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The tourism industry faces multiple changes (economic crises, climate change, technology innovation…). Because of this vulnerability, as evidenced by the COVID-19 pandemic, the study of hotel resilience is a key issue for the survival and competitiveness of organisations and destinations. Therefore, this paper proposes a holistic model to measure organisational resilience. To that end, it aims to analyse the determinants of organisational resilience, i.e. predictors of resilience (strategy and change), and to assess how they contribute to hotel resilience and performance. Firstly, the hotel context in the Canary Islands is examined to identify the level of impact, frequency and predictability of each type of change. Secondly, scales development and validation were conducted. Finally, the proposed model is validated. Findings confirm that the strategy and change dimensions have a considerable effect on hotel resilience, which positively influences hotel performance. Discussion provides hotel managers with guidelines to improve organisational resilience and performance.We report a case of a 56-year-old Brazilian woman, with relapsing lepromatous leprosy, and onychomycosis caused by a non-dermatophyte filamentous fungi. The pathogenic fungi was identified as Arthrinium arundinis and treated with chemical abrasion of the nail with 40% urea and application of terbinafine cream. selleck compound Onychomycosis caused by Arthrinium species is rare, and this is the second reported case.

Surgical management of pancreatic cysts differ according to the specific location of the cyst on the pancreas. Cysts located on the pancreatic head require a radical procedure such as pancreaticoduodenectomy (Whipple procedure). Cysts of the pancreatic body or tail, however, require distal pancreatectomy as the standard surgical approach. An alternative surgical approach for cysts located in the mid-pancreas is central pancreatectomy with distal pancreaticogastrostomy.

In this report, we present a case of a 22-year-old woman with a cyst located on the mid-pancreas consistent with a solid pseudopapillary neoplasia. Central pancreatectomy with distal pancreaticogastrostomy was the surgical technique of choice performed in this case.

Central pancreatectomy has emerged as an alternative surgical approach to mid-pancreatic cysts which includes only the removal of a segment of the pancreas, thereby sparing the distal parenchyma. Compared with the traditional approach, this technique of partial resection of the pancreatic tissue is desirable due to its organ-sparing function.

Central pancreatectomy with distal pancreaticogastrostomy can be an alternative to distal pancreatectomy for cysts located in the mid-pancreatic region. This rare procedure prevents any unnecessary healthy pancreatic tissue loss, reduces the risk of developing complications, and is an alternative treatment of choice to distal pancreatectomy.

Central pancreatectomy with distal pancreaticogastrostomy can be an alternative to distal pancreatectomy for cysts located in the mid-pancreatic region. This rare procedure prevents any unnecessary healthy pancreatic tissue loss, reduces the risk of developing complications, and is an alternative treatment of choice to distal pancreatectomy.

The etiology of community-acquired pneumonia (CAP) has evolved since the beginning of the antibiotic era. Recent guidelines encourage immediate empiric antibiotic treatment once a diagnosis of CAP is made. Concerns about treatment recommendations, on the one hand, and antibiotic stewardship, on the other, motivated this review of the medical literature on the etiology of CAP.

We conducted a systematic review of English-language literature on the etiology of CAP using methods defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed using a combination of the keywords ‘pneumonia’, ‘CAP’, ‘etiology’, ‘microbiology’, ‘bacteriology’, and ‘pathogen’. We examined articles on antibiotics that were develop to treat pneumonia. We reviewed all ‘related articles’ as well as studies referenced by those that came up in the search. After we excluded articles that did not give sufficient microbiological data or failed to meet other predetermined criteria, 1er attention to the routine use of sputum Gram stain and culture. Because viral/bacterial coinfection is relatively common, the identification of a virus by PCR does not, by itself, allow for discontinuation of the antibiotic therapy.

The results of this study justify current guidelines for initial empiric treatment of CAP. With pneumococcus and Haemophilus continuing to predominate, efforts at antibiotic stewardship might be enhanced by greater attention to the routine use of sputum Gram stain and culture. Because viral/bacterial coinfection is relatively common, the identification of a virus by PCR does not, by itself, allow for discontinuation of the antibiotic therapy.Absorption spectra of vacuum-deposited films of ammonia have been obtained in the range 115 nm to 310 nm for a set of 15 deposition temperatures, Td, between 20 K and 80 K. Results focus upon the region 115 nm to 130 nm in overlapping D, E, F and G←X Rydberg transitions involving Wannier-Mott excitons. We identify two phases of ammonia, showing the solid to be polymorphic. Peak absorption wavelengths in the region of interest are found to shift to the red by 299 cm-1, for Td between 20 K to 50 K, and 1380 cm-1 for Td between 55 K to 80 K. Shifts provide evidence for the presence of spontaneously generated electric fields in these films, of values in excess of 108 V m-1 for Td of 20 K to 50 K to a few times 107 V m-1 for 55 K to 80 K. Results enable us to place a lower limit of 1.58 nm on the size of crystallites in the low temperature regime. This dimension represents 16 unit cells or 64 species, giving a more quantitative description than the nebulous term amorphous, as applied to solid ammonia. We also determine that crystallites formed in the high temperature regime contain, within ±20 %, 1688, 756 and 236 molecules of ammonia, respectively at Td of 65 K, 60 K and 55 K.