Miracle-dz/UniFAR-FTUs huggingface dataset:
Management of open lower limb injuries in South West England and Wales.

INTRODUCTION The joint British Association of Plastic, Reconstructive and Aesthetic Surgeons/British Orthopaedic Association standards define best practice management in open diaphyseal fractures of the lower limb. The aim of our study was to review the regional approach and experience in South West England and Wales. A further objective was to evaluate service provision with regard to the standards' key recommendations. METHODS A prospective audit was undertaken of open diaphyseal fracture patients. Compliance with published standards within all orthoplastic services in South West England and Wales was assessed, and facilities were evaluated. RESULTS A total of 86 patients were managed between October 2012 and March 2013. This was a 56% increase from 2008. Over half (56%) presented directly to the orthoplastic services with all patients undergoing debridement within 24 hours. Two-thirds (66%) of procedures were in daylight hours excluding those requiring immediate surgical intervention. Adherence to correct antibiotic therapy was 88% at admission, 50% at primary surgery and 62% at definitive surgery. Almost two-thirds (60%) of primary procedures were performed with combined senior orthoplastic teams, with 81% achieving definitive soft tissue coverage and fixation within seven days. Compliance improved in units with larger patient caseloads and where there was an early combined approach during daylight hours. CONCLUSIONS Increased open lower limb fracture workload was demonstrated across South West England and Wales, probably owing to centralisation of trauma services. An improvement in early transfer of this patient group to orthoplastic facilities has allowed all patients to be assessed and debrided within the recommended timeframe. Standards were most likely to be met in those centres seeing higher numbers of injuries and when there was a daylight hours procedure by combined orthoplastic teams.
A 23-year retrospective investigation of Salmonella Typhi and Salmonella Paratyphi isolated in a tertiary Kathmandu hospital

Background Salmonella serovars Typhi (S. Typhi) and Paratyphi A (S. Paratyphi A), the causative agents of enteric fever, have been routinely isolated organisms from the blood of febrile patients in the Kathmandu Valley since the early 1990s. Susceptibility against commonly used antimicrobials for treating enteric fever has gradually changed throughout South Asia since this time, posing serious treatment challenges. Here, we aimed to longitudinally describe trends in the isolation of Salmonella enterica and assess changes in their antimicrobial susceptibility in Kathmandu over a 23-year period. Methods We conducted a retrospective analysis of standardised microbiological data from April 1992 to December 2014 at a single healthcare facility in Kathmandu, examining time trends of Salmonella-associated bacteraemia and the corresponding antimicrobial susceptibility profiles of the isolated organisms. Results Over 23 years there were 30,353 positive blood cultures. Salmonella enterica accounted for 65.4% (19,857/30,353) of all the bacteria positive blood cultures. S. Typhi and S. Paratyphi A were the dominant serovars, constituting 68.5% (13,592/19,857) and 30.5% (6,057/19,857) of all isolated Salmonellae. We observed (i) a peak in the number of Salmonella-positive cultures in 2002, a year of heavy rainfall and flooding in the Kathmandu Valley, followed by a decline toward pre-flood baseline by 2014, (ii) an increase in the proportion of S. Paratyphi in all Salmonella-positive cultures between 1992 and 2014, (iii) a decrease in the prevalence of MDR for both S. Typhi and S. Paratyphi, and (iv) a recent increase in fluoroquinolone non-susceptibility in both S. Typhi and S. Paratyphi isolates. Conclusions Our work describes significant changes in the epidemiology of Salmonella enterica in the Kathmandu Valley during the last quarter of a century. We highlight the need to examine current treatment protocols for enteric fever and suggest a change from fluoroquinolone monotherapy to combination therapies of macrolides or cephalosporins along with older first-line antimicrobials that have regained their efficacy.
A Rapid Non-Culture-Based Assay for Clinical Monitoring of Phenotypic Resistance of Human Immunodeficiency Virus Type 1 to Lamivudine (3TC)

ABSTRACT Monitoring for lamivudine (3TC) resistance is important both for the clinical management of human immunodeficiency virus type 1 (HIV-1)-infected patients treated with 3TC and for surveillance of transmission of 3TC-resistant HIV-1. We developed a novel non-culture-based assay for the rapid analysis of phenotypic resistance to 3TC of HIV-1 in plasma. The assay measures the susceptibility of HIV-1 reverse transcriptase (RT) activity to 3TC triphosphate (3TC-TP) in plasma. RT detection was done by the Amp-RT assay, an ultrasensitive PCR-based RT assay. Under our assay conditions, we found that 5 μM 3TC-TP inhibited RT activity from wild-type (WT), zidovudine-resistant, or nevirapine-resistant HIV-1 but not from HIV-1 carrying either the M184V mutation or multidrug (MD) resistance mutations (77L/116Y/151M or 62V/75I/77L/116Y/151M). Mixing experiments showed a detection threshold of 10% 3TC-resistant virus (M184V) in a background of WT HIV-1. To validate the assay for the detection of phenotypic resistance of HIV-1 to 3TC in plasma samples, HIV-1 RT in 30 plasma specimens collected from 15 patients before and during therapy with 3TC was tested for evidence of phenotypic resistance by the Amp-RT assay. The results were compared with those of genotypic analysis. The RT in 12 samples was found to be 3TC sensitive, while the RT in 18 samples had evidence of phenotypic resistance. All 12 samples with 3TC-sensitive RT had WT genotypes at codon 184 and were retrieved before treatment with 3TC. In contrast, all 18 specimens with 3TC-resistant RT were posttherapy samples. This assay provides a simple, rapid, and reliable method for the detection of phenotypic resistance of HIV-1 to 3TC in plasma.
An exploratory analysis of resource utilization across organizational units

This study explores the applicability of the resource‐based view at the organizational unit level by investigating why resource utilization, as measured by efficiency, might differ within a firm. Using a downstream petroleum firm as the context for this study, the data envelopment analysis framework is applied to examine resource input congestion of its DCs (i.e. distribution centers). The study also provides a more granular analysis by decomposing distribution efficiency into managerial, scale, and programmatic efficiency, and examines the impact of corporate‐level decision making by including non‐discretionary variables. The analysis identifies opportunities to improve efficiency at the organizational unit level, using alternative views of the operational problem. The approach also provides practicing managers with an objective means to evaluate performance at the level of the organizational unit. Both the efficiency view and the managerial performance view are discussed simultaneously from a strategic view of firm resources.
Structuring the European administrative space: policy instruments of multi-level administration

How can we perceive a European administrative space (EAS), given the persistent diversity between public administrations of the member states? To overcome theoretical and conceptual hurdles, I argue that a suitable pragmatic approach is to start from typology that presents ideal types of supranational instrumentation. The distinct actor constellations between supranational and national levels that are linked to each type entail divergent dynamics of an integrating administrative structure. Despite the external promotion of a metaphorical single administrative space during the Eastern enlargement, the driving dynamics of the emerging EAS remain based on mechanisms that respect and sustain differences between increasingly interdependent national public administrations. The theoretical framework and empirical application provide a first step for further research towards a comprehensive understanding of multi-level public administration and a systematic account of the varying effects that EU governance has on domestic public administrations.
Revisiting CEO power and firm value

Prior literature associates CEO power with agency problems and documents the negative relationship between CEO power and firm value (e.g., Bebchuk et al., 2011). However, the ‘optimal’ level of CEO power may differ for every firm and for individual CEO depending on firm and CEO characteristics. In this study, we estimate the normal (‘optimal’) level of CEO power and show that the association between CEO power and firm value is nonmonotonic. Our results reveal that the normal level of CEO power is positively associated with firm value while excess and deficient CEO power is negatively associated with firm value. Using the residuals from our estimation model of CEO power, we illustrate that our measure of residual CEO power has an inverse U-shaped relationship with firm value.
[Continuity of care of patient with diabetes and its affecting factors in Korea].

OBJECTIVES The objectives of this study were to estimate the continuity of care for all Koreans with diabetes and to identify factors affecting the continuity of care. METHODS We obtained National Health Insurance claims data for patients with diabetes who visited health-care providers during the year 2004. A total of 1,498,327 patients were included as study subjects. Most Frequent Provider Continuity (MFPC) and Modified, Modified Continuity Index (MMCI) were used as indexes of continuity of care. A multiple linear regression analysis was used to identify factors affecting continuity of care. RESULTS The average continuity of care in the entire population of 1,498,327 patients was 0.89 +/- 0.17 as calculated by MFPC and 0.92 +/- 0.16 by MMCI. In a multiple linear regression analysis, both MFPC and MMCI were lower for females than males, disabled than non-disabled, Medicaid beneficiaries than health insurance beneficiaries, patients with low monthly insurance contributions, patients in rural residential areas, and patients whose most frequently visited provider is the hospital. CONCLUSIONS The continuity of care for patients with diabetes is high in Korea. However, women, the disabled and people of low socio-economic status have relatively low continuity of care. Therefore, our first priority is to promote a diabetes management program for these patients.
The impact on conflict of ‘state-led no-military reconstruction during war’: the case of the protection of Land Rights for IDPs during conflict in Colombia (2007-2010)

This thesis examines, via a single case-study – The Colombian Government’s “Land and Property Protection Program” (LPPP)– whether non-military state-led programs developed to help civil populations during conflict impacts on the conflict; and whether the impact is positive or negative. The rationality for this is that studies on activities of reconstruction after armed conflicts usually include assessments of the positive and negative impacts of such activities on the conflict itself; and a consensus in academia and field-work practice that peace can be built through proper reconstruction programs. However, a similar level of scholarly interest does not exist regarding reconstruction during warfare. Such reconstruction is conflated with notions which regard it as being part of a war effort and commanded by the military and/or a matter of political necessity. This research proposes that both: Post war reconstruction and During War Reconstruction (DWR), must be studied under the complexity of ‘Reconstruction’ in general. This empirical thesis demonstrated the existence of and studied a State-led non-military DWR program which – as defined – is not used for military purposes by the Colombian’ state and whose final goal must be to repair the political link between citizens and the state. It was found that the LPPP seeks to restore confidence in the state, either by approaching populations that historically have been abandoned by the state and trying to win back their confidence; or returning property rights to those from whom it was unjustly removed. Three main recommendations flowing from the research: the first claims for more academic studies about DWR; the second for the study and design of protective programs reinforcing the role of the state as primary protector of private property in society; the third for more in-depth studies of the LPPP and the dual behaviour of ‘violence corridors’ and ‘illicit crops’ problems in Colombia.
Tinea capitis in a dermatology center in the city of Fortaleza, Brazil: the role of Trichophyton tonsurans

Background Over a 3‐year period (March 1999 to March 2002), 944 patients with scalp lesions attended a dermatology reference center in the city of Fortaleza, Ceará, Brazil. Clinical specimens were examined at the Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza‐CE, Brazil, to detect patients with tinea capitis.
Gender Mainstreaming and Gender Equality in the EU: The Impact of the EU Employment Strategy

The visibility of the European Union’s commitment to gender equality has risen considerably since the agreement at the Luxembourg summit in 1997 to include strengthening equal opportunities between women and men as the fourth pillar of the employment guidelines, alongside those of employability, adaptability and entrepreneurship. The inclusion of a new guideline on gender mainstreaming in 1999 that requires member states to consider the gender impact of all policies under each of the pillars1 provided a further major impetus to the integration of equal opportunities issues into the employment framework. This impetus has been reinforced by many of the Council of Ministers recommendations on employment policy which have stressed the need to strengthen mainstreaming or other equal opportunities policies. The European employment strategy is part of the EU’s adoption of the socalled ‘open method of coordination’ (Goetschy, 2001; Rodrigues, 2001) which allows member states to develop policy programmes appropriate to their particular situation but according to agreed common guidelines. This approach is also likened to benchmarking (Terry and Towers, 2000; Tronti, 1999; Plantenga and Hansen, 1999). Employment was the first of these programmes to use action plans along common guidelines but has since been followed by social inclusion. However, in the recent period by far the most important EU influence on equal opportunities policies has come from the employment strategy.
Statin pretreatment and risk of in-hospital atrial fibrillation among patients undergoing cardiac surgery: a collaborative meta-analysis of 11 randomized controlled trials.

AIMS Statin pretreatment in patients undergoing cardiac surgery is understood to prevent postoperative atrial fibrillation (AF). However, this is based on observational and limited randomized trial evidence, resulting in uncertainty about any genuine anti-arrhythmic benefits of these agents in this setting. We therefore aimed to quantify precisely the association between statin pretreatment and postoperative AF among patients undergoing cardiac surgery. METHODS AND RESULTS A detailed search of MEDLINE and PubMed databases (1st January 1996 to 31st July 2012) was conducted, followed by a review of the reference lists of published studies and correspondence with trial investigators to obtain individual-participant data for meta-analysis. Evidence was combined across prospective, randomized clinical trials that compared the risk of postoperative AF among individuals randomized to statin pretreatment or placebo/control medication before elective cardiac surgery. Postoperative AF was defined as episodes of AF lasting ≥5 min. Overall, 1105 participants from 11 trials were included; of them, 552 received statin therapy preoperatively. Postoperative AF occurred in 19% of these participants when compared with 36% of those not treated with statins (odds ratio 0.41, 95% confidence interval 0.31-0.54, P < 0.00001, using a random-effects model). Atrial fibrillation prevention by statin pretreatment was consistent across different subgroups. CONCLUSION Short-term statin pretreatment may reduce the risk of postoperative AF among patients undergoing cardiac surgery.
Widening Inequality Combined with Modest Growth

The author argues that inequality, combined with only modest growth, can have grave moral consequences. History suggests that, in the past, a rising standard of living has promoted tolerance for others, commitment to economic opportunity, and democracy. But stagnating incomes due to inequality can lead to the opposite outcomes. The nation's response to immigration is a good example, says the author.
Preparing Corrections Staff for the Future

The aging of the prison population presents corrections staff with unique challenges in knowing how to support inmates while maintaining security. This article describes a 2-day training program to introduce the aging process to select staff at all levels. While the results of a pre-posttest measure, using a modified version of Palmore’s Facts on Aging Quiz, did not produce a statistically significant difference at the conclusion of the training, attendees did express satisfaction with the training and their newfound insight into the challenges faced by aging inmates. They also offered recommendations for future training to include more practical suggestions for the work environment.
Competitive factors of semiconductor industry in Malaysia: the managers’ perspectives

In an emerging global competitive environment, the Malaysian semiconductor industry is facing threats from low cost countries with limited innovative capabilities. It urges for improvement in competitiveness of the Malaysian semiconductor industry. This study focuses on the perspectives of the managers towards the enhancement of competitiveness. Through a focus group interview and data collected from 200 managers working in semiconductor‐manufacturing units in Malaysia, the study identified twenty‐two competitive factors for the improvement of competitiveness of the semiconductor industry in Malaysia. Since the collected data did not form a normal distribution, nonparametric tests such as Chi‐squire test and Mann‐Whitney U test were used to test the framed hypotheses. Based on the analysis, ten key competitive factors were identified out of the identified twenty‐two competitive factors through focus group interview. Further, the study also highlighted the differences in the opinion of competitive factors of technical and non‐technical job functioning managers.
Unsustainability Risk Causality in a Private Industrial Forest: An Institutional Analysis of Factors Affecting Stand Ecosystem Services in Kochi Prefecture, Japan

Much research in recent years has analyzed the ecosystem service aspect of forests, while highlighting the need for sustainable forests. Forest management mechanisms at an inter-institutional level in Japan have been identified to hinder the implementation of forest management that is focused on the equal production of ecosystem services. This study presents an institutional analysis of unsustainability risk causality in a private industrial forest in Kochi Prefecture, Japan, from an ecosystem perspective incorporating common ecosystem service hazards that affect the sustainability functions of forests. This was performed with the aim to offer a basis for a less complicated analysis of ecosystem service hazards in industrial forests and to provide causal clarity at different institution levels. It was found that due to Japan’s systematic top-down forest management approach with the law at the top, vertical relationships cause direct and indirect negative horizontal relationships at each institutional level. To mitigate vertical and horizontal effects, institutional adaptions must be performed to address a combination of satisfier and hygiene factors. Under current conditions of non-enforceable forest policy, objectives and decisions regarding policy and management instruments at the national level must be integrated. This requires effective and adaptive multi-level institutional governance.
China’s Crisis Bargaining in the South China Sea Dispute (2010-2013)

As one of China’s most intricate territorial dispute, the South China Sea dispute has sufficiently consumed significant amount of Chinese leaders’ attention in Beijing. This paper reveals that China exerts signaling strategy in its crisis bargaining over the South China Sea dispute. This strategy contains reassurance as positive signal through offering negotiation and appearing self-restraint and of negative signal by means of escalatory acts and verbal threats. China’s crisis bargaining in the South China Sea dispute aims to preserve crisis stability: a stabilized condition after escalation in which neither further escalation nor near-distant resolution is in order. From the yearly basis analysis in the four-year span study, China’s longing for crisis stability fits into its conduct in crisis bargaining with Southeast Asian states.
Can Russia Break the "Resource Curse"?

A noted European economist argues that the Russian economy and its post-2000 growth have been heavily dependent on natural resources, especially hydrocarbons, and are bound to remain so for some time to come. Given that many economists have come to view rich natural resource endowments as a "curse" that undermines development, the question arises as to whether Russian economic development is doomed. The author argues that while the challenges posed by resource dependence are serious, they can be overcome, or at least substantially mitigated, if accompanied by the right economic policies as the examples of Australia, Canada, and the Scandinavian countries demonstrate. He analyzes what these economic policies are for Russia, and how to set up Russian economic and political conditions to facilitate their implementation. Journal of Economic Literature, Classification Numbers: E6, O1, O52, P2, Q43. 4 figures, 2 tables, 50 references.
Are you in or out? Leukocyte, ion, and neurotransmitter permeability across the epileptic blood–brain barrier

The credo that epileptic seizures can be initiated only by “epileptic” neurons has been recently challenged. The recognition of key astrocytic‐neuronal communication, and the close interaction and crosstalk between astrocytes and brain endothelial cells, has shifted attention to the blood–brain barrier (BBB) and the “neurovascular unit. ” Therefore, the pursuit of mechanisms of seizure generation and epileptogenesis now includes investigations of cerebral blood flow and permeability of cerebral microvessels. For example, leukocyte adhesion molecules at the BBB have been proposed to play a role as an initiating factor for pilocarpine‐induced status epilepticus, and a viral infection model with a strong BBB etiology has been used to study epileptogenesis. Finally, the fact that in nonepileptic subjects seizures can be triggered by BBB disruption, together with the antiseizure effects obtained by administration of potent antiinflammatory “BBB repair” drugs, has increased the interest in neuroinflammation; both circulating leukocytes and resident microglia have been studied in this context. The dual scope of this review is the following: (1) outline the proposed role of BBB damage and immune cell activation in seizure disorders; and (2) explain how increased cerebrovascular permeability causes neuronal misfiring. The temporal sequence linking seizures to peripheral inflammation and BBB dysfunction remains to be clarified. For example, it is still debated whether seizures cause systemic inflammation or vice versa. The topographic localization of fundamental triggers of epileptic seizures also remains controversial: Are immunologic mechanisms required for seizure generation brain‐specific or is systemic activation of immunity sufficient to alter neuronal excitability? Finally, the causative role of “BBB leakage” remains a largely unresolved issue.