Has the CSR engagement of electrical companies had an effect on their performance? A closer look at the environment

Even though electrical companies attain a top ranking in the publication of CSR reports, they are often accused of 'green‐washing' due to their bad environmental reputation. The current economic crisis is testing their real CSR commitment more than ever, especially when this goes beyond its economic consequences. Based on a worldwide sample of electrical companies, we are going to study why companies are being socially responsible. We wish to know if it is due to the impact on the firms' performance or whether there are other motives (legitimation, improving their reputation) that lead companies to carry out these practices. We will also consider if it changes across the kind of CSR action considered. The results show that there is an economic justification beyond the socially responsible behaviour of the electrical companies. Additionally, most kinds of CSR action (community, diversity, corporate governance, product responsibility) are also carried out looking for economic rewards. However, the CSR actions oriented to the environment are mainly motivated by their need to improve their image and reverse their negative impact

Indicaciones y oportunidad del trasplante hepático

El trasplante hepático (TH) está indicado en pacientes con enfermedades hepáticas agudas o crónicas severas e irreversibles para las cuales no exista un tratamiento alternativo y en ausencia de contraindicaciones. Las indicaciones de TH pueden ser agrupadas en cuatro categorías: cirrosis hepática, hepatitis fulminante, tumores hepáticos y defectos genéticos de origen hepático que producen daño en otros órganos. Deben ser derivados para TH los pacientes con cirrosis que desarrollen cualquier complicación mayor o coagulopatía. La derivación precoz es "la clave del éxito" en la hepatitis fulminante por el alto riesgo de muerte y por tener una evolución mayormente impredecible. La oportunidad del TH es el momento en la historia natural de la hepatopatía cuando la sobrevida esperada es mayor con TH que en lista de espera. Estudios recientes han sugerido que el máximo beneficio del TH se obtiene en pacientes con MELD >15. Sin embargo, en algunos casos sin riesgo de muerte inminente, el objetivo del TH es mejorar la calidad de vida o prevenir contraindicaciones como la progresión del hepatocarcinoma cuando el tiempo de espera excede los 8 meses. Actualmente existe una marcada desproporción entre el número de donantes disponibles y el número creciente de potenciales receptores, lo que ha determinado un incremento progresivo del tiempo y mortalidad en lista. La racionalidad de distribuir los órganos en base al score de MELD es otorgar prioridad en la lista a los candidatos más enfermos y a aquellos que no pueden esperar como los pacientes con hepatocarcinoma

Trasplante intestinal. Revisión y descripción de su evolución en Latinoamérica

La insuficiencia intestinal continúa siendo una causa de morbilidad y mortalidad en niños y adultos. En la actualidad todo paciente portador de insuficiencia intestinal debe ser evaluado por un equipo multidisciplinario capaz de optimizar el soporte parenteral, determinar potencialidad de rehabilitación o indicar el trasplante. El Trasplante Intestinal (TxI) ha sido el último de los trasplantes de órganos abdominales en desarrollarse. Finalmente, las indicaciones y los procedimientos se han estandarizado; nuevas drogas inmunosupresoras y la experiencia en el manejo de estos pacientes concentrada en un número limitado de centros ha permitido reducir las complicaciones y mejorar la sobrevida temprana y alejada. Cuarenta años después de la experiencia inicial el TxI puede ser ofrecido también en Latinoamérica. El objetivo de la siguiente revisión es actualizar la situación del TxI enfatizando los progresos recientes y mostrando su evolución en el mundo y en nuestro continente, pretendiendo además brindar a nutricionistas, gastroenterólogos y cirujanos generales los conocimientos básicos para entender la necesidad del manejo integral de los pacientes con insuficiencia intestinal

Supercontinuum-based nondisruptive scattering analyses of mouse fibroblast L929 cells before and after necrosis

The scattering properties of biological tissue are highly dependent on the structure size, refractive index, and wavelength of the incident light. Furthermore, these scattering characteristics are strongly influenced by movements of the scattering objects. A method is developed to determine the angular- and spectral-resolved scattering properties that enabled the characterization of biological nano- and microscaled cell structures. Nanosecond pulses from a spectrally filtered supercontinuum light source are captured and time-resolved to depress background noise and minimize disruptive effects of the biological cells. The scattering characteristics of a monolayer of mouse fibroblast L929 cells are measured at defined wavelengths in a standard cell culture plate. Because of the size and distribution of the scattering structures, a Fourier transform-based Mie scattering scheme is used to analyze the data. The system is tested to detect structural changes of mouse fibroblast L929 cells before and after poisoning with Triton X100. The final result is the development of a contamination-free method to study pathological changes in cell cultures, necrosis, or other cell-damaging effects

Comparison of the Serion IgM ELISA and Microscopic Agglutination Test for diagnosis of Leptospira spp. infections in sera from different geographical origins and estimation of Leptospira seroprevalence in the Wiwa indigenous population from Colombia.

Leptospirosis is among the most important zoonotic diseases in (sub-)tropical countries. The research objective was to evaluate the accuracy of the Serion IgM ELISA EST125M against the Microscopic Agglutination Test (MAT = imperfect reference test); to assess its ability to diagnose acute leptospirosis infections and to detect previous exposure to leptospires in an endemic setting. In addition, to estimate the overall Leptospira spp. seroprevalence in the Wiwa indigenous population in North-East Colombia. We analysed serum samples from confirmed leptospirosis patients from the Netherlands (N = 14), blood donor sera from Switzerland (N = 20), and sera from a cross-sectional study in Colombia (N = 321). All leptospirosis ELISA-positive, and a random of negative samples from Colombia were tested by the MAT for confirmation. The ELISA performed with a sensitivity of 100% (95% CI 77% - 100%) and a specificity of 100% (95% CI 83% - 100%) based on MAT confirmed Leptospira spp. positive and negative samples. In the cross-sectional study in Colombia, the ELISA performed with a sensitivity of 100% (95% CI 2-100%) and a specificity of 21% (95% CI 15-28%). Assuming a 5% Leptospira spp. seroprevalence in this population, the positive predictive value was 6% and the negative predictive value 100%. The Leptospira spp. seroprevalence in the Wiwas tested by the ELISA was 39%; however, by MAT only 0.3%. The ELISA is suitable to diagnose leptospirosis in acutely ill patients in Europe several days after onset of disease. For cross-sectional studies it is not recommended due to its low specificity. Despite the evidence of a high leptospirosis prevalence in other study areas and populations in Colombia, the Wiwa do not seem to be highly exposed to Leptospira spp.. Nevertheless, leptospirosis should be considered and tested in patients presenting with febrile illness

Outbreak of hepatitis A in a post-vaccination era: High rate of co-infection with sexually transmitted diseases

Introduction and objectives: After hepatitis A (HAV) mandatory immunization in 2005 in Argentina, the incidence of HAV declined drastically. However, several new autochthonous cases of HAV have been reported since 2017. We aimed to evaluate the clinical and epidemiological characteristics and possible transmission routes of affected patients. Patients or Materials and methods: We performed a cross-sectional study of patients residing in Argentina with acute hepatitis A between 30.06.2017 and 31.12.2018. Results: 66 cases of HAV were registered. Fifty-six patients (86%) were males, with a mean age of 34 ± 12 years old. The most likely routes of transmission were sexual intercourse of men with men, reported by 31 patients. Additionally, 23% and 26% of patients tested positive for HIV and syphilis, respectively. In total, 35% of patients required hospitalization. When assessing outcomes, 79% had a mild presentation and 21% had a severe/fulminant presentation: one patient underwent liver transplantation, and one patient died. Conclusions: Our study describes that during the study period, HAV infection affected predominantly young adults, particularly men who have sex with men. An elevated proportion of them was diagnosed with a concomitant sexually transmitted disease, and several patients had a severe presentation of the disease

Argentinian clinical practice guideline for surveillance, diagnosis, staging and treatment of hepatocellular carcinoma

The A.A.E.E.H has developed this guideline for the best care of patients with hepatocellular carcinoma (HCC) from Argentina. It was done from May 2018 to March 2020. Specific clinical research questions were systematically searched. The quality of evidence and level of recommendations were organized according to GRADE. HCC surveillance is strongly recommended with abdominal ultrasound (US) every six months in the population at risk for HCC (cirrhosis, hepatitis B or hepatitis C); it is suggested to add alpha-feto protein (AFP) levels in case of inexeperienced sonographers. Imaging diagnosis in patients at risk for HCC has high specificity and tumor biopsy is not mandatory. The Barcelona Clinic Liver Cancer algorithm is strongly recommended for HCC staging and treatment-decision processes. Liver resection is strongly recommended for patients without portal hypertension and preserved liver function. Composite models are suggested for liver transplant selection criteria. Therapies for HCC with robust clinical evidence include transarterial chemoembolization (TACE) and first to second line systemic treatment options (sorafenib, lenvatinib, regorafenib, cabozantinib and ramucirumab). Immunotherapy with nivolumab and pembrolizumab has failed to show statistical benefit but the novel combination of atezolizumab plus bevacizumab has recently shown survival benefit over sorafenib in frontline