Combined tools for Surgical Case Packages contents and cost optimization: a preliminary study

This paper presents a solution proposal based on mathematical and statistical tools to optimize Surgical Case Packages of an Operating Room (OR) in a Portuguese public hospital that it is the most complex environment in a hospital. In this particular hospital, more than 27000 surgeries/year are performed, employing, sometimes, misadjusted composition of standard surgical packages and non-optimized grouping of surgical instruments. Problem consequences are, among others, high transport of various surgical cases packages; high number of open cases and delays in surgical times following surgery. These type of problems are waste that do not add value to the service in the context of Lean Healthcare and must be eliminated using the most suitable tools. After the analysis, different tools were used: combinatorial analysis to optimize surgical cases composition and statistical analysis to identify the instruments usage and surgical basic case patterns. An optimization model was developed which produced a sterilizing initial solution of 135.24€. By identifying the most commonly employed instruments, it was concluded that some instruments have never been used and others rarely and some patterns were identified. The results achieved were based on minor sample and in a form of data collection that needs some adjustment

How repetitive are genomes?

BACKGROUND: Genome sequences vary strongly in their repetitiveness and the causes for this are still debated. Here we propose a novel measure of genome repetitiveness, the index of repetitiveness, I(r), which can be computed in time proportional to the length of the sequences analyzed. We apply it to 336 genomes from all three domains of life. RESULTS: The expected value of I(r )is zero for random sequences of any G/C content and greater than zero for sequences with excess repeats. We find that the I(r )of archaea is significantly smaller than that of eubacteria, which in turn is smaller than that of eukaryotes. Mouse chromosomes have a significantly higher I(r )than human chromosomes and within each genome the Y chromosome is most repetitive. A sliding window analysis reveals that the human HOXA cluster and two surrounding genes are characterized by local minima in I(r). A program for calculating the I(r )is freely available at . CONCLUSION: The general measure of DNA repetitiveness proposed in this paper can be efficiently computed on a genomic scale. This reveals a broad spectrum of repetitiveness among diverse genomes which agrees qualitatively with previous studies of repeat content. A sliding window analysis helps to analyze the intragenomic distribution of repeats

Spermatogonial Stem Cell Niche and Spermatogonial Stem Cell Transplantation in Zebrafish

Background Spermatogonial stem cells (SSCs) are the foundation of spermatogenesis, and reside within a specific microenvironment in the testes called “niche” which regulates stem cell properties, such as, self-renewal, pluripotency, quiescence and their ability to differentiate. Methodology/Principal Findings Here, we introduce zebrafish as a new model for the study of SSCs in vertebrates. Using 5′-bromo-2′-deoxyuridine (BrdU), we identified long term BrdU-retaining germ cells, type A undifferentiated spermatogonia as putative stem cells in zebrafish testes. Similar to rodents, these cells were preferentially located near the interstitium, suggesting that the SSC niche is related to interstitial elements and might be conserved across vertebrates. This localization was also confirmed by analyzing the topographical distribution of type A undifferentiated spermatogonia in normal, vasa::egfp and fli::egfp zebrafish testes. In the latter one, the topographical arrangement suggested that the vasculature is important for the SSC niche, perhaps as a supplier of nutrients, oxygen and/or signaling molecules. We also developed an SSC transplantation technique for both male and female recipients as an assay to evaluate the presence, biological activity, and plasticity of the SSC candidates in zebrafish. Conclusions/Significance We demonstrated donor-derived spermato- and oogenesis in male and female recipients, respectively, indicating the stemness of type A undifferentiated spermatogonia and their plasticity when placed into an environment different from their original niche. Similar to other vertebrates, the transplantation efficiency was low. This might be attributed to the testicular microenvironment created after busulfan depletion in the recipients, which may have caused an imbalance between factors regulating self-renewal or differentiation of the transplanted SSCs

Temporal variation in black-caiman-nest predation in varzea of central Brazilian amazonia

On the Amazon floodplain, the main predators of black caiman (Melanosuchus niger) eggs are jaguars (Panthera onca), tegu lizards (Tupinambis teguixim), capuchin monkeys (Sapajus macrocephalus) and humans (Homo sapiens). In this study, we investigated the relationship between predator attacks on nests and incubation period, and evaluated the influence of initial predation on subsequent predation in the Mamirauá Sustainable Development Reserve. We also evaluated the influence of presence of females near the nests and manipulation of nests on the occurrence of attacks. We compared results from data obtained with camera traps and vestiges left by predators on estimates of rates of predation by different predators. Egg predation was recorded in 32% of the 658 black caiman nests monitored during two years. Our results suggest that the probability of predation on black caiman eggs is relatively constant throughout the incubation period and that predation on eggs was lower when adults, presumably females, were present. Careful opening of nests and handling of eggs did not increase the number of attacks on black caiman nests. Nest opening by a predator appeared to increase the chances of a subsequent attack because most of the attacks on nests occurred soon after a predator first opened the nest. However, attacks by another species of predator do not appear to be necessary to initiate attacks by any other species of predator. Results based on camera traps and vestiges differed, but use of vestiges was adequate for identifying the principal predators on eggs in black caiman nests and, in many circumstances, the vestiges may be better for estimating predation by humans. In this study, opening nests and handling eggs did not increase the number of attacks on black caiman nests. © 2017 Torralvo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited