DEVELOPING HUMAN RESOURCES’ SKILLS AND KNOWLEDGE IN TOURISM AND HOSPITALITY INDUSTRY THROUGH THE DETERMINATION OF QUALITY OF TRAINING PROGRAMS

Research into tourism and hospitality training field has been focused on the subjects of training need assessments, training evaluation models, training within organizational frameworks and useful training techniques. Despite the significance of the above aspects, less afford has been made in the field of training quality and particularly in defining those factors that the quality of a training program consists of. Taking into account that training is a service which the organization, the producer, delivers to its employee, the consumer, this research is going one step further and not only exams SERVQUAL in the training field, but tries to examine inductively at distinctive training quality dimensions from the perspective of trainees point of view that are not subject of other service industry. The definition of training quality dimensions can lead those who develop a new training program to use those dimensions as a framework for greater training outcomes. Moreover, this research tests how the GAP model is compared with the measurement of perceptions merely and the measurement of expectations lone of training quality, as defined by the trainees

Acute Haemophilus parainfluenzae endocarditis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Numerous pathogens can cause infective endocarditis, including <it>Haemophilus parainfluenzae</it>. <it>H. parainfluenzae</it> is part of the <it>H. aphrophilus, Actinobacillus actinomycetemcomitans</it>,<it> Cardiobacterium hominis</it>,<it> Eikenella corrodens</it>, and <it>Kingella kingae</it> group that may cause about 3% of the total endocarditis cases, and is characterized by a subacute course and large vegetations.</p> <p>Case presentation</p> <p>Acute <it>H. parainfluenzae</it> endocarditis developed in a 54-year-old woman, with no underlying predisposing factors. The patient presented with fever of 3 days duration and a severe headache. Magnetic resonance imaging of the brain revealed multiple cerebral emboli with hemorrhagic foci. Upon suspicion of endocarditis, cardiac transesophageal ultrasonography was performed and revealed massive vegetations. The patient underwent emergency mitral valve replacement, and was further treated with ceftriaxone. Blood cultures grew <it>H. parainfluenzae</it> only after valve replacement, and a 6-week course of ceftriaxone was prescribed.</p> <p>Conclusion</p> <p>We underline the typical presentation of large vegetations in <it>H. parainfluenzae</it> endocarditis, which are associated with embolic phenomena and resulting severity. Although the majority of the few cases reported in the literature are subacute in progress, our case further underlines the possibility that <it>H. parainfluenzae</it> endocarditis may develop rapidly. Thus, awareness of the imaging characteristics of the pathogen may enhance early appropriate diagnosis and therapeutic response.</p

Pathogenic and low-frequency variants in children with central precocious puberty

Background: Central precocious puberty (CPP) due to premature activation of GnRH secretion results in early epiphyseal fusion and to a significant compromise in the achieved final adult height. Currently, few genetic determinants of children with CPP have been described. In this translational study, rare sequence variants in MKRN3, DLK1, KISS1, and KISS1R genes were investigated in patients with CPP. Methods: Fifty-four index girls and two index boys with CPP were first tested by Sanger sequencing for the MKRN3 gene. All children found negative (n = 44) for the MKRN3 gene were further investigated by whole exome sequencing (WES). In the latter analysis, the status of variants in genes known to be related with pubertal timing was compared with an in-house Cypriot control cohort (n = 43). The identified rare variants were initially examined by in silico computational algorithms and confirmed by Sanger sequencing. Additionally, a genetic network for the MKRN3 gene, mimicking a holistic regulatory depiction of the crosstalk between MKRN3 and other genes was designed. Results: Three previously described pathogenic MKRN3 variants located in the coding region of the gene were identified in 12 index girls with CPP. The most prevalent pathogenic MKRN3 variant p.Gly312Asp was exclusively found among the Cypriot CPP cohort, indicating a founder effect phenomenon. Seven other CPP girls harbored rare likely pathogenic upstream variants in the MKRN3. Among the 44 CPP patients submitted to WES, nine rare DLK1 variants were identified in 11 girls, two rare KISS1 variants in six girls, and two rare MAGEL2 variants in five girls. Interestingly, the frequent variant rs10407968 (p.Gly8Ter) of the KISS1R gene appeared to be less frequent in the cohort of patients with CPP. Conclusion: The results of the present study confirm the importance of the MKRN3-imprinted gene in genetics of CPP and its key role in pubertal timing. Overall, the results of the present study have emphasized the importance of an approach that aligns genetics and clinical aspects, which is necessary for the management and treatment of CPP

Technological competence is a precondition for effective implementation of virtual reality head mounted displays in human neuroscience:A technological review and meta-analysis

International audienceImmersive virtual reality (VR) emerges as a promising research and clinical tool. However, several studies suggest that VR induced adverse symptoms and effects (VRISE) may undermine the health and safety standards, and the reliability of the scientific results. In the current literature review, the technical reasons for the adverse symptomatology are investigated to provide suggestions and technological knowledge for the implementation of VR head-mounted display (HMD) systems in cognitive neuroscience. The technological systematic literature indicated features pertinent to display, sound, motion tracking, navigation, ergonomic interactions, user experience, and computer hardware that should be considered by the researchers. Subsequently, a meta-analysis of 44 neuroscientific or neuropsychological studies involving VR HMD systems was performed. The meta-analysis of the VR studies demonstrated that new generation HMDs induced significantly less VRISE and marginally fewer dropouts. Importantly, the commercial versions of the new generation HMDs with ergonomic interactions had zero incidents of adverse symptomatology and dropouts. HMDs equivalent to or greater than the commercial versions of contemporary HMDs accompanied with ergonomic interactions are suitable for implementation in cognitive neuroscience. In conclusion, researchers' technological competency, along with meticulous methods and reports pertinent to software, hardware, and VRISE, are paramount to ensure the health and safety standards and the reliability of neuroscientific results

Elevated Muscle-Specific miRNAs in Serum of Myotonic Dystrophy Patients Relate to Muscle Disease Progress

The discovery of reliable and sensitive blood biomarkers is useful for the diagnosis, monitoring and potential future therapy of diseases. Recently, microRNAs (miRNAs) have been identified in blood circulation and might have the potential to be used as biomarkers for several diseases and clinical conditions. Myotonic Dystrophy type 1 (DM1) is the most common form of adult-onset muscular dystrophy primarily characterized by muscle myotonia, weakness and atrophy. Previous studies have shown an association between miRNAs and DM1 in muscle tissue and, recently, in plasma. The aim of this study was to detect and assess muscle-specific miRNAs as potential biomarkers of DM1 muscle wasting, an important parameter in the disease’s natural history. Disease stable or progressive DM1 patients with muscle weakness and wasting were recruited and enrolled in the study. RNA isolated from participants’ serum was used to assess miRNA levels. Results suggest that the levels of muscle-specific miRNAs are correlated with the progression of muscle wasting and weakness observed in the DM1 patients. Specifically, miR-1, miR-133a, miR133b and miR-206 serum levels were found elevated in DM1 patients with progressive muscle wasting compared to disease stable DM1 patients. Based on these results, we propose that muscle-specific miRNAs might be useful molecular biomarkers for monitoring the progress of muscle atrophy in DM1 patients

Hepatobiliary and pancreatic manifestations in inflammatory bowel diseases: a referral center study

Abstract Background Hepatobiliary and pancreatic manifestations have been reported in patients with Crohn’s disease or ulcerative colitis. Our aim was to describe the prevalence of hepatobiliary and pancreatic manifestations in inflammatory bowel disease and their association with the disease itself and the medications used. Methods Data were retrospectively extracted from the clinical records of patients followed up at our tertiary IBD referral Center. Results Our study included 602 IBD patients, with liver function tests at regular intervals. The mean follow-up was 5.8 years (Std. Dev.: 6.72). Abdominal imaging examinations were present in 220 patients and revealed findings from the liver, biliary tract and pancreas in 55% of examined patients (120/220). The most frequent findings or manifestations from the liver, biliary tract and pancreas were fatty liver (20%, 44/220), cholelithiasis (14.5%, 32/220) and acute pancreatitis (0.6%, 4/602), respectively. There were 7 patients with primary sclerosing cholangitis. Regarding hepatitis viruses, one-third of the patients had been tested for hepatitis B and C. 5% (12/225) of them had positive hepatitis B surface antigen and 13.4% had past infection with hepatitis B virus (positive anti-HBcore). In addition, most of the patients were not immune against hepatitis B (negative anti-HBs), while 3% of patients were anti-HCV positive and only one patient had active hepatitis C. Furthermore, 24 patients had drug-related side effects from the liver and pancreas. The side effects included 21 cases of hepatotoxicity and 3 cases of acute pancreatitis. Moreover, there were two cases of HBV reactivation and one case of chronic hepatitis C, which were successfully treated. Conclusion In our study, approximately one out of four patients had some kind by a hepatobiliary or pancreatic manifestation. Therefore, it is essential to monitor liver function at regular intervals and differential diagnosis should range from benign diseases and various drug related side effects to severe disorders, such as primary sclerosing cholangitis

Elevated Muscle-Specific miRNAs in Serum of Myotonic Dystrophy Patients Relate to Muscle Disease Progress

<div><p>The discovery of reliable and sensitive blood biomarkers is useful for the diagnosis, monitoring and potential future therapy of diseases. Recently, microRNAs (miRNAs) have been identified in blood circulation and might have the potential to be used as biomarkers for several diseases and clinical conditions. Myotonic Dystrophy type 1 (DM1) is the most common form of adult-onset muscular dystrophy primarily characterized by muscle myotonia, weakness and atrophy. Previous studies have shown an association between miRNAs and DM1 in muscle tissue and, recently, in plasma. The aim of this study was to detect and assess muscle-specific miRNAs as potential biomarkers of DM1 muscle wasting, an important parameter in the disease’s natural history. Disease stable or progressive DM1 patients with muscle weakness and wasting were recruited and enrolled in the study. RNA isolated from participants’ serum was used to assess miRNA levels. Results suggest that the levels of muscle-specific miRNAs are correlated with the progression of muscle wasting and weakness observed in the DM1 patients. Specifically, miR-1, miR-133a, miR133b and miR-206 serum levels were found elevated in DM1 patients with progressive muscle wasting compared to disease stable DM1 patients. Based on these results, we propose that muscle-specific miRNAs might be useful molecular biomarkers for monitoring the progress of muscle atrophy in DM1 patients.</p></div

Muscle-specific miRNAs levels are elevated in the serum of DM1 patients.

<p>Serum samples from twenty three DM1 patients and twenty three healthy participants were analysed for the presence of muscle-specific miRNAs. miR-1 (<b>A</b>), miR-133a (<b>B</b>), miR-133b (<b>C</b>) and miR-206 (<b>D</b>) were significantly elevated in the serum of DM1 patients compared to the serum of healthy participants (p<0.005). Distribution charts of miR-1 (<b>E</b>), miR-133a (<b>F</b>), miR-133b (<b>G</b>) and miR-206 (<b>H</b>) levels in DM1 patients and healthy participants show the elevated levels of the muscle-specific miRNAs in the serum of DM1 patients compared to healthy participants. Horizontal lines inside the boxes mark the medians. Mean expression values are marked with rhombus. *** p < 0.0001.</p

The serum levels of muscle-specific miRNAs are correlated with the progression of muscle wasting of DM1 patients.

<p>The DM1 patients were classified as progressive and non-progressive based on the progression of the muscle wasting that the patients faced at the time of blood sample collection. miR-1 (<b>A</b>), miR-133a (<b>B</b>), miR-133b (<b>C</b>) and miR-206 (<b>D</b>) serum levels were significantly higher in the progressive DM1 patients compared to the non-progressive DM1 patients (p<0.005). Distribution charts of miR-1 (<b>E</b>), miR-133a (<b>F</b>), miR-133b (<b>G</b>) and miR-206 (<b>H</b>) levels in progressive and non-progressive DM1 patients show the elevated levels of the muscle-specific miRNAs in the serum of progressive DM1 patients compared to non-progressive DM1 patients. Horizontal lines inside the boxes mark the medians. Mean expression values are marked with rhombus. *** p < 0.0001, ** p < 0.005.</p