Accessibility in libraries during the Corona crisis

Die VÖB-Arbeitsgruppe „Barrierefreiheit in Bibliotheken“, die im Jänner 2020 gegründet wurde, konzipierte eine Umfrage, die die Auswirkungen der Covid-19-Pandemie auf die Barrierefreiheit in Bibliotheken zum Thema hatte. Es wurde ein Online-Fragebogen entworfen, der den Umgang mit der Pandemie in Bibliotheken, Auswirkungen auf die Organisation und die Infrastruktur, rechtliche Rahmenbedingungen und auch Erfahrungsberichte von Leser*innen abfragte. Über 100 Bibliothekar*innen aus dem deutschsprachigen Raum nahmen an der Umfrage teil, die mit Hilfe der Statistiksoftware SPSS ausgewertete wurde. Es wurden Defizite sichtbar, die bereits vor der Pandemie bestanden, aber auch Verbesserungen, die die Pandemie erst in Gang gebracht hat, wie beispielsweise barrierefrei aufbereitete Online-Medien für Menschen mit Sehbehinderungen oder auch Bibliotheksangebote wie Schulungen, die als online-Services stattgefunden haben. Menschen mit Mobilitäts- oder Seheinschränkungen und guter digitaler IT-Infrastruktur konnten die digitalen barrierefreien Angebote am besten nutzen und haben von den Anpassungen am meisten profitiert. Die große Mehrheit der Teilnehmer*innen hat zudem angegeben, dass sie auch zukünftig großes Interesse am Thema Barrierefreiheit in Bibliotheken haben.The VÖB working group "Accessibility in Libraries", which was founded in 2020, designed a survey that focused on the impact of the Covid-19 pandemic on accessibility in libraries. An online questionnaire was designed that asked about how libraries were dealing with the pandemic, impacts on organization and infrastructure, legal frameworks, and also readers' testimonials. Over 100 librarians from German-speaking countries took part in the survey, which was analyzed using SPSS statistical software. It revealed deficits that existed before the pandemic, but also improvements that the pandemic had only just set in motion, such as accessible online media for people with visual impairments or library services such as training courses that took place as online services. People with mobility or visual impairments and good digital IT infrastructure were able to make the best use of the digital accessible services and benefited the most from the adaptations. The vast majority of participants also stated that they would continue to be very interested in the topic of accessibility in libraries in the future

Automation of tree‐ring detection and measurements using deep learning

Abstract Core samples from trees are a critical reservoir of ecological information, informing our understanding of past climates, as well as contemporary ecosystem responses to global change. Manual measurements of annual growth rings in trees are slow, labour‐intensive and subject to human bias, hindering the generation of big datasets. We present an alternative, neural network‐based implementation that automates detection and measurement of tree‐ring boundaries from coniferous species. We trained our Mask R‐CNN extensively on over 8000 manually annotated ring boundaries from microscope‐imaged Norway Spruce Picea abies increment cores. We assessed the performance of the trained model after post‐processing on real‐world data generated from our core processing pipeline. The CNN after post‐processing performed well, with recognition of over 98% of ring boundaries (recall) with a precision in detection of 96% when tested on real‐world data. Additionally, we have implemented automatic measurements based on minimum distance between rings. With minimal editing for missed ring detections, these measurements were 98% correlated with human measurements of the same samples. Tests on other three conifer species demonstrate that the CNN generalizes well to other species with similar structure. We demonstrate the efficacy of automating the measurement of growth increment in tree core samples. Our CNN‐based system provides high predictive performance in terms of both tree‐ring detection and growth rate determination. Our application is readily deployable as a Docker container and requires only basic command line skills. Additionally, an easy re‐training option allows users to expand capabilities to other wood types. Application outputs include both editable annotations of predictions as well as ring‐width measurements in a commonly used .pos format, facilitating the efficient generation of large ring‐width measurement datasets from increment core samples, an important source of environmental data

Use of Fondaparinux Off-Label or Approved Anticoagulants for Management of Heparin-Induced Thrombocytopenia.

BACKGROUND Life-threatening heparin-induced thrombocytopenia (HIT) is treated with the alternative nonheparin anticoagulants argatroban, lepirudin, or danaparoid. Frequently, the pentasaccharide fondaparinux is used off-label. OBJECTIVES The authors sought to investigate the safety and efficacy of the different anticoagulants for treating HIT. METHODS In a national, multicenter registry study, hospitalized patients who were diagnosed with HIT, an at least intermediate clinical HIT-risk (4Ts score ≥4 points), and received treatment with ≥1 dose of the aforementioned anticoagulants were included. Main outcome measures were the incidences of HIT-specific complications (thromboembolic venous/arterial events, amputations, recurrent/persistent thrombocytopenia, skin lesions) and bleedings. RESULTS Of 195 patients, 46 (23.6%), 4 (2.1%), 61 (31.3%), and 84 (43.1%) had been treated first-line with argatroban, lepirudin, danaparoid, and fondaparinux, respectively. The composite endpoint of HIT-specific complications (thromboembolic events, amputation, skin necrosis) occurred in 11.7% of patients treated with approved alternative anticoagulation and in 0.0% of fondaparinux-treated patients. The all-cause in-hospital mortality rates were 14.4% during approved alternative anticoagulation and 0.0% during fondaparinux treatment. Bleeding complications occurred in alternatively anticoagulated patients and in fondaparinux-treated patients in 6.3% and 4.8%, respectively. Post hoc analysis of clinical and laboratory features confirmed "true" HIT in at least 74 of 195 (38.0%) patients; 35 of 74 (47.3%) were treated with fondaparinux. CONCLUSIONS Fondaparinux is effective and safe in suspected acute HIT; no HIT-specific complications occurred in the fondaparinux-treated patients, even among those with a high clinical HIT probability. Further data from randomized controlled trials are urgently needed because lepirudin was recalled from the market; danaparoid access has been limited and is not approved in the United States; and argatroban is contraindicated in patients with impaired liver function, and activated partial thromboplastin time confounding may interfere with monitoring. (Retrospective Registry of Patients With Acute Heparin-induced Thrombocytopenia Type II; NCT01304238)

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