164 research outputs found

    Rewards systems at the organizational level and execution of projects in the construction industry in Gaza strip

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    Rewards systems at the organizational level and execution of projects in the construction industry in Gaza stripManaging knowledge efficiently and effectively is considered a core competence for organizations to survive in the long run, so incentives play an important role in influencing of performance of employees , not available and not distributed equitably of incentives may be reflected directly on the performance of employees . This research aims to contribute to enhance the performance of construction industry through investigating rewards systems in contracting construction companies in Gaza strip, measure the effectiveness applying reward system, determine the challenges for applying different reward system. Data was gathered from employee in contracting companies by using questionnaire survey to assess the importance of applying rewards systems in contracting companies, to fulfill these objectives, research was carried in to two stages: literature review and questionnaire survey. A total number of 103 questionnaire have been completed. And after making analysis using statistical package for the social sciences program (SPSS). The result confirm that Most of the contracting companies have a comprehensive knowledge of positive and negative rewards systems and most of these companies are used both of rewards system, the study also proved the effectiveness of incentive systems in the contracting companies operating in the Gaza strip turned out that the use of incentives lead to (raise the level of performance, increase productivity, increase performance speed of doing business, increase positive competition between the work crews, access to quality in the work done and compliance with specifications, application of safety factors at work), and there are many obstacles facing the application of rewards systems in general contracting firms in the Gaza strip, majority of companies agreed that most these obstacles are (surrounding political circumstances, not to include incentives in the company's budget, the difficult economic conditions, misuse of powers in the distribution of incentives). And at the end asset of recommendation was made to encourage the firms to apply rewards systems. For example, work to strengthen the rewards system and make it more visible to staff and a more transparent and fair, including the incentives in the company's budget, and providing workshops for engineering companies to illustrate the importance of incentives in the performance of work.Supervised by : Eng. Eman Y. El - Swait

    Consensus evidence-based recommendations for treat-to-target management of immunoglobulin A vasculitis

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    IgA vasculitis (IgAV), formerly known as Henoch-Schönlein purpura, is the most common cause of systemic vasculitis in childhood. Given its potential life-threatening systemic complications, early and accurate diagnosis as well as management of IgAV represent a major challenge for health care professionals. This study was carried out to attain an evidence-based expert consensus on a treat-to-target management approach for IgAV using Delphi technique. The preliminary scientific committee identified a total of 16 key clinical questions according to the patient, intervention, comparison, and outcomes (PICO) approach. An evidence-based, systematic, literature review was conducted to compile evidence for the IgAV management. The core leadership team identified researchers and clinicians with expertise in IgAV management in Egypt upon which experts were gathered from different governorates and health centers across Egypt. Delphi process was implemented (two rounds) to reach a consensus. An online questionnaire was sent to expert panel (n = 26) who participated in the two rounds. After completing round 2, a total of 20 recommendation items, categorized into two sections were obtained. Agreement with the recommendations (rank 7–9) ranged from 91.7–100%. Consensus was reached (i.e. ⩾75% of respondents strongly agreed or agreed) on the wording of all the 20 clinical standards identified by the scientific committee. Algorithms for the diagnosis and management have been suggested. This was an expert, consensus recommendations for the diagnosis and treatment of IgAV and IgA vasculitic nephritis, based on best available evidence and expert opinion. The guideline presented a strategy of care with a pathway to achieve a state of remission as early as possible

    Diasporic virginities: social representations of virginity and identity formation amongst British arab muslim women

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    This study compares how practising and non-practising British Arab Muslim women position themselves in relation to representations of virginity. Overall, in our qualitative study, we found that representations of culture and religion influenced social practices and social beliefs in different ways: non-practising Muslim women felt bound by culture to remain virgins, while practising Muslim women saw it as a religious obligation but were still governed by culture regarding the consequences of engaging in premarital sex. Interestingly, some practising Muslim participants used Mut’a (a form of temporary ‘marriage’) to justify premarital sex. This, however, did not diminish the importance of virginity in their understanding and identification as Arab women. In fact, this study found that virginity, for the British Arabs interviewed, embodied a sense of ‘Arabness’ in British society. Positioning themselves as virgins went beyond simply honour; it was a significant cultural symbol that secured their sense of cultural identity. In fact this cultural identity was often so powerful that it overrode their Islamic identities, prescribing their behaviour even if religion was seen as more ‘forgiving’

    Male gender, Charnley class C, and severity of bone defects predict the risk for aseptic loosening in the cup of ABG I hip arthroplasty

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    <p>Abstract</p> <p>Background</p> <p>We studied which factor could predict aseptic loosening in ABG I hip prosthesis with hydroxyapatite coating. Aseptic loosening and periprosthetic osteolysis are believed to be caused, at least in part, by increased polyethylene (PE) wear rate via particle disease. Based on it, increased PE wear rate should be associated with aseptic loosening regardless of the type of implant.</p> <p>Methods</p> <p>We analyzed data from 155 revisions of ABG I hip prostheses to examine the influence of patient, implant, surgery, and wear related factors on the rate of aseptic loosening at the site of the cup. This was calculated by stepwise logistic regression analysis. The stability of the implant and severity of bone defects were evaluated intraoperatively.</p> <p>Results</p> <p>We found that men (odds ratio, OR = 5.6; <it>p </it>= 0.004), patients with Charnley class C (OR = 6.71; <it>p </it>= 0.013), those having more severe acetabular bone defects (OR = 4 for each degree of severity; <it>p </it>= 0.002), and longer time to revision surgery (OR = 1.51 for each additional year; <it>p </it>= 0.012) had a greater chance of aseptic loosening of the cup. However, aseptic loosening was not directly predicted by polyethylene wear rate in our patients.</p> <p>Conclusion</p> <p>Severity of bone defects predicts the risk for aseptic loosening in ABG I cup. Factors potentially associated with the quality of bone bed and biomechanics of the hip might influence on the risk of aseptic loosening in this implant.</p

    Interleukin-10 inhibits osteoclastogenesis by reducing NFATc1 expression and preventing its translocation to the nucleus

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    BACKGROUND: IL-10 has a potent inhibitory effect on osteoclastogenesis. In vitro and in vivo studies confirm the importance of this cytokine in bone metabolism, for instance IL-10-deficient mice develop the hallmarks of osteoporosis. Although it is known that IL-10 directly inhibits osteoclastogenesis at an early stage, preventing differentiation of osteoclast progenitors to preosteoclasts, the precise mechanism of its action is not yet clear. Several major pathways regulate osteoclastogenesis, with key signalling genes such as p38, TRAF6, NF-κB and NFATc1 well established as playing vital roles. We have looked at gene expression in eleven of these genes using real-time quantitative PCR on RNA extracted from RANKL-treated RAW264.7 monocytes. RESULTS: There was no downregulation by IL-10 of DAP12, FcγRIIB, c-jun, RANK, TRAF6, p38, NF-κB, Gab2, Pim-1, or c-Fos at the mRNA level. However, we found that IL-10 significantly reduces RANKL-induced NFATc1 expression. NFATc1 is transcribed from two alternative promoters in Mus musculus and, interestingly, only the variant transcribed from promoter P1 and beginning with exon 1 was downregulated by IL-10 (isoform 1). In addition, immunofluorescence studies showed that IL-10 reduces NFATc1 levels in RANKL-treated precursors and suppresses nuclear translocation. The inhibitory effect of IL-10 on tartrate-resistant acid phosphatase-positive cell number and NFATc1 mRNA expression was reversed by the protein kinase C agonist phorbol myristate acetate, providing evidence that interleukin-10 disrupts NFATc1 activity through its effect on Ca(2+ )mobilisation. CONCLUSION: IL-10 acts directly on mononuclear precursors to inhibit NFATc1 expression and nuclear translocation, and we provide evidence that the mechanism may involve disruption of Ca(2+ )mobilisation. We detected downregulation only of the NFATc1 isoform 1 transcribed from promoter P1. This is the first report indicating that one of the ways in which IL-10 directly inhibits osteoclastogenesis is by suppressing NFATc1 activity

    Clinical, genetic, and structural basis of apparent mineralocorticoid excess due to 11β-hydroxysteroid dehydrogenase type 2 deficiency

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    Mutations in 11β-hydroxysteroid dehydrogenase type 2 gene (HSD11B2) cause an extraordinarily rare autosomal recessive disorder, apparent mineralocorticoid excess (AME). AME is a form of low renin hypertension that is potentially fatal if untreated. Mutations in the HSD11B2 gene result either in severe AME or a milder phenotype (type 2 AME). To date, ∼40 causative mutations have been identified. As part of the International Consortium for Rare Steroid Disorders, we have diagnosed and followed the largest single worldwide cohort of 36 AME patients. Here, we present the genotype and clinical phenotype of these patients, prominently from consanguineous marriages in the Middle East, who display profound hypertension and hypokalemic alkalosis. To correlate mutations with phenotypic severity, we constructed a computational model of the HSD11B2 protein. Having used a similar strategy for the in silico evaluation of 150 mutations of CYP21A2, the disease-causing gene in congenital adrenal hyperplasia, we now provide a full structural explanation for the clinical severity of AME resulting from each known HSD11B2 missense mutation. We find that mutations that allow the formation of an inactive dimer, alter substrate/coenzyme binding, or impair structural stability of HSD11B2 yield severe AME. In contrast, mutations that cause an indirect disruption of substrate binding or mildly alter intramolecular interactions result in type 2 AME. A simple in silico evaluation of novel missense mutations could help predict the often-diverse phenotypes of an extremely rare monogenic disorder

    Inhibition of Host Vacuolar H+-ATPase Activity by a Legionella pneumophila Effector

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    Legionella pneumophila is an intracellular pathogen responsible for Legionnaires' disease. This bacterium uses the Dot/Icm type IV secretion system to inject a large number of bacterial proteins into host cells to facilitate the biogenesis of a phagosome permissive for its intracellular growth. Like many highly adapted intravacuolar pathogens, L. pneumophila is able to maintain a neutral pH in the lumen of its phagosome, particularly in the early phase of infection. However, in all cases, the molecular mechanisms underlying this observation remain unknown. In this report, we describe the identification and characterization of a Legionella protein termed SidK that specifically targets host v-ATPase, the multi-subunit machinery primarily responsible for organelle acidification in eukaryotic cells. Our results indicate that after being injected into infected cells by the Dot/Icm secretion system, SidK interacts with VatA, a key component of the proton pump. Such binding leads to the inhibition of ATP hydrolysis and proton translocation. When delivered into macrophages, SidK inhibits vacuole acidification and impairs the ability of the cells to digest non-pathogenic E. coli. We also show that a domain located in the N-terminal portion of SidK is responsible for its interactions with VatA. Furthermore, expression of sidK is highly induced when bacteria begin to enter new growth cycle, correlating well with the potential temporal requirement of its activity during infection. Our results indicate that direct targeting of v-ATPase by secreted proteins constitutes a virulence strategy for L. pneumophila, a vacuolar pathogen of macrophages and amoebae

    Complexity and Experience Grading to Guide Patient Selection for Minimally-invasive Pancreatoduodenectomy: An ISGPS Consensus.

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    ObjectiveThe ISGPS aims to develop a universally accepted complexity and experience grading system to guide the safe implementation of robotic and laparoscopic minimally-invasive pancreatoduodenectomy (MIPD).BackgroundDespite the perceived advantages of MIPD, its global adoption has been slow due to the inherent complexity of the procedure and challenges to acquiring surgical experience. Its wider adoption must be undertaken with an emphasis towards appropriate patient selection according to adequate surgeon and center experience.MethodsThe ISGPS developed a complexity and experience grading system to guide patient selection for MIPD based on an evidence-based review and a series of discussions.ResultsThe ISGPS complexity and experience grading system for MIPD is subclassified into patient-related risk factors and provider experience-related variables. The patient-related risk factors include anatomical (main pancreatic and common bile duct diameters), tumor-specific (vascular contact), and conditional (obesity and previous complicated upper abdominal surgery/disease) factors, all incorporated in an A-B-C classification, graded as no, a single, and multiple risk factors. The surgeon and center experience-related variables include surgeon total MIPD experience (cut-offs 40 and 80) and center annual MIPD volume (cut-offs 10 and 30), all also incorporated in an A-B-C classification.ConclusionThis ISGPS complexity and experience grading system for robotic and laparoscopic MIPD may enable surgeons to optimally select patients after duly considering specific risk factors known to influence the complexity of the procedure. This grading system will likely allow for a thoughtful and stepwise implementation of MIPD and facilitate a fair comparison of outcome between centers and countries

    Gallium incorporation into phosphate based glasses: bulk and thin film properties

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    The osteogenic ions Ca2+, P5+, Mg2+, and antimicrobial ion Ga3+ were homogenously dispersed into a 1.45 mum thick phosphate glass coating by plasma assisted sputtering onto CP grade titanium. The objective was to deliver therapeutic ions in orthopedic/dental implants such as hip prosthesis or dental screws. The hardness 4.7 GPa and elastic modulus 69.7 GPa, of the coating were comparable to plasma sprayed hydroxyapatite/dental enamel, whilst superseding femoral cortical bone. To investigate the manufacturing challenge of translation from a target to vapour condensed coating, structural/compositional properties of the target (P51MQ) were compared to the coating (P40PVD) and a melt-quenched equivalent (P40MQ). Following condensation from P51MQ to P40PVD, P2O5 content reduced from 48.9 to 40.5 mol%. This depolymerisation and reduction in the P-O-P bridging oxygen content as determined by 31P-NMR, FTIR and Raman spectroscopy techniques was attributed to a decrease in the P2O5 network former and increases in alkali/alkali-earth cations. P40PVD appeared denser (3.47 vs. 2.70 g cm-3) and more polymerised than it’s compositionally equivalent P40MQ, showing that structure/ mechanical properties were affected by manufacturing route
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