Miracle-dz/UniFAR-FTUs huggingface dataset:
What are the True Advantages of a Pediatric Appendicitis Clinical Pathway?

Multiple protocols have been described for pediatric appendicitis, but few have been compared with off-protocol treatment. We performed such a comparison. Children treated for appendicitis by three pediatric surgeons over a 28-month period were studied. A protocol of primary wound closure without drains, standardized use of antibiotics, and patient discharge according to predetermined clinical criteria was compared with individualized drain use, antibiotic selection, and discharge timing. Three hundred ninety-seven children were treated, 43 per cent on pathway (Group I) and 57 per cent off pathway (Group II). The two groups showed similar incidence of acute (45% vs 46%), complicated (50% vs 49%), and normal (5%) appendix. Among patients with simple appendicitis, Group I had less postoperative antibiotic use (16% vs 80% P < 0.001), shorter hospital stays (1.44 vs 1.89 days, P = 0.001), and decreased hospital charges ($9,289 vs $10,751, P = 0.001). Among patients with complicated appendicitis, Group I had less drain placement (4% vs 27%, P < 0.001), less use of discharge antibiotics (13% vs 39%, P < 0.001), and no readmission (0% vs 5%, P = 0.05). Infectious complications were similar between the two groups. A clinical pathway decreases the use of unnecessary antibiotics, hospital stay, and charges for simple appendicitis. It decreases the use of unnecessary drains, and eliminates readmissions after complicated appendicitis.
Small Earnings Changes by Using Fair Value Measurement: Evidence from the Banking Industry of Sri Lanka

One of the most serious concerns presently facing the accounting profession is the growing complexity, extension, and significance of issues adjoining fair value measurements. The fair value accounting is liable for enhancing financial destruction. This research study the samples of licensed commercial banks and the financial institution listed under Colombo stock exchange to examine the association between the fair value accounting and the small earnings increase reported by the banks attributable to earnings management. We used the statistical methodology follow by Beatty et al. [1] to test the banks reported fair value assets and liabilities associated with bank report small earnings increase. We use both the current year and one-year ahead data after controlling discretionary provision for loan loss, discretionary security gains and losses and other features of banks. We found evidence that; banks reported fair value assets and liabilities are positively associate with bank reported small earnings increase. We further use the fair value hierarchy; to identify which level of fair value assets and liabilities associated with bank reported small earnings increase and we found the evidence that the level 2 fair value assets and liabilities are a predominant determination for the association between banks reported fair value assets and liabilities associated with bank report small earnings increase. The assets available-sales report under fair value is the primary use of item earnings management and the level 2 fair value assets and liabilities to reporting smooth earnings over the periods. Therefore, consistent with past research and present us, banks use the fair value measurements to manage the earnings.
Effect of propranolol after acute myocardial infarction in patients with congestive heart failure.

The incidence of congestive heart failure was studied in the Beta Blocker Heart Attack Trial in which postmyocardial infarction patients between the ages of 30 and 69 years, with no contraindication to propranolol, were randomly assigned to receive placebo (n = 1921) or propranolol 180 or 240 mg daily (n = 1916) 5 to 21 days after admission to the hospital for the event. Survivors of acute myocardial infarction with compensated or mild congestive heart failure, including those on digitalis and diuretics, were included in the study. A history of congestive heart failure before randomization characterized 710 (18.5%) patients: 345 (18.0%) in the propranolol group and 365 (19.0%) in the placebo group. The incidence of definite congestive heart failure after randomization and during the study was 6.7% in both groups. In patients with a history of congestive heart failure before randomization, 51 of 345 (14.8%) in the propranolol group and 46 of 365 (12.6%) in the placebo group developed congestive heart failure during an average 25 month follow-up. In the patients with no history of congestive heart failure, 5% in the propranolol group developed congestive heart failure and 5.3% in the placebo group developed congestive heart failure. Baseline characteristics predictive of the occurrence of congestive heart failure by multivariate analyses included an increased cardiothoracic ratio, diabetes, increased heart rate, low baseline weight, prior myocardial infarction, age, and more than 10 ventricular premature beats per hour. (ABSTRACT TRUNCATED AT 250 WORDS)
“If I have nothing to eat, I get angry and push the pills bottle away from me”: A qualitative study of patient determinants of adherence to antiretroviral therapy in the Democratic Republic of Congo

The global response to the HIV/AIDS epidemic has improved access to antiretroviral therapy (ART) and has contributed to decreased HIV/AIDS morbidity and mortality in sub-Saharan Africa. Patient adherence to ART is crucial to the success of HIV/AIDS treatment. However, little is known about the determinants of adherence to ART among people living with HIV/AIDS (PLWHA) in the Democratic Republic of Congo (DRC). This qualitative study used in-depth semi-structured patient interviews, a purposive sampling strategy and thematic analysis scheme to identify barriers and facilitators of adherence to ART in the DRC. We recruited three categories of participants from the Centre Hospitalier Monkole and the NGO ACS/Amo-Congo including participants on antiretroviral (ARV) treatment (n=19), on ARV re-treatment (n=13) and lost to follow-up (n=6). Among 38 participants interviewed, 24 were female and the median age was 41 years. Food insecurity as a barrier to adherence emerged as a dominant theme across the three categories of participants. Other barriers included financial constraints, forgetfulness and fear of disclosure/stigma. Religious beliefs were both a barrier and a facilitator to ART adherence. We found that food insecurity was a common and an important barrier to ART adherence among patients in the DRC. Our findings suggest that food insecurity should be appropriately addressed and incorporated into ARV treatment programs to ensure patient adherence and ultimately the long-term success of HIV treatment in the region.
Understanding and Predicting Behavioral Intention to Adopt Mobile Banking: The Korean Experience

Although mobile banking provides cost-saving opportunities as well as convenient banking experience for customers, today's banks still face challenges when deploying the technology because a good number of customers are reluctant to use mobile banking for personal reasons. This article is an empirical investigation of the determinants of the intention to use mobile banking services. The determinants are grouped into two categories including personal factors and social influence factors. The authors conducted an empirical analysis using 751 survey responses collected from present users of mobile banking services. The results of the analysis reveal that all the personal factors have positive relationships with the intention to use mobile banking services. On the other hand, it was found that of the social influence factors, perceived herding behavior has a significantly positive relationship with the intention to use mobile banking services, whereas subjective norm is not significantly related to the intention. The authors provide practical as well as academic implications of the research findings.
Acute respiratory effects of low level summer smog in primary school children.

We aimed to study the possible effects of exposure to a summer smog episode on the respiratory health of 212 school children. Furthermore, the suitability of the forced oscillation technique (FOT) to demonstrate such effects was evaluated. Acute respiratory symptoms were evaluated by questionnaire and lung function was assessed by spirometry and respiratory impedance measurements. For each child, comparisons were made between measurements performed at baseline (low levels of air pollutant: 55 micrograms.m-3 for SO2 and 58 micrograms.m-3 for NO2 (maximum 24 h means); O3 levels ranged from 2-56 micrograms.m-3 (8 h mean)); and after a summer smog episode (characterized by 8 h O3 levels > 120 micrograms.m-3 (163 micrograms.m-3) and 1 h levels > 160 micrograms.m-3 (215 micrograms.m-3). No significant effects were observed on the prevalence of acute respiratory symptoms. When individual changes in lung function indices (delta LF) were regressed on changes in previous day ozone (8 h mean) and changes in mean daily temperature (delta MTemp), using multiple linear regression analysis, a significant negative association was observed with peak expiratory flow (PEF), but not with other spirometry indices. Although significant associations were observed with reactance at 8 Hz (Xrs8), resonant frequency (f0) and frequency dependence of resistance (FD), the signs of the beta s were opposite to the direction expected when O3 adversely affected the impedance outcomes. In conclusion, in this study short-term exposure to moderately high levels of ozone did not result in clear adverse effects on the respiratory health of the children. (ABSTRACT TRUNCATED AT 250 WORDS)
Reliability of various observers in determining common radiographic parameters of adult hip structural anatomy.

BACKGROUND Radiographic evaluation of the hip is extremely important in the diagnosis and treatment decisionmaking process for pre-arthritic hip disease. Many different radiographic measurements have been described as indicators of underlying structural hip deformity. The purpose of this study was to determine the interobserver and intraobserver reliability of various musculoskeletal physicians in performing selected measurements of adult structural hip anatomy. METHODS A blinded review of 45 sets of radiographs from patients with developmental dysplasia, femoro-acetabular impingement, and normal anatomy was performed. Data points included the lateral center-edge angle (LCEA), vertical-center-anterior angle (VCA), head-neck offset ratio (UNO), alpha angle, Tönnis angle, Tönnis osteoarthritis grade and a radiographic diagnosis. One orthopaedic fellow, two orthopaedic residents, and two attending musculoskeletal physiatrists analyzed radiographs on two separate occasions. One sports medicine orthopaedic attending physician completed a single analysis of the image sets. Intraobserver and interobserver reliability was established using intra-class correlation coefficients (ICC) for continuous variables. Agreement regarding categorical variables was performed using the kappa coefficient RESULTS Excellent intraobserver reliability was found for the following: LCEA (ICC = 0.88), VCA (0.88), Tönnis angle (0.83), HNO on the frog lateral (0.78), alpha angle on the frog lateral (0.76), HNO on the cross-table lateral (0.75), and angle alpha on the cross-table lateral (0.76). Intraobserver reliability for osteoarthritis grade was poor (weighted kappa = 0.57). For all data points, interobserver reliability was considerably worse, with 95% confidence intervals spanning below 0.55. CONCLUSIONS While the described measurements of adult structural hip anatomy provide excellent reliability for a given reader, these measurements are less reliable across readers. Taken in isolation, these measurements, as performed by observers with varied clinical experience and clinical backgrounds, are limited in determining a consistent radiographic diagnosis.
Creation and testing of a practical visual function assessment for use in Africa: correlation with visual acuity, contrast sensitivity, and near vision in Malawian adults

AIM To develop and test a practical visual function assessment for use in developing countries. METHODS Using focus group discussions and interviews with eyecare workers and low vision specialists in Malawi, 13 questions related to visual characteristics of activities of daily living were designed. Patients presenting to an eye clinic were recruited and interviewed. Visual acuity, near vision, and contrast sensitivity were measured. Analysis sought to determine the degree of correlation between the vision indices and visual function. RESULTS The visual function questionnaire was easy to administer. Visual function correlated with visual acuity, contrast sensitivity, near vision, and patient reported visual problem. People with a higher frequency of “not applicable” responses had lower visual function scores. Multivariate modelling revealed that visual acuity and number of questions felt to be applicable were independently associated with visual function. Reducing the questionnaire to nine questions did not affect the degree of correlation with any of the visual indices. CONCLUSION The authors’ visual function assessment correlates well with different measures of visual acuity. People with reduced vision for a prolonged period may no longer consider doing certain tasks and the number of questions considered appropriate by an individual may be an additional measure of visual function. Assessment of visual function by health workers may be a valuable tool in improving surgical uptake by encouraging both health personnel and patients to recognise that they have difficulties undertaking activities of daily living as well as a measure of monitoring and evaluating cataract outcomes.
Optimization of the helper-dependent adenovirus system for production and potency in vivo.

Helper-dependent (HD) adenoviral vectors devoid of all viral coding sequences provide for safe and highly efficient gene transfer with long-lasting transgene expression. High titer stocks of HD vectors can be generated by using the cre-recombinase system. However, we have encountered difficulties with this system, including rearranged HD vectors and variable efficiency of HD vector rescue. These problems represent a major hindrance, particularly with regard to large-scale production. To overcome these limitations, we have modified the system in two ways: We constructed a new helper virus with a modified packaging signal and enhanced growth characteristics. We also redesigned the vector backbones by including noncoding adenovirus sequences adjacent to the right inverted terminal repeat and by incorporated a number of different segments of noncoding DNA of human origin as "stuffer. " Comparison of these vectors showed that the nature of the stuffer sequence affects replication of the HD vector. Optimization of the system resulted in a more robust and consistent production of HD vectors with low helper contamination and high in vivo potency.
Clinical Disease Activity and Inflammatory Activity in the Rectum in Relation to Mucosal Inflammation Assessed by Colonoscopy A Study of Children and Adolescents with Chronic Inflammatory Bowel Disease

ABSTRACT. The relationship between clinical disease activity, rectal inflammatory activity and mucosal inflammation established at total colonoscopy has been studied in 36 young patients with ulcerative colitis (UC) and 24 with Crohn's colitis (CC). Semiformed stools, diarrhea and frequent bowel movements seem to be better indicators of extensive mucosal inflammation of a moderate or severe degree than blood in faeces. There were, however, several patients with a discrepancy between the degree of clinical disease activity and the extent and degree of mucosal inflammation at endoscopic and histologic assessment. In about one‐third of the patients with UC and in about half of the patients with CC, who had mucosal inflammatory activity of a moderate or severe degree, the rectal inflammatory activity was of a lower degree. Total colonoscopy seems to be necessary in order to establish the extent and degree of mucosal inflammation.
Historical considerations and comments on the type series of Cyrtodactylus marmoratus Gray, 1831, with an updated comparative table for the bent-toed geckos of the Sunda Islands and Sulawesi.

Cyrtodactylus marmoratus Gray, 1831, a species of bent-toed gecko exhibiting a precloacal groove in males, was described on the basis of specimens collected by Heinrich Kuhl and Johan Conrad van Hasselt in Java, Greater Sunda Islands, Indonesia. Kluge (1985) subsequently designated a lectotype for C. marmoratus from a series of these specimens (i.e., syntypes), now housed in the herpetological collection at Naturalis (formerly the Rijksmuseum van Natuurlijke Historie; RMNH), Leiden, the Netherlands. Our work at Naturalis shows that the type series of C. marmoratus at RMNH actually comprises two sets of specimens, and that examination of specimens from one set or the other by different authors, including Kluge (1985), is responsible for some confusion surrounding the type series of this species. As a consequence, we present relevant morphological data for all 14 specimens constituting the type series of C. marmoratus at RMNH for the first time. The type status of two specimens of C. marmoratus in the collection at the Muséum National d'Histoire Naturelle, Paris, France, remains unresolved at present. Owing to the inconsistent naming and application of terms for some key characters (e.g., groove, sulcus, pit, hollow, depression) used in the diagnoses of Cyrtodactylus species, we here propose a set of novel and useful definitions that are supported by photographs. We also illustrate the sexually dimorphic expression of this character in C. marmoratus. Finally, we present a revised comparative table for the bent-toad geckos of the Sunda Islands and Sulawesi.
Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study.

BACKGROUND Infertile women positive for thyroid antibodies suffer from a poor pregnancy/delivery outcome, although conflicting data have been published. Our objective was to investigate if levothyroxine (LT4) exerts any effect on pregnancy and/or delivery rates in thyroid peroxidase antibody (TPOAb)-positive (+) women undergoing assisted reproductive technologies. METHODS Patients undergoing treatment were screened for TPOAb, thyroid-stimulating hormone (TSH) and free thyroxine (FT4). A total of 72 (15%) out of the 484 euthyroid women selected were TPOAb (+). These 72 patients were randomly divided into two groups: group A (n = 36) underwent LT4 treatment, group B (n = 36) placebo. Group C consisted of 412 women (85%) who were TPOAb negative (-). All patients received controlled ovarian stimulation. The endpoints of treatment were pregnancy rate, miscarriage rate and delivery rate. RESULTS No differences in pregnancy rate were observed between the three groups. Miscarriage rate was higher in TPOAb (+) in comparison to TPOAb (-) [relative risk: 2.01 (95% CI = 1.13-3.56), P = 0.028]. CONCLUSIONS The pregnancy rate is not affected either by presence of TPOAb or treatment with LT4. However, TPOAb (+) women show a poorer delivery rate compared to TPOAb (-). LT4 treatment in TPOAb (+) does not affect the delivery rate.
Landiolol hydrochloride infusion for treatment of junctional ectopic tachycardia in post-operative paediatric patients with congenital heart defect.

AIMS Junctional ectopic tachycardia (JET) after cardiopulmonary bypass surgery for congenital heart defects is often therapy-resistant and associated with high morbidity and mortality. Improvement of pharmacological therapy is needed. METHODS AND RESULTS We retrospectively analysed the clinical data of four patients with congenital heart defects, who developed post-operative JET and were treated with landiolol hydrochloride, representing all such patients treated at our university. In two patients, landiolol was used after failure of response to anti-arrhythmic therapies, including thermal control, sedation, discontinuation of catecholamines, and pharmacological therapy with nifekalant and amiodarone. Landiolol was used as a first-line therapy in the other two patients. In all patients, landiolol, at a dose ranging from 1.0 to 10.0 µg/kg/min, achieved successful sinus conversion within 15 min. No adverse events, such as bradycardia, hypotension, or hypoglycaemia, were encountered in all four patients. CONCLUSION Although limited to a small and heterogeneous group of patients, the results suggest that landiolol is a potentially useful therapeutic option for the well-known difficult condition of post-operative JET, and warrant further investigation in large-scale controlled studies.
Hydrogen ion concentration differentiates effects of methamphetamine and dopamine on transporter‐mediated efflux

Methamphetamine (METH) causes release of stored intracellular dopamine (DA). We explored the interactions of METH with the recombinant human vesicular monoamine (hVMAT2) and/or human DA transporters (hDAT) in transfected mammalian (HEK293) cells and compared the findings with those for DA. In ‘static’ release assays at 37°C, less than 20% of pre‐loaded [3H]DA was lost after 60 min, while nearly 80% of pre‐loaded [3H]METH was lost at 37°C under non‐stimulated conditions. Results obtained by measuring substrate release using a superfusion apparatus revealed an even greater difference in substrate efflux. At pH 7.4, nearly all of the pre‐loaded [3H]METH was lost after just 6 min, compared with the loss of 70–80% of pre‐loaded [3H]DA (depending on cell type) after superfusion for 32 min. Increasing the extracellular pH from 7.4 to 8.6 had opposite effects on [3H]DA and [3H]METH retention. At pH 8.6, [3H]METH was retained more effectively by both hDAT and hDAT‐hVMAT2 cells, compared with results obtained at extracellular pH 7.4. [3H]DA, however, was more effectively retained at pH 7.4 than at pH 8.6. These data suggest that DA and METH interact differently with the DAT and VMAT2, and require different H+ concentrations to exert their effects.
Does Global Warming Increase Public Concern about Climate Change?

Scholars have not determined whether exposure to a changing climate influences public understanding of or concern about climate change. We examine this question using a comprehensive index of public concern about climate change in each state from 1999 to 2017. The index aggregates data from over 400,000 survey respondents in 170 polls. These new estimates of state-level climate concern enable us to exploit geographic variation in locally experienced climate changes over an extended time period. We show that climate concern peaked in 2000 and again in 2017 and that climate concern is modestly responsive to changes in state-level temperatures. Overall, our results suggest that continued increases in temperature are likely to cause public concern about climate change to grow in the future. But a warming climate, on its own, is unlikely to yield a consensus in the mass public about the threat posed by climate change.