Ejaculation-sparing thulium laser enucleation of the prostate (ES-ThuLEP): outcomes on a large cohort

Purpose: To assess the effects of a new ejaculation-sparing thulium laser enucleation of the prostate (ES-ThuLEP) technique on sexual functions and micturition, in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH) and to evaluate how the surgical technique of ES-ThuLEP can lead to ejaculation preservation. Methods: A prospective study was carried out between January 2015 and January 2018 on patients with surgical indication for BPH, who wished to preserve ejaculation. The patients were treated with ES-ThuLEP and were evaluated before and 3 and 6 months after surgery. Three validated questionnaires (ICIQ-MLUTSsex, IIEF-5 and IPSS) were used to assess changes in ejaculation, erectile function and urinary symptoms. Uroflowmetry (Qmax and Qavg), post-void residual volume and voided volume were also evaluated, to assess micturition improvement. Patients with moderate to severe erectile dysfunction were excluded. Statistical analysis was performed with the Student\u2019s t test, Chi-square test and logistic regression analysis. Results: Two hundred and eighty three patients were enrolled. Ejaculation was spared in 203 and 219 patients at 3 and 6 months after surgery. No significant differences were observed between erectile function before and after surgery: baseline IIEF-5 = 16.2 \ub1 4.47 vs 16.7 \ub1 2.9 (p = 0.419) and 17.7 \ub1 3.2 (p = 0.410) at 3 and 6 months. Significant improvement in urinary symptoms was achieved: baseline IPSS = 19.4 \ub1 7.24 vs 5.8 \ub1 4.3 (p = 0.032) and 3.9 \ub1 4.1 (p = 0.029) at 3 and 6 months. Conclusion: ES-ThuLEP effectively preserved ejaculation in over two thirds of the patients without compromising micturition improvement or erectile function. ES-ThuLEP could be a valid treatment option for BPH in young and sexually active men

The institutional shaping of management: in the tracks of English individualism

Globalisation raises important questions about the shaping of economic action by cultural factors. This article explores the formation of what is seen by some as a prime influence on the formation of British management: individualism. Drawing on a range of historical sources, it argues for a comparative approach. In this case, the primary comparison drawn is between England and Scotland. The contention is that there is a systemic approach to authority in Scotland that can be contrasted to a personal approach in England. An examination of the careers of a number of Scottish pioneers of management suggests the roots of this systemic approach in practices of church governance. Ultimately this systemic approach was to take a secondary role to the personal approach engendered by institutions like the universities of Oxford and Cambridge, but it found more success in the different institutional context of the USA. The complexities of dealing with historical evidence are stressed, as is the value of taking a comparative approach. In this case this indicates a need to take religious practice as seriously as religious belief as a source of transferable practice. The article suggests that management should not be seen as a simple response to economic imperatives, but as shaped by the social and cultural context from which it emerges

In vitro production of anti-RBC antibodies and cytokines in chronic lymphocytic leukemia

B-chronic lymphocytic leukemia (B-CLL) patients have a high prevalence of autoimmune phenomena, mainly autoimmune hemolytic anemia (AIHA). Immunoregulatory cytokines play a role in the regulation of both autoimmunity and leukemic B-cell growth. Mitogen-stimulated direct antiglobulin test (MS-DAT) is a recently described test able to disclose latent anti-RBC autoimmunity in AIHA. We investigated the prevalence of anti-RBC autoimmunity by MS-DAT and the pattern of cytokine production by PHA-stimulated whole blood cultures from 69 B-CLL patients and 53 controls. Results showed that anti-RBC IgG values in unstimulated, PHA-, PMA-, and PWM-stimulated cultures were significantly higher in B-CLL patients compared with controls. In B-CLL, the prevalence of anti-RBC autoimmunity was 28.9% by MS-DAT, compared with 4.3% by the standard DAT. Production of IFN-gamma, IL-2, IL-13, TNF-alpha, sCD23, and sCD30 was significantly increased in all B-CLL patients compared with controls, whereas there was no difference in IL-4, IL-6, IL-10, and TGF-beta production. Multivariate analysis showed that IL-4 was significantly increased in MS-DAT-positive compared with -negative patients. Patients with autoantibody positivity displayed greater IFN-gamma production than negative patients. These data are in line with the hypothesis that autoimmune phenomena in B-CLL are associated with an imbalance towards a Th-2-like profile. The elevated prevalence of anti-RBC autoimmunity found by MS-DAT suggests that an underestimated latent autoimmunity exists in B-CLL

Effect of essential oils from Eucalyptus on the growth of aflatoxigenic species

In Brazil, Eucalyptus species has been cultivated as source of energy and cellulose. They represent the most important cultivated forest in the country. In production areas, the leaves from the trees decay on the soil as green fertilizer. In this study were evaluated pure and blends of essential oils from different species of eucalyptus trees grown in Brazil for antifungal activity against aflatoxigenic species Aspergillus flavus and A. parasiticus. These fungal species can grow and contaminate grains during the storage period under high r.h. conditions, with an eventual production of aflatoxins. Antifungal activity was evaluated by the radial growth measurement of the fungi inoculated on maize meal extract agar basic medium. The eucalyptus oils were evaluated in a contact assay and a fumigant assay using pure and blended oils. Six concentrations of pure and blended oils were evaluated at the following doses: 0, 2, 4, 16, 32 and 84 μL per 20 mL of fungi culture medium. Fungal inocula from conidia suspensions containing 106 spores/mL was inoculated by a needle. Glass Petri dishes were incubated for 9 days at 28°C (± 0.3°C) in the dark. Antifungal activity was observed in all pure and blended oils, in different concentrations of contact and fumigant assay, for both fungi. Eucalyptus stageiriana oil and E. stageiriana + the hybrid E. grandis x E. urophylla oils blend controlled the total fungal growth at the lowest dose (20 μL). Keywords: Essential oil; Eucalyptus spp.; Aspergillus flavus; Aspergillus parasiticus; Antifungal activity

The use of Reamer–irrigator–aspirator in the management of long bone osteomyelitis: an update

Purpose: Reamer–irrigator–aspirator (RIA) is an innovative device that its indications have recently been expanded to the management of long bone infections. Methods: In this narrative review, we summarise the most important studies in the field and we present the current open questions pertaining to the use of RIA in the management of osteomyelitis of long bones. Results: The relevant literature is sparse and low quality. Nevertheless, the use of RIA for infected cases has yielded promising outcomes in specialised centres. Technical aspects that merit special attention in osteomyelitis of long bones are its inapplicability in small diameter long bones, the inadequate debridement of wide metaphyseal areas and the potential bleeding sequelae. The use of RIA in open fracture management to reduce infection risk has not gained acceptance. The antibiotic impregnated nails and rods constitute a complimentary strategy for the management of infections. Conclusions: The use of RIA for the management of long bone infections is an innovative and promising strategy. High quality studies are needed to shed light in its efficacy compared to conventional methods of management of osteomyelitis of long bones

Tropospheric Products from High-Level GNSS Processing in Latin America

ARTÍCULO PUBLICADO EN REVISTA EXTERNA. The present geodetic reference frame in Latin America and the Caribbean is given by a network of about 400 continuously operating GNSS stations. These stations are routinely processed by ten Analysis Centres following the guidelines and standards set up by the International Earth Rotation and Reference Systems Service (IERS) and International GNSS Service (IGS). The Analysis Centres estimate daily and weekly station positions and station zenith tropospheric path delays (ZTD) with an hourly sampling rate. This contribution presents some attempts aiming at combining the individual ZTD estimations to generate consistent troposphere solutions over the entire region and to provide reliable time series of troposphere parameters, to be used as a reference. The study covers ZTD and IWV series for a time-span of 5 years (2014–2018). In addition to the combination of the individual solutions, some advances based on the precise point positioning technique using BNC software (BKG NTRIP Client) and Bernese GNSS Software V.5.2 are presented. Results are validated using the IGS ZTD products and radiosonde IWV data. The agreement was evaluated in terms of mean bias and rms of the ZTD differences w.r.t IGS products (mean bias 1.5 mm and mean rms 6.8 mm) and w.r.t ZTD from radiosonde data (mean bias 2 mm and mean rms 7.5 mm). IWV differences w.r.t radiosonde IWV data (mean bias 0.41 kg/m2 and mean rms 3.5 kg/m2).Sitio de la revista: https://link.springer.com/chapter/10.1007/1345_2020_12

What we talk about when we talk about "global mindset": managerial cognition in multinational corporations

Recent developments in the global economy and in multinational corporations have placed significant emphasis on the cognitive orientations of managers, giving rise to a number of concepts such as “global mindset” that are presumed to be associated with the effective management of multinational corporations (MNCs). This paper reviews the literature on global mindset and clarifies some of the conceptual confusion surrounding the construct. We identify common themes across writers, suggesting that the majority of studies fall into one of three research perspectives: cultural, strategic, and multidimensional. We also identify two constructs from the social sciences that underlie the perspectives found in the literature: cosmopolitanism and cognitive complexity and use these two constructs to develop an integrative theoretical framework of global mindset. We then provide a critical assessment of the field of global mindset and suggest directions for future theoretical and empirical research

Association between psychological distress and liver disease mortality: a meta-analysis of individual study participants

Background & Aims: Risk factors for cardiovascular disease, such as obesity and hypertension, have been associated with non-alcoholic fatty liver disease. Psychological distress (symptoms of anxiety and depression) is a risk factor for cardiovascular disease, so it might also be associated, directly or indirectly, with elevated rates of liver disease. We investigated the relation of psychological distress (measured by the 12-item General Health Questionnaire; GHQ) with liver disease mortality. Methods: We performed a meta-analysis of data from individual participants in 16 prospective studies of the general population of the UK, initiated from 1994 through 2008. We categorized GHQ score into four groups: zero (no distress), 1-3, 4-6, and 7-12. Results: We used data from 166,631 individuals (55% women; age, 46.6±18.4 years; range, 16−102 years). During a mean follow-up period of 9.5 years, 17,368 participants died (457 with liver disease). We found a significant increase in risk for liver disease mortality as GHQ score increased across categories (ptrend<0.001). The age- and sex-adjusted hazard ratio for the highest GHQ category (7-12) compared to those scoring zero was 3.48 (95% confidence interval, 2.68−4.52). After adjustment for health behaviors, socioeconomic status, body mass index, and diabetes, the hazard ratio was partially attenuated to 2.59 (95% confidence interval, 1.82–3.68). Conclusions: Our novel finding that psychological distress was associated with liver disease mortality requires testing in other studies. Though results are unlikely to be causal, we provide further evidence for the deleterious effects of psychological problems on physical health