Laparoscopic subtotal reconstituting cholecystectomy in type II & III Mirizzi syndrome: Case series of 5 patients.

BACKGROUND: Mirizzi syndrome Type II & III treatment is a true surgical challenge. The purpose was to determine whether the laparoscopic subtotal reconstituting cholecystectomy can be a safe and effective approach in our institution to treat Mirizzi Syndrome type II and III. CASE PRESENTATION: We report a case series of 5 patients with Mirizzi syndrome type II and III who underwent laparoscopic subtotal reconstituting cholecystectomy. DISCUSSION: We found only one patient had presurgical diagnosis, average surgical time of 218 min, average surgical bleeding of 230 ml and the mean hospital stay of 3.4 days; one patient presented low volume and auto limited biliary leak; no cases presented biliary injury, major complications, or reintervention. CONCLUSIONS: Laparoscopic subtotal reconstituting cholecystectomy is a security and effective technique to treat type II and III Mirizzi syndrome in our context.

Automated Workflow for Usability Audits in the PHR Realm.

Teleworking is an everyday reality in today's world. Many companies are opting for this way of working remotely, as it improves employers' satisfaction along with the work-life balance and it does not lead to any significant reduction in performance. In general, the comfortable use of software applications is a priority, and quality aspects such as usability are of vital importance. In this paper, a novel workflow is proposed. It consists of the following components: (1) a tool to manage usability evaluations based on expert reviews, called Usevalia; (2) a set of heuristics to be considered when performing the evaluations; (3) a catalogue of usability requirements to guide the evaluations; (4) a checklist related to the heuristics to verify that the evaluations have been performed correctly by all the auditors; and (5) a set of tasks to know in advance the functionality of the applications to be audited. Personal health records (PHRs) were taken as a case study. This methodology made it possible to involve a total of 31 working groups that evaluated the usability of four PHRs. Concerning the main results, the evaluators agreed that with Usevalia the usability evaluations could go a step further because they are coordinated and can work together remotely. In addition, analyses of usability scores provided insight into current proposals for improving usability of applications.

Position statement on the use of albumin in liver cirrhosis.

Cirrhosis is characterised by a prolonged asymptomatic period in which the inflammation persists, increasing as the disease progresses. Characteristic of this is the increase in pro-inflammatory cytokines and pro-oxidant molecules which are determining factors in the development of multiple organ dysfunction. In the early development of cirrhosis, splanchnic arterial vasodilation, activation of vasoconstrictor systems (renin-angiotensin-aldosterone) and the sympathetic nervous system (noradrenaline) bring about bacterial translocation and systemic dissemination via portal circulation of bacterial products, and molecular patterns associated with damage, which exacerbate the systemic inflammation present in the patient with cirrhosis. Albumin is a molecule that undergoes structural and functional changes as liver damage progresses, affecting its antioxidant, immunomodulatory, oncotic and endothelial stabilising properties. Our knowledge of the properties of albumin reveals a molecule with multiple treatment options in patients with cirrhosis, from the compensated then decompensated phases to multiple organ dysfunction. Its recognised uses in spontaneous bacterial peritonitis, post-paracentesis circulatory dysfunction, acute kidney injury and hepatorenal syndrome are fully validated, and a treatment option has opened up in decompensated cirrhosis and in acute-on-chronic liver disease.

Investigating the Impact of Usability on Energy Efficiency of Web-based Personal Health Records.

Usability plays an important role in eHealth applications for their widespread adoption. These software systems have been studied in depth in the literature from this perspective. However, the energy consumption of information systems in the eHealth domain lacks comprehensive research. In this paper, the relationship between the energy consumption of the main components of a PC and the usability evaluations of graphical user interfaces (GUI) were studied in client applications. For this purpose, personal health records (PHR) were used as a case study. A set of 4 web-based PHRs were evaluated with the performance of 20 common tasks in the aforementioned systems. The usability evaluations were carried out by 4 experts. A total of 8 heuristics particularly designed for electronic health record systems and based on the Nielsen usability heuristics were employed. The instantaneous energy values of the power supply and the monitor were collected with an energy consumption measuring equipment. As a result, the following significant correlations were found. In NoMoreClipboard between the Memory heuristic and the power supply (rs = 0.495, p = 0.044), and the Minimalist heuristic and the monitor (rs = - 0.513, p = 0.035). In PatientsLikeMe between the Minimalist heuristic and the power supply (rs = - 0.479, p = 0.083), as well as in the Error heuristic and the power supply (rs = - 0.638, p = 0.014). Finally, in Health Companion between the Match heuristic and the power supply (rs = - 0.481, p = 0.043), and the Error heuristic and the power supply again (rs = - 0.602, p = 0.008). Apart from that, the tasks were divided into those with excellent and fair usability. Those tasks with high usability scores were evaluated to detect whether they also had low energy consumption during task performance. Significant differences were found in PatientsLikeMe with respect to the Error heuristic and the power supply (212.39 ± 18.85W). Significant differences were also found in Health Companion with respect to the Match heuristic and the power supply (199.91 ± 7.19W). The results were discussed to reveal the fundamentals of how implementing usability can impact on energy costs when running client applications.

A Study on the Relationship between Usability of GUIs and Power Consumption of a PC: The Case of PHRs.

Usability is key to achieve quality in software products. The client applications with a high score in usability might impact on the power consumption when they are run in a PC. For this reason, energy savings turn to be critical in green software systems. In this paper the relationship between the usability evaluations of the GUIs and the power consumption measurements of the main components of a PC were analysed. A set of 5 web-based personal health records (PHRs) were selected as a case study. The usability assessment was performed by an expert, employing the 14 principles of design by Alan Dix as heuristics. They were scored on a Likert scale after performing a collection of common tasks in the PHRs. At the same time, an equipment to measure the energy consumption of hard disk drive, graphics card, processor, monitor and power supply was used. Spearman's index was studied for the correlations between the usability assessments and the power consumption measurements. As a results, some weak relationships were found. A total of 5 usability heuristics were observed to may influence energy consumption when they were considered in the implementation of the PHRs. These heuristics were the following ones: consistency, task migratability, observability, recoverability and responsiveness. Based on the results, the usability principles of design cannot always be related to lower energy consumption. Future research should focus on the tradeoffs between usability and power consumption of client applications when they are used in a computer.

Are the expected benefits of requirements reuse hampered by distance? An experiment.

BACKGROUND: Software development processes are often performed by distributed teams which may be separated by great distances. Global software development (GSD) has undergone a significant growth in recent years. The challenges concerning GSD are especially relevant to requirements engineering (RE). Stakeholders need to share a common ground, but there are many difficulties as regards the potentially variable interpretation of the requirements in different contexts. We posit that the application of requirements reuse techniques could alleviate this problem through the diminution of the number of requirements open to misinterpretation. RESULTS: This paper presents a reuse-based approach with which to address RE in GSD, with special emphasis on specification techniques, namely parameterised requirements and traceability relationships. An experiment was carried out with the participation of 29 university students enrolled on a Computer Science and Engineering course. Two main scenarios that represented co-localisation and distribution in software development were portrayed by participants from Spain and Morocco. The global teams achieved a slightly better performance than the co-located teams as regards effectiveness, which could be a result of the worse productivity of the global teams in comparison to the co-located teams. Subjective perceptions were generally more positive in the case of the distributed teams (difficulty, speed and understanding), with the exception of quality. CONCLUSIONS: A theoretical model has been proposed as an evaluation framework with which to analyse, from the point of view of the factor of distance, the effect of requirements specification techniques on a set of performance and perception-based variables. The experiment utilised a new internationalisation requirements catalogue. None of the differences found between co-located and distributed teams were significant according to the outcome of our statistical tests. The well-known benefits of requirements reuse in traditional co-located projects could, therefore, also be expected in GSD projects.