198 research outputs found

    The impact of trust and power on knowledge sharing in design projects: some empirical evidence from the aerospace industry

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    It is acknowledged by aerospace engineers that relationships between partners are influenced by topics such as trust and that they enable or inhibit knowledge flow. This paper presents findings from interviews with engineers in the aerospace industry on how trust and power within supply chain teams impact knowledge sharing and integration. From a trust perspective, the results of the paper indicate that individually, engineers are aware of its importance but that there is little organisational awareness and consequently no framework or support exists for managing it. With regards to power, we show that there are positive as well as negative impacts on knowledge sharing to be considered

    A Variant of the Sciatic Nerve and its Clinical Implications.

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    Variants of gluteal neural anatomy are important to consider, especially during surgical approaches to the hip. During the routine dissection of the gluteal region, a variant of the sciatic nerve was found where the nerve left the pelvis fully split into its tibial and common fibular components. Intrapelvically and extrapelvically, there was no splitting of the two components by the piriformis muscle. Distally, the two parts of the nerve were draped over the medial and lateral edges of the ischial tuberosity. To avoid iatrogenic injury to the sciatic nerve during invasive or surgical approaches to this region, all possible anatomical variations, such as the one presented herein, should be appreciated by the clinician

    The discovery, abundances and [Fe/H]NB392 distributions of metal-poor stars in the halo of the Milky Way

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    By boldly looking where no one has looked before, this study surveyed a volume within the Milky Way halo to discover population III stars or their direct descendants. A cat- alogue of 123,505 sources was obtained by surveying the COSMOS field with the WFC and the NB392 filter (λc=3918 ̊A, ∆λ=52 ̊A), sensitive to CaHK. A star-galaxy cut was devised from samples of confirmed stars and galaxies based on spectroscopic redshifts and the apparent optical and infra-red colours of the samples, with a completeness and contamination of 75.3% and 6.1% respectively. The catalogue was reduced to 338 potential stars by introducing a limiting magnitude of 24.7, making it 5-7 magni- tudes deeper than the Pristine survey and corresponding to a limiting distance of 166 kpc for G-type stars. This survey covered 1.89 deg2, corresponding to volumes from (1.89 × 108)pc3 to (8.55 × 1016)pc3 from spectral types M to O. Stars with known metallicity, [Fe/H], values from the POLLUX database were used to create an [Fe/H] (NB392−u) − (g − i) by (g − i) grid and the 338 candidates were assigned metallicity values. This created a final catalogue that was sorted by metallicity and candidates with [Fe/H]<−3 were visually inspected using the HST F814W filter to determine whether they were stars, in which seven were found. These could give an insight to the earliest stars in the universe. Number densities were calculated for F, G and K-type stars with [Fe/H] values of −4 to be (4.3±3.0)×10−14 pc −3, (1.36±0.96)×10−13 pc −3 and (3.0 ± 2.1) × 10−11 pc −3 respectively. It was found that the number density of stars with [Fe/H]<−3 is less than expected by a factor of ∼ 10.8, however it is ≈ 6.3 times larger for stars with [Fe/H]<−4

    Orphans and other vulnerable children : what role for social protection ?

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    Recent estimates have provided unprecedented numbers of orphans, and vulnerable children, either brought about because of the HIV/AIDS epidemic, or carriers themselves of HIV infections, a relentless growth which has precipitated a multifaceted care burden, that will too, grow for the next twenty years. This report records the proceedings of the Conference"Orphans and Other Vulnerable Children", which sought to promote awareness of the extent of this crisis, and, to probe the role of social protection in implementing a balanced response. The social protection framework for working with orphans, and vulnerable children shaped the conference agenda. Provision of appropriate risk management instruments is crucial for lasting poverty reduction, while programs to reduce the vulnerability of orphans, and other children, should play an integral role in any national development strategy, in the context of the HIV/AIDS epidemic. Building community capacity will constitute the centerpiece of any feasible response. Within a realistic framework, programs must spread, and scale up, to address the vast, and growing need.Street Children,Youth and Governance,Health Monitoring&Evaluation,Children and Youth,Primary Education

    Etude de l’anémie chez les enfants séropositifs au VIH naïfs au traitement antirétroviral à Lubumbashi, République Démocratique du Congo

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    Introduction: Beaucoup d'enfants infectés par le VIH arrivent à la consultation dans un état d'anémie.  Notre objectif était d'évaluer la prévalence et le typage de l'anémie chez ces enfants.Méthodes: C'est une étude transversale réalisée dans 3 centres de prise en charge des Personnes Vivant avec le VIH à Lubumbashi de Mai 2010 à Mai 2011. La population d'étude était de 152 enfants, âgés de 6 à 180 mois, naïfs au traitement antirétroviral. Les statistiques descriptives usuelles ont été utilisées. Résultats: La prévalence globale de l'anémie (définie comme l'hémoglobine &lt; 11g/dl) était de 69,1% (n=105) et 11,4% avaient une anémie sévère (Hg &lt; 7,0 g/dl). Parmi eux, 16% ont été transfusés au moins 1 fois. L'anémie sévère était positivement associée au stade clinique de la maladie (p=0,02). L'anémie microcytaire était majoritaire dans les deux tranches d'âge. Elle était plus hypochrome chez les enfants en âge préscolaire soit 9,5% et plus normochrome en âge scolaire soit 15,2%. L'anémie  normocytaire était plus normochrome dans les deux tranches d'âge soit 12,4% en âge préscolaire et 6,7% en âge scolaire. L'anémie macrocytaire était rare.Conclusion: Environ sept enfants sur dix, âgés de moins de 15 ans infectés par le VIH naïfs au traitement antirétroviral dans notre milieu sont  anémiques. L'anémie est corrélée à la sévérité de la maladie. Il est important d'associer une prise en charge nutritionnelle et corriger l'anémie avant une trithérapie antirétrovirale.Key words: Anémie, enfants séropositifs au VIH/SIDA, Lubumbashi, RD Cong

    Clinicopathologic characteristics of early-onset breast cancer: a comparative analysis of cases from across Ghana

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    BACKGROUND: Breast cancer is the commonest cancer diagnosed globally and the second leading cause of cancer-related mortality among women younger than 40 years. This study comparatively reviewed the demographic, pathologic and molecular features of Early-Onset Breast Cancer (EOBC) reported in Ghana in relation to Late Onset Breast Cancer (LOBC). METHODS: A descriptive, cross-sectional design was used, with purposive sampling of retrospective histopathology data from 2019 to 2021. Reports of core or incision biopsy, Wide Local Excision or Mastectomy with or without axillary lymph node dissection specimen and matched immunohistochemistry reports were merged into a single file and analysed with SPSS v. 20.0. Descriptive statistics of frequencies and percentages were used to describe categorical variables. Cross-tabulation and chi-square test was done at a 95% confidence interval with significance established at p \u3c 0.05. RESULTS: A total of 2418 cases were included in the study with 20.2% (488 cases) being EOBCs and 79.8% (1930 cases) being LOBCs. The median age at diagnosis was 34.66 (IQR: 5.55) in the EOBC group (\u3c 40 years) and 54.29 (IQR: 16.86) in the LOBC group (≥ 40 years). Invasive carcinoma-No Special Type was the commonest tumour type with grade III tumours being the commonest in both categories of patients. Perineural invasion was the only statistically significant pathologic parameter with age. EOBC was associated with higher DCIS component (24.8% vs 21.6%), lower hormone-receptor-positive status (52.30% vs 55.70%), higher proliferation index (Ki-67 \u3e 20: 82.40% vs 80.30%) and a higher number of involved lymph nodes (13.80% vs 9.00%). Triple-Negative Breast cancer (26.40% vs 24.30%) was the most predominant molecular subtype of EOBC. CONCLUSION: EOBCs in our setting are generally more aggressive with poorer prognostic histopathological and molecular features when compared with LOBCs. A larger study is recommended to identify the association between relevant pathological features and early onset breast cancer in Ghana. Again, further molecular and genetic studies to understand the molecular genetic drivers of the general poorer pathological features of EOBCs and its relation to patient outcome in our setting is needed

    The oral microbiome and breast cancer and nonmalignant breast disease, and its relationship with the fecal microbiome in the Ghana Breast Health Study

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    The oral microbiome, like the fecal microbiome, may be related to breast cancer risk. Therefore, we investigated whether the oral microbiome was associated with breast cancer and nonmalignant breast disease, and its relationship with the fecal microbiome in a case-control study in Ghana. A total of 881 women were included (369 breast cancers, 93 nonmalignant cases and 419 population-based controls). The V4 region of the 16S rRNA gene was sequenced from oral and fecal samples. Alpha-diversity (observed amplicon sequence variants [ASVs], Shannon index and Faiths Phylogenetic Diversity) and beta-diversity (Bray-Curtis, Jaccard and weighted and unweighted UniFrac) metrics were computed. MiRKAT and logistic regression models were used to investigate the case-control associations. Oral sample alpha-diversity was inversely associated with breast cancer and nonmalignant breast disease with odds ratios (95% CIs) per every 10 observed ASVs of 0.86 (0.83-0.89) and 0.79 (0.73-0.85), respectively, compared to controls. Beta-diversity was also associated with breast cancer and nonmalignant breast disease compared to controls (P ≤ .001). The relative abundances of Porphyromonas and Fusobacterium were lower for breast cancer cases compared to controls. Alpha-diversity and presence/relative abundance of specific genera from the oral and fecal microbiome were strongly correlated among breast cancer cases, but weakly correlated among controls. Particularly, the relative abundance of oral Porphyromonas was strongly, inversely correlated with fecal Bacteroides among breast cancer cases (r&nbsp;=&nbsp;-.37, P ≤ .001). Many oral microbial metrics were strongly associated with breast cancer and nonmalignant breast disease, and strongly correlated with fecal microbiome among breast cancer cases, but not controls

    Associations of Circulating Estrogens and Estrogen Metabolites with Fecal and Oral Microbiome in Postmenopausal Women in the Ghana Breast Health Study

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    ABSTRACT The human fecal and oral microbiome may play a role in the etiology of breast cancer through modulation of endogenous estrogen metabolism. This study aimed to investigate associations of circulating estrogens and estrogen metabolites with the fecal and oral microbiome in postmenopausal African women. A total of 117 women with fecal (N = 110) and oral (N = 114) microbiome data measured by 16S rRNA gene sequencing, and estrogens and estrogen metabolites data measured by liquid chromatography tandem mass spectrometry were included. The outcomes were measures of the microbiome and the independent variables were the estrogens and estrogen metabolites. Estrogens and estrogen metabolites were associated with the fecal microbial Shannon index (global P < 0.01). In particular, higher levels of estrone (β = 0.36, P = 0.03), 2-hydroxyestradiol (β = 0.30, P = 0.02), 4-methoxyestrone (β = 0.51, P = 0.01), and estriol (β = 0.36, P = 0.04) were associated with higher levels of the Shannon index, while 16alpha-hydroxyestrone (β = −0.57, P < 0.01) was inversely associated with the Shannon index as indicated by linear regression. Conjugated 2-methoxyestrone was associated with oral microbial unweighted UniFrac as indicated by MiRKAT (P < 0.01) and PERMANOVA, where conjugated 2-methoxyestrone explained 2.67% of the oral microbial variability, but no other estrogens or estrogen metabolites were associated with any other beta diversity measures. The presence and abundance of multiple fecal and oral genera, such as fecal genera from families Lachnospiraceae and Ruminococcaceae, were associated with several estrogens and estrogen metabolites as indicated by zero-inflated negative binomial regression. Overall, we found several associations of specific estrogens and estrogen metabolites and the fecal and oral microbiome. IMPORTANCE Several epidemiologic studies have found associations of urinary estrogens and estrogen metabolites with the fecal microbiome. However, urinary estrogen concentrations are not strongly correlated with serum estrogens, a known risk factor for breast cancer. To better understand whether the human fecal and oral microbiome were associated with breast cancer risk via the regulation of estrogen metabolism, we conducted this study to investigate the associations of circulating estrogens and estrogen metabolites with the fecal and oral microbiome in postmenopausal African women. We found several associations of parent estrogens and several estrogen metabolites with the microbial communities, and multiple individual associations of estrogens and estrogen metabolites with the presence and abundance of multiple fecal and oral genera, such as fecal genera from families Lachnospiraceae and Ruminococcaceae, which have estrogen metabolizing properties. Future large, longitudinal studies to investigate the dynamic changes of the fecal and oral microbiome and estrogen relationship are needed
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