Laparoscopic surgery for Crohn’s disease: a meta-analysis of perioperative complications and long term outcomes compared with open surgery

BACKGROUND: Previous meta-analyses have had conflicting conclusions regarding the differences between laparoscopic and open techniques in patients with Crohn’s Disease. The objective of this meta-analysis was to compare outcomes in patients with Crohn’s disease undergoing laparoscopic or open surgical resection. METHODS: A literature search of EMBASE, MEDLINE, The Cochrane Central Register of Controlled Trials and the US National Institute of Health’s Clinical Trials Registry was completed. Randomized clinical trials and non-randomized comparative studies were included if laparoscopic and open surgical resections were compared. Primary outcomes assessed included perioperative complications, recurrence requiring surgery, small bowel obstruction and incisional hernia. RESULTS: 34 studies were included in the analysis, and represented 2,519 patients. Pooled analysis showed reduced perioperative complications in patients undergoing laparoscopic resection vs. open resection (Risk Ratio 0.71, 95% CI 0.58 – 0.86, P = 0.001). There was no evidence of a difference in the rate of surgical recurrence (Rate Ratio 0.78, 95% CI 0.54 – 1.11, P = 0.17) or small bowel obstruction (Rate Ratio 0.63, 95% CI 0.28 – 1.45, P = 0.28) between techniques. There was evidence of a decrease in incisional hernia following laparoscopic surgery (Rate Ratio 0.24, 95% CI 0.07 – 0.82, P = 0.02). CONCLUSIONS: This is the largest review in this topic. The results of this analysis are based primarily on non-randomized studies and thus have significant limitations in regards to selection bias, confounding, lack of blinding and potential publication bias. Although we found evidence of decreased perioperative complications and incisional hernia in the laparoscopic group, further randomized controlled trials, with adequate follow up, are needed before strong recommendations can be made

Parallel and Context Based Search in Cloud using Multi Agent System

Cloud Computing is one of the fast growing Technology. Cloud computing support large scale infrastructure used to increase high performance of computing. This technology support agents and with the help of integration of the agents that is Multi Agent System (MAS) which is capable of intelligent behavior. They run in an environment where they communicate with each other using message passing technique. Each agent has its own set of behavior and they run independent of each other. When a message arrives each agent shows their own behavior and hence an agent shows their coordination. The use of MAS in cloud computing help us for searching context with better performance. The JADE is a platform which supports agent. This paper discusses about Cloud computing models and architectures, information retrieving technique and the use of MAS that improve the performance of big data search from Distributed File System (DFS) which is difficult to achieve using single agent or thread. Keywords: Cloud Computing, Distributed File System, JADE, MA

The H1 Forward Track Detector at HERA II

In order to maintain efficient tracking in the forward region of H1 after the luminosity upgrade of the HERA machine, the H1 Forward Track Detector was also upgraded. While much of the original software and techniques used for the HERA I phase could be reused, the software for pattern recognition was completely rewritten. This, along with several other improvements in hit finding and high-level track reconstruction, are described in detail together with a summary of the performance of the detector.Comment: Minor revision requested by journal (JINST) edito

Loss of Immunohistochemical Reactivity in Association With Handling-Induced Dark Neurons in Mouse Brains.

The handling-induced dark neuron is a histological artifact observed in brain samples handled before fixation with aldehydes. To explore associations between dark neurons and immunohistochemical alterations in mouse brains, we examined protein products encoded by Cav3 (neuronal perikarya/neurites), Rbbp4 (neuronal nuclei), Gfap (astroglia), and Aif1 (microglia) genes in adjacent tissue sections. Here, dark neurons were incidental findings from our prior project, studying the effects of age and high-fat diet on metabolic homeostasis in male C57BL/6N mice. Available were brains from 4 study groups: middle-aged/control diet, middle-aged/high-fat diet, old/control diet, and old/high-fat diet. Young/control diet mice were used as baseline. The hemibrains were immersion-fixed with paraformaldehyde and paraffin-embedded. In the hippocampal formation, we found negative correlations between dark neuron hyperbasophilia and immunoreactivity for CAV3, RBBP4, and glial fibrillary acidic protein (GFAP) using quantitative image analysis. There was no significant difference in dark neuron hyperbasophilia or immunoreactivity for any protein examined among all groups. In contrast, in the hippocampal fimbria, old age seemed to be associated with higher immunoreactivity for GFAP and allograft inflammatory factor-1. Our findings suggest that loss of immunohistochemical reactivity for CAV3, RBBP4, and GFAP in the hippocampal formation is an artifact associated with the occurrence of dark neurons. The unawareness of dark neurons may lead to misinterpretation of immunohistochemical reactivity alterations

Potts Flux Tube Model at Nonzero Chemical Potential

We model the deconfinement phase transition in quantum chromodynamics at nonzero baryon number density and large quark mass by extending the flux tube model (three-state, three-dimensional Potts model) to nonzero chemical potential. In a direct numerical simulation we confirm mean-field-theory predictions that the deconfinement transition does not occur in a baryon-rich environment.Comment: 14 pp RevTeX, 10 Postscript figures, submitted to Phys. Rev D. (Corrected some typographical errors.

Independent Configurable Architecture for Reliable Operation of Unmanned Systems with Distributed Onboard Services

This paper presents the development of ICAROUS-2 (Independent Configurable Architecture for Reliable Operation of Unmanned Systems with Distributed Onboard Services), the second generation of a software architecture that integrates several algorithms as distributed onboard services to enable robust autonomous UAS applications. In particular, the ICAROUS architecture defines a framework to perform detect and avoid, geofencing, path monitoring, path planning, and autonomous decision making to ensure safety and mission progress. Most of the core algorithms implemented in ICAROUS are formally verified using an interactive theorem prover. These algorithms are composed together using a plan execution engine, whose operational semantics is formally specified. A description of the integrated architecture, services currently available, and flight test results highlighting the capability of ICAROUS are presented

Heavy Flavour Baryons in Hyper Central Model

Heavy flavor baryons containing single and double charm (beauty) quarks with light flavor combinations are studied using the hyper central description of the three-body problem. The confinement potential is assumed as hyper central coulomb plus power potential with power index $\upsilon$. The ground state masses of the heavy flavor, $J^P={1/2}^+$ and ${3/2}^+$ baryons are computed for different power index, $\nu$ starting from 0.5 to 2.0. The predicted masses are found to attain a saturated value in each case of quark combinations beyond the power index $\nu=1.0$.Comment: 10 pages, 4 figure

Efficacy and superiority of an innovative method (IM) of intravenous (IV) fluid drip drop rate calculation using IV set and its comparison with conventional methods (CM)

Background: Almost every indoor patient requires some form of intravenous (IV) fluids and its infusion rate should be proper as recommended for best treatment outcomes. To overcome the same, a simple, quick and easily applicable new method for drip drop rate calculation is proposed, which is user-friendly at bedside and doesn’t require mathematical skills or help.Methods: Author compared this novel innovative method (IM) of IV fluid drip drop rate method for both regular macro and micro drop infusion set against conventional mathematical calculation method (MC) of infusion in various IV fluid indoor orders and assessed for time-to-initiation of treatment (TI) required and its accuracy. Ten resident doctors and ten nursing staff participated to grade both conventional and novel methods by using pre-printed forms of various parameters like time consumption, comfort level, accuracy and applicability in ward and these both methods were scored on a scale of 1 to 10.Results: Conventional method (CM) required 14.23±1.10seconds, while novel method (IM) required average 3.63±0.73seconds for calculation of drop rate. Average grading for conventional method was 3.63±0.49 and for novel method was 7.84±0.6 out of 10.Conclusions: Novel method of IV fluid drip drop rate formula is easy, quick and superior in comparison to conventional method and it doesn’t require any additional instrumental help. It is good alternative to conventional formula for IV drip drop rate calculation in absence of infusion pump