A Model for Costing Absenteeism in Hotels

While absenteeism models have been developed and applied in the manufacturing industries, little work has been done on absenteeism in service industries. Due to the labor intensity of service industries, specifically the hotel industry, a model to track and quantify the costs of absenteeism could be useful to managers. The authors propose just such a model.

Development and validation of a stability-indicating UPLC method for rosuvastatin and its related impurities in pharmaceutical dosage forms

The present work describes a novel stability-indicating reversed-phase ultra performance liquid chromatography method for the separation and quantification of rosuvastatin (RSV) and its related impurities in the pharmaceutical dosage forms under forced degradation conditions. An unknown degradation impurity detected in the acid degradation was identified by using quadrupole time-of-flight mass spectrometry. The chromatographic separation was carried out on C-18 column (100 x 2.1 mm, 1.7 μm) using isocratic elution with methanol and 0.1% trifluoroacetic acid (50:50). The total run time was 12 min within which RSV as well as all related impurities and degradation products were separated. The developed method was validated for RSV and related impurities in pharmaceutical dosage forms.

¿Qué factores inciden en la hospitalización de pacientes con cálculos ureterales menores a 10 mm en Fundación Santa Fe?

Debido a que el 12% de la población tendrá un cálculo en uréter hacia la mitad de su vida y a que las tasas de recurrencia en los que ya lo presentan son del 50% es necesario estudiar esta patología para aproximarse a un manejo adecuado en el servicio de urgencias. La literatura identifica un conjunto de factores que pueden contribuir a un cambio en el manejo médico. Objetivo: El objetivo de este estudio fue determinar los factores demográficos y clínicos asociados a manejo hospitalario en los pacientes con diagnóstico de cálculo ureteral menor de 10 mm. Métodos: Se diseñó un estudio de casos y controles no emparejados. Un caso fue definido como un paciente de 18 o más años con diagnóstico de urolitiasis con cálculo menor a 10 mm realizado por urotac que consultó (por primera vez para ese episodio) al servicio de urgencias de la Fundación Santa Fe de Bogotá entre el 1 de marzo de 2007 y 30 de abril de 2012. Se indagaron factores como edad, sexo, tamaño y localización del cálculo, respuesta a los analgésicos, evidencia de obstrucción e infección urinaria, además de otros antecedentes medicamentosos y clínicos. Se utilizó regresión logística no condicional bivariada y multivariada para evaluar la asociación entre tipo de manejo (hospitalario o ambulatorio) y las variables recolectadas, calculando odds ratio (OR) e intervalos de confianza al 95% (IC95%). Resultados: El riesgo de hospitalización se incrementó con: 1. La localización del cálculo en tercio superior o medio (OR=1.49; IC95%: 0.751-2.966) al comparar con el inferior, 2. El aumento del tamaño del cálculo (OR=1.49; IC95%: 0.751-2.966, por cada milímetro de incremento), y 3: Por la evidencia de obstrucción o infección urinaria y elevación de azoados. Por el contrario, hubo menos riesgo de hospitalización en aquellos pacientes con una respuesta analgésica apropiada en urgencias.

Efectos del consumo de cigarrillo en la presentación y severidad de la dismenorrea

Introducción: La dismenorrea se presenta como una patología cada vez más frecuente en mujeres de 16-30 años. Dentro de los factores asociados a su presentación, el consumo de tabaco ha revelado resultados contradictorios. El objetivo del presente estudio es explorar la asociación entre el consumo de cigarrillo y la presentación de dismenorrea, y determinar si los trastornos del ánimo y la depresión, alteran dicha asociación. Materiales y métodos: Se realizó un estudio de prevalencia analítica en mujeres de la Universidad del Rosario matriculadas en pregrado durante el primer semestre de 2013, para determinar la asociación entre el consumo de tabaco y la presentación de dismenorrea. En el estudio se tuvieron en cuenta variables tradicionalmente relacionadas con dismenorrea, incluyendo las variables ansiedad y depresión como potenciales variables de confusión. Los registros fueron analizados en el programa Estadístico IBM SPSS Statistics Versión 20.0. Resultados: Se realizaron 538 cuestionarios en total. La edad promedio fue 19.92±2.0 años. La prevalencia de dismenorrea se estimó en 89.3%, la prevalencia de tabaquismo 11.7%. No se encontró una asociación entre dismenorrea y tabaquismo (OR 3.197; IC95% 0.694-14.724). Dentro de las variables analizadas, la depresión y la ansiedad constituyen factores de riesgo independientes para la presentación de dismenorrea con una asociación estadísticamente significativa p=0.026 y p=0.024 respectivamente. El análisis multivariado encuentra como factor determinante en la presentación de dismenorrea, la interacción de depresión y ansiedad controlando por las variables tradicionales p<0.0001. Sin embargo, esta asociación se pierde cuando se analiza en la categoría de dismenorrea severa y gana relevancia el uso de métodos de anticoncepción diferentes a los hormonales, mientras que el hecho de haber iniciado la vida sexual presenta una tendencia limítrofe de riesgo. Conclusiones: No se puede demostrar que el tabaco es un factor asociado a la presentación de dismenorrea. Los trastornos del ánimo y la ansiedad constituyen factores determinantes a la presentación de dismenorrea independientemente de la presencia de otros concomitantes. Las variables de asociación se modifican cuando la variable dependiente se categoriza en su estado más severo. Se necesitan estudios más amplios y detallados para establecer dicha asociación.

BAECC: a field campaign to elucidate the impact of Biogenic Aerosols on Clouds and Climate

Observations obtained during an 8-month deployment of AMF2 in a boreal environment in Hyytiälä, Finland, and the 20-year comprehensive in-situ data from SMEAR-II station enable the characterization of biogenic aerosol, clouds and precipitation, and their interactions. During “Biogenic Aerosols - Effects on Clouds and Climate (BAECC)”, the U.S. Department of Energy’s Atmospheric Radiation Measurement (ARM) Program deployed the ARM 2nd Mobile Facility (AMF2) to Hyytiälä, Finland, for an 8-month intensive measurement campaign from February to September 2014. The primary research goal is to understand the role of biogenic aerosols in cloud formation. Hyytiälä is host to SMEAR-II (Station for Measuring Forest Ecosystem-Atmosphere Relations), one of the world’s most comprehensive surface in-situ observation sites in a boreal forest environment. The station has been measuring atmospheric aerosols, biogenic emissions and an extensive suite of parameters relevant to atmosphere-biosphere interactions continuously since 1996. Combining vertical profiles from AMF2 with surface-based in-situ SMEAR-II observations allow the processes at the surface to be directly related to processes occurring throughout the entire tropospheric column. Together with the inclusion of extensive surface precipitation measurements, and intensive observation periods involving aircraft flights and novel radiosonde launches, the complementary observations provide a unique opportunity for investigating aerosol-cloud interactions, and cloud-to-precipitation processes, in a boreal environment. The BAECC dataset provides opportunities for evaluating and improving models of aerosol sources and transport, cloud microphysical processes, and boundary-layer structures. In addition, numerical models are being used to bridge the gap between surface-based and tropospheric observations.

The genomes of two key bumblebee species with primitive eusocial organization

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Genomic signatures of evolutionary transitions from solitary to group living

The evolution of eusociality is one of the major transitions in evolution, but the underlying genomic changes are unknown. We compared the genomes of 10 bee species that vary in social complexity, representing multiple independent transitions in social evolution, and report three major findings. First, many important genes show evidence of neutral evolution as a consequence of relaxed selection with increasing social complexity. Second, there is no single road map to eusociality; independent evolutionary transitions in sociality have independent genetic underpinnings. Third, though clearly independent in detail, these transitions do have similar general features, including an increase in constrained protein evolution accompanied by increases in the potential for gene regulation and decreases in diversity and abundance of transposable elements. Eusociality may arise through different mechanisms each time, but would likely always involve an increase in the complexity of gene networks.

La qualità erogata da un'azienda di trasporto collettivo in ambito urbano: calcolo del livello di servizio delle principali linee di ATC (BO)

Oggetto di questa tesi è lo studio della qualità del servizio di trasporto erogato che condiziona la qualità percepita dall’utente, poiché spesso proprio a causa di un errato processo di pianificazione e gestione della rete, molte aziende non sono in grado di consolidare un alto livello di efficienza che permetta loro di attrarre e servire la crescente domanda. Per questo motivo, si è deciso di indagare sugli aspetti che determinano la qualità erogata e sui fattori che la influenzano, anche attraverso la definizione di alcuni indicatori rappresentativi del servizio erogato. L’area di studio considerata è stata quella urbana di Bologna, e sono state prese in esame due linee di ATC, la 19 e la 27, caratterizzate entrambe da una domanda di trasporto molto elevata. L’interesse è ricaduto in modo particolare sugli aspetti legati alla regolarità del servizio, ovvero al rispetto della cadenza programmata delle corse e alla puntualità, ossia il rispetto dell’orario programmato delle stesse. Proprio da questi due aspetti, infatti, dipende in larga misura la percezione della qualità che gli utenti hanno del servizio di trasporto collettivo. Lo studio è stato condotto sulla base di dati raccolti attraverso due campagne di rilevamento, una effettuata nel mese di maggio dell’anno 2008 e l’altra nel mese di settembre dello stesso anno. La scelta del periodo, della zona e delle modalità di rilevamento è strettamente connessa all’obiettivo prefissato. Il servizio è influenzato dalle caratteristiche del sistema di trasporto: sia da quelle legate alla domanda che da quelle legate all’offerta. Nel caso della domanda di trasporto si considera l’influenza sul servizio del numero di passeggeri saliti e del tempo di sosta alle fermate. Nel caso dell’offerta di trasporto si osservano soprattutto gli aspetti legati alla rete di trasporto su cui si muovono gli autobus, analizzando quindi i tempi di movimento e le velocità dei mezzi, per vedere come le caratteristiche dell’infrastruttura possano condizionare il servizio. A tale proposito è opportuno dire che, mentre i dati della prima analisi ci sono utili per lo studio dell’influenza del tempo di sosta sull’intertempo, nella seconda analisi si vuole cercare di effettuare ulteriori osservazioni sull’influenza del tempo di movimento sulla cadenza, prendendo in esame altri elementi, come ad esempio tratti di linea differenti rispetto al caso precedente. Un’attenzione particolare, inoltre, verrà riservata alla verifica del rispetto della cadenza, dalla quale scaturisce la definizione del livello di servizio per ciò che riguarda la regolarità. Per quest’ultima verrà, inoltre, determinato anche il LOS relativo alla puntualità. Collegato al problema del rispetto della cadenza è il fenomeno dell’accodamento: questo si verifica quando i mezzi di una stessa linea arrivano contemporaneamente ad una fermata uno dietro l’altro. L’accodamento ha, infatti, origine dal mancato rispetto della cadenza programmata tra i mezzi ed è un’evidente manifestazione del mal funzionamento di un servizio di trasporto. Verrà infine condotta un’analisi dei fattori che possono influenzare le prestazioni del servizio di trasporto pubblico, così da collocare i dati ottenuti dalle operazioni di rilevamento in un quadro più preciso, capace di sottolineare alcuni elementi di criticità e possibili rapporti di causalità.

Purification, cDNA structure and biological significance of a single insulin-like growth factor-binding domain protein (SIBD-1) identified in the hemocytes of the spider Cupiennius salei

Cupiennius salei single insulin-like growth factor-binding domain protein (SIBD-1), which exhibits an IGFBP N-terminal domain-like profile, was identified in the hemocytes of the spider C. salei. SIBD-1 was purified by RP-HPLC and the sequence determined by a combination of Edman degradation and 5'-3'- RACE PCR. The peptide (8676.08 Da) is composed of 78 amino acids, contains six intrachain disulphide bridges and carries a modified Thr residue at position 2. SIBD-1 mRNA expression was detected by quantitative real-time PCR mainly in hemocytes, but also in the subesophageal nerve mass and muscle. After infection, the SIBD-1 content in the hemocytes decreases and, simultaneously, the temporal SIBD-1 expression seems to be down-regulated. Two further peptides, SIBD-2 and IGFBP-rP1, also exhibiting IGFBP N-terminal domain variants with unknown functions, were identified on cDNA level in spider hemocytes and venom glands. We conclude that SIBD-1 may play an important role in the immune system of spiders.

The extended diep flap: extending the possibilities for breast reconstruction with tissue from the lower abdomen

The classical DIEP-flap is considered state-of-the-art in microsurgical autologous breast reconstruction. Some patients may require additional volume to match the contralateral breast. This quality control study prospectively evaluates the feasibility and outcome of a surgical technique, which pursues the volumetric augmentation of the DIEP-flap by harvesting of additional subscarpal fat tissue cranial to the classical flap border.

Care of the bariatric surgery patient in the emergency department

Obesity has reached epidemic proportions in the United States, with an estimated 50% of adults meeting the definition of being overweight. As this condition has become more prevalent, bariatric surgery has become an increasingly accepted form of treatment of the severely obese. Patients who have had bariatric surgery are presenting more commonly to Emergency Departments as a result. This article will review the most common bariatric surgery procedures, the complications that can arise post-operatively, and the approach to the assessment and management of the bariatric surgery patient in the Emergency Department.

Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy

PURPOSE Metastatic renal cell carcinoma can be clinically diverse in terms of the pattern of metastatic disease and response to treatment. We studied the impact of metastasis and location on cancer specific survival. MATERIALS AND METHODS The records of 2,017 patients with renal cell cancer and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 centers in the United States and Europe were analyzed. Number and location of synchronous metastases were compared with respect to patient cancer specific survival. Multivariable Cox regression models were used to quantify the impact of covariates. RESULTS Lymph node metastasis (155) or distant metastasis (725) was present in 880 (44%) patients. Of the patients with distant disease 385 (53%) had an isolated metastasis. The 5-year cancer specific survival was 51.3% (95% CI 48.6-53.9) for the entire group. On univariable analysis patients with isolated lymph node metastasis had a significantly worse cancer specific survival than those with a solitary distant metastasis. The location of distant metastasis did not have any significant effect on cancer specific survival. On multivariable analysis the presence of lymph node metastasis, isolated distant metastasis and multiple distant metastases were independently associated with cancer specific survival. Moreover higher tumor thrombus level, papillary histology and the use of postoperative systemic therapy were independently associated with worse cancer specific survival. CONCLUSIONS In our multi-institutional series of patients with renal cell cancer who underwent radical nephrectomy and tumor thrombectomy, almost half of the patients had synchronous lymph node or distant organ metastasis. Survival was superior in patients with solitary distant metastasis compared to isolated lymph node disease.

A Missense Change in the ATG4D Gene Links Aberrant Autophagy to a Neurodegenerative Vacuolar Storage Disease.

Inherited neurodegenerative disorders are debilitating diseases that occur across different species. We have performed clinical, pathological and genetic studies to characterize a novel canine neurodegenerative disease present in the Lagotto Romagnolo dog breed. Affected dogs suffer from progressive cerebellar ataxia, sometimes accompanied by episodic nystagmus and behavioral changes. Histological examination revealed unique pathological changes, including profound neuronal cytoplasmic vacuolization in the nervous system, as well as spheroid formation and cytoplasmic aggregation of vacuoles in secretory epithelial tissues and mesenchymal cells. Genetic analyses uncovered a missense change, c.1288G>A; p.A430T, in the autophagy-related ATG4D gene on canine chromosome 20 with a highly significant disease association (p = 3.8 x 10-136) in a cohort of more than 2300 Lagotto Romagnolo dogs. ATG4D encodes a poorly characterized cysteine protease belonging to the macroautophagy pathway. Accordingly, our histological analyses indicated altered autophagic flux in affected tissues. The knockdown of the zebrafish homologue atg4da resulted in a widespread developmental disturbance and neurodegeneration in the central nervous system. Our study describes a previously unknown canine neurological disease with particular pathological features and implicates the ATG4D protein as an important autophagy mediator in neuronal homeostasis. The canine phenotype serves as a model to delineate the disease-causing pathological mechanism(s) and ATG4D function, and can also be used to explore treatment options. Furthermore, our results reveal a novel candidate gene for human neurodegeneration and enable the development of a genetic test for veterinary diagnostic and breeding purposes.