Remote video auditing with real-time feedback in an academic surgical suite improves safety and efficiency metrics: a cluster randomised study

IMPORTANCE: Compliance with the surgical safety checklist during operative procedures has been shown to reduce inhospital mortality and complications but proper execution by the surgical team remains elusive. OBJECTIVE: We evaluated the impact of remote video auditing with real-time provider feedback on checklist compliance during sign-in, time-out and sign-out and case turnover times. DESIGN, SETTING: Prospective, cluster randomised study in a 23-operating room (OR) suite. PARTICIPANTS: Surgeons, anaesthesia providers, nurses and support staff. EXPOSURE: ORs were randomised to receive, or not receive, real-time feedback on safety checklist compliance and efficiency metrics via display boards and text messages, followed by a period during which all ORs received feedback. MAIN OUTCOMES AND MEASURES: Checklist compliance (Pass/Fail) during sign-in, time-out and sign-out demonstrated by (1) use of checklist, (2) team attentiveness, (3) required duration, (4) proper sequence and duration of case turnover times. RESULTS: Sign-in, time-out and sign-out PASS rates increased from 25%, 16% and 32% during baseline phase (n=1886) to 64%, 84% and 68% for feedback ORs versus 40%, 77% and 51% for no-feedback ORs (

Nucleotide cofactor-dependent structural change of Xenopus laevis Rad51 protein filament detected by small-angle neutron scattering measurements in solution

Rad51 protein, a eukaryotic homologue of RecA protein, forms a filamentous complex with DNA and catalyzes homologous recombination. We have analyzed the structure of Xenopus Rad51 protein (XRad51.1) in solution by small-angle neutron scattering (SANS). The measurements showed that XRad51.1 forms a helical filament independently of DNA. The sizes of the cross-sectional and helical pitch of the filament could be determined, respectively, from a Guinier plot and the position of the subsidiary maximum of SANS data. We observed that the helical structure is modified by nucleotide binding as in the case of RecA. Upon ATP binding under high-salt conditions (600 mM NaCl), the helical pitch of XRad51.1 filament was increased from 8 to 10 nm and the cross-sectional diameter decreased from 7 to 6 nm. The pitch sizes of XRad51.1 are similar to, though slightly larger than, those of RecA filament under corresponding conditions. A similar helical pitch size was observed by electron microscopy for budding yeast Rad51 [Ogawa, T., et al. (1993) Science 259, 1896-1899]. In contrast to the RecA filament, the structure of XRad51.1 filament with ADP is not significantly different from that with ATP. Thus, the hydrolysis of ATP to ADP does not modify the helical filament of XRad51.1. Together with our recent observation that ADP does not weaken the XRad51.1/DNA interaction, the effect of ATP hydrolysis on XRad51.1 nucleofilament should be very different from that on RecA

The High-resolution Calorimeter of the Chorus Experiment

The CHORUS Collaboration is presently building a new detector for the search of nu(mu)-nu(tau) oscillations on the CERN neutrino beam, this experiment being sensitive to a mixing angle an order of magnitude smaller than previous experiments. The basic components of the CHORUS ''hybrid'' detector are an active target made of nuclear emulsions (for the direct observation of the decay of tau-leptons), an air-core spectrometer with scintillating fiber tracking, a lead-scintillator (fibers and strips) calorimeter (with mu-tracking provided by planes of limited streamer tubes) and a muon spectrometer, consisting of iron toroids and drift chambers. We report here on the design of the calorimeter and on the tests performed on prototype modules

Performance of the CHORUS lead-scintillating fiber calorimeter

We report on the design and performance of the lead-scintillating fiber calorimeter of the CHORUS experiment, which searches for νμ-ντ oscillations in the CERN Wide Band Neutrino beam. Two of the three sectors in which the calorimeter is divided are made of lead and plastic scintillating fibers, and they represent the first large scale application of this technique for combined electromagnetic and hadronic calorimetry. The third sector is built using the sandwich technique with lead plates and scintillator strips and acts as a tail catcher for the hadronic energy flow. From tests performed at the CERN SPS and PS an energy resolution of σ(E)/E=(32.3±2.4)%/E(GeV)+(1.4±0.7)% was measured for pions, and σ(E)/E=(13.8±0.9)%/E(GeV)+(−0.2±0.4)% for electrons