Rifamycin Resistance in Clostridium difficile Is Generally Associated with a Low Fitness Burden

We characterized clinically occurring and novel mutations in the β subunit of RNA polymerase in Clostridium difficile (CdRpoB), conferring rifamycin (including rifaximin) resistance. The Arg(505)Lys substitution did not impose an in vitro fitness cost, which may be one reason for its dominance among rifamycin-resistant clinical isolates. These observations were supported through the structural modeling of CdRpoB. In general, most mutations lacked in vitro fitness costs, suggesting that rifamycin resistance may in some cases persist in the clinic

Análisis financiero para reforzar la rentabilidad afectada por la Pandemia Covid-19 de una empresa dedicada a la producción y distribución de huevos y aves del municipio de San Salvador.

En el año 2019 en la provincia de China Wuhan se comenzaron a reportar los primeros casos de contagio COVID-19, debido a la forma de propagación del virus principalmente a través de personas a personas a través de las gotículas que salen despedidas de la nariz o boca de una persona infectada, rápidamente se convirtió en pandemia, siendo la primera pandemia de la década, esto implico que los países tuvieron que tomar políticas sanitarias para salvaguardar la salud de la población y evitar un colapso inminente de los sistemas de salud pública, principalmente en aquellos países de escasos recursos. A mediados de marzo del 2020, en El Salvador se reportó el primer caso de COVID-19, detectado en el occidente del país, lo cual implicó la implementación de diferentes protocolos de salud sanitaria, mediante Decretos Ejecutivos y Legislativos. Entre las medidas abordadas por estos protocolos están las siguientes: la suspensión de clases, la restricción de la movilidad de las personas, cierres de todas las fronteras, tanto para extranjeros y connacionales, cuarentena a nivel nacional y focalizado, todo impactó directamente en la demanda y oferta del mercado. En las empresas pertenecientes a los sectores de alimentación, no pararon actividades, sin embargo, las restricciones derivadas de los protocolos sanitarios provocaron la disminución de las ventas y el incremento de los costos. Las empresas con una falta de planificación financiera y análisis oportunos tuvieron más impacto negativo en sus rentabilidades. II El objetivo de esta investigación es identificar aquellos factores que impactaron negativamente en la rentabilidad de la empresa en estudio, apoyando con el análisis financiero, el establecimiento de una adecuada planificación para la ejecución de los gastos operativos de la empresa. Para el cumplimiento de dicho objetivo se inició un análisis del desarrollo de la pandemia en El Salvador y sus impactos en las industrias alimenticias, principalmente la empresa de producción y distribución de huevos ubicada en el municipio de San Salvador. Posteriormente facilitar a la entidad el análisis realizado y plantilla para la elaboración y control de sus presupuestos. Para la recolección de información se implementó la entrevista, dirigida a los encargados de la contabilidad administrativa y producción. Mediante esta metodología de recopilación de información, se determinó las principales problemáticas de la empresa, durante el periodo de cuarentena y sus efectos posteriores. Se realizó análisis financiero tomando de base los estados financieros de los años 2017, 2018 y 2019, adicionalmente se realizaron proyecciones para los meses de octubre, noviembre y diciembre del 2020 y se proyectaron los años 2021 y 2022, para validar los impactos negativas en las proyecciones, como efecto negativo del desarrollo de la pandemia en El Salvador. Finalizando con la propuesta de plantilla para la elaboración y control del presupuesto de la empresa: III Como principales conclusiones se tiene: ● La entidad carece de las herramientas y un análisis financieros que ayude a la toma de decisiones oportunas. ● La entidad no posee presupuesto de ingresos, costos y gastos operativos, generando la imposibilidad de identificar variaciones significativas que impacten a la empresa. Mediante el análisis de conclusiones se obtuvo las siguientes recomendaciones: ● Adoptar la elaboración de un análisis financiero, para la evaluación del desarrollo de la rentabilidad de la empresa. ● Ejercer los presupuestos adecuados para compra y adquisición de materiales y servicios preventivos para el contagio del COVID-19 en las instalaciones de la empresa

E-Cadherin gene expression in oral cancer : clinical and prospective data

Low protein expression of E-cadherin in oral squamous cell carcinoma (OSCC) has been associated with clinical and histopathological traits such as metastases, recurrence, low survival and poor tumor differentiation, and it is considered a high-risk marker of malignancy. However, it is still unknown whether low expression of E-cadherin is also present at the mRNA level in OSCC cases. Objective: The aim of this study was to compare E-cadherin mRNA expression in OSCC patients and controls and to correlate the expression with clinical and prospective characteristics. Forty patients and 40 controls were enrolled. E-cadherin mRNA expression was evaluated by quantitative real-time polymerase chain reaction using TaqMan probes. E-cadherin mRNA expression was significantly decreased in OSCC patients compared to that of controls (p<0.001). Whereas no significant association between clinical parameters and E-cadherin expression levels was observed, we noted lower E-cadherin expression levels in patients with positive lymph node metastasis. E-cadherin mRNA expression was markedly diminished in OSCC, in agreement with previous results that examined E-cadherin expression at the protein level. E-cadherin is downregulated in the early clinical stages of OSCC, and its mRNA levels do not change significantly in the advanced stages, suggesting that there is limited usefulness of this parameter for predicting disease progression

PROCESOS ADMINISTRATIVOS Y OPERATIVOS COMO FORTALECIMIENTO DEL TALENTO HUMANO

Las empresas privadas disfrutan de ventajas, incluida la existencia perpetua, de responsabilidad limitada, el empresario en la actualidad, requiere de formación científica, es decir; un conocimiento teórico, sistemático y organizado de los fenómenos económicos, además de experiencia y creatividad; la empresa, en un mercado competitivo, necesita de cambios e innovaciones frecuentes y de variables como las necesidades y gustos de los consumidores, todos los buenos administradores llevan a cabo las funciones básicas del proceso administrativo, que consiste en planear, organizar, dirigir y controlar. La empresa innovadora cambia, evoluciona, ofrece productos y adopta, o pone a punto procesos de fabricación; El fortalecimiento institucional se direcciona al logro de instituciones ágiles, dinámicas y oportunas, tanto en su gestión como en sus resultados, esto determina junto al talento humano óptimo, recursos logísticos, técnicos y ambientes adecuados para el trabajo. Toda empresa cuenta con objetivos entre ellos aprovechar los recursos humanos, técnicos, materiales, tecnológicos, administrativos y operativos como fortalecimiento de las empresas privadas como unidades productoras de bienes o servicios para la venta en el mercado independientemente del estado cuyo fin esencial es obtener ganancias y utilidades para el desarrollo económico de la ciudad de Guayaquil y el Ecuador. La presente investigación tiene como objetivo Determinar algunos procesos Administrativos y Operativos como Fortalecimiento del Talento Humano en la empresa VIMTICORP, se sustentó con la aplicación de las matrices MEFE y MEFI que permitieron demostrar indicadores de mejora o desmejora de los procesos administrativos y operativosPALABRAS CLAVE: administración; procesos operativos; empresas; talento humano.ADMINISTRATIVE AND OPERATIONAL PROCESSES SUCH AS STRENGTHENING HUMAN RESOURCEABSTRACTPrivate enterprises enjoy advantages, including perpetual existence, with limited responsibility, businessman today, It requires scientific training, it means; a theoretical, systematic and organized knowledge of economic phenomena, besides experience and creativity; the company, in a competitive market, it requires frequent changes and innovations and variables as the needs and tastes of consumers, all good managers perform the basic functions of the administrative process, consisting of planning, organizing, directing and controlling .The innovative company changes, evolves, It offers products and adopt, or put manufacturing processes; Institutional strengthening is directed to achieving, dynamic and relevant institutions, both in management and in its results, this determines the optimal human talent together, logistical, technical resources and environments suitable for the job. Every company has goals including use of human resources, technical, materials, technological, administrative and operational like strengthening of private companies as producing unit’s goods or services for sale on the market regardless of the state whose essential purpose is profit and profit for the economic development of the city of Guayaquil and Ecuador. This research has a main objective to determine some administrative and operational processes and strengthening of human talent in the company VIMTICORP, with the implementation of MEFE and matrices that allowed MEFI indicators show improvement or deterioration of administrative and operational processes.KEYWORDS: Management; Business Processes; Enterprises; Human Talent

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study (Intensive Care Medicine, (2021), 47, 2, (160-169), 10.1007/s00134-020-06234-9)

The original version of this article unfortunately contained a mistake. The members of the ESICM Trials Group Collaborators were not shown in the article but only in the ESM. The full list of collaborators is shown below. The original article has been corrected