Having high cytotoxicity cell line effect, Cinnamomum zeylanicum Blume essential oil offers a novel approach to the chemotherapy treatment. In order to enhance its quantity/purity, the experimental conditions to produce essential oil should be more exploited. Steam distillation was used to isolate essential oil, and its conditions' optimization was carried out with the surface-response methodology. The maximum amount (2.6 g/100 g d.b.) was obtained under minimum condensation water flow (0.8 mL/min), a sample size of 6.5 cm, a saline solution concentration of 262.5 g/L, and five washings. The produced essential oil contains >77% of polyphenols. In vitro cytotoxicity was examined using an MTT assay against HeLa and Raji cell lines. The essential oil's capability to inhibit the proliferation of HeLa and Raji cell lines was studied under some conditions presenting IC₅₀ values of 0.13 and 0.57 μg/mL, respectively. The essential oil was evaluated for its potential as an antioxidant by using in vitro models, such as phosphomolybdenum, DPPH, and H₂O₂ methods, in comparison with the synthetic antioxidant BHT (butylated hydroxytoluene) and ascorbic acid (vitamin C) as positive controls. The ammonium phosphomolybdate potency in the present study is of the order of 108.75 ± 32.63 mg of essential oil/equivalent to 1 mg of vitamin C in terms of antioxidant power, and the antioxidant activity of DPPH-H₂O₂ was 21.3% and 55.2%, respectively. The Cinnamomum zeylanicum Blume essential oil (CEO) covers important antioxidant and antiproliferative effects. This can be attributed to the presence of few minor and major phenolic compounds.

For hospitality organizations, the need for compelling corporate narratives is particularly acute in dealing with the COVID-19 crisis due to the scope and severity of its threat to employees, customers, the general public, and the fundamental survival of the company itself. Thus, this study aims to identify corporate narrative strategies and examine how hospitality companies deploy such narrative strategies with impression management tactics during the COVID-19 pandemic. Anchored in the Aristotelian concept of persuasive rhetoric and impression management theory, this study content-analyzed 57 CEO letters published by hospitality companies during the COVID-19 outbreak and found the prevalent rhetoric appeals and patterns of rhetoric appeals with impression management tactics embedded in the letters.

Keywords: CEO letters; Covid-19; organizational impression management; rhetoric appeals; the Aristotelian concept of persuasive rhetoric, hospitality corporate narratives.

Despite recent advancements in the field of microfluidic paper-based analytical devices (μPADs), a key challenge remains in developing a simple and efficient μPAD with customized imaging capabilities for antioxidant assays. In the present study, we report a facile approach for μPAD fabrication through the application of transparent nail paint leading to creation of hydrophobic barriers and well-defined channels. The resultant μPADs were then characterized through scanning electron microscopy and contact angle measurements. The resolution and functional features of the fabricated μPAD were amenable to the intended assay. The μPAD's impregnated poly(methacrylic acid) (PMAA)-coated cerium oxide (CeO₂) nanoparticles oxidized the 3,3',5,5'-tetramethylbenzidine (TMB) leading to the formation of a blue-colored charge-transfer complex. The addition of different antioxidant standard solutions resulted in a reduction in the blue color in a dose-dependent manner which could be observed visually. The color intensity of the PMAA-CeO₂ nanoparticle@TMB oxidation product was inversely proportional to the antioxidant concentration and was measured using customized in-house MATLAB-based image processing software. Importantly, PMAA-CeO₂ nanoparticle-based μPADs demonstrated good analytical characteristics and were able to be stored for long periods without any loss of activity. Moreover, potential interferents did not pose any threat to the colorimetric signal read-out for determination of antioxidant activity. The developed method was further applied for the assessment of antioxidant activity in a variety of tea samples and performed satisfactorily in comparison with a commonly used antioxidant detection method. Collectively, the developed μPAD-based platform holds great potential as a low-cost, convenient, portable and reliable method for pursuing various on-site antioxidant assays. Graphical Abstract.

Keywords: Antioxidant activity; Cerium oxide; Colorimetric; Image processing software; Nail paint; μPAD.

Thousands of nanomaterials (NMs)-containing products are currently under development or incorporated in the consumer market, despite our very limited understanding of their genotoxic potential. Taking into account that the toxicity and genotoxicity of NMs strongly depend on their physicochemical characteristics, many variables must be considered in the safety evaluation of each given NM. In this scenario, the challenge is to establish high-throughput methodologies able to generate rapid and robust genotoxicity data that can be used to critically assess and/or predict the biological effects associated with those NMs being under development or already present in the market. In this study, we have evaluated the advantages of using a flow cytometry-based approach testing micronucleus (MNs) induction (FCMN assay). In the frame of the EU NANoREG project, we have tested six different NMs-namely NM100 and NM101 (TiO₂NPs), NM110 (ZnONPs), NM212 (CeO₂NPs), NM300K (AgNPs) and NM401 (multi-walled carbon nanotubes (MWCNTs)). The obtained results confirm the ability of AgNPs and MWCNTs to induce MN in the human bronchial epithelial BEAS-2B cell line, whereas the other tested NMs retrieved non-significant increases in the MN frequency. Based on the alignment of the results with the data reported in the literature and the performance of the FCMN assay, we strongly recommend this assay as a reference method to systematically evaluate the potential genotoxicity of NMs.

Cerium oxide (CeO _x) with a reversible surface Ce³⁺/Ce⁴⁺ redox pair has played an important role in catalytic reactions, whereas catalase mimetics of CeO _x have attracted little attention in the field of biotherapy. Herein, a smart photosensitizer-cerium oxide nanoprobe was developed to represent a promising paradigm in high-performance photodynamic therapy. The photosensitizer was linked to CeO _x nanoparticles through a substrate peptide (EGPLGVRGK) of matrix metalloproteinase-2 (MMP-2). The smart nanoprobe could be converted from the "silent state" before arriving at the cancer cells to the "activated state" within the cells to turn on the fluorescence and ¹O₂ generation when the peptide linker (EGPLGVRGK) was cut by the cancer biomarker MMP-2. Moreover, CeO _x played the role of an excellent catalase-like compound to decompose endogenous hydrogen peroxide to relieve tumor hypoxia. Via the conventional application of CeO _x, our study showed innovatively how a smart nanoprobe could relieve tumor hypoxia and achieve a therapeutic effect for highly selective and efficient personalized treatment.

This study examines decision-making responsibility in multihospital system governance. The investigation focuses on the division of decision-making authority between local (hospital) and corporate boards. Fifteen decision areas were considered, including strategic planning, allocation of financial resources, appointment and evaluation of hospital CEOs, and controlling medical staff privileges. Results suggest moderately high levels of corporate (centralized) decision making in multihospital systems. Findings also indicate that type of decision determines whether control is centralized or decentralized. Most centralized decisions were related to resource allocation, formation of new companies, and changes in by-laws of a system hospital. Most decentralized decisions were related to medical staff privileges, service changes, and hospital strategic planning.

Purpose - The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations. Design/methodology/approach - In total, 18 of Sweden's 20 healthcare chief executive officers (CEOs) and 20 clinical department managers (CDMs) were interviewed about their views on management of physicians. Interviews were performed in the context of one aspect of healthcare management; i.e., management of physicians' sickness certification practice. A discourse analysis approach was used for data analysis. Findings - Few managers used a management-based discourse to construct the manager role. Instead, a profession-based discourse dominated and managers frequently used the attributes "physician" or "non-physician" to categorise themselves or other managers in their managerial roles. Some managers, both CEOs and CDMs, shifted between the management- and profession-based discourses, resulting in a kind of "yes, but […]" approach to management in the organisations. The dominating profession-based discourse served to reproduce the power and status of physicians within the organisation, thereby rendering the manager role weaker than the medical profession for both physician and non-physician managers. Research limitations/implications - Further studies are needed to explore the impact of gender, managerial level, and basic profession on how managers construct the manager role in relation to physicians. Practical implications - The results suggest that there is a need to address the organisational conditions for managers' role taking in healthcare organisations. Originality/value - Despite the general strengthening of the manager position in healthcare through political reforms during the last decades, this study shows that a profession-based discourse clearly dominated in how the managers constructed the manager role in relation to the medical profession on the workplace level in their organisations.

BACKGROUND

A study was conducted in 2004 to determine if 26 interventions--distributed among nine patient safety areas and as recommended by an expert panel as relevant to rural hospitals--would be validated in terms of relevance and implementability for small and rural facilities.

METHODS

The chief executive officers (CEOs) and/or key managers responsible for patient safety activities in a diverse group of 29 small and rural hospitals assessed the potential effectiveness and feasibility of the 26 interventions. Representatives of 25 hospitals participated in structured, follow-up phone discussions.

RESULTS

Adverse drug events were the highest-priority area for 14 hospitals, followed by patient falls (selected by 5 hospitals). Some hospitals had already implemented intervention 1 (use at least two patient identifiers) and intervention 6 (read back of verbal orders) and thus ranked them highly, especially for implementability. Intervention 3 (24-hour pharmacist coverage) was ranked low, especially on implementability. Interventions involving health information technology were ranked lower by the hospitals than by the expert panel.

CONCLUSIONS

Safety interventions should reflect the general state of the science of safe practices while incorporating relevant contextual issues unique to rural hospitals. The results have important implications for survey and accreditation activity, and the focus of technical assistance and research efforts.

Purchasing a mobile unit to deliver health-care services can be an expensive undertaking for anyone interested in pursuing this option. Yet, little information is found in the literature on planning or designing such vehicles. A set of guidelines could help administrators to make better decisions regarding this approach for delivering healthcare. This article focuses on mobile health units (MHU). It provides a synthesis of the literature in addition to information from written and oral correspondence with the chief executive officers (CEO) of firms that manufacture MHU. On-site visits to agencies using an MHU were made by one of the authors (DM) to glean their perspective. The combined sources led to the development of guidelines and checklists that can assist administrators in planning the function, design and operation of an MHU to deliver health-care services to remote rural sites.

Incomes in Canada, as in many other countries, are becoming increasingly unequal. In North America this process has several notable features. First, after 40 years of stability, income has since 1980 been increasingly concentrated in the hands of the top 0.01% of earners. Second, this concentration correlates with an explosion in the relative earnings of corporate CEOs, a sort of "corporate kleptocracy." Third, the top earners have appropriated most of the productivity gains over this period. The resources and political influence of the super-rich underlie the growing prominence of the "elite" agenda: lower taxes, smaller government and privatization or shrinkage of social programs. The marketing of this agenda may explain much of the nonsense that contaminates health policy debates.

Herein an unusual case of Wegener's granulomatosis with a painless, bulbar-conjunctival ulcer in the right eye is reported. Rapid disease progression occurred with central retinal artery occlusion in the fellow eye. Biopsy of the diseased conjunctiva confirmed the clinical diagnosis. The clinical and histopathological findings are discussed.

A 54-year-old man with a history of severe proliferative diabetic retinopathy in both eyes and profound visual impairment presented with severe corneal blood staining in the left eye secondary to a "spontaneous" total hyphaema and raised intraocular pressure in an eye with iris neovascularization. Despite anterior chamber washout, the cornea remained virtually opaque and thickened. The subject subsequently underwent pars plana vitrectomy with endolaser using a temporary keratoprosthesis, insertion of a Morcher iris-surround intraocular lens and penetrating keratoplasty. Histopathology of the excised corneal button revealed fine eosinophilic granules composed of aggregations of haemoglobin and its breakdown products dispersed throughout the stroma, with occasional foci of weakly positive Perl staining for intracellular haemosiderin. Fluorescence confocal microscopy revealed a marked increase in fluorescence throughout the corneal stroma and the basal epithelial layer. This case highlights the microstructural features and aspects of the surgical management of severe corneal blood staining.

BACKGROUND

To evaluate fibrovascular ingrowth into porous polyethylene orbital implants, using serial gadolinium (Gd)-enhanced magnetic resonance imaging (MRI).

METHODS

40 rabbits were divided into two groups, according to the surgical techniques used. Group 1 underwent enucleation of one eye and Medpor implantation, group 2 underwent evisceration and Medpor implantation. All subjects from each group were examined via MRI, and the implants were assessed histologically on the first, second, fourth and eighth postoperative weeks. The degree to which fibrovascular ingrowth occurred was then assessed by measuring the Gd-enhanced portion via MRI, as well as by histologic examination.

RESULTS

There was a significant correlation between the enhanced area on MRI and the fibrovascularized area observed upon histological examination in the two study groups (group 1: r = 0.850 P < 0.001, group 2: r = 0.788, P < 0.001). The area enhanced on MRI was 2.70% smaller in mean value than the fibrovascularized area observed upon histological examination. There was no differences in fibrovascular ingrowth between group 1 and 2. It was also found that there was no differences between the two groups with regard to the enhanced areas on MRI.

CONCLUSIONS

Gd-enhanced MRI study proved to be an excellent method for the assessment of fibrovascular ingrowth into the Medpor orbital implants, after both enucleation and evisceration.

Engaging family doctors in clinical practice innovations has often been seen to be a difficult challenge. It is happening in some creative ways with the Hamilton Family Health Team. This article illustrates how Ontario's Ministry of Health and Long-Term Care, some of the original leaders in the Hamilton Team, and CEO Terry McCarthy have created an environment that fosters emergent leadership. Their approach has accelerated the delivery of both increased access and improved patient care.

Unless President-elect Barack Obama-America's CEO-and the CEOs who run large businesses work together, health care changes will not occur. The government and private sector must abandon business as usual to reduce costs, reward outcomes, and stimulate innovative ways to achieve those outcomes. President-elect Obama will find a willing partner in corporate America if he reaches out in ways that recognize that solutions must put the patient at the center of our health care system and also drive efficiencies to allow U.S. companies to compete globally. It is past time for the nation's elected and appointed CEOs to take action to transform U.S. health care.

We present an octave-spanning Ti:sapphire oscillator supporting Fourier-limited pulses as short as 3.7 fs. This laser system can be directly CEO-phase stabilized delivering an average output power of about 90 mW with a pulse duration of 4.4 fs. The phase-stabilization is realized without additional spectral broadening using an f-2f interferometer approach allowing for full control of the electric pulse field on a sub-femtosecond time-scale.

Today, more than ever in the past, the variables within the health care environment (demand, costs, system deregulation) are undergoing such rapid change that hospital administrators are finding it necessary to develop and implement competitive strategies in order to survive in the increasingly competitive hospital environment. The primary aim of this paper is to answer the following question: Is it possible to transfer strategic management research from other sectors into the hospital industry? The first objective was to identify strategies in hospital management. A questionnaire was designed and sent to hospital CEOs and the data extracted were used to construct the variables needed to identify strategies and perform the subsequent analyses. The second aim was to try to identify groups of organizations using similar strategies and, finally, analyse the impact of these on hospital performance.

PolyHeme is a chemically modified haemoglobin solution derived from human blood. It has been developed by Northfield Laboratories as an alternative to transfused blood for the treatment of acute blood loss (such as in trauma or surgery). Single molecules of haemoglobin are toxic to the kidneys and cause vasoconstriction. The haemoglobin molecules in PolyHeme are polymerised to create small chains of linked tetramers. In August 2001, Northfield Laboratories stated that it had submitted a Biologics Licence Application (BLA) to the US FDA for approval of PolyHeme as a blood substitute for use in the treatment of urgent, life-threatening blood loss. There were some undisclosed problems with the BLA, and the US FDA asked for more information before it would accept the application or allow the company to conduct a trial for this indication. In March 2003, Northfield Laboratories announced that it had received clearance from the US FDA to proceed with a pivotal phase III trial evaluating the safety and efficacy of PolyHeme in improving patient survival when used to treat severely injured and bleeding trauma patients at the scene of injury and during ambulance transport to the hospital. Because of the severity of patients' injuries, this trial will be conducted under federal regulations that allow clinical research in emergency settings without obtaining informed consent. This trial will be conducted in urban settings where transit times to hospital may be short and not long enough to demonstrate superiority to the control group, therefore dual primary endpoints of superiority and non-inferiority will be evaluated. Northfield Laboratories has initiated a public disclosure and community consultation process; because informed consent will not be possible, this is one of the US FDA requirements that must be met prior to initiating the trial. In June 2003, Northfield Laboratories reached an agreement with the US FDA on Special Protocol Assessment (SPA) for the trial. The SPA is an acknowledgment and agreement between the trial sponsor and the US FDA for successful completion of the proposed trial to form the primary basis for an efficacy claim. In October 2002, Northfield Laboratories announced that it was collaborating with the US Army in developing a treatment Investigational New Drug Application (IND) for the battlefield use of PolyHeme. The IND is being developed to gain authorisation for the use of PolyHeme in patients in shock in remote battlefield settings, where red blood cells are not available. Phase III trials in the UK, Germany and Sweden are underway with Pharmacia Corporation (now Pfizer), who has licenced PolyHeme in these countries. On 16 April 2003, Pharmacia Corporation was acquired by, and merged into, Pfizer. Northfield Laboratories' US phase III trials have focused on elective surgery indications while the European trials are focusing on surgery with acute trauma patients where large amounts of blood are lost. Up to 20 units of PolyHeme have been infused in US trials in trauma patients. This volume represents 200% of an average person's blood volume. Northfield Laboratories has estimated that of the approximately 14 million units of blood which were used for transfusions in the US in 2001, about 8.5 million units were for acute blood loss, for which patient charges amounted to an estimated $US2.5 billion. The US transfusion market consists of two principal segments: the acute blood loss segment, which accounts for about 60% of the total market according to Northfield Laboratories, and the chronic blood loss segment, accounting for the remaining 40%. The former includes transfusions in connection with trauma, surgery and unexpected blood loss, while the latter includes transfusions used in general medical applications and chronic anaemias. Northfield Laboratories believes that PolyHeme's largest potential is in the elective surgery market, at the time estimated to use approximately 6.5 million units of blood in the US annually.Earlier, on 7 March 2003, the newswires quoted er, on 7 March 2003, the newswires quoted the CEO of Northfield Laboratories, stating that it is to administer 10 000 units of PolyHeme to 20 US trauma centres, following US FDA approval of a third phase III trial. Pending market approval of PolyHeme, the company will initially produce 75 000 units of the product, but expects this to increase to 400 000 units annually. Wall Street analysts have estimated the market potential for a substitute blood product to be in the "multibillion-dollar" range, according to the CEO. However, launch of PolyHeme was at the time said to be "a couple of years away".

"Pay fo performance" and "service-based funding" are fast-growing international trends, rapidly becoming dominant models in American and British healthcare. Now they're a bigger role in years to come. This reality led the Canadian Health Services Research foundation (CHSRF) to organize its third annual CEO forum on the subject in February 2009.

Research into the importance of organizational healthcare ethics has increasingly appeared in healthcare publications. However, to date, few published studies have examined ethical issues from the perspective of healthcare executives, and no empirical study has addressed organizational ethics with an explicit focus on rural hospitals. For our study, we sought to identify the frequency of ethical conflicts occurring within 12 general categories (domains) of administrative activities. Also, we wanted to determine what ethics resources are currently available and whether additional resources would be helpful. We conducted a structured telephone interview of all 13 chief executive officers (CEOs) of critical access hospitals in New Hampshire. All the CEOs in the study indicated that they encountered ethical conflicts. On average, the three most frequently noted domains were organizational-professional staff relations, reimbursement, and clinical care. All CEOs indicated they would like to have additional ethics resources to address these conflicts. This study verified that CEOs encounter a broad spectrum of ethical conflicts and need additional ethics resources to address them. Because this study used a small sample of CEOs and represented only one New England state, further ethics-related research in rural healthcare facilities is warranted. Follow-up study would allow for (1) a higher level of generalization of the findings, (2) clarity regarding specific ethical dilemmas that rural healthcare executives encounter, and (3) an assessment of ethics resources and training that healthcare executives need to address the ethical conflicts.

The quality domains of patient-centered and equitable care are increasingly relevant to today's healthcare leaders as hospitals care for patients with increasingly diverse cultural and linguistic needs. Hospital leaders face substantial tensions in defining their organization's strategic priorities to improve care for diverse populations with limited resources, increased competition, and complex regulatory and accreditation requirements. We sought to understand what motivates hospitals to focus on and commit resources to supporting the delivery of culturally competent care by analyzing interviews with chief executive officers (CEOs) in 60 hospitals across the United States. Hospital CEOs in our study most often embraced cultural competence efforts because doing so helped them achieve the organization's mission and priorities and/ or meet the needs of a particular patient population. Less often, they were motivated by perceived benefits and legal or regulatory issues. Many CEOs articulated a link between quality and cultural competence, and a smaller number went on to link cultural competence efforts to improved financial outcomes through cost savings, increased market share, and improved efficiency of care. However, the link between quality and cultural competence is still in the early stages. Fortunately, frameworks for hospitals to adopt and steps that hospitals can take to improve the quality of care for all patients have been identified. They begin with a commitment from hospital leaders based on understanding the needs of patients and communities and are propelled by data that reveal the impact of efforts to improve care. Leaders must communicate and shepherd organizations to align the congruence between improvement efforts and business strategies.

Americans have long believed that U.S. military officers--trained for high-stakes positions, resilience, and mental agility--make excellent CEOs. That belief is sound, but the authors' analysis of the performance of 45 companies led by CEOs with military experience revealed differences in how the branches (Army, Navy, Air Force, Marine Corps) prepare leaders for business. Those differences reflect the trade-off between flexibility and process that each branch of the armed services must make. Army and Marine Corps officers operate in an inherently uncertain environment. They define the mission but then give subordinates the flexibility to adjust to realities on the ground. This leadership experience tends to turn out business executives who excel in small firms, where they can set a goal and then empower others to work toward it. Navy and Air Force officers, who operate expensive, complex systems such as submarines and aircraft carriers, are trained to follow processes to the letter, because even small deviations can have large consequences. In corporations, these leaders excel in regulated industries and in firms that take a process approach to innovation. The larger lesson that the military can offer the business world is that fit matters. Different circumstances demand different leadership skills. Hire the person who fits the job.