Miracle-dz/UniFAR-FTUs huggingface dataset:
Emergency peripartum hysterectomy in a Nigerian hospital: a 20-year review

Postpartum haemorrhage is a major cause of maternal morbidity and mortality and occasionally severe enough to warrant hysterectomy to prevent maternal death. Hysterectomy often is fraught with danger and regular audit is necessary to assist in the reduction of these dangers. A 20-year audit of all emergency peripartum hysterectomies, performed at Havana Specialist hospital Lagos, Nigeria, is reported. Of the 6599 deliveries and peripartum referrals seen during the period, 22 had an emergency hysterectomy as a result of severe postpartum haemorrhage (0.33%). The aetiological factors associated with the postpartum haemorrhage included uterine atony (45.5%), placenta praevia (27.3%), pathologically adherent placenta (18.2%) and ruptured uterus (9.1%). The majority of the procedures were subtotal hysterectomy (81.8%) and the mean operative time was significantly shorter than for total hysterectomy (P < 0.05). The postoperative complications included postoperative anaemia (28.6%), febrile morbidity (36.9%), wound infection (19.0%) and urinary tract infection (9.5%), together with three maternal deaths. In conclusion, emergency peripartum hysterectomy, although life-saving, is associated with severe morbidity and mortality and subtotal hysterectomy is usually the operation of choice.
B and T Cell Responses to the Spliceosomal Heterogeneous Nuclear Ribonucleoproteins A2 and B1 in Normal and Lupus Mice1

Autoantibodies directed against spliceosomal heterogeneous nuclear ribonucleoproteins (hnRNPs) are a typical feature of rheumatoid arthritis, systemic lupus erythematosus, and mixed-connective tissue disease. With the aim of investigating a potential pathogenic role of these Abs, we have studied the Ab response to A2/B1 hnRNPs in different murine models of lupus. The specificity of anti-A2/B1 Abs was tested with a series of 14 overlapping synthetic peptides covering the region 1–206 of A2 that contains most of the epitopes recognized by patients’ Abs. A major epitope recognized very early during the course of the disease by Abs from most of MRL lpr/lpr mice but not from other lupus mice and from mice of different MHC haplotypes immunized against B1 was identified in residues 50–70. This peptide contains a highly conserved sequence RGFGFVTF also present in other hnRNPs and small nuclear ribonucleoproteins. Abs reacting with a second A2 epitope identified in residues 35–55 were detectable several weeks later, suggesting an intramolecular B cell epitope spreading during the course of the disease. We identified several T cell epitopes within the region 35–175 that generated an effective Th cell response with IL-2 and IFN-γ secretion in nonautoimmune CBA/J mice sharing the same MHC haplotype H-2k as MRL/lpr mice. None of the peptides stimulated T cells primed in vivo with B1. Because Abs to peptide 50–70 were detected significantly earlier than Abs reacting with other A2 peptides and the protein itself, it is possible that within the protein, this segment contains residues playing an initiator role in the induction of the anti-A2/B1 and antispliceosome Ab response.
Evidence that a plasmid from a hyperthermophilic archaebacterium is relaxed at physiological temperatures

A plasmid of 3.45 kb (pGT5) was recently discovered in a strain of hyperthermophilic archaebacterium which was isolated from samples collected in a deep-sea hydrothermal vent. This strain (GE5) grows within a temperature range of 68 to 101.5 degrees C, and we show here that it contains a strong ATP-dependent reverse gyrase activity (positive DNA supercoiling). By comparison with eubacterial plasmids of known superhelical densities, we estimated the superhelical density of the archaebacterial plasmid pGT5 to be -0.026 at 25 degrees C. The equation which relates the change of the rotation angle of the DNA double helix with temperature was validated at 95 degrees C, the optimal growth temperature of the GE5 strain. Considering these new data, the superhelical density of plasmid pGT5 was calculated to be -0.006 at the physiological temperature of 95 degrees C, which is close to the relaxed state. This finding shows that the DNA topology of a plasmid isolated from a hyperthermophilic archaebacterium containing reverse gyrase activity is strikingly different from that of typical eubacterial plasmids.
Shaping the Provision of Outsourced Public Services

Local governments that contract out services are faced with a complex problem of developing an appropriate mix of incentives to elicit performance from a diverse set of service providers, including networks of other local governments, mission-driven nonprofit organizations, and profit-maximizing firms. This paper employs agency and stewardship theory to motivate an analysis of rewards and sanctions used in service delivery relationships. Our findings, consistent with principal-agent theory, indicate that a significant proportion of local governments in our sample employ high-powered incentives with for-profit firms. It is interesting to note, however, that governments with short-term relationships with for-profit firms do not utilize high-powered incentives. These incentives are found in longer duration contracts. In line with the predictions of stewardship theory, governments in our sample do not use high-powered incentives with other governments or nonprofit service providers. Low-powered incentives, primarily informal discussions with those providers, constitute the primary means by which the contracting government ensures that the necessary adjustments to service delivery are made. The efficacy of informal discussion with nonprofits and other governments diminished significantly with longer term contracts, leaving contracting governments with few tools to influence the behavior of their contracting partners. Trust, value congruence, and mission compatibility can explain the initiation of relationships with nonprofits and other governments but do not yet inform government officials about how such relationships can be maintained and enhanced.
Primary care anticoagulant clinic management using computerized decision support and near patient International Normalized Ratio (INR) testing: routine data from a practice nurse-led clinic.

BACKGROUND Increasing indications for warfarin therapy has led to increased pressure on primary care to undertake therapeutic monitoring. OBJECTIVE This study evaluates a primary care model of oral anticoagulation monitoring which utilises computerized decision support (CDSS) and near patient testing (NPT) within a practice nurse-led clinic. Whilst this has been shown to be a successful model under trial conditions, this paper reports the first data from a long-standing clinic, outside a formal study. METHOD A prospective evaluation of therapeutic and clinical control of all patients taking warfarin within one inner city general practice. Data were collected via CDSS. RESULTS 29 patients were seen in 208 appointments. The mean percentage of patients within therapeutic range was 72%. The costs to the practice were pound sterling 1751. The costs the practice would have incurred had these patients been seen at the hospital with the same frequency would have been pound sterling 2290. CONCLUSIONS The use of CDSS and NPT for nurse-delivered oral anticoagulation monitoring could enable the safe transfer of the majority of patients from secondary to primary care. Funding mechanisms to support the transfer of costs will be essential for most practices, as will be the maintenance of adequate staff training and quality assurance.
A psychosomatic intervention in pregnant in-patient women with prenatal somatic risks

Purpose. This study examined whether a short-term psychosomatic intervention during pregnancy had effects on characteristics of labour and delivery as well as on the long-term course of anxiety, depression and physical complaints in pregnant in-patient women. Methods. All gynaecological and obstetric inpatients of a university hospital, who had either exhibited complications during their pregnancy or were considered high-risk pregnancies, were examined. Symptoms of anxiety and depression (HADS) and physical symptoms (GBB) were assessed by standardised questionnaires. Women with elevated scores on either the HADS or the GBB were randomly assigned to either a treatment group, which had received a psychosomatic intervention or an untreated control group. Of the n = 238 women who were assessed during their stay in our hospital, n = 135 were included in the follow-up 1-year later. Results. More than one-third of the participants (38.7%) had elevated scores of anxiety, depression and/or physical symptoms. The psychosomatic intervention had a significant effect on anxiety scores (p = 0.006), but not on depression scores, physical complaints and characteristics of labour and delivery. Conclusions. Findings suggest that a short-term psychosomatic intervention can have a positive long-term effect on anxiety symptoms. Future studies are needed to show whether the reduction of anxiety symptoms in turn can lead to a reduction of postnatal complications and lower rates of disturbed mother–child interactions.
A Review of Study on the Competing Values Framework

The Competing Values Framework (CVF) is one of the most influential and extensively used models in the area of organizational culture research. Compared with other models and scales, the CVF and its matched scale OCAI have better validity and reliability in the context of China, and are very convenient for practical operations. This article firstly introduces the development of the CVF, and discusses the meanings and prerequisites of different culture types in the CVF. Then the article briefly reviews some empirical studies using the CVF and OCAI, compares the CVF and OCAI with other major organizational culture models and scales, and finally points out future research areas for CVF’s application in China.
Building contraventions and incidence of flood in the Lagos Metropolis, Nigeria

Frequent floods have led to loss of lives and destruction of property in both coastal and landlocked cities across the globe, particularly where floodplains have been developed without recourse to space standards. This paper investigated the contributions of contravention of building codes to flooding in flood-prone areas in the Lagos metropolis. Global Positioning Systems (GPSs) were used to determine the location and elevation above sea level of 1,025 buildings situated in 211 streets that were prone to flooding. The distance of buildings from drainage channels/the lagoon was determined in ArcGIS 10.2 environment. Findings revealed that building code contravention contributed significantly to flooding (r = 0.926). About 63.5% and 63.3% of sampled buildings contravened building-plot ratio and statutory setbacks from drainage channels/the lagoon, respectively. Proactive urban planning, strict enforcement of building codes and development control regulations are required to reduce flooding and its consequences in cities of developing nations where flooding has become an annual occurrence.
Foetal outcome in patients with meconium stained liquor.

OBJECTIVE To determine the foetal outcome and mode of delivery in patients with meconium stained liquor during labour. METHODS The observational study was carried out at the Obstetrics and Gynaecology Unit-II of Liaquat University of Medical Health Sciences from June to November 2007. The patients with gestational age more than 37 weeks who presented with meconium stained liquor and cephalic presentation were included and the foetal outcome and mode of delivery was assessed in all such subjects. The data was collected on pre-designed proforma and analysed using SPSS version 10. Chi square test was applied with 95% confidence interval and p-value < or = 0.05 was considered significant. RESULTS A total of 75 patients with meconium stained liquor were identified during the study period. The patients with reactive cardiotocography (CTG) were 50 (66.7%) and with non-reactive CTG, 25 (33.36%). Of the total, 45 (60%) patients were delivered through normal vaginal delivery, while 30 (40%) were delivered by caesarean section. The rate of instrumental delivery was also increased which was 12 (26.7%). Among the neonates exposed to meconium stained liquor, 62 (82.7%) babies were delivered with apgar score > 7. Only 13 (17.3%) babies were delivered with apgar score < 7 in one minute. CONCLUSION Meconium stained amniotic fluid is a common occurrence during labour and is associated with increased caesarean section rate and foetal morbidity and mortality.
Moving beyond Innovation Diffusion in Smaller Local Governments: Does Performance Management Exist?

The performance paradigm of today, which is commonly referred to as performance management, includes the two distinct stages of developing performance measures and actually using them for service improvement. The good news is that the literature contains evidence that performance management does exist to some extent among local governments in the United States and in other countries; however, this same literature focuses primarily on larger local governments. We respond by presenting a comparative case study analysis between two municipalities from the United States and one municipality from Italy within the population range of 1,000 to 4,999. The findings of our research suggest that performance management can be found in smaller local governments when the necessary leadership and the higher-order measures of efficiency and effectiveness are in place. We conclude by discussing the implications of our findings for smaller local governments and by presenting possibilities for next steps regarding future performance management research.
Identification of calcium-independent phospholipase A2 (iPLA2) beta, and not iPLA2gamma, as the mediator of arginine vasopressin-induced arachidonic acid release in A-10 smooth muscle cells. Enantioselective mechanism-based discrimination of mammalian iPLA2s.

The agonist-stimulated release of arachidonic acid (AA) from cellular phospholipids in many cell types (e.g. myocytes, beta-cells, and neurons) has been demonstrated to be primarily mediated by calcium-independent phospholipases A(2) (iPLA(2)s) that are inhibited by the mechanism-based inhibitor (E)-6-(bromomethylene)-3-(1-naphthalenyl)-2H-tetrahydropyran-2-one (BEL). Recently, the family of mammalian iPLA(2)s has been extended to include iPLA(2)gamma, which previously could not be pharmacologically distinguished from iPLA(2)beta. To determine whether iPLA(2)beta or iPLA(2)gamma (or both) were the enzymes responsible for arginine vasopressin (AVP)-induced AA release from A-10 cells, it became necessary to inhibit selectively iPLA(2)beta and iPLA(2)gamma in intact cells. We hypothesized that the R- and S-enantiomers of BEL would possess different inhibitory potencies for iPLA(2)beta and iPLA(2)gamma. Accordingly, racemic BEL was separated into its enantiomeric constituents by chiral high pressure liquid chromatography. Remarkably, (S)-BEL was approximately an order of magnitude more selective for iPLA(2)beta in comparison to iPLA(2)gamma. Conversely, (R)-BEL was approximately an order of magnitude more selective for iPLA(2)gamma than iPLA(2)beta. The AVP-induced liberation of AA from A-10 cells was selectively inhibited by (S)-BEL (IC(50) approximately 2 microm) but not (R)-BEL, demonstrating that the overwhelming majority of AA release is because of iPLA(2)beta and not iPLA(2)gamma activity. Furthermore, pretreatment of A-10 cells with (S)-BEL did not prevent AVP-induced MAPK phosphorylation or protein kinase C translocation. Finally, two different cell-permeable protein kinase C activators (phorbol-12-myristate-13-acetate and 1,2-dioctanoyl-sn-glycerol) could not restore the ability of A-10 cells to release AA after exposure to (S)-BEL, thus supporting the downstream role of iPLA(2)beta in AVP-induced AA release.
Factor Structure of the Tennessee Self-Concept Scale for an Institutionalized, Disabled Population

Separate factor analyses of responses to the Tennessee Self-concept Scale using item and scale data are reported for a sample of 255 disabled veterans. A global self-satisfaction factor and several subsidiary factors roughly approximate the external dimension of the scale. The internal dimension interacts with the external one in defining several factors but does not emerge as an independent dimension. Scale data yield a self-esteem factor incorporating both external and internal scales and a self-concept conflict-integration factor. The evidence supports the external dimension more than the internal dimension. The findings are consistent with previous studies that have not validated the two-dimensional design of the scale.
The Value of Primary, Secondary, and Plantation Forests for a Neotropical Herpetofauna

Abstract: Plantation forests and second‐growth forests are becoming dominant components of many tropical forest landscapes. Yet there is little information available concerning the consequences of different forestry options for biodiversity conservation in the tropics. We sampled the leaf‐litter herpetofauna of primary, secondary, and Eucalyptus plantation forests in the Jari River area of northeastern Brazilian Amazonia. We used four complementary sampling techniques, combined samples from 2 consecutive years, and collected 1739 leaf‐litter amphibians (23 species) and 1937 lizards (30 species). We analyzed the data for differences among forest types regarding patterns of alpha and beta diversity, species‐abundance distributions, and community structure. Primary rainforest harbored significantly more species, but supported a similar abundance of amphibians and lizards compared with adjacent areas of second‐growth forest or plantations. Plantation forests were dominated by wide‐ranging habitat generalists. Secondary forest faunas contained a number of species characteristic of primary forest habitat. Amphibian communities in secondary forests and Eucalyptus plantations formed a nested subset of primary forest species, whereas the species composition of the lizard community in plantations was distinct, and was dominated by open‐area species. Although plantation forests are relatively impoverished, naturally regenerating forests can help mitigate some negative effects of deforestation for herpetofauna. Nevertheless, secondary forest does not provide a substitute for primary forest, and in the absence of further evidence from older successional stands, we caution against the optimistic claim that natural forest regeneration in abandoned lands will provide refuge for the many species that are currently threatened by deforestation.
Lack of evidence for the presence of emerging HoBi-like viruses in North American fetal bovine serum lots

The detection of an emerging pestivirus species, “HoBi-like virus,” in fetal bovine serum (FBS) labeled as U.S. origin, but packaged in Europe, raised concerns that HoBi-like virus may have entered the United States. In the current study, 90 lots of FBS originating in North America (NA) were screened for pestivirus antigen and antibodies. Lots in group 1 (G1, 72 samples) and group 2 (G2, 9 samples) originated in NA and were packaged in the United States. Group 3 (G3) was composed of 9 lots collected in NA and processed in Europe. Lots in G1 were claimed negative for Bovine viral diarrhea virus (BVDV), while lots in G2 and G3 were claimed positive by the commercial processor. All lots in G1 and G2 tested negative by reverse transcription polymerase chain reaction (RT-PCR) using HoBi-like–specific primers. Two G1 lots tested positive by BVDV RT-PCR. One of these was also positive by virus isolation. All G2 lots were positive by BVDV RT-PCR. In addition, four G2 lots were VI positive while 1 lot was antigen-capture enzyme-linked immunosorbent assay (ELISA) positive. Two G3 lots were positive by HoBi-like–specific RT-PCR tests. All lots were negative for HoBi_D32/00 neutralizing antibodies. Seven lots (4 G1; 1 G2; 2 G3) had antibodies against BVDV by virus neutralization and/or antigen-capture ELISA. While there is no evidence of HoBi-like viruses in NA based on tested samples, further studies are required to validate HoBi-like virus–free status and develop means to prevent the spread of HoBi-like virus into NA.
How price moderates assessments of coffee quality across profiles of gender and experience

Proceeding from studies that identify the extrinsic price cue as a mediator between a product’s perceived and intrinsic merit, we report on a blind-versus-sighted coffee tasting experiment conducted to determine the impact of the price-cue across coffee-user categories of gender and relative experience. Seven instant coffees were tasted by 100 subjects producing 700 paired blind and sighted tastings. Aggregating the data, OLS regression models were run to estimate price-effects across discrete and overlapping bands of gender and self-confessed expertise (non-expert and expert). Our analysis reveals the extent to which price-effects demean a coffee’s intrinsic merit during sighted tastings, with experienced male coffee drinkers most especially susceptible to price persuasion, and less experienced female drinkers the least. Thus our paper introduces a cheap and affective means of testing for such cue-effects. Neuromarketing styles of testing are usually cumbersome, expensive and difficult to scale. The method show-cased here offers a meaningful alternative. These findings uphold the view that the price cue remains a critical tool in the marketing of coffee; most notably because of its potential cost-free contribution to the ramping of experienced pleasure without any augmentation of quality. Further implications are explored.
Single-Incision Laparoscopy Could Be Better than Standard Laparoscopy in Right Colectomy for Cancer.

BACKGROUND Human natural orifice transluminal endoscopic surgery (NOTES) is slowed down by technical hurdles. Concomitantly, single-incision laparoscopy has been increasingly reported as an alternative. By reducing the invasiveness of standard laparoscopy, we may further reduce postoperative pain, decrease morbidity, preserve abdominal wall, and enhance cosmesis. Such techniques have been widely applied, including in colorectal surgery. The aim of this multicenter study is to compare the results of single-incision right colectomy (SIRC) with the results of the standard laparoscopic right colectomy (SLRC) in patients with colon cancer. METHODS The files of patients who underwent right colectomy for cancer in five hospitals between January 2010 and December 2013 have been reviewed. Exclusion criteria were open surgery, emergency setting, and American Society of Anesthesiologists (ASA) score >3. Patients were distributed in Groups A (SIRC) or B (SLRC). RESULTS Five hundred ninety-two patients were included in this study, 336 in Group A and 256 in Group B. Mean operative time was 129.0 minutes (range 65-245) in Group A and 168.1 minutes in the Group B (range 70-290), respectively (P < .001). No mortality occurred in either group. The overall 30-day morbidity rates were 21.4% in Group A and 25% in Group B, respectively (P = .64). The median length of hospital stay was 4.95 days (range 3-14) in Group A and 5.5 days in Group B (range 3-12), respectively (P = .28). Conversion to laparotomy occurred in four patients in each group (P = 1). Length of skin incision was significantly shorter in Group A than in Group B (2.99 ± 0.63 cm versus 4.94 ± 0.65 cm, P < .001). Histological analysis of the operative specimens showed no significant differences. CONCLUSION SIRC is feasible and sure for patients with colon cancer. As compared with SLRC, SIRC may offer some advantages, including lower operative morbidity, shorter hospital stay, and better cosmoses, without compromising the oncological quality of the resected specimen.