Endoscopic diagnosis of gastric peptic ulcer penetrating into the liver

A 61-year-old man was admitted with upper gastrointestinal bleeding. Endoscopy showed a large gastric peptic ulcer with a pseudotumoral mass protruding from the ulcer bed. Histological examination of biopsies taken from the mass revealed distorted hepatic tissue and inflammatory changes. Hepatic penetration was diagnosed as the cause of bleeding. Surgery findings confirmed the endoscopic diagnosis

Characterization and wear performance of boride phases over tool steel substrates

This research work was conducted to characterize boride phases, obtained from the powder-pack process, on AISI H13 and D2 steel substrates, and investigate their tribological behavior. The boriding was developed at a temperature of 1273 K with an exposure time of 8 h. X-ray diffraction, scanning electron microscopy, and energy-dispersive X-ray spectroscopy were conducted on the borided material to characterize the presence of the FeB, Fe2B, and CrB phases and the distribution of heavy elements on the surface of the substrates. The adherence of the boride layers was evaluated, in a qualitative form, through the Daimler-Benz Rockwell-C indentation technique. Sliding wear tests were then performed using a reciprocating wear test machine. All tests were conducted in dry conditions at room temperature. A frequency of 10 Hz and 15-mm sliding distance were used. The applied Hertzian pressure was 2.01 GPa. Scanning electron microscopy was used to observe and analyze the wear mechanisms. Additionally, the variation of the friction coefficient versus the number of cycles was obtained. Experimental results showed that the characteristic wear mechanism for the borided surface was plastic deformation and mild abrasive wear; for unborided substrates, cracking and spalling were observed

The effect of calcitriol, paricalcitol, and a calcimimetic on extraosseous calcifications in uremic rats

Vitamin D derivatives and calcimimetics are used to treat secondary hyperparathyroidism in patients with chronic renal failure. We investigated the effect of calcitriol, paricalcitol, and the calcimimetic AMG 641 on soft-tissue calcification in uremic rats with secondary hyperparathyroidism. Control and uremic rats were treated with vehicle, calcitriol, paricalcitol, AMG 641, or a combination of AMG 641 plus calcitriol or paricalcitol. Parathyroid hormone levels were reduced by all treatments but were better controlled by the combination of paricalcitol and AMG 641. The calcimimetic alone did not induce extraosseous calcification but co-administration of AMG 641 reduced soft-tissue calcification and aortic mineralization in both calcitriol- and paricalcitol-treated rats. Survival was significantly reduced in rats treated with calcitriol and this mortality was attenuated by co-treatment with AMG 641. Our study shows that extraskeletal calcification was present in animals treated with calcitriol and paricalcitol but not with AMG 641. When used in combination with paricalcitol, AMG 641 provided excellent control of secondary hyperparathyroidism and prevented mortality associated with the use of vitamin D derivatives without causing tissue calcification

Efficiency of evolutionary algorithms in water network pipe sizing

© 2015, Springer Science+Business Media Dordrecht. The pipe sizing of water networks via evolutionary algorithms is of great interest because it allows the selection of alternative economical solutions that meet a set of design requirements. However, available evolutionary methods are numerous, and methodologies to compare the performance of these methods beyond obtaining a minimal solution for a given problem are currently lacking. A methodology to compare algorithms based on an efficiency rate (E) is presented here and applied to the pipe-sizing problem of four medium-sized benchmark networks (Hanoi, New York Tunnel, GoYang and R-9 Joao Pessoa). E numerically determines the performance of a given algorithm while also considering the quality of the obtained solution and the required computational effort. From the wide range of available evolutionary algorithms, four algorithms were selected to implement the methodology: a PseudoGenetic Algorithm (PGA), Particle Swarm Optimization (PSO), a Harmony Search and a modified Shuffled Frog Leaping Algorithm (SFLA). After more than 500,000 simulations, a statistical analysis was performed based on the specific parameters each algorithm requires to operate, and finally, E was analyzed for each network and algorithm. The efficiency measure indicated that PGA is the most efficient algorithm for problems of greater complexity and that HS is the most efficient algorithm for less complex problems. However, the main contribution of this work is that the proposed efficiency ratio provides a neutral strategy to compare optimization algorithms and may be useful in the future to select the most appropriate algorithm for different types of optimization problems

Methionine adenosyltransferase S-nitrosylation is regulated by the basic and acidic amino acids surrounding the target thiol

S-Adenosylmethionine serves as the methyl donor for many biological methylation reactions and provides the propylamine group for the synthesis of polyamines. S-Adenosylmethionine is synthesized from methionine and ATP by the enzyme methionine adenosyltransferase. The cellular factors regulating S-adenosylmethionine synthesis have not been well defined. Here we show that in rat hepatocytes S-nitrosoglutathione monoethyl ester, a cell-permeable nitric oxide donor, markedly reduces cellular S-adenosylmethionine content via inactivation of methionine adenosyltransferase by S-nitrosylation. Removal of the nitric oxide donor from the incubation medium leads to the denitrosylation and reactivation of methionine adenosyltransferase and to the rapid recovery of cellular S-adenosylmethionine levels. Nitric oxide inactivates methionine adenosyltransferase via S-nitrosylation of cysteine 121. Replacement of the acidic (aspartate 355) or basic (arginine 357 and arginine 363) amino acids located in the vicinity of cysteine 121 by serine leads to a marked reduction in the ability of nitric oxide to S-nitrosylate and inactivate hepatic methionine adenosyltransferase. These results indicate that protein S-nitrosylation is regulated by the basic and acidic amino acids surrounding the target cysteine

Prácticas de RSE en cooperativas. Experiencias y resultados mediante el estudio de casos

La conducta observada en las organizaciones que conforman el entramado de la Economía Social ha supuesto un precedente en actuaciones y prácticas que representan una forma de hacer empresa basada en la responsabilidad social, incluidas sus múltiples acepciones y enfoques. Asimismo, se percibe un creciente interés en la llamada Responsabilidad Social de la Empresa (RSE), un modelo de gestión implantado en diversos tipos de organizaciones, con y sin fines lucrativos, que lleva consigo el compromiso con un conjunto de valores ligados a todos sus grupos de interés. En el marco de la Economía Social, las cooperativas operan en conformidad con los criterios, valores y principios de RSE, interés por la comunidad y servicio a sus miembros, no solamente en la esfera económica, sino también en el ámbito social y medioambiental. Múltiples trabajos manifiestan la concordancia entre el desarrollo de las políticas de RSE en sus tres vertientes (económica, social y ambiental) y los valores y principios cooperativos enunciados por la Alianza Cooperativa Internacional (ACI, 1995). Estos estudios avalan la afirmación de que la propia naturaleza de las cooperativas implica un comportamiento socialmente responsable. Asumidos estos postulados, el objetivo del presente trabajo es observar y constatar el cumplimiento efectivo de los mismos en cooperativas de diferentes sectores y entornos, cuestión que conlleva el análisis de la gestión integral de las actuaciones inherentes de RSE, derivadas de sus relaciones con los distintos agentes, según la Teoría de los grupos de interés (Turker, 2009). Adicionalmente, las cooperativas deben buscar la supervivencia mediante sus resultados económicos plasmados en la obtención de unos excedentes y una rentabilidad adecuados (López y Marcuello, 2006), con la finalidad de prestar servicios a los socios a lo largo del tiempo, y todo ello en sintonía con las demandas de los distintos grupos de interés. Por estos motivos, el estudio contrasta la aplicación de la RSE con la obtención de resultados económicos en un entorno de crisis económica. Mediante una metodología de estudio de casos, se han seleccionado seis cooperativas españolas pertenecientes a diversos sectores, para analizar sus memorias y cuentas de resultados, con el objeto de identificar relaciones entre sus comportamientos de RSE y los resultados económico-financieros obtenidos en un periodo de tiempo determinado. The behaviour observed in the organizations of the Social Economy framework has set a precedent in business practices which are based on social responsibility. There is also a growing interest in so-called Corporate Social Responsibility (CSR), a management model implemented in different types of for- and non-profit organizations, which entails a commitment to a set of values linked to all its stakeholders. Within the framework of the Social Economy, cooperatives operate under the criteria, values, and principles of CSR. They have an interest in the community and in providing service to their members, not only economically but also socially and environmentally. There is a body of evidence which shows the link between the development of CSR policies (economic, social and environmental) and the cooperative values and principles laid out by the International Cooperative Alliance (ICA, 1995). These studies support the claim that the very nature of cooperatives implies socially responsible behaviour. In the last two decades, and more intensely during the recent economic crisis, Spanish cooperatives have shown an increasing interest in the development of CSR policies through concrete actions (Monzon and Antunano, 2012). Likewise, cooperatives seek to broaden the communication channels with their stakeholders and with society as a whole, through the preparation of well-defined and accessible CSR reports, as an additional element of transparency in their management model. In light of the above, the general objective of this study is to observe and verify the effective CSR compliance in a scenario of economic crisis across cooperatives from different sectors and environments. This issue entails the analysis of the management of CSR actions, derived from the relations with the relevant agents, according to the Theory of Stakeholders (Turker, 2009). This is linked to the nature of cooperatives and their operating principles given their afore-posited predisposition to more effective CSR implementation in comparison to other business formulas (Bel and Marin, 2008; Sanchis and Rodriguez, 2018). This facet goes hand in hand with a marked interest in transparency, accountability and the preparation of SCR reports as a way of transmitting their differentiating characteristics to their interest groups (Gallardo and Castilla, 2015). In addition, the economic literature on the subject recognises CSR as a fundamental resource for creating a competitive advantage applicable to cooperatives. These organizations develop strategies that allow them to survive thanks to their economic results, reflected in the obtaining of adequate surpluses (Lopez and Marcuello, 2006), by the aim of providing services to members over time, and all in tune with the demands of the different interest groups. For these reasons, the second objective of the study is to contrast the CSR implementation with profit generation in these entities, in a context of economic crisis, and to seek certainties on the alignment between the social and economic function of the cooperatives (Gallardo and Castilla, 2015). Following Villareal and Landeta (2010), a case study methodology has been applied. For this, we have selected six Spanish cooperatives from different sectors with a high degree of significance within the Ranking "Relevant Companies of the Social Economy" 2010-2011 published by the Social Economy Business Confederation (CEPES). Subsequently, the chosen cooperatives have been refined and sorted based on the available documentation. For this, first all the potentially comparable information regarding the development of CSR actions has been collected. Then, the available financial data have been obtained. In parallel, qualitative and quantitative information of these cooperatives has been extracted from the publications of CSR and economic reports. These data have been complemented with information from other secondary sources. Consequently, the relevant CSR factors relating to the social, economic and environmental dimensions have been determined according to the RSECOOP model (2011) following the indicators of the Global Reporting Initiative. Then, the economic-financial ratios have been selected, which reveal positions in accordance with the different interest groups of the selected cooperatives. Next, we start from the hypothesis, widely reviewed in the literature, which associates cooperative principles with behaviours consistent with the development of social responsibility towards stakeholders, and considers that these organisations should integrate these behaviours into their management policies (Server and Capo, 2009). This issue is closely related to the creation of added (Mozas, 2010) and the obtaining of lasting competitive advantages (Castilla et al., 2015). Thus, under the stated objectives, a basic evaluation of compliance with the relevant CSR factors for these six cooperatives is first carried out (COCETA, 2001). To this end, the results obtained are verified and compared using the numerical values offered and are grouped into charts for better visualization of the degree of compliance (concentration-dispersion) with the CSR in the three vectors considered. Then, the CSR values obtained are contrasted with the average values of the profitability ratios applied for these cooperatives, to observe possible relationships between compliance with the CSR variables and the economic results of the organizations. After analyzing the CSR practices developed by the cooperatives under study, relatively high compliance with socially responsible behaviours has been observed, since the results show positive values and highly homogeneous deviations. However, not all cases denote a development of CSR according to the relative position of the cooperative in the market and its economic results. Therefore, a degree of commitment to its stakeholders based on the specific corporate culture and values present is perceived. On the other hand, certain biases in the configuration of the CSR have been observed as an integral business management model, ` since not all CSR vectors have been observed with the same intensity in each of the cases. Also, there is a correlation in the cooperatives between the economic results obtained, measured in terms of commercial margin, and the overall development of CSR practices. It is reflected more intensely in the economic profitability ratios and corresponds to the progress of social responsibility aspects in the economic vector. Finally, the results obtained could serve, in general, to strengthen the theory, generally accepted in the literature about the capacity of cooperatives to be more resistant in crisis environments by promoting a more socially responsible economy. However, it is still necessary for these organizations to make greater efforts to communicate their social performance and the advantages of the CSR''s reported management as a tool for competing in markets. One of the limitations of the study derives from the difficulty of configuring and examining a large number of variables. This leads to a reduced case study, which prevents, due to the size of the sample, the establishment and/or modelling of causal relationships for Spanish cooperatives in the reference period as a whole. Nevertheless, this issue has not been the object of analysis, as justified in the design of the study. We must also add the limitation of not having homogeneous and constant information for all cooperatives or more extended periods. The contribution of this research is reflected firstly in the particularities that can be approached in greater depth from the analysis of specific cases, reviewing social and economic behaviour of cooperatives. And secondly, the proposed methodology can be used as a guide to be adapted and expanded to analyze this type of relationship in different contexts and scenarios. For example, the study can be replicated to analyze cooperatives from the same sector or to carry out cross-sector comparisons. Future research can consider specific geographical areas and different periods, with varying dimensions and sizes, or even ultimately, the model may allow comparisons with other companies that are not part of the Social Economy

Evaluation of the prognostic value of the risk, injury, failure, loss and end-stage renal failure (RIFLE) criteria for acute kidney injury

AIM: The experts have argued about the use of the risk, injury, failure, loss and end-stage renal failure (RIFLE) criteria as a prognosis scoring system. We examined the association between in-hospital mortality and the RIFLE criteria, and discussed its accuracy as a prognosis factor. METHODS: In this prospective study, we analysed the data gathered from a cohort of 956 patients admitted in a Spanish tertiary hospital between January 1998 and April 2006. Hazard ratios for mortality, and survival curves within 60 days were calculated. Discrimination and calibration of the model were also assessed. RESULTS: Excluding 53 patients, 903 patients were finally analysed. We classified them into groups according to the maximum RIFLE class reached during their admission. The RIFLE class was assessed by the glomerular filtration rate criterion. We found an increase in the in-hospital mortality risk. Cox proportional hazard models showed that RIFLE classes risk, injury, and failure were significant predictive factors (hazard ratios were 2.77, 3.23 and 3.52, respectively; P for trend was 0.005). The multivariate analyses from the cross-classification of the participants according to Liano score values (severity of illness) and RIFLE classes showed additive effects of the exposures on in-hospital mortality. CONCLUSION: In this population, the risk of in-hospital mortality during the acute kidney injury (AKI) episode was positively associated with RIFLE classes. We showed that the RIFLE classification system had discriminative power in predicting hospital mortality within 60 days in AKI patients, but not better than a specific AKI predictive model. However, a combined use of both may give a more robust prognosis system

Karnofsky performance score in acute renal failure as a predictor of short-term survival

Karnofsky Performance Scale Index (KPS) is a measure of functional status that allows patients to be classified according to their functional impairment. We aim to assess if the prior KPS may predict the risk of death among patients with acute renal failure (ARF). METHODS: A cohort of 668 consecutive patients who had been admitted in an university-affiliated hospital between June 2000 and June 2006, and had been diagnosed with ARF, were studied. Three hundred and eighty-six patients with ARF who matched at least one of the RIFLE (Risk, Injury, Failure, Loss and End stage) criteria on increased serum creatinine were included for subsequent analysis. The group was divided into four categories, according to different Karnofsky scores measured by a nephrologist (>or=80, 70, 60 and <or=50). We used an adjusted logistic regression model to assess the relationship between the Karnofky score and mortality. RESULTS: A significant risk of in-hospital mortality within 90 days was observed when the other groups were compared with the >or=80 Karnofsky group. Adjusted odds ratios were 8.87 (95% confidence interval (CI) 3.03-25.99), 6.78 (95% CI 2.61-17.58) and 2.83 (95% CI 1.04-7.68), for Karnofsky groups of <or=50, 60 and 70, respectively. An adjusted odds ratio of 1.75 (95% CI 1.37-2.23) was observed for every 10 point decrease in KPS score. CONCLUSION: Functional status as indicated by the KPS is an independent predictor of death in this cohort of patients with ARF. Patients who presented lower scores had increased mortality rate