Simulation Modeling of Occupational Health of Tourism and Hospitality Workers

Tourism and hospitality research has utilized mostly traditional approaches to understand and explain observed phenomena. Complexity science offers great potential for studying the complex dynamical system of tourism and hospitality with greater effectiveness. The accelerating pace of technological advances, destabilization of societies, and increasing levels of uncertainty have fueled the emergence of chaos and complexity perspectives. Social scientists are increasingly viewing the conceptual and statistical assumptions underlying the linear paradigm as being seriously flawed and limiting our ability to explain social phenomena. Innovative complex-systems approaches grounded in complex adaptive systems (CAS) theoretical, methodological, and analytical perspectives have potential to lead to greater understanding of various phenomena. The foregoing methods and tools will be discussed in the context of occupational health of Hispanic immigrant hospitality sector workers

Induction of potent protection against acute and latent herpes simplex virus infection in mice vaccinated with dendritic cells

Background aims. Dendritic cells (DCs) are the most potent antigen presenting cells of the immune system and have been under intense study with regard to their use in immunotherapy against cancer and infectious disease agents. In the present study, DCs were employed to assess their value in protection against live virus challenge in an experimental model using lethal and latent herpes simplex virus (HSV) infection in Balb/c mice. Methods. DCs obtained ex vivo in the presence of granulocyte-macrophage colony-stimulating factor and interleukin-4 were loaded with HSV-1 proteins (DC/HSV-1 vaccine). Groups of mice were vaccinated twice, 7 days apart, via subcutaneous, intraperitoneal or intramuscular routes with DC/HSV-1 and with mock (DC without virus protein) and positive (alum adjuvanted HSV-1 proteins [HSV-1/ALH]) control vaccines. After measuring anti-HSV-1 antibody levels in blood samples, mice were given live HSV-1 intraperitoneally or via ear pinna to assess the protection level of the vaccines with respect to lethal or latent infection challenge. Results. Intramuscular, but not subcutaneous or intraperitoneal, administration of DC/HSV-1 vaccine provided complete protection against lethal challenge and establishment of latent infection as assessed by death and virus recovery from the trigeminal ganglia. It was also shown that the immunity was not associated with antibody production because DC/HSV-1 vaccine, as opposed to HSV-1/ALH vaccine, produced very little, if any, HSV-1-specific antibody. Conclusions. Overall, our results may have some impact on the design of vaccines against genital HSV as well as chronic viral infections such as hepatitis B virus, hepatitis C virus and human immunodeficiency virus. © 2013, International Society for Cellular Therapy

Shared Service Delivery Can Increase Client Engagement: A Study of Shared Medical Appointments

Problem definition: Clients and service providers alike often consider one-on-one service delivery to be ideal, assuming, perhaps unquestioningly, that devoting individualized attention best improves client outcomes. In contrast, in shared service delivery, clients are served in batches and the dynamics of group interaction could lead to increased client engagement, which could improve outcomes. However, the loss of privacy and personal connection might undermine engagement. The engagement dynamics in one-on-one and shared delivery models have not been rigorously studied. To the extent that shared delivery may result in comparable or better engagement than one-on-one delivery, service providers in a broad array of contexts may be able to create more value for clients by delivering service in batches. Methodology/results: We conducted a randomized controlled trial with 1,000 patients who were undergoing glaucoma treatment over a three-year period at a large eye hospital. Using verbatim and behavioral transcripts from more than 20,000 minutes of video recorded during our trial, we examine how shared medical appointments (SMAs), in which patients are served in batches, impact engagement. On average, a patient who experienced SMAs asked 33.3% more questions per minute and made 8.6% more nonquestion comments per minute. Because there were multiple patients in an SMA, this increase in engagement at the individual patient level resulted in patients hearing far more comments in the group setting. Patients in SMAs also exhibited higher levels of nonverbal engagement across a wide array of measures (attentiveness, positivity, head wobbling, or “thalai aattam” in Tamil: a South Indian gesture to signal agreement or understanding, eye contact, and end-of-appointment happiness), relative to patients who attended one-on-one appointments. Managerial implications: These results shed light on the potential for shared service delivery models to increase client engagement and thus enhance service performance

Partial-thickness macular hole in vitreomacular traction syndrome: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Vitreomacular traction syndrome has recently been recognized as a distinct clinical condition. It may lead to many complications, such as cystoid macular edema, macular pucker formation, tractional macular detachment, and full-thickness macular hole formation.</p> <p>Case presentation</p> <p>We report a case of vitreomacular traction syndrome with eccentric traction at the macula and a partial-thickness macular hole in a 63-year-old Pakistani Punjabi man. The patient was evaluated using optical coherence tomography, and he underwent a successful pars plana vitrectomy. After the operation, his foveal contour regained normal configuration, and his visual acuity improved from 20/60 to 20/30.</p> <p>Conclusions</p> <p>Pars plana vitrectomy prevents the progression of a partial thickness macular hole in vitreomacular traction syndrome. The relief of traction by vitrectomy restores foveal anatomy and visual acuity in this condition.</p

Effect of Exercise on Appetite-Regulating Hormones in Overweight Women

Over the past decade, our knowledge of how homeostatic systems regulate food intake and body weight has increased with the discovery of circulating peptides such as leptin, acyl ghrelin, des-acyl ghrelin and obestatin. These hormones regulate the appetite and food intake by sending signals to the brain regarding the body\u27s nutritional status. The purpose of this study was to investigate the response of appetite-regulating hormones to exercise. Nine overweight women undertook two 2 h trials in a randomized crossover design. In the exercise trial, subjects ran for 60 min at 50% of maximal oxygen uptake followed by a 60 min rest period. In the control trial, subjects rested for 2 h. Obestatin, acyl ghrelin, des-acyl ghrelin and leptin concentrations were measured at baseline and at 20, 40, 60, 90 and 120 min after baseline. A two-way ANOVA revealed a significant (P \u3c 0.05) interaction effect for leptin and acyl ghrelin. However, changes in obestatin and des-acyl ghrelin concentration were statistically insignificant (P \u3e 0.05). The data indicated that although acute treadmill exercise resulted in a significant change in acyl ghrelin and leptin levels, it had no effect on plasma obestatin and des-acyl ghrelin levels

A Performance Analysis on Pressure Loss and Airflow Diffusion in a Chamber with Perforated V-Profile Diffuser Designed for Air Handling Units (AHUs)

Outlet cross-sectional area of fans used in air handling units is smaller than cross-sectional area of chambers which are located next to the fan. In order to ensure efficiently operating of the air handling units, it is required that the air flows through a perforated diffuser to create a uniform air diffusion from fan outlet to following chamber with a minimum pressure loss and uniform velocity distribution. In this concept, numerical simulations and experiments were performed for the chamber with perforated V-profile diffuser, which is often used in air handling units because of its simple geometry and easy manufacturing. Pressure losses were firstly obtained experimentally for different air velocities in the chamber. Then a performance analysis on the air flow diffusion and pressure losses inside chamber with perforated V-profile diffuser for different geometric parameters such as entry length, apex angle, geometry and pattern of hole, plate thickness, porosity and surface roughness has been carried out numerically. It is seen that the experimental results validated with the numerical turbulence model results

Associations of Renal Vascular Resistance With Albuminuria and Other Macroangiopathy in Type 2 Diabetic Patients

OBJECTIVE—Albuminuria can be caused by endothelial dysfunction as a result of ischemic nephropathy rather than classic diabetic nephropathy. We studied whether renal vascular resistance (resistive index [RI]) of the main renal arteries could be associated with albuminuria and further assessed the relationship between RI and aorta stiffness measured by brachial-ankle pulse-wave velocity (baPWV)

Bilateral ureteropelvic disruption following blunt abdominal trauma: Case report

<p>Abstract</p> <p>Background</p> <p>Ureteral injury occurs in less than 1% of blunt abdominal trauma cases, partly because the ureters are relatively well protected in the retroperitoneum. Bilateral ureteral injury is extremely rare, with only 10 previously reported cases. Diagnosis may be delayed if ureteric injury is not suspected, and delay of 36 hours or longer has been observed in more than 50% of patients with ureteric injury following abdominal trauma, leading to increased morbidity.</p> <p>Case presentation</p> <p>A 29-year-old man was involved in a highway motor vehicle collision and was ejected from the front passenger seat even though wearing a seatbelt. He was in a preshock state at the scene of the accident. An intravenous line and left thoracic drain were inserted, and he was transported to our hospital by helicopter. Whole-body, contrast-enhanced computed tomography (CT) scan showed left diaphragmatic disruption, splenic injury, and a grade I injury to the left kidney with a retroperitoneal haematoma. He underwent emergency laparotomy. The left diaphragmatic and splenic injuries were repaired. Although a retroperitoneal haematoma was observed, his renal injury was treated conservatively because the haematoma was not expanding. In the intensive care unit, the patient's haemodynamic state was stable, but there was no urinary output for 9 hours after surgery. Anuresis prompted a review of the abdominal x-ray which had been performed after the contrast-enhanced CT. Leakage of contrast material from the ureteropelvic junctions was detected, and review of the repeat CT scan revealed contrast retention in the perirenal retroperitoneum bilaterally. He underwent cystoscopy and bilateral retrograde pyelography, which showed bilateral complete ureteral disruption, preventing placement of ureteral stents. Diagnostic laparotomy revealed complete disruption of the ureteropelvic junctions bilaterally. Double-J ureteral stents were placed bilaterally and ureteropelvic anastomoses were performed. The patient's postoperative progress was satisfactory and he was discharged on the 23^rdday.</p> <p>Conclusion</p> <p>Diagnosis of ureteral injury was delayed, although delayed phase contrast-enhanced CT and abdominal x-rays performed after CT revealed the diagnosis early. Prompt detection and early repair prevented permanent renal damage and the necessity for nephrectomy.</p