First nosocomial outbreak of SME-4-producing Serratia marcescens in South America / Primer brote nosocomial por Serratia marcescens productora de SME-4en Sudamérica

Abstract Carbapenemase-producing-Serratia marcescens isolates, although infrequent, are considered important nosocomial pathogens due to their intrinsic resistance to polymyxins, which limits therapeutic options. We describe a nosocomial outbreak of SME-4-producing S. marcescens in Buenos Aires city which, in our knowledge, represents the first one in South America.

Resumen Los aislamientos de origen nosocomial de Serratia marcescens productores de car-bapenemasa, si bien son infrecuentes, son considerados importantes patógenos debido a su resistencia intrínseca a las polimixinas, lo cual limita aún más las opciones terapéuticas. En este trabajo se describe un brote nosocomial causado por S. marcescens portadora de car-bapenemasa de tipo SME-4 en la Ciudad de Buenos Aires, el cual representaría el primero en Sudamérica.

Testing Occupational Hazard Self-Evaluation Module (OHSEM) Intervention among Workers of SME (Manufacturing) in Northern Malaysia

@#Introduction: Workplace accidents have been a persistent problem in Malaysia’s manufacturing industry, particularly for small and medium-sized enterprises (SMEs). Employee behavior has been identified as a significant contributing factor to these accidents, and research has suggested that improving safety knowledge and attitudes can enhance safety behavior. Despite this, there have been no empirical intervention studies in Malaysia to investigate the effectiveness of safety intervention programs aimed at improving SME worker safety behavior. Therefore, this study aimed to assess the efficacy of the Occupational Hazard Self-Evaluation Module (OHSEM) intervention in enhancing safety knowledge, attitudes, and behavior (KAB) among SME workers in the manufacturing sector. Methods: A quasi-experimental design with control group was utilized to evaluate the effectiveness of the OHSEM intervention. The intervention was implemented over a 12-week period on production workers in the experimental group, while the control group received no intervention. A self-administered questionnaire was distributed to 88 production workers in both groups before and after the intervention to measure the improvement of safety KAB. Descriptive analysis and an independent t-test were used to analyse the data. Results: The post-test results showed that safety KAB for the control group was moderate (mean = 2.11), while the mean score in the experimental group was high (m=4.17). Furthermore, the t-test result revealed a significant difference in safety KAB mean scores between the experimental and control groups. Conclusion: This study provides empirical evidence on the effectiveness of the OHSEM intervention in enhancing safety KAB in SMEs in the Malaysian SME (manufacturing) sector.

La relación entre la calidad en el servicio, satisfacción del cliente y lealtad del cliente: un estudio de caso de una empresa comercial en México / The relationship between service quality, customer satisfaction, and customer loyalty: A case study of a trading company in Mexico

Resumen La calidad en el servicio se considera una alternativa para que las empresas puedan obtener una ventaja competitiva y sostenible en un entorno económico globalizado. Las pequeñas y medianas empresas deben ofrecer una mayor calidad en el servicio que las empresas grandes, y así obtener la preferencia de los clientes. El objetivo de este estudio fue identificar la relación entre la variable calidad en el servicio y las variables satisfacción del cliente y lealtad del cliente. Se utilizó el coeficiente de correlación de Spearman y un método estadístico basado en análisis factorial exploratorio que apunta a extraer la varianza máxima del conjunto de datos dentro de cada factor. Los resultados permitieron observar una correlación altamente significativa, positiva y fuerte de la variable de calidad en el servicio con satisfacción del cliente (r = 0.820) y lealtad del cliente (r = 0.803). Un hallazgo importante también fue la asociación entre la dimensión aspectos tangibles con las variables satisfacción del cliente (r = 0.910) y lealtad del cliente (r = 0.919). Por otro lado, en el análisis factorial, a través de la varianza total explicada, se observó que el autovalor es superior a 1 en los cinco primeros casos, donde el porcentaje de la varianza alcanza un valor máximo de 54.886 % en su primer factor. Entonces, con cinco factores se consigue explicar un 73.713 % de la varianza de todos los datos originales. El estudio presentó la limitación de su aplicación en solo una empresa. Se confirmó que a través de una mejor atención y servicio al cliente, la calidad en el servicio constituye una excelente herramienta para la rentabilidad y sostenibilidad de la empresa.

Abstract Service quality is considered an alternative for companies to obtain a competitive and sustainable advantage in a globalized economic environment. Small and medium-sized enterprises must offer a higher quality of service than large companies, and thus obtain customer preference. The objective of this study was to identify the relationship between service quality variable and the customer satisfaction and customer loyalty variables. Spearman's correlation coefficient was used, and a statistical method based on exploratory factor analysis, aiming to extract the maximum variance of the data set within each factor. The results allowed observing a highly significant, positive, and strong correlation, with values of r = 0.820 and r = 0.803, between the variables of service quality, customer satisfaction, and customer loyalty. An important finding was the association between the tangible aspects dimension with the customer satisfaction and customer loyalty variables, with values of r = 0.910 and r = 0.919, respectively. On the other hand, in the factor analysis, through the explained total variance, it was observed that the eigenvalue is greater than 1 in the first five cases, where the percentage of the variance reaches a maximum value of 54.886 % in its first factor. Then, with five factors, 73.713 % of the variance of all the original data is explained. The study presented the limitation of its application in only one company. It was confirmed that, through better customer care and service, service quality constitutes an excellent tool for the profitability and sustainability of the organization.

Determinando los factores del capital relacional en la interacción de cliente proveedor en MiPyMES

El objetivo de esta investigación ha sido determinar y analizar los factores que caracterizan el capital relacional en la interacción cliente-proveedor en pequeñas y medianas empresas en una región específica de México. Con fundamento en la revisión de literatura se identifican las perspectivas de análisis de la variable de capital relacional en el trato con los proveedores. Se desarrolló y aplicó un cuestionario para recabar datos en 258 micro, pequeñas y medianas empresas (MiPyMES) del noreste de México. Se utilizó la técnica de análisis factorial exploratorio para la determinación de los factores que mejor reflejan la estructura subyacente de las variables de estudio. Se obtuvieron tres dimensiones importantes mediante lo cual se puede afirmar que la comunicación y el compromiso, la integración y la socialización son los factores que caracterizan la relación cliente - proveedor en las micro, pequeñas y medianas empresas estudiadas.

The objective of this research was to determine and analyze factors that characterize relational capital in the supplier customer interaction in small and medium enterprises in a specific region of Mexico. Based on the literature review, the prospects for analysis of relational capital variable in dealing with suppliers are identified. It was developed and applied a questionnaire to collect data on 258 small and medium enterprises (SME's) in northeastern Mexico. The exploratory factor analysis technique for the determination of the factors that better reflect the underlying structure of the study variables was used. Three important dimensions by which we can say that communication and engagement, integration and socialization are the factors that characterize the client relationship were obtained related to the SME's studied.

O objetivo desta pesquisa foi determinar e analisar os fatores que caracterizam o capital relacional na interação cliente-fornecedor em pequenas e médias empresas em uma região específica do México. Com base na literatura de análise de revisão perspectivas de capital variável relacional em lidar com fornecedores são identificados. Foi desenvolvido e aplicado um questionário para coletar dados sobre 258 micro, pequenas e médias empresas (MPMEs) no nordeste do México. foi utilizada a técnica de análise fatorial exploratória para a determinação dos fatores que melhor refletem a estrutura subjacente das variáveis do estudo. fornecedor por micro, pequenas e médias empresas estudadas - três dimensões importantes pelos quais podemos dizer que a comunicação e engajamento, integração e socialização são os fatores que caracterizam o relacionamento com o cliente é obtido.

Prototipo de una Prótesis Mioeléctrica para la Emulación de una Articulación de Codo / Prototype of a Myoelectric Prosthesis for the Emulation of an Elbow Joint

En este trabajo se describe el desarrollo de un prototipo de prótesis mioeléctrica para la articulación de codo. Se dividió en tres partes, en la primera se describe el acondicionamiento de la señal mioeléctrica (SME) donde se propuso un circuito que está formado por una etapa de pre-amplificación, seguida de una etapa de filtrado, otra etapa de amplificación y por último la etapa de rectificación. Este circuito cumple con las especificaciones para la detección de la SME según el estado del arte. En la segunda parte se describe el procesamiento de la SME basado en el método TKEO, este se implementó en MatLAB (MathWorks- Natick, Massachusetts, USA) con la finalidad de detectar la actividad muscular, y resultó robusto y eficiente. La tercera parte se enfoca al diseño y construcción del prototipo, para el sistema de transmisión se usó un par de engranes y para el sistema de actuación los actuadores eléctricos; ambos se definieron según los criterios que se describen en este trabajo. Finalmente, se integraron las tres partes para la emulación de los movimientos flexión y extension del prototipo, haciendo uso del microprocesador (Arduino UNO) y del módulo de control de motores (Controlador de servo 1350 de Pololu).

In this paper the development of a prototype for a myoelectric prosthesis elbow joint is described. It is divided into three parts; the first is the conditioning of the myoelectric signal (SME) which proposed a circuit that is formed by a stage of pre-amplification, followed by a stage of filtering, another stage of amplification and finally a stage of rectification. This circuit complies with the specifications for the detection of the SME according to the state of the art. The second part is the processing of the SME based on the method TKEO, this was implemented in MatLAB (MathWorks - Natick, Massachusetts, USA) in order to detect if the muscle is active or not, and proved to be robust and efficient. The third part focuses on the design and realization of the prototype, in the system of transmission was used a couple of gears and for the system of actuation were electrical actuators; both were defined considering several criteria referred to in this work. Finally, the three parts were joined for the emulation of flexion and extension movements of the prototype, using the microprocessor (Arduino UNO) and control module (controller servo Pololu 1350).

Impacto do rastreamento do câncer do colo do útero na prevalência de resultados citológicos / Impact of cervical cytology screening on the prevalence of cervical cytological results

Introdução: O exame citológico ainda é o método de rastreamento mais utilizado para a prevenção do câncer do colo do útero. Apesar da sua alta eficiência na prevenção do carcinoma escamoso invasivo, esses benefícios não são tão claros para as lesões escamosas em mulheres jovens e para o adenocarcinoma invasivo. Além disso, esse efeito protetor varia de acordo com o intervalo de realização dos controles. Uma vez que o teste de HPV não é recomendado para mulheres com menos de 30 anos de idade, a avaliação cuidadosa do desempenho do rastreamento neste grupo etário pode auxiliar os médicos a selecionar criteriosamente aquelas que irão ser encaminhadas para prosseguimento diagnóstico. OBJETIVO: Avaliar o impacto do rastreamento do câncer do colo do útero na prevalência dos resultados citológicos em função da idade da mulher e do intervalo entre os controles. MÉTODOS: Foi analisado o banco de dados de um laboratório central de citopatologia. O estudo incluiu 2.002.472 testes obtidos de mulheres previamente rastreadas e 217.826 testes obtidos de mulheres não previamente rastreadas. A Razão de Prevalência (RP) com um intervalo de confiança de 95% foi calculada para os resultados de testes de mulheres rastreadas em relação aos testes de mulheres não rastreadas, em função da idade. O laboratório utiliza o Sistema de Bethesda desde 1998, mas ainda subdivide o resultado Lesão Intraepitelial de Alto Grau (HSIL) em dois níveis: HSIL-CIN 2 e HSIL-CIN 3. RESULTADOS Para HSIL, a RP dos testes de mulheres rastreadas em relação aos testes de mulheres não rastreadas foi de 0,97 (0,83-1,13) em mulheres abaixo de 20 anos e 0,99 (0,86-1,14) para mulheres entre 20 e 24 anos, diminuindo significativamente em mulheres entre 25 e 29 anos (RP 0,63, 0,52-0,76)...

Background Cervical cytology still is the cervical cancer screening test for women more used. Even though there is no doubt about the impact of cytology screening on invasive squamous cervical cancer, this issue is not as clear for squamous lesions on young women and for invasive adenocarcinoma. Moreover this protective effect varies according to interval tests. HPV testing is not recommended for women under age 30, and the carefully analysis of the performance of screening on this age group can help physicians to qualify their approach. OBJECTIVE To evaluate the impact of cervical cytology screening on the prevalence of cervical cytological results in women, as a function of age and the interval between tests. METHODS A central cytopathology laboratory database for cervical screening was analyzed. It included cytology screening data of 2.002.472 tests obtained from previously screened women and 217.826 tests from unscreened women. A prevalence ratio (PR) with a 95% confidence interval for screened women was calculated, in relation to unscreened women, as a function of age. The laboratory has been using the Bethesda System since 1998, but maintain the sub-categorization of HSIL in two levels: HSIL-CIN 2 and HSIL-CIN 3. RESULTS For high-grade squamous intraepithelial lesion (HSIL), the PR was 0.97 (0.83-1.13) for women aged 20 or younger and 0.99 (0.86-1.14) for women aged 20-24 years, decreasing significantly in women aged 25-29 years (PR 0.63, 0.52-0.76). The PR for squamous cell carcinoma (SCC), adenocarcinoma in situ (AIS) and invasive adenocarcinoma showed a significant reduction in all age groups over 30 years. For the age group ranging from 30-59 years, protection conferred by screening for SCC, AIS and invasive adenocarcinoma was 83% or higher for screening intervals ranging from 1-5 years. For 5-year intervals or longer, the protective effect offered for SCC was 50%...

The detection of anticoagulant function in Kazakh women before and after delivery and clinical significance / 中国医师杂志

Objective To investigate the anticoagulant factors that Kazakh women are prone to develop deep vein thrombosis before or after delivery.MethodsThe protein C,protein S,antithrombin Ⅲ (AT-Ⅲ) activity,activated protein C resistance ratio (APCR) of 36 Kazakh women cases and 39 Hans women cases before and after delivery were determined.ResultsThe protein S (43.13±11.36,58.05±17.10) was significant changed (P＜0.01)in Kazakh women before and after delivery.The protein C (97.34±18.37,118.02±23.46) and protein S (58.05±17.10,67.97±19.22) were statistically different between Kazakh women and Han women after delivery(P＜0.05,which protein C was P＜0.01).The anticoagulant indexes of Kazak women after delivery was still within normal range.ConclusionsNormal women have prothrombotic state before and after delivery,especially the Kazakh women.It may be an important factor of deep vein thrombosis-prone before and after delivery that protein C and protein S in Kazakh women have lower activity than that in Han women.The detection of anti-coagulation have some clinical significance on the prevention of the deep vein thrombosis in Kazakh women before and after delivery.

Condução de ações em Saúde e Segurança do Trabalho em pequenas e médias empresas: análise de três casos / Three case studies on Health and Safety actions in small and medium size enterprises

Construir ações relacionadas à saúde e segurança nas Pequenas e Médias Empresas (PME) não é tarefa fácil, uma vez que essas empresas precisam lidar com o provimento deficitário de informações, poucos recursos disponíveis e metodologias de ação desenvolvidas de acordo com as características das empresas de grande porte. Partindo de estudos de caso e de metodologia qualitativa, o presente estudo teve como objetivo investigar, em três PME do setor industrial, a maneira como ações de saúde e segurança são conduzidas inclusive ações ergonômicas, bem como as justificativas para sua forma de condução,utilizando, para tanto, entrevistas e questionários. A investigação comprovou que aspectos, tais como poucos recursos financeiros, pouco acesso à informação, cultura e o modelo gerencial assumido, exercem grande influência sobre a forma como as ações em Saúde e Segurança do Trabalho (SST) serão conduzidas, sendo que a Ergonomia, quando houver, será caracterizada pela condução perceptiva e informal das mudanças no local de trabalho. Concluiu-se que algumas normas e leis, assim como ferramentas ergonômicas, deveriam ser desenvolvidas e adaptadas às PME. Moldar as ações segundo as necessidades e limitações de cada empresa poderia facilitar sua utilização e assim promover uma melhora das condições de saúde e segurança nas PME.

Building actions related to health and safety in small and medium sizeenterprises (SME) is not an easy task, since these companies need to face lack of information, short availability of resources and methodologies developed for the characteristics of a big company. Based on case study techniques and a qualitative approach, the present study aims at investigating, through interviews and questionnaires, not only the way health and safety interventions including ergonomics - are carried on in three industrial sector SMEs, but also the reasons for their being conducted that way. This investigation led us to conclude that short resource availability, difficulty in accessing information, the company phylosophy and managerial model, greatly influence the way Health and Safety (OSH) actions are conducted in small companies; and changes on work place, if Ergonomics is considered, will be guided by perception and based on informality. The authors conclude that laws, regulations and ergonomic tools to fit SMEs should be created. Adapting these actions accordingly to the needs and limitations of each company would probably make them easier to be followed and, as a consequence, would improve health and safety at SMEs.