Anti-hLAMP2-antibodies and dual positivity for anti-GBM and MPO-ANCA in a patient with relapsing pulmonary-renal syndrome

Background Pulmonary-renal syndrome associated with anti-glomerular basement membrane (GBM) antibodies, also known as Goodpasture's syndrome, is a rare but acute and life-threatening condition. One third of patients presenting as anti-GBM antibody positive pulmonary-renal syndrome or rapidly progressive glomerulonephritis are also tested positive for anti-neutrophil cytoplasmic antibodies (ANCA). Whilst anti-GBM disease is considered a non-relapsing condition, the long-term course of double-positive patients is less predictable. Case Presentation We report a patient with such dual positivity, who presented with pulmonary hemorrhage, crescentic glomerulonephritis and membranous nephropathy. Plasmapheresis in combination with immunosuppresive therapy led to a rapid remission but the disease relapsed after two years. The serum of the patient was tested positive for antibodies to human lysosomal membrane protein 2 (hLAMP2), a novel autoantigen in patients with active small-vessel vasculitis (SVV). The anti-hLAMP2 antibody levels correlated positively with clinical disease activity in this patient. Conclusion We hypothesize that this antibody may indicate a clinical course similar to ANCA-associated vasculitis in double-positive patients. However, this needs to be confirmed on comprehensive patient cohorts

Leakage, entrepreneurship, and satisfaction in hospitality

This is an Accepted Manuscript of an article published by Taylor & Francis in The Service Industries Journal on 2013, available online:http://www.tandfonline.com/10.1080/02642069.2013.740464Tourism is a very important tool for economic development. However, its economic effects are mainly conditioned by the level of leakage. This work defines leakage, provides an original evaluation of the entrepreneurial environment in showing that it is the one with the lowest level of leakage, and creates a new framework. It also measures leakage in an innovative way using a quantitative approach. In addition, the paper explores and shows how leakage can affect critical business factors, such as customer and employee satisfaction. The empirical study uses structural equations and data from hotels in the Valencian Region (Spain) to show how important leakage is in making businesses more competitive. 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Will AI ever sit at the C-suite table? The future of senior leadership

As the sophistication of artificial intelligence (AI) systems develop and AI becomes a key element of organizational strategy across a wide spectrum of industries, new demands are being placed on senior leaders. To understand the growing challenges leaders will face in the age of AI, we conducted interviews with 33 senior leaders in several countries across a wide range of industries. Our research highlights key capabilities and skills that leaders will require. Underlying these capabilities is a mindset oriented toward continuous learning and self-development, which will enable ongoing and rapid adaptation to change. Our findings identified the following key capabilities: digital know-how, data-driven focus, networking, ethics, and agility. To successfully navigate the coming era, senior leaders will need to focus on reskilling the workforce, recruiting and retaining highly skilled talent, building an intrapreneurial culture, and managing unprecedented changes in technologies and the nature of work.</p

Final report on supplementary comparison EURAMET.EM-S32: Comparison of resistance standards at 1 TΩ and 100 TΩ

Resistance standards with values in the TΩ range play an important role in electrical instrumentation. The calibration of such standards is, thus, a service offered by many metrology institutes. The techniques used to measure very high resistance values differ quite substantially from the calibration techniques applied in the lower resistance ranges. For this reason, the EURAMET technical committee for electricity and magnetism decided in 2008 to organise for the first time a supplementary comparison of resistance at 1 TΩ and 100 TΩ based on well characterized travelling standards. Eighteen European National Metrology Institutes participated in the comparison. With some exceptions, the results supplied by the participants agree reasonably well with the comparison reference value within the expanded uncertainty. As observed in other resistance comparisons, the characteristics of the standards used as transport artefacts ultimately limit the accuracy of comparisons in this field. The transport behaviour is difficult to model and introduces an undesired bias in the laboratory results. The transport uncertainties are at the level of the uncertainties claimed by some of the participants and, thus, limit the meaningfulness of the comparison results. Another remarkable observation is the big difference in the uncertainty statements made by the participants, even in cases where similar measurement systems were used. The results of the comparison allow the participants to critically review their measurement procedures and uncertainty models