Adverse events of ERCP at San José Hospital of Bogotá (Colombia)

Endoscopic retrograde cholangiopancreatography (ERCP) has become the preferred treatment method for hepatobiliary and pancreatic disease. Despite technological progress this technique continues to account for the greatest morbidity and mortality caused by digestive endoscopic procedures. ERCP carries a risk of pancreatitis, perforation, hemorrhage, cholangitis and cardiopulmonary events occurring in upto 10% of patients in referral centers, implying a mortality of up to 1%, not including therapeutic failures or the need for re-intervention. A greater mortality rate has been demonstrated in prospective studies rather than in retrospective studies, but overall, the number of complications described in the literature is much lower than the number of complications that actually occur. A descriptive prospective study was conducted at San José Hospital from April 1, 2006 to April 30, 2007 in patients who underwent an ERCP and had a 1-month follow-up. A total of 381 patients were included; 9 (2.3%) were excluded, and of the remaining 372 there was an overall success in 79.6% of cases, 8.3% had a second intervention, 7.6% developed complications (pancreatitis, perforation, hemorrhage, cholangitis, pain, intolerance to sedatives, and cardiopulmonary events), and 4.3% were failed ERCP studies. The mortality rate of the ERCP procedure was 0.8%. ERCP-related complications were determined at a teaching center, and this suggests the need to implement centers of excellence in order to improve the efficacy of the procedure

Understanding how organizational culture typology relates to organizational unlearning and innovation capabilities

This study focuses on the link between organizational unlearning and innovation capabilities and explores how this relationship might be managed within an innovative firm. In order to gain a clearer insight into to the influence of a firm’s culture on organizational unlearning and its innovation capabilities, a research model was developed that employs the Competing Values Framework (Cameron & Quinn, 1999). In this model, the influence of a firm’s cultural typology on unlearning and innovation is conceptualized and hypotheses are developed. The model was tested empirically using a sample of 145 firms drawn from the Spanish automotive components manufacturing sector and the relationships between the constructs were assessed using the partial least squares path-modeling approach. The results reveal that each distinct organizational culture exerts a different impact on the innovation and unlearning outcome variables. In particular, an adhocracy culture is associated closely with innovation capabilities while a market culture exerts a significant influence on organizational unlearnin

Thermal and light irradiation effect on the electrocatalytic performance of Hemoglobin modified Co3O4-g-C3N4 nanomaterials for oxygen evolution reaction

The oxygen evolution reaction (OER) plays a key role in the water splitting process and a high energy conversion efficiency is essential for the definitive advance of hydrogen-based technologies. Unfortunately, the green and sustainable development of electrocatalysts for water oxidation is nowadays a real challenge. Herein, a successful mechanochemical method is proposed for the synthesis of a novel hemoglobin (Hb) modified Co3O4/g-C3N4 composite nanomaterial. The controlled incorporation of cobalt entities as well as Hb functionalization, without affecting the g-C3N4 nanoarchitecture, was evaluated using different physicochemical techniques, such as X-ray diffraction, N2-physisorption, scanning electron microscopy, UV-visible spectroscopy and X-ray photoelectron spectroscopy. The beneficial effect of the resulting ternary bioconjugate together with the influence of the temperature and light irradiation was investigated by electrochemical analysis. At 60 °C and under light exposition, this electrocatalyst requires an overpotential of 370 mV to deliver a current density of 10 mA·cm−2, showing a Tafel slope of 66 mV·dec−1 and outstanding long-term stability for 600 OER cycles. This work paves a way for the controlled fabrication of multidimensional and multifunctional bio-electrocatalysts

ECONOMÍA DEL CONOCIMIENTO Y TRANSFORMACIÓN DE LOS MERCADOS LABORALES: IMPLICACIONES PARA LAS ORGANIZACIONES UNIVERSITARIAS.

La Universidad como organización sustantiva de la sociedad no puede ni debe permanecer ajena a los cambios que se presentan en su entorno. En este sentido, la evolución de las economías centradas en el capital material hacia las centradas en el conocimiento ha traído consigo un conjunto de transformaciones en el orden económico, social y laboral. En este marco, la presente comunicación tiene como objeto compartir un conjunto de reflexiones en torno a cómo la Universidad como organización puede dar respuesta a los retos que emanan de la economía y sociedad del conocimiento en forma particular: en sus formas de relación con el entorno, en su vinculación con los mercados laborales y nuevas culturas de trabajo, en el uso ético y racional de las tecnologías, en el reconocimiento y respeto a las diferencias culturales e ideológicas, y a su interior, en sus estructuras organizacionales, académicas y de gestión

TQM and business success:do all the TQM drivers have the same relevance? an empirical study in Spanish firms

Purpose Prior studies by Salaheldin (2009) and Talib et al. (2011) have assessed the relationships between TQM critical success factors (CSF) and business results. This study builds upon this research by considering the relationships between these CSFs and their sequencing during the implementation of TQM. Furthermore, the influence exerted by the maturity of TQM implementation on the link between instrumental drivers and performance is explored. Design/methodology/approach The TQM drivers are clustered by means of three constructs: strategic enablers, tactical drivers and instrumental drivers and a model employed in which the strategic and tactical factors are treated as antecedents of the instrumental drivers. The direct effect of each cluster on business results and the indirect relationship of strategic and tactical factors via the mediating role of the instrumental drivers are assessed. These assessments use the Partial Least Squares (PLS) approach which is a variance-based Structural Equation Modeling technique using a sample of 113 Spanish organizations with experience of implementing a TQM program. Findings The findings confirm the existing relationships among the CSFs and business performance identified by studies Salaheldin (2009) and Talib et al. (2011). However, our results reveal that instrumental drivers possess the highest variance explanation power over business performance outcomes and it is possible to identify a CSF implementation sequence that generates the greatest impact on business performance. Furthermore, the study was inconclusive with regard to the influence exerted by the number of years of TQM implementation on the link between the instrumental drivers and performance. Research limitations/implications The first is related to organizational bias. It seems likely that those firms which are not satisfied with their TQM system performance would be less likely to be motivated to contribute to the development of this study. Therefore, we have included in the sample a higher proportion of “good” systems than is the case in the population at large. Secondly, although we provide evidence of causality, causality itself has not been proven. Thirdly, this research relies mainly on perceptions and we only used a single method to elicit these perceptions. Finally, this research was carried out in a specific geographical setting (Spanish companies) and we must be cautious about generalizing these results in other contexts. Practical implications This study offers a substantial number of practical implications. First Firms’ managers should emphasize that continuous improvement, benchmarking, and zero-defects mentality is a never-ending process. Especially, they should understand that reliable product/service design is critical to exceed the customers’ expectations, leading to improved business success. The results of this study should also lead managers to seeing a “return on investment” in their efforts to implement a TQM program by firstly, paying more attention on how to implement the instrumental factors, and secondly, avoiding the belief that the passage of time and experience-based learning will bring business performance enhancement and success on their own. Originality/value The results suggest the need to consider whether all the CSFs are equally relevant on the basis of their contribution to business success. For example, strategic enablers are generally considered to be of primary importance with tactical and instrumental drivers assuming a secondary position. Our study challenges this view and highlights the role of instrumental drivers over strategic and tactical factors with the clear implication that managers should focus strongly on daily implementation tasks such as benchmarking, zero-defects mentality and continuous improvement processes in order to achieve good business performance outcomes

Effect of Calcium Carbonate Residues from Cement Industries on the Phenolic Composition and Yield of Shiraz Grapes

Phenolic compounds are secondary metabolites synthesised in response to biotic or abiotic stress in plants.  This stress-induced increase in phenolic compound concentrations is generally activated by internal levels of abscisic acid (ABA). The exogenous application of ABA or calcium chloride on grapevines is also known to increase grape yield and alter the phenolic composition of grapes. Residues of cement industries such as calcium carbonates (CaCO3) are a safe environmental source of calcium that could be used to induce the synthesis of phenolic compounds and act as a yield promoter in grapes and other crops. Consequently, the objective of this study was to evaluate the effect of cement industries’ CaCO3 residues (CaCO3R) on the yield and concentration of phenolic compounds in Shiraz grapes. Thirteen phenolic compounds were identified and quantified by HPLC-DAD. Malvidin-3-O-glucoside was the major anthocyanin found inShiraz grapes, and its concentration increased by more than 200% in CaCO3R-treated vines. Similarly, the concentration of cinnamic acid, the main precursor of phenolic compounds, increased by more than 900%in grapes treated with CaCO3 residues at harvest time. Finally, catechin, epicatechin and procyanidin B1 and B2 increased significantly at harvest time in CaCO3R-treated grapes relative to the controls. In general, it was found that foliar application of CaCO3 residues from the cement industry at véraison induced an increase in yield, and in the concentration and composition of phenolic compounds in grapes

Demand Management Based on Model Predictive Control Techniques

Demand management (DM) is the process that helps companies to sell the right product to the right customer, at the right time, and for the right price. Therefore the challenge for any company is to determine how much to sell, at what price, and to which market segment while maximizing its profits. DM also helps managers efficiently allocate undifferentiated units of capacity to the available demand with the goal of maximizing revenue. This paper introduces control system approach to demand management with dynamic pricing (DP) using the model predictive control (MPC) technique. In addition, we present a proper dynamical system analogy based on active suspension and a stability analysis is provided via the Lyapunov direct method

Evaluation of the immunogenicity and efficacy of BCG and MTBVAC vaccines using a natural transmission model of tuberculosis

International audienceAbstractEffective vaccines against tuberculosis (TB) are needed in order to prevent TB transmission in human and animal populations. Evaluation of TB vaccines may be facilitated by using reliable animal models that mimic host pathophysiology and natural transmission of the disease as closely as possible. In this study, we evaluated the immunogenicity and efficacy of two attenuated vaccines, BCG and MTBVAC, after each was given to 17 goats (2 months old) and then exposed for 9 months to goats infected with M. caprae. In general, MTBVAC-vaccinated goats showed higher interferon-gamma release than BCG vaccinated goats in response to bovine protein purified derivative and ESAT-6/CFP-10 antigens and the response was significantly higher than that observed in the control group until challenge. All animals showed lesions consistent with TB at the end of the study. Goats that received either vaccine showed significantly lower scores for pulmonary lymph nodes and total lesions than unvaccinated controls. Both MTBVAC and BCG vaccines proved to be immunogenic and effective in reducing severity of TB pathology caused by M. caprae. Our model system of natural TB transmission may be useful for evaluating and optimizing vaccines

Neurocognitive Function in Acromegaly after Surgical Resection of GH-Secreting Adenoma versus Naïve Acromegaly

Patients with active untreated acromegaly show mild to moderate neurocognitive disorders that are associated to chronic exposure to growth hormone (GH) and insulin-like growth factor (IGF-I) hypersecretion. However, it is unknown whether these disorders improve after controlling GH/IGF-I hypersecretion. The aim of this study was to compare neurocognitive functions of patients who successfully underwent GH-secreting adenoma transsphenoidal surgery (cured patients) with patients with naive acromegaly. In addition, we wanted to determine the impact of different clinical and biochemical variables on neurocognitive status in patients with active disease and after long-term cure. A battery of six standardized neuropsychological tests assessed attention, memory and executive functioning. In addition, a quantitative electroencephalography with Low-Resolution Electromagnetic Tomography (LORETA) solution was performed to obtain information about the neurophysiological state of the patients. Neurocognitive data was compared to that of a healthy control group. Multiple linear regression analysis was also conducted using clinical and hormonal parameters to obtain a set of independent predictors of neurocognitive state before and after cure. Both groups of patients scored significantly poorer than the healthy controls on memory tests, especially those assessing visual and verbal recall. Patients with cured acromegaly did not obtain better cognitive measures than naïve patients. Furthermore memory deficits were associated with decreased beta activity in left medial temporal cortex in both groups of patients. Regression analysis showed longer duration of untreated acromegaly was associated with more severe neurocognitive complications, regardless of the diagnostic group, whereas GH levels at the time of assessment was related to neurocognitive outcome only in naïve patients. Longer duration of post-operative biochemical remission of acromegaly was associated with better neurocognitive state. Overall, this data suggests that the effects of chronic exposure to GH/IGF-I hypersecretion could have long-term effects on brain functions. © 2013 Martín-Rodríguez et al.Funding for this project was provided by an R&D grant from Novartis Oncology and the Plan Andaluz de Investigación (CTS-444). DAC was supported by the “Ramón y Cajal” program (RYC-2006-001071) of the Spanish Ministry of Science and Innovation.Peer Reviewe