Miracle-dz/UniFAR-FTUs huggingface dataset:
Predictors of Autologous Free Fat Graft Retention in the Management of Craniofacial Contour Deformities

Background: Autologous free fat graft outcomes are not always predictable, and variables that can potentially influence fat graft retention are still not well understood or investigated. The purposes of this study were to assess fat graft retention in the management of craniofacial contour deformities and to identify possible predictive factors of this retention. Methods: A prospective analysis was conducted using consecutive patients with unilateral craniofacial contour deformities who underwent autologous free fat grafting between 2012 and 2015. Standardized ultrasonographic craniofacial soft-tissue thickness measurements were adopted to determine the fat graft retention. Bivariate and multivariate analyses were performed to identify independent predictors of 12-month postoperative fat graft retention. Results: One hundred forty-two patients were enrolled. There was significant (all p < 0.05) and progressive reduction in fat graft retention within the first 3 postoperative months, and the retained fat graft was maintained (all p > 0.05) from 3 to 12 months postoperatively, with a 12-month fat graft retention rate of 67.7 percent. Age, Parry-Romberg syndrome, previous craniofacial bone surgery, grafted volume, and forehead unit were independently negative (all p < 0.05) predictors of fat graft retention, whereas cheek unit was an independently positive (all p < 0.05) predictor of retention. Conclusion: Craniofacial fat graft retention is achievable but remains somewhat unpredictable, with age, Parry-Romberg syndrome, previous bone surgical intervention, grafted volume, and recipient sites affecting retention. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
Three-Dimensional Assessment of Facial Appearance following Surgical Repair of Unilateral Cleft Lip and Palate

Background and Objective Objective assessment of postsurgical facial asymmetry can be difficult, but three-dimensional (3D) imaging techniques have made this possible. The objective of this study was to assess residual asymmetry in surgically repaired unilateral cleft lip (UCL) and unilateral cleft lip and palate (UCLP) patients and to compare this with noncleft controls. Design Retrospective multicohort comparative study. Patients and Methods Fifty-one 10-year-old children with surgically managed UCLP and 44 children with UCL were compared with a control group of 68 ten-year-olds. The 3D facial models at rest and with maximum smile were created using a 3D imaging system. Asymmetry scores were produced using both anatomical landmarks and a novel method of facial curve analysis. Results Asymmetry for the whole face was significantly higher in both cleft groups compared with controls (P < .001). UCLP asymmetry was higher than UCL (P < .001). In cleft patients, the upper lip and nasal rim were the most asymmetric (P < .001 to .05). Control subjects also displayed a degree of facial asymmetry. Maximum smile did not significantly affect the symmetry of the whole face, but it increased asymmetry of the vermillion border and nasal rim in all three groups (P < .001). Conclusions Despite surgical intervention at an early age, asymmetry remains significant in cleft patients at 10 years of age. Three-dimensional imaging is a noninvasive objective assessment tool that identifies specific areas of the face responsible for asymmetry. Facial curve analysis describes the face more comprehensively and characterizes soft tissue contours.
Antenatal cardiotocography: experience in a Nigerian tertiary hospital.

OBJECTIVES To compare selected perinatal characteristics between infants of mothers with reactive and non-reactive antenatal cardiotocography (non-stress test) results. PATIENTS AND METHODS The medical records of all women who delivered within one week of a non-stress test were retrieved. The indication, test result, gestational age at delivery, Apgar score at 5 minutes, perinatal complications and neonatal ward admission were documented. RESULTS One hundred and twelve women met study criteria among whom 51 tests were reactive and 61 were non-reactive. Post-datism, intra-uterine growth restriction, hypertensive disorders of pregnancy, and premature rupture of membranes were the commonest indications for the test. Post-datism was more commonly associated with a non-reactive test result. Women with non-reactive tests were almost twice as likely to be delivered by emergency Caesarean section, compared with women with reactive tests; although the test result did not significantly influence the mode of delivery. A non-reactive test was significantly associated with a higher perinatal mortality (p = 0.04). Although the reactive test was associated with a three-fold reduction in the incidence of low Apgar scores compared with the non-reactive test, this difference was not statistically significant (p = 0.18). A non-reactive test was significantly associated with small for gestational age infants (p = 0.01). CONCLUSIONS Non-reactive non-stress test may be associated with higher perinatal mortality. When appropriately utilised, the test is a valuable tool for early detection of foetal compromise. Antenatal cardiotocography has a place in obstetric practice in low-resource settings for improving perinatal care.
Real-time ultrasound guided percutaneous dilatational tracheostomy with and without bronchoscopic control: an observational study.

BACKGROUND Real-time ultrasound guidance may enable precise introducer needle and guidewire insertion during percutaneous dilatational tracheostomy (PDT). However, the safety of PDT done solely under ultrasound guidance has not been compared to additional bronchoscopic confirmation. We aimed to compare the efficacy, incidence of complications and procedural times of real-time ultrasound guided PDTs done with and without bronchoscopic confirmation. METHODS We analysed all bedside PDTs performed over an 18 month period. On transverse view, the introducer needle was inserted under real time guidance into the chosen interspace. The interspace of guidewire entry was confirmed on longitudinal view. In the bronchoscope group, needle and guidewire position within the tracheal lumen were confirmed by bronchoscopy. RESULTS We performed 177 PDTs under ultrasound guidance during the study period - 95 with and 82 without bronchoscopic confirmation. The introducer needle was inserted at the desired level on the first attempt in 81.4% of instances with no difference between groups (77.9% vs. 85.4%, P=0.6). Introducer needle entry between the first and third tracheal cartilages did not differ between groups (90.5% vs. 92.7%, P=0.6). Procedural times were longer in the bronchoscope group (13.9 min vs. 10.7 min, P<0.0001). There were more episodes of fall in oxygen saturation below 90% in the bronchoscope group (16.8% vs. 3.7%, P=0.006). Minor bleeding occurred in 6.2% of cases and did not differ between groups. CONCLUSION Ultrasound guidance for PDT may be equally safe, even without bronchoscopic confirmation; the incidence of hypoxic episodes may be less and the procedure can be performed in less time.
Building climate change resilience through adaptation in smallholder farming systems in semi-arid Zimbabwe

Purpose This study aimed to determine factors that increase resilience and cause smallholder farmers to adapt better to climate change and vulnerability. Design/methodology/approach In this study, the authors used the vulnerability to resilience model and binary logit model to analyse the factors influencing household decisions to adapt. Findings Households with increased access to climate information through extension services were likely to have better adaptation abilities. It was also shown that younger farmers were likely to adapt to climate change given their flexibility to adopt new techniques and their access and use of modern information and technology. Larger households were found to have higher probability of adapting as most adaptation strategies are labour intensive. Household’s possession of livestock and access to credit significantly enhanced adaptation. However, households with higher farm income have lesser incentives to adapt to because their current farming practices might already be optimum. Research limitations/implications Given that most of the smallholder farmers are vulnerable, such as women-headed households and the elderly, who are labour constrained, there is need for research and development of labour saving technologies to increase resilience to climate change and vulnerability. Originality/value These findings underscore the importance of enabling farmer access to information and better technologies which enable them to increase adaptive capacity and resilience.
Alteration of expression of liver‐enriched transcription factors in the transition between growth and differentiation of primary cultured rat hepatocytes

In the present study, we showed the role of the liver‐enriched transcription factors in the transition during which proliferating hepatocytes become quiescent. We used primary rat hepatocytes cultured in modified L‐15 medium. The cells proliferated and, after the addition of 2% dimethyl sulfoxide (DMSO) from day 4, they stopped growing and gradually differentiated. During hepatic proliferation, expression of hepatocyte nuclear factors (HNF)1α, HNF4, C/EBPα, and C/EBPβ mRNAs was depressed, whereas that of HNF3α and HNF3β transcripts was enhanced. After the addition of DMSO, the expression of HNF1α, HNF3γ, and HNF4 returned to the level in isolated cells and HNF1β mRNA expression gradually increased. However, expression of C/EBPα and C/EBPβ mRNAs was partially recovered. The mitoinhibitory agents, IL‐1β, IL‐6, TGF‐β, and activin A, were examined to determine whether they could induce differentiation of proliferating hepatocytes as shown in cells treated with DMSO. Although these factors inhibited cell growth, the cells did not differentiate. The expression pattern of HNF3γ mRNA was quite different in the cells cultured with DMSO and those cultured with cytokines. Therefore, hepatic differentiation requires not only inhibition of DNA synthesis but also induction of appropriate transcription factors. Thus, expression of HNF3γ, C/EBPα, and C/EBPβ may be necessary for hepatocytes to acquire highly differentiated functions in addition to coexpression of certain amounts of transcripts of HNF1α, HNF1β, HNF3α, HNF3β, and HNF4 as well as suppression of C/EBPδ. J. Cell. Physiol. 174:273–284, 1998. © 1998 Wiley‐Liss, Inc.
Identifying the Source of Incumbency Advantage through a Constitutional Reform

This study provides one of the first causal estimates of both the personal and partisan incumbency advantages. Using data on six local elections taking place during the last 20 years in 278 municipalities in Portugal, it relies on a reform introducing mayoral term limits as a natural experiment that creates exogenous variation on the incumbency status of officeholders while holding the incumbency status of the party constant. A new methodology combining two quasi-experimental methods, the regression discontinuity and the difference-in-discontinuities designs, allows for a credible estimation of the independent personal and partisan returns to incumbency. Results causally identify the personal effect as the driver of the incumbency advantage.
Structure, Function, and Activator-Induced Conformations of the CRSP Coactivator

The human cofactor complexes ARC (activator-recruited cofactor) and CRSP (cofactor required for Sp1 activation) mediate activator-dependent transcription in vitro. Although these complexes share several common subunits, their structural and functional relationships remain unknown. Here, we report that affinity-purified ARC consists of two distinct multisubunit complexes: a larger complex, denoted ARC-L, and a smaller coactivator, CRSP. Reconstituted in vitro transcription with biochemically separated ARC-L and CRSP reveals differential cofactor functions. The ARC-L complex is transcriptionally inactive, whereas the CRSP complex is highly active. Structural determination by electron microscopy (EM) and three-dimensional reconstruction indicate substantial differences in size and shape between ARC-L and CRSP. Moreover, EM analysis of independently derived CRSP complexes reveals distinct conformations induced by different activators. These results suggest that CRSP may potentiate transcription via specific activator-induced conformational changes.
Meticillin-resistant Staphylococcus aureus isolated from foot ulcers in diabetic patients in a Chinese care hospital: risk factors for infection and prevalence.

A retrospective case-control study of 118 (male : female, 68 : 50) Chinese type 2 diabetic patients with foot ulcers (Wagner's grade 3-5) was conducted to determine the prevalence and risk factors for meticillin-resistant Staphylococcus aureus (MRSA) infection in relation to the original community or hospital parameters. Ulcer specimens were processed for Gram staining, aerobic culture and antimicrobial susceptibility testing. Staphylococcus species were tested for meticillin resistance using oxacillin. S. aureus was the most frequent pathogen (25.6 %) in diabetic patient specimens (160 isolates), and a high proportion of S. aureus isolates were MRSA (63.4 %). A high percentage of S. aureus isolates (65.4 %) satisfied the definition for hospital-associated MRSA (HA-MRSA) infection. The size of ulcers [adjusted odds ratio (OR) 1.61; 95 % confidence interval (CI) 1.22-2.12] and osteomyelitis (adjusted OR 18.51, 95 % CI 2.50-137.21) were independent predictors of MRSA infection. The HA-MRSA group had a significantly different distribution from the community-associated MRSA group with respect to age, history of diabetes and length of hospital stay (all P<0.001). Neuropathy, vascular disease (all P=0.049) and osteomyelitis (P=0.026) were the most common underlying conditions observed in the HA-MRSA group. This study contributes to the establishment of precautions against the emergence of MRSA including MRSA acquired from different sources among the Chinese population with diabetic foot ulcers based on their original or clinical parameters.
Long‐term trends in streamflow from semiarid rangelands: uncovering drivers of change

In the last 100 years or so, desertification, degradation, and woody plant encroachment have altered huge tracts of semiarid rangelands. It is expected that the changes thus brought about significantly affect water balance in these regions; and in fact, at the headwater‐catchment and smaller scales, such effects are reasonably well documented. For larger scales, however, there is surprisingly little documentation of hydrological change. In this paper, we evaluate the extent to which streamflow from large rangeland watersheds in central Texas has changed concurrent with the dramatic shifts in vegetation cover (transition from pristine prairie to degraded grassland to woodland/savanna) that have taken place during the last century. Our study focused on the three watersheds that supply the major tributaries of the Concho River – those of the North Concho (3279 km2), the Middle Concho (5398 km2), and the South Concho (1070 km2). Using data from the period of record (1926–2005), we found that annual streamflow for the North Concho decreased by about 70% between 1960 and 2005. Not only did we find no downtrend in precipitation that might explain this reduced flow, we found no corresponding change in annual streamflow for the other two watersheds (which have more karst parent material). When we analyzed trends in baseflow (contributions from groundwater) and stormflow (runoff events linked to specific precipitation events), however, we found that in spite of large increases in woody plants, baseflow for all the watersheds has remained essentially consistent or has increased slightly since 1960. At the same time, stormflows were of smaller magnitude. Animal numbers have declined precipitously in the latter half of the last century. We suggest that these lower stormflows result from generally higher soil infiltrability due to generally improving range condition. There is no indication that the decline in streamflow is related to diminished groundwater flows caused by extraction of subsurface water by woody plants.
The Effects of Dietary Date Pit on the Productive and Economic Efficiency of Japanese Quail

1 Economics and Farm Management, Department of Animal Wealth Development, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh 13736, Qalyubia, Egypt. Animal and poultry Production, Department of Animal Wealth Development, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh 13736, Qalyubia, Egypt. Clinical Pathology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh 13736, Qalyubia, Egypt.
Trust and Perceived Corruption Among Ukrainian Firms

This article investigates how firms build trust with one another and with third parties in endemically corrupt environments where trust is usually very low and significantly affected by corruption. Based on a representative survey of firms operating in Ukraine, an endemically corrupt environment, the authors explore some mechanisms for building trust. The study outcomes suggest positive correlations between the perception of corruption and trust among firms (especially through such mechanisms as using patronage at all levels, inviting business partners to restaurants or parties, and introducing business partners to family and friends), while other mechanisms (such as showing expertise in the field, developing communication competencies, and using notaries and lawyers to secure contracts) demonstrate no significant links. Moreover, the results demonstrate that foreign ownership might influence corruption and trust among firms. From a policy perspective, the authors recommend more work on understanding why firms engage in specific corrupt practices and less on destroying their informal relationships. International exposure might be an additional tool for mitigating corruption in Ukraine.
Impact of seizures on developing dendrites: Implications for intellectual developmental disabilities

Childhood epilepsy can be severe and even catastrophic. In these instances, cognition can be impaired—leading to long‐term intellectual disabilities. One factor that could potentially cause cognitive deficits is the frequent seizures that characterize intractable epilepsy. However, it has been difficult to separate the effects seizures may have from those of preexisting neuropathologies and/or the effects of ongoing anticonvulsant therapies. Therefore, important questions are: Do early life seizures produce the learning deficits? And if they do, how do they do it? Results from recent animal models studies reviewed here show that recurrent seizures in infancy stop the growth of CA1 hippocampal dendrites. We speculate that the molecular mechanisms responsible for seizure‐induced growth suppression are homeostatic/neuroprotective, used by the developing nervous system in an attempt to limit neuronal and network excitability and prevent the continued generation of seizures. However, by preventing the normal growth of dendrites, there is a reduction in CA1 glutamatergic synapses that supports long‐lasting forms of synaptic plasticity thought to be the cellular basis of learning and memory. Therefore, dendrite growth suppression would reduce the neuroanatomic substrates for learning and memory, and in so doing could contribute in important ways to spatial learning and memory deficits that may be relevant to the cognitive deficits associated with childhood epilepsy.
Hydrodynamic Complexity Induced by the Pulsing Flow Field in USP Dissolution Apparatus 4

USP dissolution Apparatus 4 can have a pulsing or non-pulsing flow, with most commercial apparatus employing a pulsing flow. Overall, a low velocity flow field is present, particularly in the larger 22.6-mm diameter cell. Dissolution data, computational fluid dynamics (CFD), and imaging methods are used and discussed to investigate the effects of low velocity pulsing flow on dissolution. Local velocity patterns, density gradients, and the effect of flow rate on particulate dispersion can all contribute to the observed dissolution rate. In silico simulation tools and imaging techniques have proved useful in determining local hydrodynamics and, in some cases, their effect on observed dissolution rates. Methods to investigate concentration gradients at the dissolving surface are required to investigate further the effect of hydrodynamics on the dissolution process. In conclusion, it is necessary to take local flow patterns and velocities into account, rather than overall flow rate alone, when interpreting dissolution rate data in the flow-through apparatus.
Increased aldosterone levels in a model of type 2 diabetes mellitus.

BACKGROUND Aldosterone is an important mediator of cardiovascular and renal remodeling. Type II diabetes mellitus leads to renal and cardiac end organ damage. We investigated the renin-angiotensin-aldosterone system in a model of type 2 diabetes mellitus with known diabetic nephropathy and cardiac remodeling, the Zucker Diabetic Fatty rat with and without ACE-inhibition (ZDF and ZDF+ACE-I) and its control, the Zucker Lean (ZDL) rat. METHODS Male animals were studied from an age of 7-24 weeks. At ages 7, 14, 17, 20, and 23 weeks, urinary excretion of aldosterone-glucuronide and potassium was assessed. ACE-inhibition with ramipril was started orally at week 13 (1 mg/kg/d). At the end of the study rats were sacrificed and plasma aldosterone concentration and plasma renin activity were measured. Aldosterone synthase (CYP11B2) mRNA expression in the adrenals, kidney, heart and adipose tissue was assessed by real-time PCR. Urinary albumin excretion as marker for diabetic nephropathy was measured in metabolic cages and correlated to aldosterone. RESULTS Plasma aldosterone concentration and aldosterone-glucuronide was significantly elevated in ZDF rats, and significantly reduced by ACE-inhibiton. In contrast, plasma renin activity was significantly reduced in ZDF rats and normalized by ACE-inhibition. The urinary aldosterone correlated significantly to albuminuria. Adrenal CYP11B2 expression was not significantly higher in ZDF rats. CYP11B2 mRNA was not detected in the kidney, heart and adipose tissue. CONCLUSION In ZDF rats, urinary and plasma aldosterone levels were elevated despite reduced plasma renin activity. The reversible effect of ACE-inhibition shows that the up-regulation of aldosterone must be dependent of the renin-angiotensin-system in this type II diabetes model. The correlation between aldosterone and diabetic nephropathy suggests a clinical relevance of this observation.
Removal of Plasmodium falciparum–infected red blood cells from whole blood by leukoreduction filters

BACKGROUND: There has been an unexplained decrease in the incidence of transfusion‐transmitted malaria in recent years. The decrease in incidence has paralleled the increasing use of leukoreduction filters. Malaria‐infected red blood cells (RBCs) share surface characteristics of hemoglobin S–containing cells. Because units collected from donors with sickle trait do not filter optimally due to adherence of RBCs to the filters, the possibility that malaria‐infected RBCs may also adhere to filters was investigated.