Miracle-dz/UniFAR-FTUs huggingface dataset:
Effects of Strategic Factors on Organizational Performance; A Case Study of the Kenya Geothermal Development Sector (Kengen)

Background information indicates that firms which fail to analyze their strategy ultimately underperform or perish. Numerous strategic performance management theories and a conceptualized model support this empirical research. This study analyzes strategic factors affecting organizational performance to ensure the pursued strategy is unique, inimitable and competitive. Despite the establishment of KenGen Geothermal sector as a discrete strategic business unit (SBU), it's not clear if strategic factors affect organizational performance indicated by increase in profit, revenue and growth; that may be the cause of the problems of frequent power blackouts and rationing. These problems of frequent power blackouts and rationing in the recent past by KenGen require assessing the effects of strategic factors on organizational performance; first based on a single SBU of the firm. The objectives of the study are; assess if the firm's SBU has strategic or culture fit and analyze if strategy decay affect performance. Random or probability sampling is used to collect data from respondents. Standard normal distribution at 95% confidence interval is used to test the proposed hypotheses. In all cases of these tests, the null hypotheses have been rejected. Pearson correlation coefficients have been used to test linear dependence of the variables of interest. The study output verifies strong positive linear dependence ranging from 0.574 to 0.993. The research recommends further studies to include all other SBUs in the firm and other diverse organizations in order to verify the universality of this research. The study benefits the firm as it is a cost effective method of assessing effects of strategic factors on organizational performance.
Clinical Outcomes of Myasthenia Gravis with Thymoma and Thymic Hyperplasia Undergoing Extended Transsternal Thymectomy: A Single-Center Experience

Background: Despite the widespread use of thymectomy in myasthenia gravis (MG) patients, it has remained controversial as to whether this procedure is of a similar efficacy and clinical outcome among MG patients with thymoma and thymic hyperplasia. Aim: We sought to determine the long-term clinical outcomes of MG patients who received extended transsternal thymectomy associated with pyridostigmine and prednisolone postoperatively. Materials and Methods: In a retrospective study from January 1999 to December 2013, MG patients who underwent thymectomy were followed up. Out of 41 MG patients admitted in our center, 25 patients had undergone thymectomy adjunctive to pyridostigmine and prednisolone therapy postoperatively. The primary endpoints included improvement in individual diplopia, ptosis, dysphagia, dysarthria, dyspnea, and limb weakness. In addition, according to the MG Foundation of America (MGFA) criteria, response to therapy was defined as complete stable remission (CSR), pharmacologic remission (PR), and minimal manifestation (MM) as secondary endpoints. Results: Majority of the patients were male (60%) and the mean age of the patients was 32.2 ± 13.9 years. Fifteen (60%) and 10 patients (40%) had thymoma and thymic hyperplasia, respectively. All the patients were followed up during a mean period of of 86.9 ± 50.3 months (minimum 10 months and maximum 168 months). The rates of CSR, PR, and MM were comparable between the thymoma and thymic hyperplasia groups (P = 0.584). Based on the Kaplan Meier analysis, the probabilities of CSR, PR, and MM were not significantly different between patients with thymoma and thymic hyperplasia. Conclusion: The extended transsternal thymectomy, along with the postoperative regimen of pyridostigmine and prednisolone was associated with a high rate of clinical improvement among MG patients with thymoma or thymic hyperplasia.
Dendritic Cells Novel Markers of Blood and Skin Human Identification of Lineage Relationships and

The lineage relationships and fate of human dendritic cells (DCs) have signiﬁcance for a number of diseases including HIV where both blood and tissue DCs may be infected. We used gene expression proﬁling of human monocyte and DC subpopulations sorted directly from blood and skin to deﬁne the lineage relationships. We also compared these with monocyte-derived DCs (MDDCs) and MUTZ3 Langerhans cells (LCs) to investigate their relevance as model skin DCs. Hierarchical clustering analysis showed that myeloid DCs clustered according to anatomical origin rather than putative lineage. Plasmacytoid DCs formed the most discrete cluster, but ex vivo myeloid cells formed separate clusters of cells both in blood and in skin. Separate and speciﬁc DC populations could be determined within skin, and the proportion of CD14 + dermal DCs (DDCs) was reduced and CD1a + DDCs increased during culture, suggesting conversion to CD1a + -expressing cells in situ. This is consistent with origin of the CD1a + DDCs from a local precursor rather than directly from circulating blood DCs or monocyte precursors. Consistent with their use as model skin DCs, the in vitro–derived MDDC and MUTZ3 LC populations grouped within the skin DC cluster. MDDCs clustered most closely to CD14 + DDCs; furthermore, common unique patterns of C-type lectin receptor expression were identiﬁed between these two cell types. MUTZ3 LCs, however, did not cluster closely with ex vivo–derived LCs. We identiﬁed differential expression of novel genes in monocyte and DC subsets including genes related to DC surface receptors (including C-type lectin receptors, TLRs, and galectins).
Human Δ3,Δ2‐enoyl‐CoA isomerase, type 2: a structural enzymology study on the catalytic role of its ACBP domain and helix‐10

The catalytic domain of the trimeric human Δ3,Δ2‐enoyl‐CoA isomerase, type 2 (HsECI2), has the typical crotonase fold. In the active site of this fold two main chain NH groups form an oxyanion hole for binding the thioester oxygen of the 3E‐ or 3Z‐enoyl‐CoA substrate molecules. A catalytic glutamate is essential for the proton transfer between the substrate C2 and C4 atoms for forming the product 2E‐enoyl‐CoA, which is a key intermediate in the β‐oxidation pathway. The active site is covered by the C‐terminal helix‐10. In HsECI2, the isomerase domain is extended at its N terminus by an acyl‐CoA binding protein (ACBP) domain. Small angle X‐ray scattering analysis of HsECI2 shows that the ACBP domain protrudes out of the central isomerase trimer. X‐ray crystallography of the isomerase domain trimer identifies the active site geometry. A tunnel, shaped by loop‐2 and extending from the catalytic site to bulk solvent, suggests a likely mode of binding of the fatty acyl chains. Calorimetry data show that the separately expressed ACBP and isomerase domains bind tightly to fatty acyl‐CoA molecules. The truncated isomerase variant (without ACBP domain) has significant enoyl‐CoA isomerase activity; however, the full‐length isomerase is more efficient. Structural enzymological studies of helix‐10 variants show the importance of this helix for efficient catalysis. Its hydrophobic side chains, together with residues from loop‐2 and loop‐4, complete a hydrophobic cluster that covers the active site, thereby fixing the thioester moiety in a mode of binding competent for efficient catalysis.
Temporal and Spatial Covariation of Gender and Oxidative Stress in the Galápagos Land Iguana Conolophus subcristatus

Physiological responses to organismal stress can have direct impacts on individual fitness. While responses to stressors mediated by glucocorticoid hormones are well studied, the regulation of the redox system via pro‐oxidant and antioxidant balance as well as the natural causes of oxidative stress in nature remain poorly known, especially for reptiles. In this study, we investigate the interpopulation and intersex variation in oxidative damage and plasma antioxidant capacity in the Galápagos land iguana, Conolophus subcristatus, over a 3‐yr study to evaluate what factors (e.g., season, food availability, reproductive activity) can explain levels and patterns of oxidative damage and of plasma antioxidant capacity. Our results indicate that (1) males showed lower levels of oxidative damage, higher levels of plasma antioxidant capacity, and better body condition than females and (2) significant interactions exist among patterns of oxidative damage across sexes, sampling localities, body condition, and season. These results suggest that reproductive activity and food abundance might act as determinants shaping levels and patterns of oxidative stress of land iguanas.
Reliability of the nursing home survey process: a simultaneous survey approach.

PURPOSE We designed this study to examine the reliability of the nursing home survey process in the state of Kansas using regular and simultaneous survey teams. In particular, the study examined how two survey teams exposed to the same information at the same time differed in their interpretations. DESIGN AND METHODS The protocol for simultaneous surveys consists of having one in-region and one out-of-region team survey a facility together. RESULTS The regular and simultaneous survey teams generally agreed about the number of deficiencies. The intraclass correlation coefficient was 0.87 for total deficiencies and 0.76 for deficiencies with scores of G or higher. But in a substantial number of instances the teams did not agree about the scope and severity of the deficiency or about what regulation the nursing home had breached. IMPLICATIONS The survey process is reliable when assessing aggregate results, but it is only moderately reliable when examining individual citations. Stakeholders (i.e., consumers, policy makers, nursing home administrators) should be aware of the limitations of the survey process. It needs to be modified to reduce variability.
Collapsin response‐mediator protein 5 (CRMP5) phosphorylation at threonine 516 regulates neurite outgrowth inhibition

The collapsin response‐mediator proteins (CRMPs) are multifunctional proteins highly expressed during brain development but down‐regulated in the adult brain. They are involved in axon guidance and neurite outgrowth signalling. Among these, the intensively studied CRMP2 has been identified as an important actor in axon outgrowth, this activity being correlated with the reorganisation of cytoskeletal proteins via the phosphorylation state of CRMP2. Another member, CRMP5, restricts the growth‐promotional effects of CRMP2 by inhibiting dendrite outgrowth at early developmental stages. This inhibition occurs when CRMP5 binds to tubulin and the microtubule‐associated protein MAP2, but the role of CRMP5 phosphorylation is still unknown. Here, we have studied the role of CRMP5 phosphorylation by mutational analysis. Using non‐phosphorylatable truncated constructs of CRMP5 we have demonstrated that, among the four previously identified CRMP5 phosphorylation sites (T509, T514, T516 and S534), only the phosphorylation at T516 residue was needed for neurite outgrowth inhibition in PC12 cells and in cultured C57BL/6J mouse hippocampal neurons. Indeed, the expression of the CRMP5 non‐phosphorylated form induced a loss of function of CRMP5 and the mutant mimicking the phosphorylated form induced the growth inhibition function seen in wildtype CRMP5. The T516 phosphorylation was achieved by the glycogen synthase kinase‐3β (GSK‐3β), which can phosphorylate the wildtype protein but not the non‐phosphorylatable mutant. Furthermore, we have shown that T516 phosphorylation is essential for the tubulin‐binding property of CRMP5. Therefore, CRMP5‐induced growth inhibition is dependent on T516 phosphorylation through the GSK‐3β pathway. The findings provide new insights into the mechanisms underlying neurite outgrowth.
Human papilloma virus (HPV) and p53 immunostaining in advanced tonsillar carcinoma--relation to radiotherapy response and survival.

BACKGROUND Human papilloma virus (HPV), which is frequently present in tonsillar carcinoma seems to be a prognostically favourable factor for patient survival and also for low risk of relapse. Since HPV may abrogate the function of wild type p53 and hence influence radiosensitivity we attempted to analyse if HPV and p53 status in tonsillar carcinoma affected tumour response to radiotherapy (RT) and patient survival. MATERIALS AND METHODS Pre-treatment primary tonsillar carcinoma specimens were obtained retrospectively from 40 patients, 21 complete responders (CR) and 19 non-complete responders (non-CR) of which 38/40 were stage III and IV tumours. The paraffin-embedded biopsies were analysed for presence of HPV DNA, by general and type specific PCR, and for p53 overexpression by immunohistochemical staining with the murine Mab DO-1. RESULTS It was possible to analyse HPV in 34 and p53 in 39 patients. Presence of HPV DNA (HPV+) and p53 immunostaining (p53+) were not correlated with response to RT, since 8/18 CR patients and 6/16 non-CR patients were HPV+ and 11/21 CR patients and 8/18 non-CR patients were p53+. A tendency towards a survival benefit in patients with HPV+ tumours was observed and this tendency was significant for patients with stage IV HPV + tumours (p = .0431), and in particular HPV+/p53- cancers (p = .0195). A difference in survival between patients with p53+ cancer as compared to patients with p53- lesions was not demonstrated. In conclusion, although presence of HPV and p53 immunoreactivity in tonsillar carcinoma could not be related to RT response, determination of HPV and p53 status may still prove useful as predictive/prognostic markers.
Toward a definition of competency-based education in medicine: a systematic review of published definitions

Background: Competency-based education (CBE) has emerged in the health professions to address criticisms of contemporary approaches to training. However, the literature has no clear, widely accepted definition of CBE that furthers innovation, debate, and scholarship in this area. Aim: To systematically review CBE-related literature in order to identify key terms and constructs to inform the development of a useful working definition of CBE for medical education. Methods: We searched electronic databases and supplemented searches by using authors’ files, checking reference lists, contacting relevant organizations and conducting Internet searches. Screening was carried out by duplicate assessment, and disagreements were resolved by consensus. We included any English- or French-language sources that defined competency-based education. Data were analyzed qualitatively and summarized descriptively. Results: We identified 15,956 records for initial relevancy screening by title and abstract. The full text of 1,826 records was then retrieved and assessed further for relevance. A total of 173 records were analyzed. We identified 4 major themes (organizing framework, rationale, contrast with time, and implementing CBE) and 6 sub-themes (outcomes defined, curriculum of competencies, demonstrable, assessment, learner-centred and societal needs). From these themes, a new definition of CBE was synthesized. Conclusion: This is the first comprehensive systematic review of the medical education literature related to CBE definitions. The themes and definition identified should be considered by educators to advance the field.
Mainstreaming risk reduction into self-build housing: the negligible role of perceptions

This article unpacks the relationship between risk perceptions and responses in cities of the global south. It first challenges the assumption that people are irrational and/or lack the ability to comprehend risk when they do not prioritize risk reduction. Second, it argues that the nature of risk perceptions has less direct influence on responses than previous research suggests. A social constructivist approach is applied to explore how individuals process risk and to what extent these perceptions shape preparedness activities. Results are based on ethnographic research in Cochabamba city in Bolivia, where everyday climatic hazards are linked to slow-onset and small-scale impacts. Findings first suggest that people comprehend risk in sophisticated ways. Then through exploration of self-build housing and the adoption of an anthropocentric conceptualization of the house, the article shows that people with high- and low-risk perceptions equally prepare for the impacts of climatic hazards. This is because people prioritize the transformation and consolidation of social, cultural and economic processes which are not directly related to risk reduction when designing and constructing self-built houses. However, disaster risk reduction is automatically mainstreamed into housing because the design and construction features which people associate with risk reduction represent local architectural norms that are associated with ‘good practice’.
Determinants of family care giver reaction. New and recurrent cancer.

PURPOSE The authors examined the interaction of patient and care giver variables and identified whether changes in new and recurrent patients' levels of symptoms, functioning, and depression were related to changes in care givers' reactions to providing care. DESCRIPTION OF STUDY During a 6-month observation period, the psychosocial status and burden of a matched sample of patients with either new or recurrent cancer and their family care givers were assessed and compared. RESULTS Care givers of patients with recurrent disease experienced a marginally significantly different impact on depression over time. The type of disease (new or recurrent) did not impact care givers reactions to the care they were providing for patients. Instead, patients' symptoms and symptom experience incurred a greater impact on care giver depression. CLINICAL IMPLICATIONS The impact of cancer on patients and family care givers must be evaluated carefully and thoroughly, regardless of whether the diagnosis is new or recurrent. Patients' symptoms and symptom experience, mobility, and dependencies in instrumental activities of daily living are primary influences in creating emotional burden and depression in the family care giver of the patient diagnosed with new and with recurrent cancer.
The short insulin tolerance test is safe and reproducible.

We read with concern the article by Chen et al.[1]. We believe that the modi®ed insulin tolerance test (ITT) is a safe and reproducible test when carried out correctly. Chen et al. state that `Further investigation is necessary . whether 0.1 u.kg insulin and arterialised sampling . would improve the reproducibility 1⁄4 and is safe'. However there is already suf®cient published evidence to demonstrate that the use of 0.05 u.insulin. kg insulin in a modi®ed ITT is safe and reproducible. The authors themselves quoted work which has demonstrated the reproducibility of the test, with considerably lower intraindividual coef®cient of variations (CVs) (6±13%) [2,3] than those of Chen et al. (31%). Surely such a discrepancy should have led the authors to question their own methodology rather than to propose further investigation of an established technique? As with all experimental approaches, the ability to detect the effects of a novel treatments using the short insulin tolerance test is enhanced if the measurements for an individual subject can be made with good precision, i.e. where the intra-individual variability is relatively small. A robust estimate of the intra-individual variability is given by the coef®cient of variation. However we do not believe that the method used by Chen et al. [1] to calculate the CV is the most appropriate in this context. A better method is to use the error standard deviation in the calculation of the coef®cient of variation. The best estimate of the error standard deviation(s) is given by: S  p1=2 n x1 ÿ y1
Intrastromal fluid drainage with air tamponade: anterior segment optical coherence tomography guided technique for the management of acute corneal hydrops

Aims To describe a new technique of corneal stab incision with intracameral air injection for management of patients with acute corneal hydrops. Methods Five patients with acute corneal hydrops with large Descemet's membrane (DM) detachment and multiple stromal clefts underwent the procedure. The technique entailed anterior segment optical coherence tomography guided intrastromal fluid drainage through multiple corneal stromal venting incisions along with anterior chamber air tamponade. The time taken for the DM to reattach, resolution of corneal oedema and the best-corrected visual acuity (BCVA) were assessed postoperatively. Results Five patients (age range, 10–25 years) with large DM detachment underwent the procedure. The presenting visual acuity varied from hand motions close to face to 1/60. No intraoperative complications were encountered. The DM attached on first postoperative day in four out of five cases. The corneal oedema resolved over 2–3 weeks in all cases. Repeat air injection was not required in any of the cases. All patients had a final BCVA of ≥3/60 with two of them achieving a BCVA of ≥6/24 at three months postoperatively. Conclusions The technique of intrastromal drainage of fluid combined with air tamponade can be effectively used as a treatment modality for the management of severe cases of acute corneal hydrops.
Potential urinary and plasma biomarkers of peroxisome proliferation in the rat: identification of N-methylnicotinamide and N-methyl-4-pyridone-3-carboxamide by 1H nuclear magnetic resonance and high performance liquid chromatography

This study identified two potential novel biomarkers of peroxisome proliferation in the rat. Three peroxisome proliferator-activated receptor (PPAR) ligands, chosen for their high selectivity towards the PPARα, -δ and -γ subtypes, were given to rats twice daily for 7 days at doses known to cause a pharmacological effect or peroxisome proliferation. Fenofibrate was used as a positive control. Daily treatment with the PPARα and -δ agonists produced peroxisome proliferation and liver hypertrophy. 1H nuclear magnetic resonance spectroscopy and multivariate statistical data analysis of urinary spectra from animals given the PPARα and -δ agonists identified two new potential biomarkers of peroxisome proliferation - N-methylnicotinamide (NMN) and N-methyl-4-pyridone-3-carboxamide (4PY) - both endproducts of the tryptophan-nicotinamide adenine dinucleotide (NAD+) pathway. After 7 days, excretion of NMN and 4PY increased 24- and three-fold, respectively, following high doses of fenofibrate. The correlation between total NMN excretion over 7 days and the peroxisome count was r=0.87 (r2=0.76). Plasma NMN, measured using a sensitive high performance liquid chromatography method, was increased up to 61-fold after 7 days' treatment with high doses of fenofibrate. Hepatic gene expression of aminocarboxymuconate-semialdehyde decarboxylase (EC 4.1.1.45) was downregulated following treatment with the PPARα and -δ agonists. The decrease was up to 11-fold compared with controls in the groups treated with high doses of fenofibrate. This supports the link between increased NMN and 4PY excretion and regulation of the tryptophan-NAD+ pathway in the liver. In conclusion, NMN, and possibly other metabolites in the pathway, are potential non-invasive surrogate biomarkers of peroxisome proliferation in the rat.