14 research outputs found
Critical Analysis of the Results of the CPA Exam for the Second Decade of This Century: Empirical Evidence From Puerto Rico
The research for the first time examines the performance of candidates for the uniform Certified Public Accountant exam in the Hispanic jurisdiction of Puerto Rico from 2010 to 2019. The study presents an innovative method of classifying the quality of accounting programs, based on the performance of their alumni on the exam, according to their pass rate, average score, and their contribution to the total number of new CPA’s admitted to the profession. Candidates from public institutions perform better than candidates from private institutions. The research provides methodology that can be replicated in any profession that requires a professional license
Consistent patterns of common species across tropical tree communities
Trees structure the Earth’s most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1,2,3,4,5,6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth’s 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world’s most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees.Publisher PDFPeer reviewe
Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago
Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
An Application of Judgement Modeling to Examine Inter-Cultural Differences Regarding Perceptions of Business Skill Importance
With increased global interaction, cultural awareness among stakeholders is crucial, especially for companies seeking growth in the international environment. This study focuses on comparing the perceptions of business skill importance between student subjects from China/Hong Kong (CHK) and the United States (US). The results show that the six cues representing the business skills/attributes strongly influenced student perceptions of job offer likelihood and the relative importance of these cues were not equal, with Interpersonal Effectiveness (INPER), Internship Experience (INT), and Ethical Awareness (ETH) having a higher impact than Communication (COMM), Cultural Intelligence (CULT), and Critical Thinking (CRIT). The results indicated that INPER, INT, and ETH were associated with similar, substantial effects, while COMM, CULT, and CRIT exhibited smallerand comparable effects. The analysis revealed significant interactions between the country and two cues Interpersonal Effectiveness (INPER) and Ethical Awareness (ETH). Chinese students perceived INPER to be somewhat more important than U.S. students, possibly influenced by cultural dimensions such as the emphasis on interpersonal relationships in Chinese culture. Conversely, U.S. students regarded ETH as more crucial than their Chinese counterparts, aligning with findings that suggest cultural variations,particularly in power distance and collectivism, may influence ethical values. The findings enhance our understanding of the relative importance of business skills in different cultural contexts and provide insights for educational institutions and employers in preparing students for the global business environment. The study contributes to the existing literature by providing direct comparisons of student perceptions across cultures and employing a rigorous judgment modeling methodology
An Application of Judgement Modeling to Examine Inter-Cultural Differences Regarding Perceptions of Business Skill Importance
With increased global interaction, cultural awareness among stakeholders is crucial, especially for companies seeking growth in the international environment. This study focuses on comparing the perceptions of business skill importance between student subjects from China/Hong Kong (CHK) and the United States (US). The results show that the six cues representing the business skills/attributes strongly influenced student perceptions of job offer likelihood and the relative importance of these cues were not equal, with Interpersonal Effectiveness (INPER), Internship Experience (INT), and Ethical Awareness (ETH) having a higher impact than Communication (COMM), Cultural Intelligence (CULT), and Critical Thinking (CRIT). The results indicated that INPER, INT, and ETH were associated with similar, substantial effects, while COMM, CULT, and CRIT exhibited smaller and comparable effects. The analysis revealed significant interactions between the country and two cues Interpersonal Effectiveness (INPER) and Ethical Awareness (ETH). Chinese students perceived INPER to be somewhat more important than U.S. students, possibly influenced by cultural dimensions such as the emphasis on interpersonal relationships in Chinese culture. Conversely, U.S. students regarded ETH as more crucial than their Chinese counterparts, aligning with findings that suggest cultural variations, particularly in power distance and collectivism, may influence ethical values. The findings enhance our understanding of the relative importance of business skills in different cultural contexts and provide insights for educational institutions and employers in preparing students for the global business environment. The study contributes to the existing literature by providing direct comparisons of student perceptions across cultures and employing a rigorous judgment modeling methodology
Tackling antibiotic resistance during the COVID-19 pandemic is a new challenge for paediatricians
Consistent patterns of common species across tropical tree communities
Trees structure the Earth’s most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1–6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth’s 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world’s most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees
Consistent patterns of common species across tropical tree communities
Trees structure the Earth’s most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1,2,3,4,5,6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth’s 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world’s most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees
Consistent patterns of common species across tropical tree communities
International audienceAbstract Trees structure the Earth’s most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations 1–6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth’s 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories 7 , we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world’s most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees