Miracle-dz/UniFAR-FTUs huggingface dataset:
[Risk factors for acute abdominal wall dehiscence after laparotomy in adults].

INTRODUCTION Total evisceration consists of protrusion of the abdominal viscera due to dehiscence of all the planes of the abdominal wall after laparotomy. The greater the number of risk factors, the greater the probability of evisceration. PATIENTS AND METHOD We performed a retrospective study of patients with evisceration treated in the previous 9 years. RESULTS Among 12,622 patients who underwent laparotomy, 57 eviscerations were detected (45 men, 12 women; mean age 70 years). The diagnosis was peritonitis in 26 patients and intestinal occlusion in 19. Emergency surgery was performed in 48 patients. Reintervention was performed in 12 patients. Postoperative complications were found in all patients, especially wound infection and paralytic ileus. The main clinical finding was staining of the dressing. Laboratory investigations revealed leukocytosis, hypoproteinemia, and anemia. Surgical repair consisted of simple closure and/or retention sutures; mesh was associated in 6 patients. Subsequent morbidity was 77%. Twenty-six patients required admission to the intensive care unit. The mean length of hospital stay was 28.5 days. The were 41 recoveries (72%) and 16 deaths (28%). Review of 18 parameters involved in evisceration showed that 80% (45 patients) presented 9 or more risk factors. CONCLUSIONS Evisceration is a serious occurrence that produces high morbidity and mortality. The most frequent risk factors in our series were age greater than 65 years, hemodynamic instability, increased intra-abdominal pressure, emergency surgery, infection of the wound or abdominal wall, hypoproteinemia and anemia. Because these risk factors can be predicted, when several are grouped together, reinforcement should be used when closing the abdominal wall.
Synthesis of Contemporary SAE Research 1994-2014.

In the 1990s, a series of research syntheses were conducted regarding supervised agricultural experience. These syntheses included supervised agricultural experience (SAE) research from 1964 through 1993. With these past syntheses as the premise, contemporary SAE research was identified, synthesized, and coded into emerging themes. Inclusion criteria for this synthesis required articles to (a) be published in a peer-reviewed journal or national/regional American Association for Agricultural Education research conference proceedings, (b) include research specifically pertaining to SAE, (c) be available and accessible through the search procedures, and (d) be published between January 1994 and December 2014. An exhaustive search was conducted using library databases as well as digital journals and conference proceedings. Themes that emerged from this synthesis were (a) participation, (b) teacher education, (c) benefits, (d) professional development, (e) supervision, (f) scope/structure, (g) economic impact, (h) program quality, (i) learning theory, and (k) international settings. Similar to the previous syntheses, research conducted between 1994 and 2014 was primarily descriptive, conceptually broad, and often limited to relatively small populations such as single states. Additional multistate and national studies are recommended to describe the content and context of SAE instruction in teacher education and to refine quality indicators related to SAE practice.
Malnutrition in hospitalized elderly patients: when does it matter?

BACKGROUND Identifying the individual effects of acute illness and malnutrition on elderly patient outcome and the timing of nutritional support is still an important challenge for modern medicine. OBJECTIVE The aims of this study were to assess the practical significance of serum albumin concentrations following acute illness as a measure of nutritional status in ageing patients and also to review recently published studies related to this field. DESIGN Consecutive stroke patients had their nutritional status assessed from anthropometric, haematological and biochemical data during the hospital stay. Predicted energy needs and daily in-hospital energy intake were also studied in a subgroup of 24 acute stroke patients and 24 age and sex-matched hospitalized non-stroke patients. A multivariate analysis was used to measure the amount of variance in serum albumin concentrations explained by nutritional and non-nutritional clinical variables. RESULTS Serum albumin concentrations deteriorated steadily during the study period and there was an increase in the amount of variance in the serum albumin explained by nutritional variables between admission and week 4 of the hospital stay. Almost all patients studied were in negative energy balance during hospitalization. Evidence is provided which links low serum albumin concentrations with clinical outcomes during the hospital stay and immediately following discharge. That nutritional supplementation started one week as opposed to immediately following acute illness, and continued during the convalescent period, can improve serum albumin concentrations during the hospital stay. CONCLUSION Poor nutritional status following acute illness in ageing patients may be of more prognostic significance and amenable to therapy later on during the course of hospitalization.
Smallholder Agricultural Production Efficiency of Adopters and Nonadopters of Land Conservation Technologies in Tanzania

Promotion and supporting the adoption of land management and conservation technologies (LMCTs) among poor farming households has been considered to improve crop yields as well as production technical efficiency (TE). This article compares production efficiency between adopters and nonadopters of LMCTs in Tanzania. Using national panel data, the study applied stochastic frontier model to estimate the TE of adopters and nonadopters. The findings show that adopters of LMCTs had a relatively significantly higher TE (0.73) than their nonadopter counterparts (0.69). Therefore, promotion and supporting the adoption of LMCTs among smallholder farmers is pertinent for improving their TE as well as for increasing crop yield, thereby reducing encroachment into forest areas. There is also a need to understand how adopters and nonadopters of LMCTs are affected by different factors when designing the policies that promote the adoption of LMCTs among the smallholder farmers for sustainable increase of agricultural productivity and TE.
Green Business Strategies of Exporting Manufacturing Firms: Antecedents, Practices, and Outcomes

ABSTRACT This research investigates the drivers that lead exporting manufacturing companies to adopt environmentally friendly actions, exploring green business practices/strategies they conducted and examining the outcomes which resulted from companies' green business activities. This exploratory study particularly focuses on green business strategies of Turkish manufacturing exporters. Thirty-two semi-structured interviews were conducted with executive managers from 22 companies and analyzed using qualitative content analysis. The results of the study reveal two internal (i.e., capabilities and resources) and four external stimulating forces (i.e., stakeholder pressures, institutional-based, network-based, and external factors) that encourage companies to implement green business operations, which were also classified under six functional themes. This study emphasizes several noteworthy outcomes (i.e., export competitive advantage and export performance). In doing so, the findings of this study provide a holistic insight into green business strategies within the exporting context by outlining both theoretical and managerial implications.
People´s understandings, perceptions of, and emotions towards climate change

Climate change is a global issue; one whose perception involves an ontological status whereby multiple perspectives enact its existence. Whilst biophysical scientific disciplines, such oceanography or conservation biology, have presented objective evidence of this climatic phenomenon, social science disciplines, such as sociology, politics, or psychology, have sought to explain how climate change is perceived and addressed by people. This thesis is about this subjective facet of climate change. It endeavours to engage with the worldwide interest in comprehending how people build their understanding and knowledge of climate change, but also takes a step further to investigate peoples' perception of climate change adaptation and look at emotional responses in respect to this climate issue. The specific aim of my research is therefore to provide insights that could be of value in enhancing our understanding of how people engage with climate change. Because most studies of peoples' knowledge and perceptions of climate change have been conducted with segments of the general public in the United States, Europe, and Australia, I decided to focus my study on a rather different society, namely that of my own nation, Ecuador. Moreover, here the interest was to investigate a rural community and to contrast the resulting data with those gathered from a sample of academic conservationists worldwide. In terms of the approach to the study, in being committed to allowing participants the agency to define how they themselves understand this climatic phenomenon, I employed a mixed-mode approach that incorporated qualitative and quantitative data gathering instruments, including face-to-face and online questionnaires, semi-structured interviews and participant observation. My findings provide a unique insight into the perspectives and realities that form the study populations' understandings of climate change. They suggest that despite the global nature of climate change, it is multiple local and individual realities that ultimately determine peoples' engagement with it. I conclude that action preferences, namely mitigation or adaptation to climate change, tend to be predominantly moderated by people's demographic background. I also suggest a tendency among urban dwellers to perceive climate change as an issue that cannot be tackled individually. Furthermore, because the international trend to cope with climate change highlights the relevance of 'resilience thinking', I argue that the results of my thesis can usefully inform the process of advising policy makers and when developing awareness-raising and educational programmes on climate change.
International Financial Reporting Standards Adoption and Information Quality: Evidence from Brazil

This paper examines whether the mandatory adoption of International Financial Reporting Standards (IFRS) in Brazil in 2010 has improved the value relevance of accounting information, information content of earnings, financial analyst forecasting activities, and liquidity. We examine the variables in the pre&#8208;IFRS mandatory adoption sample period, considered herein as 2008 to 2009, and the post&#8208;IFRS adoption period of 2011 to 2012. We provide evidence demonstrating improvement in value relevance of earnings and number of analysts following the firms in the period after IFRS adoption, but we do not find improvements in information content of earnings, accuracy in analyst forecasting, and liquidity in the post&#8208;adoption period. Our findings suggest a positive relationship between IFRS adoption and some areas of information quality in Brazil. By focusing on one important economy as it takes significant steps toward full convergence with IFRS, our study contributes to the growing literature concerning the impact of IFRS adoption around the world.
When Timing Is Everything: Are Placental MRI Examinations Performed Before 24 Weeks' Gestational Age Reliable?

OBJECTIVE The objective of our study was to determine if placental MRI examinations performed for the detection of abnormal placentation earlier than 24 weeks' gestational age (GA) are more or less reliable than examinations performed at a later GA. MATERIALS AND METHODS Two radiologists blinded to clinical, surgical, and pathologic reports retrospectively and independently reviewed 69 placental MRI examinations for nine imaging signs associated with abnormal placentation. A consensus of the suspicion of abnormal placentation (including accreta, increta, or percreta) was determined using a 5-point (low to high suspicion) Likert scale and compared with pathologic or surgical findings or both. RESULTS Seventeen placental MRI examinations were performed at GA 14-23 weeks, and 52 placental MRI examinations were performed at GA 24-41 weeks. Reviewer agreement (Cronbach alpha) among the nine imaging signs was 0.86 (95% CI, 0.72-0.92) and 0.92 (95% CI, 0.92-0.94) for MRI examinations at GA 14-23 weeks and GA 24-41 weeks, respectively. Pathologic or surgical evidence of abnormal placentation was found in 41% and 65% of the cases between GA 14-23 weeks and GA 24-41 weeks, respectively. The AUC for the MRI-based consensus score and the presence of abnormal placentation for GA 14-23 weeks was 0.49 (95% CI, 0.21-0.78) compared with 0.92 (95% CI, 0.83-1.0) for GA 24-41 weeks (p = 0.002). CONCLUSION Placental MRI examinations performed before 24 weeks' GA unreliably predict abnormal placentation.
Behavioral Economics and Behavioral Finance: A Bibliometric Analysis of the Scientific Fields

The aim of the study is to conduct a bibliometric analysis of the scientific field of Behavioral Economics and Behavioral Finance. The research was conducted using the Web of Science database, which returned 2617 articles, revealing that the amount of research within these fields has grown over time. Furthermore, the results also prove the relevance of the works of Daniel Kahneman and Amos Tversky for the field of Behavioral Economics and Finance, and Steven Hursh to Behavioral Economics. It is still possible to note that the field of Behavioral Economics encompasses subjects that connect human behavior with demand, consumption and price, with investments and with managerial decisions, as well as with the role played by heuristics and cognitive biases in decision‐making processes. In turn, the field of Behavioral Finance is more focused on the study of errors of judgment and of decision‐making characteristics in financial investments. Additionally, it is inferred that the field of Behavioral Economics is more wide‐ranging than the field of Behavioral Finance, as the latter is a byproduct of Behavioral Economics. Finally, a conclusion is then reached, demonstrating that the fields of Behavioral Economics and Finance have turned into an important field of study.
The Effectiveness of Femoral/Sciatic Nerve Blocks on Postoperative Pain Management in Total Knee Arthroplasty

PURPOSE Total knee arthroplasty (TKA) generates severe postoperative pain in 60% of patients and moderate pain in 30% of patients. Lack of adequate pain control can hinder early intensive physical therapy, the most influential factor for a good outcome. The purpose of this study was to evaluate the effectiveness of the femoral/sciatic block with postoperative pain management in comparison with conventional pain management in patients who have undergone unilateral primary TKA. SAMPLE Following unilateral TKA, 130 patients were evaluated: 65 in the general/spinal group and 65 in the general/femoral/sciatic group. METHODS This is a retrospective, comparative study. Participants who underwent primary TKA were randomly selected from a computer list generated by the hospitals medical records department between May 2001 to May 2002 and May 2004 to May 2005. Data collected included demographics, anesthesia type, knee range of motion, pain scores, complications, and length of stay. FINDINGS The general/femoral/sciatic group members experienced less pain as evidenced by the lower visual analog scale scores and less use of adjunct narcotics. They also performed better with increased knee flexion and extension scores than those in the general/spinal group. There was no difference in length of stay or significant differences between the groups with medical complications. DISCUSSION Findings indicate that femoral/sciatic nerve blocks in unilateral TKA are an effective method of postoperative pain management.
12-Monats-Prävalenz der selbstberichteten ärztlich diagnostizierten Depression in Deutschland

Depressionen sind häufige psychische Störungen, deren Bedeutung im Versorgungsgeschehen zunimmt. In der Studie GEDA 2014/2015-EHIS berichten 9,7 % der Frauen und 6,3 % der Männer in den letzten 12 Monaten von einer Ärztin oder einem Arzt die Diagnose einer Depression erhalten zu haben. Im Alter von 45 bis 64 Jahren sind diese aus dem Versorgungsgeschehen berichteten Depressionsdiagnosen bei beiden Geschlechtern am häufigsten. Deutliche Unterschiede bestehen nach Bildungsstatus: Bei Frauen liegen die Prävalenzen in der unteren Bildungs-gruppe etwa doppelt so hoch wie in der oberen (12,2 % vs. 6,5 %). Bei Männern zeigt sich ein geringerer Bildungs-gradient (7,5 % vs. 5,1 %). Auch zwischen den Bundesländern schwanken die Prävalenzen stark (Frauen 5,4 % – 13,4 %; Männer 3,3 % – 9,4 %). Die Ergebnisse werden im Kontext der bisherigen Datenlage diskutiert.
Microsatellite in the 3′ untranslated region of human fibroblast growth factor 9 (FGF9) gene exhibits pleiotropic effect on modulating FGF9 protein expression

Fibroblast growth factor 9 (FGF9) is a member of secreted polypeptide families and involved in many important biological processes, including implantation and morphogenesis during embryogenesis and adult life. Recently, Fgf9‐knockout mice exhibited male‐to‐female sex reversal, demonstrating a novel function for FGF9 in testicular development. We hypothesized that FGF9 is involved in sex development at an early embryonic stage in humans. In this study, we systematically screened sequences of the FGF9 gene in 21 XY females and 72 XX females and XY males to examine whether sequence variants of the FGF9 gene play a pathophysiological role on human gonadal dysgenesis. No mutation was identified, but a single nucleotide variant and two microsatellites were found. The allelic distribution of polymorphic microsatellite in the 3′‐UTR of FGF9 between patients and controls was slightly different with Bonferroni correction (P=0.06). We further applied reporter gene system and quantitative RT‐PCR to study the function of this microsatellite motif and results demonstrated that the (TG)n motif modulated gene expression at both pre‐ and post‐transcriptional levels. The (TG)14 allele, which showed a potential association with male‐to‐female sex reversal (odds ratio=6.08, 95% confidence interval=1.39–26.63), displayed the strongest promoter activity and longest mRNA stability. These data demonstrated that 3′‐UTR microsatellite of the FGF9 is a functional polymorphism that plays dual roles in regulating FGF9 expression. Although our preliminary result suggested a possible association between FGF9 and human gonadal dysgenesis, the major limitation of small dataset in this study points out the requirement for further investigation. © 2006 Wiley‐Liss, Inc.
Access to home-based hospice care for rural populations: Identification of areas lacking service.

BACKGROUND Many persons dying of cancer enroll in home-based hospice prior to death. It is established in the literature that persons in rural settings are less likely to use hospice than persons living in urban areas. We examine whether this is due, in part, to a lack of hospice providers serving rural areas. METHODS The 100% Medicare enrollment and hospice files for 2000-2002 were the basis for this study. We used a Bayesian smoothing technique to estimate the ZIP-code-level service area for each Medicare-certified hospice in the United States. These service areas were combined to identify ZIP codes not served by any hospice. RESULTS Overall, approximately 332,000 elders (7.5% of ZIP codes) reside in areas not served by home-based hospice. Each year over 15,000 deaths occur in these unserved areas. There was a strong association between lack of service and urban/rural gradient. One hundred percent of the ZIP codes in the most urban areas (>1,000,000 people) are served by hospice and only 2.8% of the ZIP codes in urban areas of less than 1,000,000 are unserved. In rural areas adjacent to urban areas, over 9% of ZIP codes are unserved and in rural areas not adjacent to an urban area almost 24% of ZIP codes are not served by hospice. CONCLUSIONS While the majority of the elderly population of the US resides in areas currently served by Medicare-certified hospice, there is a geographically large area that lacks home-based hospice services. Current payment policies may need to be adjusted to facilitate hospice availability to these rural populations.
Intermittent levosimendan infusions in advanced heart failure: a real world experience

Objective To analyse the effects of levosimendan infusions in advanced heart failure. Methods Patients with advanced heart failure treated with repeated levosimendan infusions were retrospectively compared with controls. Clinical, blood and echocardiographic parameters were obtained at baseline and after 12 months, and before and after each levosimendan infusion. Hospitalizations for heart failure and in-hospital length of stay in the 6 months before enrolment and after 6 and 12 months were recorded, along with 1-year mortality. Results Twenty-five patients treated with levosimendan and 25 controls were studied. After each levosimendan infusion, ventricular function and various clinical and metabolic parameters were improved. After 12 months, left ventricular ejection fraction (LVEF) had improved compared with baseline in the levosimendan group. The 1-year mortality rate was similar in both groups. During the 6 months before enrolment, hospitalizations were fewer in controls compared with the levosimendan group; after 6 and 12 months they increased in controls and decreased in the levosimendan group. Seven patients were super-responders to levosimendan, with LVEF improving more than 20% and hospitalizations being reduced at 12 months compared with the rest of the levosimendan group. Conclusion Intermittent levosimendan improved LVEF and decreased hospitalizations in advanced heart failure and represents a therapeutic option for patients whose disease is worsening.
Comparison of three commercial tests for buprenorphine screening in urine

Background: Rapid and sensitive tests for detecting buprenorphine and its metabolites for drug-screening situations have been long awaited. From the tests available, we have evaluated two on-site drugs-of-abuse testing devices using competitive binding immunoassays and one homogeneous enzyme immunoassay measured on an automated analyser. Methods: A total of 49 urine specimens were tested using three different kits. Two were point-of-care devices, a cassette test, QuikPac II OneStep Buprenorphine Test, and a strip test, QuikStrip OneStep Buprenorphine Test. The other was the CEDIA® Buprenorphine Assay performed on a Roche Modular P analyser. The confirmation analyses were performed using liquid chromatography-mass spectrometry. Results: The sensitivities of the three methods ranged from 88% to 100% and specificities from 91% to 100%. All three kits, especially the cassette and strip devices differed markedly from each other with respect to interpretation of the test result and to clarity of the test performance. Increasing the read time of the QuikStrip device from 5 to 30 min resulted in an increase in false-negative test results. Conclusions: Our results indicate that special care should be taken when selecting immunology-based point-of-care methods for measurement of buprenorphine.