Impact of Procedure Manual in a Cleaning Company

This project is developed in a cleaning company, which we will call "Clean Express" to maintain the anonymity of the same, said company is located Boca del Rio, Veracruz, Mexico. According to Gido in 2012, the case study company has a functional type structure because the departments group the areas

A characteristic oxygen abundance gradient in galaxy disks unveiled with CALIFA

The authors thank the Viabilidad, Diseño, Acceso y Mejorafunding program, ICTS-2009-10, for supporting the initial development of this project. S.F.S., F.F.R.O. and D. Mast thank the Plan Nacional de Investigación y Desarrollo funding programs, AYA2010-22111-C03-03 and AYA2010-10904E, of the Spanish Ministerio de Ciencia e Innovación, for their support for this project. S.F.S thanks the Ramón y Cajal project RyC-2011-07590 of the Spanish Ministerio de Economía y Competitividad, for their support for this project. S.F.S. and B.J. acknowledge support from the grants No. M100031241 and M100031201 of the Academy of Sciences of the Czech Republic (ASCR Internal support program of international cooperation projects – PIPPMS) and by the Czech Republic program for the long-term development of the research institution No. RVO67985815. R.G.D., E.P., and R.G.B. thank the Plan Nacional de Investigación y Desarrollo funding program AYA2010-15081. F.F.R.O. acknowledges the Mexican National Council for Science and Technology (CONACYT) for financial support under the program Estancias Posdoctorales y Sabáticas al Extranjero para la Consolidación de Grupos de Investigación, 2010-2012. I.M. and J.P. acknowledge financial support from the Spanish grant AYA2010-15169 and Junta de Andalucía TIC114 and Excellence Project P08-TIC-03531. D.M. and A.M.-I. are supported by the Spanish Research Council within the program JAE-Doc, Junta para la Ampliación de Estudios, cofunded by the FSE. R.A. Marino was also funded by the Spanish program of the International Campus of Excellence Moncloa (CEI). J.I.-P., J.M.V., A.M.-I., and C.K. have been partially funded by the projects AYA2010-21887 from the Spanish PNAYA, CSD2006 – 00070 “1st Science with GTC” from the CONSOLIDER 2010 program of the Spanish MICINN, and TIC114 Galaxias y Cosmología of the Junta de Andalucía (Spain). M.A.P.T. acknowledges support by the Spanish MICINN through grant AYA2012-38491-C02-02 and by the Autonomic Government of Andalusia through grants P08-TIC-4075 and TIC-126. CJW acknowledges support through the Marie Curie Career Integration Grant 303912. Polychronis Papaderos is supported by a Ciencia 2008 contract, funded by FCT/MCTES (Portugal) and POPH/FSE (EC). Jean Michel Gomes is supported by a grant SFRH/BPD/66958/2009 from FCT (Portugal).We present the largest and most homogeneous catalog of H II regions and associations compiled so far. The catalog comprises more than 7000 ionized regions, extracted from 306 galaxies observed by the CALIFA survey. We describe the procedures used to detect, select, and analyze the spectroscopic properties of these ionized regions. In the current study we focus on characterizing of the radial gradient of the oxygen abundance in the ionized gas, based on the study of the deprojected distribution of H II regions. We found that all galaxies without clear evidence of an interaction present a common gradient in the oxygen abundance, with a characteristic slope of aO/H = -0.1 dex/re between 0.3 and 2 disk effective radii (re), and a scatter compatible with random fluctuations around this value, when the gradient is normalized to the disk effective radius. The slope is independent of morphology, the incidence of bars, absolute magnitude, or mass. Only those galaxies with evidence of interactions and/or clear merging systems present a significantly shallower gradient, consistent with previous results. The majority of the 94 galaxies with H II regions detected beyond two disk effective radii present a flattening in the oxygen abundance. The flattening is statistically significant. We cannot provide a conclusive answer regarding the origin of this flattening. However, our results indicate that its origin is most probably related to the secular evolution of galaxies. Finally, we find a drop/truncation of the oxygen abundance in the inner regions for 26 of the galaxies. All of them are non-interacting, mostly unbarred Sb/Sbc galaxies. This feature is associated with a central star-forming ring, which suggests that both features are produced by radial gas flows induced by resonance processes. Our result suggests that galaxy disks grow inside-out, with metal enrichment driven by the local star formation history and with a small variation galaxy-by-galaxy. At a certain galactocentric distance, the oxygen abundance seems to be correlated well with the stellar mass density and total stellar mass of the galaxies, independently of other properties of the galaxies. Other processes, such as radial mixing and inflows/outflows seem to have a limited effect on shaping of the radial distribution of oxygen abundances, although they are not ruled out.Peer reviewe

Development of a longitudinal integrated clerkship at an academic medical center

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center

Outer-disk reddening and gas-phase metallicities: The CALIFA connection

Astronomy and Astrophysics 585 (2016): A47 reproduced with permission from Astronomy & AstrophysicsWe study, for the first time in a statistically significant and well-defined sample, the relation between the outer-disk ionized-gas metallicity gradients and the presence of breaks in the surface brightness profiles of disk galaxies. Sloan Digital Sky Survey (SDSS) g′- and r′-band surface brightness, (g′ - r′) color, and ionized-gas oxygen abundance profiles for 324 galaxies within the Calar Alto Legacy Integral Field Area (CALIFA) survey are used for this purpose. We perform a detailed light-profile classification, finding that 84% of our disks show down- or up-bending profiles (Type II and Type III, respectively), while the remaining 16% are well fitted by one single exponential (Type I). The analysis of the color gradients at both sides of this break shows a U-shaped profile for most Type II galaxies with an average minimum (g′ - r′) color of ∼ 0.5mag and an ionized-gas metallicity flattening associated with it only in the case of low-mass galaxies. Comparatively, more massive systems show a rather uniform negative metallicity gradient. The correlation between metallicity flattening and stellar mass for these systems results in p-values as low as 0.01. Independent of the mechanism having shaped the outer light profiles of these galaxies, stellar migration or a previous episode of star formation in a shrinking star-forming disk, it is clear that the imprint in their ionized-gas metallicity was different for low- and high-mass Type II galaxies. In the case of Type III disks, a positive correlation between the change in color and abundance gradient is found (the null hypothesis is ruled out with a p-value of 0.02), with the outer disks of Type III galaxies with masses ≤1010 M′ showing a weak color reddening or even a bluing. This is interpreted as primarily due to a mass downsizing effect on the population of Type III galaxies that recently experienced an enhanced inside-out growthWe acknowledge support from the Plan Nacional de Investigación y Desarrollo funding programs, AyA2010-15081, AyA2012-30717 and AyA2013-46724P, of Spanish Ministerio de Economía y Competitividad (MINECO). A.G.d.P. acknowledges the support from the FP7 Marie Curie Actions of the European Commission, via the Initial Training Network DAGAL under REA grant agreement PITNGA- 2011-289313. C.C.-T. thanks the support of the Spanish Ministerio de Educación, Cultura y Deporte by means of the FPU fellowship program. C.J.W. acknowledges support through the Marie Curie Career Integration Grant 303912. Support for L.G. is provided by the Ministry of Economy, Development, and Tourism’s Millennium Science Initiative through grant IC 120009, awarded to The Millennium Institute of Astrophysics, MAS. L.G. acknowledges support by CONIC YT through FONDECYT grant 3140566. S.F.S. thanks the CONACYT-125180 and DGAPA-IA100815 projects for providing him support in this study. J.M.A. acknowledges support from the European Research Council Starting Grant (SEDmorph; P.I. V. Wild). P.P. is supported by FCT through the Investigador FCT Contract No. IF/01220/2013 and POPH/FSE (EC) by FEDER funding through the program COMPETE. He also acknowledges support by FCT under project FCOMP-01-0124-FEDER-029170 (Reference FCT PTDC/FISAST/ 3214/2012), funded by FCT-MEC (PIDDAC) and FEDER (COMPETE

Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis.

Multiple sclerosis is a common disease of the central nervous system in which the interplay between inflammatory and neurodegenerative processes typically results in intermittent neurological disturbance followed by progressive accumulation of disability. Epidemiological studies have shown that genetic factors are primarily responsible for the substantially increased frequency of the disease seen in the relatives of affected individuals, and systematic attempts to identify linkage in multiplex families have confirmed that variation within the major histocompatibility complex (MHC) exerts the greatest individual effect on risk. Modestly powered genome-wide association studies (GWAS) have enabled more than 20 additional risk loci to be identified and have shown that multiple variants exerting modest individual effects have a key role in disease susceptibility. Most of the genetic architecture underlying susceptibility to the disease remains to be defined and is anticipated to require the analysis of sample sizes that are beyond the numbers currently available to individual research groups. In a collaborative GWAS involving 9,772 cases of European descent collected by 23 research groups working in 15 different countries, we have replicated almost all of the previously suggested associations and identified at least a further 29 novel susceptibility loci. Within the MHC we have refined the identity of the HLA-DRB1 risk alleles and confirmed that variation in the HLA-A gene underlies the independent protective effect attributable to the class I region. Immunologically relevant genes are significantly overrepresented among those mapping close to the identified loci and particularly implicate T-helper-cell differentiation in the pathogenesis of multiple sclerosis

Thymidylate synthase polymorphisms in genomic DNA as clinical outcome predictors in a European population of advanced non-small cell lung cancer patients receiving pemetrexed

BACKGROUND: We studied whether thymidylate synthase (TS) genotype has an independent prognostic/predictive impact on a European population of advanced non-small cell lung cancer (NSCLC) patients receiving pemetrexed. METHODS: Twenty-five patients treated with pemetrexed-based regimens were included. Genomic DNA was isolated prior to treatment. The variable number of tandem repeat (VNTR) polymorphisms, the G > C single nucleotide polymorphisms (SNP) and the TS 6-bp insertion/deletion (6/6) in the 3' untranslated region (UTR) polymorphisms were analyzed and correlated with overall response rate (ORR), progression-free survival (PFS), overall-survival (OS) and toxicity. RESULTS: The genotype +6/+6 predicted a higher ORR among active/former smokers compared to +6/-6 genotype (100% vs. 50%; p = 0.085). Overall, the 3R/3R genotype predicted a higher ORR (100%) over the rest VNTR polymorphisms (p = 0.055). The presence of 3R/3R genotype significantly correlated with a superior ORR in patients without EGFR activating mutations (100%) compared to 2R/2R, 2R/3R and 3R/4R genotype (77.8%, 33.3% and 0% respectively; p = 0.017). After a median follow-up of 21 months, a trend towards a better PFS, although not significant, was found among subjects showing 3R/3R polymorphisms (p = 0.089). A significantly superior OS was found in patients showing 3R/3R genotype rather than other VNTR polymorphisms (p = 0.019). No significant correlation with the toxicity was observed. CONCLUSION: In our series, 3R/3R polymorphism correlated with a superior OS. Also, this polymorphism, when associated to wild type EGFR, was related to a higher ORR to pemetrexed. Toxicity was not significantly correlated with a specific TS genotype

FUMEPOC: Early detection of chronic obstructive pulmonary disease in smokers

<p>Abstract</p> <p>Background</p> <p>Currently is not feasible using conventional spirometry as a screening method in Primary Care especially among smoking population to detect chronic obstructive pulmonary disease in early stages. Therefore, the FUMEPOC study protocol intends to analyze the validity and reliability of Vitalograph COPD-6 spirometer as simpler tool to aid screening and diagnosis of this disease in early stages in primary care surgery.</p> <p>Methods / Design</p> <p>Study design: An observational, descriptive study of diagnostic tests, undertaken in Primary Care and Pneumology Outpatient Care Centre at San Juan Hospital and Elda Hospital. All smokers attending the primary care surgery and consent to participate in the study will undergo a test with Vitalograph COPD-6 spirometer. Subsequently, a conventional spirometry will be performed in the hospital and the results will be compared with those of the Vitalograph COPD-6 test.</p> <p>Discussion</p> <p>It is difficult to use the spirometry as screening for early diagnose test in real conditions of primary care clinical practice. The use of a simpler tool, Vitalograph COPD-6 spirometer, can help in the early diagnose and therefore, it could improve the clinical management of the disease.</p

Light Converts Endosymbiotic Fungus to Pathogen, Influencing Seedling Survival and Niche-Space Filling of a Common Tropical Tree, Iriartea deltoidea

Pathogens are hypothesized to play an important role in the maintenance of tropical forest plant species richness. Notably, species richness may be promoted by incomplete filling of niche space due interactions of host populations with their pathogens. A potentially important group of pathogens are endophytic fungi, which asymptomatically colonize plants and are diverse and abundant in tropical ecosystems. Endophytes may alter competitive abilities of host individuals and improve host fitness under stress, but may also become pathogenic. Little is known of the impacts of endophytes on niche-space filling of their hosts