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GOALS The goal of this study was to evaluate the impact of inpatient outcomes of gastrointestinal bleeding (GIB) related to percutaneous coronary intervention (PCI). BACKGROUND With all-cause mortality increasing in patients undergoing PCIs, outcomes for GIB associated with PCI may be adversely impacted. STUDY Using the National Inpatient Sample (2007 to 2012), we performed a nested case-control study assessing inpatient outcomes including incidence and mortality for PCI-related GIB hospitalizations. Multivariate logistic regression analyses were performed to determine significant predictors for GIB incidence and mortality. RESULTS A total of 9332 (1.2%) of PCI hospitalizations were complicated by GIB with the age-adjusted incidence rate increasing 13% from 2007 (11.3 GIB per 1000 PCI) to 2012 (12.8). Patients ≥75 years of age experienced the steepest incline in GIB incidence, which increased 31% during the study period. Compared with non-GIB patients, mean length of stay (9.4 d vs. 3.3 d) and median cost of care ($29,236 vs. $17,913) was significantly higher. Significant demographic risk factors for GIB included older age and comorbid risk factors included gastritis or duodenitis, and Helicobacter pylori infection.In total, 1044 (11%) of GIB patients died during hospitalization with the GIB mortality rate increasing 30% from 2007 (95 deaths per 1000 GIB) to 2012 (123). Older age had the strongest association with inpatient mortality. CONCLUSIONS Inpatient incidence and mortality for PCI-related GIB has been increasing particularly with a large increase in incidence among older patients. A multidisciplinary approach focused on risk-stratifying patients may improve preventable causes of GIB.

En el proyecto investigativo se busca establecer lineamientos y plasmarlos en un programa en donde se estructure el desarrollo de actividades de alto riesgo haciendo énfasis al trabajo en alturas bajo los estándares establecidos en la resolución 1409 del 2012 “Reglamento de Seguridad para protección contra caídas en trabajo en alturas.” INTRODUCCIÓN 9 1 TÍTULO: PROPUESTA DEL DISEÑO DE UN PROGRAMA DE PREVENCIÓN Y PROTECCIÓN PARA TRABAJOS EN ALTURAS EN LA EMPRESA PREVENTION WORLD QHSE SAS 10 2 PROBLEMA DE INVESTIGACIÓN 10 21 Descripción del problema 10 22 Formulación del problema 11 23 Delimitación o alcance del problema 11 3 OBJETIVOS 13 31 Objetivo General 13 32 Objetivos específicos 13 4 JUSTIFICACIÓN Y DELIMITACIÓN 14 41 Justificación 14 42 Delimitación 15 43 Limitaciones 15 5 MARCOS DE REFERENCIA 16 51 Estado del arte 16 52 Marco teórico 20 521 Estándares para trabajo de alto de riesgo con énfasis en alturas 23 522 Auditoria interna 27 523 Métodos de prevención 29 53 Marco legal 30 5 Especialización Especialista en Gerencia de la Seguridad y Salud en el Trabajo Especialización en Gerencia de la Seguridad y Salud en el Trabajo

Magnetoencephalography (MEG) is a noninvasive neuroimaging tool that is increasingly becoming useful for presurgical delineation of epileptogenic zones and eloquent cortex in both lesional and non-lesional pediatric cases. During the past 10 yrs, the use of MEG in pediatric epilepsy research has increased. This paper starts with a review of the use of MEG in pediatric epilepsy. We then describe the protocol used for epilepsy patients at the pediatric MEG facility in Boston Children’s Hospital and present two case studies of intractable epilepsy obtained in our laboratory -cortical dysplasia and tuberous sclerosis complex -to illustrate our methodology in localizing epileptiform generators. In both cases, we are able to localize generators of interictal spikes in the irritative zone just outside the lesion. We also present results on localization of the somatosensory cortex based on our pediatric MEG system to illustrate the utility of MEG for identification of the eloquent cortex. We complete this review by considering advantages and limitations of MEG in children with epilepsy, its future developments and research applications. Application of MEG in pediatric epilepsy will accelerate during the coming years as different types of pediatric whole-head MEG systems and more advanced data analysis methods become available to the researchers and clinicians. These advances will lead to greater use of MEG as a complement to clinical electroencephalography, with improved noninvasive delineation of the epileptogenic zone.

University library administrators in Sri Lanka, realising the necessity of complying with customer perception of high quality service, have begun to search for alternative ways to satisfy their clientele on the basis of service quality. This study therefore aims to meet this need by identifying business domains in the university library setting to assess the extent to which service quality domains may be used to predict customer satisfaction, from a service quality perspective. Domain identification of service quality was carried out with a sample of 262 subjects. Accordingly, seven domains–affect of service personnel, building environment, collection and access, furniture and facilities, technology, service delivery and web services–were statistically tested to be confirmed as potential business domains of service quality. Whilst not detracting from preceding research studies conducted in the field, this study has demonstrated significant implications for researchers and library administrators in understanding the importance of individual business domains within the specific service spectrum of university libraries, in order to provide ultimate satisfaction for customers with a quality library service.

Online promotion of wine products is a new but indispensable approach in all promotional activities initiated by companies and producers of wine, whereas there is a need for a greater focus on this specific market, not separated from the real one, but a new component, increasingly prevalent. The new market, where demand is getting bigger in our country and where consumers are becoming more and more faithful to this type of promotion, is the online environment, which generated, as a response from manufacturers and distributors in almost all food industry areas, online marketing. Promoting in the virtual environment follows the same stages of development as any promoting strategy from other environments of intersection with customers: initial research, market segmentation, setting goals, market positio-ning, marketing mix, implementation of the promotional campaign itself and the implementation and post implementation control. The key features of wine products online promoting is interactivity and socialization. Internet communication occurs in two directions, unlike traditional marketing, which is unidirectional. The other characteristic of virtual promotional methods - socialization characterizes the future of cyberspace. The research purpose is not to separate the new form of promotion of other forms of nonvirtual marketing activities, but to emphasize that online marketing is the component that should not be missing from any promotional cam-paign launched by a company. The research was based on information provided by the S.C. Cotnari S.A. Department of Marketing. In order to determine the characteristics of online communication and modern promoting trends, we analyzed the website and social media accounts of this wine producer, as well as news portals and blogs. Questionnaires were applied on a sample of 133 consumers, to analyze the impact on their use of online marketing. The studied sample consisted of consumers of wine and, most of them, Internet users, from urban or rural areas. Each questionnaire contained 16 questions, with a total of 63 variables, and aimed to compare the behavior of respondents towards online promotion activity of S.C. Cotnari S.A., Iaşi county.

The 3' human telomeric overhang provides ample opportunities for the formation and interaction of G-quadruplexes, which have shown impacts on many biological functions including telomerase activities in the telomere region. However, in the few investigations on DNA constructs that approach to the full length of the human telomeric overhang, the presence of higher-order quadruplex-quadruplex interactions is still a subject of debate. Herein, we employed dynamic splint ligation (DSL) to prepare a DNA construct, 5'-(TTAGGG)24 or 24G, which has the length comparable to the full stretch of 3' human telomeric overhang. Using mechanical unfolding assays in laser tweezers, we observed a minor population (∼5%) of higher-order interactions between G-quadruplexes, while the majority of the quadruplexes follow the bead-on-a-string model. Analyses on the noninteracting G-quadruplexes in the 24G construct showed features similar to those of the stand-alone G-quadruplexes in the 5'-(TTAGGG)4 (4G) construct. As each 24G construct contains as many as six G-quadruplexes, this method offers increased throughput for the time-consuming mechanical unfolding experiments of non-B DNA structures.

Miscued communication often leads to misfolding and aggregation of the proteins involved in many diseases. Owing to the ensemble average property of conventional techniques, detailed communication diagrams are difficult to obtain. Mechanical unfolding affords an unprecedented perspective on cooperative transitions by observing a protein along a trajectory defined by two mutated cysteine residues. Nevertheless, this approach requires tedious sample preparation at the risk of altering native protein conformations. To address these issues, we applied click chemistry to tether a protein to the two dsDNA handles through primary amines in lysine residues as well as at the N terminus. As a proof of concept, we used laser tweezers to mechanically unfold and refold calmodulin along 36 trajectories, maximally allowed by this strategy in a single batch of protein preparation. Without a priori knowledge of the particular residues to which the double-stranded DNA handles attach, we used hierarchical cluster analysis to identify 20 major trajectories, according to the size and the pattern of unfolding transitions. We dissected the cooperativity into all-or-none and partially cooperative events, which represent strong and weak high-order interactions in proteins, respectively. Although the overall cooperativity is higher within the N or C lobe than that between the lobes, the all-or-none cooperativity is anisotropic among different the unfolding trajectories and becomes relatively more predominant when the size of the protein segments increases. The average cooperativity for all-or-none transitions falls within the expected range observed by ensemble techniques, which supports the hypothesis that unfolding of a free protein can be reconstituted from individual trajectories.

In investigating the binding interactions between the human telomeric RNA (TERRA) G-quadruplex (GQ) and its ligands, it was found that the small molecule carboxypyridostatin (cPDS) and the GQ-selective antibody BG4 simultaneously bind the TERRA GQ. We previously showed that the overall binding affinity of BG4 for RNA GQs is not significantly affected in the presence of cPDS. However, single-molecule mechanical unfolding experiments revealed a population (48 %) with substantially increased mechanical and thermodynamic stability. Force-jump kinetic investigations suggested competitive binding of cPDS and BG4 to the TERRA GQ. Following this, the two bound ligands slowly rearrange, thereby leading to the minor population with increased stability. Given the relevance of G-quadruplexes in the regulation of biological processes, we anticipate that the unprecedented conformational rearrangement observed in the TERRA-GQ-ligand complex may inspire new strategies for the selective stabilization of G-quadruplexes in cells.

Globalization has made a remarkable impact on the university education system, and the Internet has become the core resource for universities to make their facilities and opportunities available globally. University Web sites are increasingly used for a wide variety of purposes. The evaluation of universities based on their Web performance was introduced by Cybermetrics Lab as the "Webometric Ranking of World Universities" (WRWU), and this ranking system has become a popular way of measuring university excellence.

Non-alcoholic fatty liver disease (NAFLD), the most common cause of liver disease, affects approximately 75 to 100 million Americans. Patients with concurrent NAFLD and type 2 diabetes mellitus have a higher risk of progressing to advanced fibrosis and non-alcoholic steatohepatitis compared to non-diabetics. Lifestyle modifications, including weight loss, remain the mainstay of treatment for NAFLD, as there are no medications currently indicated for this disease state. Anti-diabetic pharmacologic therapies aimed at improving insulin sensitivity and decreasing insulin production have been studied to determine their potential role in slowing the progression of NAFLD. In this review, we focus on the evidence surrounding anti-diabetic medications and their ability to improve disease progression in patients with NAFLD.

El objetivo de la presente investigación fue determinar si los factores predisponentes se relacionan con el estado de salud mental de los pacientes de la Institución Prestadora de Servicios de Salud Indígena del Gran Cumbal: Nariño, Colombia, 2016. Se con un tipo descriptivo y asociativo; de diseño no experimental, de corte transversal en una población de 120 pacientes en una muestra censal por motivo circunstancial y cultural de la población en estudio. Los resultados demuestran que la salud mental no está en dependencia a los factores de ingreso o egreso del paciente es decir el hecho de que mantenga un elevado ingreso o mínimo; así como que su nivel de gasto sea poco o mucho no le afecta o altera su salud mental. Hallándose que no existe relación significativa de los factores predisponentes con el estado de salud mental de los pacientes de la Institución Prestadora de Servicios de Salud Indígena del Gran Cumbal: Nariños, Colombia, 2016. Se concluye que los factores estudiados no reflejan una asociación entre la salud mental de manera global por ser una variable muy amplia sin embargo al analizar cada dimensión si se observa algunas asociaciones dignas de tomarse en cuanto considerando que la salud mental crítica puede llevar a la muerte resaltando la peculiaridad de esta población indígena y recomendando que se realicen otros estudios mixtos con toda la población. Tesis LIMA Escuela de Posgrado Unidad de Salud Pública Salud mental

We developed a 375-channel, whole-head magnetoencephalography (MEG) system (“BabyMEG”) for studying the electrophysiological development of human brain during the first years of life. The helmet accommodates heads up to 95% of 36-month old boys in the USA. The unique two-layer sensor array consists of: (1) 270 magnetometers (10 mm diameter, ∼15 mm coil-to-coil spacing) in the inner layer, (2) thirty-five three-axis magnetometers (20 mm × 20 mm) in the outer layer 4 cm away from the inner layer. Additionally, there are three three-axis reference magnetometers. With the help of a remotely operated position adjustment mechanism, the sensor array can be positioned to provide a uniform short spacing (mean 8.5 mm) between the sensor array and room temperature surface of the dewar. The sensors are connected to superconducting quantum interference devices (SQUIDs) operating at 4.2 K with median sensitivity levels of 7.5 fT/√Hz for the inner and 4 fT/√Hz for the outer layer sensors. SQUID outputs are digitized by a 24-bit acquisition system. A closed-cycle helium recycler provides maintenance-free continuous operation, eliminating the need for helium, with no interruption needed during MEG measurements. BabyMEG with the recycler has been fully operational from March, 2015. Ongoing spontaneous brain activity can be monitored in real time without interference from external magnetic noise sources including the recycler, using a combination of a lightly shielded two-layer magnetically shielded room, an external active shielding, a signal-space projection method, and a synthetic gradiometer approach. Evoked responses in the cortex can be clearly detected without averaging. These new design features and capabilities represent several advances in MEG, increasing the utility of this technique in basic neuroscience as well as in clinical research and patient studies.

A new approach to the synthesis and 1,3-dipolar cycloadditions of nitrones has been described from 2,3-dihydro-4H-pyran and various hydroxylamines, with electron-deficient alkynes for the synthesis of isoxazoline derivatives. Significant rate acceleration and improved yields of exclusively exo isoxazolines in 1-butyl-3-methylimidazolium based ionic liquids have been observed. Novel isoxazolines may be used as a precursor for the synthesis of variety of peptides.

Recent experiments provided controversial observations that either parallel or non-parallel G-quadruplex exists in molecularly crowded buffers that mimic cellular environment. Here, we used laser tweezers to mechanically unfold structures in a human telomeric DNA fragment, 5′-(TTAGGG)4TTA, along three different trajectories. After the end-to-end distance of each unfolding geometry was measured, it was compared with PDB structures to identify the best-matching G-quadruplex conformation. This method is well-suited to identify biomolecular structures in complex settings not amenable to conventional approaches, such as in a solution with mixed species or at physiologically significant concentrations. With this approach, we found that parallel G-quadruplex coexists with non-parallel species (1:1 ratio) in crowded buffers with dehydrating cosolutes [40% w/v dimethyl sulfoxide (DMSO) or acetonitrile (ACN)]. In crowded solutions with steric cosolutes [40% w/v bovine serum albumin (BSA)], the parallel G-quadruplex constitutes only 10% of the population. This difference unequivocally supports the notion that dehydration promotes the formation of parallel G-quadruplexes. Compared with DNA hairpins that have decreased unfolding forces in crowded (9 pN) versus diluted (15 pN) buffers, those of G-quadruplexes remain the same (20 pN). Such a result implies that in a cellular environment, DNA G-quadruplexes, instead of hairpins, can stop DNA/RNA polymerases with stall forces often

There is a trend in universities to utilize e-learning to improve the quality of learning activities of campus based students. The objective of the study was to find out the IT students’ perceptions towards e-learning. The population of the study consisted of five hundred and twenty five students. Stratified random sampling was used to select the sample elements from the study population. A questionnaire was administered to two hundred and twenty six students. A total of hundred and fourty five complete questionnaires were selected for the analysis. More fourth year students are uncertain on the helpfulness of the course management systems in improving exam results. More students who use computer facilities only at the University and students who do not have a computer have negative perception on their ability to learn in an elearning environment, usefulness of online resources for learning and the availability of opportunities to share and discuss subject matters with other students. Journal of the University Librarians Association, Sri Lanka, Vol. 16, Issue 2, July 2012, Page 160-178 DOI: http://dx.doi.org/10.4038/jula.v16i2.5206

In projects, a strategic component is to identify all risks that might influence their success, prevent and manage them effectively. Risk management is essential to add value to an investment and improve results. With the economic and financial crisis in recent years, increasingly, more companies have realized the importance of using a system of risk management, given the multitude of variables that can influence the success of a project. These include: legislative changes, global political and economic instability, natural disasters, climate change, human resources, liquidity risk, environmental impact, risk of erroneous calculation of total project costs, risk of failure into initial project schedule, prolongation risk, the risk of failure of internal rate of return (IRR) and net present value (NPV) etc. The study proposes a new method of risk assessment and management in the investments projects with environmental impact and its application in a case study. The method will take into consideration besides the economic and financial indicators, hard to be understood by smaller investors, a set of simple and important questions that they have to analyze before deciding to start an investment project. The new methodology will have a comprehensive approach from identifying the investment opportunity, writing investment project until its implementation. This will take into account macroeconomic variables and the microeconomic environment that can influence the success of project implementation. The main advantage of applying the new methodology are: knowing all the variables that influence the success of a project realization; awareness of the importance of applying an effective risks management related to investment projects with environmental impact, increasing the quality and success of projects.

Microwave-induced 1,3-dipolar cycloaddition reactions of dihydropyran derived nitrone with various activated alkenes have been studied in situ and found to afford new isoxazolidine derivatives with moderate selectivity.

Continuous improvement of customer (user) service is essential to successful development of business in today’s highly competitive, dynamic and complex business environment. There is no exception from it for philanthropic areas including libraries. Thus, this paper reviews the existing literature related to customer satisfaction in relation to service quality to identify the research issues and implications to establish further research avenues in the field. The study revealed that there is a consensus among service marketing researchers on the causal sequence/order of the concepts of customer satisfaction and service quality. Through conceptual improvement and empirical findings of past studies, most researchers have concurred on the fact that quality judgments cause satisfaction, leading to the finding on service quality being the antecedent of customer satisfaction. The formation of satisfaction in relation to service quality is generally based upon some significant theories identified in the literature and it recognised two dominant theoretical paradigms, disconfirmation and performance-only, which can be duly used for modelling customer satisfaction through the service quality perspective in organisations, enabling them to perform possible customer-led service quality evaluations. Secondly, the review more closely examined the potentiality of the prevalent service quality and customer satisfaction models which have been applied in the field of library and information services, such as SERVQUAL, SERVPREF and LibQUAL, understand the customer satisfaction process in the context of service quality. These models were, however, not adequately qualified to confirm their strong applicability for the modelling of the satisfaction process in libraries. Finally, the review concluded with fourteen research issues and their implications relating to library services in demonstrating the void of the prevailing body of knowledge, for new research avenues. Keywords: Customer satisfaction; User satisfaction; Service quality; User services; Library marketing; User modelling DOI: http://dx.doi.org/10.4038/jula.v15i1.3188 Journal of the University Librarians’ Association of Sri Lanka, Vol.15, Issue 1, June 2011; 23-82

The research method used for obtaining some functional poultry aliments will be made of: identification of sources for raw materials and additional, which can offer the quality of functional aliments for finite poultry products, determination of sensorial, physics and chemistry, micro-biological and nutritive characteristics, making of new technological recipes which should contain nutritive elements with a determinative role in controlling the human metabolism, testing the new products on variable periods of time, at refrigeration and frozen temperatures, in order to be stored and kept in proper conditions, testing the recipes from a sensorial point of view by comparing with the qualitative standards valid for the presented qualitative characteristics and watching of qualitative losses according to the storage conditions of products stored by freezing, analyze and their interpretation. In order to measure and evaluate the qualitative characteristics of raw materials and of finite products we will develop our own processes of testing in research activity.

Access to fresh international research is a prerequisite for meaningful research endeavor. With the objective of providing online scholarly information, the e-Information service was established in 2003 and it was quickly became the hart of the library services and a catalyst for change and collaboration. The e-Information service of the University of Colombo's leading edge resource based teaching and learning facility, provides a collaborative interdisciplinary environment where campus wide access is granted. Identification of CSFs and degree of user satisfaction towards the e-Information service were the objectives of this study. The method of collecting data was informal discussions with 10 postgraduate students, 05 undergraduate students and 8 lecturers who were familiar with using e-resources and where comfortable using IT in FGS, Education, Arts and Science faculties. Physical observations in e-Resource centers were also made. The data collection was preliminary focused on four key areas namely Infrastructure, Support, Resources and Patrons. Conducting e-Information Literacy Development Programmes, enhancing resource sharing activities, strengthening e-information acquisition and delivery procedures were important suggestions.DOI: http://dx.doi.org/10.4038/sllim.v2i2.441 Sri Lankan Journal of Librarianship and Information Management Volume 2, No.2 pp. 1-12 The full text of this article is available on the NILIS website.

It is well known that the conventional fuels are responsible for environmental pollution. On the other hand, the unconventional sources for energy and biofuels are more environmentally friendly with a lower pollution degree than the conventional ones. Following the European Union Directive 2003/30/EC regarding the use of biodiesel in mixture with conventional diesel and its gradual replacement, Romania has either to produce its own percentage of biodiesel for the mixture or to import it. In this paper, the authors intend to present the history of biodiesel production, and the future potential of biodiesel production in Romania, especially in the Northeast Region. The analysis covers economic, social, and pedo-climatic conditions for raw material crops for biodiesel production. Also in this paper are presented the main vegetable sources for biodiesel production and the most representative factories of biodiesel in Romania. The study is made from 2004 until present, the results have been presented by relevant graphics and tables.

This paper reviews the prevailing literature on Knowledge Management in banking industries. The purpose of KM is to value to information resides in organizations resulting value addition to their tasks and ultimately to approach competitive advantage. Most common KM applications identified in the banking industries are risk management. Customer Relationship Management/Marketing (CRM), performance evaluation etc, Decision Support Systems (DSS), data where houses and data mining are rapidly growing techniques in this particular sector. However, most banks around the world do not use comprehensive knowledge management systems while other financial organizations in the same disciplines do. Keywords: Knowledge Management, Ban king Industries, Information Management doi: 10.4038/jula.v12i0.329 Journal of the University Librarians Association of Sri Lanka (Vol. 12) 2008 p.68-84

The separate arrangement of target recognition and signal transduction in conventional biosensors often compromises the real-time response and can introduce additional noise. To address these issues, we combined analyte recognition and signal reporting by mechanochemical coupling in a single-molecule DNA template. We incorporated a DNA hairpin as a mechanophore in the template, which, under a specific force, undergoes stochastic transitions between folded and unfolded hairpin structures (mechanoescence). Reminiscent of a tuning fork that vibrates at a fixed frequency, the device was classified as a molecular tuning fork (MTF). By monitoring the lifetime of the folded and unfolded hairpins with equal populations, we were able to differentiate between the mono- and bivalent binding modes during individual antibody-antigen binding events. We anticipate these mechanospectroscopic concepts and methods will be instrumental for the development of novel bioanalyses.

Disturbances of the autonomic nervous system (ANS) are common in neuropsychiatric disorders. Disease specific alterations of both sympathetic and parasympathetic activity can be assessed by heart rate variability (HRV), whereas electrodermal activity (EDA) can assess sympathetic activity. In posttraumatic stress disorder (PTSD), parasympathetic HRV parameters are typically decreased and EDA is increased, whereas in major depressive disorder (MDD) and dissociation, both parasympathetic and sympathetic markers are decreased. ANS abnormalities have also been identified in psychogenic nonepileptic seizures (PNES) by using HRV, indicating lower parasympathetic activity at baseline. In addition to reviewing the current literature on ANS abnormalities in PTSD, MDD, and disorders with prominent dissociation, including borderline personality disorder (BPD), this article also presents data from a pilot study on EDA in patients with PNES. Eleven patients with PNES, during an admission to our epilepsy monitoring unit (EMU), were compared with 9 with generalized tonic-clonic seizures (GTCS). The area under the EDA curve, the number of EDA responses lasting longer than 2 seconds, and the number of EDA surges during sleep (sympathetic sleep storms) were calculated on ictal and interictal days by an automated algorithm. EDA changes in PNES patients did not follow a systematic pattern of sympathetic hyperarousal (like EDA after GTCS) but were more variable. How specific PNES semiologies, and/or underlying neuropsychiatric disorders, may influence ictal and interictal EDA patterns, and lead to a novel diagnostic biomarker remains to be evaluated in future larger studies.