EBV+ cutaneous B-cell lymphoproliferation of the leg in an elderly patient with mycosis fungoides and methotrexate treatment.

A 77-year-old man with a 5-year history of mycosis fungoides (MF) who had received several lines of therapy, including intravenous courses of Methotrexate (MTX) for the past 2 years, went on to develop several ulcerated cutaneous nodules on the left leg. Biopsy revealed diffuse sheets of EBV-positive large B cells (CD20+ CD30 ± IgM Lambda), with an angiocentric distribution and a monoclonal IGH gene rearrangement. Although the pathological features were diagnostic for an EBV-positive diffuse large B-cell lymphoma (DLBCL), several possibilities could be considered for assignment to a specific entity: EBV-positive DLBCL of the elderly, methotrexate-induced lymphoproliferative disorder (LPD), lymphomatoid granulomatosis, or the more recently described EBV-positive mucocutaneous ulcer. The development of EBV+ lymphoproliferations has been reported in two other patients with MF under MTX, and occurred as skin lesions of the leg in one of these and in the current case, which may question the relatedness to primary cutaneous DLCBL, leg-type.

Avaliação de Desempenho no Sector Bancário em Cabo Verde

Presentemente, o controlo de gestão está vocacionado para agir antes de os factos indesejáveis ocorrerem, assegurando que os objectivos estabelecidos pela gestão são atingidos dentro do timing fixado. Além disso, o controlo de gestão deve ser o motor que permita alcançar as melhores performances nas áreas críticas da empresa, não só no domínio económico e financeiro, mas também nas áreas do crescimento, segurança e produtividade. Um dos mais importantes objectos das administrações actuais, é determinar se o desempenho da organização está de acordo com o que foi estabelecido previamente, ou seja, seus objectivos e metas. O meio através do qual se verificaria este desempenho seria a utilização de métodos e sistemas de avaliação de desempenho eficazes. Neste contexto, o presente estudo consiste em fazer um estudo exploratório descritivo identificando e averiguando de que forma as instituições bancárias de Cabo Verde efectuam a gestão de alguns aspectos, especialmente a avaliação de desempenho e o controlo estratégico, e que indicadores utilizam. Não obstante os objectivos específicos do trabalho serem outros, também damos especial atenção às características do mercado cabo-verdiano e à importância do sector bancário para a economia. Finalmente, apresentamos o Balanced Scorecard como uma ferramenta capaz de suprir as dificuldades da avaliação de desempenho e o conjunto de indicadores que vemos como o mais adequado. Neste ponto, concentramos nas quatro perspectivas básicas e no mapa estratégico, referindo o papel do Balanced Scorecard no alinhamento estratégico e na avaliação do desempenho organizacional. Para concluir, reforçamos o estudo, entrevistando um especialista (Director Financeiro) de um dos bancos da praça, cujo nome prometemos não publicar. Dessa forma, esperamos contribuir para uma melhor percepção da realidade em estudo, tanto do ponto de vista teórico, quanto da verificação das práticas no sector. Presently, the management control is oriented to act before the undesirable facts happen, assuring that the management established objectives are being achieved in the fixed timing. Besides, the management control must be an engine that permits to achieve the best performances at critical company areas, not only in the economic and financial areas, but at the growth, security and productivity areas too. One of the most important administration objects nowadays is to know if the organization performance is according to the fixed targets. The performance measurement could be done through effective methods and performance measurement systems. That’s why this assignment consists in doing an exploratory and descriptive study, identifying and investigating how the bank institutions of Cape Verde manage some things, particularly the performance measurement and the strategic control, and to know which indicators they use. Although the specific objectives of this assignment are others, we also give special attention to the Capeverdean market characteristics, and to the relevance of the banking industry to the economy of the country. Finally, we present the Balanced Scorecard as a competent tool to supply the measurement performance difficulties and a number of indicators that we find appropriate. In this point, we focus in the four basic perspectives and the strategic map, referring to the role of the Balanced Scorecard in the strategic alignment and organization performance measurement. We conclude this study with an interview to an expert (A Financial Manager) of a bank working in Cape Verde, whose name we promise to preserve. In this way, we hope to contribute to a better perception of this reality, in the theoretical point-of-view as much as in the practical check of this industry’s labour.

Heterogeneity as a coordination device

A model of directed search with a finite number of buyers and sellers is considered, where sellers compete in direct mechanisms. Buyer heterogeneity and Nash equilibrium results in perfect sorting. The restriction to complementary inputs, that the match value function Q is supermodular, in addition coordinates the sellers strategies. In that case, equilibrium implements positive assortative matching, which is efficient and consistent with the stable (cooperative equilibrium) outcome. This provides a non-cooperative and decentralizedsolution for the Assignment Game. Conversely, if buyers are identical, no such coordination is possible, and there is a continuum of equilibria, one of which exhibits price posting, another yields competition in auctions.

Doctors without borders: The returns to an occupational license for Soviet immigrant physicians in Israel

Re-licensing requirements for professionals that move across borders arewidespread. In this paper, we measure the returns to an occupationallicense using novel data on Soviet trained physicians that immigrated toIsrael. An immigrant re-training assignment rule used by the IsraelMinistry of Health provides an exogenous source of variation inre-licensing outcomes. Instrumental variables and quantile treatmenteffects estimates of the returns to an occupational license indicate excesswages due to occupational entry restrictions and negative selectioninto licensing status. We develop a model of optimal license acquisitionwhich suggests that the wages of high-skilled immigrant physicians in thenonphysician sector outweigh the lower direct costs that these immigrantsface in acquiring a medical license. Licensing thus leads to lower averagequality of service. However, the positive earnings effect of entry restrictionsfar outweighs the lower practitioner quality earnings effect that licensinginduces.

INTRODUCTORY EDUCATIONAL COUNSELLING

Tiana Campos is a student of a Master in Agribusiness at University of Queensland. She is a Mozambican awardee of AUSAID scholarship. At the moment she is experiencing emotional stress with her studies. Her main concern is the time pressure and assignment overload. She fears not being able to cope and finish her degree in the expected time as agreed with AUSAID Office and thus be forced to return to her country without the Masters Certificate.

Assessment of a new MRI classification of spinal stenosis based on cross-sectional morphology of the dural sac : FM2

Introduction: Quantitative measures of degree of lumbar spinal stenosis (LSS) such as antero-posterior diameter of the canal or dural sac cross sectional area vary widely and do not correlate with clinical symptoms or results of surgical decompression. In an effort to improve quantification of stenosis we have developed a grading system based on the morphology of the dural sac and its contents as seen on T2 axial images. The grading comprises seven categories ranging form normal to the most severe stenosis and takes into account the ratio of rootlet/CSF content. Material and methods: Fifty T2 axial MRI images taken at disc level from twenty seven symptomatic lumbar spinal stenosis patients who underwent decompressive surgery were classified into seven categories by five observers and reclassified 2 weeks later by the same investigators. Intra- and inter-observer reliability of the classification were assessed using Cohen's and Fleiss' kappa statistics, respectively. Results: Generally, the morphology grading system itself was well adopted by the observers. Its success in application is strongly influenced by the identification of the dural sac. The average intraobserver Cohen's kappa was 0.53 ± 0.2. The inter-observer Fleiss' kappa was 0.38 ± 0.02 in the first rating and 0.3 ± 0.03 in the second rating repeated after two weeks. Discussion: In this attempt, the teaching of the observers was limited to an introduction to the general idea of the morphology grading system and one example MRI image per category. The identification of the dimension of the dural sac may be a difficult issue in absence of complete T1 T2 MRI image series as it was the case here. The similarity of the CSF to possibly present fat on T2 images was the main reason of mismatch in the assignment of the cases to a category. The Fleiss correlation factors of the five observers are fair and the proposed morphology grading system is promising.

The evolution of personally disadvantageous punishment among cofoundresses of the ant Acromyrmex versicolor

Cofoundresses of the desert fungus garden ant Acromyrmex versicolorexhibit a forager specialist who subsumes all foraging risk priorto first worker eclosion (Rissing et al. 1989). In an experimentdesigned to mimic a "cheater" who refuses foraging assignment whenher lot, cofoundresses delayed/failed to replace their forager,often leading to demise of their garden (Rissing et al. 1996). Thecheater on task assignment is harmed, but so too is the punisher,as all will die without a healthy garden. In this paper we studythrough simulation the cofoundress interaction with haploid, asexualgenotypes which either replace a cheater or not (punishment), underboth foundress viscosity (likely for A. versicolor) and randomassortment. We find replacement superior to punishment only whenthere is no foraging risk and cheating is not costly to groupsurvival. Generally, punishment is evolutionarily superior,especially as forager risk increases, under both forms of dispersal.

Performance assessment and league tables. Comparing like with like

We formulate performance assessment as a problem of causal analysis and outline an approach based on the missing data principle for its solution. It is particularly relevant in the context of so-called league tables for educational, health-care and other public-service institutions. The proposed solution avoids comparisons of institutions that have substantially different clientele (intake).

Inbreeding in the greater white-toothed shrew, Crocidura russula.

We combined mark-and-recapture studies with genetic techniques of parentage assignment to evaluate the interactions between mating, dispersal, and inbreeding, in a free-ranging population of Crocidura russula. We found a pattern of limited and female-biased dispersal, followed by random mating within individual neighborhoods. This results in significant inbreeding at the population level: mating among relatives occurs more often than random, and F(IT) analyses reveal significant deficits in heterozygotes. However, related mating partners were not less fecund, and inbred offspring had no lower lifetime reproductive output. Power analyses show these negative results to be quite robust. Absence of phenotypic evidence of inbreeding depression might result from a history of purging: local populations are small and undergo disequilibrium gene dynamics. Dispersal is likely caused by local saturation and (re)colonization of empty breeding sites, rather than inbreeding avoidance.

Propuesta creativa para la nueva línea de vinos ENJOYME

El projecte presentat en aquest document formal conté la proposta per a la nova marca de vins Enjoyme, el projecte consta de la creació de diverses peces gràfiques per tal de construir una proposta global per a la marca. L’encàrrec per part del client consta de: construcció de marca Enjoyme (logotip), lloc web enfocat a la venda on line, packaging del producte, OPI i revista digital. Cadascuna d’aquestes peces es troba explicada detalladament dins d’aquest document amb les seves respectives especificacions creatives, tècniques, estratègiques i econòmiques. El concepte creatiu d’aquesta campanya “Cultiva els teus sentits” està reflectit en cadascuna de les peces, formant un equilibri en conjunt. La idea central de la campanya s’enfoca a transmetre als clients totes les sensacions que li pot donar la natura en ser humà, tenint en compte l’orgànic i biodinàmic com a part fonamental del projecte, ja que aquest producte elaborat amb aquest tipus d’agricultura.

Space Utilization and Building Study for the Department of General Services, October 9, 2000

Purposes of this Report: • Recommend the most logical and economical options to address state governmental space needs in the Polk County metropolitan area to the year 2010. • Include building size, location, phasing, financing, method of project delivery and estimated cost. • Develop a software tool to compare costs of leasing vs. ownership of space. Methodology: Identify: 1. Current amount and location of owned and leased space, by agency; 2. Types of space and whether best located on or off of the Capitol Complex; 3. Utilization of space, noting over-crowding and under-utilization; 4. Current number of workstations for full and part time employees, Personnel Employment Organization (PEO) workers, contractors, interns, etc.; and, 5. History of staff levels to assist in the prediction of staff growth. Scope: This report focuses on 10 state-owned buildings located on the Capitol Complex and 48 leased spaces in the Polk County metropolitan area. (See Figures 1 and 2.) • Due to a separate space study under way by the Legislature, implications of area and staff for the State Capitol building are included only for the Governor, Lieutenant Governor, Treasurer, Secretary of State, Auditor and the Department of Management. • Because it is largely a museum building that does not have office space available for other agencies, the area and staff of the Historical Building are not fully addressed. • Only the parking implications of the new Judicial Building are included in this study because the building space is under the jurisdiction of the Judicial Branch and not available for other agencies. Several state-owned buildings are not included in the scope of this report, generally because they have highly focused purposes, and their space is not available for assignment to other agencies. Several leased locations are not included for similar reasons, including leases that do not fall within the authority of the Department of General Services.

Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial.

BACKGROUND: Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. METHODS: The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. FINDINGS: The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4.0%) events of disabling stroke or death in the stenting group compared with 27 (3.2%) events in the endarterectomy group (hazard ratio [HR] 1.28, 95% CI 0.77-2.11). The incidence of stroke, death, or procedural myocardial infarction was 8.5% in the stenting group compared with 5.2% in the endarterectomy group (72 vs 44 events; HR 1.69, 1.16-2.45, p=0.006). Risks of any stroke (65 vs 35 events; HR 1.92, 1.27-2.89) and all-cause death (19 vs seven events; HR 2.76, 1.16-6.56) were higher in the stenting group than in the endarterectomy group. Three procedural myocardial infarctions were recorded in the stenting group, all of which were fatal, compared with four, all non-fatal, in the endarterectomy group. There was one event of cranial nerve palsy in the stenting group compared with 45 in the endarterectomy group. There were also fewer haematomas of any severity in the stenting group than in the endarterectomy group (31 vs 50 events; p=0.0197). INTERPRETATION: Completion of long-term follow-up is needed to establish the efficacy of carotid artery stenting compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for patients suitable for surgery. FUNDING: Medical Research Council, the Stroke Association, Sanofi-Synthélabo, European Union.

Proyecto de ejecución para las obras de concesión de dominio público para la reforma y adecuación de la central térmica y de la red de saneamiento en un hospital de 350 camas

El Hospital Punta de Europa en Algeciras (Cádiz), centro sanitario del Servicio Andaluz de Salud, desea optimizar la gestión de sus instalaciones de generación de energía térmica (vapor, agua caliente sanitaria y agua caliente de calefacción) y adecuarlas a la normativa vigente así como la sustitución de bajantes del edificio, para lo cual sacará a concurso público la licitación para la concesión de dominio público de dichas instalaciones. Para definir el alcance y condiciones de la citada concesión, el Hospital Punta de Europa (Algeciras) del Servicio Andaluz de Salud ha solicitado a Pedro Alonso Martín el estudio para la reforma y adecuación de las instalaciones productoras de energía térmica del citado Hospital. El objetivo principal de este trabajo es hacer un estudio, propuesta y valoración de las actuaciones necesarias para la reforma y mejora de la explotación de las instalaciones generadoras de energía térmica y de la red saneamiento interior del Hospital Punta de Europa de Algeciras (Cádiz). Las actuales instalaciones de generación térmica consumidoras de energía del hospital dentro del alcance de este Proyecto son: Generación de vapor (lavandería y esterilización). Producción de agua caliente sanitaria (ACS). Producción de agua caliente de calefacción. La mayoría de los equipos productores de energía datan del año 1975, por lo que en la mayoría de los casos se ha cumplido su plazo de amortización y periodo de vida útil. Se hace necesaria la instalación de gas natural, debido a que se tendrá que abastecer a todas las calderas de la central térmica. El diseño del sistema de producción de agua caliente sanitaria garantiza el máximo confort y economía del usuario, compatible con el máximo ahorro energético y la protección del medio ambiente, cubriendo las necesidades de agua caliente sanitaria mediante la combinación de un sistema de calderas a gas con los colectores solares.

Memoria de la elaboración de subtítulos para "Babel", primer capítulo de la serie documental Fry's Planet Word

This work tries to identify some of the skills an audio visual translator must develop, from a practical point of view, in order to pursue a career in this field, putting the stress on mastering subtitling-specific software. This report describes trial and error process during the making of the subtitles for a documentary and identifies some of the difficulties we might encounter while working on an assignment of this kind if we work with free licensing software. Moreover, it tries to contribute with some answers to these issues.

Inbreeding and sex-biased gene flow in the ant Formica exsecta.

The objective of this study was to assess breeding and dispersal patterns of both males and females in a monogyne (a single queen per colony) population of ants. Monogyny is commonly associated with extensive nuptial flights, presumably leading to considerable gene flow over large areas. Opposite to these expectations we found evidence of both inbreeding and sex-biased gene flow in a monogyne population of Formica exsecta. We found a significant degree of population subdivision at a local scale (within islands) for queens (females heading established colonies) and workers, but not for colony fathers (the males mated to the colony queens). However, we found little evidence of population subdivision at a larger scale (among islands). More conclusive support for sex-biased gene flow comes from the analysis of isolation by distance on the largest island, and from assignment tests revealing differences in female and male philopatry. The genetic similarity between pairs of queens decreased significantly when geographical distance increased, demonstrating limited dispersal and isolation by distance in queens. By contrast, we found no such pattern for colony fathers. Furthermore, a significantly greater fraction of colony queens were assigned as having originated from the population of residence, as compared to colony fathers. Inbreeding coefficients were significantly positive for workers, but not for mother queens. The queen-male relatedness coefficient of 0.23 (regression relatedness) indicates that mating occurs between fairly close relatives. These results suggest that some monogyne species of ants have complex dispersal and mating systems that can result in genetic isolation by distance over small geographical scales. More generally, this study also highlights the importance of identifying the relevant scale in analyses of population structure and dispersal.