Laparoscopic One-Stage vs Endoscopic Plus Laparoscopic Management of Common Bile Duct Stones – A Prospective Randomized Study

Improvements in diagnostic and operative approach to CBD stones associated with cholelithiasis allow the surgeon to treat in a single stage the disease through a laparoscopic approach, The AA report the results of a prospective randomised study comparing this approach to a a double stage endoscopic plus laparoscopic cholecistectomy in 124 patients. techniques and procedures are referred and the results are statistically analysed. the outcome of the two procedures were recorded as success or failure according to the complete clearance of the CB

Revival of Philozoon Geddes for host-specialized dinoflagellates, ‘zooxanthellae’, in animals from coastal temperate zones of northern and southern hemispheres

The dinoflagellate family Symbiodiniaceae comprises numerous genera and species with large differences in diversity, ecology and geographic distribution. An evolutionarily divergent lineage common in temperate symbiotic cnidarians and designated in the literature by several informal names including ‘temperate–A’, AI, Phylotype A´ (A-prime) and ‘Mediterranean A’, is here assigned to the genus Philozoon. This genus was proposed by Geddes (1882) in one of the earliest papers that recognized ‘yellow cells’ as distinct biological entities separate from their animal and protist hosts. Using phylogenetic data from nuclear (rDNA), chloroplast (cp23S) and mitochondrial genes (cob and cox1), as well as morphology (cell size), ecological traits (host affinity) and geographic distributions, we emend the genus Philozoon Geddes and two of its species, P. medusarum and P. actiniarum, and describe six new species. Each symbiont species exhibits high host fidelity for particular species of sea anemone, soft coral, stony coral and a rhizostome jellyfish. Philozoon is most closely related to Symbiodinium (formerly Clade A), but, unlike its tropical counterpart, occurs in hosts in shallow temperate marine habitats in northern and southern hemispheres including the Mediterranean Sea, north-eastern Atlantic Ocean, eastern Australia, New Zealand and Chile. The existence of a species-diverse lineage adapted to cnidarian hosts living in high latitude habitats with inherently wide fluctuations in temperature calls further attention to the ecological and biogeographic reach of the Symbiodiniaceae

Parallel algebraic multilevel Schwarz preconditioners for a class of elliptic PDE systems

Algebraic multilevel preconditioners for algebraic problems arising from the discretization of a class of systems of coupled elliptic partial differential equations (PDEs) are presented. These preconditioners are based on modifications of Schwarz methods and of the smoothed aggregation technique, where the coarsening strategy and the restriction and prolongation operators are defined using a point-based approach with a primary matrix corresponding to a single PDE. The preconditioners are implemented in a parallel computing framework and are tested on two representative PDE systems. The results of the numerical experiments show the effectiveness and the scalability of the proposed methods. A convergence theory for the twolevel case is presented

The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews.

BACKGROUND: Nurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of existing literature, much of which is already in review form. In order to advance the usefulness of the literature for nurse and human resource managers, we undertook an overview (review of systematic reviews). The aim of the overview was to identify high quality evidence of the determinants and consequences of turnover in adult nursing. METHODS: Reviews were identified which were published between 1990 and January 2015 in English using electronic databases (the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS) and forward searching. All stages of the review were conducted in parallel by two reviewers. Reviews were quality appraised using the Assessment of Multiple Systematic Reviews and their findings narratively synthesised. RESULTS: Nine reviews were included. We found that the current evidence is incomplete and has a number of important limitations. However, a body of moderate quality review evidence does exist giving a picture of multiple determinants of turnover in adult nursing, with - at the individual level - nurse stress and dissatisfaction being important factors and -at the organisational level - managerial style and supervisory support factors holding most weight. The consequences of turnover are only described in economic terms, but are considered significant. CONCLUSIONS: In making a quality assessment of the review as well as considering the quality of the included primary studies and specificity in the outcomes they measure, the overview found that the evidence is not as definitive as previously presented from individual reviews. Further research is required, of rigorous research design, whether quantitative or qualitative, particularly against the outcome of actual turnover as opposed to intention to leave. TRIAL REGISTRATION: PROSPERO Registration 17 March 2015: CRD42015017613

Impact of internet of things (IoT) in disaster management: a task-technology fit perspective

YesDisaster management aims to mitigate the potential damage from the disasters, ensure immediate and suitable assistance to the victims, and attain effective and rapid recovery. These objectives require a planned and effective rescue operation post such disasters. Different types of information about the impact of the disaster are, hence, required for planning an effective and immediate relief operation. The IoT technology available today is quite mature and has the potential to be very useful in disaster situations. This paper analyzes the requirements for planning rescue operation for such natural disasters and proposes an IoT based solution to cater the identified requirements. The proposed solution is further validated using the task-technology fit (TTF) approach for analyzing the significance of the adoption of IoT technology for disaster management. Results from the exploratory study established the core dimensions of the task requirements and the TTF constructs. Results from the confirmatory factor analysis using PLS path modelling, further, suggest that both task requirements and IoT technology have significant impact on the IoT TTF in the disaster management scenario. This paper makes significant contributions in the development of appropriate constructs for modeling TTF for IoT Technology in the context of disaster management

Cumulative chi-squared statistics for the service quality improvement: new properties and tools for the evaluation

In service quality evaluation, data are often categorical variables with ordered categories and collected in two way contingency table. The Taguchi’s statistic is a measure of the association between these variables as a simple alternative to Pearson’s test. An extension of this statistic for three way contingency tables handled in two way mode is introduced.We highlight its several properties, the approximated distribution, a decomposition according to orthogonal quantities reflecting the main effects and the interaction terms, and an extension of cumulative correspondence analysis based on it