Miracle-dz/UniFAR-FTUs huggingface dataset:
The Tropical Diabetic Hand Syndrome: A Surgical Perspective

AbstractTropical diabetic hand syndrome (TDHS) is an aggressive type of hand sepsis that results in significant morbidity and mortality among patients with diabetes in the tropics. This study set out to establish a protocol for the holistic management of TDHS to improve digit/hand salvage and function at AIC Kijabe Hospital. This prospective study examined the following demographics of patients presenting to the authors institution between October 2009 and September 2010 with TDHS: their sex, age, comorbidities, length of in-hospital stay, surgical and medical treatment, total cost of treatment, and immediate postdischarge outcomes. A total of 10 patients (3 men and 7 women) were presented with TDHS during the study period. Surgical procedures included a thorough debridement of the hand at initial presentation, followed by procedures aimed at preserving length and hand function, with digit or hand amputation when there was no possibility of salvage. Three hands were salvaged, without the need for an amputation; 2 of these, however, developed severe stiffness with resultant poor function. Fifty percent of the patients developed considerable disability; 3 of these patients had disabilities of the arm, shoulder, and hand, (DASH) scores of >90 at 6 months after treatment.TDHS appears to be more aggressive in some patients than in others; a multidisciplinary approach, with early involvement of the surgical team, and a radical surgical debridement are essential to improved outcomes. Although the goal of medical treatment (ie, glycemic control) is simple and easily achieved, surgical goals (salvage of limb or life, preservation of hand function) are more complex, costly, and difficult to achieve.Educating health care workers, diabetic patients, and their relatives on hand care is an important preventive measure. Diligence in taking antidiabetic medicine, early presentation, and appropriate care of TDHS are required for meaningful improvement in outcomes of patients with diabetes who develop hand sepsis in the tropics.
Indications, Evaluation, Complications, and Results of Functional Endoscopic Sinus Surgery in 200 Patients

Functional endoscopic sinus surgery (FESS) is a new and exciting treatment for chronic sinus disease. Our knowledge of the surgery continues to expand. A retrospective and prospective review of 200 patients undergoing FESS was undertaken at the Houston Ear, Nose, and Throat Clinic. Parameters studied included patient symptoms, medical history, medical therapy, and radiologic findings. Also reviewed were length of hospitalization, complications, and postoperative symptoms. Nasal obstruction was the most common preoperative symptom. Anterior ethmoid and ostiomeatal complex disease were the most common preoperative CT scan findings. More than 84% of the surgeries were performed on an outpatient basis. Minor complications developed in 8% of the patients, and only one major complication occurred (0.05%). With a mean followup of 17 months, 88% of the patients were symptom-free or Improved; however, 41.5% still required some medical therapy. FESS can safely be performed while the patient is under general anesthesia. Partial middle turblnectomy is a safe and recommended procedure; no cases of atrophic rhinitis occurred. We conclude that FESS is a highly successful treatment for chronic sinus disease (p < 0.01) and that a strong patient history for sinus symptoms is the most Important Indication for FESS.
The Effect of Inter-Organisational Collaboration Networks on Climate Knowledge Flows and Communication to Pastoralists in Kenya

In Kenya, pastoralists have utilized natural grasslands using practices that often result in overgrazing, low productivity and low income. Such practices have caused environmental problems, which could be exacerbated by climate change. Although knowledge on practices that increase pastoralists’ capacity to adapt to climate and environmental challenges is currently available, the adoption rate remains poor. Hence, there is growing interest in understanding how cross-scale inter-organizational collaboration process either facilitates or hinders climate knowledge communications to and uptake by pastoralists. This study used network analysis to identify how inter-organizational collaborations in knowledge production and dissemination shape knowledge flow and communication to pastoralists in Kenya. A knowledge mapping workshop, key informant interviews and questionnaire surveys were used to identify the key organizations involved in the generation, brokering, and dissemination of adaptation knowledge to pastoralists. Two networks of configurations were explored: (i) relations of collaboration in knowledge production and (ii) relations of collaboration in knowledge dissemination. Measure of clustering coefficient, density, core-periphery location, and degree centrality were used to analyze the network structure and cohesion, and its influence on knowledge flow and adoption. Findings revealed a strong integration across the network with research institutes, NGOs (Non-governmental organizations), and CBOs (Community based organizations) identified as among the central actors, based on their degree centrality. Further, we observed a higher density of ties among actors in the knowledge production network than the dissemination network. The lower density of the dissemination network indicates there are not that many activities by key organizations aimed at ensuring that knowledge reaches the users, compared to activities related to knowledge generation. This also results in poor feedback processes from local pastoralists to knowledge generators and brokers. Knowledge transfer and uptake could therefore be enhanced by improving dissemination activities and feedback mechanisms in the dissemination network as a means of capturing pastoralist perspectives on the relevance, reliability, and usability of knowledge for action. Reflection and revision can be used to improve knowledge so that it is more in sync with a pastoralist context.
Understanding the Molecular Genetics of Basal Cell Carcinoma

Basal cell carcinoma (BCC) is the most common human cancer and represents a growing public health care problem. Several tumor suppressor genes and proto-oncogenes have been implicated in BCC pathogenesis, including the key components of the Hedgehog pathway, PTCH1 and SMO, the TP53 tumor suppressor, and members of the RAS proto-oncogene family. Aberrant activation of the Hedgehog pathway represents the molecular driver in basal cell carcinoma pathogenesis, with the majority of BCCs carrying somatic point mutations, mainly ultraviolet (UV)-induced, and/or copy-loss of heterozygosis in the PTCH1 gene. Recent advances in sequencing technology allowed genome-scale approaches to mutation discovery, identifying new genes and pathways potentially involved in BCC carcinogenesis. Mutational and functional analysis suggested PTPN14 and LATS1, both effectors of the Hippo–YAP pathway, and MYCN as new BCC-associated genes. In addition, emerging reports identified frequent non-coding mutations within the regulatory promoter sequences of the TERT and DPH3-OXNAD1 genes. Thus, it is clear that a more complex genetic network of cancer-associated genes than previously hypothesized is involved in BCC carcinogenesis, with a potential impact on the development of new molecular targeted therapies. This article reviews established knowledge and new hypotheses regarding the molecular genetics of BCC pathogenesis.
Time compression increases with eccentricity: a magnocellular property

Accurate time perception is crucial in peripheral vision especially for the spatial perception during actions. To investigate the dynamics of time perception in peripheral vision, parvocellular-biased and magnocellular-biased flashes were presented at different eccentricities (0–48°) in an interflash interval discrimination task. Results showed an increase in time compression with eccentricity for both stimuli (magnocellular-biased and parvocellular-biased flashes). Nevertheless, when stimulus visibility was ‘equalized’ across the visual field, the increase in time compression was only found for magnocellular-biased stimuli. Thus, we suggest that the magnocellular pathway accounts for time underestimation. Moreover, its increase with eccentricity could be an inherent property of the magnocellular system more than a result of a decrease in stimulus visibility.
The Human Papillomavirus Type 16 E6 Oncoprotein Can Down-Regulate p53 Activity by Targeting the Transcriptional Coactivator CBP/p300

ABSTRACT The transforming proteins of the small DNA tumor viruses, simian virus 40 (SV40), adenovirus, and human papillomavirus (HPV) target a number of identical cellular regulators whose functional abrogation is required for transformation. However, while both adenovirus E1A and SV40 large T transforming properties also depend on the targeting of the transcriptional coactivator CBP/p300, no such interaction has been described for the HPV oncoprotein E6 or E7. Here, we demonstrate that the HPV-16 E6 protein, previously shown to facilitate the degradation of p53 in a complex with E6-associated protein (E6AP), also targets CBP/p300 in an interaction involving the C-terminal zinc finger of E6 and CBP residues 1808 to 1826. Furthermore, this interaction is limited to E6 proteins of high-risk HPVs associated with cervical cancer that have the capacity to repress p53-dependent transcription. An HPV-16 E6 mutant (L50G) that binds CBP/p300, but not E6AP, is still capable of down-regulating p53 transcriptional activity. Thus, HPV E6 proteins possess two distinct mechanisms by which to abrogate p53 function: the repression of p53 transcriptional activity by targeting the p53 coactivator CBP/p300, and the removal of cellular p53 protein through the proteosome degradation pathway.
TQM Practices and Customer Satisfaction among Small and Medium-Scale Enterprises in Nigeria: An Empirical Investigation Edoka Reuben Ogbaje and Ndunagu

This study focused on TQM Practices and Customer Satisfaction among Small and Mediumscale Enterprises in Nigeria. The study used survey research design. Primary data were collected through structured five-point likert scale questionnaire. The population of the study captures the management staff and employees population which totalled 5000; other sub-population is the selected SMEs customers. The sample sizes were 500 respondents from the management staff and employees of the selected SMEs, and that of the customers was 600. A random sampling method which was judgmental was used to select the SMEs covered. The study analyze data using descriptive and linear multiple regression model. The study revealed that TQM practices among SMEs in Nigeria have little or no effect at all on customer’s satisfaction, retention and loyalty. Furthermore, findings shows that TQM practices among many SMEs cannot influences customers retention and loyalty. The study concludes that effective implementation of TQM can lead to customer’s satisfaction. The study recommends that SME owners should be properly educated on the importance of TQM practices and awareness; that they should not only be on the management of quality as the only TQM determinants but should also incorporate training, customers focus, teamwork, suppliers quality, process and strategy management, as well as human resources management as part of their TQM policies and practices determinants; and that the government should stimulate and assist SMEs towards participating in improvement activities that will lead to excellence in customers’ satisfaction.
Menstruation, menstrual protection and menstrual cycle problems: The knowledge, attitudes and practices of young Australian women

The results of a survey of 1377 young Australian women aged 14 to 19 years, conducted to determine their attitudes, state of knowledge and practices with regard to menstruation, are presented. The young women, as a group, lacked sufficient information about menstruation, about the time of ovulation, about menstrual discharge, and about the use of tampons. A high proportion (80%) considered menstruation to be inconvenient or embarrassing. Certain measures aimed at remedial action are suggested.
Public policy, technology and lived experience : three case studies of technology in support of urban transport policies in London

High-quality public services can support policy outcomes in many areas of government this thesis focuses on public policy in transport. An essential factor, often overlooked, is the usability of public services. Usability is crucial to e-government, both because quality of service is a public value, and because poor public perception of services may weaken policy acceptance. However, usability, as developed in the Human-Computer Interaction research tradition, has not been prominent in the theory or practice of public policy. This is a critical shortcoming, since policy decisions inscribed in e-government systems have implications for the lived experience of transport users. Actualising this critique, the history of the HCI concept of usability is traced, and related to research traditions which deepen understanding of the inter-relations between technology and the social. This leads to a view that usability is meaningless outside the lived experiences of system users. This goes beyond the "user experience" with technology, because people live with technology as it becomes increasingly intertwined with everyday situations. This thesis makes its contributions from three case studies in urban transport. Semi- structured, recorded interviews and focus groups with 126 transport users were held alongside over 100 public policy documents and interviews with 25 key post- holders, and laboratory and situated observations. The insights of phenomenology, dialogism and pragmatic philosophy provide a route to understanding experiences with technology. A qualitative analysis based on Grounded Theory and Discourse Analysis is developed and used to illuminate these lived experiences. The embodied-ness of inter-actions with technology is investigated from an ecological perspective of affordances and genres. As service users freely mix electronic and non-electronic artefacts to meet real-life needs, the contingency of their actions calls into question a simple model of cognitive or institutional schemata this has profound implications for electronic systems in support of public policy aims.
Models of Matching Markets

The structure, length, and characteristics of matching markets affect the outcomes for their participants. This dissertation attempts to fill the lacuna in our understanding about matching markets on three dimensions through three essays. The first essay highlights the role of constraints at the interviewing stage of matching markets where participants have to make choices even before they discover their own preferences entirely. Two results stand out from this setting. When preferences are ex ante aligned, relaxing the interviewing constraints for one side of the market improves the welfare for everyone on the other side. Moreover, such interventions can lead to a decrease in the number of matched agents. The second essay elucidates the importance of rematching opportunities when relationships last over multiple periods. It identifies sufficient conditions for existence of a stable matching which accommodates the form of preferences we expect to see in multi-period environments. Preferences with inter-temporal complementarities, desire for variety and a status-quo bias are included in this setting. The third essay furthers our understanding while connecting two of the sufficient conditions in a specialized matching with contracts setting. It provides a novel linkage by providing a constructive way of arriving at a preference condition starting from another and thus proving that the later implies the former.
Morbidity and mortality of children with chronic liver diseases who were listed for liver transplantation in Iran

Abstract: Liver transplantation is the treatment of choice for end‐stage liver disease in children, but donor shortage is still a main problem in this age group. The aim of the present study is to evaluate the complications and mortality of liver disease in children waiting for transplantation. We analyzed medical records of 83 children aged <18 yr, who were listed for liver transplantation but the organ was not available for them between 1999 and 2006. The outcome was assessed from their records or follow‐up data. Among the children (mean age, 8 ± 5 yr; 50.5% boys) listed for liver transplantation, but the organ was not available for them, the common causes of cirrhosis were biliary atresia (27.7%) and cryptogenic (24.1%). The mean follow‐up duration was 14 ± 13.4 months (range 0.5–54 months). Sixty‐seven (80.7%) patients developed one or more complications while awaiting transplantation. The most common complications were gastrointestinal bleeding (44.6%), spontaneous bacterial peritonitis (36.1%), infectious complications (28.9%), encephalopathy (24.1%), renal (18.1%), and pulmonary problems (10.8%). Fifty‐one (61.4%) patients needed hospital admission because of complications and 26 (31.3%) patients died while awaiting transplantation. About two‐thirds of children listed for liver transplantation needed hospital admission because of complications and one‐third of them died without any liver transplantation. It seems that more split liver transplantation as well as the introduction of a live‐related program in our center will provide many benefits to our children.
The actin-organizing formin protein Fhod3 is required for postnatal development and functional maintenance of the adult heart in mice

Cardiac development and function require actin–myosin interactions in the sarcomere, a highly organized contractile structure. Sarcomere assembly mediated by formin homology 2 domain-containing 3 (Fhod3), a member of formins that directs formation of straight actin filaments, is essential for embryonic cardiogenesis. However, the role of Fhod3 in the neonatal and adult stages has remained unknown. Here, we generated floxed Fhod3 mice to bypass the embryonic lethality of an Fhod3 knockout (KO). Perinatal KO of Fhod3 in the heart caused juvenile lethality at around day 10 after birth with enlarged hearts composed of severely impaired myofibrils, indicating that Fhod3 is crucial for postnatal heart development. Tamoxifen-induced conditional KO of Fhod3 in the adult heart neither led to lethal effects nor did it affect sarcomere structure and localization of sarcomere components. However, adult Fhod3-deleted mice exhibited a slight cardiomegaly and mild impairment of cardiac function, conditions that were sustained over 1 year without compensation during aging. In addition to these age-related changes, systemic stimulation with the α1-adrenergic receptor agonist phenylephrine, which induces sustained hypertension and hypertrophy development, induced expression of fetal cardiac genes that was more pronounced in adult Fhod3-deleted mice than in the control mice, suggesting that Fhod3 modulates hypertrophic changes in the adult heart. We conclude that Fhod3 plays a crucial role in both postnatal cardiac development and functional maintenance of the adult heart.
Rat Mast Cell Protease 4 Is a β-Chymase with Unusually Stringent Substrate Recognition Profile*

Activated mast cells release a variety of potent inflammatory mediators including histamine, cytokines, proteoglycans, and serine proteases. The serine proteases belong to either the chymase (chymotrypsin-like substrate specificity) or tryptase (trypsin-like specificity) family. In this report we have investigated the substrate specificity of a recently identified mast cell protease, rat mast cell protease-4 (rMCP-4). Based on structural homology, rMCP-4 is predicted to belong to the chymase family, although rMCP-4 has previously not been characterized at the protein level. rMCP-4 was expressed with an N-terminal His tag followed by an enterokinase site substituting for the native activation peptide. The enterokinase-cleaved fusion protein was labeled by diisopropyl fluorophosphate, demonstrating that it is an active serine protease. Moreover, rMCP-4 hydrolyzed MeO-Suc-Arg-Ala-Tyr-pNA, thus verifying that this protease belongs to the chymase family. rMCP-4 bound to heparin, and the enzymatic activity toward MeO-Suc-Arg-Ala-Tyr-pNA was strongly enhanced in the presence of heparin. Detailed analysis of the substrate specificity was performed using peptide phage display technique. After six rounds of amplification a consensus sequence, Leu-Val-Trp-Phe-Arg-Gly, was obtained. The corresponding peptide was synthesized, and rMCP-4 was shown to cleave only the Phe-Arg bond in this peptide. This demonstrates that rMCP-4 displays a striking preference for bulky/aromatic amino acid residues in both the P1 and P2 positions.
An Economic Theory of Depression and its Impact on Health Behavior and Longevity

Abstract In this paper, I propose an economic theory of depression and its impact on health behavior and longevity. Based on studies from happiness research, depression is conceptualized as a drastic loss of utility and value of life for unchanged fundamentals. The model is used to explain how untreated depression leads to unhealthy behavior and adverse health outcomes: depressed individuals are predicted to save less, invest less in their health, consume more unhealthy goods, and exercise less. As a result, they age faster and die earlier than non-depressed individuals. I calibrate the model for an average American and discus how depression enlarges the socioeconomic gradient of health and consider feedback effects of depression on earnings and of physical exercise on depression as well as a variety of depression shocks. Delays in treatment for depression in young adulthood are predicted to have significant repercussions on late-life health outcomes and longevity.
Clinical performance of the posterior composite QuiXfil after 3, 6, and 18 months in Class 1 and 2 cavities.

OBJECTIVE This longitudinal randomized controlled clinical trial evaluated direct composite restorations for clinical acceptability of posterior restoratives in single- or multisurface cavities and provided a preliminary survey of the 3-, 6-, and 18-month results. METHOD AND MATERIALS Three clinicians placed 46 QuiXfil (Xeno III; Dentsply DeTrey) and 50 Tetric Ceram (Syntac Classic; Vivadent) composite restorations in stress-bearing Class 1 and 2 cavities in first or second molars (43 adult patients). Clinical evaluation was performed at baseline and after 3, 6, and 18 months by 2 other clinicians using modified US Public Health Service criteria. At the final recall period, 45 QuiXfil and 49 Tetric Ceram restorations were assessed. RESULTS A total of 97.8% of QuiXfil and 100% of Tetric Ceram posterior composites were assessed to be clinically excellent or acceptable with predominating Alpha scores. At the 18-month recall, 1 QuiXfil restoration had failed because of bulk fracture. No significant differences between either composite could be detected at 18 months for all evaluated clinical criteria (P > .05). Small QuiXfil restorations exhibited significantly less marginal discoloration (P = .003) and better restoration integrity (P = .008) than large restorations. The comparison of restoration performance with time within both groups yielded a significant increase in marginal discoloration for QuiXfil (P = .011) and significant deterioration for anatomic form at the marginal step for Tetric Ceram (P = .011). However, both changes were only effects of scoring shifts from Alpha to Bravo. CONCLUSION Clinical assessment of stress-bearing QuiXfil and Tetric Ceram posterior composite restorations exhibited for both materials good clinical results with predominating Alpha scores.