Outsourcing: More Harm than Good

Outsourcing is a highly effective strategy, widely used in various types of business to gain a competitive edge. The tremendous growth of outsourcing first started in the manufacturing and information technology industries. It has also spread into the accounting industry as well. However, in accounting the major problems and benefits caused by outsourcing are different from those identified in the manufacturing and IT industries. This leads to the question of whether or not outsourcing in accounting would create more advantages than disadvantages. This paper analyzes the question through four steps: (1) how accounting outsourcing is done, (2) which accounting tasks (both private and public) are fit for outsourcing, (3) what are the benefits and challenges of accounting outsourcing, and (4) what are the effects that outsourcing, including accounting outsourcing, have on the U.S economy. The author argues that accounting outsourcing generates more risks and harmful effects than benefits for companies and their stakeholders. Therefore, accounting outsourcing should be discouraged. This research provides a comprehensive view on the topic of outsourcing in accounting, including rewards and problems caused by accounting outsourcing, effects of outsourcing on business stakeholders, effects of outsourcing on the U.S economy, and future outsourcing trends and regulations

Assessment of the Effectiveness of Ich Tam Khang as a Supportive Therapy for Chronic Heart Failure

Background: Heart failure is a chronic disease needing lifelong management. Despite the advances that have been made in the treatment of the disease, both the longevity and quality of life for those with chronic heart failure remain impaired. A more effective therapeutic approach with less negative side effects is still needed. In this study, we evaluate Ich Tam Khang (ITK), the poly-ingredient herbal and nutritional preparation with multiple physiological actions, as a supportive therapy for patients with chronic heart failure.Aims of Study: To evaluate the effectiveness and safety of Ich Tam Khang as an adjunctive treatment of chronic heart failure.Methods: A total of 60 patients with chronic congestive heart failure were enrolled in this open label, cross-sectional and prospective study. All patients were treated with a conventional regimen (digoxin, diuretics, angiotensin-converting-enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), beta blockers) for at least 4 weeks before being divided into two equal groups. In the treated patients with ITK, patients received conventional therapy plus 4 tablets ITK per day added in two divided doses. In the control patients, all patients kept the same conventional regimen without ITK. All patients were followed up for 3 months for clinical and para-clinical outcomes.Result: The symptoms of heart failure (dyspnea, palpitation, peripheral edema, neck vein distention, heptojugular reflex) decreased. Heart rate and blood pressure stabilized during treatment in the treated patients with ITK. Additionally, total cholesterol and HDL-cholesterol normalized in the patients treated with ITK. Most of echocardiography parameters in the ITK treated patients were superior to the control patients. ITK is safe and it has no side effects.Conclusion: ITK as a combination of herbal and nutritional preparation is effective in reducing heart failure symptoms, improving patient's quality of life for the patients with decompensated heart failure and reducing total cholesterol and LDL-C

NGHIÊN CỨU THÀNH PHẦN VÀ HÀM LƯỢNG CÁC LỚP CHẤT LIPID, PHOSPHOLIPID, AXIT BÉO, VÀ PHOSPHATIDYLCHOLINE LOÀI SAN HÔ MỀM CAPNELLA SP.

The total lipid content of the soft coral Capnella sp. contained 1.44 ± 0.10% of the fresh weight. In the fatty acid content, the tetracosapolyenoic fatty acids 24:5n-6 and 24:6n-3, which were the typical markers for the soft corals (the eight compartment coral), and the fatty acids that marked for symbiotic microorganism including 18:5n-3, 18:2n-6, 18:3n-6, 18:4n-3, 20:4n-3 were presented. The result of the lipid composition analysis showed that the total lipid contained polar lipid, sterol, free fatty acid, triacylglycerol, monoalkyldiacylglycerol, hydrocarbon and wax. Of these, the polar lipid displayed the highest content with 21.14 ± 1.17% of the total lipid. The phospholipid composition of the soft coral Capnella sp. contained the characteristic phospholipid subclasses of the animals of the phylum Cnidaria, including phosphatidylethanolamine, phosphatidylcholine, phosphatidylserine, phosphatidylinositol, and ceramide aminoethylphosphonate (phosphonolipid, CAEP). Of these, phosphatidylcholine exhibited the highest content with 35.53 ± 1.46% of the total phospholipid. This is the first time that the content and composition of the molecular types of the phosphatidylcholine from a Vietnamese soft coral species have been investigated and reported. By using modern mass spectrometry IT TOF LC-MS, the presence of 13 molecular types have been precisely identified, which PC 18:0e/20:4 and PC 16:0e/20:4 were the two ingredients displaying the highest content.Hàm lượng lipid tổng của mẫu san hô mềm Capnella sp. chiếm 1,44 ± 0,10% so với trọng lượng mẫu tươi. Trong thành phần axit béo có mặt các axit béo tetracosapolyenoic 24:5n-6 và 24:6n-3 là axit béo đánh dấu điển hình cho san hô mềm (san hô tám ngăn) và các axit béo đánh dấu cho vi sinh vật cộng sinh như 18:5n-3, 18:2n-6, 18:3n-6, 18:4n-3, 20:4n-3. Kết quả phân tích lớp chất lipid cho thấy trong lipid tổng có mặt các lớp chất lipid chính là lipid phân cực, sterol, axit béo tự do, triacylglycerol, monoalkyldiacylglycerol, hydrocacbon và sáp, trong đó lipid phân cực chiếm hàm lượng cao nhất (21,14 ± 1,17% hàm lượng lipid tổng). Thành phần phospholipid của san hô mềm Capnella sp. có mặt các phân lớp phospholipid đặc trưng của động vật ngành Cnidarian là phosphatidylethanolamine, phosphatidylcholine, phosphatidylserine, phosphatidylinositol, phosphonolipid là ceramide aminoethylphosphonate, trong đó phosphatidylcholine chiếm hàm lượng cao nhất (35,53 ± 1,46% tổng phospholipid). Đây là lần đầu tiên ở Việt Nam, thành phần và hàm lượng các dạng phân tử trong lớp chất phosphatidylcholine từ loài san hô mềm của Việt Nam được nghiên cứu và công bố, kết quả đã xác định được sự có mặt của 13 dạng phân tử bằng phương pháp phổ khối hiện đại LC-MS IT TOF với độ chính xác cao. Hai dạng phân tử chiếm hàm lượng cao nhất là PC 18:0e/20:4 và PC 16:0e/20:4

Study on total lipid content, lipid class composition of some fire and soft corals collected in Nha Trang, Vietnam

For the first time, the total lipid content and lipid class composition of  the Vietnamese soft corals (Sinularia brassica, Sinularia flexibilis) and fire corals (Millepora dichotoma, Millepora platyphylla) were investigated. The results indicated that the total lipid content of the investigated species was significantly different. Compositions of the lipid classes were analyzed using TLC and image analysis program Sorbfil TLC Videodensitometer DV and the results showed that phospholipids (PL, 10.91–16.02%), monoalkyldiacylglycerols (MADAG, 20.69-39.92%) and hydrocarbon wax (HW, 29.83-37.17%) were the main lipid classes of the total lipid in soft coral species. Meanwhile, PL (24.11-33.23%), TG (14.27–34.92%), ST (10.10–14.50%) and HW (12.08–19.95%) were predominant in fire coral species. ST, TG and FFA contents in soft and fire corals were at low level. DG was only present in the Sinularia flexibilis but not in other studied corals

Complete genome characterization of two wild-type measles viruses from Vietnamese infants during the 2014 outbreak

A large measles virus outbreak occurred across Vietnam in 2014. We identified and obtained complete measles virus genomes in stool samples collected from two diarrheal pediatric patients in Dong Thap Province. These are the first complete genome sequences of circulating measles viruses in Vietnam during the 2014 measles outbreak

Genome sequences of a novel Vietnamese bat bunyavirus

To document the viral zoonotic risks in Vietnam, fecal samples were systematically collected from a number of mammals in southern Vietnam and subjected to agnostic deep sequencing. We describe here novel Vietnamese bunyavirus sequences detected in bat feces. The complete L and S segments from 14 viruses were determined

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Syndrome d'interruption de la tige pituitaire (anomalies et malformations associées, A propos de 84 patients)

LE KREMLIN-B.- PARIS 11-BU Méd (940432101) / SudocSudocFranceF