Ιn Vitro screening of γ-Aminobutyric Acid and Autoinducer-2 signalling in lactic acid bacteria exhibiting probiotic potential isolated from natural black conservolea olives

In the present study, 33 strains of lactic acid bacteria (LAB) previously isolated from natural black Conservolea olives were assessed for their probiotic potential in vitro, as well as for their autoinducer-2 (AI-2) activity under standard growth conditions and the production of γ-aminobutyric acid (GABA). The probiotic tests included the in vitro resistance to low pH and resistance to bile salts, the evaluation of bile salt hydrolase activity, as well as safety tests regarding their possible haemolytic activity and their antimicrobial activity against pathogens. The results indicated that 17 strains were able to survive in low pH and in the presence of bile, with 15 of them also exhibiting partial bile salt hydrolase activity. None of the strains exhibited haemolytic activity or inhibited the growth of any of the examined pathogens. Moreover, the strains displayed generally low AI-2 activity under the growth conditions tested, regardless of the species. Interestingly, in contrast to what has been found in most foods, none of the isolates were found to produce GABA after 48 h of growth. The results from the AI-2 activity and extracellular GABA detection were considered as unexpected for LAB with probiotic attributes

Towards Efficient Decentralized Federated Learning

We focus on the problem of efficiently deploying a federated learning training task in a decentralized setting with multiple aggregators. To that end, we introduce a number of improvements and modifications to the recently proposed IPLS protocol. In particular, we relax its assumption for direct communication across participants, using instead indirect communication over a decentralized storage system, effectively turning it into a partially asynchronous protocol. Moreover, we secure it against malicious aggregators (that drop or alter data) by relying on homomorphic cryptographic commitments for efficient verification of aggregation. We implement the modified IPLS protocol and report on its performance and potential bottlenecks. Finally, we identify important next steps for this line of research

Towards an open and decentralized case law curation ecosystem.

Case law is the term that refers to reports of past court decisions. It is considered an essential source of law, vital for legal professionals. Existing case law services are currently centralized, with an entity having complete control over the data and often charging fees for its access and other adding value services. This paper attempts to leverage the potential of blockchain technology in order to develop a public and decentralized platform that allows the submission of court decisions in a decentralized database and employs a network of curators who offer their validation, classification, and evaluation. Specifically, we design, analyze and implement AnyCase, a proof-of-concept prototype system on the Ethereum platform. We focus on the establishment of a sybil-resistant voting protocol used for reaching agreement and the development of a tokenized economy that incentivizes participation. Our preliminary analysis indicates that, besides being decentralized, AnyCase has the potential to compete with existing centralized systems in several other aspects

Ποιότητα επαγγελματικής ζωής του ιατρονοσηλευτικού προσωπικού στις παιδιατρικές ΜΕΘ

Εισαγωγή: Το περιβάλλον της ΜΕΘ είναι απαιτητικό, δημιουργώντας άγχος και εξουθένωση στο προσωπικό. Η επαγγελματική ποιότητα ζωής είναι η ποιότητα που βιώνει ο άνθρωπος σε σχέση με την εργασία του, επηρεασμένη από τις θετικές και αρνητικές πτυχές της. Σκοπός: Η διερεύνηση της ποιότητας της επαγγελματικής ζωής του ιατρονοσηλευτικού προσωπικού στις παιδιατρικές ΜΕΘ της Ελλάδας και των παραγόντων που την επηρεάζουν. Υλικό και μέθοδος: Τον πληθυσμό της μελέτης αποτέλεσαν 147 ιατροί και νοσηλευτές των ελληνικών παιδιατρικών ΜΕΘ. Για τη συλλογή των δεδομένων χρησιμοποιήθηκε το ερωτηματολόγιο της B.H.Stamm, (ProQOL, 5η 2009, Greek) για την ποιότητα της επαγγελματικής ζωής,. με 30 κλειστού τύπου ερωτήσεις σε πεντάβαθμη κλίμακα Likert, για την ικανοποίηση από την συμπόνια, την επαγγελματική εξουθένωση και το δευτερεύον τραυματικό άγχος. Ο συντελεστής Cronbach’s alpha ήταν a=0,865 για την ικανοποίηση, a=0,750 για το δευτερεύον τραυματικό άγχος και a=0,751 για την επαγγελματική εξουθένωση. Υπήρχε ποσοστό ανταπόκρισης 100%. Η συλλογή των δεδομένων πραγματοποιήθηκε από Ιούνιο 2018 έως Αύγουστο 2018. Για τη στατιστική ανάλυση χρησιμοποιήθηκε το στατιστικό πακέτο SPSS. Το επίπεδο στατιστικής σημαντικότητας ορίστηκε ίσο με 0,05 Αποτελέσματα: Παρατηρήθηκε μέτριο επίπεδο ικανοποίησης στο 76,9% των συμμετεχόντων. Το δευτερεύον τραυματικό άγχος χαρακτηρίστηκε μέτριο σε ποσοστό 74,8%. Το 73,5% των συμμετεχόντων βίωσε μέτριο επίπεδο επαγγελματικής εξουθένωσης. Οι εργαζόμενοι της ΜΕΘ Πεντέλης και Αγία Σοφία παρουσίασαν χαμηλή ικανοποίηση από την συμπόνια (p=0,010) και εκείνοι της ΜΕΘ Πεντέλης παρουσίασαν υψηλότερο επίπεδο επαγγελματικής εξουθένωσης (p=0,001). Οι έγγαμοι παρουσίασαν υψηλότερα επίπεδα δευτερεύοντος τραυματικού άγχους (p=0,027). Οι ιατροί είχαν υψηλότερο επίπεδο ικανοποίησης (p=0,002). Υψηλότερα επίπεδα εξουθένωσης είχαν οι νοσηλευτές απόφοιτοι ΤΕΙ (p=0,012). Οι κάτοχοι διδακτορικού τίτλου είχαν υψηλότερα επίπεδα ικανοποίησης (p=0,002) και οι κάτοχοι παιδιατρικής νοσηλευτικής ειδικότητας μεγαλύτερο ποσοστό εξουθένωσης και δευτερεύοντος τραυματικού άγχους (p=0,003). Οι εξειδικευμένοι εντατικολόγοι, παρουσίασαν υψηλή ικανοποίηση (p=0,006) και επαγγελματική εξάντληση (p=0,011). Παρατηρήθηκε υψηλότερη ικανοποίηση σε όσους δεν δουλεύουν κυκλικό ωράριο (p=0,003), ενώ εξουθένωση σε όσους σπάνια δουλεύουν (p=0,015). Στα περιφερειακά νοσοκομεία παρατηρήθηκε μεγαλύτερη ικανοποίηση και επαγγελματική εξουθένωση, (p≤0,001) ενώ στα νοσοκομεία της Αττικής χαμηλότερο επίπεδο ικανοποίησης (p=0,007). Για το φύλο, την ηλικία, την επαγγελματική εμπειρία και την εμπειρία στη ΜΕΘ δεν παρατηρήθηκαν στατιστικά σημαντικές διαφορές. H καθημερινότητα στη ΜΕΘ «συχνά» επηρεάζει τη στάση των εργαζομένων απέναντι στην ζωή, ποσοστό 41,5% (n=61). Συμπεράσματα: Το ιατρονοσηλευτικό προσωπικό των ελληνικών παιδιατρικών ΜΕΘ, βιώνει μέτρια ποιότητα επαγγελματικής ζωής. Η ικανοποίηση από τη συμπόνια, το δευτερεύον τραυματικό άγχος και η εξουθένωση του επηρεάζονται από την γεωγραφική περιφέρεια και τη ΜΕΘ στην οποία εργάζονται, την οικογενειακή κατάσταση, την επαγγελματική ιδιότητα, την μεταπτυχιακή εκπαίδευση και το ωράριοIntroduction: The environment in a PICU is demanding, causing stress and burnout in healthcare professionals. The professional quality of life is the quality experienced by a person in relation to one’s occupation, influenced by it’s positive and negative aspects. Objective: The study of occupational quality of life of healthcare professionals in Greek PICUs and all influencing factors Methods: The study group consisted of 147 doctors and nurses working in Greek PICUs. For data gathering, the questionnaire by B.H. Stamm was used (ProQOL, 5η 2009, Greek) in relation to the Professional quality of life, consisting of 30 enclosed questions (five-range Likert scale), compassion satisfaction, occupationa burnout and secondary traumatic stress. Cronbach’s alpha value was a=0,751 for occupational burnout. The response rate was 100%. The data was collected from June 2018 to August 2018. For the statistical analysis and result processing, SPSS was used. The level of statistical significance was < 0,05. Results: A moderate level of satisfaction was observed at the 76.9% of the participants. Secondary traumatic stress was characterized as moderate in the 74.8% of the participants. 73.5% of the participants experience moderate occupational burnout. The healthcare professionals in PICU of “Penteli” and “Agia Sofia” Children’s Hospital were the ones with the lowest satisfaction from compassion (p=0,010), whereas, the ones working in PICU of “Penteli” Children’s Hospital depicted the highest level of occupational burnout. In married professionals, higher levels of secondary traumatic stress were observed (p=0,027). Medical doctors had higher levels of occupational satisfaction (p=0,002) and higher levels of burnout were observed in nurses form technologic institutes (p=0,012). PhD doctors had higher levels of satisfaction (p=0,002) and nurses that specialised in paediatric patients depicted higher percentage of burnout and secondary traumatic stress (p=0,003). Intensivists had higher levels of satisfaction (p=0,006) but higher level of occupational burnout (p=0,011), respectively. Higher satisfaction and professional burnout was observed in regional hospitals (p≤0,001), while hospitals οf Attiki had a lower level of satisfaction (p = 0,007). No statistically significant differences were observed for gender, age, work experience and ICU experience. Everyday life in PICU «often» influences the attitude of healthcare professionals towards life, a percentage of 41.5% (n=61). Conclusion: The healthcare professionals in Greek PICUs experience moderate professional quality of life in relation to its positive and negative aspects. Satisfaction from compassion, secondary traumatic stress and occupational burnout are influenced by geographical region and PICU where they work, marital status, occupation, post graduate studies, but their working hours as well

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London