Compliance with the surgical safety checklist in Switzerland: an observational multicenter study based on self-reported data.

BACKGROUND Since publication of the surgical safety checklist by the WHO in 2009, it has been introduced in many hospitals. However, frequency and quality of surgical safety checklist use is often low probably limiting the effectiveness of the checklist in preventing patient harm. The focus of this study was to examine the current state of compliance with the surgical safety checklist in Switzerland and to evaluate how the data relates to international comparative data. METHODS Between November 2020 and March 2021 twelve hospitals with 15 sites collected for at least 200 surgical interventions each whether the three sections of the surgical safety checklist (Sign In, Team Time Out, Sign Out) have been applied. This data collection was part of a large quality improvement project focusing on measuring and improving compliance with the surgical safety checklist via peer observation and feedback. Descriptive statistics were used to analyze the data; chi-square tests were used to compare sub-samples. RESULTS The hospitals collected valid compliance data for 8622 surgical interventions. Mean compliance rate was 91% when distinguishing between the two categories applied (including partially applied) and not applied. In line with previous research, Sign In (93%) and Team Time Out (94%) sections have been applied more frequently than Sign Out (86%). All three surgical safety checklist sections have been applied in 79% of the surgical interventions, no sections in 1%. CONCLUSIONS The results of this study indicate that the overall application of the surgical safety checklist in Switzerland can be considered high, although the completeness, especially of the Sign Out section, could be improved. At present, it seems difficult to compare compliance rates from different studies as measurement methods and definitions of compliance vary widely. A systematization and homogenization of the methodology within, but also beyond, national borders is desirable for the future

A molecular motor from lignocellulose

Lignin is the largest natural source of functionalized aromatics on the planet, therefore exploiting its inherent structural features for the synthesis of aromatic products is a timely and ambitious goal. While the recently developed lignin depolymerization strategies gave rise to well-defined aromatic platform chemicals, the diversification of these structures, especially toward high-end applications is still poorly addressed. Molecular motors and switches have found widespread application in many important areas such as targeted drug delivery systems, responsive coatings for self-healing surfaces, paints and resins or muscles for soft robotics. They typically comprise a functionalized aromatic backbone, yet their synthesis from lignin has not been considered before. In this contribution, we showcase the synthesis of a novel light-driven unidirectional molecular motor from the specific aromatic platform chemical 4-(3-hydroxypropyl)-2,6-dimethoxyphenol (dihydrosynapyl alcohol) that can be directly obtained from lignocellulose via a reductive catalytic fractionation strategy. The synthetic path takes into account the principles of green chemistry and aims to maintain the intrinsic functionality of the lignin-derived platform molecule

Correlation of Atrial Natriuretic Peptide and Cyclic Guanosine Monophosphate Plasma Concentrations in Patients with Heart Disorders During Rest and Exercise

Peer Reviewe

Conditional Adversarial Camera Model Anonymization

The model of camera that was used to capture a particular photographic image (model attribution) is typically inferred from high-frequency model-specific artifacts present within the image. Model anonymization is the process of transforming these artifacts such that the apparent capture model is changed. We propose a conditional adversarial approach for learning such transformations. In contrast to previous works, we cast model anonymization as the process of transforming both high and low spatial frequency information. We augment the objective with the loss from a pre-trained dual-stream model attribution classifier, which constrains the generative network to transform the full range of artifacts. Quantitative comparisons demonstrate the efficacy of our framework in a restrictive non-interactive black-box setting.Comment: ECCV 2020 - Advances in Image Manipulation workshop (AIM 2020

A novel semi-fragile forensic watermarking scheme for remote sensing images

Peer-reviewedA semi-fragile watermarking scheme for multiple band images is presented. We propose to embed a mark into remote sensing images applying a tree structured vector quantization approach to the pixel signatures, instead of processing each band separately. The signature of themmultispectral or hyperspectral image is used to embed the mark in it order to detect any significant modification of the original image. The image is segmented into threedimensional blocks and a tree structured vector quantizer is built for each block. These trees are manipulated using an iterative algorithm until the resulting block satisfies a required criterion which establishes the embedded mark. The method is shown to be able to preserve the mark under lossy compression (above a given threshold) but, at the same time, it detects possibly forged blocks and their position in the whole image.Se presenta un esquema de marcas de agua semi-frágiles para múltiples imágenes de banda. Proponemos incorporar una marca en imágenes de detección remota, aplicando un enfoque de cuantización del vector de árbol estructurado con las definiciones de píxel, en lugar de procesar cada banda por separado. La firma de la imagen hiperespectral se utiliza para insertar la marca en el mismo orden para detectar cualquier modificación significativa de la imagen original. La imagen es segmentada en bloques tridimensionales y un cuantificador de vector de estructura de árbol se construye para cada bloque. Estos árboles son manipulados utilizando un algoritmo iteractivo hasta que el bloque resultante satisface un criterio necesario que establece la marca incrustada. El método se muestra para poder preservar la marca bajo compresión con pérdida (por encima de un umbral establecido) pero, al mismo tiempo, detecta posiblemente bloques forjados y su posición en la imagen entera.Es presenta un esquema de marques d'aigua semi-fràgils per a múltiples imatges de banda. Proposem incorporar una marca en imatges de detecció remota, aplicant un enfocament de quantització del vector d'arbre estructurat amb les definicions de píxel, en lloc de processar cada banda per separat. La signatura de la imatge hiperespectral s'utilitza per inserir la marca en el mateix ordre per detectar qualsevol modificació significativa de la imatge original. La imatge és segmentada en blocs tridimensionals i un quantificador de vector d'estructura d'arbre es construeix per a cada bloc. Aquests arbres són manipulats utilitzant un algoritme iteractiu fins que el bloc resultant satisfà un criteri necessari que estableix la marca incrustada. El mètode es mostra per poder preservar la marca sota compressió amb pèrdua (per sobre d'un llindar establert) però, al mateix temps, detecta possiblement blocs forjats i la seva posició en la imatge sencera

Amisulpride augmentation in clozapine-unresponsive schizophrenia: A double-blind, placebo-controlled, randomised trial of clinical and cost-effectiveness.

BACKGROUND: When treatment-refractory schizophrenia shows an insufficient response to a trial of clozapine, clinicians commonly add a second antipsychotic, despite the lack of robust evidence to justify this practice. OBJECTIVES: The main objectives of the study were to establish the clinical effectiveness and cost-effectiveness of augmentation of clozapine medication with a second antipsychotic, amisulpride, for the management of treatment-resistant schizophrenia. DESIGN: The study was a multicentre, double-blind, individually randomised, placebo-controlled trial with follow-up at 12 weeks. SETTINGS: The study was set in NHS multidisciplinary teams in adult psychiatry. PARTICIPANTS: Eligible participants were people aged 18-65 years with treatment-resistant schizophrenia unresponsive, at a criterion level of persistent symptom severity and impaired social function, to an adequate trial of clozapine monotherapy. INTERVENTIONS: Interventions comprised clozapine augmentation over 12 weeks with amisulpride or placebo. Participants received 400 mg of amisulpride or two matching placebo capsules for the first 4 weeks, after which there was a clinical option to titrate the dosage of amisulpride up to 800 mg or four matching placebo capsules for the remaining 8 weeks. MAIN OUTCOME MEASURES: The primary outcome measure was the proportion of 'responders', using a criterion response threshold of a 20% reduction in total score on the Positive and Negative Syndrome Scale. RESULTS: A total of 68 participants were randomised. Compared with the participants assigned to placebo, those receiving amisulpride had a greater chance of being a responder by the 12-week follow-up (odds ratio 1.17, 95% confidence interval 0.40 to 3.42) and a greater improvement in negative symptoms, although neither finding had been present at 6-week follow-up and neither was statistically significant. Amisulpride was associated with a greater side effect burden, including cardiac side effects. Economic analyses indicated that amisulpride augmentation has the potential to be cost-effective in the short term [net saving of between £329 and £2011; no difference in quality-adjusted life-years (QALYs)] and possibly in the longer term. LIMITATIONS: The trial under-recruited and, therefore, the power of statistical analysis to detect significant differences between the active and placebo groups was limited. The economic analyses indicated high uncertainty because of the short duration and relatively small number of participants. CONCLUSIONS: The risk-benefit of amisulpride augmentation of clozapine for schizophrenia that has shown an insufficient response to a trial of clozapine monotherapy is worthy of further investigation in larger studies. The size and extent of the side effect burden identified for the amisulpride-clozapine combination may partly reflect the comprehensive assessment of side effects in this study. The design of future trials of such a treatment strategy should take into account that a clinical response may be not be evident within the 4- to 6-week follow-up period usually considered adequate in studies of antipsychotic treatment of acute psychotic episodes. Economic evaluation indicated the need for larger, longer-term studies to address uncertainty about the extent of savings because of amisulpride and impact on QALYs. The extent and nature of the side effect burden identified for the amisulpride-clozapine combination has implications for the nature and frequency of safety and tolerability monitoring of clozapine augmentation with a second antipsychotic in both clinical and research settings. TRIAL REGISTRATION: EudraCT number 2010-018963-40 and Current Controlled Trials ISRCTN68824876. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 49. See the NIHR Journals Library website for further project information

Digital image watermarking: its formal model, fundamental properties and possible attacks

While formal definitions and security proofs are well established in some fields like cryptography and steganography, they are not as evident in digital watermarking research. A systematic development of watermarking schemes is desirable, but at present their development is usually informal, ad hoc, and omits the complete realization of application scenarios. This practice not only hinders the choice and use of a suitable scheme for a watermarking application, but also leads to debate about the state-of-the-art for different watermarking applications. With a view to the systematic development of watermarking schemes, we present a formal generic model for digital image watermarking. Considering possible inputs, outputs, and component functions, the initial construction of a basic watermarking model is developed further to incorporate the use of keys. On the basis of our proposed model, fundamental watermarking properties are defined and their importance exemplified for different image applications. We also define a set of possible attacks using our model showing different winning scenarios depending on the adversary capabilities. It is envisaged that with a proper consideration of watermarking properties and adversary actions in different image applications, use of the proposed model would allow a unified treatment of all practically meaningful variants of watermarking schemes

The Polycomb repressive complex 2 deposits H3K27me3 and represses transposable elements in a broad range of eukaryotes

The mobility of transposable elements (TEs) contributes to evolution of genomes. Their uncontrolled activity causes genomic instability; therefore, expression of TEs is silenced by host genomes. TEs are marked with DNA and H3K9 methylation, which are associated with silencing in flowering plants, animals, and fungi. However, in distantly related groups of eukaryotes, TEs are marked by H3K27me3 deposited by the Polycomb repressive complex 2 (PRC2), an epigenetic mark associated with gene silencing in flowering plants and animals. The direct silencing of TEs by PRC2 has so far only been shown in one species of ciliates. To test if PRC2 silences TEs in a broader range of eukaryotes, we generated mutants with reduced PRC2 activity and analyzed the role of PRC2 in extant species along the lineage of Archaeplastida and in the diatom P. tricornutum. In this diatom and the red alga C. merolae, a greater proportion of TEs than genes were repressed by PRC2, whereas a greater proportion of genes than TEs were repressed by PRC2 in bryophytes. In flowering plants, TEs contained potential cis-elements recognized by transcription factors and associated with neighbor genes as transcriptional units repressed by PRC2. Thus, silencing of TEs by PRC2 is observed not only in Archaeplastida but also in diatoms and ciliates, suggesting that PRC2 deposited H3K27me3 to silence TEs in the last common ancestor of eukaryotes. We hypothesize that during the evolution of Archaeplastida, TE fragments marked with H3K27me3 were selected to shape transcriptional regulation, controlling networks of genes regulated by PRC2

Validation of a Mass Spectrometry Method To Quantify Oak Ellagitannins in Wine Samples

[EN] Detection and individual quantification of oak wood ellagitannins in oak barrel aged red wine samples are difficult mainly due to their low levels and the similarity between their structures. In this work, a quantification method using mass spectrometry has been developed and validated to quantify wine ellagitannins after sample fractionation with a previously reported method. The use of an internal standard is a requirement to correct mass signal variability. (−)-Gallocatechin, among the different tested compounds, was the only one that proved to be a suitable internal standard making possible the accurate and individual quantification of the main oak wood ellagitannins. The developed methodology has been used to detect and quantify these ellagitannins in different Spanish commercial wines, proving its usefulness

Understanding the ellagitannin extraction process from oak wood

[EN] The extractability of the main oak ellagitannins has been studied in five model solutions containing different types of oak chips (two sizes and different toasting degrees for each size). A new extraction kinetic model has been proposed from the quantitative experimental results obtained by means of HPLCeESI-MS/MS-multiple reaction monitoring method. The model considers an initial extraction (i.e., washing step) followed by a diffusion step, which involves two different processes that follow first-order kinetics at different rates. Differences in the extractability of the ellagitannins in the different model solutions have been observed and explained on the basis of the kinetic model here proposed