Emotions and decision-making processes in management teams: a collective level analysis / Emociones y Procesos de Toma de Decisiones en Grupos Ejecutivos: un Análisis Colectivo

Discrete emotions are rarely studied in relationship with group decision-making. Using data from 20 simulated companies run by a total of 106 managers attending executive education programs, the current research examined to what extent four classes of emotions (positive achievement, positive approach, negative resignation, and negative antagonistic) were related to team decision-making processes (alternative generation and alternative evaluation). Significant intra-class coefficients confirmed that aggregation of emotion and decision-making processes was feasible. Correlations at the collective or aggregated team level showed that approach emotions were related to alternative generation, particularly in the developing phase of a group decision-making task. Finally, a ratio of positive emotions over negative emotions correlated positively with a better team decision process. Future research extending emotion influence in decision process is suggested, and practical implications are discussed(AU)

Las emociones específicas se han estudiado poco en relación a la toma de decisiones. Utilizando los datos de 20 compañías simuladas en juego de roles por 106 directivos que asistieron a programas de formación para ejecutivos, este estudio examina en qué medida cuatro clases de emociones (positivas de logro, positivas de aproximación, negativas de resignación, y negativa de antagonismo) se asocian a procesos de toma de decisión en equipo o grupales. Coeficiente intra-clase significativos confirmaron la factibilidad de agregar en media grupales tanto las emociones como los procesos de toma de decisiones. Correlaciones colectivas o realizadas con las puntuaciones agregadas al nivel de equipo de trabajo mostraron que las emociones de aproximación se asociaban a la generación de alternativas, particularmente en la fase de desarrollo de una tarea de toma de decisiones en equipo. Finalmente, una ratio de emociones positivas sobre negativas correlacionó positivamente con un buen proceso de toma decisiones. Nuevas investigaciones ampliando el estudio de la influencia de las emociones en los procesos de decisión se plantean, así como se discuten las implicaciones prácticas del estudio(AU)

BCGosis: case report of intravesicular bacille Calmette-Guérin causing upper tract granulomas simulating a renal mass without evidence of ipsilateral vesicoureteral reflux.

Very rarely, dissemination of intravesical bacille Calmette-Guérin for superficial bladder cancer treatment can lead to a complication in the upper urinary tract. Two mechanisms for dissemination have been proposed: vesicoureteral reflux and hematogenous spread. We report a case of "BCGosis" with the clinical appearance of multifocal renal masses in a patient without ipsilateral reflux. This case highlights the importance of obtaining a renal biopsy in all patients previously treated with bacille Calmette-Guérin presenting with a renal mass. Furthermore, the findings from the present case suggest that vesicoureteral reflux might not be the only mechanism responsible for dissemination of bacille Calmette-Guérin to the upper urinary tract.

A PEDF N-terminal peptide protects the retina from ischemic injury when delivered in PLGA nanospheres.

The neuroprotective effects of small pigment epithelium-derived factor (PEDF) peptides injected intravitreally as free peptides or delivered in poly(lactide-co-glycolide) (PLGA) nanospheres, were tested in retinal ischemic injury. We induced transient ischemia in C57BL/6 mice by elevating the intraocular pressure to the equivalent of 120 mmHg for 60 min, then injected these eyes with one of the following: PBS, full-length native PEDF, N-terminal peptides-PEDF(136-155) and PEDF(82-121), blank PLGA nanospheres or PLGA loaded with PEDF(82-121) (PLGA-PEDF(82-121)). Morphometric analysis and TUNEL assays were used to determine the extent of retinal damage. Transient ischemia caused a rapid reduction in the number of viable cells in the retinal ganglion cell (RGC) layer over 48h as compared to non-ischemic retinas. About 76% surviving cells in the RGC layer were observed in the full-length PEDF protein treated group, whereas only 32% of cells survived in the PBS group. Thus, PEDF prevented approximately 44% of the cell death in the RGC layer resulting from transient ischemia. PEDF(82-121) peptide was as effective as full-length PEDF when injected as either a free peptide or delivered in PLGA nanospheres. PLGA-PEDF(82-121) showed longer-term protection of the RGC layer with no noticeable side effects at 7days. PEDF and PEDF(82-121) lessened damage to the IPL as measured by layer thickness. PEDF and PEDF(82-121) also delayed retinal responses to ischemic injury as measured by GFAP immunolabeling in Müller cells. PEDF(82-121) is an effective neuroprotective peptide in retinal ischemia. PLGA-PEDF(82-121) offers greater protection to the retina suggesting that this peptide and the method of delivering therapeutically active drugs have potential clinical advantages for longer-term treatments of retinal diseases.

Comparison of running and interrupted vesicourethral anastomoses in a porcine model.

PURPOSE: To compare running and interrupted suturing techniques for porcine vesicourethral anastomosis with regard to procedure time, histopathologic effects, and leakage. MATERIALS AND METHODS: Twelve domestic pigs were randomized to a running (N = 6) or an interrupted (N = 6) vesicourethral anastomosis with polyglycolic acid sutures. In each case, the bladder was drained for 7 days. A cystogram was performed immediately after completion of each anastomosis and on postoperative days 7 and 30. Animals were sacrificed on postoperative day 30, and the area of the anastomosis was excised en bloc for histopathologic evaluation. RESULTS: All procedures were completed laparoscopically. The mean operative time for continuous and interrupted suturing were 27.5 and 36.8 minutes, respectively (P = 0.3324). A significant learning curve was noted for both anastomoses, with operative times decreasing with experience in both groups. There was no difference in anastomotic leakage. Histopathology examination revealed more muscle-layer fibrosis in the interrupted- suture group than in the continuous-suture group, with a mean score of 2.17 and 1.67, respectively (P = 0.0325). CONCLUSIONS: Both continuous and interrupted vesicourethral anastomoses are feasible. In this in-vivo porcine comparison, there was no difference with respect to procedure time or anastomotic leakage. However, histopathologic grading demonstrated greater muscle fibrosis in the interrupted-suture group.

Single-setting bilateral laparoscopic renal surgery: assessment of single-stage procedure.

OBJECTIVES: To assess the safety and efficacy of single-setting bilateral laparoscopic renal procedures. The continued advancement of laparoscopic surgical technology and surgeon expertise has allowed increasingly technically challenging procedures to be completed laparoscopically. Little has been reported on patient outcome, morbidity, and mortality of bilateral laparoscopic single-stage procedures. METHODS: Between May 2000 and February 2004, 13 patients underwent synchronous bilateral renal surgery. Both retroperitoneal (n = 5) and transperitoneal (n = 8) approaches were used. The data were retrospectively analyzed for operative time, morbidity, mortality, and postoperative course. RESULTS: Bilateral laparoscopic procedures were successfully completed in 11 (85%) of 13 patients. One patient required conversion to an open procedure because of significant adhesions. Another patient with von Hippel-Lindau disease had unexpected extensive pathologic features in each kidney and was therefore treated in a staged fashion. The mean operative time was 5.5 hours (range 4.7 to 8.5). The mean estimated blood loss was 268 mL (range 50 to 950). Patients resumed oral intake and ambulated within 24 hours after surgery. The mean analgesic requirement was 40.5 mg MSO4 equivalents (range 2 to 178). The mean hospital stay was 3.1 days (range 1 to 6). Patients returned to partial activity within the first week and enjoyed full activity at 3 weeks. One intraoperative complication and five postoperative complications occurred in 5 patients. CONCLUSIONS: Our results have demonstrated that single-setting bilateral laparoscopic renal surgery is safe and can expedite resolution of urologic pathologic findings without increased morbidity. Bilateral single-setting laparoscopic surgery should only be performed if the primary procedure has been completed expeditiously and without complications.

Assessment of preemptive treatment to prevent severe candidiasis in critically ill surgical patients.

OBJECTIVE: To assess the efficacy of a preemptive antifungal therapy in preventing proven candidiasis in critically ill surgical patients. DESIGN: Before/after intervention study, with 2-yr prospective and 2-yr historical control cohorts. SETTING: Surgical intensive care unit (SICU) in a university-affiliated hospital. PATIENTS: Nine hundred and thirty-three patients, 478 in the prospective group and 455 in the control group, with SICU stay > or =5 days. INTERVENTIONS: During the prospective period, systematic mycological screening was performed on all patients admitted to the SICU, immediately at admittance and then weekly until discharge. A corrected colonization index was used to assess intensity of Candida mucosal colonization. Patients with corrected colonization index > or =0.4 received early preemptive antifungal therapy (fluconazole intravenously: loading dose 800 mg, then 400 mg/day for 2 wks). MEASUREMENTS AND MAIN RESULTS: End points of this study were the frequency of proven candidiasis, especially SICU-acquired candidiasis. During the retrospective period, 32 patients of 455 (7%) presented with proven candidiasis: 22 (4.8%) were imported and 10 (2.2%) were SICU-acquired cases. During the prospective period, 96 patients with corrected colonization index > or =0.4 of 478 received preemptive antifungal treatment and only 18 cases (3.8%) of proven candidiasis were diagnosed; all were imported infections. Candida infections occurred more frequently in the control cohort (7% vs. 3.8%; p = .03). Incidence of SICU-acquired proven candidiasis significantly decreased from 2.2% to 0% (p < .001, Fisher test). Incidence of proven imported candidiasis remained unchanged (4.8% vs. 3.8%; p = .42). No emergence of azole-resistant Candida species (especially Candida glabrata, Candida krusei) was noted during the prospective period. CONCLUSIONS: Targeted preemptive strategy may efficiently prevent acquisition of proven candidiasis in SICU patients. Further studies are being performed to assess cost-effectiveness of this strategy and its impact on selection of azole-resistant Candida strains on a long-term basis.

Understanding of basic mechanisms of beta-cell function and survival: prelude to new diabetes therapies.

Type 1 and type 2 diabetes are both diseases of insulin insufficiency, although they develop by distinct pathways. The recent surge in the incidence of type 2 diabetes and the chronic ailments confronted by patients with either form of the disease highlight the need for better understanding of beta-cell biology. In this review, we present recent work focused on this goal. Our hope is that basic research being conducted in this and other laboratories will ultimately contribute to the development of methods for enhancing beta-cell function and survival in the context of both major forms of diabetes. Our strategy for understanding the beta-cell involves a multidisciplinary approach in which tools from the traditional fields of biochemistry, enzymology, and physiology are teamed with newer technologies from the fields of molecular biology, gene discovery, cell and developmental biology, and biophysical chemistry. We have focused on two important aspects of beta-cell biology in our studies: beta-cell function, specifically the metabolic regulatory mechanisms involved in glucose-stimulated insulin secretion, and beta-cell resistance to immune attack, with emphasis on resistance to inflammatory cytokines and reactive oxygen species.

Discrete and complementary mechanisms of protection of beta-cells against cytokine-induced and oxidative damage achieved by bcl-2 overexpression and a cytokine selection strategy.

We have been investigating the potential utility of engineered cell lines as surrogates for primary islet cells in treatment of type 1 diabetes. To this end, two strategies that have emerged for procuring cell lines with resistance to immune-mediated damage are 1) selection of cytokine-resistant cell lines by growth of INS-1 insulinoma cells in iteratively increasing concentrations of interleukin (IL)-1beta + gamma-interferon (IFN-gamma), and 2) stable overexpression of the anti-apoptotic gene bcl-2 in INS-1 cells. Herein, we show that bcl-2-overexpressing cells are resistant to the cytotoxic effects of reactive oxygen and nitrogen species (ROS/RNS), but are only modestly protected against high concentrations of IL-1beta + INF-gamma, whereas the converse is true in cytokine selected cells. We also found that the combination of bcl-2 expression and cytokine selection confers a broader spectrum of resistance than either procedure alone, such that the resultant cells are highly resistant to cytokines and ROS/RNS, with no impairment in glucose-stimulated insulin secretion. INS-1-derived cells with combined bcl-2 expression and cytokine selection are also more resistant to damage induced by coculture with mitogen-activated peripheral blood mononuclear cells. Surprisingly, application of the cytokine selection procedure to bcl-2-overexpressing cells does not result in impairment of nuclear factor-kappaB translocation, iNOS expression, and NO production, as clearly occurs upon application of the selection procedure to cells without bcl-2 overexpression. Further investigation of the diverse pathways involved in the development of cytokine and ROS/RNS resistance may define simplified and specific strategies for preservation of beta-cell mass.