1,553 research outputs found
Medical complications associated with carotid endarterectomy
No full textBackground and purpose: Carotid endarterectomy (CE) has been shown to be beneficial in patients with symptomatic high-grade (70% to 99%) internal carotid artery stenosis. To achieve this benefit, complications must be kept to a minimum. Complications not associated with the procedure itself, but related to medical conditions, have received little attention.
Methods: Medical complications that occurred within 30 days after CE were recorded in 1415 patients with symptomatic stenosis (30% to 99%) of the internal carotid artery. They were compared with 1433 patients who received medical care alone. All patients were in the North American Symptomatic Carotid Endarterectomy Trial (NASCET).
Results: One hundred fifteen patients (8.1%) had 142 medical complications: 14 (1%) myocardial infarctions, 101 (7.1%) other cardiovascular disorders, 11 (0.8%) respiratory complications, 6 (0.4%) transient confusions, and 10 (0.7%) other complications. Of the 142 complications, 69.7% were of short duration, and only 26.8% prolonged hospitalization. Five patients died: 3 from myocardial infarction and 2 suddenly. Medically treated patients experienced similar complications with one third the frequency. Endarterectomy was approximately 1.5 times more likely to trigger medical complications in patients with a history of myocardial infarction, angina, or hypertension (P<0.05).
Conclusions: Perioperative medical complications were observed in slightly fewer than 1 of every 10 patients who underwent CE. The majority of these complications completely resolved. Most complications were cardiovascular and occurred in patients with 1 or more cardiovascular risk factors. In this selected population, the occurrence of perioperative myocardial infarction was uncommon.Background and Purpose - Carotid endarterectomy (CE) has been shown to be beneficial in patients with symptomatic high-grade (70% to 99%) internal carotid artery stenosis. To achieve this benefit, complications must be kept to a minimum. Complications not associated with the procedure itself, but related to medical conditions, have received little attention. Methods - Medical complications that occurred within 30 days after CE were recorded in 1415 patients with symptomatic stenosis (30% to 99%) of the internal carotid artery. They were compared with 1433 patients who received medical care alone. All patients were in the North American Symptomatic Carotid Endarterectomy Trial (NASCET). Results - One hundred fifteen patients (8.1%) had 142 medical complications: 14 (1%) myocardial infarctions, 101 (7.1%) other cardiovascular disorders, 11 (0.8%) respiratory complications, 6 (0.4%) transient confusions, and 10 (0.7%) other complications. Of the 142 complications, 69.7% were of short dura..
Vascular endothelial growth factor restores delayed tumor progression in tumors depleted of macrophages
No full textGenetic depletion of macrophages in Polyoma Middle T oncoprotein (PyMT)-induced mammary tumors in mice delayed the angiogenic switch and the progression to malignancy. To determine whether vascular endothelial growth factor A (VEGF-A) produced by tumor-associated macrophages regulated the onset of the angiogenic switch, a genetic approach was used to restore expression of VEGF-A into tumors at the benign stages. This stimulated formation of a high-density vessel network and in macrophage-depleted mice, was followed by accelerated tumor progression. The expression of VEGF-A led to a massive infiltration into the tumor of leukocytes that were mostly macrophages. This study suggests that macrophage-produced VEGF regulates malignant progression through stimulating tumor angiogenesis, leukocytic infiltration and tumor cell invasion
Fidelidad del cliente del Hotel JW Marriott el Convento Cusco -2020
No full textEl presente trabajo de investigación se titula “La fidelidad del cliente del hotel JW Marriott El
Convento Cusco-2020”. Teniendo en cuenta que la fidelidad del cliente es un tema que en la
hotelería es uno de los principales intereses y lo vienen desarrollando la mayoría de las cadenas
hoteleras más renombradas, como es Marriott Hotels y específicamente el hotel JW Marriott El
Convento Cusco. En el cual encontramos un problema del cual tratamos en la presente
investigación, la cual se basa en que: si el cliente no pasa satisfactoriamente las fases de
fidelización, no llega a fidelizarse completamente, ello se debe a que existen ciertos aspectos que
impiden una fidelización, es decir que pueden resquebrajar la fidelidad del cliente, por ejemplo los
inconvenientes que puede tener el cliente, ya sea previo al servicio (desde la reserva del servicio
por medio de Online Travel Agency o por otro medio), la entrega o disfrute del servicio (la estadía)
y el post servicio (después del check out del hotel). Por ello, la presente investigación tiene como
objetivo principal describir la fidelidad del cliente del hotel JW Marriott El Convento Cusco-2020.
Como también, los objetivos específicos que describen la fidelidad del cliente en cada una de las
fases de fidelización. La metodología manejada para la elaboración de la presente tesis fue de tipo
cuantitativo, el nivel es descriptivo no experimental.
Se obtuvo datos del autor (Oliver R. , 1999) sobre las fases de la fidelidad del cliente, que son
fidelidad cognitiva, fidelidad afectiva, fidelidad conativa y fidelidad de acción; las cuales se
utilizaron como dimensiones de la variable, describiendo cada una de ellas. Para describir la
fidelidad del cliente del hotel JW Marriott El Convento Cusco-2020 se realizó encuestas vía web
dada la coyuntura actual, con una muestra no probabilística de 102 personas que fueron los clientes
que voluntariamente respondieron el cuestionario.
Según los resultados obtenidos de las encuestas realizadas, se determinó que la fidelidad del cliente
del hotel JW Marriott El Convento Cusco-2020 es muy buena, al igual que sus cuatro fases de
fidelidad del cliente. Debido a que el hotel cumple con todas las expectativas que tiene el cliente y
al final genera una recompra por parte del cliente hacia el hotel JW Marriott El Convento Cusco,
dado por el cumplimiento de las cuatro fases de fidelización del cliente por lo siguiente: El cliente
es inicialmente fiel en un sentido cognitivo basado en la información y creencia que tiene el cliente,
después de las experiencias satisfactorias se genera un sentimiento de compromiso hacia el hotel
siendo fiel afectivamente, para así por medio de intenciones de comportamientos positivos por parte de asociados del hotel siendo fiel conativa, y finalmente el hotel al cumplir con todas las
expectativas del cliente y superar todos los obstáculos posibles se produce un control de la acción
que viene a ser la fidelidad de acción donde se produce la recompra del servicio del hotel JW
Marriott El Convento Cusco y retener al cliente.
Se pudo concluir que, el hotel JW Marriott El Convento Cusco es muy bueno fidelizando a sus
clientes y puede ser mejor incluso, si se siguen las propuestas planteadas. En la investigación, se
ha logrado describir cómo retener a los clientes y generar un compromiso profundo de recompra
del servicio JW Marriott El Convento Cusco por medio de las fases de fidelización.This research is titled “The costumer loyalty of the JW Marriott El Convento Cusco hotel-2020”.
We know that the loyalty in costumers is one of the most important issues for the hospitality
industry and it is been developed by most of the renowned hotel chains in the World, such as
Marriott Hotels and specifically the JW Marriott El Convento Cusco hotel. We found a problem
wich is based on the fact that: if the costumer doesn´t satisfactorily obtain the four loyalty phases,
the client will not become completely loyal to the hotel. This because there are some aspects that
don´t allow the loyalty, for example the pre service (from the reservation of the service through the
Online Travel agency or other method of reservation), the service (the stay) and the post service
(after the check out of the hotel). The main objective of this research is to describe the customer
loyalty of the JW Marriott El Convento Cusco hotel-2020. As well as, the especific objectives, that
describes the customer loyalty in each of the loyalty phases. The methodology used to prepare this
research was quantitative, and the level is descriptive, not experimental.
The data was obtained from the author (Oliver R. , 1999) that explained about the phases of
customer loyalty, which are Cognitive Loyalty, Afective loyalty, Conative loyalty and Action
loyalty; which were used as dimensions, describing each one of them. In order to describe the
costumer loyalty of the JW Marriott El Convento Cusco hotel-2020, we make the surveys via web
because of the current situation, with a non probability sample of 102 people who were the
costumers who voluntarily answered the questionnaire.
The costumer loyalty of the JW Marriott El Convento Cusco hotel -2020 was determined to be very
good, and also the phases of the customer loyalty as well. All that because the hotel meets all the
expectations that the customer has and in the end generates a repurchase by the customer from the
JW Marriott El Convento Cusco hotel, all that with the four phases of the loyalty of the client, and
we can detail that: The cliente initially gets the cognitive loyalty based in the information and
believes that the client has; after the satisfactory experiences, a feeling of commitment to the hotel
is generated, that is the afective loyalty; and for this reason through the intentions of positive
behaviors of the associates of the hotel, that is the conative loyalty; and finally when the hotel
meets all the expectations of the clients and overcoming all the possible obstacles, there is a control
of the action that comes to be the action loyalty, and the repurchase of the service of the JW Marriott
El Convento Cusco hotel occurs and retain more clients. In conclusion, the hotel JW Marriott El Convento Cusco is very good building customers loyalty
and can be better if the proposals proposed are followed. In the research, it has been possible to
describe how to retain customers and generate a deep commitment to repurchase the service of the
JW Marriott El Convento Cusco hotel through the loyalty phases
Recent advances in minimally invasive colorectal cancer surgery
No full textLaparoscopy has improved surgical treatment of various diseases due to its limited surgical trauma and has developed as an interesting therapeutic alternative for the resection of colorectal cancer. Despite numerous clinical advantages (faster recovery, less pain, fewer wound and systemic complications, faster return to work) the laparoscopic approach to colorectal cancer therapy has also resulted in unusual complications, i.e. ureteral and bladder injury which are rarely observed with open laparotomy. Moreover, pneumothorax, cardiac arrhythmia, impaired venous return, venous thrombosis as well as peripheral nerve injury have been associated with the increased intraabdominal pressure as well as patient's positioning during surgery. Furthermore, undetected small bowel injury caused by the grasping or cauterizing instruments may occur with laparoscopic surgery. In contrast to procedures performed for nonmalignant conditions, the benefits of laparoscopic resection of colorectal cancer must be weighed against the potential for poorer long-term outcomes of cancer patients that still has not been completely ruled out. In laparoscopic colorectal cancer surgery, several important cancer control issues still are being evaluated, i.e. the extent of lymph node dissection, tumor implantation at port sites, adequacy of intraperitoneal staging as well as the distance between tumor site and resection margins. For the time being it can be assumed that there is no significant difference in lymph node harvest between laparoscopic and open colorectal cancer surgery if oncological principles of resection are followed. As far as the issue of port site recurrence is concerned, it appears to be less prevalent than first thought (range 0-2.5%), and the incidence apparently corresponds with wound recurrence rates observed after open procedures. Short-term (3-5 years) survival rates have been published by a number of investigators, and survival rates after laparoscopic surgery appears to compare well with data collected after conventional surgery for colorectal cancer. However, long-term results of prospective randomized trials are not available. The data published so far indicate that the oncological results of laparoscopic surgery compare well with the results of the conventional open approach. Nonetheless, the limited information available from prospective studies leads us to propose that minimally invasive surgery for colorectal cancer surgery should only be performed within prospective trials
The impact of neutralizer-free ignition of a radio frequency ion thruster on the lifetime of the ion optics system
No full textIn the initial stage of a radio frequency ion thruster (RIT) ignition, an influx of electrons is required from an external source into the discharge chamber and ionization of the neutral gas propellant. A neutralizer-free method for Townsend breakdown discharge ignition based on Paschen's law was developed in this study. The feasibility of the ignition method was confirmed by performing thousands of ignition experiments. Metallic Molybdenum (Mo), pyrolytic graphite (PG) and Zr41.2Ti13.8Cu12.5Ni10Be22.2 alloy acceleration grids were prepared, and ignition-induced damage on the grids was investigated. A field-emission scanning electron microscope was used to inspect surface damage on the grids after multiple ignitions and to analyze the influence of the ignition method on the lifetime of the ion optical system. Grid materials for space missions that require multiple RIT ignitions (10(3)) should be high-strength blocks that are resistant to sputtering corrosion and high temperature.</p
Role of BMP3 in progression of gastric carcinoma in Chinese people
No full textAuthor contributions: Chen XR designed the study and wrote the manuscript; Wang JW performed the majority of experiments; Li X and Wang JW provided the vital reagents and analytical tools and were also involved in editing the manuscript; Zhang H and Ye ZY coordinated and provided the collection of all human materials in addition to financial support for this work
Amenouahsou et les deux Sobek de Gebelein. Prosopographie et géographie religieuse d’Jnr.ty à Jw-Mjtrwآمن-واح-سو مع المعبودين على هيئة سوبك بمنطقة الجبليْن. البروزوبوغرافيا
No full textInternational audienceتهدف هذه الدراسة إلى زيادة فهم اللقب الكهنوتي الخاص بكبير الكهنة «آمون-واح-سو» المُعاصر لفترة حُكم مرنپتاح. لقد كان الكاهن الأوّل للعديد من المعبودات التي ما زالت هويتها مجهولة حتّى الآن بسبب أسمائها، حيث استخدمت في بعض الأوقات العلامات التصويريّة فقط في كتابتها.تمّ تحديد هذه المعبودات والتعرُّف عليها بكونها: أنوبيس، وخونسو، والمعبودين على هيئة سوبك. توضّح هذه الدراسة، التي استندت على عدّة أنواع من المصادر، أنَّ مكان عبادتهم جميعًا هي منطقة الجبلين، على وجه التحديد في مدينة Swmnw سومنو (حيث مكان عبادة سوبك) و Jw-Mjtrw إو-ميترو (حيث مكان عبادة سوبك وأنوبيس وخونسو). علاوة على ذلك، يقترح المؤلف أن معبد سومنو قد تمَّ نقله في بداية عصر الدولة القديمة بسبب التغيُّرات الحادثة في مجرى النيل. قد تفسر هذه الظاهرة الجغرافيا الدينيَّة المُعقَّدة، بالإضافة إلى الصعوبات الناتجة التي تواجه الأثريّين الدارسين لهذه المعتقدات حتّى اليوم.The aim of this study is to better understand the pontifical titles of the high priest Jmn-wȝḥ-sw, contemporary of Merenptah. He was the first prophet of several deities whose identification has remained uncertain until now, since their names are sometimes written only with ideograms. First, these deities are identified as Anubis, Khonsu and “two Sobeks”. Secondly, the study, which is based on several types of sources, shows that they were all worshipped in the Gebelein region, more precisely in the cities of Swmnw (Sobek) and Jw-Mjtrw (Sobek, Anubis and Khonsu). Furthermore, the author proposes that the temple of Swmnw was moved at the beginning of the New Kingdom due to changes in the course of the Nile. This phenomenon would be at the origin of a complex religious geography, as well as the cause of difficulties for Egyptologists who study these cults until today.L’objectif de cette étude est de comprendre au mieux le titre pontifical du grand prêtre Jmn-wȝḥ-sw, contemporain de Mérenptah. Il officiait comme premier prophète de plusieurs divinités dont l’identification est restée jusqu’à présent incertaine en raison de leurs noms, parfois écrits seulement avec des idéogrammes. Ces divinités sont identifiées comme étant Anubis, Khonsou et « deux Sobek ». L’étude proposée, qui se fonde sur plusieurs types de sources, montre qu’elles recevaient toutes un culte dans la région de Gebelein, plus précisément dans les cités de Swmnw (Sobek) et Jw-Mjtrw (Sobek, Anubis et Khonsou). L’auteur envisage la possibilité que le temple de Swmnw ait été déplacé au début du Nouvel Empire à cause de changements qui auraient affecté le cours du Nil. Ce phénomène expliquerait une géographie religieuse complexe, de même que les difficultés des égyptologues à étudier ces cultes jusqu’à aujourd’hui
Correction to:Grieving the Living: The Social Death of Former Jehovah’s Witnesses (Journal of Religion and Health, (2022), 61, 3, (2458-2480), 10.1007/s10943-020-01156-8)
No full textIn the original publication of the article, the author noticed an error in abstract section. The first sentence in abstract should read, “Addressing a relative lack of research investigating the experiences of individuals who have left the Jehovah’s Witnesses (JW), this research utilizes a social identity approach to examine qualitatively, the process of transitioning towards post-JW life, experiences of ostracism and perceived threats to self-identity”. The original article has been corrected.</p
A neural network approach to real-time pattern recognition
No full textThis paper presents a new neural network approach to real-time pattern recognition on a given set of binary (or bipolar) sample patterns. The perceptive neuron of a binary pattern is defined and constructed as a binary neuron with a neighborhood perceptive field. Letting its hidden units be the respective perceptive neurons of the patterns, a three-layer forward neural network is constructed to recognize these patterns with minimum error probability in a noisy environment. The theoretical and simulation analyses show that the network is effective for pattern recognition and can be easily implemented under strict real-time constraints
In religion’s name: abuses against religious minorities in Indonesia
No full textOn February 6, 2011, in Cikeusik, a village in western Java, around 1,500 Islamist militants attacked two dozen members of the Ahmadiyah religious community with stones, sticks, and machetes. The mob shouted, “You are infidels! You are heretics!” As captured on video, local police were present at the scene but many left when the crowd began descending on the Ahmadiyah house. By the time the attack was over, three Ahmadiyah men had been bludgeoned to death.
Ahmad Masihuddin, a 25-year-old Ahmadiyah student, recalled, “They held my hands and cut my belt with a machete. They cut my shirt, pants, and undershirt. I was only in my underwear. They took 2.5 million rupiah (US$270) and my Blackberry [cell phone]. They tried to take off my underwear and cut my penis. I was laying in the fetal position. I tried to protect my face, but my left eye was stabbed. Then I heard them say, ‘He is dead, he is dead.’”
While the Cikeusik attack was particularly gruesome, it is part of a growing trend of religious intolerance and violence in Indonesia. Targets have included Ahmadis (the Ahmadiyah), Baha’is, Christians, and Shias, among others. There have also been cases of Christians in Christian-majority areas preventing Sunni Muslim mosques from being built. Affected individuals have ranged from people with permits to build houses of worship to those seeking to have their actual religion listed on their ID cards, to children bullied by teachers and other pupils at school.
In important respects, Indonesia is rightly touted for its religious diversity and tolerance. Since President Suharto was forced to step down in 1998, after more than three decades in power, inaugurating an era of greater freedom in Indonesia, viewpoints long repressed have emerged into the open. A strong thread of religious militancy is among them. As detailed in this report, the government has not responded decisively when that intolerance is expressed through acts of harassment, intimidation, and violence, which often affect freedom of expression and association, creating a climate in which more such attacks can be expected.
According to the Jakarta-based Setara Institute, which monitors religious freedom in Indonesia, there were 216 cases of violent attacks on religious minorities in 2010, 244 cases in 2011, and 264 cases in 2012. The Wahid Institute, another Jakarta-based monitoring group, documented 92 violations of religious freedom and 184 incidents of religious intolerance in 2011, up from 64 violations and 134 incidents of intolerance in 2010.
In researching this report, Human Rights Watch interviewed 16 members of religious minorities who had been physically assaulted by Islamist militants in seven separate incidents−four of them sustaining serious injuries. Twenty-two others had their houses of worship or own houses burned down in six separate incidents. We also summarize here many more incidents reported in the press or documented by other investigators. In addition to intimidation and physical assaults, houses of worship have been closed, construction of new worship facilities halted, and adherents of minority faiths subjected to arbitrary arrest on blasphemy and other charges.
In most cases, the perpetrators of the intimidation and violence have been Sunni militant groups − described throughout this report as Islamist groups − at times acting with the tacit, or occasionally open, support of government officials and police. Groups that have participated in or supported the targeting of minority religions include: the Islamic People’s Forum (Forum Umat Islam, FUI), the Indonesian Muslim Communication Forum (Forum Komunikasi Muslim Indonesia, known as Forkami), the Islamic Defenders Front (Front Pembela Islam, FPI), Hizbut-Tahrir Indonesia, and the Islamic Reformist Movement (Gerakan Islam Reformis, Garis). These groups are united by their espousal of an interpretation of Sunni Islam that labels non-Muslims, excluding Christians and Jews, as “infidels,” and labels Muslims who do not adhere to what they define as Sunni orthodoxy as “blasphemers.”
The harassment and violence directed at minority religious groups is facilitated by a legal architecture in Indonesia that purports to maintain “religious harmony,” but in practice undermines religious freedom. Indonesia’s 1945 constitution explicitly guarantees freedom of religion, as does the International Covenant on Civil and Political Rights, to which Indonesia is a party. However, the Indonesian government has long enacted, and in recent years strengthened, legislation and regulations that have subjected minority religions to official discrimination and made them extremely vulnerable to the members of the majority community who take the law into their own hands.
In numerous instances documented in this report, harassment and intimidation of minority communities by militant Islamist groups has been facilitated by the active or passive involvement of Indonesian government officials and security forces. These groups have cooperated with, or applied pressure on, local authorities to prevent the issuance of building permits for religious minorities’ houses of worship, sought the removal of religious minority communities to new locations, or to stop them from worshipping in their area altogether. In some cases, Christian churches that have met all of the legal requirements for construction have had their permits revoked by local authorities after pressure from Islamist groups, even in the face of Indonesian Supreme Court decisions ruling the construction legal.
This report also documents incidents in which police failed to take action to prevent violence against religious minorities or provided no assistance in the aftermath of such incidents. Police all too often have been unwilling to properly investigate reports of violence against religious minorities, suggesting complicity with the perpetrators. Nor has the justice system proven to be a defender of religious minorities. In the few cases of violence that have gone to the courts, prosecutors have sought ridiculously lenient sentences for the perpetrators of serious crimes, which the judges seem content to oblige. The exception has been cases construed by authorities as acts of “terrorism,” as with the bombing of a church in Solo, Central Java, on September 25, 2011, in which a suicide bomber died and the wife of its funder is still being prosecuted for money laundering, and an attempt to bomb another church in Serpong in April 2012, in which 19 people were arrested.
Indonesia’s religious minorities also face entrenched discrimination in their dealings with the Indonesian government bureaucracy. During the Suharto era, Indonesians were required to list their religion on their national identification cards, choosing from one of five recognized religions, a practice that discriminated against, and put in an untenable position, followers of hundreds of minority religions. Although the current Population Administration Law gives citizens the choice of whether or not to declare their religious faith on their ID cards, those who wish to declare a faith still must choose from a list of six protected religions. Individuals who do not declare a religion risk being labeled “godless” by some Muslim clerics and officials and subject to possible blasphemy prosecution. In 2012 alone, a self-declared atheist, a Shia cleric, and a spiritualist have all been jailed for blasphemy after listing Islam as their religion on their ID cards.
Indonesian government institutions have also played a role in the violation of the rights and freedoms of the country’s religious minorities. Those institutions, which include the Ministry of Religious Affairs, the Coordinating Board for Monitoring Mystical Beliefs in Society (Badan Koordinasi Pengawas Aliran Kepercayaan Masyarakat, Bakor Pakem) under the Attorney General’s Office, and the semi-official Indonesian Ulama Council, have eroded religious freedom by issuing decrees and fatwas (religious rulings) against members of religious minorities and using their position of authority to press for the prosecution of “blasphemers.”
Indonesia has in recent years made meaningful progress toward strengthening democracy and respect for human rights. Those gains, along with perceptions of Indonesia as a bulwark of a progressive, moderate Islam, have prompted international praise of Indonesia as a model Islamic democracy. For instance, in November 2010, US President Barack Obama, when visiting Jakarta, praised “the spirit of religious tolerance that is enshrined in Indonesia’s constitution, and that remains one of this country’s defining and inspiring characteristics.”
If that reputation is to remain intact, strong and immediate action is needed, including more forceful leadership by Indonesian President Susilo Bambang Yudhoyono to reform the laws and government practices that have facilitated abuses against religious minorities. The Indonesian government needs to meet its obligations to hold accountable police, government officials, and members of groups implicated in the abuses. Indonesia’s reputation as a country “underpinned by the principle of religious freedom and tolerance” can only be realized if the government takes steps to curb the increasing targeting of and discrimination against religious minorities, returning to its founding principles, and fostering a national culture of acceptance and respect for all religious groups
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