLA-Class II antigens and death. Logistic regression models revealed no associations between central nervous system (CNS) disease nor musculoskeletal manifestations with any of the DR antigens. There was a trend towards a lower frequency of HLA-DR6 in patients with renal involvement and lower prevalence of HLA-DR1 and HLA-DR7 in patients with vasculitis.
The influence of farnesyl protein transferase inhibitor R115777 (Zarnestra) alone and in combination with purine nucleoside analogs on acute myeloid leukemia progenitors in vitro

R115777 (Tipifarnib, Zarnestra) – farnesyl transferase inhibitor belongs to the new class of signal transduction inhibitors which seems to be yielding results in the treatment of patients with solid tumors. Recently it has also been considered as a drug of promise in hematologic malignancies such as acute myeloid leukemia (AML), especially in older patients, in chronic myelogenous leukemia (CML) as well as myelodysplastic syndromes (MDS). The aim of our study was to evaluate the influence of R115777 used alone or with purine nucleoside analogs (PNA): cladribine (2‐CdA) and fludarabine (F‐ara‐A) on leukemic progenitors [colony‐forming unit‐leukemia (CFU)‐L] from AML patients. Our studies were based on the methods of semisolid leukemic CFU‐L and normal granulocyte–macrophage progenitor (CFU‐GM) cultures in vitro. R115777 was added to the culture alone or in combinations with PNA. We showed that R115777 used alone or together with PNA at all combinations significantly inhibited the colony growth of AML CFU‐L, when compared with normal CFU‐GM (P < 0.01). In addition, the drugs used in combinations of two higher concentrations in significantly higher degree inhibited CFU‐L colony growth, when compared either with R115777 or with any of PNA used alone (P < 0.04). IC50 for R115777 were 67.1 and 121.9 nm for AML CFU‐L and normal CFU‐GM, respectively. Furthermore, in the case of AML the combination index was 0.89 and 1.16, respectively, for the combination of R115777 with 2‐CdA and R115777 with F‐ara‐A. An additive effect on AML CFU‐L cells and subadditive effect on normal CFU‐GM were seen. To assess a proapoptotic effect, the drugs were added to the liquid cultures at the same concentrations as for clonogenic assays. A significant increase in the rate of apoptosis induced by combinations of drugs in comparison with single agents was observed. In conclusion, the combination of R115777 with both PNA could be more effective than the drugs used alone. However, further experimental studies on the usefulness of these combinations in the treatment of myeloid leukemia patients are warranted.
Use of 2-Octyl-Cyanoacrylate Skin Adhesive (Dermabond) for Wound Closure following Reduction Mammaplasty: A Prospective, Randomized Intervention Study

Background: 2-Octyl-cyanoacrylate skin adhesive may be used for surgical wound closure. However, its use in plastic surgery has not been properly assessed. Methods: The authors conducted a prospective, randomized, controlled clinical intervention study in which the scar characteristics after use of skin adhesive were compared with those after suture closure. Bilateral reduction mammaplasty was performed in 50 patients. The method of closure (sutures versus skin adhesive) applied to each breast was determined randomly, using each patient as her own control. Scars were assessed by the patient and by a blinded panel, at 1 week, 6 weeks, and 6 months after surgery, using a visual analogue scale, the modified Hollander Wound Evaluation Scale, and the Patient and Observer Scar Assessment Scale. Results: Both patients and panelists expressed an overall preference for the adhesive side as of 1 week after surgery. Patients’ visual analogue scale scores for scar comfort and scar appearance and panelists’ visual analogue scale scores for aesthetic outcome were significantly better for the adhesive side after 6 weeks and 6 months (p < 0.05), as was the total Hollander Wound Evaluation Scale score of the panelists after 6 weeks (p < 0.02). The total Patient and Observer Scar Assessment Scale score after 6 months was significantly better for the adhesive side according to the patients (p < 0.01), but not according to the panelists (p = 0.11). Conclusion: The authors conclude that 2-octyl-cyanoacrylate is a sound alternative for wound closure.
Local Induction of B Cell Interleukin-10 Competency Alleviates Inflammation and Bone Loss in Ligature-Induced Experimental Periodontitis in Mice

ABSTRACT Interleukin-10 (IL-10)-producing B cells (B10 cells) play a critical role in the immune system balance by negatively regulating inflammatory responses. This study was conducted to determine the effect of local B10 cell induction on periodontal inflammation and bone loss in ligature-induced experimental periodontitis in vivo. Purified spleen B cells from C57BL/6J mice (8 to 10 weeks old) were cultured with CD40 ligand (CD40L) and the Toll-like receptor 9 (TLR9) agonist cytidine-phosphate-guanosine oligodeoxynucleotide (CpG) to determine effective IL-10 induction in vitro. Silk ligatures (size 7-0) were tied around the mouse maxillary second molars on day 0, followed by the injection of CD40L and CpG into the palatal gingiva on days 3, 6, and 9. All the mice were sacrificed, and samples were collected on day 14. CD40L and CpG significantly increased the level of IL-10 production by B cells in vitro, although the frequencies of CD1dhi CD5+ and IL-10-producing (IL-10+) CD45+ cells were decreased. IL-10 was predominantly produced by the CD1dhi CD5+ subpopulation of B cells. In vivo, both IL-10 mRNA expression and the number of IL-10+ CD45+ cells were significantly increased after gingival injection of CD40L and CpG. Periodontal bone loss was significantly decreased and the gingival expression of IL-1β, tumor necrosis factor alpha, and RANKL was significantly reduced. The number of multinucleated tartrate-resistant acid phosphatase-positive cells along the alveolar bone surface was significantly decreased after gingival injection of CD40L and CpG. This study indicates for the first time that the local induction of B10 cell activity could inhibit periodontal inflammation and bone loss.