United Bank Research Articles

The Impact of Training and Development on Employees Performance and Productivity A case study of United Bank Limited Peshawar City, KPK, Pakistan

This paper main objective was to investigate whether training and development has impact on employees’ performance and productivity. This paper is quantitative in nature. Data for the paper have been collected through primary source that are from questionnaires surveys. The data have been checked through statistical software to find the impact of training and development on employees’ performance and productivity. There were two variable Training and Development (Independent) and Employees’ performance and productivity (Dependant). Eight united banks limited were selected for the study. Eighty questionnaires were distributed for the collection of data. Descriptive statistic tools SPSS were applied on the questionnaire to see the reliability and consistency. The goal was to see whether Training and Development has an impact on Employees Performance and Productivity. Data were analyzed and discussed. The result showed that there was significant relationship between the variables, the Pearson correlation was used in study and Cronbach Alpha for each questionnaire was

Hair follicle dermal sheath derived mesenchymal stem cells: in-vitro characterization and effects of its conditioned medium on cutaneous wound healing

297 HAIR FOLLICLE DERMAL SHEATH DERIVED MESENCHYMAL STEM CELLS: IN-VITRO CHARACTERIZATION AND EFFECTS OF ITS CONDITIONED MEDIUM ON CUTANEOUS WOUND HEALING A Chua, J Kua, D Ma, S Lee Skin Bank Unit / Department of Plastic, Reconstructive & Aesthetic Surgery , Singapore General Hospital, Singapore, Singapore, Department of Plastic, Reconstructive & Aesthetic Surgery , Singapore General Hospital, Singapore, Singapore

The Role of Islamic Rural Bank in Financing the SMEs: Customer Perspective Analysis (Case Study of Amanah Ummah Bank in Bogor City, Indonesia)

One of the basic problems faced by small scale and medium enterprises (SMEs) in Indonesia is the availability of financing access provided by financial institutions including banking institution. There are three types of Islamic bank operating in Indonesia presently: Islamic commercial bank, Islamic banking unit and Islamic rural bank. Providing the SMEs with sufficient financing source is highly required. This paper attempts to observe empirically the role that have been played by Islamic rural bank in financing the SMEs, by taking case study of Amanah Ummah Bank, the best Islamic rural bank in the country. Thirty small and medium entrepreneurs have been selected as the sample of the research, and have been deeply interviewed on September and October 2008. Descriptive statistics, IPA (Importance Performance Analysis) and CSI (Customer Satisfaction Index) methods have been used as analytical methods. The results show that the financing given by the bank does really help the SMEs. There are three factors, which are important, and which have satisfied the SMEs. These are easiness of bank’s requirements, the speed of financing approval, and bank’s services. In general, the respondents are of the view that the bank has shown a good performance. Keywords : SMEs, Islamic rural bank, customers’ perception

Increase the quality of banked cord blood units without limiting HLA diversity: how cord blood banks could face this dilemma

Increase the quality of banked cord blood units without limiting <scp>HLA</scp> diversity: how cord blood banks could face this dilemma

The paradoxical genesis of too-big-to-fail

At least since the Global Financial Crisis of 2007-2009, the problem of too-big-to-fail (TBTF) has received widespread attention. The research conducted in this context has, however, generally focused on the econometric aspect and the contribution of the TBTF doctrine to the financial crisis of 2007-2009, while the economic historical approach has been confined to tracing the doctrine to its first appearance. This paper attempts to fill this gap in the academic literature by offering an explanation for why, as opposed to how, the TBTF doctrine has developed. This paper identifies the US population’s distrust and at times hostility against the prospect of concentration of power in large financial institutions as the causal factor leading to the TBTF phenomenon. The resulting socially non-optimal regulation favoured a fragmented and fragile banking system based on small unit banks at the cost of more diversified branch banks. The Great Depression impressively highlighted the deep structural flaws of the US banking system. At the same time, however, it caused a shift in the public opinion, which had generally been opposed to deposit insurance, and thereby aligned the public interest with that of small banks, which would profit most from deposit insurance. The newly acquired public and political support enabled weak unit banks to lobby successfully against reforming the banking structure and instead for the adaption of federal deposit insurance. However, the Federal Deposit Insurance Corporation (FDIC) only addressed the symptoms of the weak banking industry but not its causes. Moreover, the strongly biased FDIC policies have generally favoured creditors at large banks, which ultimately led to the TBTF doctrine which, in turn, provided banks with a non-technical incentive to grow in size in order to gain TBTF protection. Initially aimed at preserving the US financial landscape based on small unit banks, the FDIC as the main conduit for TBTF rescues thus became the main driver for big bank corporate welfare. Deposit insurance gave rise to TBTF and, at the same time, put small banks deemed “too-small-to-safe” at a competitive disadvantage, further accelerating the trend towards increasingly large and complex banks.

Operationalizing First Referral Units (FRUs) in Jharkhand, India: Experiences from an operations research

Background: Till 2008, Jharkhand had only 12 designated first referral units (FRUs) at the district level and none of them were fully functional. This paper focuses on the processes, experiences and health system challenges in operationalizing FRUs in Jharkhand. Methods: In an operations research, a pre and post assessment of designated FRUs in the study area was undertaken using standardized tool during March 2009 and February 2011. Results: There was 33 % (04) increase in availability of obstetricians, surgeons and pathologists across the facilities. The availability of pediatrician was improved in 26% (02) facilities, while there were only 14 % (01) of anaesthetists across all the seven facilities. There was rise in recruitment of medical-officers and there were surplus in number for the designated FRUs. Only 29 % (02) of the facilities operated with a blood bank or blood storage unit. Parenteral-antibiotics and oxytocin availability remained stagnate at 86 % (06) and 57 % (04) respectively across the seven designated FRUs. Magnesium-sulphate availability had improved by 29 % across the facilities. There was rise in availability of Misoprostol in four (57%) facilities and dip in availability of Nifedepine in six (86 %) and lignocaine-hydrochloride in one (14 %). About four (58 %) of the facilities did not have maternal-newborn care equipments. At the end of the project, only three out of seven designated FRUs achieved operational status. Conclusions: This piece of work on small scale generated evidence from Jharkhand made to think strategically to scale-up operationalization of FRUs. Lack of leadership, management, skilled human resources, infrastructure and medical supplies impeded operationalization of FRUs in Jharkhand. Access to comprehensive emergency obstetric and new-born care services (CEmONC) is remaining as a major issue.

Efficiency Evaluation of Web-based Learning on Multinational: A Case Study on Financial Industry

Based on the web-based learning efficiency of Taiwan’s financial industry investing in China in 2010-2012, Data Envelopment Analysis (DEA), Sensitivity Analysis, and Malmquist Productivity Index are integrated to measure the total efficiency (TE), pure technical efficiency (PTE), and scale efficiency (SE) of eleven banks which invested in China for further web-based learning improvement. The empirical results show that Mega International Commercial Bank and Bank of Taiwan present the best total efficiency (1.00), followed by Cooperative Bank (0.93); Mega International Commercial Bank and Bank of Taiwan reveal the best pure technical efficiency (1.00), followed by Land Bank (0.92); and, Mega International Commercial Bank and Bank of Taiwan appear the best scale efficiency (1.00), followed by Cathay United Bank (0.85). From Malmquist Productivity Index, Taiwan Cooperative Bank, Mega International Commercial Bank, and Bank of Taiwan show improvement on pure technical efficiency change that the web-based learning effectiveness is enhanced.

An Evaluation of Green Banking Practices in Bangladesh

Green Banking is any form of banking that benefits the environment. Green banking shifts banks from the ‘profit, profit and profit motive to ‘planet, people and profit’ motive. Green banking is very important in mitigating the Credit Risk, Legal Risk, Security Risk and Reputation Risk in the banking sector. The study mainly aims to analyze the Green Banking practices among SCBs, SDBs, PCBs and FCBs in Bangladesh. The study is of analytical and theoretical in nature based on secondary data. The study finds that 47 banks have adopted the Green Banking policy, formed Green Banking Unit, allocated and utilized budget for green banking. But the allocation and utilization of budget of SCBs and SDBs are not satisfactory. Online banking and ATM facilities of SCBs and SDBs are very poor. It is also found that there is a sharp increase in giving loans to environmentally friendly projects by banks. Researcher found that some banks still do not and some banks are in the first phase in the policy guideline set by BB. The greatest reason for not adopt Green Banking perhaps is that it often require a large initial cost. As SCBs and SDBs are far behind to adopt online banking and ATM facilities, our government should provide enough fund and technical support to them. Bangladesh Bank should enforce SCBs, SDBs, PCBs and FCBS, that they should assess the sensitive issues like vulnerable groups; involuntary displacement etc while investing or funding the projects. Keywords: GB= Green Banking, FCBs = Foreign Commercial Banks, PCBs = Private Commercial Banks, SCBs = State owned Commercial Banks, SDBs = Specialized Development Banks.

The Influence of Macroeconomic Factors and Banking Fragility on Offshore Banking Unit (OBU)

This paper focuses on the offshore banking units (OBUs) of Taiwan, Singapore, Hong Kong, Japan, Malaysia, and Thailand as research samples and uses the bank competition index to separate both perfect competition and oligopoly. We employ the seemingly unrelated regression (SUR) model to examine the differences in the influence of OBU assets from macroeconomic factors and the degree of banking fragility. The empirical results from our monthly data from 1996-2005 suggest that the constrained equations of the SUR model are suitable for evaluating the OBUs. The main factors affecting OBU assets were the ratio of imports to GDP, financial deepening index, lending-deposit rate differences, banking sector fragility, M2 multiplier, and real exchange rates. If a regional crisis occurs, the spillover effect could be more easily avoided by having more restrictions on OBU loans. By contrast, Thailand and Malaysia have loose expansionary financial systems, leading to crisis occurrence.

Analysis Of 402 Cord Blood Units To Assess Factors Influencing Infused Viable CD34+ Cell Dose: The Critical Determinant Of Engraftment

IntroductionThe selection of CB units with a high engraftment potential is key to the success of single and double-unit CB transplantation (CBT). However, the best predictors of engraftment potential at the time of unit selection and prior to infusion are not established. MethodsWe analyzed determinants of engraftment in recipients of double-unit CBT at our transplant center (TC) who underwent myeloablative conditioning for hematological malignancies from 10/2005-5/2013. As infused viable CD34+ cell dose was critical to engraftment in this analysis, we then evaluated units thawed at our center for the two determinants of infused viable CD34+ cell dose: post-thaw CD34+ cell recovery and CD34+ cell viability. CD34+ cell recovery was calculated as TC CD34+ cell count/Bank CD34+ cell count. Post-thaw viability was evaluated by flow cytometry using modified ISHAGE gating and 7-AAD exclusion to assess the percentage of viable CD34+ cells (of total present). ResultsThe cumulative incidence of neutrophil engraftment in the 128 myeloablative double-unit CBT recipients was 96% (95%CI: 93-100%). Reported Bank total nucleated cell (TNC) dose, Bank CD34+ cell dose, TC infused TNC dose, TC infused total CD34+ cell dose, TC infused viable CD34+ cell dose, and TC CFU dose were all significantly associated with neutrophil engraftment on univariate analysis. However, only the infused viable CD34+ cell dose was significant on multivariate analysis [HR=1.95 (1.33-2.86), p = 0.001, Figure]. Platelet engraftment was also strongly associated with infused viable CD34 cell dose (data not shown). To evaluate the reliability of CD34+ cell counts and determinants of viability, 402 units (302 domestic and 100 international) from 43 Banks thawed at our TC between 10/2005-5/2013 were then analyzed. For 7 selected Banks accounting for 135 (33%) units, there was strong correlation between Bank and TC CD34+ cell counts (r2 = 0.8, p < 0.001) with a median 92% CD34+ cell recovery at the TC (range 44-189%). However, for the remainder, there was greater variation in CD34+ cell recovery (range 12-1480%, median 107%) with a weaker (but still significant) correlation between CD34+ cell counts (r2 = 0.5, p < 0.001). In 40 (10%) units the recovery was less than 66%. Finally, while the median post-thaw CD34+ cell viability was 92%, it ranged 34-99%, and 33 units (8%) had <75% viable CD34+ cells. Unit characteristics significantly associated with CD34+ cell viability are shown in the Table. Bank location (domestic vs. international), shipping distance (New York vs. Australia), processing method (manual vs. automated or semi-automated) and unit hematocrit did not correlate with viability. In multivariate analysis, Bank FACT accreditation, year of cryopreservation, and cryovolume were associated with viability. ConclusionInfused viable CD34+ cell dose was the critical determinant of neutrophil and platelet engraftment. Although correlation between Bank and TC CD34+ cell counts was excellent for some banks and post-thaw CD34+ cell viability was satisfactory for the majority of units, 17% of units had <66% CD34+ cell recovery and/or <75% CD34+ cell viability post-thaw. The variability in CD34+ cell recovery and viability was not random but linked to known differences in banking practice and at least one independent measure of Bank quality (FACT accreditation). These findings have significant implications to CB banking and transplantation. Although units can be selected based on CD34+ cell dose, TC must be able to react to lower than expected post-thaw CD34+ cell counts and/or low CD34+ cell viability. Thus, methods to measure the infused viable CD34+ cell dose on transplant day (or other rapidly available measures of potency) should be employed to ensure the delivery of a graft with optimal engraftment potential and a back-up strategy in case of a compromised unit. This is even more important in single-unit CBT in which, unlike double-unit CBT, engraftment is solely dependent on a single unit.▪ [Display omitted] Disclosures:No relevant conflicts of interest to declare.

Impact Of Umbilical Cord Unit Banking Conditions On Clinical Outcomes In Double Cord Transplant Recipients

▪ IntroductionUmbilical cord blood (UCB) transplantation yields survival comparable to adult stem cell transplantation, but there is significant variability among UCB products, in large part because of differences in processing conditions from collection to cryopreservation at cord banks. While impact of processing conditions on the actual UCB product has been reported, there is a little information regarding impact on patient-level outcomes. We report a retrospective exploratory analysis of processing performed at cord banks prior to freezing of UCB units and the impact on clinical outcomes such as engraftment, cord dominance, transplant-related mortality (TRM) and overall survival (OS) in 133 UCB recipients.MethodsAll adult recipients of unmanipulated double UCB transplantation (dUCBT) for hematologic malignancy from 2003 to 2011 at the 3 Harvard Cancer Center sites (Dana-Farber Cancer Institute, Massachusetts General Hospital, and Beth Israel Deaconess Medical Center) were included. All UCB units were thawed and washed prior to infusion. Multivariate analyses controlled for prognostic factors including age, malignancy, conditioning intensity, degree of HLA matching, presence of anti-HLA antibodies, order of cord infusion, TNC/kg, and CD34+/kg infused. Time to engraftment and treatment-related mortality were analyzed in the competing risks regression setting and survival was analyzed using proportional hazards models. Results98 recipients underwent reduced-intensity conditioning, primarily fludarabine, melphalan and anti-thymocyte globulin. 35 underwent myeloablative conditioning, primarily cyclophosphamide and total body irradiation. Of the 48 banks contributing cords to this study, 42% employed simple cryopreservation and 23% employed plasma/volume reduction only, at some point during operation. These 2 methods were considered “RBC replete”. Of the 34 banks sharing their current practices, simple cryopreservation is no longer practiced by any; 12% practice plasma/volume reduction alone. 88% of the banks now employ RBC depletion, of which 67% use hydroxyethyl starch for RBC sedimentation and 67% use automated processing systems. Engraftment – Neutrophil and platelet engraftment were not impacted by RBC depletion, sedimentation with hydroxyethyl starch, automated processing, HLA matching or CD34+/kg dose in multivariate analyses. An anti-HLA antibody against one or more cords (p<0.001), myeloablative conditioning (p=0.001) and lower TNC/kg doses (p=0.027) were associated with longer time to engraftment. Cord Dominance –Cord dominance was not significantly affected by RBC depletion, RBC sedimentation, use of an automated system, cord bank inventory or years in existence, time in storage, or viability less than 90% at infusion in a multivariate model. Transplant-related Mortality – None of the processing conditions had a significant effect on TRM at 100 days or 1 year. Overall Survival –Although recipient numbers were small, an interesting observation was the improved survival of the 17 recipients of 2 RBC replete units versus the 115 who received 1 or more RBC-depleted units. This was significant in univariate modeling (p=0.022, see Figure) and just significant in multivariate modeling (HR 3.20, p=0.049, 100day OS of 72% vs 100% and 1year OS of 47% vs 82%). Age over 50 and myeloablative conditioning were the only other cord or patient factors to correlate with increased TRM (p=0.033 and 0.001) and decreased overall survival (p=0.062 and 0.003). Conclusions1) UCB bank practices have changed with time and currently employ primarily RBC depletion by sedimentation via automated systems prior to cryopreservation. 2) Neutrophil and platelet engraftment and TRM were not significantly affected by processing conditions at the cord bank in our models. 3) Receipt of 1 or more RBC-depleted units seemed to be associated with inferior survival at 100 days and 1 year vs receipt of 2 RBC-replete cords in multivariate modeling. A clear limitation to our interpretation is sample size, with only 17 recipients receiving 2 RBC-replete cords. While our observations require validation in a larger population, processing conditions at the collection banks and their potential impact on clinical outcomes merit further investigation to determine which aspects of processing should be considered in UCB unit selection. [Display omitted] Disclosures:Koreth:Takeda Pharmaceuticals: Consultancy; Millennium pharmaceuticals: Research Funding.

Occupy risk weighting: how the minimum leverage ratio dominates capital requirements

Purpose – In September 2009, G20 representatives called for introducing a minimum leverage ratio as an instrument of financial regulation. It is supposed to assure a certain degree of core capital for banks, independent of the controversial procedures used to assess risk. The paper aims to discuss these issues. Design/methodology/approach – This paper discusses the interaction and tensions between the leverage ratio and risk-based capital requirements, using financial data of the Swiss systemically important bank United Bank of Switzerland. Findings – It can be shown that the leverage ratio potentially undermines risk weighting such that banks feel encouraged to take greater risks. Originality/value – The paper proposes an alternative instrument that is conceived as a base risk weight and functions as a backstop. It ensures a minimum core capital ratio, based on unweighted total exposure by ensuring a minimum ratio of risk-weighted to total assets for all banks. The proposed measure is easy to compute like the leverage ratio, and also like the latter, it is independent of risk weighting. Yet, its primary advantage is that it does not supersede risk-based capital adequacy targets, but rather supplements them.

82-P: THE PREVALENCE OF CCR5 DELTA 32 MUTATION IN SAUDI ARABIA

Delta 32 CCR5 mutant allele of the chemokine receptor CCR5 prevents HIV transmission. In addition, stem cell transplantation of HIV patients with the delta 32 CCR5 mutated gene cured HIV infection. Our aim was to investigate the prevalence of delta 32 CCR5 mutation in the Saudi population specifically in our cord blood bank units. High prevalence of delta 32 CCR5 will encourage us to add this as a routine test to our donated samples. A total of 400 samples were collected from healthy cord blood donor units. DNA was extracted and the CCR5 gene was amplified by polymerase chain reaction (PCR) in a light cycler system using SYBRGreen dye. The mutated gene was confirmed by direct sequencing. We found only one cord unit with a homozygous CCR5 mutation (delta 32/ delta 32) out of the 400 tested samples. We conclude that the protective delta 32 CCR5 allele is rarely present in Saudi Arabia. Due to the low frequency we will not include this as a routine test. Further studies are planned to further investigate the family tree in which we found the mutated gene.

Nigeria Deposit Money Bankss Credit Administration and the Incidence of Bad Loans: An Empirical Investigation

The thrust of this study was to empirically investigate Nigeria’s’ Deposit Money Banks’ Credit Administration and the recurring incidence of Bad Loans. The research work critically examined credit Administration in Nigeria’s Deposit Money Banks, the origin and incidence of bad debts, the recoveries of Non Performing Loans and also offered possible way out of their bad credit and investment portfolio management.The data collected for the study were analyzed using tables, simple percentages and chi-square. A sample of 25 credit officers in each of the four selected banks (Access Bank Plc, First Bank Plc, United Bank of Africa Plc and Wema Bank Plc) were chosen and questionnaires administered on them. Based on the information supplied and the analysis of the data gathered from the questionnaires using the chi-square technique, it was found that the unwillingness of banks’ customers’ to provide adequate information and the failure to carry out detailed assessment of the customers’ loan requests results in bad debt, it was also discovered that inadequate securitization in bank lending has a significant effect on bad debts.The study therefore recommends amongst other things that proper legal documentation be in put place. This would reduce the losses arising from problem loans and minimise the effects of such loans in the form of bad debt provisions, it also suggested that effective monitoring and evaluation is key to avoid the diversion of facilities for unapproved purposes to reduce or forestall the incidence of bad debts in Nigerian Deposit Money Banks.

Time Spent and Importance of Managerial Activities for Senior and Middle Managers in a Banking Unit: Self versus Other Perceptions

Managerial activities and their relationship with self perceptions and other perceptions have been rarely studiedin a banking unit. What makes a manager are the nine important managerial activities he/she performs identifiedfrom the literature. The time and importance given to these is studied here within the context of the twomanagerial positions i.e. the senior and the middle managers based on managerial self reports and perceptions ina Pakistani bank. The first aim of the study was to find out the role difference existing between the two groups.The second aim was to find out a match between importance and time spent on the activities of single managerand the third aim was to find out the difference in perception of senior versus middle managers about theactivities in a dyadic one to one relationship of a single banking branch. The results of the study revealed that(1). The two management levels due to their different roles differ in time and importance they give on four outof nine activities (2). Dyadic group comparison revealed the existence of disparity between self reports andreports by knowledgeable others on time spent on activities. (3). The comparison of importance of activitiesexhibited greater number of similarities between the perceptions of one group for the other group. In someinstances differences were also observed from which important lessons were learned.

Assessing the HLA diversity of cord blood units collected from a birth clinic caring for pregnant women in an ethnically diverse metropolitan area

New strategies are emerging in cord blood banking where focusing on birth clinics caring for a high number of mothers belonging to ethnic minorities could offer new possibilities for allotransplantation both for patients of European origin and for patients from ethnic minorities or mixed ancestries. Marseilles Cord Blood Bank works with one university birth clinic caring for a culturally and sociologically diverse population. Stringent French legal restrictions apply to recording the geographic origin of parents. To circumvent this limitation and evaluate the contribution of newly banked cord blood units (CBUs) to increasing HLA diversity, we applied an algorithm that allows for the determination of parents' putative haplotypes and thus grossly deduce information on their ancestry. Generic resolution HLA-A, HLA-B, and allelic resolution HLA-DRB1 genotyping for 328 CBUs and 2691 unrelated donors (UDs) between January 2009 and May 2012 were performed. Enrichment from international CBU registry with nonreferenced generic HLA-A, HLA-B, and allelic HLA-DRB1 phenotypes was compared between CBUs identified with one or two non-European haplotypes and CBUs identified with two European haplotypes. Marseilles CBUs display an increased proportion of HLA antigens frequently expressed in African populations compared to UDs. Whereas 93% of 199 CBUs identified with one or two non-European haplotypes enrich international CBU registry, this result is reduced to 42% for the 129 CBUs identified with two European haplotypes. This study supports a new method to assess HLA diversity. However, such an increased of HLA diversity raises questions about frequencies of CBUs released and clinical relevance from their uses.

The Economic Crisis Impact on Coping Styles, Mental and Physical Health and Performances in a Financial Company from Romania

Stress in organizations is felt both at individual and organizational level. The objective of the current research is to high light the impact of the economic crisis on the predictive power of the variables: satisfaction, physical health, mental health, stress reactions and coping for employees’ performance at work in a financial banking unit. Participants were 83 employees from several departments of the financial company, aged between 25 and 46 years old (M=35.27; S.D.=6.72), mal e and female, work experience within the company of minimum 2 years, in an attempt to distribute these characteristics in equal as possible. The results confirmed the hypothesis (p <0.05) and, therefore, the regression model applied for the pressure of the economic cris is is valid for the selected predictors.

Human erythrocytes as drug carriers: Loading efficiency and side effects of hypotonic dialysis, chlorpromazine treatment and fusion with liposomes

Human red blood cells (RBCs) are emerging as a highly biocompatible microparticulate drug delivery system. So far, drugs have commonly been loaded into freshly isolated RBCs using rather disruptive methods based on hypotonic shock, and assessment of damage was restricted to hemolysis. Here, we investigated loading of RBCs from blood bank units with enzymes of various molecular weights using hypotonic dialysis (HD), pretreatment with chlorpromazine (CPZ) and fusion with liposomes. The latter two techniques have received little attention in RBC loading so far. Along with loading efficiency, all methods were tested for the induction of side effects. Very importantly, next to hemolysis, we also addressed morphological changes and phosphatidyl serine (PS) exposure, which has been recognized as a critical parameter associated with premature RBC removal and induction of transfusion-related pathologies. The efficiency of loading using hypotonic dialysis decreased with the molecular weight of the enzyme. For liposomes and chlorpromazine, loading efficiencies were higher and independent of enzyme molecular weights. While hypotonic dialysis always induced a high degree of hemolysis, irreversible modifications in the morphology of the cells and PS exposure, the side effects that were induced by loading using CPZ and liposomes were limited. In particular, PS exposure, although high immediately after treatment, returned to physiological levels after recovery. Retention and deformability studies using a spleen-mimicking device showed that RBCs treated with CPZ and liposomes behave like physiological RBCs, while HD led to very fragile and poorly deformable RBCs.

A quantitative analysis of surgical capacity in Santa Cruz, Bolivia

ObjectivesThis investigation aimed to document surgical capacity at public medical centers in a middle-income Latin American country using the Surgeons OverSeas (SOS) Personnel, Infrastructure, Procedures, Equipment, and Supplies (PIPES) survey tool. Materials and methodsWe applied the PIPES tool at six urban and 25 rural facilities in Santa Cruz, Bolivia. Outcome measures included the availability of items in five domains (Personnel, Infrastructure, Procedures, Equipment, and Supplies) and the PIPES index. PIPES indices were calculated by summing scores from each domain, dividing by the total number of survey items, and multiplying by 10. ResultsThirty-one of the 32 public facilities that provide surgical care in Santa Cruz were assessed. Santa Cruz had at least 7.8 surgeons and 2.8 anesthesiologists per 100,000 population. However, these providers were unequally distributed, such that nine rural sites had no anesthesiologist. Few rural facilities had blood banking (4/25), anesthesia machines (11/25), postoperative care (11/25), or intensive care units (1/25). PIPES indices ranged from 5.7–13.2, and were significantly higher in urban (median 12.6) than rural (median 7.8) areas (P < 0.01). ConclusionsThis investigation is novel in its application of a Spanish-language version of the PIPES tool in a middle-income Latin American country. These data document substantially greater surgical capacity in Santa Cruz than has been reported for Sierra Leone or Rwanda, consistent with Bolivia’s development status. Unfortunately, surgeons are limited in rural areas by deficits in anesthesia and perioperative services. These results are currently being used to target local quality improvement initiatives.

The Euro Crisis: Mission Accomplished?

The Euro Crisis: Mission Accomplished?