The axillary approach to raising the latissimus dorsi free flap for facial re-animation: a descriptive surgical technique

The latissimus dorsi flap is popular due to the versatile nature of its applications. When used as a pedicled flap it provides a robust solution when soft tissue coverage is required following breast, thoracic and head and neck surgery. Its utilization as a free flap is extensive due to the muscle's size, constant anatomy, large caliber of the pedicle and the fact it can be used for functional muscle transfers. In facial palsy it provides the surgeon with a long neurovascular pedicle that is invaluable in situations where commonly used facial vessels are not available, in congenital cases or where previous free functional muscle transfers have been attempted, or patients where a one-stage procedure is indicated and a long nerve is required to reach the contra-lateral side. Although some facial palsy surgeons use the trans-axillary approach, an operative guide of raising the flap by this method has not been provided. A clear guide of raising the flap with the patient in the supine position is described in detail and offers the benefits of reducing the risk of potential brachial plexus injury and allows two surgical teams to work synchronously to reduce operative time

An investigation of project success factors in the South African petrochemical industry

Includes bibliographical references.This study will investigate project success factors in the South African petrochemical industry. The availability of capital for projects was reduced by the 2008-2009 global economic recession. This resulted in additional strain on project performance, since the potential implications of cost and schedule overruns for clients, project teams and project managers became harsher. For project failure, the implications may be even worse. Possible implications include career damage; unemployment; financial loss; or liquidation of companies. Projects in the South African petrochemical industry are faced with many challenges such as unfavourable legislation; lack of competent and experienced project human resources; low quality of work; low productivity; and remoteness of the region and industry. These challenges pose a risk to project success. When projects are completed successfully, it can hold major advantages for clients as well as for project team members. These potential advantages include corporate growth; improved job security; career advancement; and financial gain. There are certain factors which need to be managed effectively on projects to improve the probability of project success. These are referred to as success factors. The research question for this study is: What are the most critical factors that project managers need to manage effectively in the South African petrochemical industry to improve project success? This question will be answered by first considering theoretical data, as well as empirical data collected from project professionals with relevant experience by means of interviews and a survey. Purposive sampling was used to obtain inputs from 61 project professionals with over 1,000 years combined project experience in this region and industry. The sample includes participants from project engineering consultants, client organisations, as well as project professionals working for owner project management companies. From the empirical data, challenges unique or dominant in the region or the industry were identified. Using qualitative content analysis, challenges were coded, which resulted in 30 challenge categories. The 10 highest priority challenge categories were consolidated to form 5 general challenges. These are an unfavourable environment; low competence and experience levels; poor availability of project resources; low quality of work; and low productivity. These challenges are a hindrance to project success

A Review of Fetal Scarless Healing

Wound healing is a complex process involving a number of processes. Fetal regeneration has been shown to have a number of differences compared to scar-forming healing. This review discusses the number of differences identified in fetal regeneration. Understanding these differences may result in new therapeutic targets which may reduce or even prevent scarring in adult healing

Making Software Humane: The Effects of Affective and Anthropomorphism on the Adoption of an M-Health Application

Conference ProceedingsWith the proliferation of mobile devices, provision of M-health care services has become feasible even in the remotest villages of Africa. Research however shows that many M-health initiatives have not been adopted and used effectively especially in rural communities. Some of the factors contributing to this range from a lack of knowledge with regard the use of technology, literacy challenges, possible fear of technology, to a lack of information regarding these interventions. In this paper, we demonstrate that an initiative designed to recognize usability as its core function plays a critical role in the use and adoption of M-health interventions in rural communities. Two versions of an M-health intervention were developed and two interface design principles that may have an impact on users’ emotions applied, namely affective design and anthropomorphism. Using the Sethakeng rural community in the Northern Cape (South Africa) as the case study, we were able to determine the extent to which both anthropomorphism and affective design influence the adoption of an M-Health application. Further, the research revealed that because of its ability to include human-like qualities to non-living objects, anthropomorphism is a more effective method for designing M-Health applications targeting rural communities

The political context of AIDS-related stigma and knowledge in a South African township

The purpose of this study was to examine the presentation of AIDS-related stigma and knowledge within the political context of the South African government\'s response to the AIDS epidemic. It was during the 2000 - 2004 period that key government officials publicly challenged the orthodox views of HIV/AIDS, with the South African president, Thabo Mbeki, actively positing the primary role of poverty and other socio-economic stressors in the progression of the AIDS epidemic. This discursive position had real-time effects for AIDS policy-making and ultimately delayed the implementation of a national antiretroviral (ARV) rollout programme. Consequently this position was criticised by commentators in the media and elsewhere for contributing to an already widespread climate of AIDS stigmatisation and misinformation. To shed more light on these claims we conducted a survey in 2005 in Atteridgeville, a South African township, and compared results with those of a similar survey conducted shortly after ARV medications became available in 2004. Results indicated a reduction in AIDS stigma levels across the 1-year period, and that those participants who endorsed contentious political views (such as those expressed by key government officials) were more likely to have a higher level of AIDS-related stigma than those who disagreed. Nevertheless, this study cautions against drawing a causal relationship between the South African government\'s position and AIDS-stigmatising attitudes, and suggests that further political and social factors be accounted for in an attempt to gain a fuller understanding of this seemingly complex relationship. Keywords: HIV/AIDS, AIDS-related stigma, South African government, AIDS debate, antiretroviral rollout, Atteridgeville.SAHARA J Vol. 5 (2) 2008: pp. 74-8

Pre- and post-weaning performance of artificially reared lambs

No Abstract

Toxin release by conditional remodelling of ParDE1 from Mycobacterium tuberculosis leads to gyrase inhibition

\ua9 The Author(s) 2023. Published by Oxford University Press on behalf of Nucleic Acids Research.Mycobacterium tuberculosis, the causative agent of tuberculosis, is a growing threat to global health, with recent efforts towards its eradication being reversed in the wake of the COVID-19 pandemic. Increasing resistance to gyrase-targeting second-line fluoroquinolone antibiotics indicates the necessity to develop both novel therapeutics and our understanding of M. tuberculosis growth during infection. ParDE toxin–antitoxin systems also target gyrase and are regulated in response to both host-associated and drug-induced stress during infection. Here, we present microbiological, biochemical, structural, and biophysical analyses exploring the ParDE1 and ParDE2 systems of M. tuberculosis H37Rv. The structures reveal conserved modes of toxin–antitoxin recognition, with complex-specific interactions. ParDE1 forms a novel heterohexameric ParDE complex, supported by antitoxin chains taking on two distinct folds. Curiously, ParDE1 exists in solution as a dynamic equilibrium between heterotetrameric and heterohexameric complexes. Conditional remodelling into higher order complexes can be thermally driven in vitro. Remodelling induces toxin release, tracked through concomitant inhibition and poisoning of gyrase activity. Our work aids our understanding of gyrase inhibition, allowing wider exploration of toxin–antitoxin systems as inspiration for potential therapeutic agents

Lessons from the hepatoblastoma- familial polyposis connection

The original publication is available at http://www.samj.org.zaBackground. Approximately one-third of hepatoblastoma (HB) patients have associated congenital abnormalities, but familial recurrence is rare, except in association with familial adenomatous polyposis (FAP). This correlation may be missed if not actively sought, with implications for long-term outcome and management. Methods. We retrospectively investigated 3 families with an HB-familial polyposis connection, from a cohort of 113 FAP families (1989 - 2010). Data were analysed to assess clinical problem, treatment, complications and management. Long-term morbidity and functional outcome were analysed to identify management difficulties. Results. Three FAP families (2.65%) had an HB association. In one case, undiagnosed FAP at the time of HB diagnosis was only detected 5 years later, when the mother presented with advanced colorectal carcinoma. A chromosome 5 APC gene mutation (exon 15 codon 793 C→T) was then identified. In a second case, a nonrelated boy presented with a stage 4 multifocal HB with lung metastases. Genetic studies identified an APC gene mutation (exon 6 codon 232 C→T). Further family investigation showed >20 related FAP patients. A third HB-FAP association was identified in a known FAP family early in the study, prior to the availability of genetic testing. Conclusion. Although a rare association, a family history of FAP in HB patients is an important ‘hidden connection’. Germline variation may be outside the usual FAP gene site. Identifying families with unknown HB/FAP is important due to long-term management implications and follow-up

Lessons from the hepatoblastoma-familial polyposis connection

Background. Approximately one-third of hepatoblastoma (HB) patients have associated congenital abnormalities, but familial recurrence is rare, except in association with familial adenomatous polyposis (FAP). This correlation may be missed if not actively sought, with implications for long-term outcome and management. Methods. We retrospectively investigated 3 families with an HB-familial polyposis connection, from a cohort of 113 FAP families (1989 - 2010). Data were analysed to assess clinical problem, treatment, complications and management. Long-term morbidity and functional outcome were analysed to identify management difficulties. Results. Three FAP families (2.65%) had an HB association. In one case, undiagnosed FAP at the time of HB diagnosis was only detected 5 years later, when the mother presented with advanced colorectal carcinoma. A chromosome 5 APC gene mutation (exon 15 codon 793 C→T) was then identified. In a second case, a non-related male child presented with a stage 4 multifocal HB with lung metastases. Genetic studies identified an APC gene mutation (exon 6 codon 232 C→T). Further family investigation showed >20 related FAP patients. A third HB-FAP association was identified in a known FAP family early in the study, prior to the availability of genetic testing. Conclusion. Although a rare association, a family history of FAP in HB patients is an important ‘hidden connection’. Germline variation may be outside the usual FAP gene site. Identifying families with unknown HB/FAP is important due to long-term management implications and follow-up